Lista de medicamentos preferidos aprobado por Medicaid · Washington Lista de medicamentos...
Transcript of Lista de medicamentos preferidos aprobado por Medicaid · Washington Lista de medicamentos...
Washington
Lista de medicamentos preferidos aprobado por Medicaid En vigencia desde el 1 de febrero de 2018
Leyenda
En cada categoría, los medicamentos se listan en orden alfabético por marca o nombre genérico.
Medicamento de marca: letra mayúscula en negrita
Medicamento genérico: letra minúscula en texto sin formato
AL: restricción de límite de edad
DO: programa de optimización de dosis
GR: restricción de género
OTC: medicamento de venta libre disponible con receta. (Los recetadores deben incluir la sigla OTC en la
receta).
PA: requiere autorización previa. La autorización previa es el proceso mediante el cual se obtiene la aprobación
de los beneficios antes de que se puedan abastecer ciertas recetas.
QL: límites de cantidad. Ciertos medicamentos recetados tienen límites de cantidad específicos, por receta o por
mes.
SP: farmacia especializada ST: requiere terapia escalonada. Es posible que necesite utilizar un medicamento antes de que los beneficios
para el uso de otro medicamento puedan autorizarse.
Nombre del medicamento Reference Notas
ADJUVANTES QUÍMICOS O FARMACÉUTICOS
ADJUVANTE FARMACÉUTICO (INHALADORES)
sodium chloride inhalation solution for nebulization
NebuSal
ADJUVANTE FARMACÉUTICO
syrpalta oral syrup OTC
AGENTES ANORRECTALES
AGENTES ANORRECTALES
hydrocortisone topical cream with perineal applicator
Anusol-HC QL
proctosol hc topical cream with perineal applicator
QL
proctozone-hc topical cream with perineal applicator
QL
AGENTES ANTI-INFECCIOSOS
AGENTES ANTIBACTERIANOS ANTIPROTOZOARIOS ANAEROBIOS
metronidazole oral capsule Flagyl
metronidazole oral tablet Flagyl
tinidazole oral tablet QL
AGENTES ANTILATIVOS, OTROS
dapsone oral tablet
AGENTES ANTIMICOBACTERIANOS
ethambutol oral tablet Myambutol
isoniazid oral solution
isoniazid oral tablet
PRIFTIN ORAL TABLET
pyrazinamide oral tablet
rifabutin oral capsule Mycobutin
rifampin oral capsule Rifadin
RIFATER ORAL TABLET
AGENTES PARA EL TRATAMIENTO DE HEPATITIS B
adefovir oral tablet Hepsera PA; QL
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Nombre del medicamento Reference Notas
BARACLUDE ORAL SOLUTION PA; QL
entecavir oral tablet Baraclude PA; QL
EPIVIR HBV ORAL SOLUTION PA; QL
lamivudine oral tablet Epivir HBV QL
AMIBICIDAS
paromomycin oral capsule
AMINOGLICÓSIDOS
neomycin oral tablet
AMINOPENICILINAS
amoxicillin oral capsule
amoxicillin oral suspension for reconstitution
QL
amoxicillin oral tablet
amoxicillin oral tablet,chewable
amoxicillin-pot clavulanate oral suspension for reconstitution
Augmentin ES-600
amoxicillin-pot clavulanate oral tablet
amoxicillin-pot clavulanate oral tablet extended release 12 hr
Augmentin XR QL
amoxicillin-pot clavulanate oral tablet,chewable
ampicillin oral capsule
AUGMENTIN ORAL SUSPENSION FOR RECONSTITUTION
ANTIBIÓTICO SULFONAMIDA
sulfadiazine oral tablet
ANTIBIÓTICOS ANTIMICÓTICOS
fluconazole oral suspension for reconstitution 10 mg/ml, 40 mg/ml
Diflucan QL
fluconazole oral tablet 100 mg, 150 mg, 200 mg, 50 mg
Diflucan QL
flucytosine oral capsule Ancobon
griseofulvin microsize oral suspension
griseofulvin ultramicrosize oral tablet Gris-PEG (ultramicrosize)
itraconazole oral capsule Sporanox PA
ketoconazole oral tablet QL
nystatin oral powder
nystatin oral tablet
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Nombre del medicamento Reference Notas
terbinafine hcl oral tablet Lamisil QL
voriconazole intravenous solution Vfend IV PA
voriconazole oral suspension for reconstitution
Vfend PA; QL
voriconazole oral tablet 200 mg, 50 mg Vfend PA; QL
ANTIHELMÍNTICOS
ALBENZA ORAL TABLET
BILTRICIDE ORAL TABLET
ivermectin oral tablet Stromectol
pin-x oral suspension OTC
pin-x oral tablet,chewable OTC
ANTIVIRALES, ESPECÍFICOS DE VIH
abacavir oral solution Ziagen
abacavir oral tablet Ziagen
abacavir-lamivudine oral tablet Epzicom
abacavir-lamivudine-zidovudine oral tablet Trizivir
APTIVUS ORAL CAPSULE
APTIVUS ORAL SOLUTION
atazanavir oral capsule Reyataz
ATRIPLA ORAL TABLET
COMPLERA ORAL TABLET
CRIXIVAN ORAL CAPSULE
DESCOVY ORAL TABLET
didanosine oral capsule,delayed release(dr/ec)
Videx EC
EDURANT ORAL TABLET
efavirenz oral capsule Sustiva
efavirenz oral tablet Sustiva
EMTRIVA ORAL CAPSULE
EMTRIVA ORAL SOLUTION
EVOTAZ ORAL TABLET
fosamprenavir oral tablet Lexiva
FUZEON SUBCUTANEOUS RECON SOLN
GENVOYA ORAL TABLET
INTELENCE ORAL TABLET
INVIRASE ORAL CAPSULE
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Nombre del medicamento Reference Notas
INVIRASE ORAL TABLET
ISENTRESS HD ORAL TABLET
ISENTRESS ORAL POWDER IN PACKET
ISENTRESS ORAL TABLET
ISENTRESS ORAL TABLET,CHEWABLE
KALETRA ORAL TABLET
lamivudine oral solution Epivir
lamivudine oral tablet Epivir
lamivudine-zidovudine oral tablet Combivir
LEXIVA ORAL SUSPENSION
lopinavir-ritonavir oral solution Kaletra
nevirapine oral suspension Viramune
nevirapine oral tablet Viramune
nevirapine oral tablet extended release 24 hr
Viramune XR
NORVIR ORAL CAPSULE
NORVIR ORAL SOLUTION
NORVIR ORAL TABLET
ODEFSEY ORAL TABLET
PREZCOBIX ORAL TABLET
PREZISTA ORAL SUSPENSION
PREZISTA ORAL TABLET
RESCRIPTOR ORAL TABLET
RESCRIPTOR ORAL TABLET, DISPERSIBLE
RETROVIR INTRAVENOUS SOLUTION
REYATAZ ORAL POWDER IN PACKET
SELZENTRY ORAL SOLUTION
SELZENTRY ORAL TABLET
stavudine oral capsule Zerit
stavudine oral recon soln Zerit
STRIBILD ORAL TABLET
tenofovir disoproxil fumarate oral tablet Viread QL
TIVICAY ORAL TABLET
TRIUMEQ ORAL TABLET
TRUVADA ORAL TABLET
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Nombre del medicamento Reference Notas
VIDEX 2 GRAM PEDIATRIC ORAL RECON SOLN
VIDEX 4 GRAM PEDIATRIC ORAL RECON SOLN
VIRACEPT ORAL TABLET
VIRAMUNE ORAL SUSPENSION
VIREAD ORAL POWDER QL
VIREAD ORAL TABLET QL
zidovudine oral capsule Retrovir
zidovudine oral syrup Retrovir
zidovudine oral tablet
ANTIVIRALES, GENERALES
acyclovir oral capsule Zovirax
acyclovir oral suspension Zovirax
acyclovir oral tablet Zovirax
famciclovir oral tablet 125 mg, 250 mg, 500 mg
QL
oseltamivir oral capsule Tamiflu
oseltamivir oral suspension for reconstitution
Tamiflu
RELENZA DISKHALER INHALATION BLISTER WITH DEVICE
QL
rimantadine oral tablet Flumadine
TAMIFLU ORAL CAPSULE
TAMIFLU ORAL SUSPENSION FOR RECONSTITUTION
valacyclovir oral tablet 1 gram, 500 mg Valtrex QL
valganciclovir oral recon soln Valcyte
valganciclovir oral tablet Valcyte
CEFALOSPORINA, ANTIBIÓTICOS
cefaclor oral capsule
cefaclor oral suspension for reconstitution
cefaclor oral tablet extended release 12 hr
cefadroxil oral capsule
cefadroxil oral suspension for reconstitution
cefadroxil oral tablet
cefdinir oral capsule QL
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Nombre del medicamento Reference Notas
cefdinir oral suspension for reconstitution 125 mg/5 ml, 250 mg/5 ml
QL
cefpodoxime oral suspension for reconstitution
cefpodoxime oral tablet
cefprozil oral suspension for reconstitution
cefprozil oral tablet
CEFTIN ORAL SUSPENSION FOR RECONSTITUTION
ceftriaxone injection recon soln QL
cefuroxime axetil oral suspension for reconstitution
Ceftin
cefuroxime axetil oral tablet
cephalexin oral capsule Keflex
cephalexin oral suspension for reconstitution
cephalexin oral tablet
COMBINACIONES DE PLASMOCIDAS
atovaquone-proguanil oral tablet Malarone Pediatric
LINCOSAMIDAS
clindamycin hcl oral capsule Cleocin HCl
clindamycin palmitate hcl oral recon soln Cleocin Pediatric
clindamycin pediatric oral recon soln
MACRÓLIDOS
azithromycin oral packet Zithromax
azithromycin oral suspension for reconstitution 100 mg/5 ml
Zithromax
azithromycin oral suspension for reconstitution 200 mg/5 ml
Zithromax QL
azithromycin oral tablet 250 mg, 500 mg Zithromax
azithromycin oral tablet 600 mg Zithromax QL
clarithromycin oral suspension for reconstitution
clarithromycin oral tablet
clarithromycin oral tablet extended release 24 hr
e.e.s. 400 oral tablet
ery-tab oral tablet,delayed release (dr/ec)
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Nombre del medicamento Reference Notas
erythrocin (as stearate) oral tablet
erythromycin ethylsuccinate oral tablet E.E.S. 400
erythromycin oral capsule,delayed release(dr/ec)
erythromycin oral tablet
PENICILINAS
dicloxacillin oral capsule
penicillin v potassium oral recon soln
penicillin v potassium oral tablet
PLASMOCIDAS
chloroquine phosphate oral tablet
hydroxychloroquine oral tablet Plaquenil
mefloquine oral tablet QL
PRIMAQUINE ORAL TABLET
QUINOLONES
ciprofloxacin hcl oral tablet AL; QL
levofloxacin oral solution QL
levofloxacin oral tablet Levaquin
ofloxacin oral tablet 300 mg QL
ofloxacin oral tablet 400 mg AL; QL
SULFONAMIDAS ABSORBIBLES
sulfamethoxazole-trimethoprim oral suspension
Sulfatrim
sulfamethoxazole-trimethoprim oral tablet Bactrim
trimethoprim oral tablet
TETRACÍLICAS
demeclocycline oral tablet
doxycycline monohydrate oral capsule 100 mg, 50 mg
Mondoxyne NL QL
doxycycline monohydrate oral capsule 150 mg
doxycycline monohydrate oral capsule 75 mg
Mondoxyne NL
doxycycline monohydrate oral suspension for reconstitution
Vibramycin
minocycline oral capsule Minocin
minocycline oral tablet
tetracycline oral capsule
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Nombre del medicamento Reference Notas
VANCOMICINA Y DERIVADOS
linezolid oral suspension for reconstitution Zyvox PA; QL
linezolid oral tablet Zyvox PA; QL
vancomycin oral capsule Vancocin PA
AGENTES DE DIAGNÓSTICO
AGENTES DE DIAGNÓSTICO: FUNCIÓN DE LA HIPÓFISIS
cosyntropin injection recon soln Cortrosyn QL
cosyntropin intravenous solution
DIAGNOSTIC DROGAS
GLUCAGEN DIAGNOSTIC KIT INJECTION RECON SOLN
QL
AGENTES DE TERAPIA CARDIOVASCULAR
AGENTES BLOQUEADORES ALFA ADRENÉRGICOS
doxazosin oral tablet 1 mg, 2 mg, 4 mg, 8 mg
Cardura QL
prazosin oral capsule Minipress
terazosin oral capsule 1 mg, 10 mg, 2 mg, 5 mg
QL
AGENTES BLOQUEADORES ALFA/BETA ADRENÉRGICOS
carvedilol oral tablet 12.5 mg, 25 mg, 3.125 mg, 6.25 mg
Coreg QL
labetalol oral tablet
AGENTES BLOQUEADORES BETA ADRENÉRGICOS
acebutolol oral capsule
atenolol oral tablet Tenormin
betaxolol oral tablet
bisoprolol fumarate oral tablet
metoprolol succinate oral tablet extended release 24 hr
Toprol XL
metoprolol tartrate oral tablet 100 mg, 50 mg
Lopressor QL
metoprolol tartrate oral tablet 25 mg, 37.5 mg, 75 mg
nadolol oral tablet Corgard
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Nombre del medicamento Reference Notas
pindolol oral tablet
propranolol oral capsule,extended release 24 hr
Inderal LA
propranolol oral solution
propranolol oral tablet
sotalol oral tablet Betapace QL
timolol maleate oral tablet
AGENTES BLOQUEADORES DEL CANAL DE CALCIO
afeditab cr oral tablet extended release 30 mg
DO; QL
afeditab cr oral tablet extended release 60 mg
QL
amlodipine oral tablet 10 mg, 2.5 mg, 5 mg
Norvasc QL
cartia xt oral capsule,extended release 24hr 120 mg, 180 mg, 240 mg
DO; QL
cartia xt oral capsule,extended release 24hr 300 mg
QL
diltiazem hcl oral capsule,ext.rel 24h degradable 120 mg, 180 mg
DILT-XR DO; QL
diltiazem hcl oral capsule,ext.rel 24h degradable 240 mg
DILT-XR QL
diltiazem hcl oral capsule,extended release 12 hr
QL
diltiazem hcl oral capsule,extended release 24 hr 120 mg, 180 mg
Taztia XT DO; QL
diltiazem hcl oral capsule,extended release 24 hr 240 mg, 300 mg, 360 mg
Taztia XT QL
diltiazem hcl oral capsule,extended release 24 hr 420 mg
Tiazac QL
diltiazem hcl oral capsule,extended release 24hr 120 mg, 180 mg, 240 mg
Cardizem CD DO; QL
diltiazem hcl oral capsule,extended release 24hr 300 mg, 360 mg
Cardizem CD QL
diltiazem hcl oral tablet 120 mg, 30 mg, 60 mg
Cardizem QL
diltiazem hcl oral tablet 90 mg QL
diltiazem hcl oral tablet extended release 24 hr 180 mg, 240 mg
Cardizem LA DO; QL
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Nombre del medicamento Reference Notas
diltiazem hcl oral tablet extended release 24 hr 300 mg, 360 mg, 420 mg
Cardizem LA QL
dilt-xr oral capsule,ext.rel 24h degradable 120 mg, 180 mg
DO; QL
dilt-xr oral capsule,ext.rel 24h degradable 240 mg
QL
felodipine oral tablet extended release 24 hr 10 mg
QL
felodipine oral tablet extended release 24 hr 2.5 mg, 5 mg
DO; QL
isradipine oral capsule 2.5 mg, 5 mg QL
matzim la oral tablet extended release 24 hr 180 mg, 240 mg
DO; QL
matzim la oral tablet extended release 24 hr 300 mg, 360 mg, 420 mg
QL
nicardipine oral capsule 20 mg, 30 mg QL
nifedipine oral capsule QL
nifedipine oral tablet extended release 24hr 30 mg
Procardia XL DO; QL
nifedipine oral tablet extended release 24hr 60 mg, 90 mg
Procardia XL QL
nifedipine oral tablet extended release 30 mg
Adalat CC DO; QL
nifedipine oral tablet extended release 60 mg, 90 mg
Adalat CC QL
taztia xt oral capsule,extended release 24 hr 120 mg, 180 mg
DO; QL
taztia xt oral capsule,extended release 24 hr 240 mg, 300 mg, 360 mg
QL
verapamil oral capsule, 24 hr er pellet ct Verelan PM DO; QL
verapamil oral capsule,ext rel. pellets 24 hr 120 mg, 180 mg
Verelan DO; QL
verapamil oral capsule,ext rel. pellets 24 hr 240 mg, 360 mg
Verelan QL
verapamil oral tablet QL
verapamil oral tablet extended release Calan SR QL
AGENTES DE TERAPIA ANAFILAXIA
epinephrine 0.3 mg auto-inject inner Auvi-Q
epinephrine 0.3 mg auto-inject outer Auvi-Q
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Nombre del medicamento Reference Notas
epinephrine injection auto-injector 0.15 mg/0.3 ml
EpiPen Jr QL
epinephrine injection solution Adrenalin
AGENTES DIURÉTICOS, OTROS
acetazolamide oral capsule, extended release
acetazolamide oral tablet
methazolamide oral tablet
spironolactone oral tablet Aldactone
ANTAGONISTAS DEL RECEPTOR DE LA ALDOSTERONA
spironolactone oral tablet Aldactone
ANTIARRÍTMICOS
amiodarone oral tablet 200 mg Pacerone QL
amiodarone oral tablet 400 mg Pacerone
disopyramide phosphate oral capsule Norpace
flecainide oral tablet 100 mg, 150 mg, 50 mg
QL
mexiletine oral capsule
pacerone oral tablet 200 mg QL
pacerone oral tablet 400 mg
propafenone oral capsule,extended release 12 hr
Rythmol SR
propafenone oral tablet
quinidine gluconate oral tablet extended release
quinidine sulfate oral tablet
sorine oral tablet QL
sotalol af oral tablet QL
sotalol oral tablet Betapace QL
DIURÉTICOS AHORRADORES DE POTASIO
amiloride oral tablet
amiloride-hydrochlorothiazide oral tablet
spironolacton-hydrochlorothiaz oral tablet Aldactazide
triamterene-hydrochlorothiazid oral capsule
triamterene-hydrochlorothiazid oral tablet Maxzide-25mg
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Nombre del medicamento Reference Notas
DIURÉTICOS DE ASA
bumetanide oral tablet
furosemide oral solution
furosemide oral tablet Lasix
torsemide oral tablet Demadex
GLUCÓSIDOS DIGITÁLICOS
digox oral tablet
digoxin oral solution
digoxin oral tablet Digitek
HIPERTENSIÓN ARTERIAL PULMONAR
ADCIRCA ORAL TABLET PA; QL
LETAIRIS ORAL TABLET PA; QL
sildenafil (antihypertensive) oral tablet Revatio PA; QL
HIPOTENSIVOS, ANTAGONISTA DE LOS RECEPTORES DE LA ANGIOTENSINA
candesartan oral tablet Atacand
candesartan-hydrochlorothiazid oral tablet Atacand HCT
irbesartan oral tablet 150 mg, 75 mg Avapro DO; QL
irbesartan oral tablet 300 mg Avapro QL
irbesartan-hydrochlorothiazide oral tablet 150-12.5 mg, 300-12.5 mg
Avalide QL
losartan oral tablet Cozaar QL
