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Appendix A

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JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 1

APPENDIX A - PRODUCT NAME INDEX

** A **
ABACAVIR SULFATE, ABACAVIR SULFATE
ABACAVIR SULFATE AND LAMIVUDINE, ABACAVIR SULFATE
ABACAVIR SULFATE, LAMIVUDINE AND ZIDOVUDINE, ABACAVIR SULFATE
ABELCET, AMPHOTERICIN B
ABILIFY, ARIPIPRAZOLE
ABILIFY ASIMTUFII, ARIPIPRAZOLE
ABILIFY MAINTENA KIT, ARIPIPRAZOLE
ABILIFY MYCITE KIT, ARIPIPRAZOLE
ABIRATERONE ACETATE, ABIRATERONE ACETATE
ABLYSINOL, ALCOHOL
ABRAXANE, PACLITAXEL
ABREVA, DOCOSANOL (OTC)
ABSORICA, ISOTRETINOIN
ABSORICA LD, ISOTRETINOIN
ACAMPROSATE CALCIUM, ACAMPROSATE CALCIUM
ACANYA, BENZOYL PEROXIDE
ACARBOSE, ACARBOSE
ACCOLATE, ZAFIRLUKAST
ACCRUFER, FERRIC MALTOL
ACEBUTOLOL HYDROCHLORIDE, ACEBUTOLOL HYDROCHLORIDE
ACEPHEN, ACETAMINOPHEN (OTC)
ACETADOTE, ACETYLCYSTEINE
ACETAMINOPHEN, ACETAMINOPHEN (OTC)
ACETAMINOPHEN, ACETAMINOPHEN
ACETAMINOPHEN AND CODEINE PHOSPHATE, ACETAMINOPHEN
ACETAMINOPHEN AND IBUPROFEN, ACETAMINOPHEN (OTC)
ACETAMINOPHEN, ASPIRIN AND CAFFEINE, ACETAMINOPHEN (OTC)
ACETAMINOPHEN, CAFFEINE AND DIHYDROCODEINE BITARTRATE, ACETAMINOPHEN
ACETAZOLAMIDE, ACETAZOLAMIDE
ACETAZOLAMIDE SODIUM, ACETAZOLAMIDE SODIUM
ACETIC ACID, ACETIC ACID, GLACIAL
ACETIC ACID 0.25% IN PLASTIC CONTAINER, ACETIC ACID, GLACIAL
ACETYLCYSTEINE, ACETYLCYSTEINE
ACHROMYCIN V, TETRACYCLINE HYDROCHLORIDE
ACIPHEX, RABEPRAZOLE SODIUM
ACITRETIN, ACITRETIN
ACTHAR GEL, CORTICOTROPIN
ACTICLATE, DOXYCYCLINE HYCLATE
ACTIGALL, URSODIOL
ACTIQ, FENTANYL CITRATE
ACTIVELLA, ESTRADIOL
ACTONEL, RISEDRONATE SODIUM
ACTOPLUS MET, METFORMIN HYDROCHLORIDE
ACTOS, PIOGLITAZONE HYDROCHLORIDE
ACULAR, KETOROLAC TROMETHAMINE
ACULAR LS, KETOROLAC TROMETHAMINE
ACUVAIL, KETOROLAC TROMETHAMINE
ACYCLOVIR, ACYCLOVIR
ACYCLOVIR SODIUM, ACYCLOVIR SODIUM
ACZONE, DAPSONE
ADAPALENE, ADAPALENE (OTC)
ADAPALENE, ADAPALENE
ADAPALENE AND BENZOYL PEROXIDE, ADAPALENE
ADASUVE, LOXAPINE
ADCIRCA, TADALAFIL
ADDERALL XR 10, AMPHETAMINE ASPARTATE
ADDERALL XR 15, AMPHETAMINE ASPARTATE
ADDERALL XR 20, AMPHETAMINE ASPARTATE
ADDERALL XR 25, AMPHETAMINE ASPARTATE
ADDERALL XR 30, AMPHETAMINE ASPARTATE
ADDERALL XR 5, AMPHETAMINE ASPARTATE
ADDYI, FLIBANSERIN
ADEFOVIR DIPIVOXIL, ADEFOVIR DIPIVOXIL
ADEMPAS, RIOCIGUAT
ADENOSINE, ADENOSINE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 2

APPENDIX A - PRODUCT NAME INDEX

** A **
ADIPEX-P, PHENTERMINE HYDROCHLORIDE
ADLARITY, DONEPEZIL HYDROCHLORIDE
ADRENACLICK, EPINEPHRINE
ADRENALIN, EPINEPHRINE
ADREVIEW, IOBENGUANE SULFATE I-123
ADVAIR DISKUS 100/50, FLUTICASONE PROPIONATE
ADVAIR DISKUS 250/50, FLUTICASONE PROPIONATE
ADVAIR DISKUS 500/50, FLUTICASONE PROPIONATE
ADVAIR HFA, FLUTICASONE PROPIONATE
ADVIL, IBUPROFEN (OTC)
ADVIL, IBUPROFEN SODIUM (OTC)
ADVIL ALLERGY AND CONGESTION RELIEF, CHLORPHENIRAMINE MALEATE (OTC)
ADVIL ALLERGY SINUS, CHLORPHENIRAMINE MALEATE (OTC)
ADVIL COLD AND SINUS, IBUPROFEN (OTC)
ADVIL CONGESTION RELIEF, IBUPROFEN (OTC)
ADVIL DUAL ACTION WITH ACETAMINOPHEN, ACETAMINOPHEN (OTC)
ADVIL LIQUI-GELS, IBUPROFEN (OTC)
ADVIL MIGRAINE LIQUI-GELS, IBUPROFEN (OTC)
ADVIL MULTI-SYMPTOM COLD & FLU, CHLORPHENIRAMINE MALEATE (OTC)
ADVIL PM, DIPHENHYDRAMINE CITRATE (OTC)
ADVIL PM, DIPHENHYDRAMINE HYDROCHLORIDE (OTC)
ADZENYS XR-ODT, AMPHETAMINE
AEMCOLO, RIFAMYCIN SODIUM
AFINITOR, EVEROLIMUS
AFINITOR DISPERZ, EVEROLIMUS
AFIRMELLE, ETHINYL ESTRADIOL
AGGRASTAT, TIROFIBAN HYDROCHLORIDE
AGRYLIN, ANAGRELIDE HYDROCHLORIDE
AIRDUO DIGIHALER, FLUTICASONE PROPIONATE
AIRDUO RESPICLICK, FLUTICASONE PROPIONATE
AIRSUPRA, ALBUTEROL SULFATE
AK-FLUOR 10%, FLUORESCEIN SODIUM
AK-FLUOR 25%, FLUORESCEIN SODIUM
AKLIEF, TRIFAROTENE
AKOVAZ, EPHEDRINE SULFATE
AKPENTOLATE, CYCLOPENTOLATE HYDROCHLORIDE
AKTEN, LIDOCAINE HYDROCHLORIDE
AKYNZEO, FOSNETUPITANT CHLORIDE HYDROCHLORIDE
AKYNZEO, NETUPITANT
ALA-CORT, HYDROCORTISONE
ALA-SCALP, HYDROCORTISONE
ALAVERT, LORATADINE (OTC)
ALAWAY, KETOTIFEN FUMARATE (OTC)
ALBENDAZOLE, ALBENDAZOLE
ALBUTEROL SULFATE, ALBUTEROL SULFATE
ALBUTEROL SULFATE AND IPRATROPIUM BROMIDE, ALBUTEROL SULFATE
ALCAFTADINE, ALCAFTADINE (OTC)
ALCAINE, PROPARACAINE HYDROCHLORIDE
ALCLOMETASONE DIPROPIONATE, ALCLOMETASONE DIPROPIONATE
ALDACTAZIDE, HYDROCHLOROTHIAZIDE
ALDACTONE, SPIRONOLACTONE
ALECENSA, ALECTINIB HYDROCHLORIDE
ALENDRONATE SODIUM, ALENDRONATE SODIUM
ALEVE, NAPROXEN SODIUM (OTC)
ALEVE PM, DIPHENHYDRAMINE HYDROCHLORIDE (OTC)
ALFENTA, ALFENTANIL HYDROCHLORIDE
ALFENTANIL, ALFENTANIL HYDROCHLORIDE
ALFUZOSIN HYDROCHLORIDE, ALFUZOSIN HYDROCHLORIDE
ALIMTA, PEMETREXED DISODIUM
ALINIA, NITAZOXANIDE
ALIQOPA, COPANLISIB DIHYDROCHLORIDE
ALISKIREN HEMIFUMARATE, ALISKIREN HEMIFUMARATE
ALKINDI SPRINKLE, HYDROCORTISONE
ALLEGRA ALLERGY, FEXOFENADINE HYDROCHLORIDE (OTC)
ALLEGRA HIVES, FEXOFENADINE HYDROCHLORIDE (OTC)
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 3

APPENDIX A - PRODUCT NAME INDEX

** A **
ALLEGRA-D 12 HOUR ALLERGY AND CONGESTION, FEXOFENADINE HYDROCHLORIDE (OTC)
ALLEGRA-D 24 HOUR ALLERGY AND CONGESTION, FEXOFENADINE HYDROCHLORIDE (OTC)
ALLI, ORLISTAT (OTC)
ALLOPURINOL, ALLOPURINOL
ALLOPURINOL SODIUM, ALLOPURINOL SODIUM
ALLZITAL, ACETAMINOPHEN
ALMOTRIPTAN MALATE, ALMOTRIPTAN MALATE
ALOMIDE, LODOXAMIDE TROMETHAMINE
ALOPRIM, ALLOPURINOL SODIUM
ALOSETRON HYDROCHLORIDE, ALOSETRON HYDROCHLORIDE
ALPHAGAN P, BRIMONIDINE TARTRATE
ALPRAZOLAM, ALPRAZOLAM
ALPROSTADIL, ALPROSTADIL
ALREX, LOTEPREDNOL ETABONATE
ALTABAX, RETAPAMULIN
ALTACE, RAMIPRIL
ALTAFLUOR BENOX, BENOXINATE HYDROCHLORIDE
ALTAVERA, ETHINYL ESTRADIOL
ALTOPREV, LOVASTATIN
ALTRENO, TRETINOIN
ALUNBRIG, BRIGATINIB
ALVESCO, CICLESONIDE
ALVIMOPAN, ALVIMOPAN
ALYACEN 1/35, ETHINYL ESTRADIOL
ALYACEN 7/7/7, ETHINYL ESTRADIOL
ALYQ, TADALAFIL
AMABELZ, ESTRADIOL
AMANTADINE HYDROCHLORIDE, AMANTADINE HYDROCHLORIDE
AMARYL, GLIMEPIRIDE
AMBIEN, ZOLPIDEM TARTRATE
AMBIEN CR, ZOLPIDEM TARTRATE
AMBISOME, AMPHOTERICIN B
AMBRISENTAN, AMBRISENTAN
AMCINONIDE, AMCINONIDE
AMELUZ, AMINOLEVULINIC ACID HYDROCHLORIDE
AMERGE, NARATRIPTAN HYDROCHLORIDE
AMICAR, AMINOCAPROIC ACID
AMIDATE, ETOMIDATE
AMIFOSTINE, AMIFOSTINE
AMIKACIN SULFATE, AMIKACIN SULFATE
AMILORIDE HYDROCHLORIDE, AMILORIDE HYDROCHLORIDE
AMILORIDE HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, AMILORIDE HYDROCHLORIDE
AMINO ACIDS, AMINO ACIDS
AMINOACETIC ACID 1.5% IN PLASTIC CONTAINER, GLYCINE
AMINOCAPROIC ACID, AMINOCAPROIC ACID
AMINOCAPROIC ACID IN PLASTIC CONTAINER, AMINOCAPROIC ACID
AMINOPHYLLINE, AMINOPHYLLINE
AMINOSYN II 10% IN PLASTIC CONTAINER, AMINO ACIDS
AMINOSYN II 15% IN PLASTIC CONTAINER, AMINO ACIDS
AMINOSYN-PF 10%, AMINO ACIDS
AMINOSYN-PF 7%, AMINO ACIDS
AMIODARONE HYDROCHLORIDE, AMIODARONE HYDROCHLORIDE
AMITIZA, LUBIPROSTONE
AMITRIPTYLINE HYDROCHLORIDE, AMITRIPTYLINE HYDROCHLORIDE
AMLODIPINE AND OLMESARTAN MEDOXOMIL, AMLODIPINE BESYLATE
AMLODIPINE BESYLATE, AMLODIPINE BESYLATE
AMLODIPINE BESYLATE AND ATORVASTATIN CALCIUM, AMLODIPINE BESYLATE
AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE, AMLODIPINE BESYLATE
AMLODIPINE BESYLATE AND VALSARTAN, AMLODIPINE BESYLATE
AMLODIPINE BESYLATE, VALSARTAN AND HYDROCHLOROTHIAZIDE, AMLODIPINE BESYLATE
AMMONIA N 13, AMMONIA N-13
AMMONIUM CHLORIDE IN PLASTIC CONTAINER, AMMONIUM CHLORIDE
AMMONIUM LACTATE, AMMONIUM LACTATE
AMMONUL, SODIUM BENZOATE
AMNESTEEM, ISOTRETINOIN
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 4

