FORMULARIO ENFOQUE CLÍNICO
Transcript of FORMULARIO ENFOQUE CLÍNICO
La siguiente es una lista de los fármacos más comúnmente recetados. Representa unaversión resumida de la lista de fármacos (lista de medicamentos disponibles) que es eleje de su plan de beneficios para fármacos de venta con receta. Esta lista no escompleta y no garantiza la cobertura. Además de usar esta lista, le recomendamos quele pida a su médico que le recete fármacos genéricos siempre que sea apropiado.
FORMULARIO ENFOQUE CLINICO
TENGA EN CUENTA LO SIGUIENTE: Es posible que los medicamentos de marcacambien al estado de “Fuera de Formulario” si durante el año una versión genérica sepone a disposición. No todos los fármacos que aparecen en la lista están cubiertospor todos los programas de beneficios de fármacos recetados; lea su material sobrebeneficios para ver qué medicamentos específicos están cubiertos y cuáles son loscopagos según su programa de beneficios de medicamentos recetados. Si tienepreguntas específicas sobre su cobertura, llame al número de teléfono que apareceen su tarjeta de identificación de miembros.
ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ANOREXIANTS
ADDERALL XRAE
ADDERALLAE
ADHANSIA XRQL, ST, AE
ADIPEX-PQL, PA
ADZENYS ERQL, AE
ADZENYS XR-ODTQL, ST, AE
AMPHETAMINE ERQL, AE
amphetamine sulfateQL, ST, AE
amphetamine-dextroamphet erAE
amphetamine-dextroamphetamineAE
APTENSIO XRQL, AE
armodafinilQL, PA
atomoxetine hclQL, AE
AZSTARYSQL, ST
benzphetamine hclQL, PA
CAFCITCAFFEINE ANHYDROUSCAFFEINE CITRATEDcaffeine citrateCAFFEINEclonidine hcl erQL
CONTRAVEQL, PA
COTEMPLA XR-ODTQL, ST, AE
DESOXYNPA, AE
DEXEDRINEQL, AE
dexmethylphenidate hclerQL, AE
dexmethylphenidate hclQL, AE
dextroamphetamine sulfateerAE
dextroamphetaminesulfateQL, ST, AE
diethylpropion hcl erPA
DIETHYLPROPION HCLQL, PA
EVEKEO ODTQL, ST, AE
EVEKEOQL, ST, AE
FOCALIN XRQL, ST, AE
FOCALINQL, AE
guanfacine hcl erQL
INTUNIVQL
KAPVAYQL
LOMAIRAQL, PA
metadate erQL, AE
methamphetamine hclPA, ST,
AE
METHYLINQL, AE
methylphenidate hcl er(cd)QL, AE
methylphenidate hcl er(la)QL, AE
methylphenidate hcl er(xr)QL, AE
methylphenidate hcl erQL, AE
methylphenidate hclQL, ST, AE
modafinilQL, PA
NUVIGILQL
phendimetrazine tartrateQL,
PA
phentermine hclQL, PA
procentraQL, ST, AE
PROVIGILQL
QELBREEQL
QSYMIAQL, PA
REGIMEXQL, PA
RITALIN LAQL, AE
RITALINQL, AE
STRATTERAQL, AE
WEGOVYQL, PA
XENICALQL, PA
ZENZEDIQL, ST, AE
ALLERGENICEXTRACTS/BIOLOGICALSMISC
ALK SQ CAT HAIR [INJ]HONEY BEE TREATMENT[INJ]HONEY BEE VENOM [INJ]MIXED VESPID VENOMPROTEIN [INJ]ORALAIR CHILDRENSSTARTER PACKQL
WASP VENOM PROTEIN[INJ]WHITE FACED HORNETVENOM PROT [INJ]YELLOW HORNET VENOMPROTEIN [INJ]YELLOW JACKET VENOMPROTEIN [INJ]
ALTERNATIVE MEDICINES
ALPHA-LIPOIC ACID [INJ]COENZYME Q-10 [INJ]RESERVAPAK PLUSRESERVAPAK
AMEBICIDES
IODOQUINOL
AMINOGLYCOSIDES
amikacin sulfate [INJ]AMIKACIN SULFATEGENTAMICIN IN SALINE
gentamicin sulfate [INJ]neomycin sulfateSTREPTOMYCIN SULFATETOBRAMYCIN SULFATE [INJ]TOBRAMYCIN SULFATE
ANALGESICS - ANTI-INFLAMMATORY
ANAPROX DSARAVAARTHROTECQL
CELEBREXQL
celecoxibQL, ST
DAYPROdiclofenac potassiumdiclofenac sodium erdiclofenac sodiumdiclofenac-misoprostolQL
DYLOJECTEC-NAPROSYNec-naproxenetodolac eretodolacFELDENEFENOPROFEN CALCIUMFLURBIPROFENibuprofen lysineIBUPROFENibuINDOCINindomethacin erST
indomethacin sodiumINDOMETHACINketoprofenketorolac tromethamineQL
[INJ]ketorolac tromethamineQL
KETOROLAC-ROPIV-KETAMINE [INJ]leflunomideLODINEMECLOFENAMATE SODIUMMEFENAMIC ACIDmeloxicamMOBICnabumetoneNALFONNAPROSYNnaproxen sodiumNAPROXENoxaprozinST
PHENYLBUTAZONEPIROXICAMPONSTEL
profenoRELAFEN DSQL, ST
relafenSULINDAC
ANALGESICS -NONNARCOTIC
acetaminophenACETYL SALICYLIC ACIDASPIRINbacQL
butalbital-acetaminophenQL
butalbital-apap-caffeineQL
butalbital-apapQL
butalbital-aspirin-caffeineQL
capacetQL
choline-mag trisalicylateDIFLUNISALESGICQL
FIORICETQL
FIORINALQL
marten-tabQL
OFIRMEVphrenilin forteQL
salsalateSODIUM SALICYLATETENCONQL
VANATOL LQQL
VANATOL SQL
zebutalQL
ANALGESICS - OPIOID
acetaminophen-codeine #2acetaminophen-codeine #3acetaminophen-codeine #4acetaminophen-codeineACTIQQL, PA
ALFENTANIL HCLAPADAZQL
APAP-CAFF-DIHYDROCODEINEQL
ARYMO ERQL
ascomp-codeineQL
BELBUCAQL, PA
BENZHYDROCODONE-ACETAMINOPHENQL
BUPRENEX [INJ]buprenorphine hcl-naloxone hclQL
buprenorphine hclQL [INJ]buprenorphine hclQL
BUPRENORPHINEQL
butalbital-apap-caff-codQL
butalbital-asa-caff-codeineQL
butorphanol tartrateQL, PA
[INJ]butorphanol tartrateQL, PA
BUTRANSQL
CODEINE PHOSPHATECODEINE SULFATECONZIPQL
DEMEROLDILAUDID [INJ]DILAUDIDDOLOPHINEDSUVIAduramorph [INJ]DVORAHQL
EMBEDAendocetQL
EXALGOQL
FENTANYL CIT-ROPIVACAINE-NACLfentanyl citrate (pf) [INJ]FENTANYL CITRATE-NACLFENTANYL CITRATEFENTANYL CITRATEQL, PA
fentanylQL
FIORICET/CODEINEQL
FIORINAL/CODEINE #3QL
hydrocodone bitartrate erQL
hydrocodone-acetaminophenHYDROCODONE-ACETAMINOPHENhydrocodone-ibuprofenhydromorphone hcl erQL
HYDROMORPHONE HCL PF[INJ]HYDROMORPHONE HCL-NACLHYDROMORPHONE HCL[INJ]HYDROMORPHONE HCLHYSINGLA ERQL
IBUDONEIONSYSKADIANQL
lorcet hdlorcet pluslorcetLORTABmeperidine hcl [INJ]MEPERIDINE HCLMEPERIDINE-PROMETHAZINEmethadone hcl intensolMETHADONE HCL [INJ]
METHADONE HCLMETHADOSE SUGAR-FREEMETHADOSEmitigo [INJ]morphine sulfate(concentrate)morphine sulfate (pf) [INJ]morphine sulfate (pf)MORPHINE SULFATE ERBEADSQL
morphine sulfate erQL
MORPHINE SULFATE-NACL[INJ]MORPHINE SULFATE-NACLMORPHINE SULFATEMS CONTINQL
nalbuphine hcl [INJ]NORCOOLINVYKPA
OPANAQL [INJ]OPANAQL
OXAYDOOXYCODONE HCLOXYCODONE-ACETAMINOPHENQL
oxycodone-aspirinOXYMORPHONE HCL ERQL
oxymorphone hclQL
panlorQL
pentazocine-naloxone hclPERCOCETQL
remifentanil hclROXICODONESUBSYSQL, PA
sufentanil citrateSYNALGOS-DCtramadol hcl er (biphasic)QL
TRAMADOL HCL ERQL
tramadol hclTRAMADOL HCLQL
tramadol-acetaminophenTYLENOL WITH CODEINE #3TYLENOL WITH CODEINE #4ULTRACETULTRAMverdrocetvicodin esvicodin hpvicodinXODOLXTAMPZA ERQL
xylonZAMICET
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ACTUALIZADA EL 9/1/2021. ESTA LISTA ESTÁ SUJETA A CAMBIO.©2021 Todos los derechos reservados.
ANDROGENS-ANABOLIC
ANDROGELPA
ANDROIDPA
AVEEDPA
DANAZOLDEPO-TESTOSTERONEEC-RX TESTOSTERONEPA
FIRST-TESTOSTERONE MCPA
FIRST-TESTOSTERONEPA
METHYLTESTOSTERONENANDROLONE DECANOATE[INJ]NANDROLONE-TESTOSTERONE CYP&EN[INJ]OXANDRINoxandroloneTESTIMPA
TESTONE CIKPA
TESTOPELPA
TESTOSTERONECOMPOUNDING KITPA
TESTOSTERONE CYPIONATE& PROPPA [INJ]TESTOSTERONE CYPIONATE[INJ]testosterone cypionateTESTOSTERONEENANTHATEPA [INJ]testosterone enanthatePA
TESTOSTERONEPROPIONATEPA [INJ]TESTOSTERONEPA
TESTREDPA
VOGELXO PUMPPA
XYOSTEDPA
ANORECTAL ANDRELATED PRODUCTS
ana-lexANALPRAM HC SINGLESANALPRAM HCANALPRAM-HCanucort-hcANUSOL-HCcolocortCORTENEMAhemmorex-hchydrocort-pramoxine(perianal)hydrocortisone (perianal)hydrocortisone ace-pramoxinehydrocortisone acetatehydrocortisonelidocaine-hydrocort(perianal)lidocaine-hydrocortisoneacelidocortPROCORTprocto-med hcprocto-pakPROCTOCORT
proctosol hcproctozone-hc
ANTACIDS
MAGNESIUM OXIDEMAGNESIUM TRISILICATE
ANTHELMINTICS
albendazoleALBENZABENZNIDAZOLEAE
BILTRICIDEEGATENivermectinQL
MEBENDAZOLEPIPERAZINE CITRATEpraziquantelSTROMECTOLQL
THIABENDAZOLE
ANTI-INFECTIVE AGENTS -MISC.
AEMCOLOQL, PA
atovaquoneAZACTAM [INJ]aztreonam [INJ]azuphen mbbaciimbacitracinBACTRIM DSBACTRIMCLEOCIN PHOSPHATE [INJ]CLEOCIN PHOSPHATECLEOCINclindamycin hclclindamycin palmitate hclclindamycin phosphate ind5wclindamycin phosphate [INJ]clindamycin phosphateCUBICIN RFCUBICINdapsoneAE
daptomycinDORIPENEMertapenem sodium [INJ]FIRST-METRONIDAZOLEFIRST-VANCOMYCINFLAGYLfosfomycin tromethaminefuradantinHIPREXhyolev mbimipenem-cilastatinindiomin mbINVANZ [INJ]LINCOCIN [INJ]lincomycin hcl [INJ]linezolidQL
MACROBIDMACRODANTINme/naphos/mb/hyo1MEPRONmeropenemMERREM
methenamine hippuratemethenamine mandelateMETRONIDAZOLEBENZO+SYRSPENDmetronidazole in naclmetronidazoleMONUROLNALIDIXIC ACIDnitazoxanideQL, PA
NITROFURANTOINMACROCRYSTALnitrofurantoin monohydmacronitrofurantoinpentamidine isethionate[INJ]pentamidine isethionatePENTAM [INJ]phosphasalpolymyxin b sulfate [INJ]POLYMYXIN B SULFATEPRIMAXIN IVPRIMSOLRECARBRIOsulfamethoxazole-trimethoprimsulfatrim pediatricSYNERCIDTINDAMAXtinidazoleTRIMETHOPRIMTRIMPEXur n-curamit mburelleuretron d/suribelurin dsuro-458uro-mpurophen mburylustellUTAuticaputira-cutrona-cVABOMEREQL, PA
VANCOCIN HCLVANCOCINVANCOMYCIN HCL INDEXTROSEVANCOMYCIN HCL IN NACLVANCOMYCIN HCLVANCOSOL PACKvilamit mbvilevev mbXENLETAQL, PA, AE
ZYVOXQL
ANTIANGINAL AGENTS
DILATRATE-SRISORDIL TITRADOSEisosorbide dinitrate
isosorbide mononitrate erisosorbide mononitrateminitranNITRO-DURnitro-timenitroglycerin ernitroglycerin in d5wnitroglycerinNITROLINGUALNITROSTATranolazine erQL
ANTIANXIETY AGENTS
alprazolam eralprazolam xralprazolamATIVAN [INJ]ATIVANbuspirone hclchlordiazepoxide hclclorazepate dipotassiumdiazepam intensoldiazepam [INJ]diazepamdroperidol [INJ]DROPERIDOLhydroxyzine hclHYDROXYZINE PAMOATElorazepam intensollorazepam [INJ]lorazepamLOREEV XRPA
meprobamateoxazepamTRANXENE-TVALIUMVISTARILXANAX XRXANAX
ANTIARRHYTHMICS
adenosineamiodarone hclCORVERTdisopyramide phosphateflecainide acetateibutilide fumaratelidocaine hcl (cardiac) pflidocaine hcl (cardiac)lidocaine in d5wMULTAQQL
NORPACE CRNORPACEpaceroneprocainamide hcl [INJ]PROCAINAMIDE HCLpropafenone hcl erpropafenone hclquinidine gluconate erRYTHMOL SRXYLOCAINE (CARDIAC)
ANTIASTHMATIC ANDBRONCHODILATORAGENTS
AIRDUO DIGIHALERQL, PA
ALBUTEROL SULFATE ERalbuterol sulfate hfaQL
ALBUTEROL SULFATEAMINOPHYLLINEANHYDROUSAMINOPHYLLINEARMONAIR DIGIHALERQL, PA
ARMONAIR RESPICLICK113QL
ARMONAIR RESPICLICK232QL
ARMONAIR RESPICLICK 55QL
budesonideQL
CROMOLYN SODIUMdifil-g forteELIXOPHYLLINEPHEDRINE HCLEPHEDRINE SULFATEFLUNISOLIDEIPRATROPIUM BROMIDEipratropium-albuterolisoproterenol hcl [INJ]ISOPROTERENOL-SODIUMCHLORIDEISUPREL [INJ]levalbuterol hclQL
LEVALBUTEROL TARTRATEQL
LONHALA MAGNAIR REFILLKITQL
LONHALA MAGNAIRSTARTER KITQL
METAPROTERENOLSULFATEmontelukast sodiumPULMICORTQL
SINGULAIRSTRIVERDI RESPIMATQL
terbutaline sulfate [INJ]TERBUTALINE SULFATEtheophylline erTHEOPHYLLINE-ETHYLENEDIAMINEtheophyllineUTIBRON NEOHALERQL
VOSPIRE ERXOPENEX CONCENTRATEQL
XOPENEXQL
zafirlukast
ANTICOAGULANTS
ANGIOMAXARGATROBANARIXTRAbivalirudin trifluoroacetateBIVALIRUDIN-SODIUMCHLORIDEenoxaparin sodium [INJ]enoxaparin sodiumfondaparinux sodiumHEPARIN (PORCINE) INNACLheparin lock flush
heparin sod (porcine) ind5wHEPARIN SOD (PORCINE)-D10heparin sodium (porcine) pf[INJ]HEPARIN SODIUM(PORCINE) [INJ]HEPARIN SODIUM(PORCINE)heparin sodium flushheparin sodium lock flushIPRIVASKjantovenLOVENOX [INJ]LOVENOXSASH KITSODIUM CITRATE LOCKFLUSHWARFARIN SODIUM
ANTICONVULSANTS
BANZELQL
BRIVIACTQL
carbamazepine erCARBAMAZEPINEclobazamDEPACONDEPAKENEDEPAKOTE SPRINKLESDILANTIN INFATABSDILANTINdivalproex sodium erepitolfelbamatefosphenytoin sodium [INJ]gabapentinGABITRILKLONOPINLAMICTAL ODTQL
LAMICTAL STARTERQL
LAMICTAL XRLAMICTALlamotrigine erlamotrigine starter kit-blueQL
lamotrigine starter kit-greenQL
lamotrigine starter kit-orangeQL
levetiracetam erlevetiracetam in naclLYRICAQL
MYSOLINENEURONTINONFIoxcarbazepinePHENYTEKphenytoin infatabsphenytoin sodium extendedphenytoin sodium [INJ]PHENYTOIN SODIUMQUDEXY XRQL
roweepra xr
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ACTUALIZADA EL 9/1/2021. ESTA LISTA ESTÁ SUJETA A CAMBIO.©2021 Todos los derechos reservados.
