FDA Approved Drugs List

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A
TRANEXAMIC ACID, TRANEXAMIC ACID

**

PRODUCT NAME INDEX
**

A - 1

**
8-MOP, METHOXSALEN

8

**

**

A

**

ABACAVIR SULFATE, ABACAVIR SULFATE ABELCET, AMPHOTERICIN B ABILIFY MAINTENA KIT, ARIPIPRAZOLE ABILIFY, ARIPIPRAZOLE ABLAVAR, GADOFOSVESET TRISODIUM ABRAXANE, PACLITAXEL ABREVA, DOCOSANOL (OTC) ABSORICA, ISOTRETINOIN ABSTRAL, FENTANYL CITRATE ACANYA, BENZOYL PEROXIDE ACARBOSE, ACARBOSE ACCOLATE, ZAFIRLUKAST ACCUNEB, ALBUTEROL SULFATE ACCUPRIL, QUINAPRIL HYDROCHLORIDE ACCURETIC, HYDROCHLOROTHIAZIDE ACEBUTOLOL HYDROCHLORIDE, ACEBUTOLOL HYDROCHLORIDE ACEON, PERINDOPRIL ERBUMINE ACEPHEN, ACETAMINOPHEN (OTC) ACETADOTE, ACETYLCYSTEINE ACETAMINOPHEN AND CODEINE PHOSPHATE, ACETAMINOPHEN ACETAMINOPHEN AND PENTAZOCINE HYDROCHLORIDE, ACETAMINOPHEN ACETAMINOPHEN, ACETAMINOPHEN (OTC) ACETAMINOPHEN, ASPIRIN AND CAFFEINE, ACETAMINOPHEN (OTC) ACETASOL HC, ACETIC ACID, GLACIAL ACETAZOLAMIDE SODIUM, ACETAZOLAMIDE SODIUM ACETAZOLAMIDE, ACETAZOLAMIDE ACETIC ACID 0.25% IN PLASTIC CONTAINER, ACETIC ACID, GLACIAL ACETIC ACID 2% IN AQUEOUS ALUMINUM ACETATE, ACETIC ACID, GLACIAL ACETIC ACID, ACETIC ACID, GLACIAL ACETOHEXAMIDE, ACETOHEXAMIDE ACETYLCYSTEINE, ACETYLCYSTEINE ACIPHEX SPRINKLE, RABEPRAZOLE SODIUM ACIPHEX, RABEPRAZOLE SODIUM ACITRETIN, ACITRETIN ACLOVATE, ALCLOMETASONE DIPROPIONATE ACOVA, ARGATROBAN ACTHREL, CORTICORELIN OVINE TRIFLUTATE ACTIGALL, URSODIOL ACTIQ, FENTANYL CITRATE ACTIVELLA, ESTRADIOL ACTONEL, RISEDRONATE SODIUM ACTOPLUS MET XR, METFORMIN HYDROCHLORIDE ACTOPLUS MET, METFORMIN HYDROCHLORIDE ACTOS, PIOGLITAZONE HYDROCHLORIDE ACULAR LS, KETOROLAC TROMETHAMINE ACULAR, KETOROLAC TROMETHAMINE ACUVAIL, KETOROLAC TROMETHAMINE ACYCLOVIR IN SODIUM CHLORIDE 0.9% PRESERVATIVE FREE, ACYCLOVIR SODIUM ACYCLOVIR SODIUM, ACYCLOVIR SODIUM ACYCLOVIR, ACYCLOVIR ACZONE, DAPSONE ADAGEN, PEGADEMASE BOVINE ADALAT CC, NIFEDIPINE ADAPALENE, ADAPALENE ADASUVE, LOXAPINE ADCIRCA, TADALAFIL ADDERALL XR 10, AMPHETAMINE ASPARTATE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
A **

A - 2

ADDERALL XR 15, AMPHETAMINE ASPARTATE ADDERALL XR 20, AMPHETAMINE ASPARTATE ADDERALL XR 25, AMPHETAMINE ASPARTATE ADDERALL XR 30, AMPHETAMINE ASPARTATE ADDERALL XR 5, AMPHETAMINE ASPARTATE ADENOCARD, ADENOSINE ADENOSCAN, ADENOSINE ADENOSINE, ADENOSINE ADIPEX-P, PHENTERMINE HYDROCHLORIDE ADRENACLICK, EPINEPHRINE ADRENALIN, EPINEPHRINE ADREVIEW, IOBENGUANE SULFATE I-123 ADVAIR DISKUS 100/50, FLUTICASONE PROPIONATE ADVAIR DISKUS 250/50, FLUTICASONE PROPIONATE ADVAIR DISKUS 500/50, FLUTICASONE PROPIONATE ADVAIR HFA, FLUTICASONE PROPIONATE ADVICOR, LOVASTATIN ADVIL ALLERGY AND CONGESTION RELIEF, CHLORPHENIRAMINE MALEATE ADVIL ALLERGY SINUS, CHLORPHENIRAMINE MALEATE (OTC) ADVIL COLD AND SINUS, IBUPROFEN (OTC) ADVIL CONGESTION RELIEF, IBUPROFEN (OTC) ADVIL LIQUI-GELS, IBUPROFEN (OTC) ADVIL MIGRAINE LIQUI-GELS, IBUPROFEN (OTC) ADVIL PM, DIPHENHYDRAMINE CITRATE (OTC) ADVIL PM, DIPHENHYDRAMINE HYDROCHLORIDE (OTC) ADVIL, IBUPROFEN (OTC) ADVIL, IBUPROFEN SODIUM (OTC) AEROBID, FLUNISOLIDE AEROSPAN HFA, FLUNISOLIDE AFEDITAB CR, NIFEDIPINE AFINITOR DISPERZ, EVEROLIMUS AFINITOR, EVEROLIMUS AFRINOL, PSEUDOEPHEDRINE SULFATE (OTC) AGGRASTAT, TIROFIBAN HYDROCHLORIDE AGGRENOX, ASPIRIN AGRYLIN, ANAGRELIDE HYDROCHLORIDE A-HYDROCORT, HYDROCORTISONE SODIUM SUCCINATE AKBETA, LEVOBUNOLOL HYDROCHLORIDE AK-FLUOR 10%, FLUORESCEIN SODIUM AK-FLUOR 25%, FLUORESCEIN SODIUM AKINETON, BIPERIDEN HYDROCHLORIDE AKNE-MYCIN, ERYTHROMYCIN AKPENTOLATE, CYCLOPENTOLATE HYDROCHLORIDE AKPRO, DIPIVEFRIN HYDROCHLORIDE AKTEN, LIDOCAINE HYDROCHLORIDE AKTOB, TOBRAMYCIN ALA-CORT, HYDROCORTISONE ALAMAST, PEMIROLAST POTASSIUM ALA-SCALP, HYDROCORTISONE ALAVERT, LORATADINE (OTC) ALAWAY, KETOTIFEN FUMARATE (OTC) ALBALON, NAPHAZOLINE HYDROCHLORIDE ALBENZA, ALBENDAZOLE ALBUTEROL SULFATE AND IPRATROPIUM BROMIDE, ALBUTEROL SULFATE ALBUTEROL SULFATE, ALBUTEROL SULFATE ALCAINE, PROPARACAINE HYDROCHLORIDE ALCLOMETASONE DIPROPIONATE, ALCLOMETASONE DIPROPIONATE ALCOHOL 10% AND DEXTROSE 5%, ALCOHOL ALCOHOL 5% AND DEXTROSE 5%, ALCOHOL ALDACTAZIDE, HYDROCHLOROTHIAZIDE ALDACTONE, SPIRONOLACTONE ALDARA, IMIQUIMOD ALENDRONATE SODIUM, ALENDRONATE SODIUM

(OTC)

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
A **

A - 3

ALEVE, NAPROXEN SODIUM (OTC) ALEVE-D SINUS & COLD, NAPROXEN SODIUM (OTC) ALFENTA, ALFENTANIL HYDROCHLORIDE ALFENTANIL, ALFENTANIL HYDROCHLORIDE ALFUZOSIN HYDROCHLORIDE, ALFUZOSIN HYDROCHLORIDE ALIMTA, PEMETREXED DISODIUM ALINIA, NITAZOXANIDE ALKERAN, MELPHALAN ALKERAN, MELPHALAN HYDROCHLORIDE ALLEGRA ALLERGY, FEXOFENADINE HYDROCHLORIDE (OTC) ALLEGRA HIVES, FEXOFENADINE HYDROCHLORIDE (OTC) ALLEGRA, FEXOFENADINE HYDROCHLORIDE ALLEGRA-D 12 HOUR ALLERGY AND CONGESTION, FEXOFENADINE HYDROCHLORIDE (OTC) ALLEGRA-D 24 HOUR ALLERGY AND CONGESTION, FEXOFENADINE HYDROCHLORIDE (OTC) ALLI, ORLISTAT (OTC) ALLOPURINOL SODIUM, ALLOPURINOL SODIUM ALLOPURINOL, ALLOPURINOL ALOCRIL, NEDOCROMIL SODIUM ALOMIDE, LODOXAMIDE TROMETHAMINE ALOPRIM, ALLOPURINOL SODIUM ALORA, ESTRADIOL ALOXI, PALONOSETRON HYDROCHLORIDE ALPHAGAN P, BRIMONIDINE TARTRATE ALPRAZOLAM, ALPRAZOLAM ALPROSTADIL, ALPROSTADIL ALREX, LOTEPREDNOL ETABONATE ALSUMA, SUMATRIPTAN SUCCINATE ALTABAX, RETAPAMULIN ALTACE, RAMIPRIL ALTAVERA, ETHINYL ESTRADIOL ALTOPREV, LOVASTATIN ALVESCO, CICLESONIDE ALYACEN 1/35, ETHINYL ESTRADIOL ALYACEN 7/7/7, ETHINYL ESTRADIOL AMANTADINE HYDROCHLORIDE, AMANTADINE HYDROCHLORIDE AMARYL, GLIMEPIRIDE AMBIEN CR, ZOLPIDEM TARTRATE AMBIEN, ZOLPIDEM TARTRATE AMBISOME, AMPHOTERICIN B AMCINONIDE, AMCINONIDE AMERGE, NARATRIPTAN HYDROCHLORIDE A-METHAPRED, METHYLPREDNISOLONE SODIUM SUCCINATE AMICAR, AMINOCAPROIC ACID AMIDATE, ETOMIDATE AMIFOSTINE, AMIFOSTINE AMIKACIN SULFATE, AMIKACIN SULFATE AMILORIDE HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, AMILORIDE HYDROCHLORIDE AMILORIDE HYDROCHLORIDE, AMILORIDE HYDROCHLORIDE AMINO ACIDS, AMINO ACIDS AMINOACETIC ACID 1.5% IN PLASTIC CONTAINER, GLYCINE AMINOCAPROIC ACID IN PLASTIC CONTAINER, AMINOCAPROIC ACID AMINOCAPROIC ACID, AMINOCAPROIC ACID AMINOCAPROIC, AMINOCAPROIC ACID AMINOHIPPURATE SODIUM, AMINOHIPPURATE SODIUM AMINOPHYLLINE, AMINOPHYLLINE AMINOSYN 10% (PH6), AMINO ACIDS AMINOSYN 10%, AMINO ACIDS AMINOSYN 3.5% M, AMINO ACIDS AMINOSYN 3.5%, AMINO ACIDS AMINOSYN 5%, AMINO ACIDS AMINOSYN 7% (PH6), AMINO ACIDS AMINOSYN 7% W/ ELECTROLYTES, AMINO ACIDS AMINOSYN 7%, AMINO ACIDS

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
A **

A - 4

AMINOSYN 8.5% (PH6), AMINO ACIDS AMINOSYN 8.5% W/ ELECTROLYTES, AMINO ACIDS AMINOSYN 8.5%, AMINO ACIDS AMINOSYN II 10% IN PLASTIC CONTAINER, AMINO ACIDS AMINOSYN II 10% W/ ELECTROLYTES, AMINO ACIDS AMINOSYN II 10%, AMINO ACIDS AMINOSYN II 15% IN PLASTIC CONTAINER, AMINO ACIDS AMINOSYN II 7%, AMINO ACIDS AMINOSYN II 8.5% W/ ELECTROLYTES, AMINO ACIDS AMINOSYN II 8.5%, AMINO ACIDS AMINOSYN-HBC 7%, AMINO ACIDS AMINOSYN-HF 8%, AMINO ACIDS AMINOSYN-PF 10%, AMINO ACIDS AMINOSYN-PF 7%, AMINO ACIDS AMINOSYN-RF 5.2%, AMINO ACIDS AMIODARONE HYDROCHLORIDE, AMIODARONE HYDROCHLORIDE AMITIZA, LUBIPROSTONE AMITRIPTYLINE HYDROCHLORIDE, AMITRIPTYLINE HYDROCHLORIDE AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE, AMLODIPINE BESYLATE AMLODIPINE BESYLATE AND VALSARTAN, AMLODIPINE BESYLATE AMLODIPINE BESYLATE, AMLODIPINE BESYLATE AMLODIPINE,VALSARTAN AND HYDROCHLOROTHIAZIDE, AMLODIPINE AMMONIA N 13, AMMONIA N-13 AMMONIUM CHLORIDE IN PLASTIC CONTAINER, AMMONIUM CHLORIDE AMMONIUM LACTATE, AMMONIUM LACTATE AMMONUL, SODIUM BENZOATE AMNESTEEM, ISOTRETINOIN AMOXAPINE, AMOXAPINE AMOXICILLIN AND CLAVULANATE POTASSIUM, AMOXICILLIN AMOXICILLIN PEDIATRIC, AMOXICILLIN AMOXICILLIN, AMOXICILLIN AMOXIL, AMOXICILLIN AMPHADASE, HYALURONIDASE AMPHETAMINE ASP AMPHETAMINE SULF DEXTROAMPHET SACCHARATE & DEXTR SULF, AMPHETAMINE ASPARTATE AMPHETAMINE SULFATE, AMPHETAMINE SULFATE AMPHOTEC, AMPHOTERICIN B AMPHOTERICIN B, AMPHOTERICIN B AMPICILLIN AND SULBACTAM, AMPICILLIN SODIUM AMPICILLIN SODIUM, AMPICILLIN SODIUM AMPICILLIN TRIHYDRATE, AMPICILLIN/AMPICILLIN TRIHYDRATE AMPYRA, DALFAMPRIDINE AMRINONE LACTATE, INAMRINONE LACTATE AMRIX, CYCLOBENZAPRINE HYDROCHLORIDE AMTURNIDE, ALISKIREN HEMIFUMARATE AMYVID, FLORBETAPIR F-18 ANADROL-50, OXYMETHOLONE ANAFRANIL, CLOMIPRAMINE HYDROCHLORIDE ANAGRELIDE HYDROCHLORIDE, ANAGRELIDE HYDROCHLORIDE ANAPROX DS, NAPROXEN SODIUM ANAPROX, NAPROXEN SODIUM ANASTROZOLE, ANASTROZOLE ANCEF IN PLASTIC CONTAINER, CEFAZOLIN SODIUM ANCOBON, FLUCYTOSINE ANDRODERM, TESTOSTERONE ANDROGEL, TESTOSTERONE ANDROID 10, METHYLTESTOSTERONE ANDROID 25, METHYLTESTOSTERONE AN-DTPA, TECHNETIUM TC-99M PENTETATE KIT ANECTINE, SUCCINYLCHOLINE CHLORIDE ANEXSIA 5/325, ACETAMINOPHEN ANEXSIA 7.5/325, ACETAMINOPHEN ANEXSIA 7.5/650, ACETAMINOPHEN ANEXSIA, ACETAMINOPHEN

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
A **

A - 5

ANGELIQ, DROSPIRENONE ANGIOMAX, BIVALIRUDIN ANSAID, FLURBIPROFEN AN-SULFUR COLLOID, TECHNETIUM TC-99M SULFUR COLLOID KIT ANTABUSE, DISULFIRAM ANTARA (MICRONIZED), FENOFIBRATE ANTHELIOS 20, AVOBENZONE (OTC) ANTHELIOS 40, AVOBENZONE (OTC) ANTHELIOS SX, AVOBENZONE (OTC) ANTIVERT, MECLIZINE HYDROCHLORIDE ANTIZOL, FOMEPIZOLE ANUSOL HC, HYDROCORTISONE ANZEMET, DOLASETRON MESYLATE APIDRA SOLOSTAR, INSULIN GLULISINE RECOMBINANT APIDRA, INSULIN GLULISINE RECOMBINANT APLENZIN, BUPROPION HYDROBROMIDE APOKYN, APOMORPHINE HYDROCHLORIDE APRACLONIDINE HYDROCHLORIDE, APRACLONIDINE HYDROCHLORIDE APREPITANT, APREPITANT APRISO, MESALAMINE APTIVUS, TIPRANAVIR AQUASOL A, VITAMIN A PALMITATE ARALEN, CHLOROQUINE PHOSPHATE ARANELLE, ETHINYL ESTRADIOL ARAVA, LEFLUNOMIDE ARCAPTA NEOHALER, INDACATEROL MALEATE ARESTIN, MINOCYCLINE HYDROCHLORIDE ARGATROBAN IN SODIUM CHLORIDE, ARGATROBAN ARGATROBAN, ARGATROBAN ARICEPT ODT, DONEPEZIL HYDROCHLORIDE ARICEPT, DONEPEZIL HYDROCHLORIDE ARIDOL KIT, MANNITOL ARIMIDEX, ANASTROZOLE ARISTOSPAN, TRIAMCINOLONE HEXACETONIDE ARIXTRA, FONDAPARINUX SODIUM ARMODAFINIL, ARMODAFINIL AROMASIN, EXEMESTANE ARRANON, NELARABINE ARTHROTEC, DICLOFENAC SODIUM ARTICAINE HYDROCHLORIDE AND EPINEPHRINE BITARTRATE, ARTICAINE HYDROCHLORIDE ARTICAINE HYDROCHLORIDE WITH EPINEPHRINE, ARTICAINE HYDROCHLORIDE ASACOL HD, MESALAMINE ASACOL, MESALAMINE ASCLERA, POLIDOCANOL ASMANEX TWISTHALER, MOMETASONE FUROATE ASPIRIN AND DIPYRIDAMOLE, ASPIRIN ASPIRIN, ASPIRIN (OTC) ASTELIN, AZELASTINE HYDROCHLORIDE ASTEPRO, AZELASTINE HYDROCHLORIDE ASTRAMORPH PF, MORPHINE SULFATE ATACAND HCT, CANDESARTAN CILEXETIL ATACAND, CANDESARTAN CILEXETIL ATELVIA, RISEDRONATE SODIUM ATENOLOL AND CHLORTHALIDONE, ATENOLOL ATENOLOL, ATENOLOL ATIVAN, LORAZEPAM ATORVASTATIN CALCIUM, ATORVASTATIN CALCIUM ATOVAQUONE AND PROGUANIL HYDROCHLORIDE, ATOVAQUONE ATRACURIUM BESYLATE PRESERVATIVE FREE, ATRACURIUM BESYLATE ATRACURIUM BESYLATE, ATRACURIUM BESYLATE ATRALIN, TRETINOIN ATRIDOX, DOXYCYCLINE HYCLATE ATRIPLA, EFAVIRENZ

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
A **

A - 6

ATROPEN, ATROPINE ATROPINE SULFATE ANSYR PLASTIC SYRINGE, ATROPINE SULFATE ATROVENT HFA, IPRATROPIUM BROMIDE ATROVENT, IPRATROPIUM BROMIDE AUBAGIO, TERIFLUNOMIDE AUGMENTIN '125', AMOXICILLIN AUGMENTIN '200', AMOXICILLIN AUGMENTIN '250', AMOXICILLIN AUGMENTIN '400', AMOXICILLIN AUGMENTIN '500', AMOXICILLIN AUGMENTIN '875', AMOXICILLIN AUGMENTIN ES-600, AMOXICILLIN AUGMENTIN XR, AMOXICILLIN AUVI-Q, EPINEPHRINE AVAGARD, ALCOHOL (OTC) AVAGE, TAZAROTENE AVALIDE, HYDROCHLOROTHIAZIDE AVANDAMET, METFORMIN HYDROCHLORIDE AVANDARYL, GLIMEPIRIDE AVANDIA, ROSIGLITAZONE MALEATE AVAPRO, IRBESARTAN AVC, SULFANILAMIDE AVELOX IN SODIUM CHLORIDE 0.8% IN PLASTIC CONTAINER, MOXIFLOXACIN HYDROCHLORIDE AVELOX, MOXIFLOXACIN HYDROCHLORIDE AVENTYL HYDROCHLORIDE, NORTRIPTYLINE HYDROCHLORIDE AVIANE-28, ETHINYL ESTRADIOL AVINZA, MORPHINE SULFATE AVITA, TRETINOIN AVODART, DUTASTERIDE AXERT, ALMOTRIPTAN MALATE AXID AR, NIZATIDINE (OTC) AXID, NIZATIDINE AXIRON, TESTOSTERONE AYGESTIN, NORETHINDRONE ACETATE AZACTAM IN PLASTIC CONTAINER, AZTREONAM AZACTAM, AZTREONAM AZASAN, AZATHIOPRINE AZASITE, AZITHROMYCIN AZATHIOPRINE SODIUM, AZATHIOPRINE SODIUM AZATHIOPRINE, AZATHIOPRINE AZELASTINE HYDROCHLORIDE, AZELASTINE HYDROCHLORIDE AZELEX, AZELAIC ACID AZILECT, RASAGILINE MESYLATE AZITHROMYCIN, AZITHROMYCIN AZITHROMYCIN, AZITHROMYCIN, UNSPECIFIED FORM AZOPT, BRINZOLAMIDE AZOR, AMLODIPINE BESYLATE AZTREONAM, AZTREONAM AZULFIDINE EN-TABS, SULFASALAZINE AZULFIDINE, SULFASALAZINE

**

B

**

BACIIM, BACITRACIN BACITRACIN ZINC AND POLYMYXIN B SULFATE, BACITRACIN ZINC BACITRACIN, BACITRACIN BACITRACIN-NEOMYCIN-POLYMYXIN W/ HYDROCORTISONE ACETATE, BACITRACIN BACLOFEN, BACLOFEN BACTERIOSTATIC SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, SODIUM CHLORIDE BACTERIOSTATIC WATER FOR INJECTION IN PLASTIC CONTAINER, STERILE WATER FOR INJECTION BACTOCILL IN PLASTIC CONTAINER, OXACILLIN SODIUM BACTRIM DS, SULFAMETHOXAZOLE BACTRIM, SULFAMETHOXAZOLE BACTROBAN, MUPIROCIN

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
B **

A - 7

BACTROBAN, MUPIROCIN CALCIUM BAL, DIMERCAPROL BALANCED SALT, CALCIUM CHLORIDE BALSALAZIDE DISODIUM, BALSALAZIDE DISODIUM BALZIVA-28, ETHINYL ESTRADIOL BANZEL, RUFINAMIDE BARACLUDE, ENTECAVIR BECONASE AQ, BECLOMETHASONE DIPROPIONATE MONOHYDRATE BELVIQ, LORCASERIN HYDROCHLORIDE BENAZEPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, BENAZEPRIL HYDROCHLORIDE BENAZEPRIL HYDROCHLORIDE, BENAZEPRIL HYDROCHLORIDE BENICAR HCT, HYDROCHLOROTHIAZIDE BENICAR, OLMESARTAN MEDOXOMIL BENTYL PRESERVATIVE FREE, DICYCLOMINE HYDROCHLORIDE BENTYL, DICYCLOMINE HYDROCHLORIDE BENZACLIN, BENZOYL PEROXIDE BENZAMYCIN PAK, BENZOYL PEROXIDE BENZAMYCIN, BENZOYL PEROXIDE BENZONATATE, BENZONATATE BENZPHETAMINE HYDROCHLORIDE, BENZPHETAMINE HYDROCHLORIDE BENZTROPINE MESYLATE, BENZTROPINE MESYLATE BEPREVE, BEPOTASTINE BESILATE BESIVANCE, BESIFLOXACIN HYDROCHLORIDE BETADINE, POVIDONE-IODINE BETAGAN, LEVOBUNOLOL HYDROCHLORIDE BETAMETHASONE ACETATE AND BETAMETHASONE SODIUM PHOSPHATE, BETAMETHASONE ACETATE BETAMETHASONE DIPROPIONATE, BETAMETHASONE DIPROPIONATE BETAMETHASONE VALERATE, BETAMETHASONE VALERATE BETAPACE AF, SOTALOL HYDROCHLORIDE BETAPACE, SOTALOL HYDROCHLORIDE BETA-VAL, BETAMETHASONE VALERATE BETAXOLOL HYDROCHLORIDE, BETAXOLOL HYDROCHLORIDE BETHANECHOL CHLORIDE, BETHANECHOL CHLORIDE BETHKIS, TOBRAMYCIN BETIMOL, TIMOLOL BETOPTIC S, BETAXOLOL HYDROCHLORIDE BETOPTIC, BETAXOLOL HYDROCHLORIDE BEYAZ, DROSPIRENONE BIAXIN XL, CLARITHROMYCIN BIAXIN, CLARITHROMYCIN BICALUTAMIDE, BICALUTAMIDE BICILLIN C-R 900/300, PENICILLIN G BENZATHINE BICILLIN C-R, PENICILLIN G BENZATHINE BICILLIN L-A, PENICILLIN G BENZATHINE BICNU, CARMUSTINE BIDIL, HYDRALAZINE HYDROCHLORIDE BILTRICIDE, PRAZIQUANTEL BINOSTO, ALENDRONATE SODIUM BIOSCRUB, CHLORHEXIDINE GLUCONATE (OTC) BISOPROLOL FUMARATE AND HYDROCHLOROTHIAZIDE, BISOPROLOL FUMARATE BISOPROLOL FUMARATE, BISOPROLOL FUMARATE BLEOMYCIN SULFATE, BLEOMYCIN SULFATE BLEPH-10, SULFACETAMIDE SODIUM BLEPHAMIDE S.O.P., PREDNISOLONE ACETATE BLEPHAMIDE, PREDNISOLONE ACETATE BLOXIVERZ, NEOSTIGMINE METHYLSULFATE BONIVA, IBANDRONATE SODIUM BONTRIL PDM, PHENDIMETRAZINE TARTRATE BONTRIL, PHENDIMETRAZINE TARTRATE BOSULIF, BOSUTINIB MONOHYDRATE BRANCHAMIN 4% IN PLASTIC CONTAINER, AMINO ACIDS BRAVELLE, UROFOLLITROPIN BREATHTEK UBT FOR H-PYLORI, UREA C-13