losartan-hydrochlorothiazide oral tablet 100-12.5 mg, 100-25 mg
Hyzaar QL
losartan-hydrochlorothiazide oral tablet 50-12.5 mg
Hyzaar DO; QL
valsartan oral tablet Diovan QL
valsartan-hydrochlorothiazide oral tablet Diovan HCT
HIPOTENSIVOS, INHIBIDORES DE LA ECA, COMBINACIONES
benazepril oral tablet QL
benazepril-hydrochlorothiazide oral tablet QL
captopril oral tablet QL
captopril-hydrochlorothiazide oral tablet QL
enalapril maleate oral tablet Vasotec QL
enalapril-hydrochlorothiazide oral tablet QL
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Nombre del medicamento Reference Notas
fosinopril oral tablet QL
fosinopril-hydrochlorothiazide oral tablet QL
lisinopril oral tablet 10 mg, 20 mg, 5 mg Prinivil DO; QL
lisinopril oral tablet 2.5 mg Zestril DO; QL
lisinopril oral tablet 30 mg, 40 mg Zestril QL
lisinopril-hydrochlorothiazide oral tablet 10-12.5 mg
Zestoretic DO; QL
lisinopril-hydrochlorothiazide oral tablet 20-12.5 mg, 20-25 mg
Zestoretic QL
moexipril oral tablet
moexipril-hydrochlorothiazide oral tablet
perindopril erbumine oral tablet QL
quinapril oral tablet Accupril QL
quinapril-hydrochlorothiazide oral tablet Accuretic QL
ramipril oral capsule Altace QL
trandolapril oral tablet
HIPOTENSIVOS, SIMPATOLÍTICOS
clonidine hcl oral tablet Catapres
guanfacine oral tablet
methyldopa oral tablet
HIPOTENSIVOS, VARIOS
atenolol-chlorthalidone oral tablet Tenoretic 100
bisoprolol-hydrochlorothiazide oral tablet Ziac
methyldopa-hydrochlorothiazide oral tablet
metoprolol ta-hydrochlorothiaz oral tablet 100-25 mg, 100-50 mg
QL
metoprolol ta-hydrochlorothiaz oral tablet 50-25 mg
Lopressor HCT QL
nadolol-bendroflumethiazide oral tablet Corzide QL
propranolol-hydrochlorothiazid oral tablet
HIPOTENSIVOS, VASODILATADORES
hydralazine oral tablet
minoxidil oral tablet
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Nombre del medicamento Reference Notas
INHIBIDOR DE LA ECA/COMBINACIÓN DEL BLOQUEADOR DEL CANAL DE CALCIO
amlodipine-benazepril oral capsule QL
INHIBIDORES DE LA PCSK-9
REPATHA PUSHTRONEX SUBCUTANEOUS WEARABLE INJECTOR
PA; QL
REPATHA SURECLICK SUBCUTANEOUS PEN INJECTOR
PA; QL
REPATHA SYRINGE SUBCUTANEOUS SYRINGE
PA; QL
LIPOTRÓPICOS
atorvastatin oral tablet Lipitor DO; QL
cholestyramine (with sugar) oral powder Questran
cholestyramine (with sugar) oral powder in packet
Questran
cholestyramine light oral powder
cholestyramine light oral powder in packet
colestipol oral granules Colestid
colestipol oral packet Colestid
colestipol oral tablet Colestid
fenofibrate micronized oral capsule 130 mg, 134 mg, 200 mg, 43 mg
QL
fenofibrate micronized oral capsule 67 mg PA; QL
fenofibrate nanocrystallized oral tablet Tricor QL
fenofibrate oral tablet QL
fenofibric acid (choline) oral capsule,delayed release(dr/ec) 135 mg
Trilipix QL
fenofibric acid (choline) oral capsule,delayed release(dr/ec) 45 mg
Trilipix PA; QL
fenofibric acid oral tablet Fibricor PA; QL
gemfibrozil oral tablet Lopid
lovastatin oral tablet QL
niacin oral tablet Niacor OTC
pravastatin oral tablet Pravachol
prevalite oral powder
prevalite oral powder in packet
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Nombre del medicamento Reference Notas
simvastatin oral tablet 10 mg, 20 mg, 40 mg, 5 mg
Zocor DO; QL
simvastatin oral tablet 80 mg Zocor PA; QL
TIAZIDA Y DIURÉTICOS RELACIONADOS
chlorothiazide oral tablet
chlorthalidone oral tablet
hydrochlorothiazide oral capsule Microzide QL
hydrochlorothiazide oral tablet 12.5 mg QL
hydrochlorothiazide oral tablet 25 mg, 50 mg
indapamide oral tablet
metolazone oral tablet
VASODILATADORES, CORONARIA
isosorbide dinitrate oral tablet
isosorbide dinitrate oral tablet extended release
ISOCHRON
isosorbide mononitrate oral tablet
isosorbide mononitrate oral tablet extended release 24 hr
nitro-bid transdermal ointment
NITRO-DUR TRANSDERMAL PATCH 24 HOUR
nitroglycerin oral capsule, extended release
Nitro-Time
nitroglycerin sublingual tablet Nitrostat
nitroglycerin transdermal patch 24 hour Minitran
nitro-time oral capsule, extended release
VASOPRESOR ADRENÉRGICO
midodrine oral tablet
AGENTES DE TERAPIA GASTROINTESTINAL
AGENTES ANTIEMÉTICOS/ANTIVÉRTIGOS
aprepitant oral capsule 125 mg, 40 mg, 80 mg
Emend QL
aprepitant oral capsule,dose pack Emend QL
compro rectal suppository
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Nombre del medicamento Reference Notas
DICLEGIS ORAL TABLET,DELAYED RELEASE (DR/EC)
PA; QL
dimenhydrinate oral tablet Dramamine OTC
driminate oral tablet OTC
granisetron (pf) intravenous solution
granisetron hcl intravenous solution
granisetron hcl oral tablet QL
meclizine oral tablet OTC
meclizine oral tablet,chewable Bonine OTC
medi-meclizine oral tablet OTC
motion relief (meclizine) oral tablet OTC
motion sickness (meclizine) oral tablet OTC
motion sickness oral tablet OTC
motion sickness relief oral tablet OTC
ondansetron hcl (pf) injection solution
ondansetron hcl (pf) injection syringe
ondansetron hcl intravenous solution Zofran (as hydrochloride)
ondansetron hcl oral solution Zofran (as hydrochloride) QL
ondansetron hcl oral tablet 24 mg QL
ondansetron hcl oral tablet 4 mg, 8 mg Zofran (as hydrochloride) QL
ondansetron oral tablet,disintegrating 4 mg, 8 mg
Zofran ODT QL
phenadoz rectal suppository
prochlorperazine edisylate injection solution
prochlorperazine maleate oral tablet Compazine
prochlorperazine rectal suppository Compazine
promethazine rectal suppository Phenadoz
promethegan rectal suppository
travel sickness (meclizine) oral tablet,chewable
OTC
travel sickness oral tablet OTC
trimethobenzamide oral capsule Tigan
AGENTES PARA LA ENFERMEDAD INFLAMATORIA INTESTINAL
budesonide oral capsule,delayed,extend.release
Entocort EC QL
colocort rectal enema
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Nombre del medicamento Reference Notas
HUMIRA PEDIATRIC CROHN'S START SUBCUTANEOUS SYRINGE KIT
PA; QL
HUMIRA PEN CROHN'S-UC-HS START SUBCUTANEOUS PEN INJECTOR KIT
PA; QL
HUMIRA PEN PSORIASIS-UVEITIS SUBCUTANEOUS PEN INJECTOR KIT
PA; QL
HUMIRA PEN SUBCUTANEOUS PEN INJECTOR KIT
PA; QL
HUMIRA SUBCUTANEOUS SYRINGE KIT
PA; QL
hydrocortisone rectal enema Colocort
ANTIÁCIDOS
antacid (calcium carbonate) oral tablet,chewable
OTC; QL
antacid calcium oral tablet,chewable OTC; QL
antacid ext str (calcium carb) oral tablet,chewable
OTC
antacid extra-strength oral tablet,chewable
OTC
calcium antacid oral tablet,chewable 200 mg calcium (500 mg)
OTC; QL
calcium antacid oral tablet,chewable 300 mg (750 mg), 320 mg calcium (750 mg), 400 mg calcium (1,000 mg)
OTC
calcium antacid tropical oral tablet,chewable
OTC
calcium antacid ultra max st oral tablet,chewable
OTC
calcium carbonate oral tablet OTC; QL
cal-gest antacid oral tablet,chewable OTC; QL
tums ultra oral tablet,chewable OTC
ultra strength calcium antacid oral tablet,chewable
OTC
ANTIDIARREICOS
anti-diarrhea oral tablet OTC; QL
anti-diarrheal (loperamide) oral liquid OTC; QL
anti-diarrheal (loperamide) oral tablet OTC; QL
bismatrol oral suspension OTC; QL
bismatrol oral tablet,chewable OTC
bismuth oral suspension OTC; QL
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Nombre del medicamento Reference Notas
diphenoxylate-atropine oral liquid
diphenoxylate-atropine oral tablet Lomotil
kao-tin (bismuth subsalicylat) oral suspension
OTC; QL
k-pec antidiarrheal (bism sub) oral suspension
OTC; QL
loperamide oral capsule Anti-Diarrheal (loperamide) OTC; QL
loperamide oral liquid Anti-Diarrheal (loperamide) OTC; QL
loperamide oral tablet Anti-Diarrhea OTC; QL
peptic relief oral suspension OTC; QL
peptic relief oral tablet,chewable OTC
pepto-bismol oral tablet,chewable OTC
pink bismuth oral suspension OTC; QL
pink bismuth oral tablet OTC
pink bismuth oral tablet,chewable OTC
stomach relief oral suspension OTC; QL
stomach relief oral tablet OTC
stomach relief oral tablet,chewable OTC
stomach relief original oral suspension OTC; QL
ANTIESPASMÓDICOS
dicyclomine oral capsule
dicyclomine oral solution
dicyclomine oral tablet
glycopyrrolate oral tablet Robinul
hyoscyamine sulfate oral drops Hyosyne
hyoscyamine sulfate oral elixir Hyosyne
hyoscyamine sulfate oral tablet Levsin
hyoscyamine sulfate oral tablet extended release 12 hr
Levbid
hyoscyamine sulfate oral tablet,disintegrating
Anaspaz
hyoscyamine sulfate sublingual tablet Levsin/SL
hyosyne oral drops
hyosyne oral elixir
oscimin oral tablet
oscimin oral tablet,disintegrating
oscimin sl sublingual tablet
19
Nombre del medicamento Reference Notas
oscimin sr oral tablet extended release 12 hr
propantheline oral tablet
symax fastabs oral tablet,disintegrating
ANTIFLATULENTOS
gas relief 80 oral tablet,chewable OTC
gas relief extra strength oral capsule OTC
gas relief extra strength oral tablet,chewable
OTC
gas relief oral capsule OTC
gas relief oral drops,suspension OTC
gas relief oral tablet,chewable OTC
infants gas relief oral drops,suspension OTC
mi-acid gas relief oral tablet,chewable OTC
mytab gas maximum strength oral tablet,chewable
OTC
mytab gas oral tablet,chewable OTC
simethicone oral drops,suspension Gas Relief OTC
simethicone oral tablet,chewable Gas Relief OTC
ENZIMAS PANCREÁTICAS
CREON ORAL CAPSULE,DELAYED RELEASE(DR/EC) 12,000-38,000 -60,000 UNIT, 24,000-76,000 -120,000 UNIT, 6,000-19,000 -30,000 UNIT
QL
CREON ORAL CAPSULE,DELAYED RELEASE(DR/EC) 3,000-9,500- 15,000 UNIT, 36,000-114,000- 180,000 UNIT
ZENPEP ORAL CAPSULE,DELAYED RELEASE(DR/EC)
QL
ESTIMULANTES DE MOTILIDAD INTESTINAL
metoclopramide hcl oral solution
metoclopramide hcl oral tablet Reglan
INFLAMACIÓN CRÓNICA, ENFERMEDAD DE COLON, 5 AMINOSALICILATOS
APRISO ORAL CAPSULE,EXTENDED RELEASE 24HR
QL
balsalazide oral capsule Colazal QL
mesalamine rectal enema Rowasa QL
20
Nombre del medicamento Reference Notas
mesalamine with cleansing wipe rectal enema kit
Rowasa
sulfasalazine oral tablet Azulfidine QL
sulfasalazine oral tablet,delayed release (dr/ec)
Azulfidine EN-tabs QL
LAXANTES Y CATÁRTICOS
bisac-evac rectal suppository OTC
bisacodyl oral tablet,delayed release (dr/ec)
Alophen OTC; QL
bisacodyl rectal suppository Bisac-Evac OTC
bisa-lax oral tablet,delayed release (dr/ec) OTC; QL
biscolax rectal suppository OTC
citrate of magnesia oral solution OTC
clearlax oral powder OTC
clearlax oral powder in packet OTC; QL
constulose oral solution QL
diocto oral liquid OTC
diocto oral syrup OTC
dioctyl oral syrup OTC
doc-q-lace oral capsule OTC; QL
docu oral liquid OTC
docusate sodium oral capsule Col-Rite OTC; QL
docusate sodium oral liquid Diocto OTC
docusate sodium oral syrup Diocto OTC
docusate sodium oral tablet Docuprene OTC
docusil oral capsule OTC; QL
dok oral capsule 100 mg OTC; QL
dok oral capsule 250 mg OTC
dok oral tablet OTC
ducodyl oral tablet,delayed release (dr/ec) OTC; QL
enema disposable rectal enema OTC
enema rectal enema OTC
enulose oral solution
fiber (psyllium husk/sugar) oral powder OTC
fiber (with aspartame) oral powder OTC
fiber oral powder OTC
fiber smooth (sucrose) oral powder OTC
fiber smooth oral powder OTC
21
Nombre del medicamento Reference Notas
fleet enema rectal enema OTC
fleet glycerin (adult) rectal suppository OTC
fleet laxative oral tablet,delayed release (dr/ec)
OTC; QL
gavilax oral powder OTC
gavilyte-c oral recon soln QL
gavilyte-g oral recon soln QL
gavilyte-n oral recon soln QL
generlac oral solution
gentle laxative oral tablet,delayed release (dr/ec)
OTC; QL
gentle laxative rectal suppository OTC
glycerin (child) rectal suppository Fleet Glycerin (Child) OTC
glycolax oral powder OTC
healthylax oral powder in packet OTC; QL
kao-tin (docusate calcium) oral capsule OTC
konsyl (sugar) oral powder OTC
lactulose oral solution 10 gram/15 ml Constulose QL
lactulose oral solution 10 gram/15 ml (15 ml), 20 gram/30 ml
QL
laxative (bisacodyl) oral tablet OTC; QL
laxative (bisacodyl) oral tablet,delayed release (dr/ec)
OTC; QL
laxative (bisacodyl) rectal suppository OTC
laxative feminine oral tablet OTC; QL
magnesium citrate oral solution Citrate of Magnesia OTC
milk of magnesia oral suspension OTC
mineral oil rectal enema Fleet Mineral Oil OTC
natural fiber laxative (sugar) oral powder OTC
natural fiber laxative therapy oral powder OTC
natural fiber laxative(aspart) oral powder OTC
natural veg laxative(sennosid) oral tablet OTC
natural vegetable powder oral powder OTC
oral saline laxative oral liquid OTC
oral saline laxative oral solution OTC
peg 3350-electrolytes oral recon soln GaviLyte-G QL
peg-3350 with flavor packs oral recon soln QL
peg-electrolyte soln oral recon soln GaviLyte-N QL
22
Nombre del medicamento Reference Notas
polyethylene glycol 3350 oral powder ClearLax OTC
polyethylene glycol 3350 oral powder in packet
ClearLax OTC; QL
ready-to-use enema rectal enema OTC
reguloid oral powder OTC
reguloid, sugar free oral powder OTC
sani-supp (adult) rectal suppository OTC
sani-supp (infant) rectal suppository OTC
senexon oral tablet OTC
senna lax oral tablet OTC
senna laxative oral tablet OTC
senna oral syrup OTC
senna oral tablet OTC
senno oral tablet OTC
sen-o-tab oral tablet OTC
silace oral liquid OTC
silace oral syrup OTC
smoothlax oral powder in packet OTC; QL
sof-lax oral capsule OTC; QL
stool softener (docusate cal) oral capsule OTC
stool softener oral capsule 100 mg OTC; QL
stool softener oral capsule 250 mg OTC
stool softener oral liquid OTC
stool softener oral syrup OTC
stool softener oral tablet OTC
trilyte with flavor packets oral recon soln QL
women's gentle laxative(bisac) oral tablet,delayed release (dr/ec)
OTC; QL
women's laxative (bisacodyl) oral tablet OTC; QL
REDUCTORES DE SECRECIÓN ÁCIDA GÁSTRICA
acid control (ranitidine) oral tablet OTC; QL
acid controller oral tablet 10 mg, 20 mg OTC; QL
acid reducer (famotidine) oral tablet 10 mg, 20 mg
OTC; QL
acid reducer (ranitidine) oral tablet 150 mg, 75 mg
OTC; QL
23
Nombre del medicamento Reference Notas
acid reducer complete (famot) oral tablet,chewable
OTC
CARAFATE ORAL SUSPENSION
complete oral tablet,chewable OTC
esomeprazole magnesium oral capsule,delayed release(dr/ec)
Nexium OTC; QL
famotidine (pf) intravenous solution
famotidine oral suspension Pepcid
famotidine oral tablet 10 mg, 20 mg Acid Controller OTC; QL
famotidine oral tablet 40 mg Pepcid QL
heartburn relief (famotidine) oral tablet 10 mg, 20 mg
OTC; QL
heartburn relief (ranitidine) oral tablet 150 mg, 75 mg
OTC; QL
heartburn treatment 24 hour oral capsule,delayed release(dr/ec)
PA; OTC; QL
lansoprazole oral capsule,delayed release(dr/ec)
Heartburn Treatment 24 Hour
PA; OTC; QL
misoprostol oral tablet Cytotec
nizatidine oral capsule
nizatidine oral solution
omeprazole magnesium oral capsule,delayed release(dr/ec)
Acid Reducer (omeprazole) OTC; QL
omeprazole oral tablet,delayed release (dr/ec)
OTC; QL
PREVACID 24HR ORAL CAPSULE,DELAYED RELEASE(DR/EC)
PA; OTC; QL
ranitidine hcl oral capsule 150 mg
ranitidine hcl oral capsule 300 mg QL
ranitidine hcl oral syrup
ranitidine hcl oral tablet 150 mg Acid Control (ranitidine) OTC; QL
ranitidine hcl oral tablet 300 mg Zantac QL
ranitidine hcl oral tablet 75 mg Acid Reducer (ranitidine) OTC; QL
sucralfate oral suspension Carafate
sucralfate oral tablet Carafate
zantac 75 oral tablet OTC; QL
zantac maximum strength oral tablet OTC; QL
zantac oral tablet OTC; QL
24
Nombre del medicamento Reference Notas
SALES BILIARES
ursodiol oral capsule Actigall