APPENDIX A - PRODUCT NAME INDEX

** A **
AMONDYS 45, CASIMERSEN
AMOXAPINE, AMOXAPINE
AMOXICILLIN, AMOXICILLIN
AMOXICILLIN AND CLAVULANATE POTASSIUM, AMOXICILLIN
AMOXICILLIN PEDIATRIC, AMOXICILLIN
AMOXIL, AMOXICILLIN
AMPHETAMINE, AMPHETAMINE
AMPHETAMINE SULFATE, AMPHETAMINE SULFATE
AMPHOTERICIN B, AMPHOTERICIN B
AMPICILLIN AND SULBACTAM, AMPICILLIN SODIUM
AMPICILLIN SODIUM, AMPICILLIN SODIUM
AMPICILLIN TRIHYDRATE, AMPICILLIN/AMPICILLIN TRIHYDRATE
AMPYRA, DALFAMPRIDINE
AMRINONE LACTATE, INAMRINONE LACTATE
AMRIX, CYCLOBENZAPRINE HYDROCHLORIDE
AMVUTTRA, VUTRISIRAN SODIUM
AMYVID, FLORBETAPIR F-18
AMZEEQ, MINOCYCLINE HYDROCHLORIDE
AN-SULFUR COLLOID, TECHNETIUM TC-99M SULFUR COLLOID KIT
ANAFRANIL, CLOMIPRAMINE HYDROCHLORIDE
ANAGRELIDE HYDROCHLORIDE, ANAGRELIDE HYDROCHLORIDE
ANAPROX DS, NAPROXEN SODIUM
ANASTROZOLE, ANASTROZOLE
ANCEF IN PLASTIC CONTAINER, CEFAZOLIN SODIUM
ANCOBON, FLUCYTOSINE
ANDROGEL, TESTOSTERONE
ANDROID 25, METHYLTESTOSTERONE
ANECTINE, SUCCINYLCHOLINE CHLORIDE
ANEXSIA 5/325, ACETAMINOPHEN
ANEXSIA 7.5/325, ACETAMINOPHEN
ANGELIQ, DROSPIRENONE
ANGIOMAX, BIVALIRUDIN
ANGIOMAX RTU, BIVALIRUDIN
ANNOVERA, ETHINYL ESTRADIOL
ANORO ELLIPTA, UMECLIDINIUM BROMIDE
ANTARA (MICRONIZED), FENOFIBRATE
ANTHELIOS 20, AVOBENZONE (OTC)
ANTHELIOS 40, AVOBENZONE (OTC)
ANTHELIOS SX, AVOBENZONE (OTC)
ANTIVERT, MECLIZINE HYDROCHLORIDE
ANUSOL HC, HYDROCORTISONE
ANZEMET, DOLASETRON MESYLATE
APIXABAN, APIXABAN
APLENZIN, BUPROPION HYDROBROMIDE
APOKYN, APOMORPHINE HYDROCHLORIDE
APOMORPHINE HYDROCHLORIDE, APOMORPHINE HYDROCHLORIDE
APONVIE, APREPITANT
APRACLONIDINE HYDROCHLORIDE, APRACLONIDINE HYDROCHLORIDE
APREMILAST, APREMILAST
APREPITANT, APREPITANT
APRETUDE, CABOTEGRAVIR
APRISO, MESALAMINE
APTENSIO XR, METHYLPHENIDATE HYDROCHLORIDE
APTIOM, ESLICARBAZEPINE ACETATE
APTIVUS, TIPRANAVIR
AQUASOL A, VITAMIN A PALMITATE
ARAKODA, TAFENOQUINE SUCCINATE
ARANELLE, ETHINYL ESTRADIOL
ARAVA, LEFLUNOMIDE
ARAZLO, TAZAROTENE
ARESTIN, MINOCYCLINE HYDROCHLORIDE
ARFORMOTEROL TARTRATE, ARFORMOTEROL TARTRATE
ARGATROBAN, ARGATROBAN
ARGATROBAN IN SODIUM CHLORIDE, ARGATROBAN
ARICEPT, DONEPEZIL HYDROCHLORIDE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 5

APPENDIX A - PRODUCT NAME INDEX

** A **
ARIDOL KIT, MANNITOL
ARIKAYCE KIT, AMIKACIN SULFATE
ARIMIDEX, ANASTROZOLE
ARIPIPRAZOLE, ARIPIPRAZOLE
ARISTADA, ARIPIPRAZOLE LAUROXIL
ARISTADA INITIO KIT, ARIPIPRAZOLE LAUROXIL
ARIXTRA, FONDAPARINUX SODIUM
ARMODAFINIL, ARMODAFINIL
ARMONAIR DIGIHALER, FLUTICASONE PROPIONATE
ARNUITY ELLIPTA, FLUTICASONE FUROATE
AROMASIN, EXEMESTANE
ARRANON, NELARABINE
ARSENIC TRIOXIDE, ARSENIC TRIOXIDE
ARTESUNATE, ARTESUNATE
ARTHROTEC, DICLOFENAC SODIUM
ASCLERA, POLIDOCANOL
ASCOR, ASCORBIC ACID
ASENAPINE MALEATE, ASENAPINE MALEATE
ASHLYNA, ETHINYL ESTRADIOL
ASMANEX HFA, MOMETASONE FUROATE
ASMANEX TWISTHALER, MOMETASONE FUROATE
ASPIRIN AND DIPYRIDAMOLE, ASPIRIN
ASPRUZYO SPRINKLE, RANOLAZINE
ASTAGRAF XL, TACROLIMUS
ASTEPRO ALLERGY, AZELASTINE HYDROCHLORIDE (OTC)
ATACAND, CANDESARTAN CILEXETIL
ATACAND HCT, CANDESARTAN CILEXETIL
ATAZANAVIR SULFATE, ATAZANAVIR SULFATE
ATELVIA, RISEDRONATE SODIUM
ATENOLOL, ATENOLOL
ATENOLOL AND CHLORTHALIDONE, ATENOLOL
ATHENTIA NEXT, LEVONORGESTREL (OTC)
ATIVAN, LORAZEPAM
ATOMOXETINE HYDROCHLORIDE, ATOMOXETINE HYDROCHLORIDE
ATORVALIQ, ATORVASTATIN CALCIUM
ATORVASTATIN CALCIUM, ATORVASTATIN CALCIUM
ATOVAQUONE, ATOVAQUONE
ATOVAQUONE AND PROGUANIL HYDROCHLORIDE, ATOVAQUONE
ATRACURIUM BESYLATE, ATRACURIUM BESYLATE
ATRACURIUM BESYLATE PRESERVATIVE FREE, ATRACURIUM BESYLATE
ATRALIN, TRETINOIN
ATRIPLA, EFAVIRENZ
ATROPINE SULFATE, ATROPINE SULFATE
ATROVENT HFA, IPRATROPIUM BROMIDE
AUBAGIO, TERIFLUNOMIDE
AUGMENTIN '125', AMOXICILLIN
AUGMENTIN '250', AMOXICILLIN
AUGMENTIN '875', AMOXICILLIN
AUGMENTIN ES-600, AMOXICILLIN
AUROVELA 1.5/30, ETHINYL ESTRADIOL
AUROVELA 1/20, ETHINYL ESTRADIOL
AUROVELA 24 FE, ETHINYL ESTRADIOL
AUROVELA FE 1.5/30, ETHINYL ESTRADIOL
AUROVELA FE 1/20, ETHINYL ESTRADIOL
AURYXIA, FERRIC CITRATE
AUSTEDO, DEUTETRABENAZINE
AUSTEDO XR, DEUTETRABENAZINE
AUVELITY, BUPROPION HYDROCHLORIDE
AUVI-Q, EPINEPHRINE
AVAGARD, ALCOHOL (OTC)
AVAGE, TAZAROTENE
AVALIDE, HYDROCHLOROTHIAZIDE
AVAPRO, IRBESARTAN
AVEED, TESTOSTERONE UNDECANOATE
AVIANE-28, ETHINYL ESTRADIOL
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 6

APPENDIX A - PRODUCT NAME INDEX

** A **
AVITA, TRETINOIN
AVODART, DUTASTERIDE
AVYCAZ, AVIBACTAM SODIUM
AXID AR, NIZATIDINE (OTC)
AXUMIN, FLUCICLOVINE F-18
AYUNA, ETHINYL ESTRADIOL
AYVAKIT, AVAPRITINIB
AZACITIDINE, AZACITIDINE
AZACTAM, AZTREONAM
AZASAN, AZATHIOPRINE
AZASITE, AZITHROMYCIN
AZATHIOPRINE, AZATHIOPRINE
AZATHIOPRINE SODIUM, AZATHIOPRINE SODIUM
AZEDRA, IOBENGUANE I-131
AZELAIC ACID, AZELAIC ACID
AZELASTINE HYDROCHLORIDE, AZELASTINE HYDROCHLORIDE
AZELASTINE HYDROCHLORIDE AND FLUTICASONE PROPIONATE, AZELASTINE HYDROCHLORIDE
AZELEX, AZELAIC ACID
AZILECT, RASAGILINE MESYLATE
AZITHROMYCIN, AZITHROMYCIN
AZOPT, BRINZOLAMIDE
AZOR, AMLODIPINE BESYLATE
AZSTARYS, DEXMETHYLPHENIDATE HYDROCHLORIDE
AZTREONAM, AZTREONAM
AZULFIDINE, SULFASALAZINE
AZULFIDINE EN-TABS, SULFASALAZINE
** B **
BACITRACIN, BACITRACIN
BACITRACIN ZINC AND POLYMYXIN B SULFATE, BACITRACIN ZINC
BACITRACIN-NEOMYCIN-POLYMYXIN W/ HYDROCORTISONE ACETATE, BACITRACIN ZINC
BACLOFEN, BACLOFEN
BACTERIOSTATIC SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, SODIUM CHLORIDE
BACTERIOSTATIC WATER FOR INJECTION IN PLASTIC CONTAINER, STERILE WATER FOR INJECTION
BACTOCILL IN PLASTIC CONTAINER, OXACILLIN SODIUM
BACTRIM, SULFAMETHOXAZOLE
BACTRIM DS, SULFAMETHOXAZOLE
BAFIERTAM, MONOMETHYL FUMARATE
BAL, DIMERCAPROL
BALANCED SALT, CALCIUM CHLORIDE
BALCOLTRA, ETHINYL ESTRADIOL
BALSALAZIDE DISODIUM, BALSALAZIDE DISODIUM
BALVERSA, ERDAFITINIB
BALZIVA-28, ETHINYL ESTRADIOL
BANZEL, RUFINAMIDE
BAQSIMI, GLUCAGON
BARACLUDE, ENTECAVIR
BARHEMSYS, AMISULPRIDE
BAXDELA, DELAFLOXACIN MEGLUMINE
BECONASE AQ, BECLOMETHASONE DIPROPIONATE MONOHYDRATE
BEKYREE, DESOGESTREL
BELBUCA, BUPRENORPHINE HYDROCHLORIDE
BELEODAQ, BELINOSTAT
BELRAPZO, BENDAMUSTINE HYDROCHLORIDE
BELSOMRA, SUVOREXANT
BENAZEPRIL HYDROCHLORIDE, BENAZEPRIL HYDROCHLORIDE
BENAZEPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, BENAZEPRIL HYDROCHLORIDE
BENDAMUSTINE HYDROCHLORIDE, BENDAMUSTINE HYDROCHLORIDE
BENDEKA, BENDAMUSTINE HYDROCHLORIDE
BENICAR, OLMESARTAN MEDOXOMIL
BENICAR HCT, HYDROCHLOROTHIAZIDE
BENTYL, DICYCLOMINE HYDROCHLORIDE
BENTYL PRESERVATIVE FREE, DICYCLOMINE HYDROCHLORIDE
BENZAMYCIN, BENZOYL PEROXIDE
BENZNIDAZOLE, BENZNIDAZOLE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 7

APPENDIX A - PRODUCT NAME INDEX

** B **
BENZONATATE, BENZONATATE
BENZPHETAMINE HYDROCHLORIDE, BENZPHETAMINE HYDROCHLORIDE
BENZTROPINE MESYLATE, BENZTROPINE MESYLATE
BEPOTASTINE BESILATE, BEPOTASTINE BESILATE
BEPREVE, BEPOTASTINE BESILATE
BESIVANCE, BESIFLOXACIN HYDROCHLORIDE
BETA-VAL, BETAMETHASONE VALERATE
BETADINE, POVIDONE-IODINE
BETAGAN, LEVOBUNOLOL HYDROCHLORIDE
BETAINE, BETAINE
BETAMETHASONE ACETATE AND BETAMETHASONE SODIUM PHOSPHATE, BETAMETHASONE ACETATE
BETAMETHASONE DIPROPIONATE, BETAMETHASONE DIPROPIONATE
BETAMETHASONE VALERATE, BETAMETHASONE VALERATE
BETAPACE, SOTALOL HYDROCHLORIDE
BETAPACE AF, SOTALOL HYDROCHLORIDE
BETAXOLOL HYDROCHLORIDE, BETAXOLOL HYDROCHLORIDE
BETHANECHOL CHLORIDE, BETHANECHOL CHLORIDE
BETHKIS, TOBRAMYCIN
BETIMOL, TIMOLOL
BETOPTIC, BETAXOLOL HYDROCHLORIDE
BETOPTIC S, BETAXOLOL HYDROCHLORIDE
BEVESPI AEROSPHERE, FORMOTEROL FUMARATE
BEXAROTENE, BEXAROTENE
BEYAZ, DROSPIRENONE
BICALUTAMIDE, BICALUTAMIDE
BICILLIN C-R, PENICILLIN G BENZATHINE
BICILLIN C-R 900/300, PENICILLIN G BENZATHINE
BICILLIN L-A, PENICILLIN G BENZATHINE
BICNU, CARMUSTINE
BIDIL, HYDRALAZINE HYDROCHLORIDE
BIJUVA, ESTRADIOL
BIKTARVY, BICTEGRAVIR SODIUM
BILTRICIDE, PRAZIQUANTEL
BIMATOPROST, BIMATOPROST
BINOSTO, ALENDRONATE SODIUM
BIORPHEN, PHENYLEPHRINE HYDROCHLORIDE
BIOSCRUB, CHLORHEXIDINE GLUCONATE (OTC)
BISMUTH SUBCITRATE POTASSIUM, METRONIDAZOLE AND TETRACYCLINE HYDROCHLORIDE, BISMUTH
BISMUTH SUBSALICYLATE, METRONIDAZOLE AND TETRACYCLINE HYDROCHLORIDE, BISMUTH SUBSALICYLATE
BISOPROLOL FUMARATE, BISOPROLOL FUMARATE
BISOPROLOL FUMARATE AND HYDROCHLOROTHIAZIDE, BISOPROLOL FUMARATE
BIVALIRUDIN, BIVALIRUDIN
BLEOMYCIN SULFATE, BLEOMYCIN SULFATE
BLEPH-10, SULFACETAMIDE SODIUM
BLISOVI 24 FE, ETHINYL ESTRADIOL
BLISOVI FE 1.5/30, ETHINYL ESTRADIOL
BLISOVI FE 1/20, ETHINYL ESTRADIOL
BLOXIVERZ, NEOSTIGMINE METHYLSULFATE
BLUDIGO, INDIGOTINDISULFONATE SODIUM
BONJESTA, DOXYLAMINE SUCCINATE
BONSITY, TERIPARATIDE
BONTRIL PDM, PHENDIMETRAZINE TARTRATE
BORTEZOMIB, BORTEZOMIB
BOSENTAN, BOSENTAN
BOSULIF, BOSUTINIB MONOHYDRATE
BRAFTOVI, ENCORAFENIB
BRENZAVVY, BEXAGLIFLOZIN
BREO ELLIPTA, FLUTICASONE FUROATE
BRETHINE, TERBUTALINE SULFATE
BREVIBLOC, ESMOLOL HYDROCHLORIDE
BREVIBLOC DOUBLE STRENGTH IN PLASTIC CONTAINER, ESMOLOL HYDROCHLORIDE
BREVIBLOC IN PLASTIC CONTAINER, ESMOLOL HYDROCHLORIDE
BREVITAL SODIUM, METHOHEXITAL SODIUM
BREXAFEMME, IBREXAFUNGERP CITRATE
BREXPIPRAZOLE, BREXPIPRAZOLE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 8