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
B **

A - 8

BREO ELLIPTA, FLUTICASONE FUROATE BRETYLIUM TOSYLATE IN DEXTROSE 5% IN PLASTIC CONTAINER, BRETYLIUM TOSYLATE BREVIBLOC DOUBLE STRENGTH IN PLASTIC CONTAINER, ESMOLOL HYDROCHLORIDE BREVIBLOC IN PLASTIC CONTAINER, ESMOLOL HYDROCHLORIDE BREVIBLOC, ESMOLOL HYDROCHLORIDE BREVICON 28-DAY, ETHINYL ESTRADIOL BREVITAL SODIUM, METHOHEXITAL SODIUM BRIAN CARE, CHLORHEXIDINE GLUCONATE (OTC) BRIELLYN, ETHINYL ESTRADIOL BRILINTA, TICAGRELOR BRIMONIDINE TARTRATE, BRIMONIDINE TARTRATE BRISDELLE, PAROXETINE MESYLATE BROMDAY, BROMFENAC SODIUM BROMFED-DM, BROMPHENIRAMINE MALEATE BROMFENAC SODIUM, BROMFENAC SODIUM BROMOCRIPTINE MESYLATE, BROMOCRIPTINE MESYLATE BRONCHO SALINE, SODIUM CHLORIDE (OTC) BROVANA, ARFORMOTEROL TARTRATE BSS PLUS, CALCIUM CHLORIDE BSS, CALCIUM CHLORIDE BUDESONIDE, BUDESONIDE BUMETANIDE, BUMETANIDE BUPHENYL, SODIUM PHENYLBUTYRATE BUPIVACAINE HYDROCHLORIDE AND EPINEPHRINE, BUPIVACAINE HYDROCHLORIDE BUPIVACAINE HYDROCHLORIDE PRESERVATIVE FREE, BUPIVACAINE HYDROCHLORIDE BUPIVACAINE HYDROCHLORIDE W/EPINEPHRINE, BUPIVACAINE HYDROCHLORIDE BUPIVACAINE HYDROCHLORIDE, BUPIVACAINE HYDROCHLORIDE BUPRENEX, BUPRENORPHINE HYDROCHLORIDE BUPRENORPHINE HYDROCHLORIDE AND NALOXONE HYDROCHLORIDE DIHYDRATE, BUPRENORPHINE HYDROCHLORIDE BUPRENORPHINE HYDROCHLORIDE, BUPRENORPHINE HYDROCHLORIDE BUPROPION HYDROCHLORIDE, BUPROPION HYDROCHLORIDE BUSPIRONE HYDROCHLORIDE, BUSPIRONE HYDROCHLORIDE BUSULFEX, BUSULFAN BUTALBITAL AND ACETAMINOPHEN, ACETAMINOPHEN BUTALBITAL, ACETAMINOPHEN AND CAFFEINE, ACETAMINOPHEN BUTALBITAL, ACETAMINOPHEN, CAFFEINE AND CODEINE PHOSPHATE, ACETAMINOPHEN BUTALBITAL, ASPIRIN AND CAFFEINE, ASPIRIN BUTALBITAL, ASPIRIN, CAFFEINE, AND CODEINE PHOSPHATE, ASPIRIN BUTAPAP, ACETAMINOPHEN BUTISOL SODIUM, BUTABARBITAL SODIUM BUTOCONAZOLE NITRATE, BUTOCONAZOLE NITRATE BUTORPHANOL TARTRATE PRESERVATIVE FREE, BUTORPHANOL TARTRATE BUTORPHANOL TARTRATE, BUTORPHANOL TARTRATE BUTRANS, BUPRENORPHINE BYDUREON, EXENATIDE SYNTHETIC BYETTA, EXENATIDE SYNTHETIC BYSTOLIC, NEBIVOLOL HYDROCHLORIDE

**

C

**

CABERGOLINE, CABERGOLINE CADUET, AMLODIPINE BESYLATE CAFCIT, CAFFEINE CITRATE CAFERGOT, CAFFEINE CAFFEINE CITRATE, CAFFEINE CITRATE CALAN SR, VERAPAMIL HYDROCHLORIDE CALAN, VERAPAMIL HYDROCHLORIDE CALCIJEX, CALCITRIOL CALCIPOTRIENE AND BETAMETHASONE DIPROPIONATE, BETAMETHASONE DIPROPIONATE CALCIPOTRIENE, CALCIPOTRIENE CALCITONIN-SALMON, CALCITONIN SALMON CALCITRIOL, CALCITRIOL CALCIUM ACETATE, CALCIUM ACETATE CALCIUM CARBONATE, FAMOTIDINE AND MAGNESIUM HYDROXIDE, CALCIUM CARBONATE

(OTC)

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
C **

A - 9

CALCIUM CHLORIDE 10% IN PLASTIC CONTAINER, CALCIUM CHLORIDE CALCIUM DISODIUM VERSENATE, EDETATE CALCIUM DISODIUM CALDOLOR, IBUPROFEN CAMBIA, DICLOFENAC POTASSIUM CAMILA, NORETHINDRONE CAMPRAL, ACAMPROSATE CALCIUM CAMPTOSAR, IRINOTECAN HYDROCHLORIDE CANASA, MESALAMINE CANCIDAS, CASPOFUNGIN ACETATE CANDESARTAN CILEXETIL AND HYDROCHLOROTHIAZIDE, CANDESARTAN CILEXETIL CANDESARTAN CILEXETIL, CANDESARTAN CILEXETIL CANTIL, MEPENZOLATE BROMIDE CAPASTAT SULFATE, CAPREOMYCIN SULFATE CAPEX, FLUOCINOLONE ACETONIDE CAPITAL AND CODEINE, ACETAMINOPHEN CAPITAL SOLEIL 15, AVOBENZONE (OTC) CAPOTEN, CAPTOPRIL CAPOZIDE 25/15, CAPTOPRIL CAPOZIDE 25/25, CAPTOPRIL CAPOZIDE 50/15, CAPTOPRIL CAPOZIDE 50/25, CAPTOPRIL CAPRELSA, VANDETANIB CAPTOPRIL AND HYDROCHLOROTHIAZIDE, CAPTOPRIL CAPTOPRIL, CAPTOPRIL CARAC, FLUOROURACIL CARAFATE, SUCRALFATE CARBAGLU, CARGLUMIC ACID CARBAMAZEPINE, CARBAMAZEPINE CARBATROL, CARBAMAZEPINE CARBIDOPA AND LEVODOPA, CARBIDOPA CARBIDOPA, LEVODOPA AND ENTACAPONE, CARBIDOPA CARBINOXAMINE MALEATE, CARBINOXAMINE MALEATE CARBOCAINE, MEPIVACAINE HYDROCHLORIDE CARBOPLATIN, CARBOPLATIN CARDENE IN 0.83% SODIUM CHLORIDE IN PLASTIC CONTAINER, NICARDIPINE HYDROCHLORIDE CARDENE IN 0.86% SODIUM CHLORIDE IN PLASTIC CONTAINER, NICARDIPINE HYDROCHLORIDE CARDENE IN 4.8% DEXTROSE IN PLASTIC CONTAINER, NICARDIPINE HYDROCHLORIDE CARDENE IN 5.0% DEXTROSE IN PLASTIC CONTAINER, NICARDIPINE HYDROCHLORIDE CARDENE SR, NICARDIPINE HYDROCHLORIDE CARDENE, NICARDIPINE HYDROCHLORIDE CARDIOGEN-82, RUBIDIUM CHLORIDE RB-82 CARDIOLITE, TECHNETIUM TC-99M SESTAMIBI KIT CARDIOPLEGIC IN PLASTIC CONTAINER, CALCIUM CHLORIDE CARDIZEM CD, DILTIAZEM HYDROCHLORIDE CARDIZEM LA, DILTIAZEM HYDROCHLORIDE CARDIZEM, DILTIAZEM HYDROCHLORIDE CARDURA XL, DOXAZOSIN MESYLATE CARDURA, DOXAZOSIN MESYLATE CARISOPRODOL AND ASPIRIN, ASPIRIN CARISOPRODOL, ASPIRIN AND CODEINE PHOSPHATE, ASPIRIN CARISOPRODOL, CARISOPRODOL CARMOL HC, HYDROCORTISONE ACETATE CARNITOR SF, LEVOCARNITINE CARNITOR, LEVOCARNITINE CARTEOLOL HYDROCHLORIDE, CARTEOLOL HYDROCHLORIDE CARTIA XT, DILTIAZEM HYDROCHLORIDE CARVEDILOL, CARVEDILOL CASODEX, BICALUTAMIDE CATAFLAM, DICLOFENAC POTASSIUM CATAPRES, CLONIDINE HYDROCHLORIDE CATAPRES-TTS-1, CLONIDINE CATAPRES-TTS-2, CLONIDINE CATAPRES-TTS-3, CLONIDINE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
C **

A - 10

CAVERJECT IMPULSE, ALPROSTADIL CAVERJECT, ALPROSTADIL CAYSTON, AZTREONAM CEDAX, CEFTIBUTEN DIHYDRATE CEENU, LOMUSTINE CEFACLOR, CEFACLOR CEFADROXIL, CEFADROXIL/CEFADROXIL HEMIHYDRATE CEFAZOLIN AND DEXTROSE, CEFAZOLIN SODIUM CEFAZOLIN SODIUM, CEFAZOLIN SODIUM CEFDINIR, CEFDINIR CEFEPIME AND DEXTROSE IN DUPLEX CONTAINER, CEFEPIME HYDROCHLORIDE CEFEPIME HYDROCHLORIDE, CEFEPIME HYDROCHLORIDE CEFEPIME IN PLASTIC CONTAINER, CEFEPIME HYDROCHLORIDE CEFOTAXIME SODIUM, CEFOTAXIME SODIUM CEFOTAXIME, CEFOTAXIME SODIUM CEFOTETAN AND DEXTROSE IN DUPLEX CONTAINER, CEFOTETAN DISODIUM CEFOTETAN, CEFOTETAN DISODIUM CEFOXITIN AND DEXTROSE IN DUPLEX CONTAINER, CEFOXITIN SODIUM CEFOXITIN, CEFOXITIN SODIUM CEFPODOXIME PROXETIL, CEFPODOXIME PROXETIL CEFPROZIL, CEFPROZIL CEFTAZIDIME IN DEXTROSE CONTAINER, CEFTAZIDIME CEFTAZIDIME, CEFTAZIDIME CEFTIN, CEFUROXIME AXETIL CEFTRIAXONE AND DEXTROSE IN DUPLEX CONTAINER, CEFTRIAXONE SODIUM CEFTRIAXONE IN PLASTIC CONTAINER, CEFTRIAXONE SODIUM CEFTRIAXONE, CEFTRIAXONE SODIUM CEFUROXIME AND DEXTROSE IN DUPLEX CONTAINER, CEFUROXIME SODIUM CEFUROXIME AXETIL, CEFUROXIME AXETIL CEFUROXIME SODIUM IN PLASTIC CONTAINER, CEFUROXIME SODIUM CEFUROXIME SODIUM, CEFUROXIME SODIUM CELEBREX, CELECOXIB CELESTONE SOLUSPAN, BETAMETHASONE ACETATE CELEXA, CITALOPRAM HYDROBROMIDE CELLCEPT, MYCOPHENOLATE MOFETIL CELLCEPT, MYCOPHENOLATE MOFETIL HYDROCHLORIDE CELONTIN, METHSUXIMIDE CENESTIN, ESTROGENS, CONJUGATED SYNTHETIC A CENTANY, MUPIROCIN CEPHALEXIN, CEPHALEXIN CERETEC, TECHNETIUM TC-99M EXAMETAZIME KIT CEREZYME, IMIGLUCERASE CERUBIDINE, DAUNORUBICIN HYDROCHLORIDE CERVIDIL, DINOPROSTONE CESAMET, NABILONE CETAMIDE, SULFACETAMIDE SODIUM CETIRIZINE HYDROCHLORIDE ALLERGY, CETIRIZINE HYDROCHLORIDE (OTC) CETIRIZINE HYDROCHLORIDE AND PSEUDOEPHEDRINE HYDROCHLORIDE, CETIRIZINE HYDROCHLORIDE CETIRIZINE HYDROCHLORIDE HIVES RELIEF, CETIRIZINE HYDROCHLORIDE (OTC) CETIRIZINE HYDROCHLORIDE HIVES, CETIRIZINE HYDROCHLORIDE (OTC) CETIRIZINE HYDROCHLORIDE, CETIRIZINE HYDROCHLORIDE CETRAXAL, CIPROFLOXACIN HYDROCHLORIDE CETROTIDE, CETRORELIX CEVIMELINE HYDROCHLORIDE, CEVIMELINE HYDROCHLORIDE CEVIMELINE, CEVIMELINE HYDROCHLORIDE CHANTIX, VARENICLINE TARTRATE CHEMET, SUCCIMER CHENODIOL, CHENODIOL CHG SCRUB, CHLORHEXIDINE GLUCONATE (OTC) CHILDREN'S ADVIL ALLERGY SINUS, CHLORPHENIRAMINE MALEATE (OTC) CHILDREN'S ADVIL COLD, IBUPROFEN (OTC) CHILDREN'S ADVIL, IBUPROFEN (OTC) CHILDREN'S ADVIL-FLAVORED, IBUPROFEN (OTC)

(OTC)

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
C **

A - 11

CHILDREN'S ALLEGRA ALLERGY, FEXOFENADINE HYDROCHLORIDE (OTC) CHILDREN'S ALLEGRA HIVES, FEXOFENADINE HYDROCHLORIDE (OTC) CHILDREN'S CETIRIZINE HYDROCHLORIDE ALLERGY, CETIRIZINE HYDROCHLORIDE (OTC) CHILDREN'S CETIRIZINE HYDROCHLORIDE HIVES RELIEF, CETIRIZINE HYDROCHLORIDE (OTC) CHILDREN'S CLARITIN, LORATADINE (OTC) CHILDREN'S ELIXSURE, IBUPROFEN (OTC) CHILDREN'S FEXOFENADINE HYDROCHLORIDE ALLERGY, FEXOFENADINE HYDROCHLORIDE (OTC) CHILDREN'S FEXOFENADINE HYDROCHLORIDE HIVES, FEXOFENADINE HYDROCHLORIDE (OTC) CHILDREN'S IBUPROFEN, IBUPROFEN (OTC) CHILDREN'S MOTRIN COLD, IBUPROFEN (OTC) CHILDREN'S MOTRIN, IBUPROFEN (OTC) CHILDREN'S ZYRTEC ALLERGY, CETIRIZINE HYDROCHLORIDE (OTC) CHILDREN'S ZYRTEC HIVES RELIEF, CETIRIZINE HYDROCHLORIDE (OTC) CHIRHOSTIM, SECRETIN SYNTHETIC HUMAN CHLORAMPHENICOL SODIUM SUCCINATE, CHLORAMPHENICOL SODIUM SUCCINATE CHLORAPREP ONE-STEP FREPP, CHLORHEXIDINE GLUCONATE (OTC) CHLORAPREP ONE-STEP SEPP, CHLORHEXIDINE GLUCONATE (OTC) CHLORAPREP ONE-STEP, CHLORHEXIDINE GLUCONATE (OTC) CHLORAPREP SINGLE SWABSTICK, CHLORHEXIDINE GLUCONATE (OTC) CHLORAPREP TRIPLE SWABSTICK, CHLORHEXIDINE GLUCONATE (OTC) CHLORAPREP WITH TINT, CHLORHEXIDINE GLUCONATE (OTC) CHLORDIAZEPOXIDE AND AMITRIPTYLINE HYDROCHLORIDE, AMITRIPTYLINE HYDROCHLORIDE CHLORDIAZEPOXIDE HYDROCHLORIDE, CHLORDIAZEPOXIDE HYDROCHLORIDE CHLORHEXIDINE GLUCONATE, CHLORHEXIDINE GLUCONATE CHLORHEXIDINE GLUCONATE, CHLORHEXIDINE GLUCONATE (OTC) CHLOROPROCAINE HYDROCHLORIDE, CHLOROPROCAINE HYDROCHLORIDE CHLOROQUINE PHOSPHATE, CHLOROQUINE PHOSPHATE CHLOROTHIAZIDE SODIUM, CHLOROTHIAZIDE SODIUM CHLOROTHIAZIDE, CHLOROTHIAZIDE CHLORPHENIRAMINE MALEATE, CHLORPHENIRAMINE MALEATE (OTC) CHLORPROMAZINE HYDROCHLORIDE, CHLORPROMAZINE HYDROCHLORIDE CHLORPROPAMIDE, CHLORPROPAMIDE CHLORTHALIDONE, CHLORTHALIDONE CHLOR-TRIMETON, CHLORPHENIRAMINE MALEATE (OTC) CHLORZOXAZONE, CHLORZOXAZONE CHOLAC, LACTULOSE CHOLEDYL SA, OXTRIPHYLLINE CHOLESTYRAMINE LIGHT, CHOLESTYRAMINE CHOLESTYRAMINE, CHOLESTYRAMINE CHOLETEC, TECHNETIUM TC-99M MEBROFENIN KIT CHOLINE C-11, CHOLINE C-11 CHOLOGRAFIN MEGLUMINE, IODIPAMIDE MEGLUMINE CHORIONIC GONADOTROPIN, GONADOTROPIN, CHORIONIC CHROMIC CHLORIDE IN PLASTIC CONTAINER, CHROMIC CHLORIDE CIALIS, TADALAFIL CICLOPIROX, CICLOPIROX CIDA-STAT, CHLORHEXIDINE GLUCONATE (OTC) CIDOFOVIR, CIDOFOVIR CILOSTAZOL, CILOSTAZOL CILOXAN, CIPROFLOXACIN HYDROCHLORIDE CIMETIDINE HYDROCHLORIDE, CIMETIDINE HYDROCHLORIDE CIMETIDINE, CIMETIDINE CIMETIDINE, CIMETIDINE (OTC) CIPRO HC, CIPROFLOXACIN HYDROCHLORIDE CIPRO IN DEXTROSE 5% IN PLASTIC CONTAINER, CIPROFLOXACIN CIPRO, CIPROFLOXACIN CIPRO, CIPROFLOXACIN HYDROCHLORIDE CIPRODEX, CIPROFLOXACIN CIPROFLOXACIN EXTENDED RELEASE, CIPROFLOXACIN CIPROFLOXACIN HYDROCHLORIDE, CIPROFLOXACIN HYDROCHLORIDE CIPROFLOXACIN IN DEXTROSE 5% IN PLASTIC CONTAINER, CIPROFLOXACIN CIPROFLOXACIN, CIPROFLOXACIN CISATRACURIUM BESYLATE PRESERVATIVE FREE, CISATRACURIUM BESYLATE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
C **

A - 12

CISATRACURIUM BESYLATE, CISATRACURIUM BESYLATE CIS-MDP, TECHNETIUM TC-99M MEDRONATE KIT CISPLATIN, CISPLATIN CIS-PYRO, TECHNETIUM TC-99M PYROPHOSPHATE KIT CITALOPRAM HYDROBROMIDE, CITALOPRAM HYDROBROMIDE CITANEST FORTE DENTAL, EPINEPHRINE BITARTRATE CLADRIBINE, CLADRIBINE CLAFORAN IN DEXTROSE 5% IN PLASTIC CONTAINER, CEFOTAXIME SODIUM CLAFORAN, CEFOTAXIME SODIUM CLARAVIS, ISOTRETINOIN CLARINEX D 24 HOUR, DESLORATADINE CLARINEX, DESLORATADINE CLARINEX-D 12 HOUR, DESLORATADINE CLARITHROMYCIN, CLARITHROMYCIN CLARITIN HIVES RELIEF REDITAB, LORATADINE (OTC) CLARITIN HIVES RELIEF, LORATADINE (OTC) CLARITIN REDITABS, LORATADINE (OTC) CLARITIN, LORATADINE (OTC) CLARITIN-D 24 HOUR, LORATADINE (OTC) CLARITIN-D, LORATADINE (OTC) CLEMASTINE FUMARATE, CLEMASTINE FUMARATE CLEMASTINE FUMARATE, CLEMASTINE FUMARATE (OTC) CLEOCIN HYDROCHLORIDE, CLINDAMYCIN HYDROCHLORIDE CLEOCIN PHOSPHATE IN DEXTROSE 5% IN PLASTIC CONTAINER, CLINDAMYCIN PHOSPHATE CLEOCIN PHOSPHATE, CLINDAMYCIN PHOSPHATE CLEOCIN T, CLINDAMYCIN PHOSPHATE CLEOCIN, CLINDAMYCIN PALMITATE HYDROCHLORIDE CLEOCIN, CLINDAMYCIN PHOSPHATE CLEVIPREX, CLEVIDIPINE CLIMARA PRO, ESTRADIOL CLIMARA, ESTRADIOL CLINDA-DERM, CLINDAMYCIN PHOSPHATE CLINDAGEL, CLINDAMYCIN PHOSPHATE CLINDAMYCIN HYDROCHLORIDE, CLINDAMYCIN HYDROCHLORIDE CLINDAMYCIN PALMITATE HYDROCHLORIDE, CLINDAMYCIN PALMITATE HYDROCHLORIDE CLINDAMYCIN PHOSPHATE AND BENZOYL PEROXIDE, BENZOYL PEROXIDE CLINDAMYCIN PHOSPHATE IN 5% DEXTROSE IN PLASTIC CONTAINER, CLINDAMYCIN PHOSPHATE CLINDAMYCIN PHOSPHATE IN DEXTROSE 5%, CLINDAMYCIN PHOSPHATE CLINDAMYCIN PHOSPHATE, CLINDAMYCIN PHOSPHATE CLINDESSE, CLINDAMYCIN PHOSPHATE CLINDETS, CLINDAMYCIN PHOSPHATE CLINIMIX 2.75/10 SULFITE FREE IN DEXTROSE 10% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 2.75/25 SULFITE FREE IN DEXTROSE 25% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 2.75/5 SULFITE FREE IN DEXTROSE 5% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 4.25/10 SULFITE FREE IN DEXTROSE 10% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 4.25/20 SULFITE FREE IN DEXTROSE 20% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 4.25/25 SULFITE FREE IN DEXTROSE 25% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 4.25/5 SULFITE FREE IN DEXTROSE 5% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 5/10 SULFITE FREE IN DEXTROSE 10% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 5/15 SULFITE FREE IN DEXTROSE 15% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 5/20 SULFITE FREE IN DEXTROSE 20% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 5/25 SULFITE FREE IN DEXTROSE 25% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 5/35 SULFITE FREE IN DEXTROSE 35% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX E 2.75/10 SULFITE-FREE W/ ELECT IN DEXTROSE 10% W/ CALCIUM IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX E 2.75/25 SULFITE-FREE W/ ELECT IN DEXTROSE 25% W/ CALCIUM IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX E 2.75/5 SULFITE-FREE W/ ELECT IN DEXTROSE 5% W/ CALCIUM IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX E 4.25/10 SULFITE-FREE W/ ELECT IN DEXTROSE 10% W/ CALCIUM IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX E 4.25/20 SULFITE-FREE W/ ELECT IN DEXTROSE 20% W/ CALCIUM IN PLASTIC CONTAINER, AMINO ACIDS

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
C **

A - 13

CLINIMIX E 4.25/25 SULFITE-FREE W/ ELECT IN DEXTROSE 25% W/ CALCIUM IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX E 4.25/5 SULFITE-FREE W/ ELECT IN DEXTROSE 5% W/ CALCIUM IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX E 5/10 SULFITE-FREE W/ ELECT IN DEXTROSE 10% W/ CALCIUM IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX E 5/15 SULFITE-FREE W/ ELECT IN DEXTROSE 15% W/ CALCIUM IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX E 5/20 SULFITE-FREE W/ ELECT IN 20% DEXTROSE W/ CALCIUM IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX E 5/25 SULFITE-FREE W/ ELECT IN DEXTROSE 25% W/ CALCIUM IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX E 5/35 SULFITE-FREE W/ ELECT IN DEXTROSE 35% W/ CALCIUM IN PLASTIC CONTAINER, AMINO ACIDS CLINISOL 15% SULFITE FREE IN PLASTIC CONTAINER, AMINO ACIDS CLINORIL, SULINDAC CLOBETASOL PROPIONATE (EMOLLIENT), CLOBETASOL PROPIONATE CLOBETASOL PROPIONATE, CLOBETASOL PROPIONATE CLOBEX, CLOBETASOL PROPIONATE CLODERM, CLOCORTOLONE PIVALATE CLOLAR, CLOFARABINE CLOMID, CLOMIPHENE CITRATE CLOMIPHENE CITRATE, CLOMIPHENE CITRATE CLOMIPRAMINE HYDROCHLORIDE, CLOMIPRAMINE HYDROCHLORIDE CLONAZEPAM, CLONAZEPAM CLONIDINE HYDROCHLORIDE, CLONIDINE HYDROCHLORIDE CLONIDINE, CLONIDINE CLOPIDOGREL BISULFATE, CLOPIDOGREL BISULFATE CLORAZEPATE DIPOTASSIUM, CLORAZEPATE DIPOTASSIUM CLORPRES, CHLORTHALIDONE CLOTRIMAZOLE AND BETAMETHASONE DIPROPIONATE, BETAMETHASONE DIPROPIONATE CLOTRIMAZOLE, CLOTRIMAZOLE CLOTRIMAZOLE, CLOTRIMAZOLE (OTC) CLOZAPINE, CLOZAPINE CLOZARIL, CLOZAPINE COARTEM, ARTEMETHER CODEINE SULFATE, CODEINE SULFATE COGENTIN, BENZTROPINE MESYLATE CO-GESIC, ACETAMINOPHEN COLAZAL, BALSALAZIDE DISODIUM COLCRYS, COLCHICINE COLESTID, COLESTIPOL HYDROCHLORIDE COLESTIPOL HYDROCHLORIDE, COLESTIPOL HYDROCHLORIDE COLGATE TOTAL, SODIUM FLUORIDE (OTC) COLISTIMETHATE SODIUM, COLISTIMETHATE SODIUM COLOCORT, HYDROCORTISONE COL-PROBENECID, COLCHICINE COLY-MYCIN M, COLISTIMETHATE SODIUM COLY-MYCIN S, COLISTIN SULFATE COLYTE WITH FLAVOR PACKS, POLYETHYLENE GLYCOL 3350 COLYTE, POLYETHYLENE GLYCOL 3350 COLYTE-FLAVORED, POLYETHYLENE GLYCOL 3350 COMBIGAN, BRIMONIDINE TARTRATE COMBIPATCH, ESTRADIOL COMBIVENT RESPIMAT, ALBUTEROL SULFATE COMBIVENT, ALBUTEROL SULFATE COMBIVIR, LAMIVUDINE COMETRIQ, CABOZANTINIB S-MALATE COMMIT, NICOTINE POLACRILEX (OTC) COMPLERA, EMTRICITABINE COMPRO, PROCHLORPERAZINE COMTAN, ENTACAPONE CONCERTA, METHYLPHENIDATE HYDROCHLORIDE CONDYLOX, PODOFILOX CONRAY 30, IOTHALAMATE MEGLUMINE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
C **

A - 14

CONRAY 43, IOTHALAMATE MEGLUMINE CONRAY, IOTHALAMATE MEGLUMINE CONSTILAC, LACTULOSE CONSTULOSE, LACTULOSE CONZIP, TRAMADOL HYDROCHLORIDE COPAXONE, GLATIRAMER ACETATE COPEGUS, RIBAVIRIN CORDARONE, AMIODARONE HYDROCHLORIDE CORDRAN SP, FLURANDRENOLIDE CORDRAN, FLURANDRENOLIDE COREG CR, CARVEDILOL PHOSPHATE COREG, CARVEDILOL CORGARD, NADOLOL CORLOPAM, FENOLDOPAM MESYLATE CORMAX, CLOBETASOL PROPIONATE CORTEF, HYDROCORTISONE CORTENEMA, HYDROCORTISONE CORTIFOAM, HYDROCORTISONE ACETATE CORTISONE ACETATE, CORTISONE ACETATE CORTISPORIN, BACITRACIN ZINC CORTISPORIN, HYDROCORTISONE CORTISPORIN, HYDROCORTISONE ACETATE CORTROSYN, COSYNTROPIN CORVERT, IBUTILIDE FUMARATE CORZIDE, BENDROFLUMETHIAZIDE COSMEGEN, DACTINOMYCIN COSOPT PF, DORZOLAMIDE HYDROCHLORIDE COSOPT, DORZOLAMIDE HYDROCHLORIDE COSYNTROPIN, COSYNTROPIN COUMADIN, WARFARIN SODIUM COVERA-HS, VERAPAMIL HYDROCHLORIDE COZAAR, LOSARTAN POTASSIUM CREON, LIPASE CRESTOR, ROSUVASTATIN CALCIUM CRINONE, PROGESTERONE CRIXIVAN, INDINAVIR SULFATE CROLOM, CROMOLYN SODIUM CROMOLYN SODIUM, CROMOLYN SODIUM CROMOLYN SODIUM, CROMOLYN SODIUM (OTC) CROTAN, CROTAMITON CRYSELLE, ETHINYL ESTRADIOL C-SOLVE-2, ERYTHROMYCIN CUBICIN, DAPTOMYCIN CUPRIC CHLORIDE IN PLASTIC CONTAINER, CUPRIC CHLORIDE CUPRIMINE, PENICILLAMINE CUROSURF, PORACTANT ALFA CUTIVATE, FLUTICASONE PROPIONATE CUVPOSA, GLYCOPYRROLATE CYANOCOBALAMIN, CYANOCOBALAMIN CYANOKIT, HYDROXOCOBALAMIN CYCLAFEM 1/35, ETHINYL ESTRADIOL CYCLAFEM 7/7/7, ETHINYL ESTRADIOL CYCLESSA, DESOGESTREL CYCLOBENZAPRINE HYDROCHLORIDE, CYCLOBENZAPRINE HYDROCHLORIDE CYCLOGYL, CYCLOPENTOLATE HYDROCHLORIDE CYCLOMYDRIL, CYCLOPENTOLATE HYDROCHLORIDE CYCLOPHOSPHAMIDE, CYCLOPHOSPHAMIDE CYCLOSET, BROMOCRIPTINE MESYLATE CYCLOSPORINE, CYCLOSPORINE CYKLOKAPRON, TRANEXAMIC ACID CYMBALTA, DULOXETINE HYDROCHLORIDE CYPROHEPTADINE HYDROCHLORIDE, CYPROHEPTADINE HYDROCHLORIDE CYSTADANE, BETAINE HYDROCHLORIDE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
C **