ursodiol oral tablet URSO 250
AGENTES DE TERAPIA RESPIRATORIA
AGENTES ALFA/BETA ADRENÉRGICOS
epinephrine injection syringe
AGENTES BETA ADRENÉRGICOS
albuterol sulfate inhalation solution for nebulization 0.63 mg/3 ml
albuterol sulfate inhalation solution for nebulization 1.25 mg/3 ml, 2.5 mg /3 ml (0.083 %), 2.5 mg/0.5 ml, 5 mg/ml
QL
albuterol sulfate oral syrup
albuterol sulfate oral tablet
albuterol sulfate oral tablet extended release 12 hr
PROAIR HFA INHALATION HFA AEROSOL INHALER
QL
PROVENTIL HFA INHALATION HFA AEROSOL INHALER
QL
SEREVENT DISKUS INHALATION BLISTER WITH DEVICE
QL
AGENTES BRONCODILATADORES GENERALES
ATROVENT HFA INHALATION HFA AEROSOL INHALER
QL
ipratropium bromide inhalation solution QL
SPIRIVA WITH HANDIHALER INHALATION CAPSULE, W/INHALATION DEVICE
QL
AGENTES PARA EL TRATAMIENTO DEL ASMA
budesonide inhalation suspension for nebulization 0.25 mg/2 ml, 0.5 mg/2 ml, 1 mg/2 ml
Pulmicort QL
cromolyn inhalation solution for nebulization
25
Nombre del medicamento Reference Notas
FLOVENT DISKUS INHALATION BLISTER WITH DEVICE 100 MCG/ACTUATION, 250 MCG/ACTUATION, 50 MCG/ACTUATION
QL
FLOVENT HFA INHALATION HFA AEROSOL INHALER 110 MCG/ACTUATION, 220 MCG/ACTUATION, 44 MCG/ACTUATION
QL
PULMICORT FLEXHALER INHALATION AEROSOL POWDR BREATH ACTIVATED
QL
AMINOGLICÓSIDOS
tobramycin in 0.225 % nacl inhalation solution for nebulization
Tobi QL
ANALGÉSICOS/ANTIPIRÉTICOS, NO SALICILATO
acetaminophen pm oral tablet OTC
diphenhydramine-acetaminophen oral tablet
Acetadryl OTC
headache pm oral tablet OTC
mapap pm oral tablet OTC
non-aspirin nightime oral tablet OTC
non-aspirin pm oral tablet OTC
pain relief pm oral tablet OTC
pain relief pm rapid release oral tablet OTC
pain reliever pm ex-strength oral tablet OTC
ANTAGONISTAS DEL RECEPTOR DE LEUCOTRIENO
montelukast oral granules in packet Singulair QL
montelukast oral tablet Singulair
montelukast oral tablet,chewable Singulair
zafirlukast oral tablet Accolate QL
ANTIBIÓTICOS NASALES
BACTROBAN NASAL NASAL OINTMENT
QL
ANTICOLINÉRGICOS NASALES
ipratropium bromide nasal spray,non-aerosol
26
Nombre del medicamento Reference Notas
ANTIHISTAMÍNICOS NASALES
azelastine nasal aerosol,spray QL
azelastine nasal spray,non-aerosol Astepro QL
ANTIHISTAMÍNICOS
aller-chlor oral tablet OTC
aller-ease oral tablet 180 mg OTC; QL
aller-ease oral tablet 60 mg OTC
allergy (chlorpheniramine) oral tablet OTC
allergy (diphenhydramine) oral capsule OTC; QL
allergy (diphenhydramine) oral tablet OTC; QL
allergy 4-hour oral tablet OTC
allergy medicine oral capsule OTC; QL
allergy medicine oral tablet OTC; QL
allergy relief (fexofenadine) oral tablet OTC; QL
allergy relief (loratadine) oral solution OTC; QL
allergy relief (loratadine) oral tablet OTC; QL
allergy relief (loratadine) oral tablet,disintegrating
OTC; QL
allergy relief(chlorpheniramn) oral tablet OTC
allergy relief(diphenhydramin) oral capsule
OTC; QL
allergy relief(diphenhydramin) oral liquid OTC; QL
allergy relief(diphenhydramin) oral tablet OTC; QL
allergy-time oral tablet OTC
banophen allergy oral liquid OTC; QL
banophen oral capsule 25 mg OTC; QL
banophen oral capsule 50 mg OTC
banophen oral liquid OTC; QL
banophen oral tablet OTC; QL
carbinoxamine maleate oral liquid
carbinoxamine maleate oral tablet
children's allergy (diphenhyd) oral liquid OTC; QL
children's allergy relief(lor) oral solution OTC; QL
chlorpheniramine maleate oral tablet Aller-Chlor OTC
clemastine oral tablet
complete allergy medicine oral capsule OTC; QL
complete allergy oral capsule OTC; QL
27
Nombre del medicamento Reference Notas
complete allergy oral liquid OTC; QL
cyproheptadine oral syrup
cyproheptadine oral tablet
DAYHIST ORAL TABLET OTC
diphedryl oral capsule OTC; QL
diphedryl oral liquid OTC; QL
diphedryl oral tablet OTC; QL
diphenhist oral capsule OTC; QL
diphenhist oral liquid OTC; QL
diphenhist oral tablet OTC; QL
diphenhydramine hcl injection solution
diphenhydramine hcl oral capsule 25 mg Aler-Cap OTC; QL
diphenhydramine hcl oral capsule 50 mg Banophen OTC
diphenhydramine hcl oral elixirChildren's Allergy (diphenhyd)
OTC; QL
fexofenadine oral suspension Children's Allegra Allergy OTC; QL
fexofenadine oral tablet 180 mg Allegra Allergy OTC; QL
fexofenadine oral tablet 60 mg Allegra Allergy OTC
loratadine oral solution Allergy Relief (loratadine) OTC; QL
loratadine oral tablet Allerclear OTC; QL
loratadine oral tablet,disintegrating Alavert OTC; QL
non-drowsy allergy oral tablet OTC; QL
pharbechlor oral tablet OTC
pharbedryl oral capsule 25 mg OTC; QL
pharbedryl oral capsule 50 mg OTC
promethazine oral syrup
promethazine oral tablet 12.5 mg, 50 mg
promethazine oral tablet 25 mg AL; QL
rest simply nighttime sleep oral tablet OTC
siladryl sa oral liquid OTC; QL
sleep-tabs oral tablet OTC
valu-dryl allergy oral capsule OTC; QL
COMBINACIÓN DE AGENTES BETA ADRENÉRGICOS
COMBIVENT RESPIMAT INHALATION MIST
QL
ipratropium-albuterol inhalation solution for nebulization
28
Nombre del medicamento Reference Notas
STIOLTO RESPIMAT INHALATION MIST
QL
COMBINACIONES ANTITUSIVAS NO NARCÓTICAS
adult tussin cough congest dm oral liquid OTC; QL
adult tussin dm oral syrup OTC; QL
benzonatate oral capsule
cough control dm oral syrup OTC; QL
cough formula dm oral syrup OTC; QL
cough relief oral liquid AL; OTC; QL
cough suppressant-expectorant oral syrup OTC; QL
cough syrup dm oral syrup OTC; QL
dextromethorphan-guaifenesin oral syrup Adult Tussin DM OTC; QL
diabetic siltussin-dm oral liquid OTC; QL
promethazine-dm oral syrup QL
ri-tussin dm oral syrup OTC; QL
robafen dm cough oral liquid OTC; QL
robafen dm cough-chest congest oral syrup
OTC; QL
robafen dm oral syrup OTC; QL
siltussin dm das oral liquid OTC; QL
siltussin-dm oral syrup OTC; QL
tusnel diabetic oral liquid OTC; QL
tussin cough (dm only) oral liquid AL; OTC; QL
tussin dm clear oral syrup OTC; QL
tussin dm cough and chest oral syrup OTC; QL
tussin dm oral liquid OTC; QL
tussin dm oral syrup OTC; QL
COMBINACIONES DE ANTIHISTAMÍNICOS Y DESCONGESTIVOS
allergy and congestion relief oral tablet extended release 12 hr
OTC; QL
allergy and congestion relief oral tablet extended release 24 hr
OTC; QL
allergy relief d-24 oral tablet extended release 24 hr
OTC; QL
allergy relief,nasal decongest oral tablet extended release 24 hr
OTC; QL
29
Nombre del medicamento Reference Notas
fexofenadine-pseudoephedrine oral tablet extended release 12 hr
Allegra-D 12 Hour OTC
lorata-dine d oral tablet extended release 24 hr
OTC; QL
loratadine-d oral tablet extended release 12 hr
OTC; QL
loratadine-d oral tablet extended release 24 hr
OTC; QL
promethazine vc oral syrup QL
promethazine-phenylephrine oral syrup Promethazine VC QL
r-tanna oral tablet
COMBINACIONES DE ANTITUSIVOS NARCÓTICOS
cheratussin ac oral liquid AL; OTC; QL
codeine-guaifenesin oral liquid Cheratussin AC AL; OTC; QL
guaiatussin ac oral liquid AL; OTC; QL
guaifenesin ac oral liquid AL; OTC; QL
guaifenesin dac oral syrup AL; OTC
hydrocodone-homatropine oral syrup Hydrocodone Compound
hydrocodone-homatropine oral tablet Tussigon
hydromet oral syrup
mar-cof cg oral liquid AL; OTC
m-clear wc oral liquid AL; OTC
promethazine vc-codeine oral syrup AL; QL
promethazine-codeine oral syrup AL; QL
promethazine-phenyleph-codeine oral syrup
Promethazine VC-Codeine AL; QL
relcof c oral liquid AL; OTC
tusnel c oral syrup AL; OTC
tussigon oral tablet
virtussin ac oral liquid AL; OTC; QL
COMBINACIONES DE DESCONGESTIVOS Y EXPECTORANTES
pe-guai oral drops AL
30
Nombre del medicamento Reference Notas
COMBINACIONES DE GLUCOCORTICOIDES Y BETA-ADRENÉRGICOS
ADVAIR DISKUS INHALATION BLISTER WITH DEVICE
QL
ADVAIR HFA INHALATION HFA AEROSOL INHALER
QL
DULERA INHALATION HFA AEROSOL INHALER
QL
fluticasone-salmeterol inhalation aerosol powdr breath activated
AirDuo RespiClick QL
SYMBICORT INHALATION HFA AEROSOL INHALER
QL
CORTICOESTEROIDES NASALES
aller-flo nasal spray,suspension OTC; QL
ALLERGY RELIEF (FLUTICASONE) NASAL SPRAY,SUSPENSION
OTC; QL
children's flonase allergy rlf nasal spray,suspension
OTC; QL
CLARISPRAY NASAL SPRAY,SUSPENSION
OTC; QL
FLONASE ALLERGY RELIEF NASAL SPRAY,SUSPENSION
OTC; QL
fluticasone nasal spray,suspension 24 Hour Allergy Relief OTC; QL
DESCONGESTANTES SINTOMATIMICOS SISTEMICOS
nasal decongestant (pseudoeph) oral tablet
OTC; QL
pseudoephedrine hcl oral tablet 30 mgNasal Decongestant (pseudoeph)
OTC; QL
pseudoephedrine hcl oral tablet 60 mg Sudogest OTC
sudogest oral tablet 30 mg OTC; QL
sudogest oral tablet 60 mg OTC
suphedrin oral tablet OTC; QL
suphedrine oral tablet OTC; QL
EXPECTORANTES
adult tussin chest congestion oral liquid AL; OTC; QL
CHILD MUCINEX CHEST CONGESTION ORAL LIQUID
AL; OTC; QL
child mucus relief expectorant oral liquid AL; OTC; QL
31
Nombre del medicamento Reference Notas
diabetic siltussin das-na oral liquid AL; OTC; QL
guaifenesin oral liquidAdult Tussin Chest Congestion
AL; OTC; QL
scot-tussin expectorant oral liquid AL; OTC; QL
tussin chest congestion oral liquid AL; OTC; QL
tussin expectorant oral liquid AL; OTC; QL
MUCOLÍTICOS
PULMOZYME INHALATION SOLUTION QL
NASAL, OTROS
nasal moisturizing nasal aerosol,spray OTC
saline nasal mist nasal aerosol,spray OTC
saline nasal nasal aerosol,spray OTC
saline nose nasal aerosol,spray OTC
XANTINAS
theophylline oral elixir Elixophyllin
theophylline oral solution
theophylline oral tablet extended release 12 hr
Theochron
theophylline oral tablet extended release 24 hr
AGENTES DEL SISTEMA NERVIOSO CENTRAL
ANSIOLÍTICOS
alprazolam oral tablet Xanax
alprazolam oral tablet,disintegrating
buspirone oral tablet 10 mg, 15 mg, 5 mg, 7.5 mg
QL
buspirone oral tablet 30 mg
chlordiazepoxide hcl oral capsule
clonazepam oral tablet Klonopin
clonazepam oral tablet,disintegrating
clorazepate dipotassium oral tablet 15 mg, 3.75 mg
QL
clorazepate dipotassium oral tablet 7.5 mg Tranxene T-Tab QL
diazepam intensol oral concentrate
diazepam oral concentrate Diazepam Intensol
diazepam oral solution
diazepam oral tablet Valium
32
Nombre del medicamento Reference Notas
hydroxyzine hcl oral solution
hydroxyzine hcl oral tablet
hydroxyzine pamoate oral capsule
lorazepam oral tablet Ativan QL
oxazepam oral capsule
ANTICONVULSIVOS
carbamazepine oral capsule, er multiphase 12 hr 100 mg, 200 mg, 300 mg
Carbatrol QL
carbamazepine oral suspension Tegretol
carbamazepine oral tablet Epitol
carbamazepine oral tablet extended release 12 hr
Tegretol XR
carbamazepine oral tablet,chewable
clonazepam oral tablet Klonopin
clonazepam oral tablet,disintegrating
diazepam rectal kit Diastat QL
divalproex oral capsule, delayed rel sprinkle
Depakote Sprinkles QL
divalproex oral tablet extended release 24 hr 250 mg, 500 mg
Depakote ER QL
divalproex oral tablet,delayed release (dr/ec) 125 mg, 250 mg
Depakote QL
divalproex oral tablet,delayed release (dr/ec) 500 mg
Depakote
epitol oral tablet
ethosuximide oral capsule Zarontin
ethosuximide oral solution Zarontin
felbamate oral suspension Felbatol
felbamate oral tablet Felbatol
gabapentin oral capsule 100 mg, 300 mg, 400 mg
Neurontin QL
gabapentin oral solution 250 mg/5 ml Neurontin QL
gabapentin oral solution 250 mg/5 ml (5 ml), 300 mg/6 ml (6 ml)
gabapentin oral tablet 600 mg, 800 mg Neurontin QL
lamotrigine oral tablet Lamictal
lamotrigine oral tablet disintegrating, dose pk
Lamictal ODT Starter (Orange)
33
Nombre del medicamento Reference Notas
lamotrigine oral tablet extended release 24hr
Lamictal XR
lamotrigine oral tablet, chewable dispersible
Lamictal
lamotrigine oral tablet,disintegrating 100 mg, 200 mg, 25 mg
Lamictal ODT
lamotrigine oral tablet,disintegrating 50 mg
Lamictal ODT QL
lamotrigine oral tablets,dose pack Lamictal Starter (Blue) Kit
levetiracetam oral solution Keppra
levetiracetam oral tablet 1,000 mg, 250 mg, 500 mg, 750 mg
Keppra QL
levetiracetam oral tablet extended release 24 hr 500 mg, 750 mg
Keppra XR QL
oxcarbazepine oral suspension Trileptal
oxcarbazepine oral tablet Trileptal
phenobarbital oral elixir
phenobarbital oral tablet 100 mg, 15 mg, 16.2 mg, 30 mg, 60 mg, 64.8 mg, 97.2 mg
phenobarbital oral tablet 32.4 mg QL
phenytoin oral suspension Dilantin-125
phenytoin oral tablet,chewable Dilantin Infatabs
phenytoin sodium extended oral capsule Phenytek
primidone oral tablet Mysoline
ROWEEPRA ORAL TABLET 1,000 MG, 500 MG, 750 MG
QL
tiagabine oral tablet Gabitril
topiramate oral capsule, sprinkle Topamax
topiramate oral tablet Topamax
valproic acid (as sodium salt) oral solution Depakene
valproic acid oral capsule Depakene QL
zonisamide oral capsule 100 mg Zonegran
zonisamide oral capsule 25 mg Zonegran QL
zonisamide oral capsule 50 mg QL
ANTIDEPRESIVOS ANTAGONISTAS DE RECEPTORES ALFA-2
mirtazapine oral tablet Remeron
mirtazapine oral tablet,disintegrating Remeron SolTab
34
Nombre del medicamento Reference Notas
ANTIDEPRESIVOS TRICÍCLICOS E INHIBIDORES DE RECAPTACIÓN NO SELECCIONADOS RELACIONADOS
amitriptyline oral tablet
amoxapine oral tablet
clomipramine oral capsule Anafranil
desipramine oral tablet Norpramin
doxepin oral capsule
doxepin oral concentrate
imipramine hcl oral tablet Tofranil
imipramine pamoate oral capsule
maprotiline oral tablet
nortriptyline oral capsule Pamelor
nortriptyline oral solution
protriptyline oral tablet
trimipramine oral capsule Surmontil
ANTIDEPRESIVOS, OTROS
olanzapine-fluoxetine oral capsule Symbyax
SYMBYAX ORAL CAPSULE
ANTIMANIA DROGAS
lithium carbonate oral capsule QL
lithium carbonate oral tablet QL
lithium carbonate oral tablet extended release
Lithobid QL
lithium citrate oral solution 8 meq/5 ml AL
lithium citrate oral solution 8 meq/5 ml (5 ml)
ANTIPSICÓTICOS, DOPAMINA ATÍPICA Y ANTAGONISTAS DE SEROTONINA
ABILIFY MAINTENA INTRAMUSCULAR SUSPENSION,EXTENDED REL RECON
AL
ABILIFY MAINTENA INTRAMUSCULAR SUSPENSION,EXTENDED REL SYRING
AL
aripiprazole oral solution
aripiprazole oral tablet 10 mg, 15 mg, 2 mg, 5 mg
Abilify
aripiprazole oral tablet 20 mg, 30 mg Abilify QL
35
Nombre del medicamento Reference Notas
aripiprazole oral tablet,disintegrating
ARISTADA INTRAMUSCULAR SUSPENSION,EXTENDED REL SYRING
AL
clozapine oral tablet Clozaril
clozapine oral tablet,disintegrating FazaClo
FANAPT ORAL TABLET PA; QL
FANAPT ORAL TABLETS,DOSE PACK PA
GEODON INTRAMUSCULAR RECON SOLN
AL; QL
INVEGA SUSTENNA INTRAMUSCULAR SYRINGE 117 MG/0.75 ML, 156 MG/ML, 234 MG/1.5 ML, 39 MG/0.25 ML, 78 MG/0.5 ML
AL; QL
INVEGA TRINZA INTRAMUSCULAR SYRINGE
AL; QL
LATUDA ORAL TABLET 120 MG, 20 MG, 40 MG, 60 MG, 80 MG
PA; QL
olanzapine intramuscular recon soln Zyprexa AL; QL
olanzapine oral tablet 10 mg, 2.5 mg, 5 mg, 7.5 mg
Zyprexa
olanzapine oral tablet 15 mg, 20 mg Zyprexa QL
olanzapine oral tablet,disintegrating 10 mg, 5 mg
Zyprexa Zydis
olanzapine oral tablet,disintegrating 15 mg, 20 mg
Zyprexa Zydis QL
paliperidone oral tablet extended release 24hr 1.5 mg
Invega
paliperidone oral tablet extended release 24hr 3 mg, 6 mg, 9 mg
Invega QL
quetiapine oral tablet Seroquel
quetiapine oral tablet extended release 24 hr
Seroquel XR
REXULTI ORAL TABLET 0.25 MG, 0.5 MG, 1 MG, 2 MG, 3 MG, 4 MG
PA; QL
RISPERDAL CONSTA INTRAMUSCULAR SYRINGE 12.5 MG/2 ML, 25 MG/2 ML, 37.5 MG/2 ML, 50 MG/2 ML
AL; QL
risperidone oral solution Risperdal AL
risperidone oral tablet Risperdal AL
risperidone oral tablet,disintegrating Risperdal M-TAB
36
Nombre del medicamento Reference Notas
SAPHRIS (BLACK CHERRY) SUBLINGUAL TABLET 10 MG, 5 MG