roweeprarufinamideQL
SPRITAMQL
subvenite starter kit-blueQL
subvenite starter kit-greenQL
subvenite starter kit-orangeQL
subveniteSYMPAZANTEGRETOL-XRtiagabine hclTOPAMAX SPRINKLEtopiramate erQL
TOPIRAMATE ERQL
topiramateVALTOCO 10 MG DOSEQL, PA
VALTOCO 15 MG DOSEQL, PA
VALTOCO 20 MG DOSEQL, PA
VALTOCO 5 MG DOSEQL, PA
XCOPRI (250 MG DAILYDOSE)QL
XCOPRI (350 MG DAILYDOSE)QL
XCOPRIQL
ZONEGRAN
ANTIDEPRESSANTS
amitriptyline hclANAFRANILbupropion hcl er (sr)bupropion hcl er (xl)bupropion hclCELEXAQL
citalopram hydrobromideQL
clomipramine hclCYMBALTAQL
DESIPRAMINE HCLDESVENLAFAXINE ERQL, ST
desvenlafaxine succinateerQL
doxepin hclduloxetine hclQL
EFFEXOR XRELAVILEMSAMQL, PA
escitalopram oxalatefluoxetine hclfluvoxamine maleate erQL, ST
fluvoxamine maleateIMIPRAMINE HCLimipramine pamoateKHEDEZLAQL, ST
LEXAPROMARPLANmirtazapineNARDILNEFAZODONE HCLNORPRAMINNORTRIPTYLINE HCLPAMELORPARNATEparoxetine hcl erST
paroxetine hclPAXIL CR
PAXILPEXEVAQL, ST
phenelzine sulfatePRAMLYTEPRISTIQQL
protriptyline hclPROZACREMERON SOLTABREMERONsertraline hclTOFRANILtranylcypromine sulfateTRAZODONE HCLTRIMIPRAMINE MALEATEvenlafaxine hcl erST
venlafaxine hclWELLBUTRIN SRZOLOFT
ANTIDIABETICS
acarboseACTOPLUS METACTOSADLYXIN STARTER PACKQL, PA
ADLYXINQL, PA
AMARYLAVANDIAQL
CYCLOSETQL
diazoxideDUETACTglimepirideglipizide erglipizide xlglipizide-metformin hclGLIPIZIDEGLUCAGON EMERGENCYQL
[INJ]GLUCOPHAGE XRQL
GLUCOPHAGEGLUCOTROL XLGLUCOTROLGLUCOVANCEglyburide micronizedglyburide-metforminGLYBURIDEGLYNASEGLYSETQL
metformin hcl erQL
metformin hclQL
miglitolQL
MYXREDLINnateglinidepioglitazone hcl-glimepiridepioglitazone hcl-metforminhclpioglitazone hclPRANDINQL
PRECOSEPROGLYCEMREPAGLINIDE-METFORMINHCLQL
repaglinideQL
RIOMET ERQL
RIOMETQL
STARLIXTANZEUMPA
ZEGALOGUEQL
ANTIDIARRHEAL/PROBIOTIC AGENTS
BISMUTH SUBGALLATEdiphenoxylate-atropineKAOLINLOMOTILLOPERAMIDE HCLMOTOFENopiumPECTIN
ANTIDOTES AND SPECIFICANTAGONISTS
ACETADOTEANTIZOLCETYLEVCHARCOAL ACTIVATEDCYANOKITDUODOTEEDETATE CALCIUMDISODIUMflumazenilfomepizoleKLOXXADOMETHYLENE BLUE [INJ]naloxone hcl [INJ]naltrexone hclQL
NALTREXONEPENTETATE CALCIUMTRISODIUMPENTETATE ZINCTRISODIUMPRALIDOXIME CHLORIDEPRAXBINDQL
ANTIEMETICS
ALOXIPA
ANZEMETPA
aprepitantQL, PA
BARHEMSYSPA
CESAMETQL, PA
dronabinolQL, PA
EMEND TRI-PACKQL, PA
EMENDQL, PA
FOSAPREPITANTDIMEGLUMINEPA
GRANISETRON HCLMARINOLQL, PA
MECLIZINE HCLONDANSETRON HCL-NACLONDANSETRON HCLQL [INJ]ondansetron hclQL
ondansetronPALONOSETRON HCLPA
scopolamineQL
SUSTOLQL, PA
SYNDROSPA
TIGANTRANSDERM SCOP (1.5MG)QL
TRANSDERM-SCOP (1.5MG)QL
trimethobenzamide hclZOFRAN ODTZOFRANQL
ZUPLENZ
ANTIFUNGALS
AMBISOMEAMPHOTERICIN BANCOBONBIO-STATINBREXAFEMMEQL, PA
CANCIDAScaspofungin acetateDIFLUCANfluconazole in dextrosefluconazole in sodiumchloridefluconazoleflucytosineGRIS-PEGgriseofulvin microsizegriseofulvin ultramicrosizeitraconazoleketoconazoleLAMISILmicafungin sodiumMICONAZOLEMYCAMINENOXAFILPA
nystatinONMELPA
posaconazolePA
SPORANOX PULSEPAKSPORANOXterbinafine hclTOLSURAPA
VFEND IVVFENDvoriconazole
ANTIHISTAMINES
BROMPHENIRAMINEMALEATEBROMPHENIRAMINETANNATEcarbinoxamine maleatecetirizine hclCHLORPHENIRAMINEMALEATECLARINEXQL
CLEMASTINE FUMARATEcyproheptadine hcldesloratadineQL
DEXCHLORPHENIRAMINEMALEATEdi-phenQL, PA
DICOPANOL RAPIDPAQdiphenhydramine hcl [INJ]DIPHENHYDRAMINE HCLdiphenDOXYLAMINE SUCCINATE
levocetirizinedihydrochloridephenadozPHENERGAN [INJ]phenerganpromethazine hcl [INJ]promethazine hclprometheganPYRILAMINE MALEATERYCLORATRIPELENNAMINE HCL
ANTIHYPERLIPIDEMICS
ANTARAQL, ST
atorvastatin calciumcholestyramine lightcholestyraminecolesevelam hclQL
COLESTID FLAVOREDCOLESTIDcolestipol hclCRESTORQL
ezetimibe-simvastatinQL, ST
ezetimibeQL, ST
fenofibrate micronizedQL, ST
fenofibrateQL, ST
fenofibric acidQL
FENOGLIDEQL
FLOLIPIDST
fluvastatin sodium erQL, ST
fluvastatin sodiumQL, ST
GEMFIBROZILicosapent ethylQL
LESCOL XLQL
LIPITORLOFIBRALOPIDlovastatinLOVAZAQL
MEVACORNEXLIZETQL, PA
niacin er(antihyperlipidemic)QL
NIASPANQL
omega-3-acid ethyl estersQL
PRAVACHOLpravastatin sodiumprevaliteQUESTRAN LIGHTQUESTRANrosuvastatin calciumQL
simvastatinTRICORQL
TRIGLIDEQL
trikloQL
TRILIPIXQL
VYTORINQL
ZETIAQL
ZOCORZYPITAMAGQL, ST
ANTIHYPERTENSIVES
ACCUPRILACCURETIC
ACEONaliskiren fumarateQL, ST
ALTACEamlodipine besy-benazeprilhclamlodipine besylate-valsartanQL
amlodipine-olmesartanQL
amlodipine-valsartan-hctzQL,
ST
ATACAND HCTATACANDQL
atenolol-chlorthalidoneAVALIDEAVAPROAZORQL
benazepril hclbenazepril-hydrochlorothiazideBENICAR HCTQL
BENICARQL
bisoprolol-hydrochlorothiazideBYVALSONQL, ST
candesartan cilexetil-hctzQL
candesartan cilexetilQL
CAPTOPRIL-HYDROCHLOROTHIAZIDEcaptoprilCARDURACATAPRES-TTS-1CATAPRES-TTS-2CATAPRES-TTS-3CATAPRESCLONIDINE HCLclonidineCLORPRESCORZIDEST
COZAARDIBENZYLINEDIOVAN HCTDIOVANdoxazosin mesylateenalapril maleateenalapril-hydrochlorothiazideenalaprilatepanedQL, PA
eplerenoneEPROSARTAN MESYLATEQL
EXFORGE HCTQL
EXFORGEQL
fosinopril sodium-hctzfosinopril sodiumguanfacine hclhydralazine hcl [INJ]hydralazine hclHYZAARINSPRAirbesartan-hydrochlorothiazideirbesartanlisinopril-hydrochlorothiazide
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ACTUALIZADA EL 9/1/2021. ESTA LISTA ESTÁ SUJETA A CAMBIO.©2021 Todos los derechos reservados.
lisinoprilLOPRESSOR HCTlosartan potassium-hctzlosartan potassiumLOTENSIN HCTLOTENSINLOTRELMETHYLDOPATE HCLmethyldopaMETOPROLOL-HYDROCHLOROTHIAZIDEMICARDIS HCTQL
MICARDISQL
MINIPRESSminoxidilmoexipril hclmoexipril-hydrochlorothiazidenadolol-bendroflumethiazideST
NITROPRESSnitroprusside sodiumolmesartan medoxomil-hctzQL
olmesartan medoxomilQL
olmesartan-amlodipine-hctzQL
perindopril erbuminephenoxybenzamine hclphentolamine mesylate[INJ]PRAZOSIN HCLPRINIVILQBRELISQL, PA
quinapril hclquinapril-hydrochlorothiazideramiprilRESERPINEsodium nitroprussideTARKAtelmisartan-amlodipineQL, ST
telmisartan-hctzQL, ST
telmisartanQL
TENORETIC 100TENORETIC 50terazosin hclTRANDOLAPRIL-VERAPAMILHCL ERST
trandolaprilTRIBENZORQL
TWYNSTAQL
valsartan-hydrochlorothiazidevalsartanVASERETICVASOTECZESTORETICZESTRILZIAC
ANTIMALARIALS
ARAKODAatovaquone-proguanil hcl
CHLOROQUINE PHOSPHATEhydroxychloroquine sulfateMALARONEmefloquine hclPLAQUENILPRIMAQUINE PHOSPHATEQL
pyrimethaminePA
QUALAQUINQL
QUINACRINE HCLQUININE SULFATEDIHYDRATEQUININE SULFATEQL
ANTIMYASTHENIC/CHOLINERGIC AGENTS
pyridostigmine bromide er
ANTIMYCOBACTERIALAGENTS
AMINOSALICYLIC ACID-4cycloserineETHAMBUTOL HCLISONIAZIDMYAMBUTOLMYCOBUTINPRETOMANIDQL, PA
pyrazinamiderifabutinRIFADINRIFAMPIN+SYRSPEND SFrifampin
ANTINEOPLASTICS ANDADJUNCTIVE THERAPIES
anastrozoleARIMIDEXAROMASINbicalutamideCASODEXdexrazoxane hclexemestaneFEMARAflutamideHYDREAhydroxyurealetrozoleleucovorin calcium [INJ]leucovorin calciumLEVAMISOLE HCLMEGESTROL ACETATEmercaptopurineMETASTRONmethotrexate sodium (pf)[INJ]methotrexate sodium [INJ]methotrexate sodiumMETHOTREXATENILANDRONnilutamideRYLAZEPA
tamoxifen citratetoremifene citratetretinoinAE
XATMEPPA
ZINECARD
ANTIPARKINSON ANDRELATED THERAPYAGENTS
AZILECTQL
benztropine mesylate [INJ]benztropine mesylateBROMOCRIPTINE MESYLATEcarbidopa-levodopa ercarbidopa-levodopaCOGENTIN [INJ]COMTANELDEPRYLentacaponeGOCOVRIQL, PA
KYNMOBI TITRATION KITQL,
PA
KYNMOBIQL, PA
LEVODOPALODOSYNMIRAPEX ERQL
MIRAPEXNOURIANZQL, PA, AE
ONGENTYSQL
OSMOLEX ERQL, PA
PARLODELpramipexoledihydrochloride erQL, ST
pramipexoledihydrochlorideREQUIP XLQL
REQUIPropinirole hcl erQL, ST
ropinirole hclSELEGILINE HCLSINEMET CRSINEMETTASMARtolcaponetrihexyphenidyl hclXADAGOQL, PA, ST
ZELAPAR
ANTIPSYCHOTICS/ANTIMANIC AGENTS
ABILIFYADASUVEPA
aripiprazoleQL, ST
asenapine maleateQL, ST
CAPLYTAQL
chlorpromazine hclCLOZAPINECLOZARILcomproEQUETROFANAPT TITRATION PACKFANAPTQL, ST
FAZACLOfluphenazine decanoate[INJ]fluphenazine hclGEODONQL, PA
HALDOL DECANOATEHALDOL [INJ]haloperidol decanoate
haloperidol lactate [INJ]haloperidol lactatehaloperidolINVEGA HAFYERAQL, PA
INVEGA SUSTENNAQL, PA
INVEGA TRINZAQL, PA
INVEGAQL, ST
lithium carbonate erLITHIUM CARBONATEloxapine succinateolanzapineQL
paliperidone erQL, ST
perphenazinePERSERISQL, PA
prochlorperazine edisylate[INJ]PROCHLORPERAZINEMALEATEprochlorperazinequetiapine fumarate erQL, ST
quetiapine fumarateQL
REXULTIQL, ST
RISPERDAL M-TABRISPERDALQL
risperidone m-tabrisperidoneQL
SECUADOQL, PA
SEROQUEL XRQL, ST
SEROQUELQL
thioridazine hclthiothixenetrifluoperazine hclVERSACLOZVRAYLARQL, ST
ziprasidone hclQL
ziprasidone mesylateQL, PA
ZYPREXA RELPREVVQL, PA
ZYPREXA ZYDISZYPREXAQL
ANTISEPTICS &DISINFECTANTS
CETYLCIDE-GCHLORHEXIDINEGLUCONATEformadonformaldehydePHENOLSILVER PROTEIN MILDTHIMEROSAL
ANTIVIRALS
acyclovir sodiumacyclovircidofovirCYTOVENEemtricitabineQL, †
famciclovirFLUMADINEfoscarnet sodiumFOSCAVIRganciclovir sodiumoseltamivir phosphateQL
TAMIFLUQL
valacyclovir hcl
VALCYTEvalganciclovir hclVALTREXVOCABRIAQL, †
XOFLUZA (40 MG DOSE)QL
XOFLUZA (80 MG DOSE)QL
ZOVIRAX
BETA BLOCKERS
ACEBUTOLOL HCLATENOLOLBETAPACE AFBETAPACEbetaxolol hclbisoprolol fumarateBREVIBLOC IN NACLBREVIBLOC PREMIXED DSBREVIBLOC PREMIXEDBREVIBLOCcarvedilol phosphate erQL, ST
carvedilolCOREG CRQL
COREGCORGARDesmolol hcl-sodium chlorideesmolol hclINDERAL LAKAPSPARGO SPRINKLELABETALOL HCL-DEXTROSELABETALOL HCL-SODIUMCHLORIDElabetalol hclLOPRESSORmetoprolol succinate erMETOPROLOL TARTRATEQL,
ST
NADOLOLST
nebivolol hclQL, ST
pindololpropranolol hcl erPROPRANOLOL HCLsorinesotalol hcl (af)sotalol hclTENORMINTIMOLOL MALEATETOPROL XLZEBETA
CALCIUM CHANNELBLOCKERS
ADALAT CCafeditab crAMLODIPINEBES+SYRSPEND SFamlodipine besylateCALAN SRCALANCARDENE IVCARDIZEM CDCARDIZEM LAST
CARDIZEMcartia xtdilt-xrdiltiazem cd
diltiazem hcl er beadsdiltiazem hcl er coatedbeadsST
diltiazem hcl erdiltiazem hclfelodipine erisradipineKATERZIAQL, ST
matzim laNICARDIPINE HCL IN NACLnicardipine hclnifedipine er osmoticreleasenifedipine erNIFEDIPINEnimodipineST
NISOLDIPINE ERST
NORVASCPROCARDIA XLPROCARDIASULARtaztia xttiadylt erTIAZACverapamil hcl erVERAPAMIL HCLVERELAN
CARDIOTONICS
digitekdigoxin [INJ]digoxindigoxdobutamine hcldobutamine in d5wdopamine hcldopamine in d5wLANOXIN [INJ]LANOXINmilrinone lactate indextrosemilrinone lactate
CARDIOVASCULARAGENTS - MISC.
ABLYSINOLamlodipine-atorvastatinST
CADUETcardioplegicCAVERJECT IMPULSEQL
CIALISQL
EDEXQL
IFE-PG20isoxsuprine hclLEVITRAQL
NYLIDRIN HCLPAPAV-PHENTOLAMINE-ALPROSTADILPAPAVERINE HCL [INJ]PAPAVERINE HCLPAPAVERINE-PHENTOLAMINEsildenafil citrateQL
tadalafilQL, ST
vardenafil hclQL
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ACTUALIZADA EL 9/1/2021. ESTA LISTA ESTÁ SUJETA A CAMBIO.©2021 Todos los derechos reservados.