A - 15

CYSTAGON, CYSTEAMINE BITARTRATE CYSTARAN, CYSTEAMINE HYDROCHLORIDE CYSTO-CONRAY II, IOTHALAMATE MEGLUMINE CYSTOGRAFIN DILUTE, DIATRIZOATE MEGLUMINE CYSTOGRAFIN, DIATRIZOATE MEGLUMINE CYSVIEW KIT, HEXAMINOLEVULINATE HYDROCHLORIDE CYTARABINE, CYTARABINE CYTOMEL, LIOTHYRONINE SODIUM CYTOSAR-U, CYTARABINE CYTOTEC, MISOPROSTOL CYTOVENE, GANCICLOVIR SODIUM CYTOXAN (LYOPHILIZED), CYCLOPHOSPHAMIDE

**

D

**

D.H.E. 45, DIHYDROERGOTAMINE MESYLATE DACARBAZINE, DACARBAZINE DACOGEN, DECITABINE DACTINOMYCIN, DACTINOMYCIN DALIRESP, ROFLUMILAST DANAZOL, DANAZOL DANTRIUM, DANTROLENE SODIUM DANTROLENE SODIUM, DANTROLENE SODIUM DAPSONE, DAPSONE DARAPRIM, PYRIMETHAMINE DASETTA 1/35, ETHINYL ESTRADIOL DASETTA 7/7/7, ETHINYL ESTRADIOL DATSCAN, IOFLUPANE I-123 DAUNORUBICIN HYDROCHLORIDE, DAUNORUBICIN HYDROCHLORIDE DAUNOXOME, DAUNORUBICIN CITRATE DAYPRO, OXAPROZIN DAYSEE, ETHINYL ESTRADIOL DAYTRANA, METHYLPHENIDATE DDAVP (NEEDS NO REFRIGERATION), DESMOPRESSIN ACETATE DDAVP, DESMOPRESSIN ACETATE DEFEROXAMINE MESYLATE, DEFEROXAMINE MESYLATE DEFINITY, PERFLUTREN DELATESTRYL, TESTOSTERONE ENANTHATE DELESTROGEN, ESTRADIOL VALERATE DELFLEX W/ DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX W/ DEXTROSE 1.5% LOW MAGNESIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX W/ DEXTROSE 1.5% LOW MAGNESIUM LOW CALCIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX W/ DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX W/ DEXTROSE 2.5% LOW MAGNESIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX W/ DEXTROSE 2.5% LOW MAGNESIUM LOW CALCIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX W/ DEXTROSE 3.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX W/ DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX W/ DEXTROSE 4.25% LOW MAGNESIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX W/ DEXTROSE 4.25% LOW MAGNESIUM LOW CALCIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX-LM W/ DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX-LM W/ DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX-LM W/ DEXTROSE 3.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX-LM W/ DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELSYM, DEXTROMETHORPHAN POLISTIREX (OTC) DELZICOL, MESALAMINE DEMADEX, TORSEMIDE DEMECLOCYCLINE HYDROCHLORIDE, DEMECLOCYCLINE HYDROCHLORIDE DEMEROL, MEPERIDINE HYDROCHLORIDE DEMSER, METYROSINE DENAVIR, PENCICLOVIR SODIUM DENDRID, IDOXURIDINE DEPACON, VALPROATE SODIUM DEPAKENE, VALPROIC ACID DEPAKOTE ER, DIVALPROEX SODIUM

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
D **

A - 16

DEPAKOTE, DIVALPROEX SODIUM DEPEN, PENICILLAMINE DEPOCYT, CYTARABINE DEPO-ESTRADIOL, ESTRADIOL CYPIONATE DEPO-MEDROL, METHYLPREDNISOLONE ACETATE DEPO-PROVERA, MEDROXYPROGESTERONE ACETATE DEPO-SUBQ PROVERA 104, MEDROXYPROGESTERONE ACETATE DEPO-TESTOSTERONE, TESTOSTERONE CYPIONATE DERMABET, BETAMETHASONE VALERATE DERMA-SMOOTHE/FS, FLUOCINOLONE ACETONIDE DERMATOP E EMOLLIENT, PREDNICARBATE DERMATOP, PREDNICARBATE DERMOTIC, FLUOCINOLONE ACETONIDE DESFERAL, DEFEROXAMINE MESYLATE DESIPRAMINE HYDROCHLORIDE, DESIPRAMINE HYDROCHLORIDE DESLORATADINE AND PSEUDOEPHEDRINE SULFATE 24 HOUR, DESLORATADINE DESLORATADINE, DESLORATADINE DESMOPRESSIN ACETATE (NEEDS NO REFRIGERATION), DESMOPRESSIN ACETATE DESMOPRESSIN ACETATE, DESMOPRESSIN ACETATE DESOGEN, DESOGESTREL DESOGESTREL AND ETHINYL ESTRADIOL, DESOGESTREL DESONATE, DESONIDE DESONIDE, DESONIDE DESOWEN, DESONIDE DESOXIMETASONE, DESOXIMETASONE DESOXYN, METHAMPHETAMINE HYDROCHLORIDE DESVENLAFAXINE, DESVENLAFAXINE DETROL LA, TOLTERODINE TARTRATE DETROL, TOLTERODINE TARTRATE DEXAMETHASONE INTENSOL, DEXAMETHASONE DEXAMETHASONE SODIUM PHOSPHATE, DEXAMETHASONE SODIUM PHOSPHATE DEXAMETHASONE, DEXAMETHASONE DEXASPORIN, DEXAMETHASONE DEXBROMPHENIRAMINE MALEATE AND PSEUDOEPHEDRINE SULFATE, DEXBROMPHENIRAMINE MALEATE (OTC) DEXCHLORPHENIRAMINE MALEATE, DEXCHLORPHENIRAMINE MALEATE DEXEDRINE, DEXTROAMPHETAMINE SULFATE DEXFERRUM, IRON DEXTRAN DEXILANT, DEXLANSOPRAZOLE DEXMETHYLPHENIDATE HYDROCHLORIDE, DEXMETHYLPHENIDATE HYDROCHLORIDE DEXRAZOXANE HYDROCHLORIDE, DEXRAZOXANE HYDROCHLORIDE DEXTROAMP SACCHARATE, AMP ASPARTATE, DEXTROAMP SULFATE AND AMP SULFATE, AMPHETAMINE ASPARTATE DEXTROAMP SACCHARATE,AMP ASPARTATE,DEXTROAMP SULFATE AND AMP SULFATE, AMPHETAMINE ASPARTATE DEXTROAMPHETAMINE SULFATE, DEXTROAMPHETAMINE SULFATE DEXTROMETHORPHAN POLISTIREX, DEXTROMETHORPHAN POLISTIREX (OTC) DEXTROSE 10% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 10% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 10% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 2.5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 2.5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 2.5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 2.5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 2.5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 2.5% IN HALF-STRENGTH LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE DEXTROSE 20% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 25%, DEXTROSE DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 30% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 40% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND ELECTROLYTE NO 75 IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND ELECTROLYTE NO.48 IN PLASTIC CONTAINER, DEXTROSE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
D **

A - 17

DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE DEXTROSE 5% AND POTASSIUM CHLORIDE 0.075% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND POTASSIUM CHLORIDE 0.15% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND POTASSIUM CHLORIDE 0.224% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND POTASSIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% IN ACETATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE DEXTROSE 5% IN LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% IN RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE DEXTROSE 5% IN SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% IN SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 10MEQ, DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 15MEQ (K), DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 20MEQ (K), DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 20MEQ, DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 30MEQ, DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 40MEQ, DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 5MEQ (K), DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 5MEQ, DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 10MEQ IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 15MEQ IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 20MEQ IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 30MEQ IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 40MEQ IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 5MEQ IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.45% AND POTASSIUM CHLORIDE 20MEQ (K) IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 50% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 60% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 70% IN PLASTIC CONTAINER, DEXTROSE DIABETA, GLYBURIDE DIABINESE, CHLORPROPAMIDE DIALYTE CONCENTRATE W/ DEXTROSE 30% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIALYTE CONCENTRATE W/ DEXTROSE 50% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIALYTE LM/ DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIALYTE LM/ DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIALYTE LM/ DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIAMOX, ACETAZOLAMIDE DIANEAL 137 W/ DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL 137 W/ DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL 137 W/ DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL LOW CALCIUM W/ DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL LOW CALCIUM W/ DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL LOW CALCIUM W/ DEXTROSE 3.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL LOW CALCIUM W/ DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL PD-1 W/ DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL PD-1 W/ DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL PD-1 W/ DEXTROSE 3.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL PD-1 W/ DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL PD-2 W/ DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL PD-2 W/ DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL PD-2 W/ DEXTROSE 3.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL PD-2 W/ DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
D **

A - 18

DIASTAT ACUDIAL, DIAZEPAM DIASTAT, DIAZEPAM DIAZEPAM INTENSOL, DIAZEPAM DIAZEPAM, DIAZEPAM DIBENZYLINE, PHENOXYBENZAMINE HYDROCHLORIDE DICLEGIS, DOXYLAMINE SUCCINATE DICLOFENAC POTASSIUM, DICLOFENAC POTASSIUM DICLOFENAC SODIUM AND MISOPROSTOL, DICLOFENAC SODIUM DICLOFENAC SODIUM, DICLOFENAC SODIUM DICLOXACILLIN SODIUM, DICLOXACILLIN SODIUM DICYCLOMINE HYDROCHLORIDE (PRESERVATIVE-FREE), DICYCLOMINE HYDROCHLORIDE DICYCLOMINE HYDROCHLORIDE, DICYCLOMINE HYDROCHLORIDE DIDANOSINE, DIDANOSINE DIDREX, BENZPHETAMINE HYDROCHLORIDE DIDRONEL, ETIDRONATE DISODIUM DIETHYLPROPION HYDROCHLORIDE, DIETHYLPROPION HYDROCHLORIDE DIFFERIN, ADAPALENE DIFICID, FIDAXOMICIN DIFLORASONE DIACETATE, DIFLORASONE DIACETATE DIFLUCAN IN DEXTROSE 5% IN PLASTIC CONTAINER, FLUCONAZOLE DIFLUCAN IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, FLUCONAZOLE DIFLUCAN IN SODIUM CHLORIDE 0.9%, FLUCONAZOLE DIFLUCAN, FLUCONAZOLE DIFLUNISAL, DIFLUNISAL DIGOXIN, DIGOXIN DIHYDROERGOTAMINE MESYLATE, DIHYDROERGOTAMINE MESYLATE DILACOR XR, DILTIAZEM HYDROCHLORIDE DILANTIN, PHENYTOIN DILANTIN, PHENYTOIN SODIUM DILANTIN-125, PHENYTOIN DILATRATE-SR, ISOSORBIDE DINITRATE DILAUDID, HYDROMORPHONE HYDROCHLORIDE DILAUDID-HP, HYDROMORPHONE HYDROCHLORIDE DILT-CD, DILTIAZEM HYDROCHLORIDE DILTIAZEM HYDROCHLORIDE, DILTIAZEM HYDROCHLORIDE DILTZAC, DILTIAZEM HYDROCHLORIDE DIMENHYDRINATE, DIMENHYDRINATE DIMETHYL SULFOXIDE, DIMETHYL SULFOXIDE DIOVAN HCT, HYDROCHLOROTHIAZIDE DIOVAN, VALSARTAN DIPENTUM, OLSALAZINE SODIUM DIPHENHYDRAMINE HYDROCHLORIDE PRESERVATIVE FREE, DIPHENHYDRAMINE HYDROCHLORIDE DIPHENHYDRAMINE HYDROCHLORIDE, DIPHENHYDRAMINE HYDROCHLORIDE DIPHENOXYLATE HYDROCHLORIDE AND ATROPINE SULFATE, ATROPINE SULFATE DIPIVEFRIN HYDROCHLORIDE, DIPIVEFRIN HYDROCHLORIDE DIPRIVAN, PROPOFOL DIPROLENE AF, BETAMETHASONE DIPROPIONATE DIPROLENE, BETAMETHASONE DIPROPIONATE DIPYRIDAMOLE, DIPYRIDAMOLE DISOPHROL, DEXBROMPHENIRAMINE MALEATE (OTC) DISOPYRAMIDE PHOSPHATE, DISOPYRAMIDE PHOSPHATE DISULFIRAM, DISULFIRAM DITROPAN XL, OXYBUTYNIN CHLORIDE DIURIL, CHLOROTHIAZIDE DIURIL, CHLOROTHIAZIDE SODIUM DIVALPROEX SODIUM, DIVALPROEX SODIUM DIVIGEL, ESTRADIOL DOBUTAMINE HYDROCHLORIDE IN DEXTROSE 5% IN PLASTIC CONTAINER, DOBUTAMINE HYDROCHLORIDE DOBUTAMINE HYDROCHLORIDE IN DEXTROSE 5%, DOBUTAMINE HYDROCHLORIDE DOBUTAMINE HYDROCHLORIDE, DOBUTAMINE HYDROCHLORIDE DOCEFREZ, DOCETAXEL DOCETAXEL, DOCETAXEL DOLOPHINE HYDROCHLORIDE, METHADONE HYDROCHLORIDE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
D **

A - 19

DONEPEZIL HYDROCHLORIDE, DONEPEZIL HYDROCHLORIDE DOPAMINE HYDROCHLORIDE AND DEXTROSE 5% IN PLASTIC CONTAINER, DOPAMINE HYDROCHLORIDE DOPAMINE HYDROCHLORIDE AND DEXTROSE 5%, DOPAMINE HYDROCHLORIDE DOPAMINE HYDROCHLORIDE IN DEXTROSE 5% IN PLASTIC CONTAINER, DOPAMINE HYDROCHLORIDE DOPAMINE HYDROCHLORIDE, DOPAMINE HYDROCHLORIDE DOPRAM, DOXAPRAM HYDROCHLORIDE DORAL, QUAZEPAM DORIBAX, DORIPENEM DORYX, DOXYCYCLINE HYCLATE DORZOLAMIDE HYDROCHLORIDE AND TIMOLOL MALEATE, DORZOLAMIDE HYDROCHLORIDE DORZOLAMIDE HYDROCHLORIDE, DORZOLAMIDE HYDROCHLORIDE DOTAREM, GADOTERATE MEGLUMINE DOVONEX, CALCIPOTRIENE DOXAPRAM HYDROCHLORIDE, DOXAPRAM HYDROCHLORIDE DOXAZOSIN MESYLATE, DOXAZOSIN MESYLATE DOXEPIN HYDROCHLORIDE, DOXEPIN HYDROCHLORIDE DOXERCALCIFEROL, DOXERCALCIFEROL DOXIL (LIPOSOMAL), DOXORUBICIN HYDROCHLORIDE DOXORUBICIN HYDROCHLORIDE (LIPOSOMAL), DOXORUBICIN HYDROCHLORIDE DOXORUBICIN HYDROCHLORIDE, DOXORUBICIN HYDROCHLORIDE DOXY 100, DOXYCYCLINE HYCLATE DOXY 200, DOXYCYCLINE HYCLATE DOXYCYCLINE HYCLATE, DOXYCYCLINE HYCLATE DOXYCYCLINE, DOXYCYCLINE DOXYCYCLINE, DOXYCYCLINE HYCLATE DOXYLAMINE SUCCINATE, DOXYLAMINE SUCCINATE (OTC) DRAXIMAGE MDP-25, TECHNETIUM TC-99M MEDRONATE DRISDOL, ERGOCALCIFEROL DRIXORAL PLUS, ACETAMINOPHEN (OTC) DRIXORAL, DEXBROMPHENIRAMINE MALEATE (OTC) DRONABINOL, DRONABINOL DROPERIDOL, DROPERIDOL DROSPIRENONE AND ETHINYL ESTRADIOL, DROSPIRENONE DROXIA, HYDROXYUREA DTIC-DOME, DACARBAZINE DTPA, TECHNETIUM TC-99M PENTETATE KIT DUAC, BENZOYL PEROXIDE DUETACT, GLIMEPIRIDE DUEXIS, FAMOTIDINE DULERA, FORMOTEROL FUMARATE DUODOTE, ATROPINE DUONEB, ALBUTEROL SULFATE DURACLON, CLONIDINE HYDROCHLORIDE DURAGESIC-100, FENTANYL DURAGESIC-12, FENTANYL DURAGESIC-25, FENTANYL DURAGESIC-50, FENTANYL DURAGESIC-75, FENTANYL DURAMORPH PF, MORPHINE SULFATE DURAPREP, IODINE POVACRYLEX (OTC) DUREZOL, DIFLUPREDNATE DUTASTERIDE, DUTASTERIDE DUTOPROL, HYDROCHLOROTHIAZIDE DUVOID, BETHANECHOL CHLORIDE DYAZIDE, HYDROCHLOROTHIAZIDE DYMISTA, AZELASTINE HYDROCHLORIDE DYNACIN, MINOCYCLINE HYDROCHLORIDE DYNA-HEX, CHLORHEXIDINE GLUCONATE (OTC) DYRENIUM, TRIAMTERENE

**
E.E.S. 200, ERYTHROMYCIN ETHYLSUCCINATE E.E.S. 400, ERYTHROMYCIN ETHYLSUCCINATE

E

**

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
E **

A - 20

E.E.S., ERYTHROMYCIN ETHYLSUCCINATE EC-NAPROSYN, NAPROXEN ECONAZOLE NITRATE, ECONAZOLE NITRATE EDARBI, AZILSARTAN KAMEDOXOMIL EDARBYCLOR, AZILSARTAN KAMEDOXOMIL EDECRIN, ETHACRYNATE SODIUM EDECRIN, ETHACRYNIC ACID EDEX, ALPROSTADIL EDLUAR, ZOLPIDEM TARTRATE EDURANT, RILPIVIRINE HYDROCHLORIDE EFFEXOR XR, VENLAFAXINE HYDROCHLORIDE EFFIENT, PRASUGREL HYDROCHLORIDE EFUDEX, FLUOROURACIL EGRIFTA, TESAMORELIN ACETATE ELDEPRYL, SELEGILINE HYDROCHLORIDE ELELYSO, TALIGLUCERASE ALFA ELESTAT, EPINASTINE HYDROCHLORIDE ELESTRIN, ESTRADIOL ELIDEL, PIMECROLIMUS ELIGARD, LEUPROLIDE ACETATE ELIMITE, PERMETHRIN ELINEST, ETHINYL ESTRADIOL ELIPHOS, CALCIUM ACETATE ELIQUIS, APIXABAN ELIXOPHYLLIN, THEOPHYLLINE ELLA, ULIPRISTAL ACETATE ELLENCE, EPIRUBICIN HYDROCHLORIDE ELLIOTTS B SOLUTION, CALCIUM CHLORIDE ELMIRON, PENTOSAN POLYSULFATE SODIUM ELOCON, MOMETASONE FUROATE ELOXATIN, OXALIPLATIN EMADINE, EMEDASTINE DIFUMARATE EMBEDA, MORPHINE SULFATE EMBELINE E, CLOBETASOL PROPIONATE EMBELINE, CLOBETASOL PROPIONATE EMCYT, ESTRAMUSTINE PHOSPHATE SODIUM EMEND, APREPITANT EMEND, FOSAPREPITANT DIMEGLUMINE EMLA, LIDOCAINE EMOQUETTE, DESOGESTREL EMSAM, SELEGILINE EMTRIVA, EMTRICITABINE ENABLEX, DARIFENACIN HYDROBROMIDE ENALAPRIL MALEATE AND HYDROCHLOROTHIAZIDE, ENALAPRIL MALEATE ENALAPRIL MALEATE, ENALAPRIL MALEATE ENALAPRILAT, ENALAPRILAT ENDOMETRIN, PROGESTERONE ENDOSOL EXTRA, CALCIUM CHLORIDE ENFLURANE, ENFLURANE ENJUVIA, ESTROGENS, CONJUGATED SYNTHETIC B ENLON, EDROPHONIUM CHLORIDE ENLON-PLUS, ATROPINE SULFATE ENOXAPARIN SODIUM (PRESERVATIVE FREE), ENOXAPARIN SODIUM ENOXAPARIN SODIUM, ENOXAPARIN SODIUM ENPRESSE-28, ETHINYL ESTRADIOL ENSKYCE, DESOGESTREL ENTACAPONE, ENTACAPONE ENTEREG, ALVIMOPAN ENTOCORT EC, BUDESONIDE ENULOSE, LACTULOSE EOVIST, GADOXETATE DISODIUM EPIDUO, ADAPALENE EPIFOAM, HYDROCORTISONE ACETATE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
E **

A - 21

EPINASTINE HYDROCHLORIDE, EPINASTINE HYDROCHLORIDE EPIPEN JR., EPINEPHRINE EPIPEN, EPINEPHRINE EPIRUBICIN HYDROCHLORIDE, EPIRUBICIN HYDROCHLORIDE EPITOL, CARBAMAZEPINE EPIVIR, LAMIVUDINE EPIVIR-HBV, LAMIVUDINE EPLERENONE, EPLERENONE EPOPROSTENOL SODIUM, EPOPROSTENOL SODIUM EPROSARTAN MESYLATE, EPROSARTAN MESYLATE EPZICOM, ABACAVIR SULFATE EQUETRO, CARBAMAZEPINE ERAXIS, ANIDULAFUNGIN ERGOCALCIFEROL, ERGOCALCIFEROL ERGOLOID MESYLATES, ERGOLOID MESYLATES ERGOMAR, ERGOTAMINE TARTRATE ERGOTAMINE TARTRATE AND CAFFEINE, CAFFEINE ERIVEDGE, VISMODEGIB ERRIN, NORETHINDRONE ERTACZO, SERTACONAZOLE NITRATE ERYC, ERYTHROMYCIN ERYGEL, ERYTHROMYCIN ERYPED, ERYTHROMYCIN ETHYLSUCCINATE ERY-TAB, ERYTHROMYCIN ERYTHRA-DERM, ERYTHROMYCIN ERYTHROCIN STEARATE, ERYTHROMYCIN STEARATE ERYTHROCIN, ERYTHROMYCIN LACTOBIONATE ERYTHROMYCIN AND BENZOYL PEROXIDE, BENZOYL PEROXIDE ERYTHROMYCIN ETHYLSUCCINATE AND SULFISOXAZOLE ACETYL, ERYTHROMYCIN ETHYLSUCCINATE ERYTHROMYCIN ETHYLSUCCINATE, ERYTHROMYCIN ETHYLSUCCINATE ERYTHROMYCIN, ERYTHROMYCIN ERYTHRO-STATIN, ERYTHROMYCIN ESCITALOPRAM OXALATE, ESCITALOPRAM OXALATE ESGIC-PLUS, ACETAMINOPHEN ESMOLOL HYDROCHLORIDE, ESMOLOL HYDROCHLORIDE ESOMEPRAZOLE SODIUM, ESOMEPRAZOLE SODIUM ESTARYLLA, ETHINYL ESTRADIOL ESTAZOLAM, ESTAZOLAM ESTRACE, ESTRADIOL ESTRADERM, ESTRADIOL ESTRADIOL AND NORETHINDRONE ACETATE, ESTRADIOL ESTRADIOL AND NORGESTIMATE, ESTRADIOL ESTRADIOL CYPIONATE, ESTRADIOL CYPIONATE ESTRADIOL VALERATE, ESTRADIOL VALERATE ESTRADIOL, ESTRADIOL ESTRASORB, ESTRADIOL HEMIHYDRATE ESTRING, ESTRADIOL ESTROGEL, ESTRADIOL ESTROPIPATE, ESTROPIPATE ESTROSTEP FE, ETHINYL ESTRADIOL ESZOPICLONE, ESZOPICLONE ETHAMBUTOL HYDROCHLORIDE, ETHAMBUTOL HYDROCHLORIDE ETHAMOLIN, ETHANOLAMINE OLEATE ETHOSUXIMIDE, ETHOSUXIMIDE ETHRANE, ENFLURANE ETHYOL, AMIFOSTINE ETIDRONATE DISODIUM, ETIDRONATE DISODIUM ETODOLAC, ETODOLAC ETOMIDATE, ETOMIDATE ETOPOPHOS PRESERVATIVE FREE, ETOPOSIDE PHOSPHATE ETOPOSIDE, ETOPOSIDE EURAX, CROTAMITON EVAMIST, ESTRADIOL

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
E **

A - 22

EVISTA, RALOXIFENE HYDROCHLORIDE EVOCLIN, CLINDAMYCIN PHOSPHATE EVOXAC, CEVIMELINE HYDROCHLORIDE EXALGO, HYDROMORPHONE HYDROCHLORIDE EXCEDRIN (MIGRAINE), ACETAMINOPHEN (OTC) EXELDERM, SULCONAZOLE NITRATE EXELON, RIVASTIGMINE EXELON, RIVASTIGMINE TARTRATE EXEMESTANE, EXEMESTANE EXFORGE HCT, AMLODIPINE BESYLATE EXFORGE, AMLODIPINE BESYLATE EXIDINE, CHLORHEXIDINE GLUCONATE (OTC) EXJADE, DEFERASIROX EXPAREL, BUPIVACAINE EXTENDED PHENYTOIN SODIUM, PHENYTOIN SODIUM EXTINA, KETOCONAZOLE EXTRANEAL, ICODEXTRIN E-Z SCRUB 201, POVIDONE-IODINE (OTC) E-Z SCRUB 241, POVIDONE-IODINE (OTC)

**

F

**

FABIOR, TAZAROTENE FACTIVE, GEMIFLOXACIN MESYLATE FALMINA, ETHINYL ESTRADIOL FAMCICLOVIR, FAMCICLOVIR FAMOTIDINE PRESERVATIVE FREE IN PLASTIC CONTAINER, FAMOTIDINE FAMOTIDINE PRESERVATIVE FREE, FAMOTIDINE FAMOTIDINE, FAMOTIDINE FAMOTIDINE, FAMOTIDINE (OTC) FAMVIR, FAMCICLOVIR FANAPT, ILOPERIDONE FARESTON, TOREMIFENE CITRATE FASLODEX, FULVESTRANT FAZACLO ODT, CLOZAPINE FELBAMATE, FELBAMATE FELBATOL, FELBAMATE FELDENE, PIROXICAM FELODIPINE, FELODIPINE FEMARA, LETROZOLE FEMCON FE, ETHINYL ESTRADIOL FEMHRT, ETHINYL ESTRADIOL FEMRING, ESTRADIOL ACETATE FEMSTAT 3, BUTOCONAZOLE NITRATE (OTC) FEMTRACE, ESTRADIOL ACETATE FENOFIBRATE (MICRONIZED), FENOFIBRATE FENOFIBRATE, FENOFIBRATE FENOFIBRIC ACID, CHOLINE FENOFIBRATE FENOGLIDE, FENOFIBRATE FENOLDOPAM MESYLATE, FENOLDOPAM MESYLATE FENOPROFEN CALCIUM, FENOPROFEN CALCIUM FENTANYL CITRATE PRESERVATIVE FREE, FENTANYL CITRATE FENTANYL CITRATE, FENTANYL CITRATE FENTANYL-100, FENTANYL FENTANYL-12, FENTANYL FENTANYL-25, FENTANYL FENTANYL-50, FENTANYL FENTANYL-75, FENTANYL FENTORA, FENTANYL CITRATE FERAHEME, FERUMOXYTOL FERRIPROX, DEFERIPRONE FERRLECIT, SODIUM FERRIC GLUCONATE COMPLEX FEXOFENADINE HYDROCHLORIDE ALLERGY, FEXOFENADINE HYDROCHLORIDE (OTC) FEXOFENADINE HYDROCHLORIDE AND PSEUDOEPHEDRINE HYDROCHLORIDE, FEXOFENADINE HYDROCHLORIDE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
F **