PA; QL
SAPHRIS (BLACK CHERRY) SUBLINGUAL TABLET 2.5 MG
PA
VRAYLAR ORAL CAPSULE PA
VRAYLAR ORAL CAPSULE,DOSE PACK
PA
ziprasidone hcl oral capsule Geodon
ZYPREXA RELPREVV INTRAMUSCULAR SUSPENSION FOR RECONSTITUTION 210 MG, 300 MG, 405 MG
AL; QL
ANTIPSICÓTICOS, TÍPICOS
chlorpromazine oral tablet
fluphenazine decanoate injection solution
fluphenazine hcl injection solution
fluphenazine hcl oral concentrate
fluphenazine hcl oral elixir
fluphenazine hcl oral tablet
HALDOL DECANOATE INTRAMUSCULAR SOLUTION
HALDOL INJECTION SOLUTION
haloperidol decanoate intramuscular solution 100 mg/ml
Haldol Decanoate QL
haloperidol decanoate intramuscular solution 50 mg/ml
Haldol Decanoate
haloperidol lactate injection solution Haldol
haloperidol lactate intramuscular syringe
haloperidol lactate oral concentrate
haloperidol oral tablet
loxapine succinate oral capsule
perphenazine oral tablet
pimozide oral tablet Orap
prochlorperazine maleate oral tablet Compazine
thioridazine oral tablet
thiothixene oral capsule
trifluoperazine oral tablet
BARBITÚRICOS
phenobarbital oral elixir
37
Nombre del medicamento Reference Notas
phenobarbital oral tablet 100 mg, 15 mg, 16.2 mg, 30 mg, 60 mg, 64.8 mg, 97.2 mg
phenobarbital oral tablet 32.4 mg QL
BENZODIACEPINAS
alprazolam oral tablet Xanax
alprazolam oral tablet,disintegrating
amitriptyline-chlordiazepoxide oral tablet
chlordiazepoxide hcl oral capsule
clonazepam oral tablet Klonopin
clonazepam oral tablet,disintegrating
clorazepate dipotassium oral tablet 15 mg, 3.75 mg
QL
clorazepate dipotassium oral tablet 7.5 mg Tranxene T-Tab QL
diazepam intensol oral concentrate
diazepam oral concentrate Diazepam Intensol
diazepam oral solution
diazepam oral tablet Valium
diazepam rectal kit Diastat QL
estazolam oral tablet 1 mg, 2 mg QL
flurazepam oral capsule
lorazepam oral tablet Ativan QL
oxazepam oral capsule
temazepam oral capsule Restoril QL
triazolam oral tablet Halcion QL
COMBINACIONES DE BENZODIACEPINA/ANTIDEPRESIVOS TRICÍCLICOS
amitriptyline-chlordiazepoxide oral tablet
COMBINACIONES DE FENOTIAZINA/ANTIDEPRESIVOS TRICÍCLICOS
perphenazine-amitriptyline oral tablet
DÉFICIT DE ATENCIÓN, HIPERACTIVIDAD (TDAH)/NARCOLEPSIA
atomoxetine oral capsule Strattera PA
caffeine citrate intravenous solution Cafcit
caffeine citrate oral solution
38
Nombre del medicamento Reference Notas
clonidine hcl oral tablet extended release 12 hr
Kapvay PA
dexmethylphenidate oral capsule,er biphasic 50-50
Focalin XR PA
dexmethylphenidate oral tablet Focalin PA
dextroamphetamine oral capsule, extended release
Dexedrine Spansule PA
dextroamphetamine oral tablet Zenzedi PA
dextroamphetamine-amphetamine oral capsule,extended release 24hr
Adderall XR PA
metadate er oral tablet extended release PA
methylphenidate hcl oral capsule, er biphasic 30-70
PA
methylphenidate hcl oral capsule,er biphasic 50-50
Ritalin LA PA
methylphenidate hcl oral solution Methylin PA
methylphenidate hcl oral tablet Ritalin PA
methylphenidate hcl oral tablet extended release
PA
methylphenidate hcl oral tablet extended release 24hr
Concerta PA
ESTIMULANTES DEL SNC
dextroamphetamine oral capsule, extended release
Dexedrine Spansule PA
dextroamphetamine oral tablet Zenzedi PA
dextroamphetamine-amphetamine oral capsule,extended release 24hr
Adderall XR PA
dextroamphetamine-amphetamine oral tablet
Adderall PA
INHIBIDOR SELECTIVO DE RECAPTACIÓN DE SEROTONINA (ISRS)
citalopram oral solution QL
citalopram oral tablet 10 mg, 20 mg Celexa
citalopram oral tablet 40 mg Celexa QL
escitalopram oxalate oral solution
escitalopram oxalate oral tablet 10 mg, 20 mg, 5 mg
Lexapro QL
fluoxetine oral capsule Prozac
39
Nombre del medicamento Reference Notas
fluoxetine oral capsule,delayed release(dr/ec)
fluoxetine oral solution
fluoxetine oral tablet Sarafem
fluvoxamine oral tablet
paroxetine hcl oral tablet Paxil
paroxetine hcl oral tablet extended release 24 hr
Paxil CR
sertraline oral concentrate Zoloft
sertraline oral tablet Zoloft
INHIBIDORES DE RECAPTACIÓN DE DOPAMINA Y NOREPINEFRINA (IRND)
bupropion hcl oral tablet
bupropion hcl oral tablet extended release 12 hr
Wellbutrin SR
bupropion hcl oral tablet extended release 24 hr 150 mg
Wellbutrin XL AL; QL
bupropion hcl oral tablet extended release 24 hr 300 mg
Wellbutrin XL
INHIBIDORES DE RECAPTACIÓN DE SEROTONINA-NOREPINEFRINA (IRSN)
venlafaxine oral capsule,extended release 24hr 150 mg, 37.5 mg
Effexor XR
venlafaxine oral capsule,extended release 24hr 75 mg
Effexor XR QL
venlafaxine oral tablet
venlafaxine oral tablet extended release 24hr
INHIBIDORES DE REUNIÓN DE ANTAGONISTAS DE SEROTONINA-2 (SARIS)
nefazodone oral tablet
trazodone oral tablet
INHIBIDORES MAO
phenelzine oral tablet Nardil
tranylcypromine oral tablet Parnate
40
Nombre del medicamento Reference Notas
MEDICAMENTOS PARA EL PARKINSON, ANTICOLINÉRGICO
benztropine oral tablet
trihexyphenidyl oral elixir
trihexyphenidyl oral tablet
MEDICAMENTOS PARA EL PARKINSON, OTRO
amantadine hcl oral capsule QL
amantadine hcl oral solution
amantadine hcl oral tablet
bromocriptine oral capsule Parlodel
bromocriptine oral tablet Parlodel
carbidopa-levodopa oral tablet Sinemet
carbidopa-levodopa oral tablet extended release
Sinemet CR
carbidopa-levodopa oral tablet,disintegrating
carbidopa-levodopa-entacapone oral tablet 12.5-50-200 mg
Stalevo 50 QL
carbidopa-levodopa-entacapone oral tablet 18.75-75-200 mg
Stalevo 75 QL
carbidopa-levodopa-entacapone oral tablet 25-100-200 mg
Stalevo 100 QL
carbidopa-levodopa-entacapone oral tablet 31.25-125-200 mg
Stalevo 125 QL
carbidopa-levodopa-entacapone oral tablet 37.5-150-200 mg
Stalevo 150 QL
carbidopa-levodopa-entacapone oral tablet 50-200-200 mg
Stalevo 200 QL
entacapone oral tablet Comtan
pramipexole oral tablet Mirapex QL
ropinirole oral tablet Requip
selegiline hcl oral capsule Eldepryl
selegiline hcl oral tablet
PREPARADOS PARA LA MIGRAÑA
divalproex oral tablet extended release 24 hr 250 mg, 500 mg
Depakote ER QL
isometh-dichloral-acetaminophn oral capsule
Nodolor
migergot rectal suppository
41
Nombre del medicamento Reference Notas
naratriptan oral tablet Amerge QL
nodolor oral capsule
sumatriptan nasal spray,non-aerosol Imitrex PA; QL
sumatriptan succinate oral tablet Imitrex QL
sumatriptan succinate subcutaneous cartridge 4 mg/0.5 ml, 6 mg/0.5 ml
Imitrex STATdose Kit Refill PA; QL
sumatriptan succinate subcutaneous pen injector 4 mg/0.5 ml, 6 mg/0.5 ml
Imitrex STATdose Pen PA; QL
sumatriptan succinate subcutaneous solution
Imitrex PA; QL
SEDANTE HIPNÓTICO, NO BARBITÚRICOS
diphenhydramine hcl oral capsule 25 mg Aler-Cap OTC; QL
diphenhydramine hcl oral capsule 50 mg Banophen OTC
estazolam oral tablet 1 mg, 2 mg QL
flurazepam oral capsule
nighttime sleep aid (diphen) oral tablet OTC
rest simply nighttime sleep oral tablet OTC
restfully sleep oral tablet OTC
sleep aid (diphenhydramine) oral capsule OTC
sleep aid (diphenhydramine) oral tablet OTC
sleep aid max str (diphenhydr) oral capsule
OTC
sleep oral tablet OTC
sleep-tabs oral tablet OTC
temazepam oral capsule Restoril QL
triazolam oral tablet Halcion QL
zaleplon oral capsule Sonata QL
zolpidem oral tablet Ambien QL
AGENTES HEMATOLÓGICOS
AGENTES ANTIFIBRINOLÍTICOS
tranexamic acid oral tablet Lysteda QL
AGENTES HEMORREOLÓGICOS
pentoxifylline oral tablet extended release
AGENTES INHIBIDORES DE C1 ESTERASA
BERINERT INTRAVENOUS RECON SOLN
42
Nombre del medicamento Reference Notas
AGENTES INHIBIDORES DE LA TROMBINA
PRADAXA ORAL CAPSULE
AGENTES PARA LA ANEMIA FALCIFORME
DROXIA ORAL CAPSULE
ANTICOAGULANTES ORALES
ELIQUIS ORAL TABLET
ELIQUIS ORAL TABLETS,DOSE PACK QL
jantoven oral tablet
warfarin oral tablet Coumadin
XARELTO ORAL TABLET
XARELTO ORAL TABLETS,DOSE PACK
HEMATÍNICOS, OTRO
ARANESP (IN POLYSORBATE) INJECTION SOLUTION 100 MCG/ML, 150 MCG/0.75 ML, 200 MCG/ML, 25 MCG/ML, 300 MCG/ML, 40 MCG/ML, 60 MCG/ML
PA; QL
ARANESP (IN POLYSORBATE) INJECTION SYRINGE 10 MCG/0.4 ML, 100 MCG/0.5 ML, 200 MCG/0.4 ML, 25 MCG/0.42 ML, 300 MCG/0.6 ML, 40 MCG/0.4 ML, 60 MCG/0.3 ML
PA
ARANESP (IN POLYSORBATE) INJECTION SYRINGE 150 MCG/0.3 ML, 500 MCG/ML
PA; QL
EPOGEN INJECTION SOLUTION PA
PROCRIT INJECTION SOLUTION PA
HEPARINA Y PREPARADOS RELACIONADOS
enoxaparin subcutaneous solution Lovenox QL
enoxaparin subcutaneous syringe 100 mg/ml, 120 mg/0.8 ml, 150 mg/ml, 30 mg/0.3 ml, 40 mg/0.4 ml, 60 mg/0.6 ml, 80 mg/0.8 ml
Lovenox QL
heparin (porcine) injection cartridge
heparin (porcine) injection solution
heparin (porcine) injection syringe
heparin, porcine (pf) injection solution
43
Nombre del medicamento Reference Notas
heparin, porcine (pf) injection syringe
INHIBIDORES DE AGREGACIÓN PLAQUETARIA
anagrelide oral capsule Agrylin
aspirin oral tablet,chewable Aspirin Childrens OTC; QL
aspirin oral tablet,delayed release (dr/ec) Adult Aspirin Regimen OTC; QL
cilostazol oral tablet
clopidogrel oral tablet 300 mg Plavix
clopidogrel oral tablet 75 mg Plavix QL
dipyridamole oral tablet
ticlopidine oral tablet
AGENTES INMUNOSUPRESORES
INMUNOSUPRESORES
azathioprine oral tablet Imuran
cyclosporine modified oral capsule Gengraf
cyclosporine modified oral solution Gengraf
cyclosporine oral capsule Sandimmune
gengraf oral capsule
gengraf oral solution
mycophenolate mofetil oral capsule CellCept
mycophenolate mofetil oral suspension for reconstitution
CellCept
mycophenolate mofetil oral tablet CellCept
mycophenolate sodium oral tablet,delayed release (dr/ec)
Myfortic
RAPAMUNE ORAL SOLUTION
SANDIMMUNE ORAL SOLUTION
sirolimus oral tablet Rapamune
tacrolimus oral capsule Prograf
AGENTES OFTÁLMICOS
AGENTES ANTIINFLAMATORIOS OFTÁLMICOS
dexamethasone sodium phosphate ophthalmic (eye) drops
diclofenac sodium ophthalmic (eye) drops
fluorometholone ophthalmic (eye) drops,suspension
FML Liquifilm
44
Nombre del medicamento Reference Notas
flurbiprofen sodium ophthalmic (eye) drops
prednisolone acetate ophthalmic (eye) drops,suspension
Omnipred
prednisolone sodium phosphate ophthalmic (eye) drops
XIIDRA OPHTHALMIC (EYE) DROPPERETTE
PA; QL
ANTIBIÓTICO OFTÁLMICO, COMBINACIONES DE CORTICOESTEROIDES
neomycin-bacitracin-poly-hc ophthalmic (eye) ointment
Neo-Polycin HC
neomycin-polymyxin b-dexameth ophthalmic (eye) drops,suspension
Maxitrol
neomycin-polymyxin b-dexameth ophthalmic (eye) ointment
Maxitrol
neomycin-polymyxin-hc ophthalmic (eye) drops,suspension
neo-polycin hc ophthalmic (eye) ointment
sulfacetamide-prednisolone ophthalmic (eye) drops
QL
tobramycin-dexamethasone ophthalmic (eye) drops,suspension
TobraDex QL
ANTIBIÓTICOS OFTÁLMICOS
bacitracin ophthalmic (eye) ointment QL
bacitracin-polymyxin b ophthalmic (eye) ointment
Polycin
ciprofloxacin hcl ophthalmic (eye) drops Ciloxan
erythromycin ophthalmic (eye) ointment
gatifloxacin ophthalmic (eye) drops Zymaxid
gentak ophthalmic (eye) ointment QL
gentamicin ophthalmic (eye) drops QL
levofloxacin ophthalmic (eye) drops
moxifloxacin ophthalmic (eye) drops Vigamox QL
neomycin-bacitracin-polymyxin ophthalmic (eye) ointment
Neo-Polycin QL
neomycin-polymyxin-gramicidin ophthalmic (eye) drops
QL
neo-polycin ophthalmic (eye) ointment QL
45
Nombre del medicamento Reference Notas
ofloxacin ophthalmic (eye) drops Ocuflox QL
polycin ophthalmic (eye) ointment
polymyxin b sulf-trimethoprim ophthalmic (eye) drops
Polytrim QL
sulfacetamide sodium ophthalmic (eye) drops
Bleph-10 QL
sulfacetamide sodium ophthalmic (eye) ointment
QL
tobramycin ophthalmic (eye) drops Tobrex QL
ANTIHISTAMÍNICOS OFTÁLMICOS
alaway ophthalmic (eye) drops OTC; QL
azelastine ophthalmic (eye) drops QL
children's alaway ophthalmic (eye) drops OTC; QL
epinastine ophthalmic (eye) drops Elestat QL
eye itch relief ophthalmic (eye) drops OTC; QL
ketotifen fumarate ophthalmic (eye) drops Alaway OTC; QL
ANTIVIRALES OFTÁLMICOS
trifluridine ophthalmic (eye) drops Viroptic QL
DESCONGESTIVOS OFTÁLMICOS
phenylephrine hcl ophthalmic (eye) drops
ESTABILIZADORES DE CÉLULAS MASTALES OPTÁLMICAS
cromolyn ophthalmic (eye) drops
LÁGRIMAS ARTIFICIALES
artificial tears (petro/min) ophthalmic (eye) ointment
OTC
artificial tears (polyvin alc) ophthalmic (eye) drops
OTC
liquitears ophthalmic (eye) drops OTC
lubrifresh pm ophthalmic (eye) ointment OTC
puralube ophthalmic (eye) ointment OTC
MIDIÁTRICOS
atropine ophthalmic (eye) drops QL
atropine ophthalmic (eye) ointment QL
MIÓTICOS/OTROS REDUCTORES DE PRESIÓN INTRAOCULAR
apraclonidine ophthalmic (eye) drops Iopidine
betaxolol ophthalmic (eye) drops
46
Nombre del medicamento Reference Notas
brimonidine ophthalmic (eye) drops QL
carteolol ophthalmic (eye) drops QL
dorzolamide ophthalmic (eye) drops Trusopt QL
dorzolamide-timolol ophthalmic (eye) drops
Cosopt QL
latanoprost ophthalmic (eye) drops Xalatan QL
levobunolol ophthalmic (eye) drops Betagan
metipranolol ophthalmic (eye) drops QL
pilocarpine hcl ophthalmic (eye) drops Isopto Carpine
timolol maleate ophthalmic (eye) drops Timoptic QL
timolol maleate ophthalmic (eye) gel forming solution
Timoptic-XE QL
ANALGÉSICO, ANTIINFLAMATORIO O ANTIPIRÉTICO
ANALGÉSICO/ANTIPIRÉTICOS, SALICILATOS
adult low dose aspirin oral tablet,delayed release (dr/ec)
OTC; QL
aspir-81 oral tablet,delayed release (dr/ec) OTC; QL
aspirin low dose oral tablet,delayed release (dr/ec)
OTC; QL
aspirin oral tablet Bayer Aspirin OTC; QL
aspirin oral tablet,chewable Aspirin Childrens OTC; QL
aspirin oral tablet,delayed release (dr/ec) 325 mg
Aspir-Trin AL; OTC; QL
aspirin oral tablet,delayed release (dr/ec) 81 mg
Adult Aspirin Regimen OTC; QL
aspir-low oral tablet,delayed release (dr/ec)
OTC; QL
aspir-trin oral tablet,delayed release (dr/ec)
OTC; QL
buffered aspirin oral tablet OTC
butalbital-aspirin-caffeine oral capsule Fiorinal QL
butalbital-aspirin-caffeine oral tablet
children's aspirin oral tablet,chewable OTC; QL
choline,magnesium salicylate oral liquid
diflunisal oral tablet
e.c. prin oral tablet,delayed release (dr/ec) OTC; QL
lite coat aspirin oral tablet OTC; QL
47
Nombre del medicamento Reference Notas
lo-dose aspirin oral tablet,delayed release (dr/ec)
OTC; QL
salsalate oral tablet Disalcid
ST. JOSEPH ASPIRIN ORAL TABLET,DELAYED RELEASE (DR/EC)
OTC; QL
tri-buffered aspirin oral tablet OTC
ANALGÉSICOS, NARCÓTICOS
acetaminophen-codeine oral solution AL
acetaminophen-codeine oral tablet AL
ascomp with codeine oral capsule AL
butalbital compound w/codeine oral capsule
AL
butalbital compound-codeine oral capsule AL
butalbital-acetaminop-caf-cod oral capsule AL
butorphanol tartrate nasal spray,non-aerosol
PA; QL
codeine sulfate oral tablet AL
endocet oral tablet
fentanyl citrate buccal lozenge on a handle
Actiq PA; QL
fentanyl transdermal patch 72 hour Duragesic
hydrocodone-acetaminophen oral solution Hycet
hydrocodone-acetaminophen oral tablet Lorcet (hydrocodone)
hydrocodone-ibuprofen oral tablet
hydromorphone oral liquid Dilaudid
hydromorphone oral tablet Dilaudid
hydromorphone rectal suppository QL
meperidine oral solution
meperidine oral tablet
morphine concentrate oral solution
morphine oral solution
morphine oral tablet
morphine oral tablet extended release MS Contin
morphine rectal suppository QL
oxycodone oral capsule
oxycodone oral concentrate
oxycodone oral solution
oxycodone oral tablet Roxicodone
48
Nombre del medicamento Reference Notas
oxycodone-acetaminophen oral tablet Endocet
oxycodone-aspirin oral tablet
pentazocine-naloxone oral tablet