APPENDIX A - PRODUCT NAME INDEX

** B **
BREYNA, BUDESONIDE
BREZTRI AEROSPHERE, BUDESONIDE
BRIDION, SUGAMMADEX SODIUM
BRIELLYN, ETHINYL ESTRADIOL
BRILINTA, TICAGRELOR
BRIMONIDINE TARTRATE, BRIMONIDINE TARTRATE
BRIMONIDINE TARTRATE AND TIMOLOL MALEATE, BRIMONIDINE TARTRATE
BRINZOLAMIDE, BRINZOLAMIDE
BRISDELLE, PAROXETINE MESYLATE
BRIVIACT, BRIVARACETAM
BRIXADI, BUPRENORPHINE
BROMFED-DM, BROMPHENIRAMINE MALEATE
BROMFENAC SODIUM, BROMFENAC SODIUM
BROMOCRIPTINE MESYLATE, BROMOCRIPTINE MESYLATE
BROMPHENIRAMINE MALEATE, PSEUDOEPHEDRINE HYDROCHLORIDE AND DEXTROMETHORPHAN HYDROBROMIDE,
BROMSITE, BROMFENAC SODIUM
BRONCHITOL, MANNITOL
BROVANA, ARFORMOTEROL TARTRATE
BRUKINSA, ZANUBRUTINIB
BRYHALI, HALOBETASOL PROPIONATE
BSS, CALCIUM CHLORIDE
BSS PLUS, CALCIUM CHLORIDE
BUDESONIDE, BUDESONIDE (OTC)
BUDESONIDE, BUDESONIDE
BUMETANIDE, BUMETANIDE
BUMEX, BUMETANIDE
BUPHENYL, SODIUM PHENYLBUTYRATE
BUPIVACAINE HYDROCHLORIDE, BUPIVACAINE HYDROCHLORIDE
BUPIVACAINE HYDROCHLORIDE AND EPINEPHRINE, BUPIVACAINE HYDROCHLORIDE
BUPIVACAINE HYDROCHLORIDE PRESERVATIVE FREE, BUPIVACAINE HYDROCHLORIDE
BUPRENEX, BUPRENORPHINE HYDROCHLORIDE
BUPRENORPHINE, BUPRENORPHINE
BUPRENORPHINE HYDROCHLORIDE, BUPRENORPHINE HYDROCHLORIDE
BUPRENORPHINE HYDROCHLORIDE AND NALOXONE HYDROCHLORIDE, BUPRENORPHINE HYDROCHLORIDE
BUPROPION HYDROCHLORIDE, BUPROPION HYDROCHLORIDE
BUSPIRONE HYDROCHLORIDE, BUSPIRONE HYDROCHLORIDE
BUSULFAN, BUSULFAN
BUSULFEX, BUSULFAN
BUTALBITAL AND ACETAMINOPHEN, ACETAMINOPHEN
BUTALBITAL, ACETAMINOPHEN AND CAFFEINE, ACETAMINOPHEN
BUTALBITAL, ACETAMINOPHEN, CAFFEINE AND CODEINE PHOSPHATE, ACETAMINOPHEN
BUTALBITAL, ASPIRIN AND CAFFEINE, ASPIRIN
BUTALBITAL, ASPIRIN, CAFFEINE, AND CODEINE PHOSPHATE, ASPIRIN
BUTAPAP, ACETAMINOPHEN
BUTENAFINE HYDROCHLORIDE, BUTENAFINE HYDROCHLORIDE (OTC)
BUTORPHANOL TARTRATE, BUTORPHANOL TARTRATE
BUTORPHANOL TARTRATE PRESERVATIVE FREE, BUTORPHANOL TARTRATE
BUTRANS, BUPRENORPHINE
BYDUREON BCISE, EXENATIDE SYNTHETIC
BYETTA, EXENATIDE SYNTHETIC
BYFAVO, REMIMAZOLAM BESYLATE
BYLVAY, ODEVIXIBAT
BYSTOLIC, NEBIVOLOL HYDROCHLORIDE
** C **
CABAZITAXEL, CABAZITAXEL
CABENUVA KIT, CABOTEGRAVIR
CABERGOLINE, CABERGOLINE
CABOMETYX, CABOZANTINIB S-MALATE
CADUET, AMLODIPINE BESYLATE
CAFCIT, CAFFEINE CITRATE
CAFFEINE CITRATE, CAFFEINE CITRATE
CALCIPOTRIENE, CALCIPOTRIENE
CALCIPOTRIENE AND BETAMETHASONE DIPROPIONATE, BETAMETHASONE DIPROPIONATE
CALCIPOTRIENE AND BETHAMETHASONE DIPROPIONATE, BETAMETHASONE DIPROPIONATE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 9

APPENDIX A - PRODUCT NAME INDEX

** C **
CALCITONIN-SALMON, CALCITONIN SALMON
CALCITRIOL, CALCITRIOL
CALCIUM ACETATE, CALCIUM ACETATE
CALCIUM CHLORIDE 10%, CALCIUM CHLORIDE
CALCIUM CHLORIDE 10% IN PLASTIC CONTAINER, CALCIUM CHLORIDE
CALCIUM GLUCONATE, CALCIUM GLUCONATE
CALCIUM GLUCONATE IN SODIUM CHLORIDE, CALCIUM GLUCONATE
CALDOLOR, IBUPROFEN
CALQUENCE, ACALABRUTINIB
CALQUENCE, ACALABRUTINIB MALEATE
CAMBIA, DICLOFENAC POTASSIUM
CAMCEVI KIT, LEUPROLIDE MESYLATE
CAMILA, NORETHINDRONE
CAMPTOSAR, IRINOTECAN HYDROCHLORIDE
CAMZYOS, MAVACAMTEN
CANASA, MESALAMINE
CANCIDAS, CASPOFUNGIN ACETATE
CANDESARTAN CILEXETIL, CANDESARTAN CILEXETIL
CANDESARTAN CILEXETIL AND HYDROCHLOROTHIAZIDE, CANDESARTAN CILEXETIL
CAPECITABINE, CAPECITABINE
CAPEX, FLUOCINOLONE ACETONIDE
CAPITAL SOLEIL 15, AVOBENZONE (OTC)
CAPLYTA, LUMATEPERONE TOSYLATE
CAPRELSA, VANDETANIB
CAPTOPRIL, CAPTOPRIL
CAPTOPRIL AND HYDROCHLOROTHIAZIDE, CAPTOPRIL
CARAC, FLUOROURACIL
CARAFATE, SUCRALFATE
CARBAGLU, CARGLUMIC ACID
CARBAMAZEPINE, CARBAMAZEPINE
CARBATROL, CARBAMAZEPINE
CARBIDOPA, CARBIDOPA
CARBIDOPA AND LEVODOPA, CARBIDOPA
CARBIDOPA, LEVODOPA AND ENTACAPONE, CARBIDOPA
CARBINOXAMINE MALEATE, CARBINOXAMINE MALEATE
CARBOCAINE, MEPIVACAINE HYDROCHLORIDE
CARBOPLATIN, CARBOPLATIN
CARBOPROST TROMETHAMINE, CARBOPROST TROMETHAMINE
CARDENE IN 0.83% SODIUM CHLORIDE IN PLASTIC CONTAINER, NICARDIPINE HYDROCHLORIDE
CARDENE IN 0.86% SODIUM CHLORIDE IN PLASTIC CONTAINER, NICARDIPINE HYDROCHLORIDE
CARDENE IN 4.8% DEXTROSE IN PLASTIC CONTAINER, NICARDIPINE HYDROCHLORIDE
CARDIOGEN-82, RUBIDIUM CHLORIDE RB-82
CARDIOLITE, TECHNETIUM TC-99M SESTAMIBI KIT
CARDIOPLEGIC IN PLASTIC CONTAINER, CALCIUM CHLORIDE
CARDIZEM, DILTIAZEM HYDROCHLORIDE
CARDIZEM CD, DILTIAZEM HYDROCHLORIDE
CARDIZEM LA, DILTIAZEM HYDROCHLORIDE
CARDURA, DOXAZOSIN MESYLATE
CARDURA XL, DOXAZOSIN MESYLATE
CARFILZOMIB, CARFILZOMIB
CARGLUMIC ACID, CARGLUMIC ACID
CARISOPRODOL, CARISOPRODOL
CARMUSTINE, CARMUSTINE
CARNITOR, LEVOCARNITINE
CARNITOR SF, LEVOCARNITINE
CAROSPIR, SPIRONOLACTONE
CARTEOLOL HYDROCHLORIDE, CARTEOLOL HYDROCHLORIDE
CARTIA XT, DILTIAZEM HYDROCHLORIDE
CARVEDILOL, CARVEDILOL
CARVEDILOL PHOSPHATE, CARVEDILOL PHOSPHATE
CASODEX, BICALUTAMIDE
CASPOFUNGIN ACETATE, CASPOFUNGIN ACETATE
CASPORYN HC, HYDROCORTISONE
CATAFLAM, DICLOFENAC POTASSIUM
CATAPRES-TTS-1, CLONIDINE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 10

APPENDIX A - PRODUCT NAME INDEX

** C **
CATAPRES-TTS-2, CLONIDINE
CATAPRES-TTS-3, CLONIDINE
CAVERJECT, ALPROSTADIL
CAVERJECT IMPULSE, ALPROSTADIL
CAYSTON, AZTREONAM
CEFACLOR, CEFACLOR
CEFADROXIL, CEFADROXIL/CEFADROXIL HEMIHYDRATE
CEFAZOLIN AND DEXTROSE, CEFAZOLIN SODIUM
CEFAZOLIN IN PLASTIC CONTAINER, CEFAZOLIN SODIUM
CEFAZOLIN SODIUM, CEFAZOLIN SODIUM
CEFDINIR, CEFDINIR
CEFEPIME AND DEXTROSE IN DUPLEX CONTAINER, CEFEPIME HYDROCHLORIDE
CEFEPIME HYDROCHLORIDE, CEFEPIME HYDROCHLORIDE
CEFEPIME HYDROCHLORIDE IN PLASTIC CONTAINER, CEFEPIME HYDROCHLORIDE
CEFEPIME IN PLASTIC CONTAINER, CEFEPIME HYDROCHLORIDE
CEFIXIME, CEFIXIME
CEFOTETAN, CEFOTETAN DISODIUM
CEFOXITIN, CEFOXITIN SODIUM
CEFOXITIN AND DEXTROSE IN DUPLEX CONTAINER, CEFOXITIN SODIUM
CEFOXITIN IN PLASTIC CONTAINER, CEFOXITIN SODIUM
CEFPODOXIME PROXETIL, CEFPODOXIME PROXETIL
CEFPROZIL, CEFPROZIL
CEFTAZIDIME, CEFTAZIDIME
CEFTRIAXONE, CEFTRIAXONE SODIUM
CEFTRIAXONE AND DEXTROSE IN DUPLEX CONTAINER, CEFTRIAXONE SODIUM
CEFTRIAXONE IN PLASTIC CONTAINER, CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM, CEFTRIAXONE SODIUM
CEFUROXIME AXETIL, CEFUROXIME AXETIL
CEFUROXIME SODIUM, CEFUROXIME SODIUM
CELEBREX, CELECOXIB
CELECOXIB, CELECOXIB
CELESTONE SOLUSPAN, BETAMETHASONE ACETATE
CELEXA, CITALOPRAM HYDROBROMIDE
CELLCEPT, MYCOPHENOLATE MOFETIL
CELLCEPT, MYCOPHENOLATE MOFETIL HYDROCHLORIDE
CELONTIN, METHSUXIMIDE
CENTANY, MUPIROCIN
CEPHALEXIN, CEPHALEXIN
CEQUA, CYCLOSPORINE
CERDELGA, ELIGLUSTAT TARTRATE
CEREBYX, FOSPHENYTOIN SODIUM
CERETEC, TECHNETIUM TC-99M EXAMETAZIME KIT
CERIANNA, FLUOROESTRADIOL F-18
CERUBIDINE, DAUNORUBICIN HYDROCHLORIDE
CERVIDIL, DINOPROSTONE
CESAMET, NABILONE
CETIRIZINE HYDROCHLORIDE, CETIRIZINE HYDROCHLORIDE (OTC)
CETIRIZINE HYDROCHLORIDE, CETIRIZINE HYDROCHLORIDE
CETIRIZINE HYDROCHLORIDE ALLERGY, CETIRIZINE HYDROCHLORIDE (OTC)
CETIRIZINE HYDROCHLORIDE AND PSEUDOEPHEDRINE HYDROCHLORIDE, CETIRIZINE HYDROCHLORIDE
CETIRIZINE HYDROCHLORIDE HIVES, CETIRIZINE HYDROCHLORIDE (OTC)
CETIRIZINE HYDROCHLORIDE HIVES RELIEF, CETIRIZINE HYDROCHLORIDE (OTC)
CETRAXAL, CIPROFLOXACIN HYDROCHLORIDE
CETRORELIX ACETATE, CETRORELIX ACETATE
CETROTIDE, CETRORELIX ACETATE
CEVIMELINE HYDROCHLORIDE, CEVIMELINE HYDROCHLORIDE
CHABELINA FE, ETHINYL ESTRADIOL
CHEMET, SUCCIMER
CHENODIOL, CHENODIOL
CHG SCRUB, CHLORHEXIDINE GLUCONATE (OTC)
CHILDREN'S ADVIL, IBUPROFEN (OTC)
CHILDREN'S ADVIL ALLERGY SINUS, CHLORPHENIRAMINE MALEATE (OTC)
CHILDREN'S ADVIL COLD, IBUPROFEN (OTC)
CHILDREN'S ADVIL-FLAVORED, IBUPROFEN (OTC)
CHILDREN'S ALAWAY, KETOTIFEN FUMARATE (OTC)
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 11