A - 23

FEXOFENADINE HYDROCHLORIDE AND PSEUDOEPHEDRINE HYDROCHLORIDE, FEXOFENADINE HYDROCHLORIDE FEXOFENADINE HYDROCHLORIDE HIVES, FEXOFENADINE HYDROCHLORIDE (OTC) FEXOFENADINE HYDROCHLORIDE, FEXOFENADINE HYDROCHLORIDE FIBRICOR, FENOFIBRIC ACID FINACEA, AZELAIC ACID FINASTERIDE, FINASTERIDE FIORICET W/ CODEINE, ACETAMINOPHEN FIORICET, ACETAMINOPHEN FIORINAL W/CODEINE, ASPIRIN FIORINAL, ASPIRIN FIRAZYR, ICATIBANT ACETATE FIRMAGON, DEGARELIX ACETATE FLAGYL ER, METRONIDAZOLE FLAGYL I.V. RTU IN PLASTIC CONTAINER, METRONIDAZOLE FLAGYL, METRONIDAZOLE FLAREX, FLUOROMETHOLONE ACETATE FLAVORED COLESTID, COLESTIPOL HYDROCHLORIDE FLAVOXATE HYDROCHLORIDE, FLAVOXATE HYDROCHLORIDE FLECAINIDE ACETATE, FLECAINIDE ACETATE FLECTOR, DICLOFENAC EPOLAMINE FLOLAN, EPOPROSTENOL SODIUM FLOMAX, TAMSULOSIN HYDROCHLORIDE FLONASE, FLUTICASONE PROPIONATE FLO-PRED, PREDNISOLONE ACETATE FLOVENT DISKUS 100, FLUTICASONE PROPIONATE FLOVENT DISKUS 250, FLUTICASONE PROPIONATE FLOVENT DISKUS 50, FLUTICASONE PROPIONATE FLOVENT HFA, FLUTICASONE PROPIONATE FLOXIN OTIC, OFLOXACIN FLOXURIDINE, FLOXURIDINE FLUCANAZOLE IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, FLUCONAZOLE FLUCONAZOLE IN DEXTROSE 5% IN PLASTIC CONTAINER, FLUCONAZOLE FLUCONAZOLE IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, FLUCONAZOLE FLUCONAZOLE IN SODIUM CHLORIDE 0.9%, FLUCONAZOLE FLUCONAZOLE, FLUCONAZOLE FLUCYTOSINE, FLUCYTOSINE FLUDARABINE PHOSPHATE, FLUDARABINE PHOSPHATE FLUDEOXYGLUCOSE F18, FLUDEOXYGLUCOSE F-18 FLUDROCORTISONE ACETATE, FLUDROCORTISONE ACETATE FLUMADINE, RIMANTADINE HYDROCHLORIDE FLUMAZENIL, FLUMAZENIL FLUNISOLIDE, FLUNISOLIDE FLUOCINOLONE ACETONIDE, FLUOCINOLONE ACETONIDE FLUOCINONIDE EMULSIFIED BASE, FLUOCINONIDE FLUOCINONIDE, FLUOCINONIDE FLUORESCITE, FLUORESCEIN SODIUM FLUOROPLEX, FLUOROURACIL FLUOROURACIL, FLUOROURACIL FLUOXETINE HYDROCHLORIDE, FLUOXETINE HYDROCHLORIDE FLUOXYMESTERONE, FLUOXYMESTERONE FLUPHENAZINE DECANOATE, FLUPHENAZINE DECANOATE FLUPHENAZINE HYDROCHLORIDE, FLUPHENAZINE HYDROCHLORIDE FLURAZEPAM HYDROCHLORIDE, FLURAZEPAM HYDROCHLORIDE FLURBIPROFEN SODIUM, FLURBIPROFEN SODIUM FLURBIPROFEN, FLURBIPROFEN FLUTAMIDE, FLUTAMIDE FLUTICASONE PROPIONATE, FLUTICASONE PROPIONATE FLUVASTATIN SODIUM, FLUVASTATIN SODIUM FLUVOXAMINE MALEATE, FLUVOXAMINE MALEATE FML FORTE, FLUOROMETHOLONE FML, FLUOROMETHOLONE FOAMCOAT, ALUMINUM HYDROXIDE (OTC) FOCALIN XR, DEXMETHYLPHENIDATE HYDROCHLORIDE

(OTC)

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
F **

A - 24

FOCALIN, DEXMETHYLPHENIDATE HYDROCHLORIDE FOLIC ACID, FOLIC ACID FOLLISTIM AQ, FOLLITROPIN ALFA/BETA FOLOTYN, PRALATREXATE FOMEPIZOLE, FOMEPIZOLE FONDAPARINUX SODIUM, FONDAPARINUX SODIUM FORADIL, FORMOTEROL FUMARATE FORANE, ISOFLURANE FORFIVO XL, BUPROPION HYDROCHLORIDE FORTAMET, METFORMIN HYDROCHLORIDE FORTAZ IN PLASTIC CONTAINER, CEFTAZIDIME SODIUM FORTAZ, CEFTAZIDIME FORTEO, TERIPARATIDE RECOMBINANT HUMAN FORTESTA, TESTOSTERONE FORTICAL, CALCITONIN SALMON RECOMBINANT FOSAMAX PLUS D, ALENDRONATE SODIUM FOSAMAX, ALENDRONATE SODIUM FOSCARNET SODIUM, FOSCARNET SODIUM FOSCAVIR, FOSCARNET SODIUM FOSINOPRIL SODIUM AND HYDROCHLOROTHIAZIDE, FOSINOPRIL FOSINOPRIL SODIUM AND HYDROCHLOROTHIAZIDE, FOSINOPRIL SODIUM FOSINOPRIL SODIUM, FOSINOPRIL SODIUM FOSPHENYTOIN SODIUM, FOSPHENYTOIN SODIUM FOSRENOL, LANTHANUM CARBONATE FRAGMIN, DALTEPARIN SODIUM FREAMINE HBC 6.9%, AMINO ACIDS FREAMINE III 10%, AMINO ACIDS FREAMINE III 3% W/ ELECTROLYTES, AMINO ACIDS FREAMINE III 8.5% W/ ELECTROLYTES, AMINO ACIDS FREAMINE III 8.5%, AMINO ACIDS FROVA, FROVATRIPTAN SUCCINATE FULYZAQ, CROFELEMER FURADANTIN, NITROFURANTOIN FUROSEMIDE, FUROSEMIDE FUSILEV, LEVOLEUCOVORIN CALCIUM FUZEON, ENFUVIRTIDE FYCOMPA, PERAMPANEL

**

G

**

GABAPENTIN, GABAPENTIN GABITRIL, TIAGABINE HYDROCHLORIDE GABLOFEN, BACLOFEN GADAVIST, GADOBUTROL GALANTAMINE HYDROBROMIDE, GALANTAMINE HYDROBROMIDE GALLIUM CITRATE GA 67, GALLIUM CITRATE GA-67 GALZIN, ZINC ACETATE GANCICLOVIR, GANCICLOVIR SODIUM GANIRELIX ACETATE INJECTION, GANIRELIX ACETATE GANITE, GALLIUM NITRATE GASTROCROM, CROMOLYN SODIUM GASTROGRAFIN, DIATRIZOATE MEGLUMINE GATTEX KIT, TEDUGLUTIDE GAVISCON, ALUMINUM HYDROXIDE (OTC) GELNIQUE 3%, OXYBUTYNIN GELNIQUE, OXYBUTYNIN CHLORIDE GEMCITABINE HYDROCHLORIDE, GEMCITABINE HYDROCHLORIDE GEMFIBROZIL, GEMFIBROZIL GEMZAR, GEMCITABINE HYDROCHLORIDE GENERLAC, LACTULOSE GENGRAF, CYCLOSPORINE GENOPTIC, GENTAMICIN SULFATE GENOTROPIN PRESERVATIVE FREE, SOMATROPIN RECOMBINANT GENOTROPIN, SOMATROPIN RECOMBINANT

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
G **

A - 25

GENTAK, GENTAMICIN SULFATE GENTAMICIN SULFATE IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, GENTAMICIN SULFATE GENTAMICIN SULFATE, GENTAMICIN SULFATE GEN-XENE, CLORAZEPATE DIPOTASSIUM GEODON, ZIPRASIDONE HYDROCHLORIDE GEODON, ZIPRASIDONE MESYLATE GIAZO, BALSALAZIDE DISODIUM GILDAGIA, ETHINYL ESTRADIOL GILDESS FE 1.5/30, ETHINYL ESTRADIOL GILDESS FE 1/20, ETHINYL ESTRADIOL GILENYA, FINGOLIMOD GLEEVEC, IMATINIB MESYLATE GLIADEL, CARMUSTINE GLIMEPIRIDE, GLIMEPIRIDE GLIPIZIDE AND METFORMIN HYDROCHLORIDE, GLIPIZIDE GLIPIZIDE, GLIPIZIDE GLOFIL-125, IOTHALAMATE SODIUM I-125 GLUCAGEN, GLUCAGON HYDROCHLORIDE RECOMBINANT GLUCAGON, GLUCAGON RECOMBINANT GLUCOPHAGE XR, METFORMIN HYDROCHLORIDE GLUCOPHAGE, METFORMIN HYDROCHLORIDE GLUCOTROL XL, GLIPIZIDE GLUCOTROL, GLIPIZIDE GLUCOVANCE, GLYBURIDE GLUMETZA, METFORMIN HYDROCHLORIDE GLYBURIDE (MICRONIZED), GLYBURIDE GLYBURIDE AND METFORMIN HYDROCHLORIDE, GLYBURIDE GLYBURIDE, GLYBURIDE GLYCINE 1.5% IN PLASTIC CONTAINER, GLYCINE GLYCOLAX, POLYETHYLENE GLYCOL 3350 GLYCOLAX, POLYETHYLENE GLYCOL 3350 (OTC) GLYCOPYRROLATE, GLYCOPYRROLATE GLYNASE, GLYBURIDE GLYSET, MIGLITOL GOLYTELY, POLYETHYLENE GLYCOL 3350 GONAL-F RFF PEN, FOLLITROPIN ALFA/BETA GONAL-F RFF, FOLLITROPIN ALFA/BETA GONAL-F, FOLLITROPIN ALFA/BETA GRALISE, GABAPENTIN GRANISETRON HYDROCHLORIDE PRESERVATIVE FREE, GRANISETRON HYDROCHLORIDE GRANISETRON HYDROCHLORIDE, GRANISETRON HYDROCHLORIDE GRANISTERON HYDROCHLORIDE, GRANISETRON HYDROCHLORIDE GRIFULVIN V, GRISEOFULVIN, MICROSIZE GRISEOFULVIN, GRISEOFULVIN, MICROSIZE GRISEOFULVIN,ULTRAMICROSIZE, GRISEOFULVIN, ULTRAMICROSIZE GRIS-PEG, GRISEOFULVIN, ULTRAMICROSIZE GUAIFENESIN, GUAIFENESIN (OTC) GUANABENZ ACETATE, GUANABENZ ACETATE GUANFACINE HYDROCHLORIDE, GUANFACINE HYDROCHLORIDE GUANIDINE HYDROCHLORIDE, GUANIDINE HYDROCHLORIDE GYNE-LOTRIMIN 3 COMBINATION PACK, CLOTRIMAZOLE (OTC) GYNE-LOTRIMIN 3, CLOTRIMAZOLE (OTC) GYNE-LOTRIMIN COMBINATION PACK, CLOTRIMAZOLE (OTC) GYNE-LOTRIMIN, CLOTRIMAZOLE (OTC)

**
H.P. ACTHAR GEL, CORTICOTROPIN HABITROL, NICOTINE (OTC) HALAVEN, ERIBULIN MESYLATE HALCION, TRIAZOLAM HALDOL, HALOPERIDOL DECANOATE HALDOL, HALOPERIDOL LACTATE HALFLYTELY, BISACODYL

H

**

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
H **

A - 26

HALOBETASOL PROPIONATE, HALOBETASOL PROPIONATE HALOG, HALCINONIDE HALOPERIDOL DECANOATE, HALOPERIDOL DECANOATE HALOPERIDOL, HALOPERIDOL HALOPERIDOL, HALOPERIDOL LACTATE HEATHER, NORETHINDRONE HECTOROL, DOXERCALCIFEROL HELIDAC, BISMUTH SUBSALICYLATE HEMABATE, CARBOPROST TROMETHAMINE HEPARIN SODIUM 1,000 UNITS AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM 1,000 UNITS IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM 10,000 UNITS IN DEXTROSE 5% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM 12,500 UNITS IN DEXTROSE 5% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM 12,500 UNITS IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM 2,000 UNITS AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM 2,000 UNITS IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM 20,000 UNITS IN DEXTROSE 5% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM 25,000 UNITS IN DEXTROSE 5% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM 25,000 UNITS IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM PRESERVATIVE FREE, HEPARIN SODIUM HEPARIN SODIUM, HEPARIN SODIUM HEPATAMINE 8%, AMINO ACIDS HEPATASOL 8%, AMINO ACIDS HEPATOLITE, TECHNETIUM TC-99M DISOFENIN KIT HEPSERA, ADEFOVIR DIPIVOXIL HERPLEX, IDOXURIDINE HEXABRIX, IOXAGLATE MEGLUMINE HEXALEN, ALTRETAMINE HIBICLENS, CHLORHEXIDINE GLUCONATE (OTC) HIBISTAT, CHLORHEXIDINE GLUCONATE (OTC) HICON, SODIUM IODIDE I-131 HIPREX, METHENAMINE HIPPURATE HOMATROPINE METHYLBROMIDE AND HYDROCODONE BITARTRATE, HOMATROPINE METHYLBROMIDE HORIZANT, GABAPENTIN ENACARBIL HUMALOG KWIKPEN, INSULIN LISPRO RECOMBINANT HUMALOG MIX 50/50 KWIKPEN, INSULIN LISPRO PROTAMINE RECOMBINANT HUMALOG MIX 50/50, INSULIN LISPRO PROTAMINE RECOMBINANT HUMALOG MIX 75/25 KWIKPEN, INSULIN LISPRO PROTAMINE RECOMBINANT HUMALOG MIX 75/25, INSULIN LISPRO PROTAMINE RECOMBINANT HUMALOG, INSULIN LISPRO RECOMBINANT HUMATROPE, SOMATROPIN RECOMBINANT HUMULIN 70/30 PEN, INSULIN RECOMBINANT HUMAN (OTC) HUMULIN 70/30, INSULIN RECOMBINANT HUMAN (OTC) HUMULIN N, INSULIN SUSP ISOPHANE RECOMBINANT HUMAN (OTC) HUMULIN R PEN, INSULIN RECOMBINANT HUMAN (OTC) HUMULIN R, INSULIN RECOMBINANT HUMAN HUMULIN R, INSULIN RECOMBINANT HUMAN (OTC) HYCAMTIN, TOPOTECAN HYDROCHLORIDE HYDERGINE, ERGOLOID MESYLATES HYDRALAZINE HYDROCHLORIDE, HYDRALAZINE HYDROCHLORIDE HYDRA-ZIDE, HYDRALAZINE HYDROCHLORIDE HYDREA, HYDROXYUREA HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE HYDROCODONE BITARTRATE AND ACETAMINOPHEN, ACETAMINOPHEN HYDROCODONE BITARTRATE AND HOMATROPINE METHYLBROMIDE, HOMATROPINE METHYLBROMIDE HYDROCODONE BITARTRATE AND IBUPROFEN, HYDROCODONE BITARTRATE HYDROCODONE POLISTIREX AND CHLORPHENIRAMINE POLISTIREX, CHLORPHENIRAMINE POLISTIREX HYDROCODONE POLISTIREX AND CHLORPHENIRAMNE POLISTIREX, CHLORPHENIRAMINE POLISTIREX HYDROCORTISONE ACETATE, HYDROCORTISONE ACETATE HYDROCORTISONE AND ACETIC ACID, ACETIC ACID, GLACIAL HYDROCORTISONE BUTYRATE, HYDROCORTISONE BUTYRATE HYDROCORTISONE IN ABSORBASE, HYDROCORTISONE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
H **

A - 27

HYDROCORTISONE VALERATE, HYDROCORTISONE VALERATE HYDROCORTISONE, HYDROCORTISONE HYDROMORPHONE HYDROCHLORIDE, HYDROMORPHONE HYDROCHLORIDE HYDRO-RX, HYDROCORTISONE HYDROXOCOBALAMIN, HYDROXOCOBALAMIN HYDROXYCHLOROQUINE SULFATE, HYDROXYCHLOROQUINE SULFATE HYDROXYUREA, HYDROXYUREA HYDROXYZINE HYDROCHLORIDE, HYDROXYZINE HYDROCHLORIDE HYDROXYZINE PAMOATE, HYDROXYZINE PAMOATE HYLENEX RECOMBINANT, HYALURONIDASE RECOMBINANT HUMAN HYTRIN, TERAZOSIN HYDROCHLORIDE HYZAAR, HYDROCHLOROTHIAZIDE

**

I

**

IBANDRONATE SODIUM, IBANDRONATE SODIUM IBUPROFEN AND DIPHENHYDRAMINE CITRATE, DIPHENHYDRAMINE CITRATE (OTC) IBUPROFEN AND DIPHENHYDRAMINE HYDROCHLORIDE, DIPHENHYDRAMINE HYDROCHLORIDE IBUPROFEN AND PSEUDOEPHEDRINE HYDROCHLORIDE, IBUPROFEN (OTC) IBUPROFEN, IBUPROFEN IBUPROFEN, IBUPROFEN (OTC) IBUPROHM COLD AND SINUS, IBUPROFEN (OTC) IBUPROHM, IBUPROFEN (OTC) IBU-TAB 200, IBUPROFEN (OTC) IBU-TAB, IBUPROFEN IBUTILIDE FUMARATE, IBUTILIDE FUMARATE IC-GREEN, INDOCYANINE GREEN ICLUSIG, PONATINIB HYDROCHLORIDE IDAMYCIN PFS, IDARUBICIN HYDROCHLORIDE IDARUBICIN HYDROCHLORIDE PFS, IDARUBICIN HYDROCHLORIDE IDARUBICIN HYDROCHLORIDE, IDARUBICIN HYDROCHLORIDE IDKIT:HP, UREA C-13 IFEX, IFOSFAMIDE IFOSFAMIDE, IFOSFAMIDE IFOSFAMIDE/MESNA KIT, IFOSFAMIDE IMIPENEM AND CILASTATIN, CILASTATIN SODIUM IMIPRAMINE HYDROCHLORIDE, IMIPRAMINE HYDROCHLORIDE IMIPRAMINE PAMOATE, IMIPRAMINE PAMOATE IMIQUIMOD, IMIQUIMOD IMITREX STATDOSE, SUMATRIPTAN SUCCINATE IMITREX, SUMATRIPTAN IMITREX, SUMATRIPTAN SUCCINATE IMODIUM A-D EZ CHEWS, LOPERAMIDE HYDROCHLORIDE (OTC) IMODIUM A-D, LOPERAMIDE HYDROCHLORIDE (OTC) IMODIUM MULTI-SYMPTOM RELIEF, LOPERAMIDE HYDROCHLORIDE (OTC) IMODIUM, LOPERAMIDE HYDROCHLORIDE IMPLANON, ETONOGESTREL IMURAN, AZATHIOPRINE INAPSINE, DROPERIDOL INCIVEK, TELAPREVIR INCRELEX, MECASERMIN RECOMBINANT INDAPAMIDE, INDAPAMIDE INDERAL LA, PROPRANOLOL HYDROCHLORIDE INDERAL, PROPRANOLOL HYDROCHLORIDE INDERIDE-40/25, HYDROCHLOROTHIAZIDE INDICLOR, INDIUM IN-111 CHLORIDE INDIUM IN 111 CHLORIDE, INDIUM IN-111 CHLORIDE INDIUM IN-111 OXYQUINOLINE, INDIUM IN-111 OXYQUINOLINE INDOCIN, INDOMETHACIN INDOCIN, INDOMETHACIN SODIUM INDOCYANINE GREEN, INDOCYANINE GREEN INDOMETHACIN SODIUM, INDOMETHACIN SODIUM INDOMETHACIN, INDOMETHACIN INFANTS' FEVERALL, ACETAMINOPHEN (OTC)

(OTC)

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
I **

A - 28

INFASURF PRESERVATIVE FREE, CALFACTANT INFED, IRON DEXTRAN INFUMORPH, MORPHINE SULFATE INFUVITE ADULT, ALPHA-TOCOPHEROL ACETATE INFUVITE PEDIATRIC (PHARMACY BULK PACKAGE), ASCORBIC ACID INFUVITE PEDIATRIC, ASCORBIC ACID INLYTA, AXITINIB INNOPRAN XL, PROPRANOLOL HYDROCHLORIDE INOMAX, NITRIC OXIDE INSPRA, EPLERENONE INTEGRILIN, EPTIFIBATIDE INTELENCE, ETRAVIRINE INTERMEZZO, ZOLPIDEM TARTRATE INTRALIPID 10%, SOYBEAN OIL INTRALIPID 20%, SOYBEAN OIL INTRALIPID 30%, SOYBEAN OIL INTROVALE, ETHINYL ESTRADIOL INTUNIV, GUANFACINE HYDROCHLORIDE INVANZ, ERTAPENEM SODIUM INVEGA SUSTENNA, PALIPERIDONE PALMITATE INVEGA, PALIPERIDONE INVIRASE, SAQUINAVIR MESYLATE INVOKANA, CANAGLIFLOZIN IONOSOL B AND DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE IONOSOL MB AND DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE IOPAMIDOL-250, IOPAMIDOL IOPAMIDOL-300, IOPAMIDOL IOPAMIDOL-370, IOPAMIDOL IOPIDINE, APRACLONIDINE HYDROCHLORIDE IOSAT, POTASSIUM IODIDE (OTC) IPRATROPIUM BROMIDE, IPRATROPIUM BROMIDE IPRIVASK, DESIRUDIN RECOMBINANT IQUIX, LEVOFLOXACIN IRBESARTAN AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE IRBESARTAN, IRBESARTAN IRINOTECAN HYDROCHLORIDE, IRINOTECAN HYDROCHLORIDE ISENTRESS, RALTEGRAVIR POTASSIUM ISOCAINE HYDROCHLORIDE, MEPIVACAINE HYDROCHLORIDE ISOFLURANE, ISOFLURANE ISOLYTE E IN PLASTIC CONTAINER, CALCIUM CHLORIDE ISOLYTE H IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE ISOLYTE M IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE ISOLYTE P IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE ISOLYTE R IN DEXTROSE 5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE ISOLYTE S IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE ISOLYTE S IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE ISOLYTE S PH 7.4 IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE ISONIAZID, ISONIAZID ISOPTO CARPINE, PILOCARPINE HYDROCHLORIDE ISORDIL, ISOSORBIDE DINITRATE ISOSORBIDE DINITRATE, ISOSORBIDE DINITRATE ISOSORBIDE MONONITRATE, ISOSORBIDE MONONITRATE ISOSULFAN BLUE, ISOSULFAN BLUE ISOTONIC GENTAMICIN SULFATE IN PLASTIC CONTAINER, GENTAMICIN SULFATE ISOVUE-200, IOPAMIDOL ISOVUE-250, IOPAMIDOL ISOVUE-300, IOPAMIDOL ISOVUE-370, IOPAMIDOL ISOVUE-M 200, IOPAMIDOL ISOVUE-M 300, IOPAMIDOL ISRADIPINE, ISRADIPINE ISTALOL, TIMOLOL MALEATE ISTODAX, ROMIDEPSIN

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A
ISUPREL, ISOPROTERENOL HYDROCHLORIDE ITRACONAZOLE, ITRACONAZOLE IVY BLOCK, BENTOQUATAM (OTC) IXEMPRA KIT, IXABEPILONE

**

PRODUCT NAME INDEX
I **

A - 29

**
JAKAFI, RUXOLITINIB PHOSPHATE JALYN, DUTASTERIDE JANTOVEN, WARFARIN SODIUM JANUMET XR, METFORMIN HYDROCHLORIDE JANUMET, METFORMIN HYDROCHLORIDE JANUVIA, SITAGLIPTIN PHOSPHATE JEANATOPE, ALBUMIN IODINATED I-125 SERUM JENCYCLA, NORETHINDRONE JENTADUETO, LINAGLIPTIN JEVTANA KIT, CABAZITAXEL JUNEL 1.5/30, ETHINYL ESTRADIOL JUNEL 1/20, ETHINYL ESTRADIOL JUNEL FE 1.5/30, ETHINYL ESTRADIOL JUNEL FE 1/20, ETHINYL ESTRADIOL JUNIOR STRENGTH ADVIL, IBUPROFEN (OTC) JUNIOR STRENGTH IBUPROFEN, IBUPROFEN (OTC) JUNIOR STRENGTH MOTRIN, IBUPROFEN (OTC) JUVISYNC, SIMVASTATIN JUXTAPID, LOMITAPIDE MESYLATE

J

**

**
KADIAN, MORPHINE SULFATE KALETRA, LOPINAVIR KALEXATE, SODIUM POLYSTYRENE SULFONATE KALYDECO, IVACAFTOR KANAMYCIN SULFATE, KANAMYCIN SULFATE KAPVAY, CLONIDINE HYDROCHLORIDE KARBINAL ER, CARBINOXAMINE MALEATE KARIVA, DESOGESTREL KAYEXALATE, SODIUM POLYSTYRENE SULFONATE KAZANO, ALOGLIPTIN BENZOATE KEFLEX, CEPHALEXIN KEFZOL, CEFAZOLIN SODIUM KELNOR, ETHINYL ESTRADIOL KENALOG, TRIAMCINOLONE ACETONIDE KENALOG-10, TRIAMCINOLONE ACETONIDE KENALOG-40, TRIAMCINOLONE ACETONIDE KEPPRA XR, LEVETIRACETAM KEPPRA, LEVETIRACETAM KETALAR, KETAMINE HYDROCHLORIDE KETAMINE HYDROCHLORIDE, KETAMINE HYDROCHLORIDE KETEK, TELITHROMYCIN KETOCONAZOLE, KETOCONAZOLE KETOPROFEN, KETOPROFEN KETOROLAC TROMETHAMINE, KETOROLAC TROMETHAMINE KETOTIFEN FUMARATE, KETOTIFEN FUMARATE (OTC) KETOZOLE, KETOCONAZOLE KINEVAC, SINCALIDE KIONEX, SODIUM POLYSTYRENE SULFONATE KLARON, SULFACETAMIDE SODIUM KLONOPIN, CLONAZEPAM KLOR-CON M10, POTASSIUM CHLORIDE KLOR-CON M15, POTASSIUM CHLORIDE KLOR-CON M20, POTASSIUM CHLORIDE KLOR-CON, POTASSIUM CHLORIDE KOMBIGLYZE XR, METFORMIN HYDROCHLORIDE KORLYM, MIFEPRISTONE

K

**

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A
K-TAB, POTASSIUM CHLORIDE KURVELO, ETHINYL ESTRADIOL KUVAN, SAPROPTERIN DIHYDROCHLORIDE KYNAMRO, MIPOMERSEN SODIUM KYPROLIS, CARFILZOMIB