VERQUVOQL, PA
VIAGRAQL
CEPHALOSPORINS
cefaclorcefadroxilCEFAZOLIN IN SODIUMCHLORIDECEFAZOLIN SODIUM-DEXTROSECEFAZOLIN SODIUM-NACLcefazolin sodium [INJ]CEFAZOLIN SODIUMcefdinircefepime hcl [INJ]cefiximeCEFOTAN [INJ]cefotaxime sodium [INJ]CEFOTAXIME SODIUM [INJ]cefotetan disodium [INJ]cefoxitin sodium [INJ]cefoxitin sodiumcefpodoxime proxetilcefprozilceftazidime [INJ]CEFTINCEFTRI-IMceftriaxone sodium [INJ]ceftriaxone sodiumCEFTRISOL PLUS [INJ]cefuroxime axetilcefuroxime sodium [INJ]cefuroxime sodiumcephalexinDAXBIAFORTAZ [INJ]KEFLEXMAXIPIME [INJ]MAXIPIMESUPRAXtazicef [INJ]TAZICEFZINACEF IN STERILE WATERZINACEF [INJ]ZINACEF
CHEMICALS
2-DEOXY-D-GLUCOSE2-METHOXYESTRADIOL4-AMINOBUTYRIC ACID4-AMINOPYRIDINE4-METHYLPYRAZOLE5-FLUOROURACIL5-HTP5-HYDROXY-L-TRYPTOPHAN5-METHYLTETRAHYDROFOLATE CALC7-KETO DHEA9-AMINOACRIDINE HCLAC DERMAPEPTIDEACARBOSEACEPROMAZINE MALEATEACESULFAME POTASSIUM
ACETAMINOPHENACETARSONEACETAZOLAMIDEACETIC ACID GLACIALACETIC ACIDACETONEACETYL DIPEPTIDE-1 CETYLESTERACETYL HEXAPEPTIDE-8ACETYL-D-GLUCOSAMINEACETYL-L-CARNITINE HCLACETYLCHOLINE CHLORIDEACIDOPHILUSLACTOBACILLUSACTIPHYTE OF ALGAE GLACTIPHYTE OF CUCUMBERACTIPHYTE OF IVYACTIPHYTE OFLEMONGRASSACYCLOVIRADEMETIONINE DISULFTOSYLATEADENOSINEADRENOCHROMESEMICARBAZONEADRENOCORTICOTROPHICHORMONEAGARALASKAN RED ALGAEALBENDAZOLEALCOHOL, USPALDOSTERONEALGINIC ACIDALKYL BENZOATE C12-15ALLANTOINALLOPURINOLALMOND OIL (SWEET)ALOE VERA FREEZE DRIEDALOE VERA LEAFALOE VERAALPHA-GPC 50%ALPHA-KETOGLUTARIC ACIDALPHA-LIPOIC ACIDALPHA-TOCOPHEROLALPRAZOLAMALPROSTADILALTRENOGESTALUMINUM ACETATE BASICALUMINUMCHLOROHYDRATEALUMINUM HYDROXIDEDRIED GELALUMINUM POTASSIUMSULFATEALUMINUM SULFATEAMANTADINE HCLAMERICAN GINSENGAMINOCAPROIC ACIDAMINOLEVULINIC ACID HCLAMINOPROPYLRACEMENTHYL PHOSAMITRIPTYLINE HCLAMLODIPINE BESYLATEAMMONIUM BROMIDE
AMMONIUM CHLORIDEAMMONIUM HYDROXIDEAMMONIUM LACTATEAMMONIUM LAURYLSULFATEAMMONIUM MOLYBDATETETRAHYDAMMONIUM PHOSPHATEDIBASICAMMONIUM SULFATEANASTROZOLEANDROSTENEDIONEANISINDIONEANTIMONY POTASSIUMTARTRATEANTIMONY TRICHLORIDEANTIMONY TRISULFIDEANTIPYRINEAPOMORPHINE HCLARBUTIN ALPHAARGININE HCLARLACEL 165ARSENIC TRIOXIDEASCORBIC ACID CASSAVEASCORBIC ACID FINEASCORBIC ACIDASCORBYL PALMITATEASPARAGINEMONOHYDRATEATORVASTATIN CALCIUMATOVAQUONEATTAPULGITEAVICEL PH 101 MICROCELLULOSEAVICEL PH 105 MICROCELLULOSEAVIPTADIL ACETATEAVOCADO OILAZELAIC ACIDAE
AZELASTINE HCLQL
AZITHROMYCIN DIHYDRATEAZITHROMYCINBACITRACIN MICRONIZEDBASE G ALMOND OIL(SWEET)BASIC FUCHSIN HCLBAY OILBECLOMETHASONEDIPROPIONATEBELLADONNA EXTRACTBELLADONNA LEAFEXTRACTBELLADONNABENACTYZINE HCLBENAZEPRIL HCLBENFOTIAMINEBENZETHONIUM CHLORIDEBENZOCAINEBENZOIN GUMBENZOQUINONE (PARA)BENZYL BENZOATEBETA CAROTENEBETA CYCLODEXTRINBETA GLUCAN
BETAHISTINEDIHYDROCHLORIDEBETAHISTINE HCLBETAINE ANHYDROUSBETAINE HCLBETAMETHASONE ACETATEBETAMETHASONEBETANAPHTHOLBETHANECHOL CHLORIDEBHABHTBIMATOPROSTST
BIORE HYDRATINGMOISTURIZERBIOTINBISABOLOL, ALPHA-LBISMUTH CITRATEBISMUTH SUBCARBONATEBISMUTH SUBNITRATEBISMUTH SUBSALICYLATEBITTER ORANGEBLUE AGAVE ORGANICBORIC ACIDBORON AMORPHOUS FINEBORON CITRATEBOSWELLIA SERRATAEXTRACTBRIJ 35BRIJ 700BRIJ 93BRILLIANT GREENBRIMONIDINE TARTRATEBROMFENAC SODIUMBUDESONIDEQL
BUFLOMEDIL HCLBUPRENORPHINE HCLQL
BUPROPION HCLBUSPIRONE HCLBUTALBITALBUTORPHANOLTARTRATEQL, PA
BUTYL ALCOHOLBUTYLATEDHYDROXYANISOLEBUTYLATEDHYDROXYTOLUENEBUTYLENE GLYCOLC INDICUM & C SINESISLEAF EXTCALCIPOTRIENEMONOHYDRATECALCIPOTRIENECALCIPOTRIOLCALCITRIOL IN ALMOND OILCALCIUM ACETATECALCIUM ALGINATECALCIUM AMINO ACIDCHELATECALCIUM CHLORIDEANHYDROUSCALCIUM CITRATETETRAHYDRATECALCIUM CITRATECALCIUM FOLINATE
CALCIUM FRUCTOBORATECALCIUM GLUBIONATECALCIUMGLYCEROPHOSPHATECALCIUM HYDROXIDECALCIUM HYDROXYAPATITECALCIUM LEVULINATEDIHYDRATECALCIUM PROPIONATECALCIUM PYRUVATECALCIUM SACCHARINCALCIUM STEARATECALCIUM SULFATEHEMIHYDRATECALCIUM SULFATECALCIUM THIOGLYCOLATECANADIAN BALSAMCANNABIDIOLCAPRYLIC ACIDCAPRYLIC CAPRICTRIGLYCERIDECAPSAICIN PALMITATECAPSICUM OLEORESINCAPTOPRILCARBACHOLCARBAMIDE PEROXIDECARBAZOCHROMECARBIDOPA ANHYDROUSCARBIDOPACARBIMAZOLECARBOMER 934P RESINCARBOMER 934PCARBOMER 940CARBOMER 941CARBOPOL 940 NFCARBOPOL 940CARBOXYMETHYLCELLULOSE SODIUMCARMINECARNAUBA WAXCARNITINE (L)CARNOSINE LCASTOR OILCEDAR LEAF OILCEFTAZIDIME WITH SODCARBONATECEFTAZIDIMECEFTRIAXONE SODIUMCELECOXIBQL, ST
CELLULASECELLULOSE CARMELLOSESODIUMCELLULOSECERAPHYL SLKCERESIN WAXCESIUM CHLORIDECETEARYL ALCOHOL-CETEARETH 20CETOSTEARYL ALCOHOLCETYL ESTERS WAXCETYL MYRISTOLEATECETYLPYRIDINIUMCHLORIDECHICKEN PROTEIN
CHLORAMBUCILCHLORAMPHENICOLPALMITATECHLORAMPHENICOLCHLORHEXIDINE DIACETATECHLOROFORMCHLOROPHYLLIN SODIUMCOPPERCHLOROXINECHLOROXYLENOLCHLORPROMAZINE HCLCHOLECALCIFEROLCHOLESTEROLCHOLINE CHLORIDECHOLINE MAGTRISALICYLATECHONDROITIN SULFATESODIUMCHORIONICGONADOTROPINCHROMIC CHLORIDECHROMIUM CHLORIDECHROMIUM K SULFATEDODECAHYDCHROMIUM PICOLINATECHROMIUMPOLYNICOTINATECHRYSINCIDOFOVIRCINNAMON BARKCIPROFLOXACIN HCLCISAPRIDECISPLATINCITRIC ACID ANHYDROUSCITRIC ACIDMONOHYDRATECITRIC ACIDCITRONELLA OILCITRULLINECITRUS BIOFLAVONOIDSCLARITHROMYCINCLEMIZOLE HCLCLIDINIUM BROMIDECLINDAMYCIN HCLMONOHYDRATECLINDAMYCIN HCLCLINDAMYCIN PHOSPHATECLOFAZIMINECLOMIPRAMINE HCLCLONAZEPAMCLOPIDOGREL BISULFATECLORSULONCLOVE OILCOAL TAR EXTRACTCOAL TARCOBALT GLUCONATECOBAMAMIDECOCAMIDE DEACOCONUT OILCOENZYME Q10COLHIBINCOLISTIMETHATE SODIUMCOLLAGEN HYDROLYSATECOPASIL
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ACTUALIZADA EL 9/1/2021. ESTA LISTA ESTÁ SUJETA A CAMBIO.©2021 Todos los derechos reservados.
COPPER GLUCONATECOPPER GLYCINATECOPPER PEPTIDECORAL CALCIUMCORN OILCORN STARCHCORTICOTROPINCOSMOCIL CQCOTTONSEED OILCOUMARINCRANBERRYCREATINE MONOHYDRATECREATINECREATININECRESOLCROSCARMELLOSE SODIUMCROTAMITONCROTON OILCRYOSERVCUCUMBER MELONCUPRIC CHLORIDEDIHYDRATECUPUACU BUTTERCURCUMIN EXTRACTCURCUMINCYANOCOBALAMINCYCLANDELATECYCLOBENZAPRINE HCLCYCLOBENZAPRINECYCLODEXTRIN-BETACYCLOMETHICONECYCLOPENTASILOX-PEG/PPG DIMETHCYCLOPENTOLATE HCLCYCLOPHOSPHAMIDECYCLOSERINECYCLOSPORINE ACYCLOSPORINECYPROHEPTADINE HCLCYSTEAMINE HCLD-MANNOSED-RIBOSEDALFAMPRIDINEDANTROLENE SODIUMDAPIPRAZOLE HCLDAPSONEAE
DEHYDROCHOLIC ACIDDEHYDROEPIANDROSTERONE MICRODEHYDROEPIANDROSTERONEDEMECARIUM BROMIDEDENATONIUM BENZOATEDEOXYCHOLIC ACIDSODIUMDEOXYCHOLIC ACIDDERMACINRX ETHOXYDIGLYCOLDESICCATED BEEF LIVERDESMOPRESSIN ACETATEDESOXIMETASONEST
DESOXYCORTICOSTERONEACETATEDEVILS CLAW
DEXAMETHASONE ACETATEDEXAMETHASONE BASEDEXAMETHASONEISONICOTINATEDEXAMETHASONEDEXPANTHENOLDEXTRAN 40000DEXTRAN 75000DEXTROMETHORPHANDHEA MICRONIZEDDHEADIAMINOPYRIDINEDIAZEPAMDIAZOXIDEDIBUCAINE HCLDIBUCAINEDIBUTYL SQUARATEDICHLORALPHENAZONEDICHLOROACETIC ACIDDICLAZURILDICLOFENAC SODIUMDICUMAROLDICYCLOMINE HCLDIETHANOLAMINEDIETHYL PHTHALATEDIETHYL TOLUAMIDEDIETHYLCARBAMAZINECITRATEDIETHYLENE GLYCOLMONOETHYL ETDIETHYLSTILBESTROLDIGOXIN MICRONIZEDDIGOXINDIHYDROCODEINEBITARTRATEDIHYDROXYACETONE (1,3)DIMERDIINDOLYLMETHANEDIIODO-L-THYRONINE 3,5DILTIAZEM HCLDIMENHYDRINATEDIMERCAPTOPROPANE-SULFONATE NADIMERCAPTOSUCCINICACIDDIMETHYL FUMARATEDIMETHYL SILOXANEHYDROXYALKYLDIMETHYL SULFONEDIMETHYL SULFOXIDEDIMETHYLACETAMIDEDIMETHYLAMINOETHANOLDIMETHYLGLYCINE HCLDINITROCHLOROBENZENEDIOSGENINDIOSMINDIOXYBENZONEDIPHENIDOL HCLDIPHENYLCYCLOPROPENONEDIPYRIDAMOLEDISOPHENOLDISULFIRAMQL
DIVALPROEX SODIUM
DL-3-HYDROXYBUTYRICACID SODDL-ALPHA LIPOIC ACIDDL-PANTHENOL ALCOHOLDL-PANTHENOLDMAE BITARTRATEDOCOSANOLDOCUSATE SODIUM-SODBENZOATEDOPAMINE HCLDOW CORNING 1501 FLUIDDOW CORNING 200DOXAZOSIN MESYLATEDOXEPIN HCLDOXYCYCLINEMONOHYDRATEDRAKKAR NOIRDULOXETINE HCLQL
DUTASTERIDEQL
DYCLONINE HCLDYPHYLLINEECONAZOLE NITRATEEDETATE ACIDEDETATE DISODIUMDIHYDRATEEDETATE DISODIUMEDETATE SODIUMEDETIC ACIDEDROPHONIUM CHLORIDEEGCGEMU OILENALAPRIL MALEATEENOVARX-AMITRIPTYLINEENROFLOXACINEPINEPHRINE BASEEPINEPHRINE BITARTRATEEPINEPHRINEQL, PA
ERGOLOID MESYLATESERYTHROMYCIN ESTOLATEESTRADIOL BENZOATEESTRADIOL CYPIONATEESTRADIOL HEMIHYDRATE(BULK)ESTRADIOL MICRONIZEDESTRADIOL VALERATEESTRIOL MICRONIZEDESTRIOLESTRONEETHERETHOSUXIMIDEETHOXY DIGLYCOLETHYL ALCOHOLETHYL OLEATEETHYL VANILLINETHYLCELLULOSEETHYLENEDIAMINEETHYLPARABENETOMIDATEETOPOSIDEEUCALYPTOLEUCALYPTUS OILEUGENOLFAMOTIDINEFENBENDAZOLE
FENOFIBRATEQL, ST
FERRIC AMMONIUMCITRATEFERRIC CHLORIDEHEXAHYDRATEFERRIC PYROPHOSPHATEFERRIC SUBSULFATEFERRIC SULFATEFERROUS BISGLYCINATECHELATEFERROUS FUMARATEFERROUS GLUCONATEDIHYDRATEFERROUS GLUCONATEFERULIC ACIDFEVERFEWFEXOFENADINE HCLFINASTERIDEFLIBANSERINFLOXURIDINEFLUCONAZOLEFLUCYTOSINEFLUMAZENILFLUNIXIN MEGLUMINEFLUORESCEIN SODIUMFLUORESCEINFLUOROURACILFLUOXETINE HCLFLUPHENAZINEDECANOATEFLUTICASONEPROPIONATEST
FORMOTEROL FUMARATEDIHYDRATEFORMOTEROL FUMARATEFORSKOLINFREEDOM ESTERDERMFRESH LINEN FRAGRANCEFULLERS EARTHFUMARIC ACIDFURAZOLIDONEGALACTOSEGAMMA-AMINOBUTYRICACIDGARDENIA FRAGRANCEGATIFLOXACINGENISTEINGERANIUM OILGERMALL PLUSGERMANIUM SESQUIOXIDEGINGER OILGINGER ROOTGINSENG ROOTGLUCONOLACTONEGLUCOSAMINE HCLGLUCOSAMINE SULFATENACLGLUCOSAMINE SULFATEPOTASSIUMGLUCOSAMINE SULFATEGLUTARALDEHYDE INWATERGLYCERINEGLYCERIN
GLYCEROL FORMALGLYCEROL MONOOLEATEGLYCERYL MONOSTEARATEGLYCINE SOYA PROTEINGLYCOFUROLGLYCOPYRROLATEGLYCOSAMINOGLYCANSGLYCYRRHIZIC ACIDGOLD SODIUMTHIOMALATEGRAMICIDIN DGRAPE SEEDGREEN SOAPGREEN TEA OIL FRAGRANCEGREEN TEAGRISEOFULVINMICRONIZEDGRISEOFULVIN MICROSIZEGUAIACOLGUANABENZ ACETATEGUANETHIDINE SULFATEGUANIDINEACETIC ACIDGUAR GUMGUARANA SEED EXTRACTGYMNEMA SYLVESTRISLEAFHALOPERIDOL DECANOATEHALOPERIDOLHAWTHORN BERRYHEMATOXYLINHEPARIN SODIUMHEPESHEPTAMINOLHISTAMINE PHOSPHATEHOMATROPINEMETHYLBROMIDEHONEY ALMONDFRAGRANCEHUMAN CHORIONICGONADOTROPINHUPERZINE SERRATE AHYALURONATE SODIUMHYALURONIC ACID SODIUMHYALURONIC ACIDHYALURONIDASEHYDRALAZINE HCLHYDRAZINE SULFATEHYDROCHLORIC ACIDHYDROCODONEBITARTRATEHYDROCORTISONEHEMISUCCINATEHYDROFLUORIC ACIDHYDROXOCOBALAMIN HCLHYDROXOCOBALAMINHYDROXYAMPHETAMINEHBRHYDROXYCHLOROQUINESULFATEHYDROXYETHYL CELLULOSEHYDROXYETHYLMETHACRYLATEHYDROXYPROGESTERONECAPROATE
HYDROXYPROPYLCELLULOSEHYDROXYPROPYLMETHYLCELLULOSEHYDROXYPROPYL-BETA-CYCLODEXTHYDROXYQUINOLINESULFATEHYDROXYTRYPTOPHAN L-5HYDROXYTRYPTOPHANHYDROXYUREAHYDROXYZINE HCLHYPROMELLOSE METHOCELK100MHYPROMELLOSEIDEBENONEIDOXURIDINEIMIDUREAIMIQUIMODINDOCYANINE GREENINDOLE-3-CARBINOLINOSITOL HEXANICOTINATEINOSITOLIODINE RESUBLIMEDIODINE STRONG (LUGOL'S)IODINEIODOFORMIOPANOIC ACIDISOMETHEPTENE MUCATEISOPROPYL ALCOHOLISOPROPYL MYRISTATEISOPROPYL PALMITATEISOPROTERENOL HCLISOSORBIDEISOTRETINOINPA, AE
ISOXSUPRINE HCLITRACONAZOLEIVERMECTINQL
JASMINE FRAGRANCEJOJOBA OILJUNIPER TARKANAMYCIN SULFATEKETOPROFENKETOTIFEN FUMARATEKETOTIFEN HYDROGENFUMARATEKINETINKIWI FRAGRANCEKOJIC ACIDKUDZUL-ARGININE HCLL-ASPARAGINEL-ASPARTIC ACIDL-CARNITINEL-CARNOSINEL-CITRULLINEL-CYSTEINE HCLL-CYSTEINEL-GLUTAMIC ACIDMONOSOD SALTL-LYSINE HCLL-MENTHOLL-METHYLFOLATE CALCIUM
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ACTUALIZADA EL 9/1/2021. ESTA LISTA ESTÁ SUJETA A CAMBIO.©2021 Todos los derechos reservados.