APPENDIX A - PRODUCT NAME INDEX

** C **
CHILDREN'S ALLEGRA ALLERGY, FEXOFENADINE HYDROCHLORIDE (OTC)
CHILDREN'S ASTEPRO ALLERGY, AZELASTINE HYDROCHLORIDE (OTC)
CHILDREN'S CETIRIZINE HYDROCHLORIDE ALLERGY, CETIRIZINE HYDROCHLORIDE (OTC)
CHILDREN'S CETIRIZINE HYDROCHLORIDE HIVES RELIEF, CETIRIZINE HYDROCHLORIDE (OTC)
CHILDREN'S CLARITIN, LORATADINE (OTC)
CHILDREN'S FEXOFENADINE HYDROCHLORIDE ALLERGY, FEXOFENADINE HYDROCHLORIDE (OTC)
CHILDREN'S FEXOFENADINE HYDROCHLORIDE HIVES, FEXOFENADINE HYDROCHLORIDE (OTC)
CHILDREN'S IBUPROFEN, IBUPROFEN (OTC)
CHILDREN'S MOTRIN, IBUPROFEN (OTC)
CHILDREN'S MOTRIN COLD, IBUPROFEN (OTC)
CHILDREN'S ZYRTEC ALLERGY, CETIRIZINE HYDROCHLORIDE (OTC)
CHILDREN'S ZYRTEC HIVES RELIEF, CETIRIZINE HYDROCHLORIDE (OTC)
CHIRHOSTIM, SECRETIN SYNTHETIC HUMAN
CHLORAMPHENICOL SODIUM SUCCINATE, CHLORAMPHENICOL SODIUM SUCCINATE
CHLORAPREP ONE-STEP, CHLORHEXIDINE GLUCONATE (OTC)
CHLORAPREP ONE-STEP FREPP, CHLORHEXIDINE GLUCONATE (OTC)
CHLORAPREP ONE-STEP SEPP, CHLORHEXIDINE GLUCONATE (OTC)
CHLORAPREP SINGLE SWABSTICK, CHLORHEXIDINE GLUCONATE (OTC)
CHLORAPREP TRIPLE SWABSTICK, CHLORHEXIDINE GLUCONATE (OTC)
CHLORAPREP WITH TINT, CHLORHEXIDINE GLUCONATE (OTC)
CHLORDIAZEPOXIDE AND AMITRIPTYLINE HYDROCHLORIDE, AMITRIPTYLINE HYDROCHLORIDE
CHLORDIAZEPOXIDE HYDROCHLORIDE, CHLORDIAZEPOXIDE HYDROCHLORIDE
CHLORDIAZEPOXIDE HYDROCHLORIDE AND CLIDINIUM BROMIDE, CHLORDIAZEPOXIDE HYDROCHLORIDE
CHLORHEXIDINE GLUCONATE, CHLORHEXIDINE GLUCONATE (OTC)
CHLORHEXIDINE GLUCONATE, CHLORHEXIDINE GLUCONATE
CHLOROPROCAINE HYDROCHLORIDE, CHLOROPROCAINE HYDROCHLORIDE
CHLOROQUINE PHOSPHATE, CHLOROQUINE PHOSPHATE
CHLOROTHIAZIDE SODIUM, CHLOROTHIAZIDE SODIUM
CHLORPHENIRAMINE MALEATE, CHLORPHENIRAMINE MALEATE (OTC)
CHLORPROMAZINE HYDROCHLORIDE, CHLORPROMAZINE HYDROCHLORIDE
CHLORTHALIDONE, CHLORTHALIDONE
CHLORZOXAZONE, CHLORZOXAZONE
CHOLBAM, CHOLIC ACID
CHOLESTYRAMINE, CHOLESTYRAMINE
CHOLESTYRAMINE LIGHT, CHOLESTYRAMINE
CHOLETEC, TECHNETIUM TC-99M MEBROFENIN KIT
CHOLINE C-11, CHOLINE C-11
CHROMIC CHLORIDE IN PLASTIC CONTAINER, CHROMIC CHLORIDE
CIALIS, TADALAFIL
CIBINQO, ABROCITINIB
CICLOPIROX, CICLOPIROX
CIDA-STAT, CHLORHEXIDINE GLUCONATE (OTC)
CIDOFOVIR, CIDOFOVIR
CILOSTAZOL, CILOSTAZOL
CILOXAN, CIPROFLOXACIN HYDROCHLORIDE
CIMDUO, LAMIVUDINE
CIMETIDINE, CIMETIDINE (OTC)
CIMETIDINE, CIMETIDINE
CIMETIDINE HYDROCHLORIDE, CIMETIDINE HYDROCHLORIDE
CINACALCET HYDROCHLORIDE, CINACALCET HYDROCHLORIDE
CINVANTI, APREPITANT
CIPRO, CIPROFLOXACIN
CIPRO, CIPROFLOXACIN HYDROCHLORIDE
CIPRO HC, CIPROFLOXACIN HYDROCHLORIDE
CIPRODEX, CIPROFLOXACIN
CIPROFLOXACIN, CIPROFLOXACIN
CIPROFLOXACIN AND DEXAMETHASONE, CIPROFLOXACIN
CIPROFLOXACIN EXTENDED RELEASE, CIPROFLOXACIN
CIPROFLOXACIN HYDROCHLORIDE, CIPROFLOXACIN HYDROCHLORIDE
CIPROFLOXACIN IN DEXTROSE 5% IN PLASTIC CONTAINER, CIPROFLOXACIN
CIS-MDP, TECHNETIUM TC-99M MEDRONATE KIT
CIS-PYRO, TECHNETIUM TC-99M PYROPHOSPHATE KIT
CISATRACURIUM BESYLATE, CISATRACURIUM BESYLATE
CISATRACURIUM BESYLATE PRESERVATIVE FREE, CISATRACURIUM BESYLATE
CISPLATIN, CISPLATIN
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 12

APPENDIX A - PRODUCT NAME INDEX

** C **
CITALOPRAM HYDROBROMIDE, CITALOPRAM HYDROBROMIDE
CITANEST FORTE DENTAL, EPINEPHRINE BITARTRATE
CLADRIBINE, CLADRIBINE
CLARAVIS, ISOTRETINOIN
CLARINEX, DESLORATADINE
CLARINEX-D 12 HOUR, DESLORATADINE
CLARISCAN, GADOTERATE MEGLUMINE
CLARITHROMYCIN, CLARITHROMYCIN
CLARITIN, LORATADINE (OTC)
CLARITIN HIVES RELIEF, LORATADINE (OTC)
CLARITIN HIVES RELIEF REDITAB, LORATADINE (OTC)
CLARITIN REDITABS, LORATADINE (OTC)
CLARITIN-D, LORATADINE (OTC)
CLARITIN-D 24 HOUR, LORATADINE (OTC)
CLEMASTINE FUMARATE, CLEMASTINE FUMARATE
CLENPIQ, CITRIC ACID
CLEOCIN, CLINDAMYCIN PALMITATE HYDROCHLORIDE
CLEOCIN, CLINDAMYCIN PHOSPHATE
CLEOCIN HYDROCHLORIDE, CLINDAMYCIN HYDROCHLORIDE
CLEOCIN PHOSPHATE, CLINDAMYCIN PHOSPHATE
CLEOCIN T, CLINDAMYCIN PHOSPHATE
CLEVIPREX, CLEVIDIPINE
CLIMARA, ESTRADIOL
CLIMARA PRO, ESTRADIOL
CLINDA-DERM, CLINDAMYCIN PHOSPHATE
CLINDAGEL, CLINDAMYCIN PHOSPHATE
CLINDAMYCIN HYDROCHLORIDE, CLINDAMYCIN HYDROCHLORIDE
CLINDAMYCIN PALMITATE HYDROCHLORIDE, CLINDAMYCIN PALMITATE HYDROCHLORIDE
CLINDAMYCIN PHOSPHATE, CLINDAMYCIN PHOSPHATE
CLINDAMYCIN PHOSPHATE AND BENZOYL PEROXIDE, BENZOYL PEROXIDE
CLINDAMYCIN PHOSPHATE AND TRETINOIN, CLINDAMYCIN PHOSPHATE
CLINDAMYCIN PHOSPHATE IN 0.9% SODIUM CHLORIDE, CLINDAMYCIN PHOSPHATE
CLINDAMYCIN PHOSPHATE IN 5% DEXTROSE IN PLASTIC CONTAINER, CLINDAMYCIN PHOSPHATE
CLINDAMYCIN PHOSPHATE IN DEXTROSE 5%, CLINDAMYCIN PHOSPHATE
CLINDESSE, CLINDAMYCIN PHOSPHATE
CLINDETS, CLINDAMYCIN PHOSPHATE
CLINIMIX 2.75/10 SULFITE FREE IN DEXTROSE 10% IN PLASTIC CONTAINER, AMINO ACIDS
CLINIMIX 2.75/25 SULFITE FREE IN DEXTROSE 25% IN PLASTIC CONTAINER, AMINO ACIDS
CLINIMIX 2.75/5 SULFITE FREE IN DEXTROSE 5% IN PLASTIC CONTAINER, AMINO ACIDS
CLINIMIX 4.25/10 SULFITE FREE IN DEXTROSE 10% IN PLASTIC CONTAINER, AMINO ACIDS
CLINIMIX 4.25/20 SULFITE FREE IN DEXTROSE 20% IN PLASTIC CONTAINER, AMINO ACIDS
CLINIMIX 4.25/25 SULFITE FREE IN DEXTROSE 25% IN PLASTIC CONTAINER, AMINO ACIDS
CLINIMIX 4.25/5 SULFITE FREE IN DEXTROSE 5% IN PLASTIC CONTAINER, AMINO ACIDS
CLINIMIX 5/10 SULFITE FREE IN DEXTROSE 10% IN PLASTIC CONTAINER, AMINO ACIDS
CLINIMIX 5/15 SULFITE FREE IN DEXTROSE 15% IN PLASTIC CONTAINER, AMINO ACIDS
CLINIMIX 5/20 SULFITE FREE IN DEXTROSE 20% IN PLASTIC CONTAINER, AMINO ACIDS
CLINIMIX 5/25 SULFITE FREE IN DEXTROSE 25% IN PLASTIC CONTAINER, AMINO ACIDS
CLINIMIX 5/35 SULFITE FREE IN DEXTROSE 35% IN PLASTIC CONTAINER, AMINO ACIDS
CLINIMIX E 2.75/10 SULFITE FREE W/ ELECT IN DEXTROSE 10% W/ CALCIUM IN PLASTIC CONTAINER,
CLINIMIX E 2.75/25 SULFITE FREE W/ ELECT IN DEXTROSE 25% W/ CALCIUM IN PLASTIC CONTAINER,
CLINIMIX E 2.75/5 SULFITE FREE W/ ELECT IN DEXTROSE 5% W/ CALCIUM IN PLASTIC CONTAINER,
CLINIMIX E 4.25/10 SULFITE FREE W/ ELECT IN DEXTROSE 10% W/ CALCIUM IN PLASTIC CONTAINER,
CLINIMIX E 4.25/20 SULFITE FREE W/ ELECT IN DEXTROSE 20% W/ CALCIUM IN PLASTIC CONTAINER,
CLINIMIX E 4.25/25 SULFITE FREE W/ ELECT IN DEXTROSE 25% W/ CALCIUM IN PLASTIC CONTAINER,
CLINIMIX E 4.25/5 SULFITE FREE W/ ELECT IN DEXTROSE 5% W/ CALCIUM IN PLASTIC CONTAINER,
CLINIMIX E 5/10 SULFITE FREE W/ ELECT IN DEXTROSE 10% W/ CALCIUM IN PLASTIC CONTAINER,
CLINIMIX E 5/15 SULFITE FREE W/ ELECT IN DEXTROSE 15% W/ CALCIUM IN PLASTIC CONTAINER,
CLINIMIX E 5/20 SULFITE FREE W/ ELECT IN 20% DEXTROSE W/ CALCIUM IN PLASTIC CONTAINER,
CLINIMIX E 5/25 SULFITE FREE W/ ELECT IN DEXTROSE 25% W/ CALCIUM IN PLASTIC CONTAINER,
CLINIMIX E 5/35 SULFITE FREE W/ ELECT IN DEXTROSE 35% W/ CALCIUM IN PLASTIC CONTAINER,
CLINISOL 15% SULFITE FREE IN PLASTIC CONTAINER, AMINO ACIDS
CLINOLIPID 20%, OLIVE OIL
CLOBAZAM, CLOBAZAM
CLOBETASOL PROPIONATE, CLOBETASOL PROPIONATE
CLOBETASOL PROPIONATE (EMOLLIENT), CLOBETASOL PROPIONATE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 13

APPENDIX A - PRODUCT NAME INDEX

** C **
CLOBEX, CLOBETASOL PROPIONATE
CLOCORTOLONE PIVALATE, CLOCORTOLONE PIVALATE
CLODERM, CLOCORTOLONE PIVALATE
CLOFARABINE, CLOFARABINE
CLOLAR, CLOFARABINE
CLOMIPHENE CITRATE, CLOMIPHENE CITRATE
CLOMIPRAMINE HYDROCHLORIDE, CLOMIPRAMINE HYDROCHLORIDE
CLONAZEPAM, CLONAZEPAM
CLONIDINE, CLONIDINE
CLONIDINE HYDROCHLORIDE, CLONIDINE HYDROCHLORIDE
CLOPIDOGREL BISULFATE, CLOPIDOGREL BISULFATE
CLORAZEPATE DIPOTASSIUM, CLORAZEPATE DIPOTASSIUM
CLOROTEKAL, CHLOROPROCAINE HYDROCHLORIDE
CLOTRIMAZOLE, CLOTRIMAZOLE (OTC)
CLOTRIMAZOLE, CLOTRIMAZOLE
CLOTRIMAZOLE AND BETAMETHASONE DIPROPIONATE, BETAMETHASONE DIPROPIONATE
CLOZAPINE, CLOZAPINE
CLOZARIL, CLOZAPINE
COARTEM, ARTEMETHER
CODEINE SULFATE, CODEINE SULFATE
COL-PROBENECID, COLCHICINE
COLAZAL, BALSALAZIDE DISODIUM
COLCHICINE, COLCHICINE
COLCRYS, COLCHICINE
COLESEVELAM HYDROCHLORIDE, COLESEVELAM HYDROCHLORIDE
COLESTID, COLESTIPOL HYDROCHLORIDE
COLESTIPOL HYDROCHLORIDE, COLESTIPOL HYDROCHLORIDE
COLISTIMETHATE SODIUM, COLISTIMETHATE SODIUM
COLOCORT, HYDROCORTISONE
COLY-MYCIN M, COLISTIMETHATE SODIUM
COLY-MYCIN S, COLISTIN SULFATE
COLYTE WITH FLAVOR PACKS, POLYETHYLENE GLYCOL 3350
COMBIGAN, BRIMONIDINE TARTRATE
COMBIPATCH, ESTRADIOL
COMBIVENT RESPIMAT, ALBUTEROL SULFATE
COMBIVIR, LAMIVUDINE
COMBOGESIC, ACETAMINOPHEN
COMETRIQ, CABOZANTINIB S-MALATE
COMPLERA, EMTRICITABINE
COMPRO, PROCHLORPERAZINE
COMTAN, ENTACAPONE
CONCERTA, METHYLPHENIDATE HYDROCHLORIDE
CONDYLOX, PODOFILOX
CONJUPRI, LEVAMLODIPINE MALEATE
CONRAY, IOTHALAMATE MEGLUMINE
CONTRAVE, BUPROPION HYDROCHLORIDE
CONZIP, TRAMADOL HYDROCHLORIDE
COPAXONE, GLATIRAMER ACETATE
COPIKTRA, DUVELISIB
CORDRAN, FLURANDRENOLIDE
COREG, CARVEDILOL
COREG CR, CARVEDILOL PHOSPHATE
CORGARD, NADOLOL
CORLANOR, IVABRADINE
CORLANOR, IVABRADINE HYDROCHLORIDE
CORLOPAM, FENOLDOPAM MESYLATE
CORMAX, CLOBETASOL PROPIONATE
CORPHEDRA, EPHEDRINE SULFATE
CORTEF, HYDROCORTISONE
CORTENEMA, HYDROCORTISONE
CORTIFOAM, HYDROCORTISONE ACETATE
CORTISONE ACETATE, CORTISONE ACETATE
CORTROSYN, COSYNTROPIN
CORVERT, IBUTILIDE FUMARATE
COSELA, TRILACICLIB DIHYDROCHLORIDE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 14