**

PRODUCT NAME INDEX
K **

A - 30

**

L

**

LABETALOL HYDROCHLORIDE, LABETALOL HYDROCHLORIDE LABETALOL HYDROCLORIDE, LABETALOL HYDROCHLORIDE LAC-HYDRIN, AMMONIUM LACTATE LACRISERT, HYDROXYPROPYL CELLULOSE LACTATED RINGER'S AND DEXTROSE 5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE LACTULOSE, LACTULOSE LAMICTAL CD, LAMOTRIGINE LAMICTAL ODT, LAMOTRIGINE LAMICTAL XR, LAMOTRIGINE LAMICTAL, LAMOTRIGINE LAMISIL AT, TERBINAFINE (OTC) LAMISIL AT, TERBINAFINE HYDROCHLORIDE (OTC) LAMISIL, TERBINAFINE HYDROCHLORIDE LAMISIL, TERBINAFINE HYDROCHLORIDE (OTC) LAMIVUDINE AND ZIDOVUDINE, LAMIVUDINE LAMIVUDINE, LAMIVUDINE LAMOTRIGINE, LAMOTRIGINE LAMPRENE, CLOFAZIMINE LANORINAL, ASPIRIN LANOXIN PEDIATRIC, DIGOXIN LANOXIN, DIGOXIN LANSOPRAZOLE, LANSOPRAZOLE LANSOPRAZOLE, LANSOPRAZOLE (OTC) LANTUS, INSULIN GLARGINE RECOMBINANT LAROTID, AMOXICILLIN LARYNG-O-JET KIT, LIDOCAINE HYDROCHLORIDE LASIX, FUROSEMIDE LASTACAFT, ALCAFTADINE LATANOPROST, LATANOPROST LATISSE, BIMATOPROST LATUDA, LURASIDONE HYDROCHLORIDE LAX-LYTE WITH FLAVOR PACKS, POLYETHYLENE GLYCOL 3350 LAZANDA, FENTANYL CITRATE LEFLUNOMIDE, LEFLUNOMIDE LESCOL XL, FLUVASTATIN SODIUM LESCOL, FLUVASTATIN SODIUM LESSINA-28, ETHINYL ESTRADIOL LETAIRIS, AMBRISENTAN LETROZOLE, LETROZOLE LEUCOVORIN CALCIUM PRESERVATIVE FREE, LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM, LEUCOVORIN CALCIUM LEUKERAN, CHLORAMBUCIL LEUPROLIDE ACETATE, LEUPROLIDE ACETATE LEUSTATIN, CLADRIBINE LEVALBUTEROL HYDROCHLORIDE, LEVALBUTEROL HYDROCHLORIDE LEVAQUIN IN DEXTROSE 5% IN PLASTIC CONTAINER, LEVOFLOXACIN LEVAQUIN, LEVOFLOXACIN LEVATOL, PENBUTOLOL SULFATE LEVEMIR FLEXPEN, INSULIN DETEMIR RECOMBINANT LEVEMIR, INSULIN DETEMIR RECOMBINANT LEVETIRACETAM IN SODIUM CHLORIDE, LEVETIRACETAM LEVETIRACETAM, LEVETIRACETAM LEVITRA, VARDENAFIL HYDROCHLORIDE LEVOBUNOLOL HYDROCHLORIDE, LEVOBUNOLOL HYDROCHLORIDE LEVOCARNITINE, LEVOCARNITINE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
L **

A - 31

LEVOCETIRIZINE DIHYDROCHLORIDE, LEVOCETIRIZINE DIHYDROCHLORIDE LEVOFLOXACIN IN DEXTROSE 5% IN PLASTIC CONTAINER, LEVOFLOXACIN LEVOFLOXACIN, LEVOFLOXACIN LEVONEST, ETHINYL ESTRADIOL LEVONORGESTREL AND ETHINYL ESTRADIOL AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL LEVONORGESTREL AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL LEVONORGESTREL, LEVONORGESTREL LEVONORGESTREL, LEVONORGESTREL (OTC) LEVOPHED, NOREPINEPHRINE BITARTRATE LEVORA 0.15/30-28, ETHINYL ESTRADIOL LEVORPHANOL TARTRATE, LEVORPHANOL TARTRATE LEVO-T, LEVOTHYROXINE SODIUM LEVOTHROID, LEVOTHYROXINE SODIUM LEVOTHYROXINE SODIUM, LEVOTHYROXINE SODIUM LEVOXYL, LEVOTHYROXINE SODIUM LEVULAN, AMINOLEVULINIC ACID HYDROCHLORIDE LEXAPRO, ESCITALOPRAM OXALATE LEXISCAN, REGADENOSON LEXIVA, FOSAMPRENAVIR CALCIUM LIALDA, MESALAMINE LIBRIUM, CHLORDIAZEPOXIDE HYDROCHLORIDE LIDOCAINE AND PRILOCAINE, LIDOCAINE LIDOCAINE HYDROCHLORIDE 0.2% AND DEXTROSE 5% IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE 0.4% AND DEXTROSE 5% IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE 0.4% IN DEXTROSE 5% IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE 0.8% AND DEXTROSE 5% IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE 0.8% IN DEXTROSE 5% IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE 5% AND DEXTROSE 7.5%, LIDOCAINE HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE, EPINEPHRINE LIDOCAINE HYDROCHLORIDE IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE PRESERVATIVE FREE IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE PRESERVATIVE FREE, LIDOCAINE HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE VISCOUS, LIDOCAINE HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE, LIDOCAINE HYDROCHLORIDE LIDOCAINE VISCOUS, LIDOCAINE HYDROCHLORIDE LIDOCAINE, LIDOCAINE LIDODERM, LIDOCAINE LIDOPEN, LIDOCAINE HYDROCHLORIDE LIGNOSPAN FORTE, EPINEPHRINE BITARTRATE LIGNOSPAN STANDARD, EPINEPHRINE BITARTRATE LINCOCIN, LINCOMYCIN HYDROCHLORIDE LINDANE, LINDANE LINEZOLID, LINEZOLID LINZESS, LINACLOTIDE LIORESAL, BACLOFEN LIOTHYRONINE SODIUM, LIOTHYRONINE SODIUM LIPITOR, ATORVASTATIN CALCIUM LIPOFEN, FENOFIBRATE LIPOSYN II 10%, SAFFLOWER OIL LIPOSYN II 20%, SAFFLOWER OIL LIPOSYN III 10%, SOYBEAN OIL LIPOSYN III 20%, SOYBEAN OIL LIPOSYN III 30%, SOYBEAN OIL LIPTRUZET, ATORVASTATIN CALCIUM LISINOPRIL AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE LISINOPRIL, LISINOPRIL LITHIUM CARBONATE, LITHIUM CARBONATE LITHIUM CITRATE, LITHIUM CITRATE LITHOBID, LITHIUM CARBONATE LITHOSTAT, ACETOHYDROXAMIC ACID LIVALO, PITAVASTATIN CALCIUM LO LOESTRIN FE, ETHINYL ESTRADIOL LO/OVRAL-28, ETHINYL ESTRADIOL

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
L **

A - 32

LOCOID LIPOCREAM, HYDROCORTISONE BUTYRATE LOCOID, HYDROCORTISONE BUTYRATE LODOSYN, CARBIDOPA LOESTRIN 21 1.5/30, ETHINYL ESTRADIOL LOESTRIN 21 1/20, ETHINYL ESTRADIOL LOESTRIN 24 FE, ETHINYL ESTRADIOL LOESTRIN FE 1.5/30, ETHINYL ESTRADIOL LOESTRIN FE 1/20, ETHINYL ESTRADIOL LOMOTIL, ATROPINE SULFATE LONOX, ATROPINE SULFATE LOPERAMIDE HYDROCHLORIDE AND SIMETHICONE, LOPERAMIDE HYDROCHLORIDE LOPERAMIDE HYDROCHLORIDE, LOPERAMIDE HYDROCHLORIDE LOPERAMIDE HYDROCHLORIDE, LOPERAMIDE HYDROCHLORIDE (OTC) LOPID, GEMFIBROZIL LOPRESSOR HCT, HYDROCHLOROTHIAZIDE LOPRESSOR, METOPROLOL TARTRATE LOPROX, CICLOPIROX LOPURIN, ALLOPURINOL LORATADINE AND PSEUDOEPHEDRINE SULFATE, LORATADINE (OTC) LORATADINE REDIDOSE, LORATADINE (OTC) LORATADINE, LORATADINE (OTC) LORAZEPAM INTENSOL, LORAZEPAM LORAZEPAM PRESERVATIVE FREE, LORAZEPAM LORAZEPAM, LORAZEPAM LORTAB, ACETAMINOPHEN LORYNA, DROSPIRENONE LOSARTAN POTASSIUM AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE LOSARTAN POTASSIUM, LOSARTAN POTASSIUM LOSEASONIQUE, ETHINYL ESTRADIOL LOTEMAX, LOTEPREDNOL ETABONATE LOTENSIN HCT, BENAZEPRIL HYDROCHLORIDE LOTENSIN, BENAZEPRIL HYDROCHLORIDE LOTREL, AMLODIPINE BESYLATE LOTRIMIN ULTRA, BUTENAFINE HYDROCHLORIDE (OTC) LOTRISONE, BETAMETHASONE DIPROPIONATE LOTRONEX, ALOSETRON HYDROCHLORIDE LOVASTATIN, LOVASTATIN LOVAZA, OMEGA-3-ACID ETHYL ESTERS LOVENOX (PRESERVATIVE FREE), ENOXAPARIN SODIUM LOVENOX, ENOXAPARIN SODIUM LOW-OGESTREL-21, ETHINYL ESTRADIOL LOW-OGESTREL-28, ETHINYL ESTRADIOL LOXAPINE SUCCINATE, LOXAPINE SUCCINATE LTA II KIT, LIDOCAINE HYDROCHLORIDE LUFYLLIN, DYPHYLLINE LUMIGAN, BIMATOPROST LUNESTA, ESZOPICLONE LUPANETA PACK, LEUPROLIDE ACETATE LUPRON DEPOT, LEUPROLIDE ACETATE LUPRON DEPOT-PED, LEUPROLIDE ACETATE LUVOX CR, FLUVOXAMINE MALEATE LUVOX, FLUVOXAMINE MALEATE LUXIQ, BETAMETHASONE VALERATE LYMPHAZURIN, ISOSULFAN BLUE LYMPHOSEEK KIT, TECHNETIUM TC-99M TILMANOCEPT LYRICA, PREGABALIN LYSODREN, MITOTANE LYSTEDA, TRANEXAMIC ACID

(OTC)

**

M

**

M.V.I. ADULT (PHARMACY BULK PACKAGE), ASCORBIC ACID M.V.I. ADULT, ASCORBIC ACID M.V.I. PEDIATRIC, ASCORBIC ACID

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
M **

A - 33

M.V.I.-12 (WITHOUT VITAMIN K), ASCORBIC ACID MACROBID, NITROFURANTOIN MACRODANTIN, NITROFURANTOIN, MACROCRYSTALLINE MACUGEN, PEGAPTANIB SODIUM MAFENIDE ACETATE, MAFENIDE ACETATE MAGNESIUM SULFATE IN DEXTROSE 5% IN PLASTIC CONTAINER, MAGNESIUM SULFATE MAGNESIUM SULFATE IN PLASTIC CONTAINER, MAGNESIUM SULFATE MAGNESIUM SULFATE, MAGNESIUM SULFATE MAGNEVIST, GADOPENTETATE DIMEGLUMINE MAKENA, HYDROXYPROGESTERONE CAPROATE MALARONE PEDIATRIC, ATOVAQUONE MALARONE, ATOVAQUONE MALATHION, MALATHION MANGANESE CHLORIDE IN PLASTIC CONTAINER, MANGANESE CHLORIDE MANNITOL 10% IN PLASTIC CONTAINER, MANNITOL MANNITOL 10% W/ DEXTROSE 5% IN DISTILLED WATER, MANNITOL MANNITOL 10%, MANNITOL MANNITOL 15% IN PLASTIC CONTAINER, MANNITOL MANNITOL 15% W/ DEXTROSE 5% IN SODIUM CHLORIDE 0.45%, MANNITOL MANNITOL 15%, MANNITOL MANNITOL 20% IN PLASTIC CONTAINER, MANNITOL MANNITOL 20%, MANNITOL MANNITOL 25%, MANNITOL MANNITOL 5% IN PLASTIC CONTAINER, MANNITOL MANNITOL 5% W/ DEXTROSE 5% IN SODIUM CHLORIDE 0.12%, MANNITOL MANNITOL 5%, MANNITOL MAPROTILINE HYDROCHLORIDE, MAPROTILINE HYDROCHLORIDE MARCAINE HYDROCHLORIDE PRESERVATIVE FREE, BUPIVACAINE HYDROCHLORIDE MARCAINE HYDROCHLORIDE W/ EPINEPHRINE PRESERVATIVE FREE, BUPIVACAINE HYDROCHLORIDE MARCAINE HYDROCHLORIDE W/ EPINEPHRINE, BUPIVACAINE HYDROCHLORIDE MARCAINE HYDROCHLORIDE, BUPIVACAINE HYDROCHLORIDE MARCAINE, BUPIVACAINE HYDROCHLORIDE MARINOL, DRONABINOL MARLISSA, ETHINYL ESTRADIOL MARPLAN, ISOCARBOXAZID MARQIBO KIT, VINCRISTINE SULFATE MATULANE, PROCARBAZINE HYDROCHLORIDE MAVIK, TRANDOLAPRIL MAXAIR, PIRBUTEROL ACETATE MAXALT, RIZATRIPTAN BENZOATE MAXALT-MLT, RIZATRIPTAN BENZOATE MAXIDEX, DEXAMETHASONE MAXIPIME, CEFEPIME HYDROCHLORIDE MAXITROL, DEXAMETHASONE MAXZIDE, HYDROCHLOROTHIAZIDE MAXZIDE-25, HYDROCHLOROTHIAZIDE MD-76R, DIATRIZOATE MEGLUMINE MD-GASTROVIEW, DIATRIZOATE MEGLUMINE MDP-BRACCO, TECHNETIUM TC-99M MEDRONATE KIT MEBENDAZOLE, MEBENDAZOLE MECAMYLAMINE HYDROCHLORIDE, MECAMYLAMINE HYDROCHLORIDE MECLIZINE HYDROCHLORIDE, MECLIZINE HYDROCHLORIDE MECLOFENAMATE SODIUM, MECLOFENAMATE SODIUM MEDROL, METHYLPREDNISOLONE MEDROXYPROGESTERONE ACETATE, MEDROXYPROGESTERONE ACETATE MEFENAMIC ACID, MEFENAMIC ACID MEFLOQUINE HYDROCHLORIDE, MEFLOQUINE HYDROCHLORIDE MEFOXIN IN PLASTIC CONTAINER, CEFOXITIN SODIUM MEGACE ES, MEGESTROL ACETATE MEGACE, MEGESTROL ACETATE MEGATOPE, ALBUMIN IODINATED I-131 SERUM MEGESTROL ACETATE, MEGESTROL ACETATE MEKINIST, TRAMETINIB DIMETHYL SULFOXIDE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
M **

A - 34

MELOXICAM, MELOXICAM MELPHALAN HYDROCHLORIDE, MELPHALAN HYDROCHLORIDE MEMBRANEBLUE, TRYPAN BLUE MENEST, ESTROGENS, ESTERIFIED MENOPUR, LUTEINIZING HORMONE MENOSTAR, ESTRADIOL MEN'S ROGAINE, MINOXIDIL (OTC) MENTAX, BUTENAFINE HYDROCHLORIDE MENTAX-TC, BUTENAFINE HYDROCHLORIDE MEPERIDINE HYDROCHLORIDE PRESERVATIVE FREE, MEPERIDINE HYDROCHLORIDE MEPERIDINE HYDROCHLORIDE, MEPERIDINE HYDROCHLORIDE MEPHYTON, PHYTONADIONE MEPIVACAINE HYDROCHLORIDE, MEPIVACAINE HYDROCHLORIDE MEPROBAMATE, MEPROBAMATE MEPRON, ATOVAQUONE MERCAPTOPURINE, MERCAPTOPURINE MEROPENEM, MEROPENEM MERREM, MEROPENEM MESALAMINE, MESALAMINE MESNA, MESNA MESNEX, MESNA MESTINON, PYRIDOSTIGMINE BROMIDE METADATE CD, METHYLPHENIDATE HYDROCHLORIDE METADATE ER, METHYLPHENIDATE HYDROCHLORIDE METAPROTERENOL SULFATE, METAPROTERENOL SULFATE METARAMINOL BITARTRATE, METARAMINOL BITARTRATE METASTRON, STRONTIUM CHLORIDE SR-89 METAXALONE, METAXALONE METFORMIN HYDROCHLORIDE, METFORMIN HYDROCHLORIDE METHADONE HYDROCHLORIDE INTENSOL, METHADONE HYDROCHLORIDE METHADONE HYDROCHLORIDE, METHADONE HYDROCHLORIDE METHADOSE, METHADONE HYDROCHLORIDE METHAMPHETAMINE HYDROCHLORIDE, METHAMPHETAMINE HYDROCHLORIDE METHAZOLAMIDE, METHAZOLAMIDE METHENAMINE HIPPURATE, METHENAMINE HIPPURATE METHERGINE, METHYLERGONOVINE MALEATE METHIMAZOLE, METHIMAZOLE METHOCARBAMOL AND ASPIRIN, ASPIRIN METHOCARBAMOL, METHOCARBAMOL METHOTREXATE PRESERVATIVE FREE, METHOTREXATE SODIUM METHOTREXATE SODIUM PRESERVATIVE FREE, METHOTREXATE SODIUM METHOTREXATE SODIUM, METHOTREXATE SODIUM METHSCOPOLAMINE BROMIDE, METHSCOPOLAMINE BROMIDE METHYCLOTHIAZIDE, METHYCLOTHIAZIDE METHYLDOPA AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE METHYLDOPA, METHYLDOPA METHYLDOPATE HYDROCHLORIDE, METHYLDOPATE HYDROCHLORIDE METHYLERGONOVINE MALEATE, METHYLERGONOVINE MALEATE METHYLIN ER, METHYLPHENIDATE HYDROCHLORIDE METHYLIN, METHYLPHENIDATE HYDROCHLORIDE METHYLPHENIDATE HYDROCHLORIDE, METHYLPHENIDATE HYDROCHLORIDE METHYLPREDNISOLONE ACETATE, METHYLPREDNISOLONE ACETATE METHYLPREDNISOLONE SODIUM SUCCINATE, METHYLPREDNISOLONE SODIUM SUCCINATE METHYLPREDNISOLONE, METHYLPREDNISOLONE METHYLTESTOSTERONE, METHYLTESTOSTERONE METIPRANOLOL, METIPRANOLOL HYDROCHLORIDE METOCLOPRAMIDE HYDROCHLORIDE, METOCLOPRAMIDE HYDROCHLORIDE METOLAZONE, METOLAZONE METOPIRONE, METYRAPONE METOPROLOL SUCCINATE, METOPROLOL SUCCINATE METOPROLOL TARTRATE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE METOPROLOL TARTRATE, METOPROLOL TARTRATE METOZOLV ODT, METOCLOPRAMIDE HYDROCHLORIDE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
M **

A - 35

METRO I.V. IN PLASTIC CONTAINER, METRONIDAZOLE METROCREAM, METRONIDAZOLE METROGEL, METRONIDAZOLE METROGEL-VAGINAL, METRONIDAZOLE METROLOTION, METRONIDAZOLE METRONIDAZOLE IN PLASTIC CONTAINER, METRONIDAZOLE METRONIDAZOLE, METRONIDAZOLE MEXILETINE HYDROCHLORIDE, MEXILETINE HYDROCHLORIDE MIACALCIN, CALCITONIN SALMON MICARDIS HCT, HYDROCHLOROTHIAZIDE MICARDIS, TELMISARTAN MICONAZOLE 3 COMBINATION PACK, MICONAZOLE NITRATE (OTC) MICONAZOLE 3, MICONAZOLE NITRATE (OTC) MICONAZOLE 7 COMBINATION PACK, MICONAZOLE NITRATE (OTC) MICONAZOLE 7, MICONAZOLE NITRATE (OTC) MICONAZOLE NITRATE COMBINATION PACK, MICONAZOLE NITRATE (OTC) MICONAZOLE NITRATE, MICONAZOLE NITRATE MICONAZOLE NITRATE, MICONAZOLE NITRATE (OTC) MICORT-HC, HYDROCORTISONE ACETATE MICROGESTIN 1.5/30, ETHINYL ESTRADIOL MICROGESTIN 1/20, ETHINYL ESTRADIOL MICROGESTIN FE 1.5/30, ETHINYL ESTRADIOL MICROGESTIN FE 1/20, ETHINYL ESTRADIOL MICRO-K 10, POTASSIUM CHLORIDE MICRO-K, POTASSIUM CHLORIDE MICRONOR, NORETHINDRONE MICROZIDE, HYDROCHLOROTHIAZIDE MIDAMOR, AMILORIDE HYDROCHLORIDE MIDAZOLAM HYDROCHLORIDE PRESERVATIVE FREE, MIDAZOLAM HYDROCHLORIDE MIDAZOLAM HYDROCHLORIDE, MIDAZOLAM HYDROCHLORIDE MIDODRINE HYDROCHLORIDE, MIDODRINE HYDROCHLORIDE MIDOL LIQUID GELS, IBUPROFEN (OTC) MIDOZALAM HYDROCHLORIDE, MIDAZOLAM HYDROCHLORIDE MIFEPREX, MIFEPRISTONE MIGERGOT, CAFFEINE MIGRANAL, DIHYDROERGOTAMINE MESYLATE MILRINONE LACTATE IN DEXTROSE 5% IN PLASTIC CONTAINER, MILRINONE LACTATE MILRINONE LACTATE IN DEXTROSE 5%, MILRINONE LACTATE MILRINONE LACTATE IN PLASTIC CONTAINER, MILRINONE LACTATE MILRINONE LACTATE, MILRINONE LACTATE MINIPRESS, PRAZOSIN HYDROCHLORIDE MINIRIN, DESMOPRESSIN ACETATE MINITRAN, NITROGLYCERIN MINIVELLE, ESTRADIOL MINOCIN, MINOCYCLINE HYDROCHLORIDE MINOCYCLINE HYDROCHLORIDE, MINOCYCLINE HYDROCHLORIDE MINOXIDIL (FOR MEN), MINOXIDIL (OTC) MINOXIDIL (FOR WOMEN), MINOXIDIL (OTC) MINOXIDIL EXTRA STRENGTH (FOR MEN), MINOXIDIL (OTC) MINOXIDIL, MINOXIDIL MINOXIDIL, MINOXIDIL (OTC) MIOCHOL-E, ACETYLCHOLINE CHLORIDE MIOSTAT, CARBACHOL MIRALAX, POLYETHYLENE GLYCOL 3350 (OTC) MIRAPEX ER, PRAMIPEXOLE DIHYDROCHLORIDE MIRAPEX, PRAMIPEXOLE DIHYDROCHLORIDE MIRCETTE, DESOGESTREL MIRENA, LEVONORGESTREL MIRTAZAPINE, MIRTAZAPINE MISOPROSTOL, MISOPROSTOL MITOMYCIN, MITOMYCIN MITOSOL, MITOMYCIN MITOXANTRONE HYDROCHLORIDE, MITOXANTRONE HYDROCHLORIDE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
M **

A - 36

MOBIC, MELOXICAM MODAFINIL, MODAFINIL MODICON 28, ETHINYL ESTRADIOL MOEXIPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE MOEXIPRIL HYDROCHLORIDE, MOEXIPRIL HYDROCHLORIDE MOMETASONE FUROATE, MOMETASONE FUROATE MONISTAT 1 COMBINATION PACK, MICONAZOLE NITRATE (OTC) MONISTAT 3 COMBINATION PACK (PREFILLED), MICONAZOLE NITRATE (OTC) MONISTAT 3 COMBINATION PACK, MICONAZOLE NITRATE (OTC) MONISTAT 3, MICONAZOLE NITRATE MONISTAT 3, MICONAZOLE NITRATE (OTC) MONISTAT 7 COMBINATION PACK, MICONAZOLE NITRATE (OTC) MONISTAT 7, MICONAZOLE NITRATE (OTC) MONISTAT-3 COMBINATION PACK, MICONAZOLE NITRATE (OTC) MONOBASIC SODIUM PHOSPHATE AND DIBASIC SODIUM PHOSPHATE, SODIUM PHOSPHATE, DIBASIC, ANHYDROUS MONODOX, DOXYCYCLINE MONOKET, ISOSORBIDE MONONITRATE MONO-LINYAH, ETHINYL ESTRADIOL MONTELUKAST SODIUM, MONTELUKAST SODIUM MONUROL, FOSFOMYCIN TROMETHAMINE MORPHINE SULFATE, MORPHINE SULFATE MOTOFEN, ATROPINE SULFATE MOTRIN IB, IBUPROFEN (OTC) MOTRIN MIGRAINE PAIN, IBUPROFEN (OTC) MOVIPREP, ASCORBIC ACID MOXATAG, AMOXICILLIN MOXEZA, MOXIFLOXACIN HYDROCHLORIDE MOZOBIL, PLERIXAFOR MPI DMSA KIDNEY REAGENT, TECHNETIUM TC-99M SUCCIMER KIT MPI INDIUM DTPA IN 111, INDIUM IN-111 PENTETATE DISODIUM MS CONTIN, MORPHINE SULFATE MUCINEX D, GUAIFENESIN (OTC) MUCINEX DM, DEXTROMETHORPHAN HYDROBROMIDE (OTC) MUCINEX, GUAIFENESIN (OTC) MULTAQ, DRONEDARONE HYDROCHLORIDE MULTIHANCE MULTIPACK, GADOBENATE DIMEGLUMINE MULTIHANCE, GADOBENATE DIMEGLUMINE MUPIROCIN, MUPIROCIN MUPIROCIN, MUPIROCIN CALCIUM MUSE, ALPROSTADIL MUSTARGEN, MECHLORETHAMINE HYDROCHLORIDE MYAMBUTOL, ETHAMBUTOL HYDROCHLORIDE MYCAMINE, MICAFUNGIN SODIUM MYCELEX, CLOTRIMAZOLE MYCELEX-7 COMBINATION PACK, CLOTRIMAZOLE (OTC) MYCELEX-7, CLOTRIMAZOLE (OTC) MYCOBUTIN, RIFABUTIN MYCOPHENOLATE MOFETIL, MYCOPHENOLATE MOFETIL MYCOPHENOLIC ACID, MYCOPHENOLIC ACID MYDRIACYL, TROPICAMIDE MYFORTIC, MYCOPHENOLIC ACID MYLERAN, BUSULFAN MYORISAN, ISOTRETINOIN MYOVIEW 30ML, TECHNETIUM TC-99M TETROFOSMIN KIT MYOVIEW, TECHNETIUM TC-99M TETROFOSMIN KIT MYRBETRIQ, MIRABEGRON MYSOLINE, PRIMIDONE MYTELASE, AMBENONIUM CHLORIDE MYZILRA, ETHINYL ESTRADIOL M-ZOLE 3 COMBINATION PACK, MICONAZOLE NITRATE (OTC)