L-ORNITHINEHYDROCHLORIDEL-SELENOMETHIONINEBLENDL-SELENOMETHIONINEL-SERINELABETALOL HCLLACTASE 5000LACTIC ACIDLAMOTRIGINEQL
LANSOPRAZOLELAURETH-9 POLIDOCANOLLAURIC ACIDLAVENDER OILLEAD ACETATE TRIHYDRATELEAD TETROXIDELECITHIN SOYALEFLUNOMIDELETROZOLELEUCOVORIN CALCIUMLEVALBUTEROL HCLQL
LEVETIRACETAMLEVOCARNITINELEVOCETIRIZINEDIHYDROCHLORIDELEVOFLOXACINHEMIHYDRATELEVOFLOXACINLEVOMEFOLATE CALCIUMLEVOMEFOLATEGLUCOSAMINELEVORPHANOL TARTRATELICORICEDEGLYCYRRHIZINATEDLICORICE ROOTLIDOCAINE HCLMONOHYDRATELIDOCAINEQL
LIME OILLIMONENELINCOMYCIN HCLLINOLEIC ACIDLINSEED OILLIOTHYRONINE SODIUMLIOTHYRONINELIPACTIVE INCA INCHI WOLIPOIC ACIDLISINOPRILLITHIUM CITRATETETRAHYDRATELOCUST BEAN GUMLORATADINELORAZEPAMLOSARTAN POTASSIUMLUTEINLYSINE HCLMACA ROOTMACADAMIA NUT OILMAFENIDE ACETATEMAGNASWEET 110MAGNASWEET 135MAGNESIUM ALUMINUMSILICATE
MAGNESIUM AMINO ACIDCHELATEMAGNESIUM ASCORBATEMAGNESIUM BISGLYCINATEDIHYDMAGNESIUM CITRATEMAGNESIUM GLUCONATEMAGNESIUM GLYCINATEMAGNESIUM HYDROXIDEMAGNESIUM MALATEMAGNESIUM PHOSPHATEMAGNESIUM SALICYLATEMALEIC ACIDMALIC ACIDMALTODEXTRINMANDELIC ACIDMANGANESE CHLORIDETETRAHYDMANGANESE GLUCONATEMANGANESE SULFATEMANNITOLMECAMYLAMINE HCLMECHLORETHAMINE HCLMECLOFENOXATE HCLMEDIUM CHAINTRIGLYCERIDESMEDROXYPROGESTERONEACE MICROMEDROXYPROGESTERONEACETATEQL
MEDROXYPROGESTERONEMICRONIZEDMEGLUMINEMELATONINMELOXICAMMEMANTINE HCLQL
MENADIONE SODIUMBISULFITEMENADIONEMENTHOLMEQUINOLMERCAPTOPURINEMONOHYDRATEMERCAPTOPURINEMETACRESOL ACETATEMETFORMIN HCLQL
METHACHOLINE CHLORIDEMETHACRYLIC ACIDCOPOLYMER AMETHANESULFONIC ACIDMETHANOLMETHENAMINEMANDELATEMETHENAMINEMETHOCARBAMOLMETHOCEL E4M PREMIUMCRMETHOCEL E4M PREMIUMMETHOCEL E4MMETHOCEL K100 PREMIUMMETHOCEL K100MPREMIUMMETHOXYAMINEHYDROCHLORIDE
METHOXYETHANOLMETHSCOPOLAMINEBROMIDEMETHSCOPOLAMINENITRATEMETHYL FOLATEMETHYL METHACRYLATECROSSPOLYMETHYL SULFONEMETHYLCOBALAMINPREMIUMMETHYLCOBALAMINMETHYLENE BLUEMETHYLMETHACRYLCROSSPOLYMERMETHYLPHENIDATE HCLQL, ST,
AE
METHYLSULFONYLMETHANEMETHYSERGIDE MALEATEMETRONIDAZOLEBENZOATEMETRONIDAZOLEMEXILETINE HCLMICROCRYSTAL CELLULOSENF 101MICROCRYSTAL CELLULOSENF 105MILK THISTLEMINOXIDILMIRTAZAPINEMISOPROSTOL DISPERSION(HPMC)MISOPROSTOL-HPMCMISOPROSTOLMITOMYCINMITOTANEMOLYBDENUMMOMETASONE FUROATEQL
MONOBENZONEMONOETHANOLAMINEMONTELUKAST SODIUMMORANTEL TARTRATEMOXISYLYTE HCLMUPIROCINN-ACETYL-L-CARNOSINENABUMETONENADH DISODIUMNADHNALBUPHINE HCLNALOXONE HCL DIHYDRATENALOXONE HCLNALTREXONE HCLANHYDROUSNALTREXONE HCLQL
NANDROLONE DECANOATENAPHAZOLINE HCLNATAPRESNATURAL MIXEDTOCOPHEROLSNEOSTIGMINEMETHYLSULFATENEPAFENACNETTLE LEAF
NIAOULINICLOSAMIDENICOTINAMIDE ADENINEDINUCLEONICOTINAMIDE RIBOSIDECHLORIDENICOTINE POLACRILEXNICOTINE TARTRATENIFEDIPINE MICRONIZEDNIMODIPINEST
NITRIC ACIDNITROFURANTOINANHYDROUSNITROFURANTOINMONOHYDRATENONOXYNOL-9NOREPINEPHRINEBITARTRATENORETHINDRONENOURISILNYSTATINOCTINOXATEOCTYL STEARATEOLIVE OILOLMESARTANMEDOXOMILQL
OMEPRAZOLEONDANSETRON HCLQL
ORIGANUM OILORLISTATORNITHINE HCLOSELTAMIVIR PHOSPHATEQL
OXALIC ACID DIHYDRATEOXANDROLONEOXYBENZONEOXYBUTYNIN CHLORIDEOXYMETAZOLINE HCLOXYMETHOLONEOXYTETRACYCLINEDIHYDRATEOXYTOCINPALMAROSAPALMIDROLPALMITOYL PENTAPEPTIDE-3PALMITOYL TRIPEPTIDE-3PANCREATINPANTHENOLPANTOPRAZOLE SODIUMQL,
ST
PAPAINPARACHLOROPHENOLPARAFORMALDEHYDEPAROMOMYCIN SULFATEPCCA DMAE COMPLEXPCCA T3 SODIUMPCCA T4 SODIUMPEANUT OILPEG 400 MONOSTEARATEPEG-40 CASTOR OILPENICILLAMINEPENNYROYAL OILPENTOSAN POLYSULFATESODIUM
PENTOXIFYLLINEPENTYLENE GLYCOLPENTYLENETETRAZOLEPEPPERMINT OILPERFLUORODECALINPERGOLIDE MESYLATEPERMETHRINPERPHENAZINEPERUVIAN BALSAMPEUCEDANUMOSTRUTHIUM EXTRACTPHENELZINE SULFATEPHENINDIONEPHENIRAMINE MALEATEPHENOLSULFONIC ACIDPHENOXYBENZAMINE HCLPHENOXYETHANOLPHENTERMINE HCLQL, PA
PHENTOLAMINE MESYLATEPHENYL SALICYLATEPHENYLETHYL ALCOHOLPHENYLETHYLAMINE HCLPHENYLMERCURIC ACETATEPHENYLMERCURIC NITRATEPHENYLTOLOXAMINECITRATEPHENYTOINPHOSPHATIDYLCHOLINEPHOSPHATIDYLSERINEPHOSPHORIC ACIDPHYTIC ACID IN WATERPHYTONADIONEPILOCARPINE HCLPILOCARPINE NITRATEPIMOBENDANPINE BARK EXTRACTPINE NEEDLE OILPINE OILPINE TARPINEAPPLE EXTRACTPINENE (L-ALPHA)PIPERINEPIRACETAMPMX-1184 SILICONEPODOFILOXPOLYETHYLENE GLYCOL 600(BULK)POLYHEXAMETHYLENEBIGUANIDEPOLYOX WSR-301POLYSORBATE 20POLYSORBATE 40POLYSORBATE 60POLYSORBATE 80POLYVINYL ALCOHOLPOLYVINYLPYRROLIDONE K-30POLYVINYLPYRROLIDONE K-90POMEGRANATE SEEDPONAZURILPOTASH SULFURATEDLUMPPOTASSIUM ACETATE
POTASSIUM ASPARTATEPOTASSIUM AZELAOYLDIGLYCINATEPOTASSIUM BENZOATEPOTASSIUM BITARTRATEPOTASSIUM BROMIDEPOTASSIUM CARBONATEPOTASSIUM GLUCONATEANHYDROUSPOTASSIUM HYDROXIDEPOTASSIUM IODIDEPOTASSIUMMETABISULFITEPOTASSIUM NITRATEPOTASSIUM PERCHLORATEPOTASSIUMPERMANGANATEPOTASSIUM PHOSPHATEDIBASICPOTASSIUM PHOSPHATEMONOBASICPOTASSIUM SODIUMTARTRATEPOTASSIUM SULFATEPOVIDONE K-30POVIDONEPOWDER SCENTFRAGRANCEPRASTERONE MICRONIZEDPRAZIQUANTELPREGABALINQL, ST
PREGNENOLONEMICRONIZEDPREGNENOLONEPRILOCAINE HCLPRILOCAINEPRIMIDONEPROCARBAZINE HCLPROCHLORPERAZINEEDISYLATEPROFLAVINE HEMISULFATEPROGESTERONE MILLEDPROGESTERONE ULTRAMICRONIZEDPROGESTERONE WETTABLEPROGESTERONEPROMAZINE HCLPROPANEDIOLPROPARACAINE HCLPROPYL GALLATEPROPYLENE GLYCOLMONOSTEARATEPROPYLENE GLYCOLPROPYLTHIOURACILPROSTAGLANDIN E1PROSTAGLANDIN E2PROTAMINE SULFATEPROTEASEPSYLLIUM HUSKPULLULANPUMICE (FLOUR)PYRANTEL PAMOATEPYRAZINAMIDEPYRIDOSTIGMINE BROMIDE
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ACTUALIZADA EL 9/1/2021. ESTA LISTA ESTÁ SUJETA A CAMBIO.©2021 Todos los derechos reservados.
PYRIDOXAL-5 PHOSPHATEPYRIDOXAL-5-PHOSPHATEPYRIMETHAMINEPA
PYROGALLOLPYRUVIC ACIDQUATERNIUM-15QUERCETIN DIHYDRATEQUINIDINE SULFATEDIHYDRATEQUININE HCL DIHYDRATERACEPINEPHRINE HCLRANITIDINE HCLRAPESEED OILRASAGILINE MESYLATEQL, ST
RAUWOLFIA SERPENTINARED YEAST RICERENOVAGERESORCINOLRESVERATROLRETINALRETINOL MOLECULAR FILMRIBAVIRINRIBOFLAVIN 5-PHOSPHATESODIUMRIBOFLAVIN-5-PHOSPHATESODIUMRIBOFLAVINRIBOSE (D)RIFAMPINRIFAXIMINROCURONIUM BROMIDERONIDAZOLEROPIVACAINE HCLROSE BENGAL BROSE OILROSEMARY OILROSINRUBIDIUM CHLORIDERUTINSACCHARIN CALCIUMSAFFLOWER OILSAGE LEAFSALICYLIC ACIDSALSALATESASSAFRAS OILSAW PALMETTO BERRYSAW PALMETTOSCARLET REDSECRETIN-MANNITOLSELENIUM SULFIDESELENIUM YEASTSENNASEPICALM VGSERMORELIN ACETATESEROTONIN HCLSERTRALINE HCLSESAME OILSHARK CARTILAGESHOWER FRESHFRAGRANCESIBERIAN GINSENGSILDENAFIL CITRATEQL
SILICA
SILICON DIOXIDE (SYLOID244FP)SILICON DIOXIDESILICONE BLEND CUSTOMSILICONE ELASTOMERBLENDSILICONE FLUID 556SILVER SULFADIAZINESIMVASTATINSINCALIDE IN MANNITOLSIROLIMUSPA, †
SODIUM 4-AMINOSALICYLATESODIUM ACETATETRIHYDRATESODIUM ALGINATESODIUM ASCORBYL PHOSDIHYDRATESODIUM ASPARTATEMONOHYDRATESODIUM ASPARTATESODIUM BICARBONATE-NACLSODIUM BICARBONATESODIUM BISULFITESODIUM BITARTRATEMONOHYDRATESODIUM BORATEDECAHYDRATESODIUM BROMIDESODIUM BUTYRATESODIUM CACODYLATESODIUM CAPRATESODIUM CAPRYLATESODIUM CARBONATEANHYDROUSSODIUM CARBONATEMONOHYDRATESODIUM CHLORITESODIUM CITRATEDIHYDRATESODIUM COCOYLGLUTAMATESODIUM DEHYDROACETATESODIUM DEOXYCHOLATESODIUM DIACETATESODIUMDICHLOROACETATESODIUM FLUORIDESODIUMFLUOROPHOSPHATESODIUM GLUCONATESODIUM HYALURONATESODIUM HYDROXIDESODIUM IODIDESODIUM LACTATESODIUM LAURETH SULFATESODIUM METABISULFITESODIUM MOLYBDATESODIUMMONOFLUOROPHOSPHATESODIUM NITRATESODIUM NITRITESODIUM OLEATE
SODIUM PERBORATESODIUM PHENYLBUTYRATESODIUM PHOSPHATEDIBASIC HEPTASODIUM PHOSPHATEDIBASICSODIUM PHOSPHATEMONOBASICSODIUM PHOSPHATETRIBASICSODIUM PIDOLATESODIUM PROPIONATESODIUM PYROPHOSPHATESODIUM SELENITESODIUM STEARATESODIUM STEARYLFUMARATESODIUM SUCCINATESODIUM SULFATESODIUM SULFITESODIUM TARTRATEDIHYDRATESODIUM TETRADECYLSULFATESODIUM THIOSALICYLATESODIUM VALPROATESORBITAN MONOLAURATESORBITAN MONOOLEATESORBITANMONOPALMITATESORBITAN MONOSTEARATESORBITOLSOYABEAN CASEIN DIGESTMEDIUMSOYBEAN LECITHINSOYBEAN OILSPAN 80SPEARMINT OILSPIRULINASQUALANESQUARIC ACIDST JOHNS WORTSTANNOUS CHLORIDEDIHYDRATESTANNOUS FLUORIDESTANOZOLOLSTARCH RICESTEVIA EXTRACTSTEVIOL GLYCOSIDESSTEVIOSIDESTRONTIUM CHLORIDESTRONTIUM NITRATESUCCIMER DMSASUCCINIC ACIDSUCCINYLCHOLINECHLORIDESUCROSE OCTAACETATESUCROSESUFENTANIL CITRATESULFACETAMIDESULFADIMETHOXINESULFAMERAZINESULFANILAMIDE
SULFOSALICYLIC ACIDDIHYDRATESULFUR PRECIPITATEDSULFUR SUBLIMEDSULFURIC ACIDSULFURSULPIRIDESUMATRIPTANSUCCINATEQL
SUMATRIPTANQL
SUPEROXIDE DISMUTASESYN-AKETACROLIMUSTADALAFILQL, ST
TALCTAMOXIFEN CITRATEMICRONIZEDTAMOXIFEN CITRATETARTARIC ACIDTEA COCOYL GLUTAMINETEA TREE OILTERBINAFINE HCLTESTOSTERONE CYPIONATETESTOSTERONEENANTHATEPA
TESTOSTERONEMICRONIZEDTESTOSTERONEPROPIONATEPA
TETRACAINE HCLTETRACAINETETRAHYDROBIOPTERINDIHCLTETRAHYDROCURCUMINTETRAHYDROZOLINE HCLTHEANINETHEOBROMINETHEOPHYLLINEANHYDROUSTHIOGUANINETHIORIDAZINE HCLTHIOTEPATHYMOL IODIDE PURIFIEDTHYMOL IODIDETHYMOLTHYMUSTHYROID (PORCINE)THYROID 3X (PORCINE)TICARCILLIN-POTCLAVULANATETINIDAZOLETINOGARD TLTIOPRONINTITANIUM DIOXIDETIZANIDINE HCLQL, ST
TOBRAMYCINTOCOPHERYL ACID SUCC D-ALPHATOCOTRIENOLSTOLAZOLINE HCLTOLTRAZURILTOLU BALSAMTOLUIDINE BLUE OTRAMADOL HCL
TRANEXAMIC ACIDQL
TRANILASTTRIACETINTRIAMCINOLONEHEXACETONIDETRIAMCINOLONETRICHLORMETHIAZIDETRICHLOROACETIC ACIDTRICLOSANTRIETHANOLAMINE LAURYLSULFATETRIETHYL CITRATETRILOSTANETRIMEPRAZINE TARTRATETRIMETHOBENZAMIDE HCLTRIOXSALENTRIPROLIDINE HCLTRITON X-100TROMETHAMINETROPOLONETRYPSINTURMERIC ROOTTURMERICTYLOSIN TARTRATETYLOXAPOLUBIDECARENONEUBIQUINOLUNDECYLENIC ACIDURIDINEURSODIOLVALACYCLOVIR HCLVALERIAN ROOTVALPROATE SODIUMVALPROIC ACIDVANADIUMVANADYL SULFATEHYDRATEVANILLINVICTORIAS SECRET VANILLALACEVIDARABINEVINPOCETINEVITAMIN A ACETATEVITAMIN A PALMITATEVITAMIN AVITAMIN D3VITAMIN E ACETATEVITAMIN E SUCCINATEVITAMIN EVITAMIN K2VORICONAZOLEWHEY PROTEIN ISOLATEWHITE KIDNEY BEANEXTRACTWHITE WILLOW BARKWITCH HAZELXYLAZINE HCLXYLITOLXYLOMETAZOLINE HCLYEAST EXTRACTYLANG-YLANG OILFRAGRANCEYOHIMBINE HCLZEAXANTHIN
ZINC CHLORIDEZINC CITRATEZINC GLUCONATEZINC MONOMETHIONINEZINC OXIDEZINC PICOLINATEZINC PYRITHIONEZINC UNDECYLENATEZIRCONIUM OXIDEZOLMITRIPTANQL
ZONISAMIDE
CONTRACEPTIVES
afirmellealtaveraalyacen 1/35alyacen 7/7/7amethia loQL
amethiaQL
amethystANNOVERAQL
apriaranelleashlynaQL
aubra eqaubraaurovela 1.5/30aurovela 1/20aurovela 24 feaurovela fe 1.5/30aurovela fe 1/20avianeayunaazuretteBALCOLTRAbalzivabekyreeBEYAZblisovi 24 feblisovi fe 1.5/30blisovi fe 1/20briellyncamilacamrese loQL
camreseQL
caziantcharlotte 24 fechateal eqchatealcryselle-28cyclafem 1/35cyclafem 7/7/7CYCLESSAcyred eqcyreddasetta 1/35dasetta 7/7/7dayseeQL
deblitanedelylaDEPO-PROVERAQL
DESOGENdesogestrel-ethinylestradiol
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ACTUALIZADA EL 9/1/2021. ESTA LISTA ESTÁ SUJETA A CAMBIO.©2021 Todos los derechos reservados.