APPENDIX A - PRODUCT NAME INDEX

** C **
COSMEGEN, DACTINOMYCIN
COSOPT, DORZOLAMIDE HYDROCHLORIDE
COSOPT PF, DORZOLAMIDE HYDROCHLORIDE
COSYNTROPIN, COSYNTROPIN
COTELLIC, COBIMETINIB FUMARATE
COTEMPLA XR-ODT, METHYLPHENIDATE
COZAAR, LOSARTAN POTASSIUM
CRESEMBA, ISAVUCONAZONIUM SULFATE
CRESTOR, ROSUVASTATIN CALCIUM
CRINONE, PROGESTERONE
CROMOLYN SODIUM, CROMOLYN SODIUM (OTC)
CROMOLYN SODIUM, CROMOLYN SODIUM
CROTAN, CROTAMITON
CRYSELLE, ETHINYL ESTRADIOL
CUPRIC CHLORIDE, CUPRIC CHLORIDE
CUPRIC CHLORIDE IN PLASTIC CONTAINER, CUPRIC CHLORIDE
CUPRIC SULFATE, CUPRIC SULFATE
CUPRIMINE, PENICILLAMINE
CUVPOSA, GLYCOPYRROLATE
CUVRIOR, TRIENTINE TETRAHYDROCHLORIDE
CYANOCOBALAMIN, CYANOCOBALAMIN
CYANOKIT, HYDROXOCOBALAMIN
CYCLESSA, DESOGESTREL
CYCLOBENZAPRINE HYDROCHLORIDE, CYCLOBENZAPRINE HYDROCHLORIDE
CYCLOGYL, CYCLOPENTOLATE HYDROCHLORIDE
CYCLOMYDRIL, CYCLOPENTOLATE HYDROCHLORIDE
CYCLOPHOSPHAMIDE, CYCLOPHOSPHAMIDE
CYCLOSET, BROMOCRIPTINE MESYLATE
CYCLOSPORINE, CYCLOSPORINE
CYKLOKAPRON, TRANEXAMIC ACID
CYMBALTA, DULOXETINE HYDROCHLORIDE
CYONANZ, ETHINYL ESTRADIOL
CYPROHEPTADINE HYDROCHLORIDE, CYPROHEPTADINE HYDROCHLORIDE
CYSTADANE, BETAINE
CYSTADROPS, CYSTEAMINE HYDROCHLORIDE
CYSTAGON, CYSTEAMINE BITARTRATE
CYSTARAN, CYSTEAMINE HYDROCHLORIDE
CYSTO-CONRAY II, IOTHALAMATE MEGLUMINE
CYSTOGRAFIN, DIATRIZOATE MEGLUMINE
CYSTOGRAFIN DILUTE, DIATRIZOATE MEGLUMINE
CYSVIEW KIT, HEXAMINOLEVULINATE HYDROCHLORIDE
CYTALUX, PAFOLACIANINE SODIUM
CYTARABINE, CYTARABINE
CYTOMEL, LIOTHYRONINE SODIUM
CYTOTEC, MISOPROSTOL
CYTOXAN, CYCLOPHOSPHAMIDE
** D **
DABIGATRAN ETEXILATE MESYLATE, DABIGATRAN ETEXILATE MESYLATE
DACARBAZINE, DACARBAZINE
DACTINOMYCIN, DACTINOMYCIN
DALFAMPRIDINE, DALFAMPRIDINE
DALIRESP, ROFLUMILAST
DALVANCE, DALBAVANCIN HYDROCHLORIDE
DANAZOL, DANAZOL
DANTRIUM, DANTROLENE SODIUM
DANTROLENE SODIUM, DANTROLENE SODIUM
DAPSONE, DAPSONE
DAPTOMYCIN, DAPTOMYCIN
DAPTOMYCIN IN 0.9% SODIUM CHLORIDE, DAPTOMYCIN
DARAPRIM, PYRIMETHAMINE
DARIFENACIN, DARIFENACIN HYDROBROMIDE
DARIFENACIN HYDROBROMIDE, DARIFENACIN HYDROBROMIDE
DARUNAVIR, DARUNAVIR
DASETTA 1/35, ETHINYL ESTRADIOL
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 15

APPENDIX A - PRODUCT NAME INDEX

** D **
DASETTA 7/7/7, ETHINYL ESTRADIOL
DATSCAN, IOFLUPANE I-123
DAUNORUBICIN HYDROCHLORIDE, DAUNORUBICIN HYDROCHLORIDE
DAURISMO, GLASDEGIB MALEATE
DAYBUE, TROFINETIDE
DAYPRO, OXAPROZIN
DAYSEE, ETHINYL ESTRADIOL
DAYTRANA, METHYLPHENIDATE
DAYVIGO, LEMBOREXANT
DDAVP, DESMOPRESSIN ACETATE
DECITABINE, DECITABINE
DEFERASIROX, DEFERASIROX
DEFERIPRONE, DEFERIPRONE
DEFEROXAMINE MESYLATE, DEFEROXAMINE MESYLATE
DEFINITY, PERFLUTREN
DEFINITY RT, PERFLUTREN
DEFITELIO, DEFIBROTIDE SODIUM
DELESTROGEN, ESTRADIOL VALERATE
DELFLEX W/ DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DELFLEX W/ DEXTROSE 1.5% LOW MAGNESIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DELFLEX W/ DEXTROSE 1.5% LOW MAGNESIUM LOW CALCIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DELFLEX W/ DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DELFLEX W/ DEXTROSE 2.5% LOW MAGNESIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DELFLEX W/ DEXTROSE 2.5% LOW MAGNESIUM LOW CALCIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DELFLEX W/ DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DELFLEX W/ DEXTROSE 4.25% LOW MAGNESIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DELFLEX W/ DEXTROSE 4.25% LOW MAGNESIUM LOW CALCIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DELSTRIGO, DORAVIRINE
DELSYM, DEXTROMETHORPHAN POLISTIREX (OTC)
DELZICOL, MESALAMINE
DEMECLOCYCLINE HYDROCHLORIDE, DEMECLOCYCLINE HYDROCHLORIDE
DEMEROL, MEPERIDINE HYDROCHLORIDE
DEMSER, METYROSINE
DENAVIR, PENCICLOVIR
DEOXYCHOLIC ACID, DEOXYCHOLIC ACID
DEPAKOTE, DIVALPROEX SODIUM
DEPAKOTE ER, DIVALPROEX SODIUM
DEPEN, PENICILLAMINE
DEPO-ESTRADIOL, ESTRADIOL CYPIONATE
DEPO-MEDROL, METHYLPREDNISOLONE ACETATE
DEPO-PROVERA, MEDROXYPROGESTERONE ACETATE
DEPO-SUBQ PROVERA 104, MEDROXYPROGESTERONE ACETATE
DEPO-TESTOSTERONE, TESTOSTERONE CYPIONATE
DERMA-SMOOTHE/FS, FLUOCINOLONE ACETONIDE
DERMABET, BETAMETHASONE VALERATE
DERMOTIC, FLUOCINOLONE ACETONIDE
DESCOVY, EMTRICITABINE
DESFERAL, DEFEROXAMINE MESYLATE
DESFLURANE, DESFLURANE
DESIPRAMINE HYDROCHLORIDE, DESIPRAMINE HYDROCHLORIDE
DESLORATADINE, DESLORATADINE
DESLORATADINE AND PSEUDOEPHEDRINE SULFATE 24 HOUR, DESLORATADINE
DESMOPRESSIN ACETATE, DESMOPRESSIN ACETATE
DESMOPRESSIN ACETATE (NEEDS NO REFRIGERATION), DESMOPRESSIN ACETATE
DESOGESTREL AND ETHINYL ESTRADIOL, DESOGESTREL
DESONIDE, DESONIDE
DESOWEN, DESONIDE
DESOXIMETASONE, DESOXIMETASONE
DESOXYN, METHAMPHETAMINE HYDROCHLORIDE
DESVENLAFAXINE, DESVENLAFAXINE
DESVENLAFAXINE SUCCINATE, DESVENLAFAXINE SUCCINATE
DETECTNET, COPPER CU-64 DOTATATE
DETROL, TOLTERODINE TARTRATE
DETROL LA, TOLTERODINE TARTRATE
DEXAMETHASONE, DEXAMETHASONE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 16

APPENDIX A - PRODUCT NAME INDEX

** D **
DEXAMETHASONE INTENSOL, DEXAMETHASONE
DEXAMETHASONE SODIUM PHOSPHATE, DEXAMETHASONE SODIUM PHOSPHATE
DEXAMETHASONE SODIUM PHOSPHATE PRESERVATIVE FREE, DEXAMETHASONE SODIUM PHOSPHATE
DEXASPORIN, DEXAMETHASONE
DEXCHLORPHENIRAMINE MALEATE, DEXCHLORPHENIRAMINE MALEATE
DEXEDRINE, DEXTROAMPHETAMINE SULFATE
DEXILANT, DEXLANSOPRAZOLE
DEXLANSOPRAZOLE, DEXLANSOPRAZOLE
DEXMEDETOMIDINE HYDROCHLORIDE, DEXMEDETOMIDINE HYDROCHLORIDE
DEXMETHYLPHENIDATE HYDROCHLORIDE, DEXMETHYLPHENIDATE HYDROCHLORIDE
DEXRAZOXANE HYDROCHLORIDE, DEXRAZOXANE HYDROCHLORIDE
DEXTENZA, DEXAMETHASONE
DEXTROAMP SACCHARATE, AMP ASPARTATE, DEXTROAMP SULFATE AND AMP SULFATE, AMPHETAMINE
DEXTROAMPHETAMINE SULFATE, DEXTROAMPHETAMINE SULFATE
DEXTROMETHORPHAN HYDROBROMIDE AND QUINIDINE SULFATE, DEXTROMETHORPHAN HYDROBROMIDE
DEXTROMETHORPHAN POLISTIREX, DEXTROMETHORPHAN POLISTIREX (OTC)
DEXTROSE 10% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 10% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 10% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 2.5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 2.5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 2.5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 2.5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 2.5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 2.5% IN HALF-STRENGTH LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DEXTROSE 20% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 25%, DEXTROSE
DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 30% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 40% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 5% AND ELECTROLYTE NO. 48 IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DEXTROSE 5% AND POTASSIUM CHLORIDE 0.075%, DEXTROSE
DEXTROSE 5% AND POTASSIUM CHLORIDE 0.075% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 5% AND POTASSIUM CHLORIDE 0.15%, DEXTROSE
DEXTROSE 5% AND POTASSIUM CHLORIDE 0.15% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 5% AND POTASSIUM CHLORIDE 0.224% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 5% AND POTASSIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 5% AND SODIUM CHLORIDE 0.225%, DEXTROSE
DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 5% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 5% AND SODIUM CHLORIDE 0.45%, DEXTROSE
DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 5% AND SODIUM CHLORIDE 0.9%, DEXTROSE
DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 5% IN LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 5% IN SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 5% IN SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 5% IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 5% IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 10MEQ, DEXTROSE
DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 15MEQ (K), DEXTROSE
DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 20MEQ, DEXTROSE
DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 20MEQ (K), DEXTROSE
DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 30MEQ, DEXTROSE
DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 40MEQ, DEXTROSE
DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 5MEQ, DEXTROSE
DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 5MEQ (K), DEXTROSE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 17

APPENDIX A - PRODUCT NAME INDEX

** D **
DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 10MEQ IN PLASTIC CONTAINER,
DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 15MEQ IN PLASTIC CONTAINER,
DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 20MEQ IN PLASTIC CONTAINER,
DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 30MEQ IN PLASTIC CONTAINER,
DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 40MEQ IN PLASTIC CONTAINER,
DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 5MEQ IN PLASTIC CONTAINER,
DEXTROSE 5%, SODIUM CHLORIDE 0.45% AND POTASSIUM CHLORIDE 20MEQ (K) IN PLASTIC CONTAINER,
DEXTROSE 50%, DEXTROSE
DEXTROSE 50% IN PLASTIC CONTAINER, DEXTROSE
DEXTROSE 70% IN PLASTIC CONTAINER, DEXTROSE
DEXYCU KIT, DEXAMETHASONE
DHIVY, CARBIDOPA
DIABETA, GLYBURIDE
DIACOMIT, STIRIPENTOL
DIANEAL LOW CALCIUM W/ DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DIANEAL LOW CALCIUM W/ DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DIANEAL LOW CALCIUM W/ DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DIANEAL LOW CALCIUM W/DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DIANEAL LOW CALCIUM W/DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DIANEAL LOW CALCIUM W/DEXTROSE 3.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DIANEAL LOW CALCIUM W/DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DIANEAL PD-2 W/ DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DIANEAL PD-2 W/ DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DIANEAL PD-2 W/ DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DIASTAT, DIAZEPAM
DIASTAT ACUDIAL, DIAZEPAM
DIATRIZOATE MEGLUMINE AND DIATRIZOATE SODIUM, DIATRIZOATE MEGLUMINE
DIAZEPAM, DIAZEPAM
DIAZEPAM INTENSOL, DIAZEPAM
DIAZOXIDE, DIAZOXIDE
DIBENZYLINE, PHENOXYBENZAMINE HYDROCHLORIDE
DICHLORPHENAMIDE, DICHLORPHENAMIDE
DICLEGIS, DOXYLAMINE SUCCINATE
DICLOFENAC POTASSIUM, DICLOFENAC POTASSIUM
DICLOFENAC SODIUM, DICLOFENAC SODIUM (OTC)
DICLOFENAC SODIUM, DICLOFENAC SODIUM
DICLOFENAC SODIUM AND MISOPROSTOL, DICLOFENAC SODIUM
DICLOXACILLIN SODIUM, DICLOXACILLIN SODIUM
DICYCLOMINE HYDROCHLORIDE, DICYCLOMINE HYDROCHLORIDE
DICYCLOMINE HYDROCHLORIDE (PRESERVATIVE FREE), DICYCLOMINE HYDROCHLORIDE
DIETHYLPROPION HYDROCHLORIDE, DIETHYLPROPION HYDROCHLORIDE
DIFFERIN, ADAPALENE (OTC)
DIFFERIN, ADAPALENE
DIFICID, FIDAXOMICIN
DIFLORASONE DIACETATE, DIFLORASONE DIACETATE
DIFLUCAN, FLUCONAZOLE
DIFLUNISAL, DIFLUNISAL
DIFLUPREDNATE, DIFLUPREDNATE
DIGOXIN, DIGOXIN
DIHYDROERGOTAMINE MESYLATE, DIHYDROERGOTAMINE MESYLATE
DILANTIN, PHENYTOIN
DILANTIN, PHENYTOIN SODIUM
DILANTIN-125, PHENYTOIN
DILAUDID, HYDROMORPHONE HYDROCHLORIDE
DILTIAZEM HYDROCHLORIDE, DILTIAZEM HYDROCHLORIDE
DIMENHYDRINATE, DIMENHYDRINATE
DIMETHYL FUMARATE, DIMETHYL FUMARATE
DIOVAN, VALSARTAN
DIOVAN HCT, HYDROCHLOROTHIAZIDE
DIPENTUM, OLSALAZINE SODIUM
DIPHENHYDRAMINE HYDROCHLORIDE, DIPHENHYDRAMINE HYDROCHLORIDE
DIPHENHYDRAMINE HYDROCHLORIDE PRESERVATIVE FREE, DIPHENHYDRAMINE HYDROCHLORIDE
DIPHENOXYLATE HYDROCHLORIDE AND ATROPINE SULFATE, ATROPINE SULFATE
DIPRIVAN, PROPOFOL
DIPROLENE, BETAMETHASONE DIPROPIONATE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 18