tramadol oral tablet Ultram PA
tramadol-acetaminophen oral tablet Ultracet PA
vicodin es oral tablet
vicodin hp oral tablet
vicodin oral tablet
ANALGÉSICOS, NO NARCÓTICOS
8 hour pain reliever oral tablet extended release
OTC; QL
acephen rectal suppository OTC
acetaminophen oral liquid Children's Pain-Fever Relief OTC; QL
acetaminophen oral solution Mapap (acetaminophen) OTC
acetaminophen oral suspension Children's Acetaminophen OTC; QL
acetaminophen oral tablet 325 mg Athenol OTC
acetaminophen oral tablet 500 mgAcetaminophen Extra Strength
OTC; QL
acetaminophen oral tablet extended release
8 Hour Pain Reliever OTC; QL
acetaminophen oral tablet,disintegrating Children's Pain-Fever Relief OTC
acetaminophen rectal suppository Acephen OTC
arthritis pain relief (acetam) oral tablet extended release
OTC; QL
arthritis pain reliever oral tablet extended release
OTC; QL
butalbital-acetaminophen oral tablet Marten-Tab QL
butalbital-acetaminophen-caff oral capsule Capacet QL
butalbital-acetaminophen-caff oral tablet Esgic QL
capacet oral capsule QL
children's acetaminophen oral suspension 160 mg/5 ml, 160 mg/5 ml (5 ml), 325 mg/10.15 ml
OTC; QL
children's mapap oral tablet,disintegrating OTC
children's pain relief oral suspension OTC; QL
children's pain reliever oral suspension OTC; QL
children's pain reliever oral tablet,disintegrating
OTC
children's pain-fever relief oral liquid OTC; QL
49
Nombre del medicamento Reference Notas
children's pain-fever relief oral suspension OTC; QL
children's pain-fever relief oral tablet,disintegrating
OTC
children's silapap oral liquid OTC; QL
ed-apap oral liquid OTC; QL
fever reducer rectal suppository OTC
feverall rectal suppository OTC
infant pain reliever oral suspension OTC; QL
infant's non-aspirin oral drops OTC
infant's non-aspirin oral drops,suspension AL; OTC; QL
infants' pain and fever oral suspension OTC; QL
infant's pain relief oral drops,suspension AL; OTC; QL
infants' pain relief oral suspension OTC; QL
infant's pain reliever oral drops,suspension
AL; OTC; QL
jr. str non-aspirin pain oral tablet,disintegrating
OTC
mapap (acetaminophen) oral capsule OTC; QL
mapap (acetaminophen) oral drops,suspension
OTC; QL
mapap (acetaminophen) oral liquid 160 mg/5 ml
OTC; QL
mapap (acetaminophen) oral liquid 500 mg/15 ml
OTC
mapap (acetaminophen) oral suspension OTC; QL
mapap (acetaminophen) oral tablet OTC
mapap arthritis pain oral tablet extended release
OTC; QL
mapap extra strength oral tablet OTC; QL
marten-tab oral tablet QL
masophen oral tablet 325 mg OTC
masophen oral tablet 500 mg OTC; QL
non-aspirin childrens oral drops OTC
non-aspirin extra strength oral liquid OTC
non-aspirin extra strength oral tablet OTC; QL
non-aspirin infants oral drops,suspension AL; OTC; QL
non-aspirin oral elixir OTC
non-aspirin oral tablet OTC
non-aspirin pain relief oral tablet 325 mg OTC
50
Nombre del medicamento Reference Notas
non-aspirin pain relief oral tablet 500 mg OTC; QL
pain and fever oral tablet 325 mg OTC
pain and fever oral tablet 500 mg OTC; QL
pain relief 8hr oral tablet extended release OTC; QL
pain relief extra strength oral tablet OTC; QL
pain relief oral tablet OTC; QL
pain relief oral tablet extended release OTC; QL
pain relief regular strength oral tablet OTC
pain reliever extra strength oral tablet OTC; QL
pain reliever oral capsule OTC; QL
pain reliever oral tablet 325 mg OTC
pain reliever oral tablet 500 mg OTC; QL
pharbetol oral tablet 325 mg OTC
pharbetol oral tablet 500 mg OTC; QL
tactinal extra strength oral tablet OTC; QL
tactinal oral tablet OTC
tylophen oral capsule OTC; QL
ANTIINFLAMATORIO, INHIBIDOR DE LA SÍNTESIS DE PIRIMIDINA
leflunomide oral tablet Arava
RIDAURA ORAL CAPSULE
ENFERMEDADES MODIFICANTES ANTI-REUMATOIDES (DMARD)
DEPEN TITRATABS ORAL TABLET PA
minocycline oral capsule Minocin
minocycline oral tablet
sulfasalazine oral tablet Azulfidine QL
sulfasalazine oral tablet,delayed release (dr/ec)
Azulfidine EN-tabs QL
INHIBIDOR DEL FACTOR DE LA NECROSIS TUMORAL ANTIINFLAMATORIA
ENBREL SUBCUTANEOUS RECON SOLN
PA; QL
ENBREL SUBCUTANEOUS SYRINGE25 MG/0.5ML (0.51), 50 MG/ML (0.98 ML)
PA; QL
ENBREL SURECLICK SUBCUTANEOUS PEN INJECTOR
PA; QL
51
Nombre del medicamento Reference Notas
HUMIRA PEDIATRIC CROHN'S START SUBCUTANEOUS SYRINGE KIT
PA; QL
HUMIRA PEN CROHN'S-UC-HS START SUBCUTANEOUS PEN INJECTOR KIT
PA; QL
HUMIRA PEN PSORIASIS-UVEITIS SUBCUTANEOUS PEN INJECTOR KIT
PA; QL
HUMIRA PEN SUBCUTANEOUS PEN INJECTOR KIT
PA; QL
HUMIRA SUBCUTANEOUS SYRINGE KIT
PA; QL
INHIBIDOR DEL FACTOR DE NECROSIS TUMORAL ANTIINFLAMATORIO
ENBREL SUBCUTANEOUS RECON SOLN
PA; QL
ENBREL SUBCUTANEOUS SYRINGE25 MG/0.5ML (0.51), 50 MG/ML (0.98 ML)
PA; QL
ENBREL SURECLICK SUBCUTANEOUS PEN INJECTOR
PA; QL
HUMIRA PEDIATRIC CROHN'S START SUBCUTANEOUS SYRINGE KIT
PA; QL
HUMIRA PEN CROHN'S-UC-HS START SUBCUTANEOUS PEN INJECTOR KIT
PA; QL
HUMIRA PEN PSORIASIS-UVEITIS SUBCUTANEOUS PEN INJECTOR KIT
PA; QL
HUMIRA PEN SUBCUTANEOUS PEN INJECTOR KIT
PA; QL
HUMIRA SUBCUTANEOUS SYRINGE KIT
PA; QL
INMUNOSUPRESORES
gengraf oral capsule
mycophenolate mofetil oral suspension for reconstitution
CellCept
NSAIDS
all day pain relief oral tablet OTC; QL
all day relief oral tablet OTC; QL
child ibuprofen oral suspension AL; OTC; QL
children's ibuprofen oral suspension AL; OTC; QL
diclofenac potassium oral tablet
52
Nombre del medicamento Reference Notas
diclofenac sodium oral tablet extended release 24 hr
Voltaren-XR PA
diclofenac sodium oral tablet,delayed release (dr/ec)
etodolac oral capsule
etodolac oral tablet Lodine
etodolac oral tablet extended release 24 hr
fenoprofen oral tablet ProFeno QL
flurbiprofen oral tablet
ibu-drops oral drops,suspension AL; OTC; QL
ibuprofen ib oral tablet OTC; QL
ibuprofen ib oral tablet,chewable OTC; QL
ibuprofen jr strength oral tablet,chewable OTC; QL
ibuprofen oral suspension Child Ibuprofen AL; OTC; QL
ibuprofen oral tablet 200 mg Advil OTC; QL
ibuprofen oral tablet 400 mg, 600 mg, 800 mg
indomethacin oral capsule
indomethacin oral capsule, extended release
infants ibu-drops oral drops,suspension AL; OTC; QL
infant's ibuprofen oral drops,suspension AL; OTC; QL
ketoprofen oral capsule
ketoprofen oral capsule,ext rel. pellets 24 hr
QL
ketorolac oral tablet QL
meclofenamate oral capsule
meloxicam oral suspension
meloxicam oral tablet Mobic PA
nabumetone oral tablet
naproxen oral suspension Naprosyn PA
naproxen oral tablet 250 mg, 375 mg QL
naproxen oral tablet 500 mg Naprosyn QL
naproxen oral tablet,delayed release (dr/ec)
EC-Naprosyn PA
naproxen sodium oral tablet 220 mg Aleve OTC; QL
naproxen sodium oral tablet 275 mg
naproxen sodium oral tablet 550 mg Anaprox DS
53
Nombre del medicamento Reference Notas
oxaprozin oral tablet Daypro
piroxicam oral capsule Feldene PA
profeno oral tablet QL
provil oral tablet OTC; QL
sulindac oral tablet
tolmetin oral capsule
tolmetin oral tablet
ANESTÉSICOS
AGENTES ANESTÉSICOS LOCALES
lidocaine hcl laryngotracheal solution LTA Pre-Attached QL
lidocaine topical ointment QL
ANTICONCEPTIVOS
ANTICONCEPTIVOS DE EMERGENCIA
econtra ez oral tablet OTC
ELLA ORAL TABLET
my way oral tablet OTC
next choice one dose oral tablet OTC
opcicon one-step oral tablet OTC
option-2 oral tablet OTC
ANTICONCEPTIVOS
altavera (28) oral tablet AL; QL
alyacen 1/35 (28) oral tablet AL
alyacen 7/7/7 (28) oral tablet AL
amethia lo oral tablets,dose pack,3 month AL; QL
amethia oral tablets,dose pack,3 month AL; QL
amethyst oral tablet AL
apri oral tablet AL
aranelle (28) oral tablet AL
ashlyna oral tablets,dose pack,3 month AL; QL
aubra oral tablet AL
aviane oral tablet AL
azurette (28) oral tablet AL
balziva (28) oral tablet AL
bekyree (28) oral tablet AL
blisovi 24 fe oral tablet AL
blisovi fe 1.5/30 (28) oral tablet AL
54
Nombre del medicamento Reference Notas
blisovi fe 1/20 (28) oral tablet AL
briellyn oral tablet AL
camila oral tablet AL
camrese lo oral tablets,dose pack,3 month AL; QL
camrese oral tablets,dose pack,3 month AL; QL
caziant (28) oral tablet AL
chateal oral tablet AL; QL
cryselle (28) oral tablet AL
cyclafem 1/35 (28) oral tablet AL
cyclafem 7/7/7 (28) oral tablet AL
cyred oral tablet AL
dasetta 1/35 (28) oral tablet AL
dasetta 7/7/7 (28) oral tablet AL
daysee oral tablets,dose pack,3 month AL; QL
deblitane oral tablet AL
delyla (28) oral tablet AL
desog-e.estradiol/e.estradiol oral tablet Azurette (28) AL
desogestrel-ethinyl estradiol oral tablet Apri AL
drospirenone-e.estradiol-lm.fa oral tablet Beyaz AL
drospirenone-ethinyl estradiol oral tablet Ocella AL
elinest oral tablet AL
emoquette oral tablet AL
enpresse oral tablet AL
enskyce oral tablet AL
errin oral tablet AL
estarylla oral tablet AL
ethynodiol diac-eth estradiol oral tablet Zovia 1/50E (28) AL
falmina (28) oral tablet AL
fayosim oral tablets,dose pack,3 month AL; QL
femynor oral tablet AL
gianvi (28) oral tablet AL
gildagia oral tablet AL
heather oral tablet AL
introvale oral tablets,dose pack,3 month AL; QL
jencycla oral tablet AL
jolessa oral tablets,dose pack,3 month AL; QL
jolivette oral tablet AL
55
Nombre del medicamento Reference Notas
juleber oral tablet AL
junel 1.5/30 (21) oral tablet AL
junel 1/20 (21) oral tablet AL
junel fe 1.5/30 (28) oral tablet AL
junel fe 1/20 (28) oral tablet AL
junel fe 24 oral tablet AL
kaitlib fe oral tablet,chewable AL
kariva (28) oral tablet AL
kelnor 1/35 (28) oral tablet AL
kimidess (28) oral tablet AL
kurvelo oral tablet AL; QL
KYLEENA INTRAUTERINE INTRAUTERINE DEVICE
l norgest/e.estradiol-e.estrad oral tablets,dose pack,3 month
Amethia AL; QL
larin 1.5/30 (21) oral tablet AL
larin 1/20 (21) oral tablet AL
larin 24 fe oral tablet AL
larin fe 1.5/30 (28) oral tablet AL
larin fe 1/20 (28) oral tablet AL
larissia oral tablet AL
layolis fe oral tablet,chewable AL
leena 28 oral tablet AL
lessina oral tablet AL
levonest (28) oral tablet AL
levonorgestrel-ethinyl estrad oral tablet 0.1-20 mg-mcg
Aubra AL
levonorgestrel-ethinyl estrad oral tablet 0.15-0.03 mg
Altavera (28) AL; QL
levonorgestrel-ethinyl estrad oral tablet 90-20 mcg
Amethyst AL
levonorgestrel-ethinyl estrad oral tablets,dose pack,3 month
Introvale AL; QL
levonorg-eth estrad triphasic oral tablet Enpresse AL
levora-28 oral tablet AL; QL
LILETTA INTRAUTERINE INTRAUTERINE DEVICE
lomedia 24 fe oral tablet AL
loryna (28) oral tablet AL
56
Nombre del medicamento Reference Notas
low-ogestrel (28) oral tablet AL
lutera (28) oral tablet AL
lyza oral tablet AL
marlissa oral tablet AL; QL
medroxyprogesterone intramuscular suspension
Depo-Provera AL
medroxyprogesterone intramuscular syringe
Depo-Provera AL
mibelas 24 fe oral tablet,chewable AL
microgestin 1.5/30 (21) oral tablet AL
microgestin 1/20 (21) oral tablet AL
microgestin fe 1.5/30 (28) oral tablet AL
microgestin fe 1/20 (28) oral tablet AL
MIRENA INTRAUTERINE INTRAUTERINE DEVICE
mono-linyah oral tablet AL
mononessa (28) oral tablet AL
myzilra oral tablet AL
necon 0.5/35 (28) oral tablet AL
necon 1/50 (28) oral tablet AL
necon 7/7/7 (28) oral tablet AL
NEXPLANON SUBDERMAL IMPLANT
nikki (28) oral tablet AL
nora-be oral tablet AL
noreth-ethinyl estradiol-iron oral tablet,chewable
Wymzya Fe AL
norethindrone (contraceptive) oral tablet Camila AL
norethindrone ac-eth estradiol oral tablet Junel 1/20 (21) AL
norethindrone-e.estradiol-iron oral tablet Blisovi Fe 1/20 (28) AL
norethindrone-e.estradiol-iron oral tablet,chewable
Melodetta 24 Fe AL
norgestimate-ethinyl estradiol oral tablet 0.18/0.215/0.25 mg-25 mcg
Ortho Tri-Cyclen LO (28) AL; QL
norgestimate-ethinyl estradiol oral tablet 0.18/0.215/0.25 mg-35 mcg (28)
Ortho Tri-Cyclen (28) AL; QL
norgestimate-ethinyl estradiol oral tablet 0.25-35 mg-mcg
Estarylla AL
norlyroc oral tablet AL
nortrel 0.5/35 (28) oral tablet AL
57
Nombre del medicamento Reference Notas
nortrel 1/35 (21) oral tablet AL
nortrel 1/35 (28) oral tablet AL
nortrel 7/7/7 (28) oral tablet AL
NUVARING VAGINAL RING AL; QL
ocella oral tablet AL
ogestrel (28) oral tablet AL
orsythia oral tablet AL
PARAGARD T 380A INTRAUTERINE INTRAUTERINE DEVICE
philith oral tablet AL
pimtrea (28) oral tablet AL
pirmella oral tablet AL
portia oral tablet AL; QL
previfem oral tablet AL
quasense oral tablets,dose pack,3 month AL; QL
rajani oral tablet AL
reclipsen (28) oral tablet AL
RIVELSA ORAL TABLETS,DOSE PACK,3 MONTH
AL; QL
setlakin oral tablets,dose pack,3 month AL; QL
sharobel oral tablet AL
SKYLA INTRAUTERINE INTRAUTERINE DEVICE
sprintec (28) oral tablet AL
sronyx oral tablet AL
syeda oral tablet AL
tarina fe 1/20 (28) oral tablet AL
tilia fe oral tablet AL; QL
tri femynor oral tablet AL; QL
tri-estarylla oral tablet AL; QL
tri-legest fe oral tablet AL; QL
tri-linyah oral tablet AL; QL
tri-lo-estarylla oral tablet AL; QL
tri-lo-marzia oral tablet AL; QL
tri-lo-sprintec oral tablet AL; QL
trinessa (28) oral tablet AL; QL
trinessa lo oral tablet AL; QL
tri-previfem (28) oral tablet AL; QL
58
Nombre del medicamento Reference Notas
tri-sprintec (28) oral tablet AL; QL
trivora (28) oral tablet AL
vcf contraceptive film vaginal film OTC
velivet triphasic regimen (28) oral tablet AL
vestura (28) oral tablet AL
vienva oral tablet AL
viorele (28) oral tablet AL
vyfemla (28) oral tablet AL
wera (28) oral tablet AL
wymzya fe oral tablet,chewable AL
xulane transdermal patch weekly AL; QL
zarah oral tablet AL
zenchent (28) oral tablet AL
zovia 1/35e (28) oral tablet AL
zovia 1/50e (28) oral tablet AL
ANTÍDOTOS Y OTROS AGENTES DE REVERSIÓN
AGENTES QUELANTES
deferoxamine injection recon soln Desferal
trientine oral capsule Syprine PA; QL
ANTAGONISTAS DE NARCÓTICOS
naloxone injection solution
naloxone injection syringe
naltrexone oral tablet
NARCAN NASAL SPRAY,NON-AEROSOL
QL
ANTINEOPLÁSICOS
MEDICAMENTOS ANTINEOPLÁSICOS/INMUNOSUPRESORES
anastrozole oral tablet Arimidex QL
bicalutamide oral tablet Casodex
EMCYT ORAL CAPSULE PA
exemestane oral tablet Aromasin QL
flutamide oral capsule
HEXALEN ORAL CAPSULE PA
hydroxyurea oral capsule Hydrea
59
Nombre del medicamento Reference Notas
imatinib oral tablet 100 mg, 400 mg Gleevec PA; QL
IRESSA ORAL TABLET PA; QL
letrozole oral tablet Femara QL
leucovorin calcium injection recon soln
leucovorin calcium oral tablet
megestrol oral tablet
melphalan oral tablet Alkeran
MESNEX ORAL TABLET PA
mitoxantrone intravenous concentrate
MYLERAN ORAL TABLET
PROLEUKIN INTRAVENOUS RECON SOLN
tamoxifen oral tablet
tretinoin (chemotherapy) oral capsule
VANTAS IMPLANT KIT PA
VELCADE INJECTION RECON SOLN PA
ANTISÉPTICOS Y DESINFECTANTES
ANTISÉPTICOS, GENERALES
alcohol swabs topical pads, medicated Alcohol Pads OTC
alcohol wipes topical pads, medicated OTC
curity alcohol swabs topical pads, medicated
OTC
easy touch alcohol prep pads topical pads, medicated
OTC
webcol topical pads, medicated OTC
BIOLÓGICOS
INMUNOGLOBULINAS
GAMUNEX-C INJECTION SOLUTION PA
OCTAGAM INTRAVENOUS SOLUTION PA
VACUNAS INMUNOLÓGICAS
ADACEL(TDAP ADOLESN/ADULT)(PF) INTRAMUSCULAR SUSPENSION
ADACEL(TDAP ADOLESN/ADULT)(PF) INTRAMUSCULAR SYRINGE
AFLURIA 2017-2018 (PF) INTRAMUSCULAR SYRINGE
QL
AFLURIA 2017-2018 INTRAMUSCULAR SUSPENSION
QL
60
Nombre del medicamento Reference Notas
AFLURIA QUAD 2017-2018 (PF) INTRAMUSCULAR SYRINGE
QL
AFLURIA QUAD 2017-2018 INTRAMUSCULAR SUSPENSION
QL
BCG VACCINE, LIVE (PF) PERCUTANEOUS SUSPENSION FOR RECONSTITUTION
BOOSTRIX TDAP INTRAMUSCULAR SUSPENSION
BOOSTRIX TDAP INTRAMUSCULAR SYRINGE