dolishaledrospiren-eth estrad-levomefoldrospirenone-ethinylestradiolelinesteluryngQL
emoquetteenpresse-28enskyceerrinestaryllaethynodiol diac-ethestradioletonogestrel-ethinylestradiolQL
FALESSAfalminafayosimQL
femynorgemmilygianvigildagiahailey 1.5/30hailey 24 fehailey fe 1.5/30hailey fe 1/20heathericleviaQL
incassiaintrovaleQL
isibloomjaimiessQL
jasmieljencyclajolessaQL
jolivettejuleberjunel 1.5/30junel 1/20junel fe 1.5/30junel fe 1/20junel fe 24kaitlib fekalligakarivakelnor 1/35kelnor 1/50kimidesskurvelolarin 1.5/30larin 1/20larin 24 felarin fe 1.5/30larin fe 1/20larissialayolis feleenalessinalevonestlevonorg-eth estradtriphasiclevonorgest-eth est & ethestQL
levonorgest-eth estrad 91-dayQL
levonorgestrel-ethinylestradlevora 0.15/30 (28)lillowlo-zumandimineLOESTRIN 1.5/30 (21)LOESTRIN 1/20 (21)LOESTRIN FE 1.5/30LOESTRIN FE 1/20lojaimiessQL
lomedia 24 felorynalow-ogestrelluteralyleqlyzamarlissamedroxyprogesteroneacetateQL
melodetta 24 femerzeemibelas 24 femicrogestin 1.5/30microgestin 1/20microgestin 24 femicrogestin fe 1.5/30microgestin fe 1/20milimono-linyahmononessamyzilranecon 0.5/35 (28)necon 7/7/7NEXTSTELLISnikkinora-benorethin ace-eth estrad-fenorethin-eth estradiol-fenorethindrone acet-ethinylestnorethindronenorgestim-eth estradtriphasicnorgestimate-eth estradiolnorlydanorlyrocnortrel 0.5/35 (28)nortrel 1/35 (21)nortrel 1/35 (28)nortrel 7/7/7NUVARINGQL
nylia 7/7/7nymyoocellaorsythiaORTHO MICRONORORTHO TRI-CYCLEN (28)ORTHO TRI-CYCLEN LOORTHO-CYCLEN (28)ORTHO-NOVUM 1/35 (28)ORTHO-NOVUM 7/7/7 (28)philith
pimtreapirmella 1/35pirmella 7/7/7portia-28previfemquasenseQL
rajanireclipsenrivelsaQL
setlakinQL
sharobelsimliyasimpesseQL
SLYNDsprintec 28sronyxsyedatarina 24 fetarina fe 1/20 eqtarina fe 1/20taysofytilia fetri femynortri-estaryllatri-legest fetri-linyahtri-lo-estaryllatri-lo-marziatri-lo-militri-lo-sprintectri-miliTRI-NORINYL (28)tri-nymyotri-previfemtri-sprintectri-vylibra lotri-vylibratrinessa (28)trinessa lotrivora (28)tulanaTWIRLAQL
tyblumetydemyvelivetvesturavienvaviorelevolneavyfemlavylibrawerawymzya fexulaneQL
YASMIN 28YAZzafemyQL
zarahzenchent fezenchentzovia 1/35 (28)zovia 1/35e (28)zovia 1/50e (28)zumandimine
CORTICOSTEROIDS
BETAMETHASONE COMBO[INJ]BETAMETHASONE SODPHOS & ACET [INJ]BETAMETHASONE SODIUMPHOSPHATE [INJ]BETAMETHASONE SODIUMPHOSPHATEbudesonide erCELESTONE SOLUSPAN [INJ]CORTEFCORTISONE ACETATEdecadrondeltasoneDEPO-MEDROL [INJ]DEX COMBO [INJ]DEXAMETHASONE (LA) [INJ]DEXAMETHASONE ACE &SOD PHOS [INJ]DEXAMETHASONE SODPHOS IN D5WDEXAMETHASONE SODPHOS-BUPIV [INJ]DEXAMETHASONE SODPHOSPHATE PF [INJ]DEXAMETHASONE SODIUMPHOSPHATE [INJ]DEXAMETHASONE SODIUMPHOSPHATEdexamethasoneDEXONTO 0.4%DEXOPIN [INJ]ENTOCORT ECFLUDROCORTISONEACETATEKENALOG-80 [INJ]KENALOG [INJ]LIDOCIDEX I [INJ]MEDROLMETHYLPREDNISOLONEACE-LIDO [INJ]METHYLPREDNISOLONEACETATE [INJ]METHYLPREDNISOLONEACETATEmethylprednisolone sodiumsucc [INJ]METHYLPREDNISOLONEMILLIPREDORAPRED ODTPEDIAPREDPREDNISOLONE ACETATEPREDNISOLONEANHYDROUSPREDNISOLONE SODIUMPHOSPHATEPREDNISOLONEPREDNISONEROPIDEX [INJ]SOLU-CORTEF [INJ]SOLU-MEDROL [INJ]
TRIAMCINOLONEACETONIDEST [INJ]TRIAMCINOLONE DIACETMICRONIZETRIAMCINOLONEDIACETATE [INJ]TRIAMCINOLONEDIACETATEUCERISVERIPRED 20ZILRETTAQL
COUGH/COLD/ALLERGY
ACETYLCYSTEINEbenzonatatebiotuss pediatricBROMHEXINE HCLCARBAPHEN 12 PEDCARBAPHEN 12CLARINEX-D 12 HOURQL
CODAR ARDEXTROMETHORPHAN HBRMONOHYDDEXTROMETHORPHAN HBRGILPHEX TRgiltuss pediatricGILTUSS TRGUAIFENESINHYCOFENIXhydrocod polst-cpm polst erhydrocodone-homatropineHYPERSALN-ACETYL-L-CYSTEINENEBUSALnortuss-deNORTUSS-EXPHENYLEPHRINE-GUAIFENESINpromethazine vc plainpromethazine vc/codeinepromethazine vcpromethazine-codeinepromethazine-phenyleph-codeinepromethazine-phenylephrinePSEUDOEPH-CHLORPHEN-HYDROCODpulmosalREZIRASEMPREX-Dsodium chlorideSSKITERPIN HYDRATEMONOHYDRATETERPIN HYDRATETESSALON PERLEStussigonTUSSIONEX PENNKINETICERTUXARIN ERQL
TUZISTRA XRZUTRIPRO
DERMATOLOGICALS
7t lidoaccutanePA, AE
acitretinACLOVATEACTICOAT 7ACTICOAT FLEX 3ACTICOAT FLEX 7ACTICOAT MOISTURECONTROLACTICOAT SITEACTICOAT SURGICALACTICOATACZONEAE
adapalene-benzoylperoxideAE
ADAPALENEAE
ADVANCED ALLERGYCOLLECTIONAKLIEFQL
AKTIPAKAE
ALA SCALPST
ala-cortalclometasone dipropionateALDARAalevicyn dermal sprayALLEVYN AG GENTLEalphaquin hpALTRENOQL, AE
ALUMINUM CHLORIDEHEXAHYDRATEAMELUZQL, PA
ammonium lactateamnesteemPA, AE
ANACAINEANASTIAANTHRALINARAZLOQL
arzol silver nit applicatorsASTEROATOPAVOavar cleanserAE
AVAR LS CLEANSERAE
AVAR LSAE
avar-e emollientAE
avar-e greenAE
AVAR-E LSAE
AVARAE
avitaAE
AVO CREAMazelaic acidAE
AZELEXAE
BACITRACIN ZINCBACITRACINBACTROBANBENZAC AC WASHAE
BENZACLIN WITH PUMPAE
BENZACLINAE
BENZAMYCINAE
BENZEFOAMULTRAAE
BENZEFOAMAE
benzepro creamy washAE
benzepro foaming clothsAE
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ACTUALIZADA EL 9/1/2021. ESTA LISTA ESTÁ SUJETA A CAMBIO.©2021 Todos los derechos reservados.
benzepro short contactAE
benzeproAE
BENZIQ LSAE
BENZIQAE
BENZOIC ACIDBENZOYL PEROXIDE FORTE-HCAE
BENZOYL PEROXIDEHYDROUSAE
benzoyl peroxide-erythromycinAE
BENZOYL PEROXIDEAE
beserST
betamethasonedipropionate augBETAMETHASONEDIPROPIONATEST
BETAMETHASONEVALERATEST
BIAFINEbimatoprostST
BIONECTblanchebp foaming washbp foamAE
bp washAE
bpo foaming clothsAE
BPOAE
CALAMINEcalcipotriene-betamethdipropPA
calcipotrienecalcitreneCAMPHORCANTHARIDINCAPEXST
CAPSAICINCENTANY ATCENTANYcerovelCHLOROACETIC ACIDCICLODAN SOLUTIONciclodanCICLOPIROX OLAMINEciclopirox treatmentciclopiroxclaravisPA, AE
clearplex xCLENIA PLUSQL
CLEOCIN-Tclindacin etzclindacin-pCLINDAGELclindamycin phos-benzoylperoxAE
CLIOQUINOLCLOBETASOL 17PROPIONATEclobetasol prop emollientbaseST
clobetasol propionateemulsionST
clobetasol propionate eST
CLOBETASOL PROPIONATEST
CLOBEX SPRAYCLOBEXCLOCORTOLONE PIVALATEPUMPST
CLOCORTOLONE PIVALATEST
clodanST
CLODERM PUMPST
CLODERMST
clotrimazole-betamethasoneCLOTRIMAZOLECOCAINE HCLCOLLAGENASECORDRANcormax scalp applicationCORTANE-Bcorti-savCORTISPORINCUTIVATEdeluoDERMA-SMOOTHE/FS BODYDERMA-SMOOTHE/FSSCALPDERMATOPDERMAWERX SURGICALPLUS PAKdermazeneDERMAZONEDESONATEST
DESONIDEST
DESOWENdesoximetasoneST
desrxDIFFERINAE
diflorasone diacetateST
DIPROLENE AFDIPROLENEDOVONEXDOXYCYCLINEQL, PA
DUACAE
DURAFIBER AGDURAFIBEReconazole nitrateEFUDEXELIMITEELOCONENOVARX-BACLOFENENOVARX-NAPROXENENOVARX-TRAMADOLenzoclearAE
EPIFOAMEPIQUIN MICROEQUIPTO-NAPROXENERTACZOERYGELeryEURAXEVOCLINEXELDERMEXTINAFABIORAE
finasterideFIRST-HYDROCORTISONE
fluocinolone acetonidebodyST
fluocinolone acetonidescalpST
FLUOCINOLONEACETONIDEST
fluocinonide emulsifiedbaseST
FLUOCINONIDEST
fluorouracilflurandrenolideST
FORAXAGENTAMICIN SULFATEGENTIAN VIOLETGLYCOLIC ACIDglydoGORDOFILMGORDONS UREAgrafco silver nit applicatorhalcinonideST
HALOBETASOLPROPIONATEST
HALOGHALOTINHYDRO 40HYDROCORTISONEACETATEhydrocortisone butyr lipobaseST
hydrocortisone butyrateST
hydrocortisone inabsorbaseST
HYDROCORTISONEMICRONIZEDhydrocortisone valerateST
hydrocortisone-iodoquinolHYDROCORTISONEHYDROQUINONEHYGELICHTHAMMOLimiquimodIMPOYZST
isotretinoinPA, AE
KAXMKENALOGKERALYT SCALPKERALYTketodanKETOPHENE RAPIDPAQKETOROLACTROMETHAMINEQL
KLARONAE
KLISYRIQL, PA
klofensaid iiKYBELLALAC-HYDRINlactic acidLATISSELATRIX XMLDO PLUSlevicyn dermal sprayLEVULAN KERASTICKQL, PA
LEXETTEST
lido-k
lido-sorblidocaine hclurethral/mucosallidocaine pakQL
LIDOCAINE-HYDROCORTISONE ACElidocaine-prilocainelidocaineQL
LIDODERMQL
lidopinLIDORXLIDOSOL-HCLIDOVEXLIDOVINlidozionLIDOZOLLINDANELOCOID LIPOCREAMLOCOIDlokaraST
LOPROXLOTRISONELURADROXLUXIQLYDEXAmafenide acetatemalathionmethoxsalen rapidMETHOXSALENMETROCREAMMETROGELMETROLOTIONMICONAZOLE NITRATEMICORT-HCST
mupirocin calciummupirocinmyorisanPA, AE
naftifine hclNAFTINNEO-SYNALARNEOMYCIN SULFATEneuacAE
NITROFURAZONENIZORALnolixST
NOXIFINE WOUNDDRESSINGNUCORTNUMBONEXnyamycnyatanystatin-triamcinolonenystopOLUX-EORACEAQL, PA
OVACE PLUS WASHOVACE PLUSOVACE WASHOVIDEOXISTATPA
OXSORALEN ULTRAPANRETINPENLACpermethrin
pimecrolimusPLEXION CLEANSERAE
PLEXION CLEANSINGCLOTHAE
PLEXIONAE
PODOCONpodofiloxPODOPHYLLUM RESINpr benzoyl peroxide washAE
PRAMOSONE EPRAMOSONEPRAMOXINE HCLpramoxPREDNICARBATEST
premium lidocaineQL
PROPECIAPROTOPICPRUTECTPYROGALLIC ACIDQBREXZAQL, PA, AE
RADIAURArea lo 39rea lo 40remergent hqremevenRENUU NLRETIN-AAE
RETINOIC ACIDREXAPHENACREZESOLAE
rosadanrosanil cleanserAE
RYNODERMsalacynSALEXsalicylic acid ersalicylic acid wart removersalicylic acid-cleansersalicylic acidsalimezsalisol forteSALISOLsalitech forteSALITECHSALRIXSALVAX DUO PLUSSALVAXSCULPTRA [INJ]seb-prev washselenium sulfideSELRXSERNIVOQL, ST
SILAZONE PHARMAPAKSILAZONE-IISILVADENESILVER NITRATEsilver sulfadiazineSILVERSEAL HYDROGELDRESSINGskin bleaching-sunscreenskin bleachingSKLICEsodium sulfacetamide washsodium sulfacetamide
SONAFINESORIATANESORILUXQL
ssdsss 10-5AE
SULCONAZOLE NITRATEsulfacetamide sod-sulfurwashAE
sulfacetamide sodium(acne)AE
SULFACETAMIDE SODIUM-SULFURAE
SULFACETAMIDE SODIUMsulfacleanse 8/4AE
SULFAMYLONSUMADAN WASHAE
SUMADAN XLTPA, AE
SUMADANAE
SUMAXIN TSAE
SUMAXIN WASHAE
SUMAXINAE
SYNALARtacrolimusTANNIC ACIDTAZAROTENEAE
tbcTEMOVATE ETEMOVATETETRACYCLINE HCLTETRAVEXTEXACORTST
THERAPEVOtl hydroquinoneTOLAKTOLNAFTATETOPICORT SPRAYTOPICORTtovetST
TRANSCYTETRANZARELTRETIN-Xtretinoin microspherepumpAE
tretinoin microsphereAE
TRETINOINAE
TRIAMCINOLONEACETONIDEST
tridermST
TRIDESILONULESFIAULTRASAL-ERULTRAVATE X (CREAM)ULTRAVATE X (OINTMENT)ULTRAVATEST
umecta mousseURALISSURAMAXIN GTURAMAXINURE-KUREA IN ZN UNDECYL-LACTIC ACIDurea nailurea-c40UREA
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ACTUALIZADA EL 9/1/2021. ESTA LISTA ESTÁ SUJETA A CAMBIO.©2021 Todos los derechos reservados.