APPENDIX A - PRODUCT NAME INDEX

** D **
DIPYRIDAMOLE, DIPYRIDAMOLE
DISOPYRAMIDE PHOSPHATE, DISOPYRAMIDE PHOSPHATE
DISULFIRAM, DISULFIRAM
DITROPAN XL, OXYBUTYNIN CHLORIDE
DIURIL, CHLOROTHIAZIDE
DIURIL, CHLOROTHIAZIDE SODIUM
DIVALPROEX SODIUM, DIVALPROEX SODIUM
DIVIGEL, ESTRADIOL
DOBUTAMINE HYDROCHLORIDE, DOBUTAMINE HYDROCHLORIDE
DOBUTAMINE HYDROCHLORIDE IN DEXTROSE 5% IN PLASTIC CONTAINER, DOBUTAMINE HYDROCHLORIDE
DOCETAXEL, DOCETAXEL
DOCOSANOL, DOCOSANOL (OTC)
DODEX, CYANOCOBALAMIN
DOFETILDE, DOFETILIDE
DOFETILIDE, DOFETILIDE
DOJOLVI, TRIHEPTANOIN
DOLISHALE, ETHINYL ESTRADIOL
DONEPEZIL HYDROCHLORIDE, DONEPEZIL HYDROCHLORIDE
DOPAMINE HYDROCHLORIDE, DOPAMINE HYDROCHLORIDE
DOPAMINE HYDROCHLORIDE IN DEXTROSE 5% IN PLASTIC CONTAINER, DOPAMINE HYDROCHLORIDE
DOPRAM, DOXAPRAM HYDROCHLORIDE
DOPTELET, AVATROMBOPAG MALEATE
DORAL, QUAZEPAM
DORYX, DOXYCYCLINE HYCLATE
DORYX MPC, DOXYCYCLINE HYCLATE
DORZOLAMIDE HYDROCHLORIDE, DORZOLAMIDE HYDROCHLORIDE
DORZOLAMIDE HYDROCHLORIDE AND TIMOLOL MALEATE, DORZOLAMIDE HYDROCHLORIDE
DOTAREM, GADOTERATE MEGLUMINE
DOVATO, DOLUTEGRAVIR SODIUM
DOVONEX, CALCIPOTRIENE
DOXAPRAM HYDROCHLORIDE, DOXAPRAM HYDROCHLORIDE
DOXAZOSIN MESYLATE, DOXAZOSIN MESYLATE
DOXEPIN HYDROCHLORIDE, DOXEPIN HYDROCHLORIDE
DOXERCALCIFEROL, DOXERCALCIFEROL
DOXIL (LIPOSOMAL), DOXORUBICIN HYDROCHLORIDE
DOXORUBICIN HYDROCHLORIDE, DOXORUBICIN HYDROCHLORIDE
DOXORUBICIN HYDROCHLORIDE (LIPOSOMAL), DOXORUBICIN HYDROCHLORIDE
DOXY 100, DOXYCYCLINE HYCLATE
DOXY 200, DOXYCYCLINE HYCLATE
DOXYCYCLINE, DOXYCYCLINE
DOXYCYCLINE, DOXYCYCLINE HYCLATE
DOXYCYCLINE HYCLATE, DOXYCYCLINE HYCLATE
DOXYLAMINE SUCCINATE, DOXYLAMINE SUCCINATE (OTC)
DOXYLAMINE SUCCINATE AND PYRIDOXINE HYDROCHLORIDE, DOXYLAMINE SUCCINATE
DRAX EXAMETAZIME, TECHNETIUM TC-99M EXAMETAZIME KIT
DRAXIMAGE DTPA, TECHNETIUM TC-99M PENTETATE KIT
DRAXIMAGE MDP-25, TECHNETIUM TC-99M MEDRONATE
DRISDOL, ERGOCALCIFEROL
DRONABINOL, DRONABINOL
DROPERIDOL, DROPERIDOL
DROSPIRENONE AND ETHINYL ESTRADIOL, DROSPIRENONE
DROSPIRENONE, ETHINYL ESTRADIOL AND LEVOMEFOLATE CALCIUM, DROSPIRENONE
DROXIA, HYDROXYUREA
DROXIDOPA, DROXIDOPA
DSUVIA, SUFENTANIL CITRATE
DUAC, BENZOYL PEROXIDE
DUAKLIR PRESSAIR, ACLIDINIUM BROMIDE
DUAVEE, BAZEDOXIFENE ACETATE
DUETACT, GLIMEPIRIDE
DUEXIS, FAMOTIDINE
DULERA, FORMOTEROL FUMARATE
DULOXETINE HYDROCHLORIDE, DULOXETINE HYDROCHLORIDE
DUOBRII, HALOBETASOL PROPIONATE
DUODOTE, ATROPINE
DUOPA, CARBIDOPA
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 19

APPENDIX A - PRODUCT NAME INDEX

** D **
DURACLON, CLONIDINE HYDROCHLORIDE
DURAMORPH PF, MORPHINE SULFATE
DURAPREP, IODINE POVACRYLEX (OTC)
DUREZOL, DIFLUPREDNATE
DURLAZA, ASPIRIN
DURYSTA, BIMATOPROST
DUTASTERIDE, DUTASTERIDE
DUTASTERIDE AND TAMSULOSIN HYDROCHLORIDE, DUTASTERIDE
DUVOID, BETHANECHOL CHLORIDE
DYANAVEL XR, AMPHETAMINE
DYANAVEL XR 10, AMPHETAMINE
DYANAVEL XR 15, AMPHETAMINE
DYANAVEL XR 20, AMPHETAMINE
DYANAVEL XR 5, AMPHETAMINE
DYCLOPRO, DYCLONINE HYDROCHLORIDE
DYMISTA, AZELASTINE HYDROCHLORIDE
DYNACIN, MINOCYCLINE HYDROCHLORIDE
DYRENIUM, TRIAMTERENE
** E **
E-Z SCRUB 201, POVIDONE-IODINE (OTC)
E-Z SCRUB 241, POVIDONE-IODINE (OTC)
E-Z-HD, BARIUM SULFATE
E-Z-PAQUE, BARIUM SULFATE
E.E.S., ERYTHROMYCIN ETHYLSUCCINATE
E.E.S. 400, ERYTHROMYCIN ETHYLSUCCINATE
EC-NAPROSYN, NAPROXEN
ECONAZOLE NITRATE, ECONAZOLE NITRATE
ECOZA, ECONAZOLE NITRATE
EDARBI, AZILSARTAN KAMEDOXOMIL
EDARBYCLOR, AZILSARTAN KAMEDOXOMIL
EDECRIN, ETHACRYNATE SODIUM
EDECRIN, ETHACRYNIC ACID
EDETATE CALCIUM DISODIUM, EDETATE CALCIUM DISODIUM
EDEX, ALPROSTADIL
EDLUAR, ZOLPIDEM TARTRATE
EDURANT, RILPIVIRINE HYDROCHLORIDE
EFAVIRENZ, EFAVIRENZ
EFAVIRENZ, EMTRICITABINE, AND TENOFOVIR DISOPROXIL FUMARATE, EFAVIRENZ
EFAVIRENZ, LAMIVUDINE AND TENOFOVIR DISOPROXIL FUMARATE, EFAVIRENZ
EFFEXOR XR, VENLAFAXINE HYDROCHLORIDE
EFFIENT, PRASUGREL HYDROCHLORIDE
EFINACONAZOLE, EFINACONAZOLE
EFUDEX, FLUOROURACIL
EGATEN, TRICLABENDAZOLE
ELCYS, CYSTEINE HYDROCHLORIDE
ELEPSIA XR, LEVETIRACETAM
ELESTRIN, ESTRADIOL
ELETRIPTAN HYDROBROMIDE, ELETRIPTAN HYDROBROMIDE
ELIDEL, PIMECROLIMUS
ELIGARD KIT, LEUPROLIDE ACETATE
ELIGLUSTAT TARTRATE, ELIGLUSTAT TARTRATE
ELINEST, ETHINYL ESTRADIOL
ELIQUIS, APIXABAN
ELIXOPHYLLIN, THEOPHYLLINE
ELLA, ULIPRISTAL ACETATE
ELLENCE, EPIRUBICIN HYDROCHLORIDE
ELLIOTTS B SOLUTION, CALCIUM CHLORIDE
ELMIRON, PENTOSAN POLYSULFATE SODIUM
ELOXATIN, OXALIPLATIN
ELUCIREM, GADOPICLENOL
ELURYNG, ETHINYL ESTRADIOL
EMBELINE, CLOBETASOL PROPIONATE
EMCYT, ESTRAMUSTINE PHOSPHATE SODIUM
EMEND, APREPITANT
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 20

APPENDIX A - PRODUCT NAME INDEX

** E **
EMEND, FOSAPREPITANT DIMEGLUMINE
EMERPHED, EPHEDRINE SULFATE
EMFLAZA, DEFLAZACORT
EMPAVELI, PEGCETACOPLAN
EMSAM, SELEGILINE
EMTRICITABINE, EMTRICITABINE
EMTRICITABINE AND TENOFOVIR DISOPROXIL FUMARATE, EMTRICITABINE
EMTRICITABINE AND TENOFOVIR DISOPROXIL FUMARATE, EMTRICITABINE
EMTRIVA, EMTRICITABINE
EMVERM, MEBENDAZOLE
EMZAHH, NORETHINDRONE
ENALAPRIL MALEATE, ENALAPRIL MALEATE
ENALAPRIL MALEATE AND HYDROCHLOROTHIAZIDE, ENALAPRIL MALEATE
ENALAPRILAT, ENALAPRILAT
ENDARI, L-GLUTAMINE
ENDOMETRIN, PROGESTERONE
ENILLORING, ETHINYL ESTRADIOL
ENOXAPARIN SODIUM, ENOXAPARIN SODIUM
ENOXAPARIN SODIUM (PRESERVATIVE FREE), ENOXAPARIN SODIUM
ENPRESSE-28, ETHINYL ESTRADIOL
ENSKYCE, DESOGESTREL
ENSTILAR, BETAMETHASONE DIPROPIONATE
ENTACAPONE, ENTACAPONE
ENTADFI, FINASTERIDE
ENTECAVIR, ENTECAVIR
ENTERO VU 24%, BARIUM SULFATE
ENTOCORT EC, BUDESONIDE
ENTRESTO, SACUBITRIL
ENVARSUS XR, TACROLIMUS
EOVIST, GADOXETATE DISODIUM
EPANED, ENALAPRIL MALEATE
EPCLUSA, SOFOSBUVIR
EPHEDRINE SULFATE, EPHEDRINE SULFATE
EPIDIOLEX, CANNABIDIOL
EPIDUO, ADAPALENE
EPIDUO FORTE, ADAPALENE
EPIFOAM, HYDROCORTISONE ACETATE
EPINASTINE HYDROCHLORIDE, EPINASTINE HYDROCHLORIDE
EPINEPHRINE, EPINEPHRINE
EPINEPHRINE (AUTOINJECTOR), EPINEPHRINE
EPINEPHRINE IN 0.9% SODIUM CHLORIDE, EPINEPHRINE
EPIPEN, EPINEPHRINE
EPIPEN JR., EPINEPHRINE
EPIRUBICIN HYDROCHLORIDE, EPIRUBICIN HYDROCHLORIDE
EPITOL, CARBAMAZEPINE
EPIVIR, LAMIVUDINE
EPIVIR-HBV, LAMIVUDINE
EPLERENONE, EPLERENONE
EPOPROSTENOL SODIUM, EPOPROSTENOL SODIUM
EPRONTIA, TOPIRAMATE
EPSOLAY, BENZOYL PEROXIDE
EPTIFIBATIDE, EPTIFIBATIDE
EPZICOM, ABACAVIR SULFATE
EQUETRO, CARBAMAZEPINE
ERAXIS, ANIDULAFUNGIN
ERGOCALCIFEROL, ERGOCALCIFEROL
ERGOLOID MESYLATES, ERGOLOID MESYLATES
ERGOMAR, ERGOTAMINE TARTRATE
ERGOTAMINE TARTRATE AND CAFFEINE, CAFFEINE
ERIVEDGE, VISMODEGIB
ERLEADA, APALUTAMIDE
ERLOTINIB HYDROCHLORIDE, ERLOTINIB HYDROCHLORIDE
ERMEZA, LEVOTHYROXINE SODIUM
ERRIN, NORETHINDRONE
ERTACZO, SERTACONAZOLE NITRATE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 21

APPENDIX A - PRODUCT NAME INDEX

** E **
ERTAPENEM SODIUM, ERTAPENEM SODIUM
ERY-TAB, ERYTHROMYCIN
ERYC, ERYTHROMYCIN
ERYGEL, ERYTHROMYCIN
ERYPED, ERYTHROMYCIN ETHYLSUCCINATE
ERYTHRA-DERM, ERYTHROMYCIN
ERYTHROCIN, ERYTHROMYCIN LACTOBIONATE
ERYTHROCIN STEARATE, ERYTHROMYCIN STEARATE
ERYTHROMYCIN, ERYTHROMYCIN
ERYTHROMYCIN AND BENZOYL PEROXIDE, BENZOYL PEROXIDE
ERYTHROMYCIN ETHYLSUCCINATE, ERYTHROMYCIN ETHYLSUCCINATE
ERYTHROMYCIN LACTOBIONATE, ERYTHROMYCIN LACTOBIONATE
ESBRIET, PIRFENIDONE
ESCITALOPRAM OXALATE, ESCITALOPRAM OXALATE
ESLICARBAZEPINE ACETATE, ESLICARBAZEPINE ACETATE
ESMOLOL HYDROCHLORIDE, ESMOLOL HYDROCHLORIDE
ESMOLOL HYDROCHLORIDE DOUBLE STRENGTH IN PLASTIC CONTAINER, ESMOLOL HYDROCHLORIDE
ESMOLOL HYDROCHLORIDE IN PLASTIC CONTAINER, ESMOLOL HYDROCHLORIDE
ESOMEPRAZOLE MAGNESIUM, ESOMEPRAZOLE MAGNESIUM (OTC)
ESOMEPRAZOLE MAGNESIUM, ESOMEPRAZOLE MAGNESIUM
ESOMEPRAZOLE SODIUM, ESOMEPRAZOLE SODIUM
ESTARYLLA, ETHINYL ESTRADIOL
ESTAZOLAM, ESTAZOLAM
ESTRACE, ESTRADIOL
ESTRADIOL, ESTRADIOL
ESTRADIOL AND NORETHINDRONE ACETATE, ESTRADIOL
ESTRADIOL AND NORGESTIMATE, ESTRADIOL
ESTRADIOL VALERATE, ESTRADIOL VALERATE
ESTRING, ESTRADIOL
ESTROGEL, ESTRADIOL
ESZOPICLONE, ESZOPICLONE
ETHACRYNATE SODIUM, ETHACRYNATE SODIUM
ETHACRYNIC ACID, ETHACRYNIC ACID
ETHAMBUTOL HYDROCHLORIDE, ETHAMBUTOL HYDROCHLORIDE
ETHAMOLIN, ETHANOLAMINE OLEATE
ETHINYL ESTRADIOL AND NORELGESTROMIN, ETHINYL ESTRADIOL
ETHINYL ESTRADIOL; ETONOGESTREL, ETHINYL ESTRADIOL
ETHOSUXIMIDE, ETHOSUXIMIDE
ETHYNODIOL DIACETATE AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL
ETHYOL, AMIFOSTINE
ETODOLAC, ETODOLAC
ETOMIDATE, ETOMIDATE
ETOPOPHOS PRESERVATIVE FREE, ETOPOSIDE PHOSPHATE
ETOPOSIDE, ETOPOSIDE
ETRAVIRINE, ETRAVIRINE
EUCRISA, CRISABOROLE
EURAX, CROTAMITON
EUTHYROX, LEVOTHYROXINE SODIUM **
EVAMIST, ESTRADIOL
EVEKEO, AMPHETAMINE SULFATE
EVEKEO ODT, AMPHETAMINE SULFATE
EVEROLIMUS, EVEROLIMUS
EVISTA, RALOXIFENE HYDROCHLORIDE
EVOMELA, MELPHALAN HYDROCHLORIDE
EVOTAZ, ATAZANAVIR SULFATE
EVOXAC, CEVIMELINE HYDROCHLORIDE
EVRYSDI, RISDIPLAM
EXCEDRIN (MIGRAINE RELIEF), ACETAMINOPHEN (OTC)
EXELDERM, SULCONAZOLE NITRATE
EXELON, RIVASTIGMINE
EXEM FOAM KIT, AIR POLYMER-TYPE A
EXEMESTANE, EXEMESTANE
EXFORGE, AMLODIPINE BESYLATE
EXFORGE HCT, AMLODIPINE BESYLATE
EXIDINE, CHLORHEXIDINE GLUCONATE (OTC)
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 22