DAPTACEL (DTAP PEDIATRIC) (PF) INTRAMUSCULAR SUSPENSION
FLUAD 2017-2018 (65 YR UP)(PF) INTRAMUSCULAR SYRINGE
QL
FLUARIX QUAD 2017-2018 (PF) INTRAMUSCULAR SYRINGE
QL
FLUBLOK 2017-2018 (PF) INTRAMUSCULAR SOLUTION
QL
FLUBLOK QUAD 2017-2018 (PF) INTRAMUSCULAR SYRINGE
QL
FLUCELVAX QUAD 2017-2018 (PF) INTRAMUSCULAR SYRINGE
QL
FLUCELVAX QUAD 2017-2018 INTRAMUSCULAR SUSPENSION
QL
FLULAVAL QUAD 2017-2018 (PF) INTRAMUSCULAR SYRINGE
QL
FLULAVAL QUAD 2017-2018 INTRAMUSCULAR SUSPENSION
QL
FLUVIRIN 2017-2018 (PF) INTRAMUSCULAR SYRINGE
QL
FLUVIRIN 2017-2018 INTRAMUSCULAR SUSPENSION
QL
FLUZONE HIGH-DOSE 2017-18 (PF) INTRAMUSCULAR SYRINGE
QL
FLUZONE INTRADERM QUAD 2017-18 INTRADERMAL SYRINGE
QL
FLUZONE QUAD 2017-2018 (PF) INTRAMUSCULAR SUSPENSION
QL
FLUZONE QUAD 2017-2018 (PF) INTRAMUSCULAR SYRINGE
QL
61
Nombre del medicamento Reference Notas
FLUZONE QUAD 2017-2018 INTRAMUSCULAR SUSPENSION
QL
FLUZONE QUAD PEDI 2017-18 (PF) INTRAMUSCULAR SYRINGE
QL
HAVRIX (PF) INTRAMUSCULAR SUSPENSION
HAVRIX (PF) INTRAMUSCULAR SYRINGE
INFANRIX (DTAP) (PF) INTRAMUSCULAR SUSPENSION
INFANRIX (DTAP) (PF) INTRAMUSCULAR SYRINGE
PREVNAR 13 (PF) INTRAMUSCULAR SYRINGE
QL
SHINGRIX (PF) INTRAMUSCULAR SUSPENSION FOR RECONSTITUTION
QL
SYNAGIS INTRAMUSCULAR SOLUTION
PA
VAQTA (PF) INTRAMUSCULAR SUSPENSION
VAQTA (PF) INTRAMUSCULAR SYRINGE
ZOSTAVAX (PF) SUBCUTANEOUS SUSPENSION FOR RECONSTITUTION
QL
DEPENDENCIA QUÍMICA, AGENTES PARA TRATAR
AGENTES PARA DEJAR DE FUMAR
bupropion hcl (smoking deter) oral tablet extended release 12 hr
Zyban QL
bupropion hcl oral tablet extended release 12 hr
Wellbutrin SR
nicorelief buccal gum OTC; QL
nicotine (polacrilex) buccal gum Nicorelief OTC; QL
nicotine (polacrilex) buccal lozenge Nicorette OTC; QL
nicotine (polacrilex) buccal mini lozenge Nicorette OTC; QL
nicotine transdermal patch 24 hour Nicoderm CQ OTC; QL
nicotine transdermal patch, td daily, sequential
OTC
ANTAGONISTA DEL ALCOHOL
acamprosate oral tablet,delayed release (dr/ec)
62
Nombre del medicamento Reference Notas
disulfiram oral tablet Antabuse
VIVITROL INTRAMUSCULAR SUSPENSION,EXTENDED REL RECON
ANTAGONISTAS DE NARCÓTICOS
buprenorphine-naloxone sublingual tablet 2-0.5 mg, 8-2 mg
QL
SUBOXONE SUBLINGUAL FILM 12-3 MG, 2-0.5 MG, 4-1 MG, 8-2 MG
QL
DERMATOLÓGICO
AGENTES ANTIACNÉ, TÓPICO
clindamycin phosphate topical gel Cleocin T
clindamycin phosphate topical solution Cleocin T QL
clindamycin phosphate topical swab Cleocin T QL
clindamycin-benzoyl peroxide topical gel Duac QL
ery pads topical swab QL
erygel topical gel QL
erythromycin with ethanol topical solution QL
erythromycin with ethanol topical swab Ery Pads QL
metronidazole topical cream MetroCream QL
metronidazole topical lotion MetroLotion
rosadan topical cream QL
AGENTES ANTIINFLAMATORIOS ESTEROIDES TÓPICOS
amcinonide topical lotion
amcinonide topical ointment QL
anti-itch (hc) topical cream OTC; QL
betamethasone dipropionate topical lotion QL
betamethasone valerate topical cream QL
betamethasone valerate topical ointment QL
betamethasone, augmented topical cream
clobetasol scalp solution Cormax QL
clobetasol topical cream Temovate QL
clobetasol topical gel
clobetasol topical ointment Temovate QL
clobetasol-emollient topical cream QL
cormax scalp solution QL
CORTAID TOPICAL CREAM OTC; QL
diflorasone topical cream Psorcon QL
63
Nombre del medicamento Reference Notas
fluocinonide-e topical cream
fluocinonide-emollient topical cream Fluocinonide-E
fluticasone topical cream Cutivate QL
fluticasone topical ointment QL
halobetasol propionate topical cream Ultravate QL
halobetasol propionate topical ointment Ultravate QL
hydrocortisone acetate topical cream OTC; QL
hydrocortisone plus topical cream OTC; QL
hydrocortisone topical cream 0.5 % OTC; QL
hydrocortisone topical cream 1 % Ala-Cort PA; OTC; QL
hydrocortisone topical cream 2.5 % Ala-Cort QL
hydrocortisone topical cream in packet OTC
hydrocortisone topical cream with perineal applicator
Anusol-HC QL
hydrocortisone topical ointment 0.5 % OTC
hydrocortisone topical ointment 1 % Anti-Itch (HC) OTC; QL
hydrocortisone topical ointment 2.5 % QL
hydrocortisone-aloe vera topical cream Cortizone-10 with aloe PA; OTC; QL
hydrocortisone-pramoxine topical cream Mezparox-HC
mometasone topical cream Elocon QL
mometasone topical ointment Elocon QL
mometasone topical solution QL
prednicarbate topical ointment Dermatop QL
proctosol hc topical cream with perineal applicator
QL
proctozone-hc topical cream with perineal applicator
QL
TEXACORT TOPICAL SOLUTION
triamcinolone acetonide topical cream 0.025 %
QL
triamcinolone acetonide topical cream 0.1 %, 0.5 %
Triderm QL
triamcinolone acetonide topical ointment 0.025 %, 0.1 %, 0.5 %
QL
trianex topical ointment QL
AGENTES ANTIPSORIÁSICOS
calcipotriene scalp solution QL
calcipotriene topical cream Dovonex QL
64
Nombre del medicamento Reference Notas
calcipotriene topical ointment Calcitrene
calcitrene topical ointment
AGENTES CONTRA EL ACNÉ SISTÉMICOS
claravis oral capsule PA
myorisan oral capsule PA
zenatane oral capsule PA
AGENTES PARA ROSÁCEA, TÓPICO
metronidazole topical gel 0.75 % Rosadan
metronidazole topical gel 1 % Metrogel QL
metronidazole topical gel with pump Metrogel QL
rosadan topical gel
AGENTES TÓPICOS, VARIOS
a and d (lan, pet) topical ointment OTC; QL
ammonium lactate topical cream Geri-Hydrolac OTC; QL
ammonium lactate topical lotion AmLactin OTC
anti-dandruff topical shampoo OTC
diclofenac sodium topical drops PA; QL
glycerin topical solution OTC
lidocaine hcl mucous membrane jelly
lidocaine topical adhesive patch,medicated
Lidoderm PA; QL
podofilox topical solution PA
prumyx topical cream
salicylic acid topical cream Salimez
salicylic acid topical film forming liquid w/appl
Virasal
salicylic acid topical foam Salvax
salicylic acid topical gel Keralyt Rx
salicylic acid topical liquid
salicylic acid topical lotion
salicylic acid topical shampoo Salex
secura protective topical ointment OTC
selenium sulfide topical lotion QL
selenium sulfide topical shampoo
silver sulfadiazine topical cream Silvadene
ssd topical cream
65
Nombre del medicamento Reference Notas
urea topical cream QL
urea topical gel 40 % QL
urea topical gel 45 % CEM-Urea
urea topical lotion Uramaxin
vitamin a and d topical ointment OTC
vits a and d-white pet-lanolin topical ointment
A and D (lan, pet) OTC; QL
vits a and d-white pet-lanolin topical ointment in packet
Vitamin A and D GRx OTC
ANESTÉSICOS TÓPICOS
hydrocortisone-pramoxine topical cream Mezparox-HC
lidocaine-prilocaine topical cream QL
ANTIBIÓTICOS TÓPICOS
antibiotic (bacitracin zinc) topical ointment OTC; QL
bacitracin topical ointment Bacitraycin Plus OTC; QL
bacitracin topical packet OTC; QL
bacitracin zinc topical ointment Antibiotic (bacitracin zinc) OTC; QL
bacitracin zinc topical packet OTC; QL
bacitracin-polymyxin b topical ointment Double Antibiotic OTC
bacitracin-polymyxin b topical packet Polysporin OTC
double antibiotic (b.tracn zn) topical ointment
OTC
double antibiotic topical ointment OTC
gentamicin topical cream
gentamicin topical ointment
mupirocin topical ointment Centany QL
poly bacitracin topical ointment OTC
sss 10-5 topical cream
sulfacetamide sodium-sulfur topical cream Avar-E
ANTIMICÓTICOS TÓPICOS
antifungal (clotrimazole) topical cream OTC; QL
antifungal (tolnaftate) topical cream OTC
antifungal cream topical cream OTC
baza antifungal topical cream OTC
ciclopirox topical cream Ciclodan PA; QL
ciclopirox topical solution Ciclodan PA; QL
ciclopirox topical suspension Loprox (as olamine) QL
clotrimazole topical cream Antifungal (clotrimazole) OTC; QL
66
Nombre del medicamento Reference Notas
clotrimazole topical solution OTC
clotrimazole-betamethasone topical cream Lotrisone QL
clotrimazole-betamethasone topical lotion QL
fungoid-d topical cream OTC
inzo antifungal topical cream OTC
ketoconazole topical cream QL
ketoconazole topical shampoo Nizoral QL
miconazole nitrate topical cream Antifungal Cream OTC
nyamyc topical powder QL
nystatin topical cream QL
nystatin topical ointment QL
nystatin topical powder Nyamyc QL
nystop topical powder QL
remedy antifungal topical cream OTC
secura antifungal extra thick topical cream OTC
secura antifungal topical cream OTC
tolnaftate topical cream Antifungal (tolnaftate) OTC
ANTIVIRALES TÓPICOS
acyclovir topical ointment Zovirax PA; QL
DERIVADOS DE LA VITAMINA A
adapalene topical cream Differin PA; QL
adapalene topical gel Differin PA; QL
DIFFERIN TOPICAL GEL OTC; QL
tretinoin microspheres topical gel Retin-A Micro PA; AL; QL
tretinoin topical cream 0.025 % Avita PA; AL
tretinoin topical cream 0.05 %, 0.1 % Retin-A PA
tretinoin topical gel Retin-A PA; QL
ESCABICIDAS Y PEDICULICIDAS
lice killing (permethrin) topical liquid OTC; QL
lice killing topical shampoo OTC
lice treatment (permethrin) topical liquid OTC; QL
lice treatment topical liquid OTC; QL
lice treatment topical shampoo OTC
permethrin topical cream Elimite QL
spinosad topical suspension Natroba
INMUNOMODULADORES TÓPICOS
imiquimod topical cream in packet Aldara PA; AL; QL
67
Nombre del medicamento Reference Notas
tacrolimus topical ointment Protopic PA; QL
TÓPICO ANTINEOPLÁSICO Y PREMALIGNO
fluorouracil topical cream Efudex QL
fluorouracil topical solution
ENDOCRINO
AGENTES ANDRÓGENOS
testosterone cypionate intramuscular oil Depo-Testosterone PA
testosterone enanthate intramuscular oil PA
testosterone transdermal gel Testim PA; QL
testosterone transdermal gel in metered-dose pump
Vogelxo PA; QL
testosterone transdermal gel in packet 1 % (25 mg/2.5gram), 1 % (50 mg/5 gram)
AndroGel PA; QL
AGENTES ESTROGÉNICOS
amabelz oral tablet
estradiol oral tablet Estrace
estradiol transdermal patch transdermal patch weekly
PA; QL
estradiol transdermal patch weekly Climara PA; QL
estradiol-norethindrone acet oral tablet Activella
estropipate oral tablet
jinteli oral tablet
lopreeza oral tablet
mimvey lo oral tablet
mimvey oral tablet
norethindrone ac-eth estradiol oral tablet Fyavolv
PREMPHASE ORAL TABLET
PREMPRO ORAL TABLET
AGENTES PARA LA FERTILIDAD
MAKENA INTRAMUSCULAR OIL PA; QL
AGENTES PROGESTACIONALES
hydroxyprogesterone caproate intramuscular oil
PA
MAKENA INTRAMUSCULAR OIL PA; QL
medroxyprogesterone oral tablet Provera QL
norethindrone acetate oral tablet Aygestin
68
Nombre del medicamento Reference Notas
progesterone micronized oral capsule 100 mg, 200 mg
Prometrium QL
AGENTES SUPRESORES HIPOFISARIOS
cabergoline oral tablet QL
ANTIHIPERGLUCÉMICOS, TIPO ANÁLOGO DE AMILINA
SYMLINPEN 120 SUBCUTANEOUS PEN INJECTOR
PA; QL
SYMLINPEN 60 SUBCUTANEOUS PEN INJECTOR
PA; QL
CALCITONINAS
calcitonin (salmon) nasal spray,non-aerosol
GLUCOCORTICOIDES
cortisone oral tablet
dexamethasone intensol oral drops
dexamethasone oral elixir
dexamethasone oral solution
dexamethasone oral tablet Decadron
dexamethasone sodium phosphate injection solution
DEXPAK 10 DAY ORAL TABLETS,DOSE PACK
DEXPAK 13 DAY ORAL TABLETS,DOSE PACK
DEXPAK 6 DAY ORAL TABLETS,DOSE PACK
hydrocortisone oral tablet Cortef
MEDROL ORAL TABLET
methylprednisolone acetate injection suspension
Depo-Medrol
methylprednisolone oral tablet Medrol
methylprednisolone oral tablets,dose pack Medrol (Pak)
millipred oral tablet
prednisolone oral solution
prednisolone sodium phosphate oral solution
prednisone intensol oral concentrate
69
Nombre del medicamento Reference Notas
prednisone oral solution
prednisone oral tablet
prednisone oral tablets,dose pack
HIPERGLUCEMIA
dex4 glucose bits oral tablet,chewable OTC
GLUCAGEN HYPOKIT INJECTION RECON SOLN
QL
GLUCAGON EMERGENCY KIT (HUMAN) INJECTION KIT
QL
glucose oral tablet,chewable Dex4 Glucose OTC
HIPOGLUCEMIA, INSULINA, INTENSIFICADOR DE RESPUESTA
pioglitazone oral tablet Actos PA; QL
pioglitazone-glimepiride oral tablet DUETACT PA
pioglitazone-metformin oral tablet Actoplus MET PA
HIPOGLUCEMIA, INSULINA, TIPO ESTIMULANTE LIBERADOR
glimepiride oral tablet Amaryl
glipizide oral tablet Glucotrol
glipizide oral tablet extended release 24hr Glucotrol XL
glipizide-metformin oral tablet
glyburide micronized oral tablet Glynase
glyburide oral tablet
glyburide-metformin oral tablet
nateglinide oral tablet Starlix PA; QL
repaglinide oral tablet Prandin PA
HIPOGLUCEMIA, TIPO BIGUANIDA
metformin oral tablet Glucophage
metformin oral tablet extended release 24 hr
Glucophage XR
HIPOGLUCEMIA, TIPO INHIBIDOR DE LA ALFA GLUCOSIDASA
acarbose oral tablet 100 mg Precose
acarbose oral tablet 25 mg, 50 mg Precose QL
70
Nombre del medicamento Reference Notas
HIPOGLUCEMIANTE, MIMÉTICO DE INCRETINA (AGONISTA DEL RECEPTOR GLP-1)
TANZEUM SUBCUTANEOUS PEN INJECTOR
PA; QL
VICTOZA 2-PAK SUBCUTANEOUS PEN INJECTOR
PA; QL
VICTOZA 3-PAK SUBCUTANEOUS PEN INJECTOR
PA; QL
HORMONAS ANTIDIURÉTICAS Y VASOPRESORAS
DDAVP NASAL SOLUTION
desmopressin nasal aerosol,spray DDAVP
desmopressin nasal solution DDAVP
desmopressin nasal spray,non-aerosol
desmopressin oral tablet 0.1 mg, 0.2 mg DDAVP QL
HORMONAS DEL CRECIMIENTO
GENOTROPIN MINIQUICK SUBCUTANEOUS SYRINGE
PA; QL
GENOTROPIN SUBCUTANEOUS CARTRIDGE
PA; QL
NORDITROPIN FLEXPRO SUBCUTANEOUS PEN INJECTOR
PA; QL
HORMONAS TIROIDEAS
levothyroxine oral tablet Levo-T
levoxyl oral tablet
liothyronine oral tablet Cytomel
np thyroid oral tablet QL
thyroid (pork) oral tablet Armour Thyroid QL
unithroid oral tablet
INHIBIDOR DE LA DIPEPTIDIL PEPTIDASA IV Y COMBINACIONES
JANUMET ORAL TABLET PA; QL
JANUMET XR ORAL TABLET, ER MULTIPHASE 24 HR 100-1,000 MG, 50-1,000 MG, 50-500 MG
PA; QL
JANUVIA ORAL TABLET PA; QL
JENTADUETO ORAL TABLET PA; QL
71
Nombre del medicamento Reference Notas
JENTADUETO XR ORAL TABLET, IR - ER, BIPHASIC 24HR 2.5-1,000 MG, 5-1,000 MG
PA; QL
TRADJENTA ORAL TABLET PA; QL
INHIBIDORES DE RESORCIÓN ÓSEA
alendronate oral solution QL
alendronate oral tablet 10 mg, 40 mg, 5 mg
QL
alendronate oral tablet 35 mg
alendronate oral tablet 70 mg Fosamax QL
raloxifene oral tablet Evista
INHIBIDORES DE SODIO-GLUCOSA (SGLT2)
JARDIANCE ORAL TABLET PA; QL
SYNJARDY ORAL TABLET PA; QL
SYNJARDY XR ORAL TABLET, IR - ER, BIPHASIC 24HR 10-1,000 MG, 12.5-1,000 MG, 25-1,000 MG, 5-1,000 MG
PA; QL
INSULINAS
HUMALOG JUNIOR KWIKPEN U-100 SUBCUTANEOUS INSULIN PEN, HALF-UNIT
HUMALOG KWIKPEN INSULIN SUBCUTANEOUS INSULIN PEN
QL
HUMALOG MIX 50-50 INSULN U-100 SUBCUTANEOUS SUSPENSION
QL
HUMALOG MIX 50-50 KWIKPEN SUBCUTANEOUS INSULIN PEN
QL
HUMALOG MIX 75-25 KWIKPEN SUBCUTANEOUS INSULIN PEN
QL
HUMALOG MIX 75-25(U-100)INSULN SUBCUTANEOUS SUSPENSION
QL
HUMALOG U-100 INSULIN SUBCUTANEOUS CARTRIDGE
QL
HUMALOG U-100 INSULIN SUBCUTANEOUS SOLUTION
QL
HUMULIN 70/30 U-100 INSULIN SUBCUTANEOUS SUSPENSION
OTC; QL
HUMULIN 70/30 U-100 KWIKPEN SUBCUTANEOUS INSULIN PEN
OTC; QL
72
Nombre del medicamento Reference Notas
HUMULIN N NPH INSULIN KWIKPEN SUBCUTANEOUS INSULIN PEN
OTC; QL
HUMULIN N NPH U-100 INSULIN SUBCUTANEOUS SUSPENSION
OTC; QL
HUMULIN R REGULAR U-100 INSULN INJECTION SOLUTION
OTC; QL
HUMULIN R U-500 (CONC) INSULIN SUBCUTANEOUS SOLUTION
QL
HUMULIN R U-500 (CONC) KWIKPEN SUBCUTANEOUS INSULIN PEN
QL
LANTUS SOLOSTAR U-100 INSULIN SUBCUTANEOUS INSULIN PEN
QL
LANTUS U-100 INSULIN SUBCUTANEOUS SOLUTION
QL
LEVEMIR FLEXTOUCH U-100 INSULN SUBCUTANEOUS INSULIN PEN
QL
LEVEMIR U-100 INSULIN SUBCUTANEOUS SOLUTION
QL
NOVOLOG FLEXPEN U-100 INSULIN SUBCUTANEOUS INSULIN PEN
QL
NOVOLOG MIX 70-30 U-100 INSULN SUBCUTANEOUS SOLUTION
QL