uredeburemez-40URESOLUREVAZVANOSvashe cleansingVENIPUNCTURE CPIQL, PA
VERDESOST
VIRASALWESTCORTWINLEVIQL, PA
WOUNDGELHA MATRIXXALIXXEPIQL, PA
XOLEGEL COREPAKxureaZACAREAE
zenatanePA, AE
zenciaAE
ZENEVIXQL, PA
zionodil 100zionodil
DIAGNOSTIC PRODUCTS
adenosine (diagnostic)ARIDOLASPERGILLUS FUMIGATUScandida albicans skn tstantgnCANDINCLARISCANCONRAY 30CONSTANT TRICHOPHYTONCORTROSYN [INJ]cosyntropin [INJ]CUSHING SYNDROMEDIAGNOSTICCYSVIEWDIAGNOSTIC [INJ]DMSADOTAREME-Z-DISKE-Z-DOSEGASTROGRAFINGLEOLANGLOFIL-125GLUCAGON HCL(DIAGNOSTIC) [INJ]HYSKONINDIGO CARMINE [INJ]INULINisosulfan bluemd-gastroviewMETOPIRONEOMNIPAQUEOPTIMARKPROSTASCINTPROVOCHOLINESERMORELIN ACETATEDIAGNOSTIC [INJ]SINOGRAFIN [INJ]T.R.U.E. TESTTRICHOPHYTON
DIETARYPRODUCTS/DIETARYMANAGEMENTPRODUCTS
ASPARTAME(NUTRASWEET)ASPARTAMEASTAMED MYOAVAILNEXCEREFOLIN NACDEPLIN 15DEPLIN 7.5ELFOLATE PLUSFOLBIC RFFOLTANX RFFOLTXGLYGESTL-METHYLFOLATE CA ME-CBL NACL-METHYLFOLATEFORMULA 15L-METHYLFOLATEFORMULA 7.5L-METHYLFOLATE FORTEL-METHYLFOLATE-ALGAE-B12-B6L-METHYLFOLATE-ALGAEL-METHYLFOLATE-B6-B12LIMBREL250LIMBREL500LIMBRELLUKAID GLAMETAFOLBIC PLUS RFMETANXMETHYLFOL-ALGAE-B12-ACETYLCYSTniva-folPODIAPNPURALOR CISACCHARINVAYACOGVAYARINVAYAROLvirt-vite forteXAQUIL XR
DIGESTIVE AIDS
L-GLUTAMIC ACID HCLPEPSIN
DIURETICS
acetazolamide eracetazolamide sodium [INJ]acetazolamideALDACTAZIDEALDACTONEAMILORIDE HCLamiloride-hydrochlorothiazidebumetanide [INJ]bumetanideBUMEXCAROSPIRQL, PA
chlorothiazide sodium
chlorothiazidechlorthalidoneDEMADEXDIAMOX SEQUELSDYAZIDEDYRENIUMEDECRINethacrynate sodiumethacrynic acidfurosemide [INJ]FUROSEMIDEHYDROCHLOROTHIAZIDEindapamideLASIXmannitolMAXZIDE-25MAXZIDEMETHAZOLAMIDEMETHYCLOTHIAZIDEmetolazoneMICROZIDENEPTAZANEosmitrolSODIUM DIURILSODIUM EDECRINspironolactone-hctzSPIRONOLACTONEtorsemidetriamterene-hctzTRIAMTERENE
ENDOCRINE ANDMETABOLIC AGENTS -MISC.
ACTONELQL
ALENDRONATE SODIUMATELVIAQL
BONIVAQL
cabergolinecalcitonin (salmon) [INJ]calcitonin (salmon)CALCITRIOLCARNITOR SFCARNITORCLOMIPHENE CITRATECYSTADANEddavp pf [INJ]DDAVP [INJ]DDAVPdesmopressin ace sprayrefrigdesmopressin acetate pf[INJ]desmopressin acetate spraydesmopressin acetate [INJ]desmopressin acetatedoxercalciferolETIDRONATE DISODIUMEVISTAQL
FOSAMAXHECTOROLibandronate sodiumQL
KERENDIAQL, PA
levocarnitine sf
LEVOCARNITINE [INJ]levocarnitineMIACALCIN [INJ]MIFEPREXmifepristoneNEXVIAZYMEPA, †
NOCTIVAQL, PA, AE
OSPHENAQL
paricalcitolraloxifene hclQL
risedronate sodiumQL, ST
ROCALTROLsod benz-sod phenylacetVASOPRESSIN-SODIUMCHLORIDEZEMPLAR
ESTROGENS
ACTIVELLAALORAQL
amabelzANGELIQQL
BI-EST 50:50BI-EST PROGEST-TESTOSTERONEQL
BIJUVAQL
CLIMARAQL
covaryx hscovaryxDELESTROGENdottiQL
EC-RX ESTRADIOLeemt hseemtest estrogens-methyltest dsest estrogens-methyltest hsest estrogens-methyltestESTRACEestradiol valerateestradiol-norethindroneacetESTRADIOLQL
ESTRIOL-PROGESTERONEMICROQL
ESTROGELQL
ETHINYL ESTRADIOLFEMHRTQL
fyavolvQL
jevantique loQL
jinteliQL
lopreezalyllanaQL
MENOSTARQL
mimvey lomimveynorethindrone-ethestradiolQL
PREFESTQL
VIVELLE-DOTQL
FLUOROQUINOLONES
AVELOXBAXDELAQL, PA
ciprofloxacin hcl
ciprofloxacin in d5wciprofloxacin-ciproflox hclerCIPROFLOXACINCIPROLEVAQUINlevofloxacin in d5wlevofloxacinmoxifloxacin hcl in naclmoxifloxacin hclST
ofloxacin
GASTROINTESTINALAGENTS - MISC.
ACTIGALLalosetron hclQL, PA
alvimopanAMINOSALICYLIC ACID-5APRISOQL
ASACOL HDQL
AURYXIAAZULFIDINE EN-TABSAZULFIDINEbalsalazide disodiumBYLVAYQL, PA, †
calcium acetate (phosbinder)calcium acetateCOLAZALDELZICOLQL
DIPENTUMST
ENTEREGenuloseFOSRENOLGASTROCROMgenerlacGIAZOlactulose encephalopathylanthanum carbonatemesalamine ermesalamine-cleanserMESALAMINEQL, ST
METOCLOPRAMIDE HCLMONOHYDRATEmetoclopramide hcl [INJ]METOCLOPRAMIDE HCLMOTEGRITYQL, PA
PHOSLYRAREGLANRENAGELRENVELAROWASAsevelamer carbonateSEVELAMER HCLSFROWASASIMETHICONESULFASALAZINETRULANCEQL, PA
URSO 250URSO FORTEURSODIOL+SYRSPEND SFursodiolZELNORMQL, PA
GENERAL ANESTHETICS
etomidateFORANEfresenius propovenisofluraneKETALAR [INJ]KETAMINE HCL-SODIUMCHLORIDEKETAMINE HCL [INJ]KETAMINE HCLpropofol-lipuroPROPOFOLsevofluraneSUPRANEterrell
GENITOURINARY AGENTS- MISCELLANEOUS
alfuzosin hcl eraminoacetic acidargyle sterile salineAVODARTQL
CARDURA XLQL, ST
curity sterile salinecytra k crystalsDEFLUX [INJ]dutasteride-tamsulosinhclQL, ST
dutasterideQL
FLOMAXglycine urologicGLYCINEJALYNQL
K-PHOS NO 2LITHOSTATneomycin-polymyxin b guNEOSPORIN GU IRRIGANTORACITPHENAZOPYRIDINE HCLphenazopot & sod cit-cit acpotassium citrate erPOTASSIUM CITRATEMONOHYDRATEpotassium citrate-citric acidPOTASSIUM CITRATEPROSCARPYRIDIUMRAPAFLOQL
RIMSO-50silodosinST
sod citrate-citric acidSODIUM CITRATEANHYDROUSSODIUM CITRATEtamsulosin hcltaron-crystalstricitratesUROCIT-K 10UROCIT-K 15UROCIT-K 5UROXATRALvirtrate-2virtrate-3virtrate-k
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ACTUALIZADA EL 9/1/2021. ESTA LISTA ESTÁ SUJETA A CAMBIO.©2021 Todos los derechos reservados.
GOUT AGENTS
allopurinol sodiumallopurinolcolchicine-probenecidCOLCHICINEQL
febuxostatprobenecidULORICQL
ZYLOPRIM
HEMATOLOGICALAGENTS - MISC.
AGGRENOXQL
AGRYLINalbuked 25albuked 5albumin humanalbumin-zlbalbuminar-25albuminar-5alburxalbuteinanagrelide hclaspirin-dipyridamole erQL
buminatecilostazolclopidogrel bisulfatedipyridamoleEFFIENTQL
eptifibatideflexbuminhetastarch-naclhuman albumin grifolskedbuminPANHEMATINpentoxifylline erplasbumin-25plasbumin-5PLAVIXprasugrel hclQL
RETAVASE HALF-KITRETAVASE
HEMATOPOIETIC AGENTS
abaneu-slACCRUFERQL, PA
ACTIVE FEairaviteav-vite fbAXIFOLCENFOLCENTRATEXcorvita 150CORVITE 150CORVITE FEcyanocobalamin [INJ]CYFOLEXDIVISTAfa-vitamin b-6-vitamin b-12fabbFERAHEMEFERIVA 21/7FERIVAFAFERIVA
feroconferotrinsicFERRO-PLEX HEMATINICferrocite plusFERROTRINFERROUS SULFATEferumoxytolfolbeeFOLGARD RXfolic acid [INJ]FOLIC ACIDfolplex 2.2FOLTRATEfoltrinhematinic plus vit/mineralshematinic/folic acidhematogen fortehematogenHEMOCYTE PLUShemocyte-fhemocyte-plusiferex 150 forteINFED [INJ]k-tan plusLIPO-BMAXFEMETHYLCOBALAMIN [INJ]myferon 150 fortena ferric gluc cplx in sucroseNEPHRON FANEURIN-SLNIFEREXNOXIFOL-DNUFERAnufolpoly-iron 150 fortepolysaccharide iron fortePRE-FOLICPUREFE PLUSpurevit dualfe plusROXIFOL-Dse-tan plusSIKLOSTANDEM PLUStl gard rxtl icontl-hem 150triconTRIFERICtrigels-f fortevirt-gardvirt-viteVIT B12-METHIONINE-INOS-CHOLwestab miniwestab one
HEMOSTATICS
AMICARaminocaproic acidASTRINGYNEVICELEVITHROMLYSTEDAQL
RAPLIXARECOTHROM SPRAY KITRECOTHROMTHROMBI-PADTHROMBIN-JMI EPISTAXISTHROMBIN-JMITHROMBOGENTRANEXAMIC ACID-NACLtranexamic acidQL
HYPNOTICS/SEDATIVES/SLEEP DISORDER AGENTS
AMBIEN CRQL
AMBIENQL
BUTISOL SODIUMCHLORAL HYDRATEdexmedetomidine hcl innacldexmedetomidine hclEDLUARQL, ST
estazolameszopicloneQL
HALCIONLUMINAL [INJ]LUNESTAQL
midazolam hcl (pf) [INJ]MIDAZOLAM HCL-SODIUMCHLORIDEmidazolam hcl [INJ]MIDAZOLAM HCLMIDAZOLAM+SYRSPEND SFMIDAZOLAM-KETAMINE-ONDANSETRONMIDAZOLAMMKO MELT DOSE PACKpentobarbital sodium [INJ]PENTOBARBITAL SODIUMPHENOBARBITAL SODIUM[INJ]PHENOBARBITAL SODIUMPHENOBARBITALPRECEDEXramelteonQL
RESTORILROZEREMQL
SONATAtemazepamtriazolamzaleplonzolpidem tartrate erQL
zolpidem tartrateQL
LAXATIVES
BISACODYLCOLYTE WITH FLAVORPACKSconstuloseDOCUSATE SODIUMgavilyte-cgavilyte-ggavilyte-hgavilyte-n with flavor packGOLYTELYlactuloseMAGNESIUM SULFATE
MINERAL OIL HEAVYMINERAL OIL LIGHTMINERAL OILMURI-LUBENULYTELY LEMON-LIMENULYTELY WITH FLAVORPACKSOSMOPREPpeg 3350-kcl-na bicarb-naclpeg 3350/electrolytespeg-3350/electrolytes/ascorbatQ
L
peg-3350/electrolytespeg-kcl-nacl-nasulf-na asc-cQL
peg-preppegylaxPLENVUpolyethylene glycol 3350trilyte
LOCAL ANESTHETICS-PARENTERAL
articadent dental [INJ]BUPIVACAINEFISIOPHARMA [INJ]bupivacaine hcl (pf) [INJ]BUPIVACAINE HCL-NACL[INJ]BUPIVACAINE HCL-NACLBUPIVACAINE HCL [INJ]BUPIVACAINE HCLbupivacaine in dextrosebupivacaine spinalbupivacaine-epinephrine(pf) [INJ]bupivacaine-epinephrine[INJ]chloroprocaine hcl (pf) [INJ]LIDOCAINE HCL (PF) [INJ]LIDOCAINE HCL [INJ]LIDOCAINE HCLlidocaine-epinephrine [INJ]MEPIVACAINE HCLMLD [INJ]NESACAINE-MPF [INJ]NESACAINE [INJ]polocaine-mpf [INJ]polocaine [INJ]PROCAINE HCLROPIV-CLONIDINE-KETOROLACROPIVACAINE HCL-NACL[INJ]ROPIVACAINE HCL-NACLropivacaine hcl [INJ]sensorcaine-mpf spinalsensorcaine-mpf/epinephrine [INJ]sensorcaine-mpf [INJ]sensorcaine/epinephrine[INJ]sensorcaine [INJ]
xylocaine dental [INJ]XYLOCAINE-MPF [INJ]ZINGO
MACROLIDES
azithromycinclarithromycin erclarithromycinDIFICIDPA
E.E.S. GRANULESery-tabERYPED 200ERYPED 400erythromycin baseERYTHROMYCINETHYLSUCCINATEERYTHROMYCINPCEZITHROMAX TRI-PAKZITHROMAX Z-PAKZITHROMAXZMAX
MEDICAL DEVICES ANDSUPPLIES
INSPIREASE RESERVOIRBAGS
MIGRAINE PRODUCTS
almotriptan malateQL
AMERGEQL
AXERTCAFERGOTD.H.E. 45QL [INJ]dihydroergotaminemesylateQL [INJ]DIHYDROERGOTAMINEMESYLATEQL
eletriptan hydrobromideQL
ERGOMARERGOTAMINE TARTRATEergotamine-caffeinefrovatriptan succinateQL
FROVAQL
IMITREX STATDOSE REFILLQL
IMITREX STATDOSESYSTEMQL
IMITREXQL
isometheptene-dichloral-apapMAXALT-MLTQL
MAXALTQL
MIGRANALQL
naratriptan hclQL
nodolorONZETRA XSAILQL
PRODRINRELPAXQL
rizatriptan benzoateQL
sumatriptan succinaterefillQL
sumatriptan succinateQL
sumatriptanQL
zolmitriptanQL
ZOMIG ZMTQL
ZOMIGQL
MINERALS &ELECTROLYTES
bd posiflushCALCIFOLCALCIUM CARBONATELIGHTCALCIUM CARBONATECALCIUM CHLORIDEDIHYDRATEcalcium chlorideCALCIUM GLUCONATEANHYDROUSCALCIUM GLUCONATEMONOHYDRATECALCIUM GLUCONATE-NACLCALCIUM GLUCONATECALCIUM LACTATEPENTAHYDRATECALCIUM PHOSPHATEDIBASICCALCIUM PHOSPHATETRIBASICchloromag [INJ]CUPRIC SULFATEdextrose in lactated ringersdextrose-nacldextrose-sodium chlorideEFFER-Keffervescent pot chlorideFLORIVAfluor-a-dayFLUORABONfluoritabFLURA-DROPSk-effervescentk-primeK-TABk-vescentKCL (IN NACL 0.9%)kcl in dextrose-naclKCL IN LACTATED RINGERSKCL-LIDOCAINE IN NACLklor-con 10klor-con m10klor-con m20klor-con sprinkleklor-con/efklor-conlactated ringersludentMAGNESIUM CARBONATEHEAVYMAGNESIUM CARBONATEMAGNESIUM CHLORIDE[INJ]MAGNESIUM CHLORIDEMAGNESIUM SULFATE IND5WMAGNESIUM SULFATE [INJ]monoject flush syringe