APPENDIX A - PRODUCT NAME INDEX

** E **
EXJADE, DEFERASIROX
EXKIVITY, MOBOCERTINIB SUCCINATE
EXONDYS 51, ETEPLIRSEN
EXPAREL, BUPIVACAINE
EXSERVAN, RILUZOLE
EXTENDED PHENYTOIN SODIUM, PHENYTOIN SODIUM
EXTINA, KETOCONAZOLE
EXTRANEAL, ICODEXTRIN
EYSUVIS, LOTEPREDNOL ETABONATE
EZALLOR SPRINKLE, ROSUVASTATIN CALCIUM
EZETIMIBE, EZETIMIBE
EZETIMIBE AND SIMVASTATIN, EZETIMIBE
** F **
FABIOR, TAZAROTENE
FALLBACK SOLO, LEVONORGESTREL (OTC)
FALMINA, ETHINYL ESTRADIOL
FAMCICLOVIR, FAMCICLOVIR
FAMOTIDINE, FAMOTIDINE (OTC)
FAMOTIDINE, FAMOTIDINE
FAMOTIDINE PRESERVATIVE FREE, FAMOTIDINE
FAMOTIDINE PRESERVATIVE FREE IN PLASTIC CONTAINER, FAMOTIDINE
FAMOTIDINE, CALCIUM CARBONATE, AND MAGNESIUM HYDROXIDE, CALCIUM CARBONATE (OTC)
FANAPT, ILOPERIDONE
FARESTON, TOREMIFENE CITRATE
FARXIGA, DAPAGLIFLOZIN
FASLODEX, FULVESTRANT
FEBUXOSTAT, FEBUXOSTAT
FELBAMATE, FELBAMATE
FELBATOL, FELBAMATE
FELDENE, PIROXICAM
FELODIPINE, FELODIPINE
FEMARA, LETROZOLE
FEMRING, ESTRADIOL ACETATE
FENOFIBRATE, FENOFIBRATE
FENOFIBRATE (MICRONIZED), FENOFIBRATE
FENOFIBRIC ACID, CHOLINE FENOFIBRATE
FENOGLIDE, FENOFIBRATE
FENOLDOPAM MESYLATE, FENOLDOPAM MESYLATE
FENOPROFEN CALCIUM, FENOPROFEN CALCIUM
FENSOLVI KIT, LEUPROLIDE ACETATE
FENTANYL CITRATE, FENTANYL CITRATE
FENTANYL CITRATE PRESERVATIVE FREE, FENTANYL CITRATE
FENTANYL-100, FENTANYL
FENTANYL-12, FENTANYL
FENTANYL-25, FENTANYL
FENTANYL-37, FENTANYL
FENTANYL-50, FENTANYL
FENTANYL-62, FENTANYL
FENTANYL-75, FENTANYL
FENTANYL-87, FENTANYL
FENTORA, FENTANYL CITRATE
FERAHEME, FERUMOXYTOL
FERRIPROX, DEFERIPRONE
FERRLECIT, FERRIC OXYHYDROXIDE
FERUMOXYTOL, FERUMOXYTOL
FESOTERODINE FUMARATE, FESOTERODINE FUMARATE
FETROJA, CEFIDEROCOL SULFATE TOSYLATE
FETZIMA, LEVOMILNACIPRAN HYDROCHLORIDE
FEXINIDAZOLE, FEXINIDAZOLE
FEXOFENADINE HYDROCHLORIDE, FEXOFENADINE HYDROCHLORIDE (OTC)
FEXOFENADINE HYDROCHLORIDE, FEXOFENADINE HYDROCHLORIDE
FEXOFENADINE HYDROCHLORIDE ALLERGY, FEXOFENADINE HYDROCHLORIDE (OTC)
FEXOFENADINE HYDROCHLORIDE AND PSEUDOEPHEDRINE HYDROCHLORIDE, FEXOFENADINE HYDROCHLORIDE
FEXOFENADINE HYDROCHLORIDE HIVES, FEXOFENADINE HYDROCHLORIDE (OTC)
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 23

APPENDIX A - PRODUCT NAME INDEX

** F **
FILSPARI, SPARSENTAN
FINACEA, AZELAIC ACID
FINASTERIDE, FINASTERIDE
FINGOLIMOD HYDROCHLORIDE, FINGOLIMOD HYDROCHLORIDE
FINTEPLA, FENFLURAMINE HYDROCHLORIDE
FINZALA, ETHINYL ESTRADIOL
FIORICET W/ CODEINE, ACETAMINOPHEN
FIRAZYR, ICATIBANT ACETATE
FIRDAPSE, AMIFAMPRIDINE PHOSPHATE
FIRMAGON, DEGARELIX ACETATE
FIRVANQ KIT, VANCOMYCIN HYDROCHLORIDE
FLAC, FLUOCINOLONE ACETONIDE
FLAGYL, METRONIDAZOLE
FLAGYL I.V. RTU IN PLASTIC CONTAINER, METRONIDAZOLE
FLAREX, FLUOROMETHOLONE ACETATE
FLAVORED COLESTID, COLESTIPOL HYDROCHLORIDE
FLAVOXATE HYDROCHLORIDE, FLAVOXATE HYDROCHLORIDE
FLECAINIDE ACETATE, FLECAINIDE ACETATE
FLECTOR, DICLOFENAC EPOLAMINE
FLEQSUVY, BACLOFEN
FLOLAN, EPOPROSTENOL SODIUM
FLOLIPID, SIMVASTATIN
FLOMAX, TAMSULOSIN HYDROCHLORIDE
FLONASE ALLERGY RELIEF, FLUTICASONE PROPIONATE (OTC)
FLONASE SENSIMIST ALLERGY RELIEF, FLUTICASONE FUROATE (OTC)
FLOVENT DISKUS 100, FLUTICASONE PROPIONATE
FLOVENT DISKUS 250, FLUTICASONE PROPIONATE
FLOVENT DISKUS 50, FLUTICASONE PROPIONATE
FLOVENT HFA, FLUTICASONE PROPIONATE
FLOXURIDINE, FLOXURIDINE
FLUCINOLONE ACETONIDE, FLUOCINOLONE ACETONIDE
FLUCONAZOLE, FLUCONAZOLE
FLUCONAZOLE IN SODIUM CHLORIDE 0.9%, FLUCONAZOLE
FLUCONAZOLE IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, FLUCONAZOLE
FLUCYTOSINE, FLUCYTOSINE
FLUDARABINE PHOSPHATE, FLUDARABINE PHOSPHATE
FLUDEOXYGLUCOSE F18, FLUDEOXYGLUCOSE F-18
FLUDROCORTISONE ACETATE, FLUDROCORTISONE ACETATE
FLUMADINE, RIMANTADINE HYDROCHLORIDE
FLUMAZENIL, FLUMAZENIL
FLUNISOLIDE, FLUNISOLIDE
FLUOCINOLONE ACETONIDE, FLUOCINOLONE ACETONIDE
FLUOCINONIDE, FLUOCINONIDE
FLUOCINONIDE ACETONIDE, FLUOCINOLONE ACETONIDE
FLUOCINONIDE EMULSIFIED BASE, FLUOCINONIDE
FLUORESCEIN SODIUM AND BENOXINATE HYDROCHLORIDE, BENOXINATE HYDROCHLORIDE
FLUORESCITE, FLUORESCEIN SODIUM
FLUORODOPA F18, FLUORODOPA F-18
FLUOROURACIL, FLUOROURACIL
FLUOXETINE HYDROCHLORIDE, FLUOXETINE HYDROCHLORIDE
FLUPHENAZINE DECANOATE, FLUPHENAZINE DECANOATE
FLUPHENAZINE HYDROCHLORIDE, FLUPHENAZINE HYDROCHLORIDE
FLURANDRENOLIDE, FLURANDRENOLIDE
FLURAZEPAM HYDROCHLORIDE, FLURAZEPAM HYDROCHLORIDE
FLURBIPROFEN, FLURBIPROFEN
FLURBIPROFEN SODIUM, FLURBIPROFEN SODIUM
FLUTAMIDE, FLUTAMIDE
FLUTICASONE PROPIONATE, FLUTICASONE PROPIONATE (OTC)
FLUTICASONE PROPIONATE, FLUTICASONE PROPIONATE
FLUTICASONE PROPIONATE AND SALMETEROL XINAFOATE, FLUTICASONE PROPIONATE
FLUVASTATIN SODIUM, FLUVASTATIN SODIUM
FLUVOXAMINE MALEATE, FLUVOXAMINE MALEATE
FML, FLUOROMETHOLONE
FML FORTE, FLUOROMETHOLONE
FOCALIN, DEXMETHYLPHENIDATE HYDROCHLORIDE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 24

APPENDIX A - PRODUCT NAME INDEX

** F **
FOCALIN XR, DEXMETHYLPHENIDATE HYDROCHLORIDE
FOLIC ACID, FOLIC ACID
FOLOTYN, PRALATREXATE
FOMEPIZOLE, FOMEPIZOLE
FONDAPARINUX SODIUM, FONDAPARINUX SODIUM
FORANE, ISOFLURANE
FORFIVO XL, BUPROPION HYDROCHLORIDE
FORMOTEROL FUMARATE, FORMOTEROL FUMARATE
FORTAMET, METFORMIN HYDROCHLORIDE
FORTEO, TERIPARATIDE
FORTESTA, TESTOSTERONE
FOSAMAX, ALENDRONATE SODIUM
FOSAMAX PLUS D, ALENDRONATE SODIUM
FOSAMPRENAVIR CALCIUM, FOSAMPRENAVIR CALCIUM
FOSAPREPITANT DIMEGLUMINE, FOSAPREPITANT DIMEGLUMINE
FOSCARNET SODIUM, FOSCARNET SODIUM
FOSCAVIR, FOSCARNET SODIUM
FOSFOMYCIN TROMETHAMINE, FOSFOMYCIN TROMETHAMINE
FOSINOPRIL SODIUM, FOSINOPRIL SODIUM
FOSINOPRIL SODIUM AND HYDROCHLOROTHIAZIDE, FOSINOPRIL SODIUM
FOSPHENYTOIN SODIUM, FOSPHENYTOIN SODIUM
FOSRENOL, LANTHANUM CARBONATE
FOTIVDA, TIVOZANIB HYDROCHLORIDE
FRAGMIN, DALTEPARIN SODIUM
FROVA, FROVATRIPTAN SUCCINATE
FROVATRIPTAN SUCCINATE, FROVATRIPTAN SUCCINATE
FULVESTRANT, FULVESTRANT
FULVICIN P/G, GRISEOFULVIN, ULTRAMICROCRYSTALLINE
FULVICIN P/G 165, GRISEOFULVIN, ULTRAMICROCRYSTALLINE
FULVICIN P/G 330, GRISEOFULVIN, ULTRAMICROCRYSTALLINE
FULVICIN-U/F, GRISEOFULVIN, MICROCRYSTALLINE
FURADANTIN, NITROFURANTOIN
FUROSCIX, FUROSEMIDE
FUROSEMIDE, FUROSEMIDE
FUSILEV, LEVOLEUCOVORIN CALCIUM
FUZEON, ENFUVIRTIDE
FYARRO, SIROLIMUS
FYAVOLV, ETHINYL ESTRADIOL
FYCOMPA, PERAMPANEL
FYREMADEL, GANIRELIX ACETATE
** G **
GABAPENTIN, GABAPENTIN
GABITRIL, TIAGABINE HYDROCHLORIDE
GABLOFEN, BACLOFEN
GADAVIST, GADOBUTROL
GADOBUTROL, GADOBUTROL
GADOTERATE MEGLUMINE, GADOTERATE MEGLUMINE
GALAFOLD, MIGALASTAT HYDROCHLORIDE
GALANTAMINE HYDROBROMIDE, GALANTAMINE HYDROBROMIDE
GALLIUM CITRATE GA 67, GALLIUM CITRATE GA-67
GALLIUM GA 68 DOTATOC, GALLIUM GA-68 DOTATOC
GALLIUM GA 68 GOZETOTIDE, GALLIUM GA-68 GOZETOTIDE
GALZIN, ZINC ACETATE
GANCICLOVIR SODIUM, GANCICLOVIR SODIUM
GANIRELIX ACETATE, GANIRELIX ACETATE
GANZYK-RTU, GANCICLOVIR
GASTROCROM, CROMOLYN SODIUM
GASTROGRAFIN, DIATRIZOATE MEGLUMINE
GATIFLOXACIN, GATIFLOXACIN
GATTEX KIT, TEDUGLUTIDE RECOMBINANT
GAVRETO, PRALSETINIB
GEFITINIB, GEFITINIB
GELNIQUE, OXYBUTYNIN CHLORIDE
GEMCITABINE HYDROCHLORIDE, GEMCITABINE HYDROCHLORIDE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 25