**
NABUMETONE, NABUMETONE

N

**

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
N **

A - 37

NADOLOL AND BENDROFLUMETHAZIDE, BENDROFLUMETHIAZIDE NADOLOL AND BENDROFLUMETHIAZIDE, BENDROFLUMETHIAZIDE NADOLOL, NADOLOL NAFCILLIN SODIUM, NAFCILLIN SODIUM NAFTIN, NAFTIFINE HYDROCHLORIDE NALBUPHINE HYDROCHLORIDE, NALBUPHINE HYDROCHLORIDE NALFON, FENOPROFEN CALCIUM NALLPEN IN PLASTIC CONTAINER, NAFCILLIN SODIUM NALOXONE HYDROCHLORIDE, NALOXONE HYDROCHLORIDE NALTREXONE HYDROCHLORIDE, NALTREXONE HYDROCHLORIDE NAMENDA XR, MEMANTINE HYDROCHLORIDE NAMENDA, MEMANTINE HYDROCHLORIDE NANDROLONE DECANOATE, NANDROLONE DECANOATE NAPHAZOLINE HYDROCHLORIDE AND PHENIRAMINE MALEATE, NAPHAZOLINE HYDROCHLORIDE (OTC) NAPHAZOLINE HYDROCHLORIDE, NAPHAZOLINE HYDROCHLORIDE NAPHCON-A, NAPHAZOLINE HYDROCHLORIDE (OTC) NAPRELAN, NAPROXEN SODIUM NAPROSYN, NAPROXEN NAPROXEN SODIUM AND PSEUDOEPHEDRINE HYDROCHLORIDE, NAPROXEN SODIUM (OTC) NAPROXEN SODIUM, NAPROXEN SODIUM NAPROXEN SODIUM, NAPROXEN SODIUM (OTC) NAPROXEN, NAPROXEN NARATRIPTAN, NARATRIPTAN NARATRIPTAN, NARATRIPTAN HYDROCHLORIDE NARDIL, PHENELZINE SULFATE NAROPIN, ROPIVACAINE HYDROCHLORIDE NASACORT AQ, TRIAMCINOLONE ACETONIDE NASCOBAL, CYANOCOBALAMIN NASONEX, MOMETASONE FUROATE MONOHYDRATE NATACYN, NATAMYCIN NATAZIA, ESTRADIOL VALERATE NATEGLINIDE, NATEGLINIDE NATRECOR, NESIRITIDE RECOMBINANT NATROBA, SPINOSAD NAVANE, THIOTHIXENE NAVELBINE, VINORELBINE TARTRATE NAVSTEL, CALCIUM CHLORIDE NEBUPENT, PENTAMIDINE ISETHIONATE NEDOCROMIL SODIUM, NEDOCROMIL SODIUM NEFAZODONE HYDROCHLORIDE, NEFAZODONE HYDROCHLORIDE NEMBUTAL SODIUM, PENTOBARBITAL SODIUM NEO-FRADIN, NEOMYCIN SULFATE NEOMYCIN AND POLYMYXIN B SULFATE, NEOMYCIN SULFATE NEOMYCIN AND POLYMYXIN B SULFATES AND BACITRACIN ZINC, BACITRACIN ZINC NEOMYCIN AND POLYMYXIN B SULFATES AND DEXAMETHASONE, DEXAMETHASONE NEOMYCIN AND POLYMYXIN B SULFATES AND GRAMICIDIN, GRAMICIDIN NEOMYCIN AND POLYMYXIN B SULFATES AND HYDROCORTISONE, HYDROCORTISONE NEOMYCIN AND POLYMYXIN B SULFATES, BACITRACIN ZINC AND HYDROCORTISONE, BACITRACIN ZINC NEOMYCIN SULFATE, NEOMYCIN SULFATE NEOPAP, ACETAMINOPHEN (OTC) NEOPROFEN, IBUPROFEN LYSINE NEORAL, CYCLOSPORINE NEOSPORIN G.U. IRRIGANT, NEOMYCIN SULFATE NEOSPORIN, GRAMICIDIN NEPAFENAC, NEPAFENAC NEPHRAMINE 5.4%, AMINO ACIDS NESACAINE, CHLOROPROCAINE HYDROCHLORIDE NESACAINE-MPF, CHLOROPROCAINE HYDROCHLORIDE NESINA, ALOGLIPTIN BENZOATE NEUPRO, ROTIGOTINE NEUROLITE, TECHNETIUM TC-99M BICISATE KIT NEURONTIN, GABAPENTIN NEVANAC, NEPAFENAC

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
N **

A - 38

NEVIRAPINE, NEVIRAPINE NEXAVAR, SORAFENIB TOSYLATE NEXCEDE, KETOPROFEN (OTC) NEXIUM IV, ESOMEPRAZOLE SODIUM NEXIUM, ESOMEPRAZOLE MAGNESIUM NEXPLANON, ETONOGESTREL NEXTERONE, AMIODARONE HYDROCHLORIDE NIACIN, NIACIN NIACOR, NIACIN NIASPAN, NIACIN NICARDIPINE HYDROCHLORIDE, NICARDIPINE HYDROCHLORIDE NICODERM CQ, NICOTINE (OTC) NICORETTE (MINT), NICOTINE POLACRILEX (OTC) NICORETTE, NICOTINE POLACRILEX (OTC) NICOTINE POLACRILEX, NICOTINE POLACRILEX (OTC) NICOTINE, NICOTINE (OTC) NICOTROL, NICOTINE NIFEDIPINE, NIFEDIPINE NILANDRON, NILUTAMIDE NIMBEX PRESERVATIVE FREE, CISATRACURIUM BESYLATE NIMBEX, CISATRACURIUM BESYLATE NIMODIPINE, NIMODIPINE NIPENT, PENTOSTATIN NIRAVAM, ALPRAZOLAM NISOLDIPINE, NISOLDIPINE NITHIODOTE, SODIUM NITRITE NITRO-DUR, NITROGLYCERIN NITROFURANTOIN (MONOHYDRATE/MACROCRYSTALS), NITROFURANTOIN NITROFURANTOIN, NITROFURANTOIN NITROFURANTOIN, NITROFURANTOIN, MACROCRYSTALLINE NITROGLYCERIN IN DEXTROSE 5%, NITROGLYCERIN NITROGLYCERIN, NITROGLYCERIN NITROLINGUAL PUMPSPRAY, NITROGLYCERIN NITROMIST, NITROGLYCERIN NITROPRESS, SODIUM NITROPRUSSIDE NITROSTAT, NITROGLYCERIN NIX, PERMETHRIN (OTC) NIZATIDINE, NIZATIDINE NIZORAL A-D, KETOCONAZOLE (OTC) NIZORAL, KETOCONAZOLE NORCO, ACETAMINOPHEN NORDETTE-28, ETHINYL ESTRADIOL NORDITROPIN FLEXPRO, SOMATROPIN RECOMBINANT NORDITROPIN NORDIFLEX, SOMATROPIN RECOMBINANT NOREPINEPHRINE BITARTRATE, NOREPINEPHRINE BITARTRATE NORETHIDRONE ACETATE, NORETHINDRONE ACETATE NORETHIDRONE, NORETHINDRONE NORETHIN 1/35E-21, ETHINYL ESTRADIOL NORETHIN 1/35E-28, ETHINYL ESTRADIOL NORETHINDRONE ACETATE AND ETHINYL ESTRADIOL AND FERROUS FUMARATE, ETHINYL ESTRADIOL NORETHINDRONE ACETATE AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL NORETHINDRONE ACETATE, NORETHINDRONE ACETATE NORETHINDRONE AND ETHINYL ESTRADIOL (10/11), ETHINYL ESTRADIOL NORETHINDRONE AND ETHINYL ESTRADIOL (7/14), ETHINYL ESTRADIOL NORETHINDRONE AND ETHINYL ESTRADIOL AND FERROUS FUMARATE, ETHINYL ESTRADIOL NORETHINDRONE AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL NORETHINDRONE, NORETHINDRONE NORFLEX, ORPHENADRINE CITRATE NORGESIC FORTE, ASPIRIN NORGESIC, ASPIRIN NORGESTIMATE AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL NORINYL 1+35 21-DAY, ETHINYL ESTRADIOL NORINYL 1+35 28-DAY, ETHINYL ESTRADIOL

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
N **

A - 39

NORINYL 1+50 28-DAY, MESTRANOL NORITATE, METRONIDAZOLE NORMOCARB HF 25, MAGNESIUM CHLORIDE NORMOCARB HF 35, MAGNESIUM CHLORIDE NORMOSOL-M AND DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE NORMOSOL-R AND DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE NORMOSOL-R IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE NOROXIN, NORFLOXACIN NORPACE CR, DISOPYRAMIDE PHOSPHATE NORPACE, DISOPYRAMIDE PHOSPHATE NORPRAMIN, DESIPRAMINE HYDROCHLORIDE NOR-QD, NORETHINDRONE NORTREL 0.5/35-28, ETHINYL ESTRADIOL NORTREL 1/35-21, ETHINYL ESTRADIOL NORTREL 1/35-28, ETHINYL ESTRADIOL NORTREL 7/7/7, ETHINYL ESTRADIOL NORTRIPTYLINE HYDROCHLORIDE, NORTRIPTYLINE HYDROCHLORIDE NORVASC, AMLODIPINE BESYLATE NORVIR, RITONAVIR NOVOLIN 70/30, INSULIN RECOMBINANT HUMAN (OTC) NOVOLIN N, INSULIN SUSP ISOPHANE RECOMBINANT HUMAN (OTC) NOVOLIN R, INSULIN RECOMBINANT HUMAN (OTC) NOVOLOG FLEXPEN, INSULIN ASPART RECOMBINANT NOVOLOG MIX 70/30 FLEXPEN, INSULIN ASPART PROTAMINE RECOMBINANT NOVOLOG MIX 70/30, INSULIN ASPART PROTAMINE RECOMBINANT NOVOLOG PENFILL, INSULIN ASPART RECOMBINANT NOVOLOG, INSULIN ASPART RECOMBINANT NOXAFIL, POSACONAZOLE NUCYNTA ER, TAPENTADOL HYDROCHLORIDE NUCYNTA, TAPENTADOL HYDROCHLORIDE NUEDEXTA, DEXTROMETHORPHAN HYDROBROMIDE NULYTELY, POLYETHYLENE GLYCOL 3350 NULYTELY-FLAVORED, POLYETHYLENE GLYCOL 3350 NUTRACORT, HYDROCORTISONE NUTRESTORE, GLUTAMINE NUTRILIPID 10%, SOYBEAN OIL NUTRILIPID 20%, SOYBEAN OIL NUTROPIN AQ PEN, SOMATROPIN RECOMBINANT NUTROPIN AQ, SOMATROPIN RECOMBINANT NUTROPIN, SOMATROPIN RECOMBINANT NUVARING, ETHINYL ESTRADIOL NUVIGIL, ARMODAFINIL NYMALIZE, NIMODIPINE NYSTATIN AND TRIAMCINOLONE ACETONIDE, NYSTATIN NYSTATIN, NYSTATIN NYSTOP, NYSTATIN

**

O

**

OCTOCAINE, EPINEPHRINE OCTREOSCAN, INDIUM IN-111 PENTETREOTIDE KIT OCTREOTIDE ACETATE (PRESERVATIVE FREE), OCTREOTIDE ACETATE OCTREOTIDE ACETATE, OCTREOTIDE ACETATE OCUCLEAR, OXYMETAZOLINE HYDROCHLORIDE (OTC) OCUFEN, FLURBIPROFEN SODIUM OCUFLOX, OFLOXACIN OCUPRESS, CARTEOLOL HYDROCHLORIDE OFIRMEV, ACETAMINOPHEN OFLOXACIN, OFLOXACIN OGEN .625, ESTROPIPATE OGEN 1.25, ESTROPIPATE OGEN 2.5, ESTROPIPATE OGEN 5, ESTROPIPATE OGESTREL 0.5/50-28, ETHINYL ESTRADIOL

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
O **

A - 40

OLANZAPINE AND FLUOXETINE HYDROCHLORIDE, FLUOXETINE HYDROCHLORIDE OLANZAPINE, OLANZAPINE OLEPTRO, TRAZODONE HYDROCHLORIDE OLUX E, CLOBETASOL PROPIONATE OLUX, CLOBETASOL PROPIONATE OMEPRAZOLE AND CLARITHROMYCIN AND AMOXICILLIN, AMOXICILLIN OMEPRAZOLE AND SODIUM BICARBONATE, OMEPRAZOLE OMEPRAZOLE MAGNESIUM, OMEPRAZOLE MAGNESIUM (OTC) OMEPRAZOLE, OMEPRAZOLE OMEPRAZOLE, OMEPRAZOLE (OTC) OMNARIS, CICLESONIDE OMNIPAQUE 140, IOHEXOL OMNIPAQUE 180, IOHEXOL OMNIPAQUE 240, IOHEXOL OMNIPAQUE 300, IOHEXOL OMNIPAQUE 350, IOHEXOL OMNIPRED, PREDNISOLONE ACETATE OMNISCAN, GADODIAMIDE OMNITROPE, SOMATROPIN RECOMBINANT ONDANSETRON HYDROCHLORIDE AND DEXTROSE IN PLASTIC CONTAINER, ONDANSETRON HYDROCHLORIDE ONDANSETRON HYDROCHLORIDE PRESERVATIVE FREE, ONDANSETRON HYDROCHLORIDE ONDANSETRON HYDROCHLORIDE, ONDANSETRON HYDROCHLORIDE ONDANSETRON, ONDANSETRON ONFI, CLOBAZAM ONGLYZA, SAXAGLIPTIN HYDROCHLORIDE ONMEL, ITRACONAZOLE OPANA ER, OXYMORPHONE HYDROCHLORIDE OPANA, OXYMORPHONE HYDROCHLORIDE OPCON-A, NAPHAZOLINE HYDROCHLORIDE (OTC) OPHTHAINE, PROPARACAINE HYDROCHLORIDE OPHTHETIC, PROPARACAINE HYDROCHLORIDE OPTICROM, CROMOLYN SODIUM OPTIMARK IN PLASTIC CONTAINER, GADOVERSETAMIDE OPTIMARK, GADOVERSETAMIDE OPTIPRANOLOL, METIPRANOLOL HYDROCHLORIDE OPTIRAY 240, IOVERSOL OPTIRAY 300, IOVERSOL OPTIRAY 320, IOVERSOL OPTIRAY 350, IOVERSOL OPTISON, ALBUMIN HUMAN OPTIVAR, AZELASTINE HYDROCHLORIDE ORACEA, DOXYCYCLINE ORAP, PIMOZIDE ORAPRED ODT, PREDNISOLONE SODIUM PHOSPHATE ORAPRED, PREDNISOLONE SODIUM PHOSPHATE ORAQIX, LIDOCAINE ORAVERSE, PHENTOLAMINE MESYLATE ORAVIG, MICONAZOLE ORETIC, HYDROCHLOROTHIAZIDE ORFADIN, NITISINONE ORPHENADRINE CITRATE, ASPIRIN, AND CAFFEINE, ASPIRIN ORPHENADRINE CITRATE, ORPHENADRINE CITRATE ORSYTHIA, ETHINYL ESTRADIOL ORTHO CYCLEN-28, ETHINYL ESTRADIOL ORTHO EVRA, ETHINYL ESTRADIOL ORTHO TRI-CYCLEN LO, ETHINYL ESTRADIOL ORTHO TRI-CYCLEN, ETHINYL ESTRADIOL ORTHO-CEPT, DESOGESTREL ORTHO-NOVUM 1/35-28, ETHINYL ESTRADIOL ORTHO-NOVUM 7/7/7-28, ETHINYL ESTRADIOL ORVATEN, MIDODRINE HYDROCHLORIDE OSENI, ALOGLIPTIN BENZOATE OSMITROL 10% IN WATER IN PLASTIC CONTAINER, MANNITOL

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
O **

A - 41

OSMITROL 10% IN WATER, MANNITOL OSMITROL 15% IN WATER IN PLASTIC CONTAINER, MANNITOL OSMITROL 15% IN WATER, MANNITOL OSMITROL 20% IN WATER IN PLASTIC CONTAINER, MANNITOL OSMITROL 20% IN WATER, MANNITOL OSMITROL 5% IN WATER IN PLASTIC CONTAINER, MANNITOL OSMITROL 5% IN WATER, MANNITOL OSMOPREP, SODIUM PHOSPHATE, DIBASIC, ANHYDROUS OSPHENA, OSPEMIFENE OTICAIR, HYDROCORTISONE OVCON-35, ETHINYL ESTRADIOL OVCON-50, ETHINYL ESTRADIOL OVIDE, MALATHION OVIDREL, CHORIOGONADOTROPIN ALFA OXACILLIN SODIUM, OXACILLIN SODIUM OXALIPLATIN, OXALIPLATIN OXANDRIN, OXANDROLONE OXANDROLONE, OXANDROLONE OXAPROZIN, OXAPROZIN OXAZEPAM, OXAZEPAM OXCARBAZEPINE, OXCARBAZEPINE OXECTA, OXYCODONE HYDROCHLORIDE OXILAN-300, IOXILAN OXILAN-350, IOXILAN OXISTAT, OXICONAZOLE NITRATE OXSORALEN, METHOXSALEN OXSORALEN-ULTRA, METHOXSALEN OXTELLAR XR, OXCARBAZEPINE OXYBUTYNIN CHLORIDE, OXYBUTYNIN CHLORIDE OXYCET, ACETAMINOPHEN OXYCODONE AND ACETAMINOPHEN, ACETAMINOPHEN OXYCODONE AND ASPIRIN, ASPIRIN OXYCODONE HYDROCHLORIDE AND IBUPROFEN, IBUPROFEN OXYCODONE HYDROCHLORIDE, OXYCODONE HYDROCHLORIDE OXYCONTIN, OXYCODONE HYDROCHLORIDE OXYMORPHONE HYDROCHLORIDE, OXYMORPHONE HYDROCHLORIDE OXYTOCIN, OXYTOCIN OXYTROL FOR WOMEN, OXYBUTYNIN (OTC) OXYTROL, OXYBUTYNIN OZURDEX, DEXAMETHASONE

**

P

**

PACERONE, AMIODARONE HYDROCHLORIDE PACLITAXEL, PACLITAXEL PAMELOR, NORTRIPTYLINE HYDROCHLORIDE PAMIDRONATE DISODIUM, PAMIDRONATE DISODIUM PAMINE FORTE, METHSCOPOLAMINE BROMIDE PAMINE, METHSCOPOLAMINE BROMIDE PANCREAZE, LIPASE PANCURONIUM BROMIDE, PANCURONIUM BROMIDE PANDEL, HYDROCORTISONE PROBUTATE PANRETIN, ALITRETINOIN PANTOPRAZOLE SODIUM, PANTOPRAZOLE SODIUM PARAFON FORTE DSC, CHLORZOXAZONE PARAGARD T 380A, COPPER PARCOPA, CARBIDOPA PAREMYD, HYDROXYAMPHETAMINE HYDROBROMIDE PARICALCITOL, PARICALCITOL PARLODEL, BROMOCRIPTINE MESYLATE PARNATE, TRANYLCYPROMINE SULFATE PAROEX, CHLORHEXIDINE GLUCONATE PAROMOMYCIN SULFATE, PAROMOMYCIN SULFATE PAROXETINE HYDROCHLORIDE, PAROXETINE HYDROCHLORIDE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
P **

A - 42

PASER, AMINOSALICYLIC ACID PATADAY, OLOPATADINE HYDROCHLORIDE PATANASE, OLOPATADINE HYDROCHLORIDE PATANOL, OLOPATADINE HYDROCHLORIDE PAXIL CR, PAROXETINE HYDROCHLORIDE PAXIL, PAROXETINE HYDROCHLORIDE PCE, ERYTHROMYCIN PEDIAMYCIN 400, ERYTHROMYCIN ETHYLSUCCINATE PEDIAMYCIN, ERYTHROMYCIN ETHYLSUCCINATE PEDIAPRED, PREDNISOLONE SODIUM PHOSPHATE PEDIATRIC ADVIL, IBUPROFEN (OTC) PEDIOTIC, HYDROCORTISONE PEG 3350 AND ELECTROLYTES, POLYETHYLENE GLYCOL 3350 PEG-3350;POTASSIUM CHLORIDE;SODIUM BICARBONATE;SODIUM CHLORIDE, POLYETHYLENE GLYCOL 3350 PEGANONE, ETHOTOIN PENICILLIN G POTASSIUM IN PLASTIC CONTAINER, PENICILLIN G POTASSIUM PENICILLIN G POTASSIUM, PENICILLIN G POTASSIUM PENICILLIN G PROCAINE, PENICILLIN G PROCAINE PENICILLIN G SODIUM, PENICILLIN G SODIUM PENICILLIN V POTASSIUM, PENICILLIN V POTASSIUM PENICILLIN-VK, PENICILLIN V POTASSIUM PENLAC, CICLOPIROX PENNSAID, DICLOFENAC SODIUM PENTAM, PENTAMIDINE ISETHIONATE PENTAMIDINE ISETHIONATE, PENTAMIDINE ISETHIONATE PENTASA, MESALAMINE PENTAZOCINE AND NALOXONE HYDROCHLORIDE, NALOXONE HYDROCHLORIDE PENTAZOCINE AND NALOXONE HYDROCHLORIDES, NALOXONE HYDROCHLORIDE PENTOLAIR, CYCLOPENTOLATE HYDROCHLORIDE PENTOSTATIN, PENTOSTATIN PENTOXIFYLLINE, PENTOXIFYLLINE PENTOXIL, PENTOXIFYLLINE PEPCID AC (GELTAB), FAMOTIDINE (OTC) PEPCID AC, FAMOTIDINE (OTC) PEPCID COMPLETE, CALCIUM CARBONATE (OTC) PEPCID, FAMOTIDINE PERCOCET, ACETAMINOPHEN PERCODAN, ASPIRIN PERFOROMIST, FORMOTEROL FUMARATE PERIDEX, CHLORHEXIDINE GLUCONATE PERINDOPRIL ERBUMINE, PERINDOPRIL ERBUMINE PERIOCHIP, CHLORHEXIDINE GLUCONATE PERIOGARD, CHLORHEXIDINE GLUCONATE PERIOSTAT, DOXYCYCLINE HYCLATE PERMAPEN, PENICILLIN G BENZATHINE PERMETHRIN, PERMETHRIN PERMETHRIN, PERMETHRIN (OTC) PERPHENAZINE AND AMITRIPTYLINE HYDROCHLORIDE, AMITRIPTYLINE HYDROCHLORIDE PERPHENAZINE, PERPHENAZINE PERSANTINE, DIPYRIDAMOLE PERTZYE, PANCRELIPASE (AMYLASE;LIPASE;PROTEASE) PEXEVA, PAROXETINE MESYLATE PFIZERPEN, PENICILLIN G POTASSIUM PHARMASEAL SCRUB CARE, CHLORHEXIDINE GLUCONATE (OTC) PHENDIMETRAZINE TARTRATE, PHENDIMETRAZINE TARTRATE PHENELZINE SULFATE, PHENELZINE SULFATE PHENOXYBENZAMINE HYDROCHLORIDE, PHENOXYBENZAMINE HYDROCHLORIDE PHENTERMINE HYDROCHLORIDE, PHENTERMINE HYDROCHLORIDE PHENTERMINE RESIN COMPLEX, PHENTERMINE RESIN COMPLEX PHENTOLAMINE MESYLATE, PHENTOLAMINE MESYLATE PHENYLEPHRINE HYDROCHLORIDE AND PROMETHAZINE HYDROCHLORIDE, PHENYLEPHRINE HYDROCHLORIDE PHENYLEPHRINE HYDROCHLORIDE, PHENYLEPHRINE HYDROCHLORIDE PHENYTEK, PHENYTOIN SODIUM

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
P **

A - 43

PHENYTOIN SODIUM, PHENYTOIN SODIUM PHENYTOIN, PHENYTOIN PHILITH, ETHINYL ESTRADIOL PHISOHEX, HEXACHLOROPHENE PHOSLO GELCAPS, CALCIUM ACETATE PHOSLYRA, CALCIUM ACETATE PHOSPHOLINE IODIDE, ECHOTHIOPHATE IODIDE PHOTOFRIN, PORFIMER SODIUM PHRENILIN FORTE, ACETAMINOPHEN PHRENILIN WITH CAFFEINE AND CODEINE, ACETAMINOPHEN PHYSIOLYTE IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE PHYSIOSOL IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE PHYTONADIONE, PHYTONADIONE PICATO, INGENOL MEBUTATE PILOCARPINE HYDROCHLORIDE, PILOCARPINE HYDROCHLORIDE PILOPINE HS, PILOCARPINE HYDROCHLORIDE PINDOLOL, PINDOLOL PIOGLITAZONE HYDROCHLORIDE AND GLIMEPIRIDE, GLIMEPIRIDE PIOGLITAZONE HYDROCHLORIDE AND METFORMIN HYDROCHLORIDE, METFORMIN HYDROCHLORIDE PIOGLITAZONE HYDROCHLORIDE, PIOGLITAZONE HYDROCHLORIDE PIPERACILLIN AND TAZOBACTAM, PIPERACILLIN SODIUM PIPERACILLIN, PIPERACILLIN SODIUM PIRMELLA 1/35, ETHINYL ESTRADIOL PIRMELLA 7/7/7, ETHINYL ESTRADIOL PIROXICAM, PIROXICAM PITOCIN, OXYTOCIN PLAN B ONE-STEP, LEVONORGESTREL PLAN B ONE-STEP, LEVONORGESTREL (OTC) PLAN B, LEVONORGESTREL PLAN B, LEVONORGESTREL (OTC) PLAQUENIL, HYDROXYCHLOROQUINE SULFATE PLASMA-LYTE 148 AND DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE PLASMA-LYTE 148 IN WATER IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE PLASMA-LYTE 56 AND DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE PLASMA-LYTE 56 IN PLASTIC CONTAINER, MAGNESIUM ACETATE TETRAHYDRATE PLASMA-LYTE A IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE PLASMA-LYTE M AND DEXTROSE 5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE PLASMA-LYTE R IN PLASTIC CONTAINER, CALCIUM CHLORIDE PLAVIX, CLOPIDOGREL BISULFATE PLEGISOL IN PLASTIC CONTAINER, CALCIUM CHLORIDE PLENDIL, FELODIPINE PLETAL, CILOSTAZOL PLIAGLIS, LIDOCAINE PODOFILOX, PODOFILOX POLOCAINE, MEPIVACAINE HYDROCHLORIDE POLOCAINE-MPF, MEPIVACAINE HYDROCHLORIDE POLYETHYLENE GLYCOL 3350, POLYETHYLENE GLYCOL 3350 POLYETHYLENE GLYCOL 3350, POLYETHYLENE GLYCOL 3350 (OTC) POLYMYCIN B SULFATE, POLYMYXIN B SULFATE POLYMYXIN B SULFATE, POLYMYXIN B SULFATE POLYTRIM, POLYMYXIN B SULFATE POMALYST, POMALIDOMIDE PONSTEL, MEFENAMIC ACID PORTIA-28, ETHINYL ESTRADIOL POTASSIUM ACETATE IN PLASTIC CONTAINER, POTASSIUM ACETATE POTASSIUM CHLORIDE 0.037% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 0.037% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 0.037% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A
POTASSIUM POTASSIUM POTASSIUM DEXTROSE POTASSIUM POTASSIUM DEXTROSE POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM CHLORIDE POTASSIUM POTASSIUM POTASSIUM POTASSIUM POTASSIUM

**

PRODUCT NAME INDEX
P **

A - 44

CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE CHLORIDE 0.075% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE CHLORIDE 0.075% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, CHLORIDE 0.075% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE CHLORIDE 0.075% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, DEXTROSE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE 0.075% IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE 0.11% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE 0.11% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE 0.11% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE 0.11% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, DEXTROSE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE 0.149% IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.15% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE 0.15% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE 0.15% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE 0.15% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, DEXTROSE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE 0.15% IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE 0.15% IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.15% IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.22% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE 0.22% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE 0.22% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE 0.22% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, DEXTROSE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE 0.224% IN SODIUM CHLORIDE 0.9%, POTASSIUM CHLORIDE 0.3% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.3% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE 0.3% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE 0.3% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE 0.3% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, DEXTROSE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE 0.3% IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE 10MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM 10MEQ 10MEQ 10MEQ 10MEQ 10MEQ IN IN IN IN IN DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE PLASTIC CONTAINER, POTASSIUM CHLORIDE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
P **

A - 45

POTASSIUM CHLORIDE 15MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE POTASSIUM CHLORIDE 15MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 15MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 15MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 15MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% IN SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 20MEQ IN PLASTIC CONTAINER, POTASSIUM CHLORIDE POTASSIUM CHLORIDE 20MEQ IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 30MEQ IN PLASTIC CONTAINER, POTASSIUM CHLORIDE POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 40MEQ IN PLASTIC CONTAINER, POTASSIUM CHLORIDE POTASSIUM CHLORIDE 40MEQ IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE POTASSIUM CHLORIDE 5MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE POTASSIUM CHLORIDE 5MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 5MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 5MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 5MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE IN PLASTIC CONTAINER, POTASSIUM CHLORIDE POTASSIUM CHLORIDE, POTASSIUM CHLORIDE POTASSIUM CITRATE, POTASSIUM CITRATE POTIGA, EZOGABINE POVIDONE IODINE, POVIDONE-IODINE (OTC) PRADAXA, DABIGATRAN ETEXILATE MESYLATE PRALIDOXIME CHLORIDE, PRALIDOXIME CHLORIDE PRAMIPEXOLE DIHYDROCHLORIDE, PRAMIPEXOLE DIHYDROCHLORIDE PRAMOSONE, HYDROCORTISONE ACETATE PRANDIMET, METFORMIN HYDROCHLORIDE PRANDIN, REPAGLINIDE PRAVACHOL, PRAVASTATIN SODIUM PRAVASTATIN SODIUM, PRAVASTATIN SODIUM PRAZOSIN HYDROCHLORIDE, PRAZOSIN HYDROCHLORIDE PRECEDEX, DEXMEDETOMIDINE HYDROCHLORIDE PRECOSE, ACARBOSE PRED FORTE, PREDNISOLONE ACETATE PRED MILD, PREDNISOLONE ACETATE PRED-G, GENTAMICIN SULFATE PREDNICARBATE, PREDNICARBATE PREDNISOLONE SODIUM PHOSPHATE, PREDNISOLONE SODIUM PHOSPHATE PREDNISOLONE, PREDNISOLONE PREDNISONE INTENSOL, PREDNISONE PREDNISONE, PREDNISONE PREFEST, ESTRADIOL