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monoject sodium chlorideflushmultitrace-4 concentratemultitrace-5 concentratenafrinse dropsnafrinsenormal saline flushnutrilytephospha 250 neutralphospho-trin 250 neutralphosphorousPOTASSIUM ACETATE-NACLPOTASSIUM BICARBONATEpotassium chloride crys erpotassium chloride erPOTASSIUM CHLORIDE IND5Wpotassium chloride indextrosePOTASSIUM CHLORIDE INNACLpotassium chloride proampPOTASSIUM CHLORIDEpotassium phosphates(66meq k)POTASSIUM PHOSPHATES-DEXTROSEpotassium phosphatesringerssaline flush zrsaline flushSODIUM ACETATESODIUM BICARBONATE[INJ]sodium chloride (pf) [INJ]sodium chloride flushsodium chloride [INJ]SODIUM CHLORIDESODIUM PHOSPHATE-NACLSODIUM PHOSPHATES-DEXTROSESODIUM PHOSPHATESswabflush saline flushTHAMvirt-phos 250 neutralZINC SULFATEHEPTAHYDRATEZINC SULFATEMONOHYDRATEZINC SULFATE
MISCELLANEOUSTHERAPEUTIC CLASSES
ADENOSINE-5-MONOPHOSPHATEADENOSINE-5-TRIPHOSPHATEalprostadil [INJ]AMPHADASE [INJ]argyle sterile waterASTAGRAF XLAZATHIOPRINEBROMELAINCELLCEPT INTRAVENOUS
CHYMOTRYPSIN (ALPHA)cyclosporine modifiedDEPEN TITRATABSENDEAVORRXENVARSUS XReverolimusgengrafHYLENEX [INJ]IMURANkionexMAHANA IBSmycophenolate mofetil hclmycophenolate mofetilmycophenolate sodiumMYFORTICPHOXILLUM B22K4/0PHOXILLUM BK4/2.5physiolytephysiosol irrigationPOLIDOCANOLPROSTIN VR [INJ]RESET FOR ANDROID APPRESET FOR IOS APPRESET FOR IOS ORANDROID APPRESET-O FOR ANDROID APPRESET-O FOR IOS APPRESET-O FOR IOS ORANDROID APPSARAPIN [INJ]sodium polystyrenesulfonateSOMRYSTspssterile water for irrigationTRISODIUM CITRATE/CRRTVARITHENAVITRASE [INJ]water for irrigation, sterileZORTRESS
MOUTH/THROAT/DENTAL AGENTS
ARESTINcavarestcevimeline hclchlorhexidine gluconateclinpro 5000DEBACTEROLdenta 5000 plusdentageleasygelEVOXACFIRST-MOUTHWASH BLMfluoridex daily renewalfluoridex enhancedwhiteningfluoridex sensitivity relieffluoridexGELCLAIRGELXlidocaine viscous hclNAFRINSE DAILYACIDULATED
NAFRINSE DAILY/NEUTRALNAFRINSE WEEKLYneutragard advancedneutral sodium fluorideoraloneORAPEUTICORAVIGparoexPERIDEXperiogardpilocarpine hclPREVIDENT 5000 BOOSTERPLUSPREVIDENT 5000 DRYMOUTHPREVIDENT 5000 ENAMELPROTECTPREVIDENT 5000 ORTHODEFENSEPREVIDENT 5000 PLUSPREVIDENT 5000 SENSITIVEPREVIDENTSALAGENsf 5000 plussfsodium fluoride 5000enamelsodium fluoride 5000 plussodium fluoride 5000 ppmsodium fluoride 5000sensitivesodium fluorideZINC ACETATE
MULTIVITAMINS
ACTIVE OBactiviteadc/f (0.5mg/ml)ATABEX ECb complex vitamins [INJ]B-COMPLEX [INJ]b-plex plusb-plexbiocelBP MULTINATAL PLUSCITRANATAL B-CALMCITRANATAL BLOOMCORVITAcorvite freeCORVITEdavitedexifolDIALYVITE 3000DIALYVITE 5000DIALYVITE SUPREME DdialyviteDUET DHA 400DUET DHA BALANCEDENBRACE HRESCAVITE DESCAVITE LQFOLBEE PLUS CZfolbee plusFOLET DHA
FOLET ONEfolika-tFOLIKA-VGENICIN VITA-Qgenicin vita-shylaviteKOSHER PRENATAL PLUSIRONLEVOMEFOLATE DHAloridlysiplex plusMARNATAL-Fmulti-vit/fluoride/ironmulti-vit/fluoridemulti-vitamin/fluoride/ironmulti-vitamin/fluoridemultipromultivitamin/fluoride/ironMULTIVITAMIN/FLUORIDEmultivitamins/fluoridemvc-fluoridemynephrocapsmynephronNATACHEWNATALVITNEEVO DHANEONATAL + DHAQL
NEPHROCAPSnephronexNESTABS ABCNESTABS ONENEXA PLUSNICOMIDENICOTINAMIDEnutrifac zxO-CAL PRENATALOB COMPLETE ONEOB COMPLETE PETITEOB COMPLETE PREMIEROB COMPLETE/DHAOBSTETRIX ONEONEVITEPNV PRENATAL PLUSMULTIVIT+DHAPOLY-VI-FLOR FSPOLY-VI-FLOR/IRONPOLY-VI-FLORPREFERA OBPREFERAOB +DHAPREMESISRXPRENAISSANCE NEXT-BPRENATAL + DHAPRENATAPRENATE AMPRENATE DHAPRENATE ELITEPRENATE ENHANCEPRENATE ESSENTIALPRENATE MINIPRENATE PIXIEPRENATE RESTOREPRENATEPRIMACAREPROVIDA DHA
PROVIDA OBPUREFE OB PLUSQUFLORA FE PEDIATRICQUFLORA FEQUFLORA GUMMIESQUFLORA PEDIATRICR-NATAL OBrenalRENATABS WITH IRONRENATABSreno capsSELECT-OBSTROVITE FORTESUPERVITETEXAVITE LQTL FOLATETRI-VI-FLOROTRI-VI-FLORTRI-VIT/FLUORIDE/IRONtri-vit/fluoridetri-vitamin/fluoridetri-vite/fluorideTRICARE PRENATAL DHAONETRICARE PRENATALtriphrocapsTRISTART DHATRISTART FREEQL
TRISTART ONEtronviteUDAMIN SPurosexv-c forteVENTRIXYLvic-forteVINATE DHA RFvirt-capsvirt-vite plusvita s fortevita-minVITA-PRENvitacelVITAFOL FE+VITAFOL GUMMIESVITAFOL STRIPSVITAFOL ULTRAVITAFOL-NANOVITAFOLVITAL-D RXvitamax pediatricvitamin b complex 100 [INJ]VITAMIN B COMPLEX-HYDROXOCOBAL [INJ]vitamin b-complex 100 [INJ]vitamins acd-fluoridevitasureVITAXYMEvol-care rxVP-PNV-DHAvp-vite rxWESTGEL DHAxvite
MUSCULOSKELETALTHERAPY AGENTS
ACTIVE-CYCLOBENZAPRINEBACLOFENcarisoprodol-aspirin-codeinecarisoprodol-aspirinCARISOPRODOLST
CYCLOPHENE RAPIDPAQDANTRIUMENOVARX-CYCLOBENZAPRINE HCLFIRST-BACLOFENmetaxallST
metaxaloneST
methocarbamol [INJ]orphenadrine citrate erorphenadrine citrate [INJ]ORPHENADRINE CITRATErevontoROBAXIN-750ROBAXIN [INJ]ROBAXINSKELAXINST
SOMATABRADOL RAPIDPAQvanadomZANAFLEXQL
NASAL AGENTS -SYSTEMIC AND TOPICAL
ADRENALINASTEPROQL
azelastine hclQL
azelastine-fluticasoneQL
BACTROBAN NASALBECONASE AQQL
DYMISTAQL
fluticasone propionateST
mometasone furoateQL
NASONEXQL
olopatadine hclQL
OMNARISQL
PATANASEQL
PHENYLEPHRINE HCLPHENYLPROPANOLAMINEHCLPROPEL MINIPROPELPSEUDOEPHEDRINE HCLtriamcinolone acetonideST
ZETONNAQL
NEUROMUSCULARAGENTS
atracurium besylatecisatracurium besylate (pf)cisatracurium besylateEXSERVANQL, PA
QUELICIN [INJ]RILUTEKriluzoleSUCCINYLCHOLINECHLORIDE [INJ]
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TIGLUTIKQL
vecuronium bromide
NUTRIENTS
ALANINEalcohol [INJ]aminoamrmsaminoreliefrmsaminosyn ii/electrolytesaminosyn/electrolytesARGININE HCL [INJ]BCAA [INJ]BCAACALM [INJ]CARDIOVID PLUSCHOLINE BITARTRATEclinisol sfCLINOLIPIDCYTOTINEdehydrated alcohol [INJ]DEXTROSE ANHYDROUSDEXTROSEDL-ALANINEDL-LEUCINEDL-METHIONINEDL-PHENYLALANINEELCYSFRUCTOSEGABA [INJ]glucoseGLUTAMINEGLUTATHIONE-L REDUCEDGLUTATHIONE-LGLUTATHIONE [INJ]GLUTATHIONEGLYCINE [INJ]INTRALIPIDL-ALANINEL-ARGININEL-CYSTINEL-GLUTAMIC ACIDL-GLUTAMINEL-HISTIDINEMONOHYDROCHLORIDEL-ISOLEUCINEL-LEUCINEL-METHIONINEL-PHENYLALANINEL-PROLINEL-THREONINEL-TRYPTOPHANL-TYROSINEL-VALINELECITHINLEUCINELIPO-CLIPOMETHIONINENUTRILIPIDplenaminepremasolTAURINE [INJ]TAURINETHREONINE
TRI-AMINO [INJ]TRYPTOPHANVALINE
OPHTHALMIC AGENTS
ACULAR LSACULARak-fluorak-poly-bacAKTENALCAINEALOCRILALOMIDEALPHAGAN PALREXaltacainealtafluor benoxaltafluoraltafrinapraclonidine hclATROPINE SULFATE-NACLATROPINE SULFATEbacitra-neomycin-polymyxin-hcbacitracin-polymyxin bbalanced saltbepotastine besilateBEPREVEBESIVANCEST
BETADINE OPHTHALMICPREPBETAGANBETIMOLBETOPTIC-Sbio gloBLEPH-10BLEPHAMIDE S.O.P.BLEPHAMIDEbrimonidine tartrateBRIMONIDINE-DORZOLAMIDEbrinzolamidebromfenac sodium (once-daily)bromfenac sodiumBROMSITEQL
carteolol hclCEFUROXIME SODIUM-NACLCELLUGELCHONDROITIN SULFATECILOXANCOSOPT PFCOSOPTCYCLOGYLCYCLOMYDRILcyclopentolate hclDEXAMETH-MOXIFLOX-KETOROLACDEXAMETHASONE-MOXIFLOXACINDISCOVISCdorzolamide hcl-timolol malpf
dorzolamide hcl-timolol malDORZOLAMIDE HCLDOUBLE PMDUOVISCELESTATEMADINEepinastine hclEYSUVISPA
FLAREXflucainefluor-i-strips a.t.fluorescein-benoxinateFLUORESCITEfluorometholoneFLURA-SAFEflurbiprofen sodiumfluroxFML FORTEFML LIQUIFILMful-gloGATIFLOXACIN-DEXAMETHASONEgatifloxacinglostripsgreen glo lissamine greenhomatropairehomatropine hbrILEVROIOPIDINEISOPTO CARPINEISTALOLLATANOPROSTlevobunolol hclLIDOCAINE-PHENYLEPHRINElissamine greenLOTEMAXloteprednol etabonateMAXIDEXMAXITROLMETIPRANOLOLMIOCHOL-EMITOSOLMOXEZAmoxifloxacin hcl (2x day)ST
MOXIFLOXACIN HCL-BSSMOXIFLOXACIN HCLST
MYDRIACYLneo-polycin hcneo-polycinneomycin-bacitracin zn-polymyxneomycin-polymyxin-dexamethneomycin-polymyxin-gramicidinNEOSPORINocucoat viscoadherentOCUFLOXOMIDRIAOMNIPREDPAREMYDPATADAYPATANOLpolycin
polymyxin b-trimethoprimPOLYTRIMPOVIDONE-IODINEPRED-G S.O.P.PRED-GPREDNISOL ACE-MOXIFLOX-BROMFENPREDNISOLON-GATIFLOX-BROMFENACPREDNISOLON-MOXIFLOX-BROMFENACPREDNISOLON-MOXIFLOX-KETOROLACPREDNISOLONE ACETATE P-FPREDNISOLONE-BROMFENACPREDNISOLONE-GATIFLOXACINPREDNISOLONE-MOXIFLOXACINPROLENSAproparacaine hclproparacaine-fluoresceinRESCULAROCKLATANsulfacetamide-prednisolonetetcainetetracaine hcltetravisc fortetetravisctimolol maleate ocudosetimolol maleate pfTIMOPTIC OCUDOSETIMOPTIC-XETIMOPTICTOBRADEXtobramycin-dexamethasonetobramycinTOBREXtravoprost (bak free)TRIAMCINOLONE-MOXIFLOXACINTRIESENCEtrifluridineTRIPLE PMBTRIPLE PMKTROPICAMIDE-PHENYLEPHRINETROPICAMIDETRUSOPTUPNEEQQL, PA
VIGAMOXVIROPTICVISCOATVYZULTAQL, ST
XALATANZIRGANZYMAXID
OTIC AGENTS
acetasol hcacetic acidCIPRO HC
CIPRODEXciprofloxacin-dexamethasoneCORTANE-B AQUEOUScortic-ndDERMOTICexotic-hcflacFLOXIN OTIChydrocortisone-acetic acidneomycin-polymyxin-hcOTICIN HC NROTIPRIOQL
PRAMOTIC
OXYTOCICS
HEMABATEmetherginemethylergonovine maleate[INJ]methylergonovine maleateoxytocin [INJ]PROSTIN E2
PASSIVE IMMUNIZINGAND TREATMENTAGENTS
ANAVIPANTIVENIN LATRODECTUSMACTANS [INJ]HYPERRAB S/D [INJ]HYPERRAB [INJ]IMOGAM RABIES-HT [INJ]KEDRAB [INJ]
PENICILLINS
AMOXICILLIN TRIHYDRATEamoxicillin-pot clavulanateerAMOXICILLIN-POTCLAVULANATEamoxicillinampicillin sodium [INJ]ampicillin sodiumampicillin-sulbactamsodium [INJ]AMPICILLIN-SULBACTAMSODIUMAUGMENTIN ES-600AUGMENTIN XRAUGMENTINBICILLIN L-Adicloxacillin sodiumMOXATAGnafcillin sodium [INJ]nafcillin sodiumoxacillin sodium [INJ]oxacillin sodiumpenicillin g potassium [INJ]PENICILLIN G PROCAINEpenicillin v potassiumPFIZERPEN [INJ]piperacillin sod-tazobactamsoUNASYN [INJ]
UNASYNZOSYN
PHARMACEUTICALADJUVANTS
ACACIAALFALFA FLAVORALKYL ACRYLATECROSSPOLYMERALMOND OIL BITTERFLAVORAMARANTHANHYDROUS GEL BASEANISE EXTRACTANISE FLAVORAPPLE FLAVORAPRICOT FLAVORASTRAGALUS ROOTAUXIPRO PLASTICIZEDBACOCALMINEBACON FLAVORBANANA CONCENTRATEBANANA CREAM FLAVORBANANA CREME FLAVORBANANA FLAVORBASE A POLYETHYLENEGLYCOLBASE C POLYETHYLENEGLYCOL 300BASE D POLYETHYLENEGLYCOLBASE FOR SALTSBASE FOR WOUNDSBASE GELATIN GUMMYTROCHEBASE XBEEF FLAVORBEEF TYPE FLAVORNATURALBEEF TYPE FLAVOR OSBEEF-ADEBEES WAXBEESWAX (YELLOW)BEESWAXBENTONITEBENZYL ALCOHOLBHRT BASEBITTER DRUGBITTER STOP FLAVORBITTERNESS MASK FLAVORBITTERNESS REDUCINGAGENTBITTERNESS SUPPRESSORFLAVORBLACKBERRY FLAVORBLUEBERRY FLAVORBRILLIANT BLUE GBUBBLE GUMCONCENTRATEBUBBLE GUM FLAVORBUTTER FLAVORBUTTER RUM FLAVORBUTTERSCOTCH FLAVORCAPSUBLEND-H
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ACTUALIZADA EL 9/1/2021. ESTA LISTA ESTÁ SUJETA A CAMBIO.©2021 Todos los derechos reservados.