NOVOLOG MIX 70-30FLEXPEN U-100 SUBCUTANEOUS INSULIN PEN
QL
NOVOLOG PENFILL U-100 INSULIN SUBCUTANEOUS CARTRIDGE
QL
NOVOLOG U-100 INSULIN ASPART SUBCUTANEOUS SOLUTION
QL
MINERALOCORTICOIDES
fludrocortisone oral tablet
OXITÓCICOS
methylergonovine injection solution
PREPARADOS ANTITIROIDEOS
methimazole oral tablet Tapazole
propylthiouracil oral tablet
EQUILIBRIO ELECTROLÍTICO-PRODUCTOS NUTRICIONALES
AGENTES CON MINERALES Y ELECTROLITOS
k-phos-neutral oral tablet
73
Nombre del medicamento Reference Notas
phospha 250 neutral oral tablet
MULTIVITAMÍNICOS
AQUADEKS ORAL TABLET,CHEWABLE
OTC
BACMIN ORAL TABLET AL; QL
corvita oral tablet
CORVITE FREE ORAL TABLET AL; QL
ICAPS AREDS ORAL CAPSULE OTC
I-CAPS ORAL CAPSULE OTC
multiple vitamin, womens oral tablet AL; OTC; QL
NUTRICAP ORAL TABLET AL; QL
OCUVITE ORAL CAPSULE OTC
PRESERVISION AREDS ORAL CAPSULE
OTC
PRESERVISION LUTEIN ORAL CAPSULE
OTC
PRORENAL QD ORAL CAPSULE OTC
purevit dualfe plus oral capsule
se-tan plus oral capsule
super ginseng multivitamin oral capsule OTC
vic-forte oral capsule
PREPARADOS DE VITAMINA B
cyanocobalamin (vitamin b-12) injection solution
Vitamin B-12
cyanocobalamin (vitamin b-12) sublingual drops
OTC
DIALYVITE 800 ORAL TABLET OTC
DIALYVITE ORAL TABLET
hydroxocobalamin intramuscular solution
nephplex rx oral tablet
niacin oral capsule, extended release OTC; QL
niacin oral tablet Niacor OTC
niacin oral tablet extended release Endur-Acin OTC
pyridoxine (vitamin b6) injection solution
renal caps oral capsule
reno caps oral capsule OTC
thiamine hcl (vitamin b1) injection solution
triphrocaps oral capsule
74
Nombre del medicamento Reference Notas
virt-vite forte oral tablet QL
virt-vite plus oral tablet
vitamin b-1 oral tablet OTC
vitamin b-12 injection solution
vitamin b-6 oral tablet OTC
vol-care rx oral tablet
vp-vite rx oral tablet
PREPARADOS DE VITAMINA C
ascorbic acid (vitamin c) injection solution
PREPARADOS DE VITAMINA D
calcitriol oral capsule Rocaltrol PA
calcitriol oral solution Rocaltrol PA
cholecalciferol (vitamin d3) oral capsule Vitamin D3 OTC
cholecalciferol (vitamin d3) oral tablet Vitamin D3 OTC
ergocalciferol (vitamin d2) oral capsule Vitamin D2
vitamin d2 oral capsule
vitamin d3 oral capsule OTC
vitamin d3 oral tablet OTC
PREPARADOS DE VITAMINA K
MEPHYTON ORAL TABLET
vitamin k injection solution
vitamin k1 injection solution
PREPARADOS DE VITAMINAS PRENATALES
classic prenatal oral tablet AL; OTC; QL
daily prenatal oral combo pack OTC; QL
dothelle dha oral capsule QL
kpn oral tablet AL; OTC; QL
MINI PRENATAL ORAL TABLET AL; OTC; QL
prenatal formula oral tablet AL; OTC; QL
prenatal one daily oral tablet OTC; QL
prenatal oral tablet OTC; QL
prenatal vitamin plus low iron oral tablet QL
prenatal vits96-iron fum-folic oral tablet OTC; QL
virt-nate dha oral capsule QL
virt-nate oral tablet QL
75
Nombre del medicamento Reference Notas
RESINAS LIBERADORAS DE POTASIO
sodium polystyrene (sorb free) oral suspension
sodium polystyrene sulfonate oral suspension
sodium polystyrene (sorb free)
sodium polystyrene sulfonate rectal enema
sps (with sorbitol) oral suspension
sps (with sorbitol) rectal enema
SOLUCIONES DE CLORURO DE SODIO
sodium chloride 0.45 % intravenous parenteral solution
SOLUCIONES DE RIEGO
sodium chloride irrigation solution Sterile Saline
SUPLEMENTOS DIETARIOS
vp-zel oral tablet AL; QL
SUSTITUTO DEL CALCIO
calcium 500 + d oral tablet OTC
calcium 500 oral tablet OTC
calcium 600 + d(3) oral tablet OTC
calcium 600 with vitamin d3 oral tablet OTC
calcium carbonate oral suspension OTC
calcium carbonate oral tablet Calcium 500 OTC
calcium carbonate-vitamin d3 oral tablet 500 mg(1,250mg) -200 unit
Calcium 500 + D OTC
calcium carbonate-vitamin d3 oral tablet 600 mg(1,500mg) -400 unit
Calcium 600 + D(3) OTC; QL
calcium-folic acid-vitamin d oral wafer
gnp calcium 600-vit d3 800 tab s/f,p/f,gluten-free
Caltrate with Vitamin D3 OTC
oysco 500/d oral tablet OTC
oysco-500 oral tablet OTC
oyster shell calcium 500 oral tablet OTC
oyster shell calcium oral tablet OTC
oyster shell calcium-vit d3 oral tablet OTC
parva-cal 500 oral tablet OTC
sm calcium 600-vit d3 800 tab Caltrate with Vitamin D3 OTC
76
Nombre del medicamento Reference Notas
tl g-fol os oral tablet
SUSTITUTO DEL ELECTROLITO
pedialyte freezer pops oral solution OTC; QL
pedialyte oral solution OTC; QL
pedialyte singles oral solution OTC; QL
pediatric electrolyte oral solution OTC; QL
SUSTITUTO DEL HIERRO
centratex oral capsule
children's iron oral drops OTC
corvita 150 oral tablet
ferate oral tablet OTC; QL
ferosul oral elixir OTC
ferosul oral tablet OTC; QL
ferraplus 90 oral tablet
ferro-time oral tablet OTC; QL
ferrous gluconate oral tablet OTC; QL
ferrous sulfate oral drops Children's Iron OTC
ferrous sulfate oral elixir FeroSul OTC
ferrous sulfate oral solution OTC
ferrous sulfate oral tablet Feosol OTC; QL
ferrous sulfate oral tablet,delayed release (dr/ec) 324 mg (65 mg iron)
OTC; QL
ferrous sulfate oral tablet,delayed release (dr/ec) 325 mg (65 mg iron)
OTC
ferrousul oral tablet OTC; QL
folivane-f oral capsule
hematogen fa oral capsule
hematogen forte oral capsule
hematogen oral capsule
iferex 150 forte oral capsule
iferex 150 oral capsule OTC
infed injection solution
iron oral tablet OTC; QL
sodium ferric gluconat-sucrose intravenous solution
Ferrlecit
taron forte oral capsule
tl icon oral capsule QL
77
Nombre del medicamento Reference Notas
tl-hem 150 oral tablet extended release 24 hr
tricon oral capsule QL
trigels-f forte oral capsule
VENOFER INTRAVENOUS SOLUTION
SUSTITUTO DEL POTASIO
effer-k oral tablet, effervescent
k-effervescent oral tablet, effervescent
klor-con 10 oral tablet extended release
klor-con 8 oral tablet extended release
klor-con m10 oral tablet,er particles/crystals
klor-con m20 oral tablet,er particles/crystals
klor-con oral packet
klor-con/ef oral tablet, effervescent
K-TAB ORAL TABLET EXTENDED RELEASE
potassium bicarb-citric acid oral tablet, effervescent
Effer-K
potassium chloride oral capsule, extended release
Klor-Con Sprinkle
potassium chloride oral liquid
potassium chloride oral packet Klor-Con
potassium chloride oral tablet extended release
K-Tab
potassium chloride oral tablet,er particles/crystals
Klor-Con M20
VITAMINAS PEDIÁTRICAS CON FLÚOR
multi-vit with fluoride-iron oral drops OTC
multi-vitamin with fluoride oral drops OTC
multivitamin with fluoride oral tablet,chewable
multi-vitamin with fluoride oral tablet,chewable
multivitamins with fluoride oral tablet,chewable
multivit-fluor (vit e acetate) oral drops
mvc-fluoride oral tablet,chewable
78
Nombre del medicamento Reference Notas
triple vitamin with fluoride oral drops
tri-vit with fluoride and iron oral drops
tri-vitamin with fluoride oral drops
vitamins a,c,d and fluoride oral drops
VITAMINAS PEDIÁTRICAS
animal shapes plus iron oral tablet,chewable
OTC
AQUADEKS PEDIATRIC ORAL DROPS OTC
POLY-VI-SOL WITH IRON ORAL DROPS
OTC
VITAMINAS
folic acid injection solution
folic acid oral tablet OTC
virt-vite forte oral tablet QL
ESCLEROSIS MÚLTIPLE
MEDICAMENTOS PARA TRATAR LA ESCLEROSIS MÚLTIPLE
AVONEX (WITH ALBUMIN) INTRAMUSCULAR KIT
QL
AVONEX INTRAMUSCULAR PEN INJECTOR KIT
QL
AVONEX INTRAMUSCULAR SYRINGE KIT
QL
BETASERON SUBCUTANEOUS KIT QL
COPAXONE SUBCUTANEOUS SYRINGE 20 MG/ML
QL
COPAXONE SUBCUTANEOUS SYRINGE 40 MG/ML
GILENYA ORAL CAPSULE QL
REBIF (WITH ALBUMIN) SUBCUTANEOUS SYRINGE
REBIF REBIDOSE SUBCUTANEOUS PEN INJECTOR
REBIF TITRATION PACK SUBCUTANEOUS SYRINGE
TECFIDERA ORAL CAPSULE,DELAYED RELEASE(DR/EC)120 MG, 120 MG (14)- 240 MG (46), 240 MG
QL
79
Nombre del medicamento Reference Notas
INSUMOS Y PREPARADOS DENTALES
AGENTES PARA LA BOCA Y GARGANTA
lidocaine hcl mucous membrane solution
lidocaine viscous mucous membrane solution
QL
oralone dental paste
pilocarpine hcl oral tablet Salagen (pilocarpine) QL
triamcinolone acetonide dental paste Oralone
ANTIBIÓTICOS ANTIMICÓTICOS
clotrimazole mucous membrane troche QL
nystatin oral suspension
ANTISÉPTICOS, GENERALES
chlorhexidine gluconate mucous membrane mouthwash
Paroex Oral Rinse QL
PREPARACIONES DE FLUORUROS
dentagel dental gel
FLUOR-A-DAY ORAL DROPS
fluoride (sodium) oral drops AL; QL
fluoride (sodium) oral tablet,chewable Fluoritab
ludent fluoride oral tablet,chewable
sf dental gel
MODIFICADORES METABÓLICOS
AGENTES DE DEFICIENCIA METABÓLICA
calcitriol oral capsule Rocaltrol PA
calcitriol oral solution Rocaltrol PA
levocarnitine oral tablet Carnitor OTC
PHARMACOENHANCER - INHIBIDORES DEL CITOCROMO P450
TYBOST ORAL TABLET
ÓTICO
PREPARADOS ÓTICOS, MISCELÁNEOS, ANTINFECCIOSOS
acetic acid otic (ear) solution
carbamoxide ear drops otic (ear) drops OTC
80
Nombre del medicamento Reference Notas
ciprofloxacin hcl otic (ear) dropperette Cetraxal QL
ear drops (carbamide peroxide) otic (ear) drops
OTC
ear drops otc otic (ear) drops OTC
ear wax removal drops otic (ear) drops OTC
ear wax removal kit otic (ear) drops OTC
ear wax removal system otic (ear) drops OTC
floxin otic (ear) drops QL
neomycin-polymyxin-hc otic (ear) drops,suspension
neomycin-polymyxin-hc otic (ear) solution
ofloxacin otic (ear) drops Floxin QL
PRODUCTOS VAGINALES
ANTIBIÓTICOS VAGINALES
CLEOCIN VAGINAL SUPPOSITORY
clindamycin phosphate vaginal cream Cleocin
metronidazole vaginal gel Metrogel Vaginal
vandazole vaginal gel
ANTIMICÓTICOS VAGINALES
3 day vaginal vaginal cream OTC
3-day vaginal vaginal cream OTC
clotrimazole vaginal cream Clotrimazole-7 OTC; QL
clotrimazole-3 vaginal cream OTC
miconazole 7 vaginal cream OTC
miconazole nitrate vaginal cream Miconazole 7 OTC
miconazole-3 vaginal suppository
terconazole vaginal cream 0.4 % Terazol 7 QL
terconazole vaginal cream 0.8 % QL
terconazole vaginal suppository QL
PREPARADOS DE ESTRÓGENO VAGINALES
estradiol vaginal tablet Vagifem
yuvafem vaginal tablet
81
Nombre del medicamento Reference Notas
SISTEMA LOCOMOTOR
AGENTES PARA EL TRATAMIENTO DE TRASTORNOS MUSCULOESQUELÉTICOS
EUFLEXXA INTRA-ARTICULAR SYRINGE
PA; QL
OTROS MEDICAMENTOS AUTÓNOMOS/DEL SNC
MESTINON ORAL SYRUP
pyridostigmine bromide oral tablet Mestinon
pyridostigmine bromide oral tablet extended release
Mestinon Timespan
RELAJANTES DEL MÚSCULO ESQUELÉTICO
baclofen oral tablet
carisoprodol oral tablet Soma QL
carisoprodol-asa-codeine oral tablet AL; QL
carisoprodol-aspirin oral tablet QL
chlorzoxazone oral tablet
cyclobenzaprine oral tablet 10 mg QL
cyclobenzaprine oral tablet 5 mg
dantrolene oral capsule Dantrium
methocarbamol oral tablet 500 mg Robaxin QL
methocarbamol oral tablet 750 mg Robaxin-750 QL
orphenadrine citrate oral tablet extended release
QL
riluzole oral tablet Rilutek PA
tizanidine oral tablet 2 mg QL
tizanidine oral tablet 4 mg Zanaflex QL
SUMINISTROS MÉDICOS Y EQUIPO MÉDICO DURADERO (DME)
AGUJAS, DISPOSITIVOS SIN AGUJAS, JERINGAS Y ACCESORIOS
1ST TIER UNIFINE PENTIPS NEEDLE OTC; QL
1ST TIER UNIFINE PENTIPS PLUS NEEDLE
OTC; QL
ADVOCATE PEN NEEDLE NEEDLE OTC; QL
ADVOCATE SYRINGES SYRINGE OTC; QL
82
Nombre del medicamento Reference Notas
ASSURE ID INSULIN SAFETY SYRINGE OTC; QL
BD AUTOSHIELD DUO PEN NEEDLE NEEDLE
OTC; QL
BD ECLIPSE LUER-LOK SYRINGE OTC; QL
BD INSULIN PEN NEEDLE UF MINI NEEDLE
OTC; QL
BD INSULIN PEN NEEDLE UF ORIG NEEDLE
OTC; QL
BD INSULIN PEN NEEDLE UF SHORT NEEDLE
OTC; QL
BD INSULIN SYRINGE HALF UNIT SYRINGE
OTC; QL
BD INSULIN SYRINGE MICRO-FINE SYRINGE
OTC; QL
BD INSULIN SYRINGE SAFETY-LOK SYRINGE
OTC; QL
BD INSULIN SYRINGE SLIP TIP SYRINGE
OTC; QL
BD INSULIN SYRINGE SYRINGE OTC; QL
BD INSULIN SYRINGE ULT-FINE II SYRINGE
OTC; QL
BD INSULIN SYRINGE ULTRA-FINE SYRINGE
OTC; QL
BD LO-DOSE MICRO-FINE IV SYRINGE OTC; QL
BD LO-DOSE ULTRA-FINE SYRINGE OTC; QL
BD LUER-LOK SYRINGE SYRINGE OTC
BD SAFETYGLIDE INSULIN SYRINGE SYRINGE
OTC; QL
BD SAFETYGLIDE SYRINGE SYRINGE OTC; QL
BD ULTRA-FINE MICRO PEN NEEDLE NEEDLE
OTC; QL
BD ULTRA-FINE NANO PEN NEEDLES NEEDLE
OTC; QL
CAREFINE PEN NEEDLE NEEDLE OTC; QL
CARETOUCH PEN NEEDLE NEEDLE OTC; QL
CLICKFINE NEEDLE OTC; QL
COMFORT EZ PEN NEEDLES NEEDLE OTC; QL
COMFORT EZ SYRINGE SYRINGE OTC; QL
DROPLET PEN NEEDLE NEEDLE OTC; QL
83
Nombre del medicamento Reference Notas
EASY COMFORT INSULIN SYRINGE SYRINGE
OTC; QL
EASY COMFORT PEN NEEDLES NEEDLE
OTC; QL
EASY TOUCH INSULIN SAFETY SYR SYRINGE
OTC; QL
EASY TOUCH INSULIN SYRINGE SYRINGE
OTC; QL
EASY TOUCH NEEDLE OTC; QL
EXEL INSULIN SYRINGE OTC; QL
FREESTYLE PRECISION SYRINGE OTC; QL
HEALTHY ACCENTS UNIFINE PENTIP NEEDLE
OTC; QL
INCONTROL PEN NEEDLE NEEDLE OTC; QL
insulin syringe microfine syringe OTC; QL
insulin syringe needleless syringe BD Insulin Syringe Slip Tip OTC; QL
insulin syringe syringe OTC; QL
insulin syringe-needle u-100 syringe Lite Touch Insulin Syringe OTC; QL
INSUPEN NEEDLE OTC; QL
LITE TOUCH INSULIN PEN NEEDLES NEEDLE
OTC; QL
LITE TOUCH INSULIN SYRINGE SYRINGE
OTC; QL
MAXI-COMFORT INSULIN SYRINGE SYRINGE
OTC; QL
MINI ULTRA-THIN II NEEDLE OTC; QL
MONOJECT INSULIN SAFETY SYRING SYRINGE 0.3 ML 29 GAUGE X 1/2", 29 GAUGE X 1/2"
OTC; QL
MONOJECT INSULIN SAFETY SYRING SYRINGE 0.3 ML 30 GAUGE X 5/16, 0.5 ML 29 GAUGE X 1/2", 1/2 ML 30 GAUGE X 5/16
QL
MONOJECT INSULIN SYRINGE SYRINGE
OTC; QL
MONOJECT SAFETY SYRINGES SYRINGE
OTC
MONOJECT SYRINGE SYRINGE QL
MONOJECT ULTRA COMFORT INSULIN SYRINGE
OTC; QL
NOVOFINE 30 NEEDLE OTC; QL
84
Nombre del medicamento Reference Notas
NOVOFINE 32 NEEDLE OTC; QL
pen needle needle 29 gauge x 1/2", 31 gauge x 1/4", 31 gauge x 3/16", 31 gauge x 5/16", 32 gauge x 5/32"
OTC; QL
pen needle needle 30 gauge x 5/16" QL
pen needle, diabetic needle 1st Tier Unifine Pentips OTC; QL
PENTIPS NEEDLE OTC; QL
PRO COMFORT PEN NEEDLE NEEDLE OTC; QL
PRODIGY INSULIN SYRINGE SYRINGE OTC; QL
RELION NEEDLES NEEDLE OTC; QL
RELION PEN NEEDLES NEEDLE OTC; QL
SURE COMFORT INS. SYR. U-100 SYRINGE
OTC; QL
SURE COMFORT INSULIN SYRINGE SYRINGE
OTC; QL
SURE COMFORT PEN NEEDLE NEEDLE
OTC; QL
SURE-FINE PEN NEEDLES NEEDLE OTC; QL
SURE-JECT INSULIN SYRINGE SYRINGE
OTC; QL
TECHLITE PEN NEEDLE NEEDLE OTC; QL
TERUMO INSULIN SYRINGE SYRINGE OTC; QL
THINPRO INSULIN SYRINGE SYRINGE OTC; QL
TOPCARE CLICKFINE NEEDLE OTC; QL
TOPCARE ULTRA COMFORT SYRINGE OTC; QL
TRUEPLUS INSULIN SYRINGE OTC; QL
TRUEPLUS PEN NEEDLE NEEDLE OTC; QL
ULTICARE PEN NEEDLE NEEDLE OTC; QL
ULTICARE SYRINGE OTC; QL
ULTILET INSULIN SYRINGE SYRINGE OTC; QL
ULTILET PEN NEEDLE NEEDLE OTC; QL
ULTRA CMFT INS SYR HALF UNIT SYRINGE
OTC; QL
ULTRA COMFORT INSULIN SYRINGE SYRINGE
OTC; QL
ULTRA-THIN II (SHORT) INS SYR SYRINGE
OTC; QL
ULTRA-THIN II (SHORT) PEN NDL NEEDLE
OTC; QL
85
Nombre del medicamento Reference Notas
ULTRA-THIN II INS PEN NEEDLES NEEDLE
OTC; QL
ULTRA-THIN II INSULIN SYRINGE SYRINGE
OTC; QL
UNIFINE PENTIPS NEEDLE OTC; QL
UNIFINE PENTIPS PLUS NEEDLE OTC; QL
VANISHPOINT SYRINGE SYRINGE OTC; QL
DIAFRAGMAS/CAPUCHÓN CERVICAL
WIDE-SEAL DIAPHRAGM 60 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 65 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 70 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 75 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 80 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 85 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 90 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 95 VAGINAL DIAPHRAGM
EQUIPOS, DISPOSITIVOS, ESPACIADORES Y AUXILIARES RESPIRATORIOS
ACE AEROSOL CLOUD ENHANCER SPACER
QL
AEROTRACH PLUS SPACER QL
AEROVENT PLUS SPACER QL
BREATHERITE MDI SPACER SPACER QL