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
P **

A - 46

PREGABALIN, PREGABALIN PREGNYL, GONADOTROPIN, CHORIONIC PRELONE, PREDNISOLONE PREMARIN, ESTROGENS, CONJUGATED PREMASOL 10% IN PLASTIC CONTAINER, AMINO ACIDS PREMASOL 6% IN PLASTIC CONTAINER, AMINO ACIDS PREMPHASE 14/14, ESTROGENS, CONJUGATED PREMPRO, ESTROGENS, CONJUGATED PRE-OP II, HEXACHLOROPHENE PRE-OP, HEXACHLOROPHENE PRE-PEN, BENZYLPENICILLOYL POLYLYSINE PREPIDIL, DINOPROSTONE PREPOPIK, CITRIC ACID PREVACID 24 HR, LANSOPRAZOLE (OTC) PREVACID, LANSOPRAZOLE PREVALITE, CHOLESTYRAMINE PREVANTICS MAXI SWABSTICK, CHLORHEXIDINE GLUCONATE (OTC) PREVANTICS SWAB, CHLORHEXIDINE GLUCONATE (OTC) PREVANTICS SWABSTICK, CHLORHEXIDINE GLUCONATE (OTC) PREVIFEM, ETHINYL ESTRADIOL PREVPAC, AMOXICILLIN PREZISTA, DARUNAVIR ETHANOLATE PRIALT, ZICONOTIDE ACETATE PRIFTIN, RIFAPENTINE PRILOCAINE HYDROCHLORIDE AND EPINEPHRINE BITARTRATE, EPINEPHRINE BITARTRATE PRILOCAINE HYDROCHLORIDE, PRILOCAINE HYDROCHLORIDE PRILOSEC OTC, OMEPRAZOLE MAGNESIUM (OTC) PRILOSEC, OMEPRAZOLE PRILOSEC, OMEPRAZOLE MAGNESIUM PRIMAQUINE, PRIMAQUINE PHOSPHATE PRIMAXIN, CILASTATIN SODIUM PRIMIDONE, PRIMIDONE PRIMSOL, TRIMETHOPRIM HYDROCHLORIDE PRINIVIL, LISINOPRIL PRINZIDE, HYDROCHLOROTHIAZIDE PRISMASOL B22GK 2/0 IN PLASTIC CONTAINER, CALCIUM CHLORIDE PRISMASOL B22GK 4/0 IN PLASTIC CONTAINER, CALCIUM CHLORIDE PRISMASOL B22GK 4/2.5 IN PLASTIC CONTAINER, CALCIUM CHLORIDE PRISMASOL BGK 0/2.5 IN PLASTIC CONTAINER, CALCIUM CHLORIDE PRISMASOL BGK 2/0 IN PLASTIC CONTAINER, CALCIUM CHLORIDE PRISMASOL BGK 2/3.5 IN PLASTIC CONTAINER, CALCIUM CHLORIDE PRISMASOL BGK 4/0/1.2 IN PLASTIC CONTAINER, CALCIUM CHLORIDE PRISMASOL BGK 4/2.5 IN PLASTIC CONTAINER, CALCIUM CHLORIDE PRISMASOL BK 0/0/1.2 IN PLASTIC CONTAINER, CALCIUM CHLORIDE PRISMASOL BK 0/3.5 IN PLASTIC CONTAINER, CALCIUM CHLORIDE PRISTIQ, DESVENLAFAXINE SUCCINATE PROAIR HFA, ALBUTEROL SULFATE PROBALAN, PROBENECID PROBENECID AND COLCHICINE, COLCHICINE PROBENECID, PROBENECID PROCAINAMIDE HYDROCHLORIDE, PROCAINAMIDE HYDROCHLORIDE PROCALAMINE, AMINO ACIDS PROCARDIA XL, NIFEDIPINE PROCARDIA, NIFEDIPINE PROCHLORPERAZINE EDISYLATE, PROCHLORPERAZINE EDISYLATE PROCHLORPERAZINE MALEATE, PROCHLORPERAZINE MALEATE PROCHLORPERAZINE, PROCHLORPERAZINE PROCOMP, PROCHLORPERAZINE MALEATE PROCTOFOAM HC, HYDROCORTISONE ACETATE PROCYSBI, CYSTEAMINE BITARTRATE PROFEN, IBUPROFEN (OTC) PROFERDEX, IRON DEXTRAN PROGESTERONE, PROGESTERONE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
P **

A - 47

PROGLYCEM, DIAZOXIDE PROGRAF, TACROLIMUS PROHANCE MULTIPACK, GADOTERIDOL PROHANCE, GADOTERIDOL PROLENSA, BROMFENAC SODIUM PROMACTA, ELTROMBOPAG OLAMINE PROMETH HYDROCHLORIDE,PHENYLEPHRINE HYDROCHLORIDE W/CODEINE PHOSPHATE, CODEINE PHOSPHATE PROMETH VC PLAIN, PHENYLEPHRINE HYDROCHLORIDE PROMETH VC W/ CODEINE, CODEINE PHOSPHATE PROMETH W/ DEXTROMETHORPHAN, DEXTROMETHORPHAN HYDROBROMIDE PROMETHAZINE DM, DEXTROMETHORPHAN HYDROBROMIDE PROMETHAZINE HYDROCHLORIDE AND CODEINE PHOSPHATE, CODEINE PHOSPHATE PROMETHAZINE HYDROCHLORIDE AND DEXTROMETHORPHAN HYDROBROMIDE, DEXTROMETHORPHAN HYDROBROMIDE PROMETHAZINE HYDROCHLORIDE AND PHENYLEPHRINE HYDROCHLORIDE, PHENYLEPHRINE HYDROCHLORIDE PROMETHAZINE HYDROCHLORIDE, PROMETHAZINE HYDROCHLORIDE PROMETHAZINE PLAIN, PROMETHAZINE HYDROCHLORIDE PROMETHAZINE W/ DEXTROMETHORPHAN, DEXTROMETHORPHAN HYDROBROMIDE PROMETHAZINE WITH CODEINE, CODEINE PHOSPHATE PROMETHEGAN, PROMETHAZINE HYDROCHLORIDE PROMETRIUM, PROGESTERONE PROPAFENONE HYDROCHLORIDE, PROPAFENONE HYDROCHLORIDE PROPANTHELINE BROMIDE, PROPANTHELINE BROMIDE PROPARACAINE HYDROCHLORIDE, PROPARACAINE HYDROCHLORIDE PROPECIA, FINASTERIDE PROPINE, DIPIVEFRIN HYDROCHLORIDE PROPOFOL, PROPOFOL PROPRANOLOL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE PROPRANOLOL HYDROCHLORIDE, PROPRANOLOL HYDROCHLORIDE PROPYLTHIOURACIL, PROPYLTHIOURACIL PROSCAR, FINASTERIDE PROSOL 20% SULFITE FREE IN PLASTIC CONTAINER, AMINO ACIDS PROSTIN E2, DINOPROSTONE PROSTIN VR PEDIATRIC, ALPROSTADIL PROTAMINE SULFATE, PROTAMINE SULFATE PROTONIX IV, PANTOPRAZOLE SODIUM PROTONIX, PANTOPRAZOLE SODIUM PROTOPAM CHLORIDE, PRALIDOXIME CHLORIDE PROTOPIC, TACROLIMUS PROTRIPTYLINE HYDROCHLORIDE, PROTRIPTYLINE HYDROCHLORIDE PROVENTIL-HFA, ALBUTEROL SULFATE PROVERA, MEDROXYPROGESTERONE ACETATE PROVIGIL, MODAFINIL PROVOCHOLINE, METHACHOLINE CHLORIDE PROZAC WEEKLY, FLUOXETINE HYDROCHLORIDE PROZAC, FLUOXETINE HYDROCHLORIDE PSEUDOEPHEDRINE HYDROCHLORIDE, PSEUDOEPHEDRINE HYDROCHLORIDE (OTC) PULMICORT FLEXHALER, BUDESONIDE PULMICORT RESPULES, BUDESONIDE PULMOLITE, TECHNETIUM TC-99M ALBUMIN AGGREGATED KIT PURINETHOL, MERCAPTOPURINE PUR-WASH, PURIFIED WATER (OTC) PYLERA, BISMUTH SUBCITRATE POTASSIUM PYRAZINAMIDE, PYRAZINAMIDE PYRIDOSTIGMINE BROMIDE, PYRIDOSTIGMINE BROMIDE PYRIDOXINE HYDROCHLORIDE, PYRIDOXINE HYDROCHLORIDE PYTEST KIT, UREA, C-14 PYTEST, UREA, C-14

**

Q

**

QNASL, BECLOMETHASONE DIPROPIONATE QSYMIA, PHENTERMINE HYDROCHLORIDE QUADRAMET, SAMARIUM SM-153 LEXIDRONAM PENTASODIUM QUALAQUIN, QUININE SULFATE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
Q **

A - 48

QUARTETTE, ETHINYL ESTRADIOL QUASENSE, ETHINYL ESTRADIOL QUELICIN PRESERVATIVE FREE, SUCCINYLCHOLINE CHLORIDE QUELICIN, SUCCINYLCHOLINE CHLORIDE QUETIAPINE FUMARATE, QUETIAPINE FUMARATE QUILLIVANT XR, METHYLPHENIDATE HYDROCHLORIDE QUINAPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE QUINAPRIL HYDROCHLORIDE, QUINAPRIL HYDROCHLORIDE QUINARETIC, HYDROCHLOROTHIAZIDE QUINIDINE GLUCONATE, QUINIDINE GLUCONATE QUINIDINE SULFATE, QUINIDINE SULFATE QUININE SULFATE, QUININE SULFATE QUIXIN, LEVOFLOXACIN QUTENZA, CAPSAICIN QVAR 40, BECLOMETHASONE DIPROPIONATE QVAR 80, BECLOMETHASONE DIPROPIONATE

**

R

**

RADIOGARDASE (PRUSSIAN BLUE), FERRIC HEXACYANOFERRATE(II) RAMIPRIL, RAMIPRIL RANEXA, RANOLAZINE RANITIDINE HYDROCHLORIDE, RANITIDINE HYDROCHLORIDE RANITIDINE HYDROCHLORIDE, RANITIDINE HYDROCHLORIDE (OTC) RAPAFLO, SILODOSIN RAPAMUNE, SIROLIMUS RASAGILINE MESYLATE, RASAGILINE MESYLATE RAVICTI, GLYCEROL PHENYLBUTYRATE RAYOS, PREDNISONE RAZADYNE ER, GALANTAMINE HYDROBROMIDE RAZADYNE, GALANTAMINE HYDROBROMIDE REBETOL, RIBAVIRIN RECLAST, ZOLEDRONIC ACID RECTIV, NITROGLYCERIN REGITINE, PHENTOLAMINE MESYLATE REGLAN, METOCLOPRAMIDE HYDROCHLORIDE REGONOL, PYRIDOSTIGMINE BROMIDE RELENZA, ZANAMIVIR RELISTOR, METHYLNALTREXONE BROMIDE RELPAX, ELETRIPTAN HYDROBROMIDE REMERON SOLTAB, MIRTAZAPINE REMERON, MIRTAZAPINE REMODULIN, TREPROSTINIL RENACIDIN, CITRIC ACID RENAGEL, SEVELAMER HYDROCHLORIDE RENAMIN W/O ELECTROLYTES, AMINO ACIDS RENOGRAFIN-76, DIATRIZOATE MEGLUMINE RENOVA, TRETINOIN RENVELA, SEVELAMER CARBONATE REPREXAIN, HYDROCODONE BITARTRATE REPRONEX, LUTEINIZING HORMONE REQUIP XL, ROPINIROLE HYDROCHLORIDE REQUIP, ROPINIROLE HYDROCHLORIDE RESCRIPTOR, DELAVIRDINE MESYLATE RESCULA, UNOPROSTONE ISOPROPYL RESECTISOL IN PLASTIC CONTAINER, MANNITOL RESERPINE, RESERPINE RESTASIS, CYCLOSPORINE RESTORIL, TEMAZEPAM RETIN-A MICRO, TRETINOIN RETIN-A, TRETINOIN RETISERT, FLUOCINOLONE ACETONIDE RETROVIR, ZIDOVUDINE REVATIO, SILDENAFIL CITRATE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
R **

A - 49

REVIA, NALTREXONE HYDROCHLORIDE REVLIMID, LENALIDOMIDE REYATAZ, ATAZANAVIR SULFATE REZIRA, HYDROCODONE BITARTRATE R-GENE 10, ARGININE HYDROCHLORIDE RHINOCORT, BUDESONIDE RIBASPHERE, RIBAVIRIN RIBAVARIN, RIBAVIRIN RIBAVIRIN, RIBAVIRIN RID MOUSSE, PIPERONYL BUTOXIDE (OTC) RIDAURA, AURANOFIN RIFADIN, RIFAMPIN RIFAMATE, ISONIAZID RIFAMPIN, RIFAMPIN RIFATER, ISONIAZID RILUTEK, RILUZOLE RILUZOLE, RILUZOLE RIMACTANE, RIFAMPIN RIMANTADINE HYDROCHLORIDE, RIMANTADINE HYDROCHLORIDE RIMSO-50, DIMETHYL SULFOXIDE RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE RIOMET, METFORMIN HYDROCHLORIDE RISEDRONATE SODIUM, RISEDRONATE SODIUM RISPERDAL CONSTA, RISPERIDONE RISPERDAL, RISPERIDONE RISPERIDONE, RISPERIDONE RITALIN LA, METHYLPHENIDATE HYDROCHLORIDE RITALIN, METHYLPHENIDATE HYDROCHLORIDE RITALIN-SR, METHYLPHENIDATE HYDROCHLORIDE RIVASTIGMINE TARTRATE, RIVASTIGMINE TARTRATE RIZATRIPTAN BENZOATE, RIZATRIPTAN BENZOATE ROBAXIN, METHOCARBAMOL ROBAXIN-750, METHOCARBAMOL ROBINUL FORTE, GLYCOPYRROLATE ROBINUL, GLYCOPYRROLATE ROCALTROL, CALCITRIOL ROCEPHIN, CEFTRIAXONE SODIUM ROCURONIUM BROMIDE, ROCURONIUM BROMIDE ROGAINE (FOR MEN), MINOXIDIL (OTC) ROGAINE (FOR WOMEN), MINOXIDIL (OTC) ROGAINE EXTRA STRENGTH (FOR MEN), MINOXIDIL (OTC) ROMAZICON, FLUMAZENIL ROPINIROLE HYDROCHLORIDE, ROPINIROLE HYDROCHLORIDE ROSIGLITAZONE MALEATE, ROSIGLITAZONE MALEATE ROWASA, MESALAMINE ROXICET 5/500, ACETAMINOPHEN ROXICET, ACETAMINOPHEN ROXICODONE, OXYCODONE HYDROCHLORIDE ROXILOX, ACETAMINOPHEN ROZEREM, RAMELTEON RYBIX ODT, TRAMADOL HYDROCHLORIDE RYTHMOL SR, PROPAFENONE HYDROCHLORIDE RYTHMOL, PROPAFENONE HYDROCHLORIDE

**
SABRIL, VIGABATRIN SAFYRAL, DROSPIRENONE SAIZEN, SOMATROPIN RECOMBINANT SALAGEN, PILOCARPINE HYDROCHLORIDE SALONPAS, MENTHOL (OTC) SALURON, HYDROFLUMETHIAZIDE SAMSCA, TOLVAPTAN SANCTURA XR, TROSPIUM CHLORIDE

S

**

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
S **

A - 50

SANCTURA, TROSPIUM CHLORIDE SANCUSO, GRANISETRON SANDIMMUNE, CYCLOSPORINE SANDOSTATIN LAR, OCTREOTIDE ACETATE SANDOSTATIN, OCTREOTIDE ACETATE SAPHRIS, ASENAPINE MALEATE SARAFEM, FLUOXETINE HYDROCHLORIDE SAVELLA, MILNACIPRAN HYDROCHLORIDE SCANDONEST L, LEVONORDEFRIN SCANDONEST PLAIN, MEPIVACAINE HYDROCHLORIDE SCANLUX-300, IOPAMIDOL SCANLUX-370, IOPAMIDOL SCLEROSOL, TALC SEASONALE, ETHINYL ESTRADIOL SEASONIQUE, ETHINYL ESTRADIOL SECONAL SODIUM, SECOBARBITAL SODIUM SECTRAL, ACEBUTOLOL HYDROCHLORIDE SELEGILINE HYDROCHLORIDE, SELEGILINE HYDROCHLORIDE SELENIUM SULFIDE, SELENIUM SULFIDE SELSUN, SELENIUM SULFIDE SELZENTRY, MARAVIROC SEMPREX-D, ACRIVASTINE SENSIPAR, CINACALCET HYDROCHLORIDE SENSORCAINE, BUPIVACAINE HYDROCHLORIDE SEPTOCAINE, ARTICAINE HYDROCHLORIDE SEPTRA DS, SULFAMETHOXAZOLE SEPTRA, SULFAMETHOXAZOLE SEREVENT, SALMETEROL XINAFOATE SEROMYCIN, CYCLOSERINE SEROPHENE, CLOMIPHENE CITRATE SEROQUEL XR, QUETIAPINE FUMARATE SEROQUEL, QUETIAPINE FUMARATE SEROSTIM, SOMATROPIN RECOMBINANT SERTRALINE HYDROCHLORIDE, SERTRALINE HYDROCHLORIDE SEVOFLURANE, SEVOFLURANE SFROWASA, MESALAMINE SHADE UVAGUARD, AVOBENZONE (OTC) SIGNIFOR, PASIREOTIDE DIASPARTATE SILDENAFIL CITRATE, SILDENAFIL CITRATE SILENOR, DOXEPIN HYDROCHLORIDE SILVADENE, SILVER SULFADIAZINE SIMBRINZA, BRIMONIDINE TARTRATE SIMCOR, NIACIN SIMVASTATIN, SIMVASTATIN SINE-AID IB, IBUPROFEN (OTC) SINEMET CR, CARBIDOPA SINEMET, CARBIDOPA SINGULAIR, MONTELUKAST SODIUM SINOGRAFIN, DIATRIZOATE MEGLUMINE SIRTURO, BEDAQUILINE FUMARATE SITAVIG, ACYCLOVIR SKELAXIN, METAXALONE SKLICE, IVERMECTIN SKYLA, LEVONORGESTREL SODIUM ACETATE IN PLASTIC CONTAINER, SODIUM ACETATE ANHYDROUS SODIUM BICARBONATE, SODIUM BICARBONATE SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, SODIUM CHLORIDE SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, SODIUM CHLORIDE SODIUM CHLORIDE 0.9% IN STERILE PLASTIC CONTAINER, SODIUM CHLORIDE SODIUM CHLORIDE 0.9%, SODIUM CHLORIDE SODIUM CHLORIDE 3% IN PLASTIC CONTAINER, SODIUM CHLORIDE SODIUM CHLORIDE 5% IN PLASTIC CONTAINER, SODIUM CHLORIDE SODIUM CHLORIDE IN PLASTIC CONTAINER, SODIUM CHLORIDE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
S **

A - 51

SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE, SODIUM FERRIC GLUCONATE COMPLEX SODIUM FLUORIDE F-18, SODIUM FLUORIDE F-18 SODIUM IODIDE I 123, SODIUM IODIDE I-123 SODIUM IODIDE I 131, SODIUM IODIDE I-131 SODIUM IODIDE I-131, SODIUM IODIDE I-131 SODIUM LACTATE 0.167 MOLAR IN PLASTIC CONTAINER, SODIUM LACTATE SODIUM LACTATE 1/6 MOLAR IN PLASTIC CONTAINER, SODIUM LACTATE SODIUM LACTATE IN PLASTIC CONTAINER, SODIUM LACTATE SODIUM NITRITE, SODIUM NITRITE SODIUM PHENYLBUTYRATE, SODIUM PHENYLBUTYRATE SODIUM PHOSPHATES IN PLASTIC CONTAINER, SODIUM PHOSPHATE, DIBASIC, HEPTAHYDRATE SODIUM POLYSTYRENE SULFONATE, SODIUM POLYSTYRENE SULFONATE SODIUM THIOSULFATE, SODIUM THIOSULFATE SOJOURN, SEVOFLURANE SOLARAZE, DICLOFENAC SODIUM SOLODYN, MINOCYCLINE HYDROCHLORIDE SOLTAMOX, TAMOXIFEN CITRATE SOLU-CORTEF, HYDROCORTISONE SODIUM SUCCINATE SOLU-MEDROL, METHYLPREDNISOLONE SODIUM SUCCINATE SOMA COMPOUND W/ CODEINE, ASPIRIN SOMA COMPOUND, ASPIRIN SOMA, CARISOPRODOL SOMATULINE DEPOT, LANREOTIDE ACETATE SOMAVERT, PEGVISOMANT SONATA, ZALEPLON SORBITOL 3% IN PLASTIC CONTAINER, SORBITOL SORBITOL 3.3% IN PLASTIC CONTAINER, SORBITOL SORBITOL-MANNITOL IN PLASTIC CONTAINER, MANNITOL SORIATANE, ACITRETIN SORILUX, CALCIPOTRIENE SORINE, SOTALOL HYDROCHLORIDE SOTALOL HYDROCHLORIDE, SOTALOL HYDROCHLORIDE SOTRADECOL, SODIUM TETRADECYL SULFATE SOTRET, ISOTRETINOIN SPECTRACEF, CEFDITOREN PIVOXIL SPIRIVA, TIOTROPIUM BROMIDE MONOHYDRATE SPIRONOLACTONE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE SPIRONOLACTONE, SPIRONOLACTONE SPORANOX, ITRACONAZOLE SPRINTEC, ETHINYL ESTRADIOL SPRIX, KETOROLAC TROMETHAMINE SPRYCEL, DASATINIB SPS, SODIUM POLYSTYRENE SULFONATE SSD AF, SILVER SULFADIAZINE SSD, SILVER SULFADIAZINE STALEVO 100, CARBIDOPA STALEVO 125, CARBIDOPA STALEVO 150, CARBIDOPA STALEVO 200, CARBIDOPA STALEVO 50, CARBIDOPA STALEVO 75, CARBIDOPA STARLIX, NATEGLINIDE STAVUDINE, STAVUDINE STAXYN, VARDENAFIL HYDROCHLORIDE STENDRA, AVANAFIL STERILE WATER FOR INJECTION IN PLASTIC CONTAINER, STERILE WATER FOR INJECTION STERILE WATER IN PLASTIC CONTAINER, STERILE WATER FOR IRRIGATION STERILE WATER, STERILE WATER FOR IRRIGATION STIE-CORT, HYDROCORTISONE STIMATE (NEEDS NO REFRIGERATION), DESMOPRESSIN ACETATE STIVARGA, REGORAFENIB STRATTERA, ATOMOXETINE HYDROCHLORIDE STREPTOMYCIN SULFATE, STREPTOMYCIN SULFATE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
S **

A - 52

STRIANT, TESTOSTERONE STRIBILD, COBICISTAT STROMECTOL, IVERMECTIN STRONTIUM CHLORIDE SR-89, STRONTIUM CHLORIDE SR-89 SUBLIMAZE PRESERVATIVE FREE, FENTANYL CITRATE SUBOXONE, BUPRENORPHINE HYDROCHLORIDE SUBSYS, FENTANYL SUCLEAR, MAGNESIUM SULFATE SUCRAID, SACROSIDASE SUCRALFATE, SUCRALFATE SUDAFED 12 HOUR, PSEUDOEPHEDRINE HYDROCHLORIDE (OTC) SUDAFED 24 HOUR, PSEUDOEPHEDRINE HYDROCHLORIDE (OTC) SUFENTA PRESERVATIVE FREE, SUFENTANIL CITRATE SUFENTANIL CITRATE, SUFENTANIL CITRATE SULAR, NISOLDIPINE SULFACETAMIDE SODIUM AND PREDNISOLONE SODIUM PHOSPHATE, PREDNISOLONE SODIUM PHOSPHATE SULFACETAMIDE SODIUM, SULFACETAMIDE SODIUM SULFADIAZINE, SULFADIAZINE SULFAMETHOXAZOLE AND TRIMETHOPRIM DOUBLE STRENGTH, SULFAMETHOXAZOLE SULFAMETHOXAZOLE AND TRIMETHOPRIM SINGLE STRENGTH, SULFAMETHOXAZOLE SULFAMETHOXAZOLE AND TRIMETHOPRIM, SULFAMETHOXAZOLE SULFAMYLON, MAFENIDE ACETATE SULFASALAZINE, SULFASALAZINE SULFATRIM PEDIATRIC, SULFAMETHOXAZOLE SULINDAC, SULINDAC SUMATRIPTAN SUCCINATE, SUMATRIPTAN SUCCINATE SUMAVEL DOSEPRO, SUMATRIPTAN SUCCINATE SUPPRELIN LA, HISTRELIN ACETATE SUPRANE, DESFLURANE SUPRAX, CEFIXIME SUPRENZA, PHENTERMINE HYDROCHLORIDE SUPREP BOWEL PREP KIT, MAGNESIUM SULFATE ANHYDROUS SURFAXIN, LUCINACTANT SURMONTIL, TRIMIPRAMINE MALEATE SURVANTA, BERACTANT SUSTIVA, EFAVIRENZ SUTENT, SUNITINIB MALATE SYEDA, DROSPIRENONE SYMBICORT, BUDESONIDE SYMBYAX, FLUOXETINE HYDROCHLORIDE SYMLIN, PRAMLINTIDE ACETATE SYNACORT, HYDROCORTISONE SYNALAR, FLUOCINOLONE ACETONIDE SYNALGOS-DC, ASPIRIN SYNAREL, NAFARELIN ACETATE SYNERA, LIDOCAINE SYNERCID, DALFOPRISTIN SYNRIBO, OMACETAXINE MEPESUCCINATE SYNTHETIC CONJUGATED ESTROGENS A, ESTROGENS, CONJUGATED SYNTHETIC A SYNTHROID, LEVOTHYROXINE SODIUM SYPRINE, TRIENTINE HYDROCHLORIDE

**
TAB-PROFEN, IBUPROFEN (OTC) TACLONEX, BETAMETHASONE DIPROPIONATE TACROLIMUS, TACROLIMUS TAFINLAR, DABRAFENIB MESYLATE TAGAMET HB, CIMETIDINE (OTC) TAGAMET, CIMETIDINE TALC, TALC TALWIN, PENTAZOCINE LACTATE TAMIFLU, OSELTAMIVIR PHOSPHATE TAMOXIFEN CITRATE, TAMOXIFEN CITRATE