CAPSUBLEND-PCAPSUBLEND-SCARAMEL FLAVORCARRAGEENANCETYL ALCOHOLCHEESE-ADE FLAVORCHEESECAKE FLAVORCHEMSIL K-12CHEMSIL K-51CHERRY FLAVORCHERRY-ADE FLAVORCHEW-HESIVECHICKEN BROTH FLAVORCHICKEN FLAVOR OILSOLUBLECHICKEN FLAVOR WATERMISCIBLECHICKEN FLAVORCHLOROBUTANOLANHYDROUSCHLOROBUTANOLCHOCOLATE FLAVORCHOCOLATE HAZELNUTFLAVORCINNAMON FLAVORCLOVAGELCOCOA BUTTERCOCONUT FLAVORCOFFEE FLAVORCOLA FLAVORCOLLASIL OSACOLLODIONCOTTON CANDY FLAVORCRAN-RASPBERRY FLAVORCREME DEMENTHE FLAVORCUSTOM LIPOTHENE 110CUSTOM LIPOTHENE 133CUSTOM POLYGLYCOLTROCHE BASEDERMASHIELD HYDROGELDILUENT FOR TREPROSTINILEFFERVESCENT BASEEMULGADE CMEMULSIFYING WAXEMULSION CONCENTRATEENGLISH TOFFEE FLAVORETHYL ACETATEEUCALYPTUS FLAVOREUGENOL FLAVOREVANS BLUEEXQUISITE HRTF-MELTFAGRON CAPFILL PROFAGRON DISPERSAPROFD&C YELLOW #5FD&C YELLOW #6ALUMINUM LAKEFDC BLUE 1FDC BLUE 2FDC GREEN #3FDC RED #3FDC RED 40FDC YELLOW 6FISH FLAVOR
FIXED OIL SUSPENSIONFIZZMIX BASEFLAVOR CONC-CHLORHEXIDINEFOOD COLOR BLACKFOOD COLOR BLUEFOOD COLOR BROWNFOOD COLOR GREENFOOD COLOR LIME GREENFOOD COLOR ORANGEFOOD COLOR PINKFOOD COLOR REDFOOD COLOR VIOLETFOOD COLOR WHITEFOOD COLOR YELLOW #5ALUM LAKEFOOD COLOR YELLOWFP CEPAFP DERMFP NATURALFP SILOFREEDOM ADAPTADERMFREEDOM CEPAPROFREEDOM LOLLIPOP BASEFREEDOM ODT BASEFREEDOM PEG TROCHEBASEFREEDOM POLOXITOLFREEDOM POLYMATRIXFREEDOM SET-GELFREEDOM SILOMACANHYDROUSFREEDOM SILOMAC ULTRAFREEDOM SIMPLECAPFREEDOM TRIBLEND BASEGELATINGRAPE FLAVORGRAPEFRUIT FLAVORGUAVA FLAVORGUM ARABICGUM BASE (GELATIN)H20 GEL BASEHAM FLAVORHONEY FLAVORHORMONE CREAM BASEHRT BASE (MEN)HRT BASEHRT BOTANICALHRT CREAM BASE WOMENHRT CREAM BASEHRT CREAMHRT ESSENTIALHRT HEAVYHRT NATURAL BASEHRT NATURAL CREAM BASEHRT NATURALHRT SUPREME CREAM BASEHSA STERILE DILUENT [INJ]ISOMALT LOLLIPOP BASEKAHLUA FLAVORKARAYA GUMKRIS-ESTER 236LACTOSE ANHYDROUSLACTOSE MONOHYDRATE
LACTOSELANOLIN ALCOHOLlanolinLECITHIN-ISOPROPYLPALMITATELEMON EXTRACTLEMON FLAVORLEMONADE FLAVORLICORICE FLAVORLIDOCAINE-PRILOCAINE(BULK)LIME FLAVORLIPMAXLIPOGEL CR BASELIPOPEN ANHYDROUSLIQUIGEL COMPLEXLISSAMINE GREEN BLIVER FLAVORLOXORAL BASELUBRAJEL NPMAGNESIUM STEARATEMANGO FLAVORSWEETENEDMANGO FLAVORMAPLE FLAVORMARSHMALLOW FLAVORMEDI-RDT BASEMEDI-RDTMEDIBASE CMETER BUFFERMETHYLCELLULOSEMETHYLPARABEN SODIUMMETHYLPARABENMINT CHOCOLATE CHIPFLAVORMOLASSES FLAVORMUCOLOXMYRJ 53NOVAFILMOINTMENT BASE(EMULSIFYING)OLEABASE PLASTICIZEDOLEIC ACIDORANGE CREAM FLAVORORANGE FLAVORORANGE OIL FLAVORPARAFFINPASSION FRUIT FLAVORSWEETENEDPASSION FRUIT FLAVORPCCA CUSTOM TROCHEBASE (LS)PCCA EMULSIFIX-205 BASEPCCA FIXED OIL BASEPCCA GELATIN BASEPCCA LECITHIN ISOPROPYLPALMPCCA LIPODERM HMWPCCA LOXASPERSE BASEPCCA OCCLUSADERMPCCA PLASTICIZED BASEPCCA PLURONIC F127 BASEPCCA POLOXAMER 407PCCA POLYGLYCOL TROCHE
PCCA PRACAMAC BASEPCCA RAPID DISSOLVETABLETPCCA SORBITOL LOLLIPOPBASEPCCA SPIRA-WASH BASEPCCA SWEETNESSENHANCERPCCA XYLIFOS BASEPEACH FLAVORPEANUT BUTTER FLAVORPEG 300PEPPERMINT FLAVORPH BUFFERPINA COLADA FLAVORPINEAPPLE FLAVORPLASTIBASEPLASTICIZED BASEPLURONIC F127PLURONIC L64PLURONICPOLOXAMER 188POLOXAMER 407POLYETHYLENE GLYCOL1000POLYETHYLENE GLYCOL1450POLYETHYLENE GLYCOL1500POLYETHYLENE GLYCOL 300POLYETHYLENE GLYCOL3350POLYETHYLENE GLYCOL 400POLYETHYLENE GLYCOL4500POLYETHYLENE GLYCOL 600POLYETHYLENE GLYCOL8000POLYETHYLENE GLYCOLPOLYMAC PROGELPOLYOXYL 40 STEARATEPOLYPEGPOTASSIUM SORBATEPRALINES AND CREAMFLAVORPROPYLPARABEN SODIUMPROPYLPARABENPUMPKIN FLAVORQUINIZARIN GREEN SSRASPBERRY CONCENTRATERASPBERRY FLAVORRDT-PLUSREGENT ALCOHOLRENEWCREAM HRTROOT BEER FLAVORsaline bacteriostatic [INJ]SEPINEO P 600SHEA BUTTER ORGANICSHEA BUTTERSHRIMP FLAVORSIMPLGEL 30SODIUM BENZOATEsodium chloridebacteriostatic [INJ]
SODIUM LAURYL SULFATESODIUM THIOSULFATESOLU-KSORBIC ACIDSORBITOL CANDY BASESPEARMINT FLAVORSPG SUPPOSI-BASESTEARIC ACIDSTEARYL ALCOHOLsterile diluent/epoprostenolsterile water for injection[INJ]sterile water for injectionSTEVIA GLYCERITE EXTRACTSTRAWBERRY FLAVORSULPHAN BLUESUPER SYNERSWEETFLAVORSUPPOSI-PURESUPPOSITORY BLENDSWEET CORN FLAVORSWEETENING ENHANCERSYNAPSINTANGERINE FLAVORSWEETENEDTANGERINE FLAVORTEABERRY FLAVORTOMMY GELTRAGACANTHTROCHE BASETROLAMINETROPICAL PUNCH FLAVORTRYPAN BLUETUNA FLAVORTUTTI FRUTTI FLAVORTUTTI-FRUTTI FLAVORUCARE POLYMER JR-400VANILLA BUTTERNUTFLAVORVANILLA FLAVORVANILLIN FLAVORVERSABASEVERSAPRO ANHYDROUSBASEVERSAPROWATERMELON FLAVORWAX, WHITEWHITE BEES WAXWILD CHERRY FLAVORWILEY BASIC ELEMENTSBHRT BASEWITEPSOLWOUND WASH BASEXANTHAN GUMZOSIL
PROGESTINS
AYGESTINEC-RX PROGESTERONEMEGACE ESNORETHINDRONE ACETATEPROGESTERONECOMPOUNDING KIT
PROGESTERONEMICRONIZEDprogesteronePROMETRIUMPROVERA
PSYCHOTHERAPEUTICAND NEUROLOGICALAGENTS - MISC.
acamprosate calciumQL
ADDYIQL, PA
ANTABUSEQL
ARICEPTQL
BRISDELLEQL
bupropion hcl er (smokingdet)QL
donepezil hclQL
EXELONQL
fluoxetine hcl (pmdd)FLUOXETINE HCL (PMDD)galantamine hydrobromideerQL
GALANTAMINEHYDROBROMIDEQL
LUCEMYRAQL, PA
LYRICA CRQL, ST
memantine hcl erQL, ST
NAMENDA TITRATIONPAKQL
NAMENDA XRQL
NAMENDANICOTROL NSNICOTROLolanzapine-fluoxetine hclQL
ORAPparoxetine mesylateQL
pimozidepregabalin erST
RAZADYNE ERQL
RAZADYNEQL
rivastigmine tartrateQL
rivastigmineQL, ST
SARAFEMSYMBYAXQL
ZYBANQL
RESPIRATORY AGENTS -MISC.
BRONCHITOL TOLERANCETESTQL, PA, †
BRONCHITOLQL, PA, †
SURVANTA
SULFONAMIDES
SULFADIAZINE SODIUMSULFADIAZINESULFAMETHOXAZOLEMICROSULFAMETHOXAZOLESULFAPYRIDINESULFATHIAZOLESULFISOXIZOLE
TETRACYCLINES
ADOXA PAK 1/100ADOXA PAK 1/150
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ACTUALIZADA EL 9/1/2021. ESTA LISTA ESTÁ SUJETA A CAMBIO.©2021 Todos los derechos reservados.
ADOXA PAK 2/100ADOXAavidoxydemeclocycline hcldoxy 100DOXYCYCLINE HYCLATEPA
doxycycline monohydrateMINOCINMINOCYCLINE HCLmondoxyne nlMONODOXmorgidoxNUZYRAQL, PA
okeboOXYTETRACYCLINE HCLSEYSARAQL, PA, AE
soloxidePA
tetracycline hclTIGECYCLINETYGACILVIBRAMYCINXERAVAPA
THYROID AGENTS
CYTOMELeuthyroxlevo-tLEVOTHYROXINE SODIUMlevoxylliothyronine sodiumMETHIMAZOLENATURE-THROIDnp thyroidpropylthiouracilTAPAZOLETHYQUIDITYTHYROIDTHYROLAR-1/2THYROLAR-1/4THYROLAR-1THYROLAR-2THYROLAR-3unithroidWP THYROID
ULCERDRUGS/ANTISPASMODICS/ANTICHOLINERGICS
ACIPHEX SPRINKLEQL, ST
ACIPHEXamoxicill-clarithro-lansoprazQL
ANASPAZATROPENATROPINE SULFATEMONOHYDRATEatropine sulfate [INJ]ATROPINE SULFATE [INJ]BENTYLCARAFATEchlordiazepoxide-clidiniumcimetidine hclCIMETIDINECYTOTECdicyclomine hcl
DONNATALed-spazesomeprazole magnesiumQL,
ST
esomeprazole sodiumESOMEPRAZOLESTRONTIUMfamotidineFIRST-LANSOPRAZOLEFIRST-OMEPRAZOLEGLYCOPYRROLATE PF [INJ]glycopyrrolate [INJ]glycopyrrolateGLYRX-PF [INJ]hyoscyamine sulfate erhyoscyamine sulfate slhyoscyamine sulfate [INJ]HYOSCYAMINE SULFATEhyosyneISOPROPAMIDE IODIDElansoprazoleLEVBIDLEVSIN/SLLEVSIN [INJ]LEVSINLIBRAXmethscopolamine bromidemisoprostolnizatidinenulevOMEPRAZOLE+SYRSPENDSF ALKAomeprazoleoscimin srosciminpantoprazole sodiumQL, ST
pb-hyoscy-atropine-scopolaminePEPCIDphenobarbital-belladonnaalkphenohytroPREVACID SOLUTABPREVACIDPREVPACPROPANTHELINE BROMIDEPROTONIXQL
PYLERAQL
rabeprazole sodiumRANITIDINE HCL [INJ]ranitidine hclROBINUL-FORTEROBINUL [INJ]ROBINULSCOPOLAMINE HBRSUCRALFATESYMAX DUOTABsymax-slsymax-srZANTAC [INJ]ZANTAC
URINARYANTISPASMODICS
darifenacin hydrobromideerQL, ST
DETROL LAQL
DETROLDITROPAN XLENABLEXQL
flavoxate hclGEMTESAQL, ST
oxybutynin chloride eroxybutynin chlorideOXYTROLQL
solifenacin succinateQL, ST
tolterodine tartrate erQL, ST
tolterodine tartratetrospium chloride erQL, ST
trospium chlorideURECHOLINEVESICARE LSQL
VESICAREQL
VACCINES
BIOTHRAXVAXCHORA
VAGINAL AND RELATEDPRODUCTS
AVC VAGINALCLINDESSEFEMRINGQL
FIRST-PROGESTERONE VGSGYNAZOLE-1IMVEXXY MAINTENANCEPACKQL
IMVEXXY STARTER PACKQL
METROGEL-VAGINALNUVESSAPHEXXIQL
TERAZOL 7terconazoleVAGIFEMvandazoleyuvafem
VASOPRESSORS
ADRENACLICKQL [INJ]EPHEDRINE SULFATE(PRESSORS) [INJ]ephedrine sulfate [INJ]epinephrine (anaphylaxis)[INJ]EPINEPHRINE HCL-DEXTROSEEPINEPHRINE HCL-NACLepinephrine pf [INJ]EPINEPHRINEQL, PA [INJ]LEVOPHEDmidodrine hclnorepinephrine bitartrateNOREPINEPHRINE-DEXTROSENOREPINEPHRINE-SODIUMCHLORIDEPHENYLEPHRINE HCL(PRESSORS)
PHENYLEPHRINE HCL-DEXTROSEPHENYLEPHRINE HCL-NACLVAZCULEP
VITAMINS
AMINOBENZOATEPOTASSIUMAMINOBENZOIC ACIDascorbic acid [INJ]CALCIUM ASCORBATECALCIUM PANTOTHENATECALCIUM-D-PANTOTHENATEDRISDOLERGOCALCIFEROLERGOCALmega-c/a plus [INJ]MEPHYTONNIACINAMIDENIACINortho-cs 250 [INJ]PARA-AMINOBENZOIC ACIDphytonadione [INJ]POTABAPOTASSIUMAMINOBENZOATEPYRIDOXINE HCL [INJ]PYRIDOXINE HCLsodium ascorbate [INJ]SODIUM ASCORBATEthiamine hcl [INJ]THIAMINE HCLTHIAMINE MONONITRATEvitamin d (ergocalciferol)vitamin k1 [INJ]
ACTUALIZADA EL 9/1/2021. ESTA LISTA ESTÁ SUJETA A CAMBIO.©2021 Todos los derechos reservados.
FORMULARIO ENFOQUE CLINICO
LEYE
ND
A
[INJ]: fármaco inyectable
ER: liberación prolongada
DR: liberación retardada
AE: especificación de edad
LD: distribución limitada
PA: autorización previa
QL: límite de cantidad
ST: terapia escalonada
† Indica medicamentos deespecialidad
Para el miembro: Es posible que el diseño específico de su plan de beneficios de medicamentos no cubradeterminados productos o categorías, independientemente de que aparezcan en este documento. Puedeque los productos reciente-mente aprobados por la Administración de Medicamentos y Alimentos (FDA,Food and Drug Administration) de los EE. UU. no estén cubiertos tras su lanzamiento al mercado.
WellDyne podrá comunicarse con su proveedor tras recibir una receta para solicitar la consideración de unproducto que figura en la lista de fármacos o de un equivalente genérico. Esto puede dar como resultadoque su proveedor recete, cuando sea clínicamente apropiado, un producto de marca diferente o unequivalente genérico en lugar del producto original. Los medicamentos genéricos contienen los mismosingredientes activos que los correspondientes medicamentos de marca, aunque pueden ser de color oforma diferente. Han sido aprobados por la FDA, de acuerdo con estrictas normas.
En la mayoría de los casos, cuando un producto genérico se hace disponible, el fármaco de marcacorrespondiente se designará como no preferido o la opción se excluirá tras el lanzamiento al mercado delproducto genérico.
Para el médico: Los genéricos deben considerarse primero a la hora de recetar. Recete productos preferidosy permita sustituciones por genéricos cuando sea clínicamente adecuado. Los fármacos de marca seenumeran con letras MAYÚSCULAS, mientras que los genéricos se enumeran en letras minúsculas.
Esta lista de fármacos es un resumen de la cobertura de medicamentos, no incluye todas las opcionesposibles y no garantiza la cobertura. Es posible que el diseño específico del plan de beneficios demedicamentos del miembro no cubra determinados productos o categorías, independientemente de queaparezcan en este documento. Puede que los productos recientemente aprobados por la FDA no esténcubiertos tras su lanzamiento al mercado.
ACTUALIZADA EL 9/1/2021. ESTA LISTA ESTÁ SUJETA A CAMBIO.©2021 Todos los derechos reservados.