BREATHERITE RIGID SPACER-MASK SPACER
QL
BREATHERITE SPACER-MASK,ADULT SPACER
QL
BREATHERITE SPACER-MASK,CHILD SPACER
QL
BREATHERITE SPACER-MASK,INFANT SPACER
QL
86
Nombre del medicamento Reference Notas
BREATHERITE SPACER-MASK,S.CHLD SPACER
QL
BREATHERITE VALVED MDI CHAMBER SPACER
QL
BREATHERITE VALVED MDI SPACER SPACER
QL
BREATHERITE WITH MASK, LARGE SPACER
QL
BREATHERITE WITH MASK, MEDIUM SPACER
QL
BREATHERITE WITH MASK, SMALL SPACER
QL
COMPACT SPACE CHAMBER SPACER QL
COMPACT SPACE CHAMBER-LRG MASK SPACER
QL
COMPACT SPACE CHAMBER-MED MASK SPACER
QL
COMPACT SPACE CHAMBER-SM MASK SPACER
QL
EASIVENT MASK LARGE DEVICE QL
EASIVENT MASK MEDIUM DEVICE QL
EASIVENT MASK SMALL DEVICE QL
LITEAIRE MDI CHAMBER SPACER QL
MICROCHAMBER SPACER QL
MICROSPACER SPACER QL
OPTICHAMBER ADULT MASK-LARGE DEVICE
QL
OPTICHAMBER DIAMOND LG MASK SPACER
QL
OPTICHAMBER DIAMOND VHC SPACER
QL
OPTICHAMBER DIAMOND-MED MSK SPACER
QL
OPTICHAMBER DIAMOND-SML MASK SPACER
QL
POCKET CHAMBER SPACER QL
PRIMEAIRE SPACER QL
PROCHAMBER SPACER QL
RITEFLO AEROCHAMBER SPACER QL
VORTEX HOLDING CHAMBER CHILD SPACER
QL
87
Nombre del medicamento Reference Notas
VORTEX HOLDING CHAMBER SPACER
QL
VORTEX HOLDING CHAMBER TODDLER SPACER
QL
VORTEX VHC FROG MASK-CHILD SPACER
QL
VORTEX VHC LADYBUG MASK-TODDLR SPACER
QL
MEDIDORES DE FLUJO ESPIRATORIO MÁXIMO Y SUMINISTROS MÉDICOS
AIRZONE PEAK FLOW METER DEVICE OTC
ASTHMA CHECK METER DEVICE OTC
IN-CHECK NASAL WITH MASK DEVICE OTC
IN-CHECK ORAL FLOW METER DEVICE
OTC
MICROLIFE PEAK FLOW METER DEVICE
OTC
MINI WRIGHT PEAK FLOW METER DEVICE
PEAK AIR PEAK FLOW METER DEVICE
OTC
PERSONAL BEST FULL RANGE DEVICE
OTC
PERSONAL BEST LOW RANGE DEVICE
OTC
PIKO 1 DEVICE OTC
POCKET PEAK FLOW METER DEVICE OTC
TRUZONE PEAK FLOW METER DEVICE
PRESERVATIVOS
AIMSCO LATEX CONDOM DEVICE OTC; QL
CONDOMS-PREM LUBRICATED DEVICE
OTC
DUREX AVANTI BARE REAL FEEL OTC
FANTASY CONDOM DEVICE OTC
FC2 FEMALE CONDOM OTC
KIMONO CONDOMS(NON-LUBRICATED) DEVICE
OTC
KIMONO MAXX CONDOMS DEVICE OTC
88
Nombre del medicamento Reference Notas
KIMONO MICROTHIN AQUA LUBE CON DEVICE
OTC
KIMONO MICROTHIN CONDOMS DEVICE
OTC
KIMONO MICROTHIN LARGE CONDOMS DEVICE
OTC
KIMONO TEXTURED CONDOMS DEVICE
OTC
TRUSTEX LATEX CONDOM DEVICE OTC
TRUSTEX LUBRICATED CONDOMS DEVICE
OTC
TRUSTEX NON-LUB CONDOMS DEVICE
OTC
TRUSTEX-RIA LUB/SPERMICIDE DEVICE
OTC
TRUSTEX-RIA LUBRICATED CONDOMS DEVICE
OTC
TRUSTEX-RIA NON-LUB CONDOMS DEVICE
OTC
SUMINISTROS MÉDICOS Y DME PARA EL ANÁLISISY MONITOREO DE LA GLUCOSA EN SANGRE
1ST TIER UNILET COMFORTOUCH OTC; QL
ACCU-CHEK SOFTCLIX LANCET DEV OTC; QL
ADJUSTABLE LANCING DEVICE OTC; QL
ADVANCED LANCING DEVICE KIT OTC; QL
ADVANCED TRAVEL LANCETS OTC; QL
ADVOCATE LANCING DEVICE OTC; QL
ADVOCATE RAPID-SAFE LANCING OTC; QL
ALTERNATE SITE LANCET OTC; QL
ALTERNATE SITE LANCING DEVICE OTC; QL
AQUA LANCE LANCING DEVICE OTC; QL
ASSURE HAEMOLANCE PLUS OTC; QL
ASSURE LANCE OTC; QL
ASSURE LANCE PLUS OTC; QL
AUTO-LANCET MINI OTC; QL
AUTOLET IMPRESSION LANC DEV KIT OTC; QL
AUTOLET LANCING DEVICE OTC; QL
AUTOLET PLUS LANCING DEVICE OTC; QL
89
Nombre del medicamento Reference Notas
CAREONE LANCING DEVICE OTC; QL
CAREONE THIN LANCET OTC; QL
CAREONE ULTRA THIN LANCET OTC; QL
CARETOUCH TWIST LANCET OTC; QL
COLOR LANCETS OTC; QL
COMFORT LANCETS OTC; QL
DROPLET LANCING DEVICE OTC; QL
EASY CLICK LANCING DEVICE OTC; QL
EASY TOUCH LANCETS OTC; QL
EASY TOUCH LANCING DEVICE OTC; QL
EASY TOUCH SAFETY LANCETS OTC; QL
EASY TOUCH TWIST LANCETS OTC; QL
E-Z JECT LANCETS OTC; QL
E-Z JECT THIN LANCETS OTC; QL
EZ SMART LANCETS OTC; QL
FINE 30 UNIVERSAL LANCETS OTC; QL
FORA LANCING DEVICE OTC; QL
FORACARE LANCETS OTC; QL
GLUCOCOM LANCETS OTC; QL
HEALTHY ACCENTS AUTOLET OTC; QL
HEALTHY ACCENTS UNILET LANCET OTC; QL
HYPOLANCE AST LANCING KIT OTC; QL
INCONTROL LANCING DEVICE OTC; QL
INCONTROL SUPER THIN LANCETS OTC; QL
INCONTROL ULTRA THIN LANCETS OTC; QL
INVACARE LANCETS OTC; QL
lancets Accu-Chek FastClix OTC; QL
lancets, super thin OTC; QL
lancets,thin OTC; QL
lancets,ultra thin OTC; QL
lancing device Adjustable Lancing Device OTC; QL
lancing device with lancets OTC; QL
lancing device with lancets kit Accu-Chek FastClix OTC; QL
lancing system OTC; QL
LANZO LANCING DEVICE KIT OTC; QL
LITE TOUCH LANCING DEVICE OTC; QL
MEDLANCE PLUS LANCETS OTC; QL
90
Nombre del medicamento Reference Notas
MICRO THIN LANCETS OTC; QL
MICROLET NEXT LANCING DEVICE KIT
OTC; QL
MINI LANCING DEVICE OTC; QL
MONOLET LANCETS OTC; QL
MONOLET THIN LANCETS OTC; QL
MULTI-LANCET DEVICE 2 KIT OTC; QL
MYGLUCOHEALTH LANCETS OTC; QL
ON CALL LANCING DEVICE OTC; QL
ON CALL PLUS LANCING DEVICE OTC; QL
ON-THE-GO LANCETS OTC; QL
PRODIGY LANCING DEVICE OTC; QL
RELIAMED MINI LANCING DEVICE OTC; QL
RELION THIN LANCETS OTC; QL
RELION ULTRA THIN PLUS LANCETS OTC; QL
RIGHTEST GD500 LANCING DEVICE OTC; QL
RIGHTEST GL300 LANCETS OTC; QL
SAFETY LANCETS OTC; QL
SMART SENSE LANCETS OTC; QL
SMARTDIABETES VANTAGE OTC; QL
STERILANCE TL OTC; QL
SUPER THIN LANCETS OTC; QL
SURE COMFORT LANCING PEN OTC; QL
SUREFLEX LANCING DEVICE OTC; QL
SURE-PEN LANCING DEVICE OTC; QL
TECHLITE LANCETS OTC; QL
THIN LANCETS OTC; QL
TOPCARE UNIVERSAL1 LANCET OTC; QL
TRUE METRIX AIR GLUCOSE METER OTC
TRUE METRIX LEVEL 1 SOLUTION OTC
TRUE METRIX LEVEL 2 SOLUTION OTC
TRUE METRIX LEVEL 3 SOLUTION OTC
TRUEDRAW LANCING DEVICE OTC; QL
TRUEPLUS LANCETS OTC; QL
TRUERESULT BLOOD GLUCOSE SYSTM KIT
OTC; QL
ULTI-LANCE OTC; QL
91
Nombre del medicamento Reference Notas
ULTRA THIN LANCETS OTC; QL
ULTRA THIN PLUS LANCETS OTC; QL
UNILET COMFORTOUCH LANCET OTC; QL
UNILET EXCELITE II LANCET OTC; QL
UNILET EXCELITE LANCET OTC; QL
UNILET GP LANCET OTC; QL
UNILET LANCET OTC; QL
UNILET LANCETS OTC; QL
UNILET SUPER THIN LANCETS OTC; QL
UNISTIK 2 DEVICE KIT OTC; QL
UNISTIK 2 EXTRA KIT OTC; QL
UNISTIK 3 COMFORT DEVICE KIT OTC; QL
UNISTIK 3 COMFORT LANCET OTC; QL
UNISTIK 3 EXTRA LANCET OTC; QL
UNISTIK 3 GENTLE OTC; QL
UNISTIK 3 KIT OTC; QL
UNISTIK 3 LANCETS OTC; QL
UNISTIK 3 NEONATAL DEVICE KIT OTC; QL
UNISTIK 3 NEONATAL KIT OTC; QL
UNISTIK 3 NORMAL LANCET OTC; QL
UNISTIK CZT LANCET OTC; QL
UNISTIK SAFETY OTC; QL
UNISTIK TOUCH LANCETS OTC; QL
UNIVERSAL 1 LANCETS OTC; QL
SUMINISTROS MÉDICOS Y EQUIPO MÉDICO DURADERO (DME)
1ST TIER UNIFINE PENTIPS NEEDLE OTC; QL
1ST TIER UNIFINE PENTIPS PLUS NEEDLE
OTC; QL
1ST TIER UNILET COMFORTOUCH OTC; QL
ACE AEROSOL CLOUD ENHANCER SPACER
QL
ADJUSTABLE LANCING DEVICE OTC; QL
ADVANCED LANCING DEVICE KIT OTC; QL
ADVANCED TRAVEL LANCETS OTC; QL
ADVOCATE LANCING DEVICE OTC; QL
ADVOCATE PEN NEEDLE NEEDLE OTC; QL
ADVOCATE RAPID-SAFE LANCING OTC; QL
92
Nombre del medicamento Reference Notas
ADVOCATE SYRINGES SYRINGE OTC; QL
AEROTRACH PLUS SPACER QL
AEROVENT PLUS SPACER QL
ASSURE HAEMOLANCE PLUS OTC; QL
ASSURE LANCE OTC; QL
ASSURE LANCE PLUS OTC; QL
AUTOLET IMPRESSION LANC DEV KIT OTC; QL
AUTOLET PLUS LANCING DEVICE OTC; QL
BD AUTOSHIELD DUO PEN NEEDLE NEEDLE
OTC; QL
BD ECLIPSE LUER-LOK SYRINGE OTC; QL
BD INSULIN PEN NEEDLE UF MINI NEEDLE
OTC; QL
BD INSULIN PEN NEEDLE UF ORIG NEEDLE
OTC; QL
BD INSULIN PEN NEEDLE UF SHORT NEEDLE
OTC; QL
BD INSULIN SYRINGE HALF UNIT SYRINGE
OTC; QL
BD INSULIN SYRINGE MICRO-FINE SYRINGE
OTC; QL
BD INSULIN SYRINGE SYRINGE OTC; QL
BD INSULIN SYRINGE ULT-FINE II SYRINGE
OTC; QL
BD INSULIN SYRINGE ULTRA-FINE SYRINGE
OTC; QL
BD LO-DOSE MICRO-FINE IV SYRINGE OTC; QL
BD LO-DOSE ULTRA-FINE SYRINGE OTC; QL
BD LUER-LOK SYRINGE SYRINGE OTC
BD SAFETYGLIDE SYRINGE SYRINGE OTC; QL
BD ULTRA-FINE MICRO PEN NEEDLE NEEDLE
OTC; QL
BREATHERITE MDI SPACER SPACER QL
BREATHERITE VALVED MDI CHAMBER SPACER
QL
BREATHERITE VALVED MDI SPACER SPACER
QL
CAREFINE PEN NEEDLE NEEDLE OTC; QL
CARETOUCH PEN NEEDLE NEEDLE OTC; QL
CARETOUCH TWIST LANCET OTC; QL
93
Nombre del medicamento Reference Notas
CLICKFINE NEEDLE OTC; QL
COLOR LANCETS OTC; QL
COMFORT EZ PEN NEEDLES NEEDLE OTC; QL
COMFORT EZ SYRINGE SYRINGE OTC; QL
COMPACT SPACE CHAMBER SPACER QL
COMPACT SPACE CHAMBER-LRG MASK SPACER
QL
COMPACT SPACE CHAMBER-MED MASK SPACER
QL
COMPACT SPACE CHAMBER-SM MASK SPACER
QL
DROPLET LANCING DEVICE OTC; QL
DROPLET PEN NEEDLE NEEDLE OTC; QL
DUREX AVANTI BARE REAL FEEL OTC
EASY CLICK LANCING DEVICE OTC; QL
EASY COMFORT INSULIN SYRINGE SYRINGE
OTC; QL
EASY COMFORT PEN NEEDLES NEEDLE
OTC; QL
EASY TOUCH INSULIN SAFETY SYR SYRINGE
OTC; QL
EASY TOUCH LANCETS OTC; QL
EASY TOUCH LANCING DEVICE OTC; QL
EASY TOUCH NEEDLE OTC; QL
EASY TOUCH SAFETY LANCETS OTC; QL
EASY TOUCH TWIST LANCETS OTC; QL
E-Z JECT LANCETS OTC; QL
E-Z JECT THIN LANCETS OTC; QL
FC2 FEMALE CONDOM OTC
FORA LANCING DEVICE OTC; QL
GLUCOCOM LANCETS OTC; QL
HEALTHY ACCENTS AUTOLET OTC; QL
HEALTHY ACCENTS UNIFINE PENTIP NEEDLE
OTC; QL
HEALTHY ACCENTS UNILET LANCET OTC; QL
IN-CHECK NASAL WITH MASK DEVICE OTC
IN-CHECK ORAL FLOW METER DEVICE
OTC
INCONTROL LANCING DEVICE OTC; QL
94
Nombre del medicamento Reference Notas
INCONTROL PEN NEEDLE NEEDLE OTC; QL
INCONTROL SUPER THIN LANCETS OTC; QL
INCONTROL ULTRA THIN LANCETS OTC; QL
INSUPEN NEEDLE OTC; QL
INVACARE LANCETS OTC; QL
lancets Accu-Chek FastClix OTC; QL
lancets,thin OTC; QL
lancets,ultra thin OTC; QL
lancing device Adjustable Lancing Device OTC; QL
lancing device with lancets OTC; QL
lancing device with lancets kit Accu-Chek FastClix OTC; QL
lancing system OTC; QL
LANZO LANCING DEVICE KIT OTC; QL
LITE TOUCH INSULIN PEN NEEDLES NEEDLE
OTC; QL
LITE TOUCH LANCING DEVICE OTC; QL
LITEAIRE MDI CHAMBER SPACER QL
MAXI-COMFORT INSULIN SYRINGE SYRINGE
OTC; QL
MEDLANCE PLUS LANCETS OTC; QL
MICROCHAMBER SPACER QL
MICROLET NEXT LANCING DEVICE KIT
OTC; QL
MICROSPACER SPACER QL
MINI LANCING DEVICE OTC; QL
MINI ULTRA-THIN II NEEDLE OTC; QL
MINI WRIGHT PEAK FLOW METER DEVICE
MONOJECT SAFETY SYRINGES SYRINGE
OTC
MONOJECT SYRINGE SYRINGE QL
MONOJECT ULTRA COMFORT INSULIN SYRINGE
OTC; QL
MONOLET LANCETS OTC; QL
MONOLET THIN LANCETS OTC; QL
MULTI-LANCET DEVICE 2 KIT OTC; QL
NOVOFINE 30 NEEDLE OTC; QL
ON CALL LANCING DEVICE OTC; QL
95
Nombre del medicamento Reference Notas
ON CALL PLUS LANCING DEVICE OTC; QL
ON-THE-GO LANCETS OTC; QL
OPTICHAMBER DIAMOND LG MASK SPACER
QL
OPTICHAMBER DIAMOND VHC SPACER
QL
OPTICHAMBER DIAMOND-MED MSK SPACER
QL
OPTICHAMBER DIAMOND-SML MASK SPACER
QL
PEAK AIR PEAK FLOW METER DEVICE
OTC
pen needle needle OTC; QL
pen needle, diabetic needle 1st Tier Unifine Pentips OTC; QL
PENTIPS NEEDLE OTC; QL
PERSONAL BEST FULL RANGE DEVICE
OTC
PERSONAL BEST LOW RANGE DEVICE
OTC
POCKET CHAMBER SPACER QL
POCKET PEAK FLOW METER DEVICE OTC
PRIMEAIRE SPACER QL
PRO COMFORT PEN NEEDLE NEEDLE OTC; QL
PROCHAMBER SPACER QL
RELIAMED MINI LANCING DEVICE OTC; QL
RELION NEEDLES NEEDLE OTC; QL
RELION PEN NEEDLES NEEDLE OTC; QL
RELION THIN LANCETS OTC; QL
RITEFLO AEROCHAMBER SPACER QL
SAFETY LANCETS OTC; QL
SMART SENSE LANCETS OTC; QL
STERILANCE TL OTC; QL
SUPER THIN LANCETS OTC; QL
SURE COMFORT PEN NEEDLE NEEDLE
OTC; QL
SURE-JECT INSULIN SYRINGE SYRINGE
OTC; QL
SURE-PEN LANCING DEVICE OTC; QL
TECHLITE LANCETS OTC; QL
96
Nombre del medicamento Reference Notas
TECHLITE PEN NEEDLE NEEDLE OTC; QL
TERUMO INSULIN SYRINGE SYRINGE OTC; QL
THIN LANCETS OTC; QL
THINPRO INSULIN SYRINGE SYRINGE OTC; QL
TOPCARE UNIVERSAL1 LANCET OTC; QL
TRUE METRIX AIR GLUCOSE METER OTC
TRUE METRIX LEVEL 1 SOLUTION OTC
TRUE METRIX LEVEL 2 SOLUTION OTC
TRUE METRIX LEVEL 3 SOLUTION OTC
TRUEDRAW LANCING DEVICE OTC; QL
TRUEPLUS INSULIN SYRINGE OTC; QL
TRUEPLUS LANCETS OTC; QL
TRUEPLUS PEN NEEDLE NEEDLE OTC; QL
TRUERESULT BLOOD GLUCOSE SYSTM KIT
OTC; QL
TRUZONE PEAK FLOW METER DEVICE
ULTICARE PEN NEEDLE NEEDLE OTC; QL
ULTI-LANCE OTC; QL
ULTILET PEN NEEDLE NEEDLE OTC; QL
ULTRA CMFT INS SYR HALF UNIT SYRINGE
OTC; QL
ULTRA THIN LANCETS OTC; QL
ULTRA-THIN II (SHORT) INS SYR SYRINGE
OTC; QL
ULTRA-THIN II (SHORT) PEN NDL NEEDLE
OTC; QL
ULTRA-THIN II INS PEN NEEDLES NEEDLE
OTC; QL
ULTRA-THIN II INSULIN SYRINGE SYRINGE
OTC; QL
UNIFINE PENTIPS NEEDLE OTC; QL
UNIFINE PENTIPS PLUS NEEDLE OTC; QL
UNILET COMFORTOUCH LANCET OTC; QL
UNILET LANCET OTC; QL
UNILET LANCETS OTC; QL
UNILET SUPER THIN LANCETS OTC; QL
UNISTIK 2 DEVICE KIT OTC; QL
UNISTIK 3 COMFORT DEVICE KIT OTC; QL
97
Nombre del medicamento Reference Notas
UNISTIK 3 GENTLE OTC; QL
UNISTIK 3 KIT OTC; QL
UNISTIK 3 LANCETS OTC; QL
UNISTIK 3 NEONATAL DEVICE KIT OTC; QL
UNISTIK 3 NEONATAL KIT OTC; QL
UNISTIK CZT LANCET OTC; QL
UNISTIK SAFETY OTC; QL
UNISTIK TOUCH LANCETS OTC; QL
UNIVERSAL 1 LANCETS OTC; QL
VORTEX HOLDING CHAMBER CHILD SPACER
QL
VORTEX HOLDING CHAMBER SPACER
QL
VORTEX HOLDING CHAMBER TODDLER SPACER
QL
VORTEX VHC FROG MASK-CHILD SPACER
QL
VORTEX VHC LADYBUG MASK-TODDLR SPACER
QL
TERAPIA ALTERNATIVA
TERAPIA ALTERNATIVA
OCUVITE LUTEIN AND ZEAXANTHIN ORAL CAPSULE
OTC
TERAPIA DE LA GOTA Y LA HIPERURICEMIA
AGENTES URICOSÚRICOS
probenecid oral tablet
COMBINADOS DE ALCALOIDE
probenecid-colchicine oral tablet
TERAPIA PARA HIPERURICEMIA, INHIBIDORES DE PURINA
allopurinol oral tablet Zyloprim
TERAPIA DEL TRASTORNO COGNITIVO
INHIBIDORES DE COLINESTERASA
donepezil oral tablet 10 mg, 5 mg Aricept QL
donepezil oral tablet 23 mg Aricept PA; QL
donepezil oral tablet,disintegrating QL
98
Nombre del medicamento Reference Notas
galantamine oral capsule,ext rel. pellets 24 hr
Razadyne ER
galantamine oral solution
galantamine oral tablet Razadyne QL
memantine oral solution
memantine oral tablet Namenda
memantine oral tablets,dose pack Namenda Titration Pak
NAMENDA TITRATION PAK ORAL TABLETS,DOSE PACK
rivastigmine tartrate oral capsule
TERAPIA GENITOURINARIA
ACIDULANTES URINARIOS (FOSFATOS)
k-phos-neutral oral tablet
phospha 250 neutral oral tablet
AGENTE PARA LA INCONTINENCIA/ANTIESPASMÓDICO PARA TRACTO URINARIO
darifenacin oral tablet extended release 24 hr
Enablex
flavoxate oral tablet QL
oxybutynin chloride oral syrup QL
oxybutynin chloride oral tablet
oxybutynin chloride oral tablet extended release 24hr
Ditropan XL QL
tolterodine oral capsule,extended release 24hr
Detrol LA
tolterodine oral tablet Detrol
trospium oral capsule,extended release 24hr
trospium oral tablet
AGENTES ANALGÉSICOS/ANESTÉSICOS PARA TRACTO URINARIO
phenazopyridine oral tablet Pyridium
AGENTES PARASIMPÁTICOS
bethanechol chloride oral tablet Urecholine QL
DESINTOXICANTES DE SANGRE
calcium acetate oral capsule PA
99
Nombre del medicamento Reference Notas
calcium acetate oral tablet Calphron PA
eliphos oral tablet PA
VELPHORO ORAL TABLET,CHEWABLE
PA
HIPERTROFIA PROSTÁTICA BENIGNA/AGENTES MICCIONALES
alfuzosin oral tablet extended release 24 hr
Uroxatral QL
finasteride oral tablet Proscar QL
tamsulosin oral capsule,extended release 24hr
Flomax QL
MODIFICADORES DEL PH URINARIO
cytra k crystals oral packet
cytra-2 oral solution
cytra-3 oral solution
cytra-k oral solution
potassium citrate oral tablet extended release
Urocit-K 10
potassium citrate-citric acid oral packet Cytra K Crystals
potassium citrate-citric acid oral solution Cytra-K
sodium citrate-citric acid oral solution Cytra-2
tricitrates oral solution
virtrate-k oral solution
QUIMIOTERAPÉUTICOS, ANTIBACTERIANOS, VARIOS
methenamine hippurate oral tablet Hiprex
methenamine mandelate oral tablet
nitrofurantoin macrocrystal oral capsule Macrodantin
nitrofurantoin monohyd/m-cryst oral capsule
Macrobid
QUINOLONES
ciprofloxacin (mixture) oral tablet, er multiphase 24 hr
Cipro XR
TERAPIA PARA TRASTORNOS DE LA ALIMENTACIÓN
AGENTES ESTIMULANTES DEL APETITO (PROGESTÁGENO)
megestrol oral suspension
100