T

**

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
T **

A - 53

TAMSULOSIN HYDROCHLORIDE, TAMSULOSIN HYDROCHLORIDE TAPAZOLE, METHIMAZOLE TARCEVA, ERLOTINIB HYDROCHLORIDE TARGRETIN, BEXAROTENE TARKA, TRANDOLAPRIL TASIGNA, NILOTINIB HYDROCHLORIDE MONOHYDRATE TASMAR, TOLCAPONE TAVIST ALLERGY/SINUS/HEADACHE, ACETAMINOPHEN (OTC) TAVIST-1, CLEMASTINE FUMARATE (OTC) TAXOL, PACLITAXEL TAXOTERE, DOCETAXEL TAZICEF, CEFTAZIDIME TAZORAC, TAZAROTENE TAZTIA XT, DILTIAZEM HYDROCHLORIDE TECFIDERA, DIMETHYL FUMARATE TECHNELITE, TECHNETIUM TC-99M SODIUM PERTECHNETATE GENERATOR TECHNESCAN MAG3, TECHNETIUM TC-99M MERTIATIDE KIT TECHNESCAN PYP KIT, TECHNETIUM TC-99M PYROPHOSPHATE KIT TECHNESCAN, TECHNETIUM TC-99M OXIDRONATE KIT TECHNETIUM TC 99M ALBUMIN AGGREGATED KIT, TECHNETIUM TC-99M ALBUMIN AGGREGATED KIT TECHNETIUM TC 99M SESTAMIBI, TECHNETIUM TC-99M SESTAMIBI KIT TECHNETIUM TC-99 SESTAMIBI, TECHNETIUM TC-99M SESTAMIBI KIT TECHNETIUM TC-99M MEBROFENIN, TECHNETIUM TC-99M MEBROFENIN KIT TEFLARO, CEFTAROLINE FOSAMIL TEGRETOL, CARBAMAZEPINE TEGRETOL-XR, CARBAMAZEPINE TEKAMLO, ALISKIREN HEMIFUMARATE TEKTURNA HCT, ALISKIREN HEMIFUMARATE TEKTURNA, ALISKIREN HEMIFUMARATE TEMAZEPAM, TEMAZEPAM TEMODAR, TEMOZOLOMIDE TEMOVATE E, CLOBETASOL PROPIONATE TEMOVATE, CLOBETASOL PROPIONATE TEMOZOLOMIDE, TEMOZOLOMIDE TENEX, GUANFACINE HYDROCHLORIDE TENORETIC 100, ATENOLOL TENORETIC 50, ATENOLOL TENORMIN, ATENOLOL TENSILON PRESERVATIVE FREE, EDROPHONIUM CHLORIDE TENSILON, EDROPHONIUM CHLORIDE TENUATE DOSPAN, DIETHYLPROPION HYDROCHLORIDE TENUATE, DIETHYLPROPION HYDROCHLORIDE TERAZOL 3, TERCONAZOLE TERAZOL 7, TERCONAZOLE TERAZOSIN HYDROCHLORIDE, TERAZOSIN HYDROCHLORIDE TERBINAFINE HYDROCHLORIDE, TERBINAFINE HYDROCHLORIDE TERBINAFINE HYDROCHLORIDE, TERBINAFINE HYDROCHLORIDE (OTC) TERBUTALINE SULFATE, TERBUTALINE SULFATE TERCONAZOLE, TERCONAZOLE TERIL, CARBAMAZEPINE TERRAMYCIN W/ POLYMYXIN B SULFATE, OXYTETRACYCLINE HYDROCHLORIDE TESSALON, BENZONATATE TESTIM, TESTOSTERONE TESTOPEL, TESTOSTERONE TESTOSTERONE CYPIONATE, TESTOSTERONE CYPIONATE TESTOSTERONE ENANTHATE, TESTOSTERONE ENANTHATE TESTOSTERONE, TESTOSTERONE TESTRED, METHYLTESTOSTERONE TETRACYCLINE HYDROCHLORIDE, TETRACYCLINE HYDROCHLORIDE TEVETEN HCT, EPROSARTAN MESYLATE TEVETEN, EPROSARTAN MESYLATE TEV-TROPIN, SOMATROPIN RECOMBINANT TEXACORT, HYDROCORTISONE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
T **

A - 54

THALITONE, CHLORTHALIDONE THALLOUS CHLORIDE TL 201, THALLOUS CHLORIDE TL-201 THALOMID, THALIDOMIDE THAM, TROMETHAMINE THEO-24, THEOPHYLLINE THEOCHRON, THEOPHYLLINE THEOLAIR, THEOPHYLLINE THEOPHYLLINE 0.04% AND DEXTROSE 5% IN PLASTIC CONTAINER, THEOPHYLLINE THEOPHYLLINE 0.08% AND DEXTROSE 5% IN PLASTIC CONTAINER, THEOPHYLLINE THEOPHYLLINE 0.16% AND DEXTROSE 5% IN PLASTIC CONTAINER, THEOPHYLLINE THEOPHYLLINE 0.32% AND DEXTROSE 5% IN PLASTIC CONTAINER, THEOPHYLLINE THEOPHYLLINE IN DEXTROSE 5% IN PLASTIC CONTAINER, THEOPHYLLINE THEOPHYLLINE, THEOPHYLLINE THERMAZENE, SILVER SULFADIAZINE THEROXIDIL, MINOXIDIL (OTC) THIAMINE HYDROCHLORIDE, THIAMINE HYDROCHLORIDE THIOGUANINE, THIOGUANINE THIORIDAZINE HYDROCHLORIDE, THIORIDAZINE HYDROCHLORIDE THIOTEPA, THIOTEPA THIOTHIXENE, THIOTHIXENE THRIVE, NICOTINE POLACRILEX (OTC) THYROGEN, THYROTROPIN ALFA THYROLAR-0.25, LIOTHYRONINE SODIUM THYROLAR-0.5, LIOTHYRONINE SODIUM THYROLAR-1, LIOTHYRONINE SODIUM THYROLAR-2, LIOTHYRONINE SODIUM THYROLAR-3, LIOTHYRONINE SODIUM THYROSAFE, POTASSIUM IODIDE (OTC) THYROSHIELD, POTASSIUM IODIDE (OTC) TIAGABINE HYDROCHLORIDE, TIAGABINE HYDROCHLORIDE TIAZAC, DILTIAZEM HYDROCHLORIDE TICLOPIDINE HYDROCHLORIDE, TICLOPIDINE HYDROCHLORIDE TIGAN, TRIMETHOBENZAMIDE HYDROCHLORIDE TIKOSYN, DOFETILIDE TIMENTIN IN PLASTIC CONTAINER, CLAVULANATE POTASSIUM TIMENTIN, CLAVULANATE POTASSIUM TIMOLOL MALEATE, TIMOLOL MALEATE TIMOPTIC IN OCUDOSE, TIMOLOL MALEATE TIMOPTIC, TIMOLOL MALEATE TIMOPTIC-XE, TIMOLOL MALEATE TINDAMAX, TINIDAZOLE TINIDAZOLE, TINIDAZOLE TIOCONAZOLE, TIOCONAZOLE (OTC) TIOPRONIN, TIOPRONIN TIROSINT, LEVOTHYROXINE SODIUM TIS-U-SOL IN PLASTIC CONTAINER, MAGNESIUM SULFATE TIS-U-SOL, MAGNESIUM SULFATE TIZANIDINE HYDROCHLORIDE, TIZANIDINE HYDROCHLORIDE TOBI PODHALER, TOBRAMYCIN TOBI, TOBRAMYCIN TOBRADEX ST, DEXAMETHASONE TOBRADEX, DEXAMETHASONE TOBRAMYCIN AND DEXAMETHASONE, DEXAMETHASONE TOBRAMYCIN SULFATE (PHARMACY BULK), TOBRAMYCIN SULFATE TOBRAMYCIN SULFATE IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, TOBRAMYCIN SULFATE TOBRAMYCIN SULFATE, TOBRAMYCIN SULFATE TOBRAMYCIN, TOBRAMYCIN TOBREX, TOBRAMYCIN TODAY, NONOXYNOL-9 (OTC) TOFRANIL, IMIPRAMINE HYDROCHLORIDE TOFRANIL-PM, IMIPRAMINE PAMOATE TOLAZAMIDE, TOLAZAMIDE TOLBUTAMIDE, TOLBUTAMIDE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
T **

A - 55

TOLMETIN SODIUM, TOLMETIN SODIUM TOLTERODINE TARTRATE, TOLTERODINE TARTRATE TOPAMAX, TOPIRAMATE TOPICORT, DESOXIMETASONE TOPIRAMATE, TOPIRAMATE TOPOTECAN HYDROCHLORIDE, TOPOTECAN HYDROCHLORIDE TOPROL-XL, METOPROLOL SUCCINATE TORISEL, TEMSIROLIMUS TORSEMIDE, TORSEMIDE TOTECT, DEXRAZOXANE HYDROCHLORIDE TOVIAZ, FESOTERODINE FUMARATE TPN ELECTROLYTES IN PLASTIC CONTAINER, CALCIUM CHLORIDE TRACLEER, BOSENTAN TRADJENTA, LINAGLIPTIN TRAMADOL HYDROCHLORIDE AND ACETAMINOPHEN, ACETAMINOPHEN TRAMADOL HYDROCHLORIDE, TRAMADOL HYDROCHLORIDE TRANDOLAPRIL AND VERAPAMIL HYDROCHLORIDE, TRANDOLAPRIL TRANDOLAPRIL, TRANDOLAPRIL TRANEXAMIC ACID, TRANEXAMIC ACID TRANSDERM SCOP, SCOPOLAMINE TRANXENE, CLORAZEPATE DIPOTASSIUM TRANYLCYPROMINE SULFATE, TRANYLCYPROMINE SULFATE TRAVASOL 10% IN PLASTIC CONTAINER, AMINO ACIDS TRAVASOL 10% W/O ELECTROLYTES, AMINO ACIDS TRAVASOL 3.5% SULFITE FREE W/ ELECTROLYTES IN PLASTIC CONTAINER, AMINO ACIDS TRAVASOL 3.5% W/ ELECTROLYTES, AMINO ACIDS TRAVASOL 5.5% IN PLASTIC CONTAINER, AMINO ACIDS TRAVASOL 5.5% SULFITE FREE W/ ELECTROLYTES IN PLASTIC CONTAINER, AMINO ACIDS TRAVASOL 5.5% W/ ELECTROLYTES, AMINO ACIDS TRAVASOL 5.5% W/O ELECTROLYTES, AMINO ACIDS TRAVASOL 8.5% IN PLASTIC CONTAINER, AMINO ACIDS TRAVASOL 8.5% SULFITE FREE W/ ELECTROLYTES IN PLASTIC CONTAINER, AMINO ACIDS TRAVASOL 8.5% W/ ELECTROLYTES, AMINO ACIDS TRAVASOL 8.5% W/O ELECTROLYTES, AMINO ACIDS TRAVATAN Z, TRAVOPROST TRAVOPROST, TRAVOPROST TRAZODONE HYDROCHLORIDE, TRAZODONE HYDROCHLORIDE TREANDA, BENDAMUSTINE HYDROCHLORIDE TRECATOR, ETHIONAMIDE TRELSTAR, TRIPTORELIN PAMOATE TRENTAL, PENTOXIFYLLINE TRETINOIN, TRETINOIN TREXALL, METHOTREXATE SODIUM TREXIMET, NAPROXEN SODIUM TRIACIN-C, CODEINE PHOSPHATE TRIAMCINOLONE ACETONIDE IN ABSORBASE, TRIAMCINOLONE ACETONIDE TRIAMCINOLONE ACETONIDE, TRIAMCINOLONE ACETONIDE TRIAMTERENE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE TRIAZOLAM, TRIAZOLAM TRIBENZOR, AMLODIPINE BESYLATE TRICOR, FENOFIBRATE TRIDERM, TRIAMCINOLONE ACETONIDE TRIDIONE, TRIMETHADIONE TRIESENCE, TRIAMCINOLONE ACETONIDE TRI-ESTARYLLA, ETHINYL ESTRADIOL TRIFLUOPERAZINE HYDROCHLORIDE, TRIFLUOPERAZINE HYDROCHLORIDE TRIFLURIDINE, TRIFLURIDINE TRIGLIDE, FENOFIBRATE TRIHEXYPHENIDYL HYDROCHLORIDE, TRIHEXYPHENIDYL HYDROCHLORIDE TRI-LEGEST 21, ETHINYL ESTRADIOL TRI-LEGEST FE, ETHINYL ESTRADIOL TRILEPTAL, OXCARBAZEPINE TRI-LINYAH, ETHINYL ESTRADIOL

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
T **

A - 56

TRILIPIX, CHOLINE FENOFIBRATE TRI-LUMA, FLUOCINOLONE ACETONIDE TRILYTE, POLYETHYLENE GLYCOL 3350 TRIMETHOBENZAMIDE HYDROCHLORIDE PRESERVATIVE FREE, TRIMETHOBENZAMIDE HYDROCHLORIDE TRIMETHOBENZAMIDE HYDROCHLORIDE, TRIMETHOBENZAMIDE HYDROCHLORIDE TRIMETHOPRIM SULFATE AND POLYMYXIN B SULFATE, POLYMYXIN B SULFATE TRIMETHOPRIM, TRIMETHOPRIM TRIMIPRAMINE MALEATE, TRIMIPRAMINE MALEATE TRI-NORINYL 28-DAY, ETHINYL ESTRADIOL TRIOSTAT, LIOTHYRONINE SODIUM TRI-PREVIFEM, ETHINYL ESTRADIOL TRISENOX, ARSENIC TRIOXIDE TRI-SPRINTEC, ETHINYL ESTRADIOL TRIVAGIZOLE 3, CLOTRIMAZOLE (OTC) TRIVORA-28, ETHINYL ESTRADIOL TRIZIVIR, ABACAVIR SULFATE TROPHAMINE 10%, AMINO ACIDS TROPHAMINE, AMINO ACIDS TROPICACYL, TROPICAMIDE TROPICAMIDE, TROPICAMIDE TROSPIUM CHLORIDE, TROSPIUM CHLORIDE TRUSOPT, DORZOLAMIDE HYDROCHLORIDE TRUVADA, EMTRICITABINE TUDORZA PRESSAIR, ACLIDINIUM BROMIDE TUSSICAPS, CHLORPHENIRAMINE POLISTIREX TUSSIGON, HOMATROPINE METHYLBROMIDE TUSSIONEX PENNKINETIC, CHLORPHENIRAMINE POLISTIREX TWINJECT 0.15, EPINEPHRINE TWINJECT 0.3, EPINEPHRINE TWYNSTA, AMLODIPINE BESYLATE TYGACIL, TIGECYCLINE TYKERB, LAPATINIB DITOSYLATE TYLENOL (CAPLET), ACETAMINOPHEN (OTC) TYLENOL (GELTAB), ACETAMINOPHEN (OTC) TYLENOL W/ CODEINE NO. 3, ACETAMINOPHEN TYLENOL W/ CODEINE NO. 4, ACETAMINOPHEN TYLOX, ACETAMINOPHEN TYVASO, TREPROSTINIL TYZEKA, TELBIVUDINE TYZINE, TETRAHYDROZOLINE HYDROCHLORIDE

**

U

**

UCERIS, BUDESONIDE U-CORT, HYDROCORTISONE ACETATE ULESFIA, BENZYL ALCOHOL ULORIC, FEBUXOSTAT ULTANE, SEVOFLURANE ULTIVA, REMIFENTANIL HYDROCHLORIDE ULTRACET, ACETAMINOPHEN ULTRAM ER, TRAMADOL HYDROCHLORIDE ULTRAM, TRAMADOL HYDROCHLORIDE ULTRATAG, TECHNETIUM TC-99M RED BLOOD CELL KIT ULTRA-TECHNEKOW FM, TECHNETIUM TC-99M SODIUM PERTECHNETATE GENERATOR ULTRAVATE, HALOBETASOL PROPIONATE ULTRAVIST (PHARMACY BULK), IOPROMIDE ULTRAVIST 150, IOPROMIDE ULTRAVIST 240, IOPROMIDE ULTRAVIST 300 IN PLASTIC CONTAINER, IOPROMIDE ULTRAVIST 300, IOPROMIDE ULTRAVIST 370, IOPROMIDE ULTRESA, LIPASE UNASYN, AMPICILLIN SODIUM UNIRETIC, HYDROCHLOROTHIAZIDE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A
UNISOM, DOXYLAMINE SUCCINATE (OTC) UNITHROID, LEVOTHYROXINE SODIUM UNIVASC, MOEXIPRIL HYDROCHLORIDE URECHOLINE, BETHANECHOL CHLORIDE UREX, METHENAMINE HIPPURATE UROCIT-K, POTASSIUM CITRATE UROXATRAL, ALFUZOSIN HYDROCHLORIDE URSO 250, URSODIOL URSO FORTE, URSODIOL URSODIOL, URSODIOL UVADEX, METHOXSALEN

**

PRODUCT NAME INDEX
U **

A - 57

**

V

**

VAGIFEM, ESTRADIOL VAGISTAT-1, TIOCONAZOLE (OTC) VALACYCLOVIR HYDROCHLORIDE, VALACYCLOVIR HYDROCHLORIDE VALCYTE, VALGANCICLOVIR HYDROCHLORIDE VALIUM, DIAZEPAM VALNAC, BETAMETHASONE VALERATE VALPROATE SODIUM, VALPROATE SODIUM VALPROIC ACID, VALPROIC ACID VALSARTAN AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE VALSTAR PRESERVATIVE FREE, VALRUBICIN VALTREX, VALACYCLOVIR HYDROCHLORIDE VALTROPIN, SOMATROPIN RECOMBINANT VALTURNA, ALISKIREN HEMIFUMARATE VANCOCIN HYDROCHLORIDE IN PLASTIC CONTAINER, VANCOMYCIN HYDROCHLORIDE VANCOCIN HYDROCHLORIDE, VANCOMYCIN HYDROCHLORIDE VANCOMYCIN HYDROCHLORIDE, VANCOMYCIN HYDROCHLORIDE VANDAZOLE, METRONIDAZOLE VANIQA, EFLORNITHINE HYDROCHLORIDE VANOS, FLUOCINONIDE VANTAS, HISTRELIN ACETATE VAPRISOL IN 5% DEXTROSE IN PLASTIC CONTAINER, CONIVAPTAN HYDROCHLORIDE VARDENAFIL HYDROCHLORIDE, VARDENAFIL HYDROCHLORIDE VASCEPA, ICOSAPENT ETHYL VASERETIC, ENALAPRIL MALEATE VASOCIDIN, PREDNISOLONE SODIUM PHOSPHATE VASOTEC, ENALAPRIL MALEATE VECTICAL, CALCITRIOL VECURONIUM BROMIDE, VECURONIUM BROMIDE VELCADE, BORTEZOMIB VELETRI, EPOPROSTENOL SODIUM VELIVET, DESOGESTREL VELTIN, CLINDAMYCIN PHOSPHATE VENLAFAXINE HYDROCHLORIDE, VENLAFAXINE HYDROCHLORIDE VENOFER, IRON SUCROSE VENTAVIS, ILOPROST VENTOLIN HFA, ALBUTEROL SULFATE VERAMYST, FLUTICASONE FUROATE VERAPAMIL HYDROCHLORIDE, VERAPAMIL HYDROCHLORIDE VERDESO, DESONIDE VEREGEN, SINECATECHINS VERELAN PM, VERAPAMIL HYDROCHLORIDE VERELAN, VERAPAMIL HYDROCHLORIDE VERSACLOZ, CLOZAPINE VESICARE, SOLIFENACIN SUCCINATE VEXOL, RIMEXOLONE VFEND, VORICONAZOLE VIAGRA, SILDENAFIL CITRATE VIBATIV, TELAVANCIN HYDROCHLORIDE VIBISONE, CYANOCOBALAMIN VIBRAMYCIN, DOXYCYCLINE

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
V **

A - 58

VIBRAMYCIN, DOXYCYCLINE CALCIUM VIBRAMYCIN, DOXYCYCLINE HYCLATE VICOPROFEN, HYDROCODONE BITARTRATE VICTOZA, LIRAGLUTIDE RECOMBINANT VICTRELIS, BOCEPREVIR VIDAZA, AZACITIDINE VIDEX EC, DIDANOSINE VIDEX, DIDANOSINE VIGAMOX, MOXIFLOXACIN HYDROCHLORIDE VIIBRYD, VILAZODONE HYDROCHLORIDE VIMOVO, ESOMEPRAZOLE MAGNESIUM VIMPAT, LACOSAMIDE VINBLASTINE SULFATE, VINBLASTINE SULFATE VINCRISTINE SULFATE PFS, VINCRISTINE SULFATE VINORELBINE TARTRATE, VINORELBINE TARTRATE VINORELBINE, VINORELBINE VIOKACE, LIPASE VIORELE, DESOGESTREL VIRACEPT, NELFINAVIR MESYLATE VIRAMUNE XR, NEVIRAPINE VIRAMUNE, NEVIRAPINE VIRAZOLE, RIBAVIRIN VIREAD, TENOFOVIR DISOPROXIL FUMARATE VIROPTIC, TRIFLURIDINE VISICOL, SODIUM PHOSPHATE, DIBASIC ANHYDROUS VISINE L.R., OXYMETAZOLINE HYDROCHLORIDE (OTC) VISINE-A, NAPHAZOLINE HYDROCHLORIDE (OTC) VISIONBLUE, TRYPAN BLUE VISIPAQUE 270, IODIXANOL VISIPAQUE 320, IODIXANOL VISTARIL, HYDROXYZINE PAMOATE VISTIDE, CIDOFOVIR VISUDYNE, VERTEPORFIN VITAMIN D, ERGOCALCIFEROL VITAMIN K1, PHYTONADIONE VITRASE, HYALURONIDASE VITUZ, CHLORPHENIRAMINE MALEATE VIVACTIL, PROTRIPTYLINE HYDROCHLORIDE VIVELLE, ESTRADIOL VIVELLE-DOT, ESTRADIOL VIVITROL, NALTREXONE VOLTAREN, DICLOFENAC SODIUM VOLTAREN-XR, DICLOFENAC SODIUM VORICONAZOLE, VORICONAZOLE VOSOL HC, ACETIC ACID, GLACIAL VOSOL, ACETIC ACID, GLACIAL VOSPIRE ER, ALBUTEROL SULFATE VOTRIENT, PAZOPANIB HYDROCHLORIDE VPRIV, VELAGLUCERASE ALFA VUMON, TENIPOSIDE VUSION, MICONAZOLE NITRATE VYTORIN, EZETIMIBE VYVANSE, LISDEXAMFETAMINE DIMESYLATE

**
WARFARIN SODIUM, WARFARIN SODIUM WELCHOL, COLESEVELAM HYDROCHLORIDE WELLBUTRIN SR, BUPROPION HYDROCHLORIDE WELLBUTRIN XL, BUPROPION HYDROCHLORIDE WELLBUTRIN, BUPROPION HYDROCHLORIDE WERA, ETHINYL ESTRADIOL

W

**

**

X

**

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
X **

A - 59

XALATAN, LATANOPROST XALKORI, CRIZOTINIB XANAX XR, ALPRAZOLAM XANAX, ALPRAZOLAM XARELTO, RIVAROXABAN XELJANZ, TOFACITINIB CITRATE XELODA, CAPECITABINE XENAZINE, TETRABENAZINE XENICAL, ORLISTAT XENON XE 133, XENON XE-133 XERESE, ACYCLOVIR XIFAXAN, RIFAXIMIN XOFIGO, RADIUM RA-223 DICHLORIDE XOLEGEL, KETOCONAZOLE XOPENEX HFA, LEVALBUTEROL TARTRATE XOPENEX, LEVALBUTEROL HYDROCHLORIDE XTANDI, ENZALUTAMIDE XYLOCAINE 4% PRESERVATIVE FREE, LIDOCAINE HYDROCHLORIDE XYLOCAINE PRESERVATIVE FREE, LIDOCAINE HYDROCHLORIDE XYLOCAINE VISCOUS, LIDOCAINE HYDROCHLORIDE XYLOCAINE W/ EPINEPHRINE, EPINEPHRINE XYLOCAINE, LIDOCAINE HYDROCHLORIDE XYREM, SODIUM OXYBATE XYZAL, LEVOCETIRIZINE DIHYDROCHLORIDE

**
YASMIN, DROSPIRENONE YAZ, DROSPIRENONE

Y

**

**
ZADITOR, KETOTIFEN FUMARATE (OTC) ZAFIRLUKAST, ZAFIRLUKAST ZALEPLON, ZALEPLON ZANAFLEX, TIZANIDINE HYDROCHLORIDE ZANOSAR, STREPTOZOCIN ZANTAC 150, RANITIDINE HYDROCHLORIDE ZANTAC 150, RANITIDINE HYDROCHLORIDE (OTC) ZANTAC 25, RANITIDINE HYDROCHLORIDE ZANTAC 300, RANITIDINE HYDROCHLORIDE ZANTAC 75, RANITIDINE HYDROCHLORIDE (OTC) ZANTAC, RANITIDINE HYDROCHLORIDE ZARONTIN, ETHOSUXIMIDE ZAROXOLYN, METOLAZONE ZAVESCA, MIGLUSTAT ZEBETA, BISOPROLOL FUMARATE ZECUITY, SUMATRIPTAN SUCCINATE ZEGERID OTC, OMEPRAZOLE (OTC) ZEGERID, OMEPRAZOLE ZELAPAR, SELEGILINE HYDROCHLORIDE ZELBORAF, VEMURAFENIB ZEMPLAR, PARICALCITOL ZEMURON, ROCURONIUM BROMIDE ZENATANE, ISOTRETINOIN ZENPEP, LIPASE ZERIT, STAVUDINE ZESTORETIC, HYDROCHLOROTHIAZIDE ZESTRIL, LISINOPRIL ZETIA, EZETIMIBE ZETONNA, CICLESONIDE ZIAC, BISOPROLOL FUMARATE ZIAGEN, ABACAVIR SULFATE ZIANA, CLINDAMYCIN PHOSPHATE ZIDOVUDINE, ZIDOVUDINE

Z

**

JUNE 2013 - APPROVED DRUG PRODUCTS LIST

APPENDIX A

**

PRODUCT NAME INDEX
Z **

A - 60

ZINACEF IN PLASTIC CONTAINER, CEFUROXIME SODIUM ZINACEF, CEFUROXIME SODIUM ZINC CHLORIDE IN PLASTIC CONTAINER, ZINC CHLORIDE ZINECARD, DEXRAZOXANE HYDROCHLORIDE ZIOPTAN, TAFLUPROST ZIPRASIDONE HYDROCHLORIDE, ZIPRASIDONE HYDROCHLORIDE ZIPSOR, DICLOFENAC POTASSIUM ZIRGAN, GANCICLOVIR ZITHROMAX, AZITHROMYCIN ZMAX, AZITHROMYCIN ZOCOR, SIMVASTATIN ZOFRAN ODT, ONDANSETRON ZOFRAN PRESERVATIVE FREE, ONDANSETRON HYDROCHLORIDE ZOFRAN, ONDANSETRON HYDROCHLORIDE ZOLADEX, GOSERELIN ACETATE ZOLEDRONIC ACID, ZOLEDRONIC ACID ZOLINZA, VORINOSTAT ZOLMITRIPTAN, ZOLMITRIPTAN ZOLOFT, SERTRALINE HYDROCHLORIDE ZOLPIDEM TARTRATE, ZOLPIDEM TARTRATE ZOLPIMIST, ZOLPIDEM TARTRATE ZOMETA, ZOLEDRONIC ACID ZOMIG, ZOLMITRIPTAN ZOMIG-ZMT, ZOLMITRIPTAN ZONALON, DOXEPIN HYDROCHLORIDE ZONEGRAN, ZONISAMIDE ZONISAMIDE, ZONISAMIDE ZORBTIVE, SOMATROPIN RECOMBINANT ZORTRESS, EVEROLIMUS ZOSYN IN PLASTIC CONTAINER, PIPERACILLIN SODIUM ZOSYN, PIPERACILLIN SODIUM ZOVIA 1/35E-28, ETHINYL ESTRADIOL ZOVIA 1/50E-28, ETHINYL ESTRADIOL ZOVIRAX, ACYCLOVIR ZUPLENZ, ONDANSETRON ZUTRIPRO, CHLORPHENIRAMINE MALEATE ZYBAN, BUPROPION HYDROCHLORIDE ZYCLARA, IMIQUIMOD ZYDONE, ACETAMINOPHEN ZYFLO CR, ZILEUTON ZYFLO, ZILEUTON ZYLET, LOTEPREDNOL ETABONATE ZYLOPRIM, ALLOPURINOL ZYMAR, GATIFLOXACIN ZYMAXID, GATIFLOXACIN ZYPREXA RELPREVV, OLANZAPINE PAMOATE ZYPREXA ZYDIS, OLANZAPINE ZYPREXA, OLANZAPINE ZYRTEC ALLERGY, CETIRIZINE HYDROCHLORIDE (OTC) ZYRTEC HIVES RELIEF, CETIRIZINE HYDROCHLORIDE (OTC) ZYRTEC, CETIRIZINE HYDROCHLORIDE ZYRTEC-D 12 HOUR, CETIRIZINE HYDROCHLORIDE (OTC) ZYTIGA, ABIRATERONE ACETATE ZYVOX, LINEZOLID