APPENDIX A - PRODUCT NAME INDEX

** G **
GEMFIBROZIL, GEMFIBROZIL
GEMMILY, ETHINYL ESTRADIOL
GEMTESA, VIBEGRON
GENERLAC, LACTULOSE
GENGRAF, CYCLOSPORINE
GENOSYL, NITRIC OXIDE
GENTAMICIN SULFATE, GENTAMICIN SULFATE
GENTAMICIN SULFATE IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, GENTAMICIN SULFATE
GENVOYA, COBICISTAT
GEODON, ZIPRASIDONE HYDROCHLORIDE
GEODON, ZIPRASIDONE MESYLATE
GIAPREZA, ANGIOTENSIN II ACETATE
GILDAGIA, ETHINYL ESTRADIOL
GILDESS 24 FE, ETHINYL ESTRADIOL
GILENYA, FINGOLIMOD HYDROCHLORIDE
GILOTRIF, AFATINIB DIMALEATE
GIMOTI, METOCLOPRAMIDE HYDROCHLORIDE
GIVLAARI, GIVOSIRAN SODIUM
GLATIRAMER ACETATE, GLATIRAMER ACETATE
GLATOPA, GLATIRAMER ACETATE
GLEEVEC, IMATINIB MESYLATE
GLEOLAN, AMINOLEVULINIC ACID HYDROCHLORIDE
GLEOSTINE, LOMUSTINE
GLIADEL, CARMUSTINE
GLIMEPIRIDE, GLIMEPIRIDE
GLIPIZIDE, GLIPIZIDE
GLIPIZIDE AND METFORMIN HYDROCHLORIDE, GLIPIZIDE
GLOFIL-125, IOTHALAMATE SODIUM I-125
GLOPERBA, COLCHICINE
GLUCAGEN, GLUCAGON HYDROCHLORIDE
GLUCAGON, GLUCAGON
GLUCAGON, GLUCAGON HYDROCHLORIDE
GLUCOTROL XL, GLIPIZIDE
GLUMETZA, METFORMIN HYDROCHLORIDE
GLYBURIDE, GLYBURIDE
GLYBURIDE (MICRONIZED), GLYBURIDE
GLYBURIDE AND METFORMIN HYDROCHLORIDE, GLYBURIDE
GLYCINE 1.5% IN PLASTIC CONTAINER, GLYCINE
GLYCOPYRROLATE, GLYCOPYRROLATE
GLYDO, LIDOCAINE HYDROCHLORIDE
GLYNASE, GLYBURIDE
GLYRX-PF, GLYCOPYRROLATE
GLYSET, MIGLITOL
GLYXAMBI, EMPAGLIFLOZIN
GOCOVRI, AMANTADINE HYDROCHLORIDE
GOLYTELY, POLYETHYLENE GLYCOL 3350
GOPRELTO, COCAINE HYDROCHLORIDE
GRALISE, GABAPENTIN
GRANISETRON HYDROCHLORIDE, GRANISETRON HYDROCHLORIDE
GRANISETRON HYDROCHLORIDE PRESERVATIVE FREE, GRANISETRON HYDROCHLORIDE
GRIS-PEG, GRISEOFULVIN, ULTRAMICROSIZE
GRISEOFULVIN, GRISEOFULVIN, MICROSIZE
GRISEOFULVIN, ULTRAMICROSIZE, GRISEOFULVIN, ULTRAMICROSIZE
GRISEOFULVIN,ULTRAMICROSIZE, GRISEOFULVIN, ULTRAMICROSIZE
GUAIFENESIN, GUAIFENESIN (OTC)
GUAIFENESIN AND DEXTROMETHORPHAN HYDROBROMIDE, DEXTROMETHORPHAN HYDROBROMIDE (OTC)
GUAIFENESIN AND PSEUDOEPHEDRINE HYDROCHLORIDE, GUAIFENESIN (OTC)
GUANFACINE HYDROCHLORIDE, GUANFACINE HYDROCHLORIDE
GVOKE HYPOPEN, GLUCAGON
GVOKE KIT, GLUCAGON
GVOKE PFS, GLUCAGON
GYNAZOLE-1, BUTOCONAZOLE NITRATE
** H **
HABITROL, NICOTINE (OTC)
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 26

APPENDIX A - PRODUCT NAME INDEX

** H **
HAILEY 1.5/30, ETHINYL ESTRADIOL
HAILEY 24 FE, ETHINYL ESTRADIOL
HAILEY FE 1.5/30, ETHINYL ESTRADIOL
HAILEY FE 1/20, ETHINYL ESTRADIOL
HALAVEN, ERIBULIN MESYLATE
HALCINONIDE, HALCINONIDE
HALCION, TRIAZOLAM
HALDOL, HALOPERIDOL DECANOATE
HALOBETASOL PROPIONATE, HALOBETASOL PROPIONATE
HALOETTE, ETHINYL ESTRADIOL
HALOG, HALCINONIDE
HALOPERIDOL, HALOPERIDOL
HALOPERIDOL, HALOPERIDOL LACTATE
HALOPERIDOL DECANOATE, HALOPERIDOL DECANOATE
HARVONI, LEDIPASVIR
HEATHER, NORETHINDRONE
HECTOROL, DOXERCALCIFEROL
HEMABATE, CARBOPROST TROMETHAMINE
HEMADY, DEXAMETHASONE
HEMANGEOL, PROPRANOLOL HYDROCHLORIDE
HEPARIN SODIUM, HEPARIN SODIUM
HEPARIN SODIUM 1,000 UNITS AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, HEPARIN SODIUM
HEPARIN SODIUM 1,000 UNITS IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, HEPARIN SODIUM
HEPARIN SODIUM 10,000 UNITS IN DEXTROSE 5% IN PLASTIC CONTAINER, HEPARIN SODIUM
HEPARIN SODIUM 12,500 UNITS IN DEXTROSE 5% IN PLASTIC CONTAINER, HEPARIN SODIUM
HEPARIN SODIUM 12,500 UNITS IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, HEPARIN SODIUM
HEPARIN SODIUM 2,000 UNITS AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, HEPARIN SODIUM
HEPARIN SODIUM 2,000 UNITS IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, HEPARIN SODIUM
HEPARIN SODIUM 20,000 UNITS IN DEXTROSE 5% IN PLASTIC CONTAINER, HEPARIN SODIUM
HEPARIN SODIUM 25,000 UNITS IN DEXTROSE 5% IN PLASTIC CONTAINER, HEPARIN SODIUM
HEPARIN SODIUM 25,000 UNITS IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, HEPARIN SODIUM
HEPARIN SODIUM IN PLASTIC CONTAINER, HEPARIN SODIUM
HEPARIN SODIUM PRESERVATIVE FREE, HEPARIN SODIUM
HEPSERA, ADEFOVIR DIPIVOXIL
HER STYLE, LEVONORGESTREL (OTC)
HETLIOZ, TASIMELTEON
HETLIOZ LQ, TASIMELTEON
HIBICLENS, CHLORHEXIDINE GLUCONATE (OTC)
HIBISTAT, CHLORHEXIDINE GLUCONATE (OTC)
HICON, SODIUM IODIDE I-131
HIPREX, METHENAMINE HIPPURATE
HOMATROPINE METHYLBROMIDE AND HYDROCODONE BITARTRATE, HOMATROPINE METHYLBROMIDE
HORIZANT, GABAPENTIN ENACARBIL
HYCAMTIN, TOPOTECAN HYDROCHLORIDE
HYCODAN, HOMATROPINE METHYLBROMIDE
HYDRA-ZIDE, HYDRALAZINE HYDROCHLORIDE
HYDRALAZINE HYDROCHLORIDE, HYDRALAZINE HYDROCHLORIDE
HYDREA, HYDROXYUREA
HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE
HYDROCODONE, HYDROCODONE BITARTRATE
HYDROCODONE BITARTRATE, HYDROCODONE BITARTRATE
HYDROCODONE BITARTRATE AND ACETAMINOPHEN, ACETAMINOPHEN
HYDROCODONE BITARTRATE AND ASPIRIN, ASPIRIN
HYDROCODONE BITARTRATE AND HOMATROPINE METHYLBROMIDE, HOMATROPINE METHYLBROMIDE
HYDROCODONE BITARTRATE AND IBUPROFEN, HYDROCODONE BITARTRATE
HYDROCODONE BITARTRATE, CHLORPHENIRAMINE MALEATE AND PSEUDOEPHEDRINE HYDROCHLORIDE,
HYDROCODONE POLISTIREX AND CHLORPHENIRAMINE POLISTIREX, CHLORPHENIRAMINE POLISTIREX
HYDROCORTISONE, HYDROCORTISONE
HYDROCORTISONE AND ACETIC ACID, ACETIC ACID, GLACIAL
HYDROCORTISONE BUTYRATE, HYDROCORTISONE BUTYRATE
HYDROCORTISONE IN ABSORBASE, HYDROCORTISONE
HYDROCORTISONE VALERATE, HYDROCORTISONE VALERATE
HYDROMORPHONE HYDROCHLORIDE, HYDROMORPHONE HYDROCHLORIDE
HYDROXOCOBALAMIN, HYDROXOCOBALAMIN
HYDROXYCHLOROQUINE SULFATE, HYDROXYCHLOROQUINE SULFATE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 27

APPENDIX A - PRODUCT NAME INDEX

** H **
HYDROXYPROGESTERONE CAPROATE, HYDROXYPROGESTERONE CAPROATE
HYDROXYUREA, HYDROXYUREA
HYDROXYZINE HYDROCHLORIDE, HYDROXYZINE HYDROCHLORIDE
HYDROXYZINE PAMOATE, HYDROXYZINE PAMOATE
HYFTOR, SIROLIMUS
HYSINGLA ER, HYDROCODONE BITARTRATE
HYZAAR, HYDROCHLOROTHIAZIDE
** I **
IBANDRONATE SODIUM, IBANDRONATE SODIUM
IBRANCE, PALBOCICLIB
IBSRELA, TENAPANOR HYDROCHLORIDE
IBUPROFEN, IBUPROFEN (OTC)
IBUPROFEN, IBUPROFEN
IBUPROFEN AND DIPHENHYDRAMINE CITRATE, DIPHENHYDRAMINE CITRATE (OTC)
IBUPROFEN AND DIPHENHYDRAMINE HYDROCHLORIDE, DIPHENHYDRAMINE HYDROCHLORIDE (OTC)
IBUPROFEN AND FAMOTIDINE, FAMOTIDINE
IBUPROFEN AND PHENYLEPHRINE HYDROCHLORIDE, IBUPROFEN (OTC)
IBUPROFEN AND PSEUDOEPHEDRINE HYDROCHLORIDE, IBUPROFEN (OTC)
IBUPROFEN LYSINE, IBUPROFEN LYSINE
IBUPROHM COLD AND SINUS, IBUPROFEN (OTC)
IBUTILIDE FUMARATE, IBUTILIDE FUMARATE
IC-GREEN, INDOCYANINE GREEN
ICATIBANT ACETATE, ICATIBANT ACETATE
ICLEVIA, ETHINYL ESTRADIOL
ICLUSIG, PONATINIB HYDROCHLORIDE
ICOSAPENT ETHYL, ICOSAPENT ETHYL
IDAMYCIN PFS, IDARUBICIN HYDROCHLORIDE
IDARUBICIN HYDROCHLORIDE, IDARUBICIN HYDROCHLORIDE
IDARUBICIN HYDROCHLORIDE PFS, IDARUBICIN HYDROCHLORIDE
IDHIFA, ENASIDENIB MESYLATE
IDKIT:HP, CITRIC ACID
IFEX, IFOSFAMIDE
IFOSFAMIDE, IFOSFAMIDE
IGALMI, DEXMEDETOMIDINE HYDROCHLORIDE
IHEEZO, CHLOROPROCAINE HYDROCHLORIDE
ILEVRO, NEPAFENAC
ILLUCCIX, GALLIUM GA-68 GOZETOTIDE
ILUVIEN, FLUOCINOLONE ACETONIDE
IMATINIB MESYLATE, IMATINIB MESYLATE
IMBRUVICA, IBRUTINIB
IMCIVREE, SETMELANOTIDE ACETATE
IMIPENEM AND CILASTATIN, CILASTATIN SODIUM
IMIPRAMINE HYDROCHLORIDE, IMIPRAMINE HYDROCHLORIDE
IMIPRAMINE PAMOATE, IMIPRAMINE PAMOATE
IMIQUIMOD, IMIQUIMOD
IMITREX, SUMATRIPTAN
IMITREX, SUMATRIPTAN SUCCINATE
IMITREX STATDOSE, SUMATRIPTAN SUCCINATE
IMMPHENTIV, PHENYLEPHRINE HYDROCHLORIDE
IMODIUM A-D, LOPERAMIDE HYDROCHLORIDE (OTC)
IMODIUM MULTI-SYMPTOM RELIEF, LOPERAMIDE HYDROCHLORIDE (OTC)
IMPAVIDO, MILTEFOSINE
IMPEKLO, CLOBETASOL PROPIONATE
IMPOYZ, CLOBETASOL PROPIONATE
IMURAN, AZATHIOPRINE
IMVEXXY, ESTRADIOL
INAPSINE, DROPERIDOL
INBRIJA, LEVODOPA
INCASSIA, NORETHINDRONE
INCRUSE ELLIPTA, UMECLIDINIUM BROMIDE
INDAPAMIDE, INDAPAMIDE
INDERAL LA, PROPRANOLOL HYDROCHLORIDE
INDIUM IN 111 CHLORIDE, INDIUM IN-111 CHLORIDE
INDIUM IN 111 OXYQUINOLINE, INDIUM IN-111 OXYQUINOLINE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 28

APPENDIX A - PRODUCT NAME INDEX

** I **
INDOCIN, INDOMETHACIN
INDOCYANINE GREEN, INDOCYANINE GREEN
INDOMETHACIN, INDOMETHACIN
INDOMETHACIN SODIUM, INDOMETHACIN SODIUM
INFANT'S ADVIL, IBUPROFEN (OTC)
INFANTS' FEVERALL, ACETAMINOPHEN (OTC)
INFED, FERRIC OXYHYDROXIDE
INFUGEM, GEMCITABINE HYDROCHLORIDE
INFUMORPH, MORPHINE SULFATE
INFUVITE ADULT, ALPHA-TOCOPHEROL ACETATE
INFUVITE PEDIATRIC, ASCORBIC ACID
INFUVITE PEDIATRIC (PHARMACY BULK PACKAGE), ASCORBIC ACID
INGREZZA, VALBENAZINE TOSYLATE
INJECTAFER, FERRIC CARBOXYMALTOSE
INLYTA, AXITINIB
INNOPRAN XL, PROPRANOLOL HYDROCHLORIDE
INOMAX, NITRIC OXIDE
INPEFA, SOTAGLIFLOZIN
INQOVI, CEDAZURIDINE
INREBIC, FEDRATINIB HYDROCHLORIDE
INSPRA, EPLERENONE
INTELENCE, ETRAVIRINE
INTRALIPID 10%, SOYBEAN OIL
INTRALIPID 20%, SOYBEAN OIL
INTRALIPID 30%, SOYBEAN OIL
INTRAROSA, PRASTERONE
INTROVALE, ETHINYL ESTRADIOL
INTUNIV, GUANFACINE HYDROCHLORIDE
INVANZ, ERTAPENEM SODIUM
INVEGA, PALIPERIDONE
INVEGA HAFYERA, PALIPERIDONE PALMITATE
INVEGA SUSTENNA, PALIPERIDONE PALMITATE
INVEGA TRINZA, PALIPERIDONE PALMITATE
INVELTYS, LOTEPREDNOL ETABONATE
INVOKAMET, CANAGLIFLOZIN
INVOKAMET XR, CANAGLIFLOZIN
INVOKANA, CANAGLIFLOZIN
IODIXANOL, IODIXANOL
IOFLUPANE I-123, IOFLUPANE I-123
IONOSOL MB AND DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE
IOPAMIDOL, IOPAMIDOL
IOPIDINE, APRACLONIDINE HYDROCHLORIDE
IOSAT, POTASSIUM IODIDE (OTC)
IPRATROPIUM BROMIDE, IPRATROPIUM BROMIDE
IRBESARTAN, IRBESARTAN
IRBESARTAN AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE
IRESSA, GEFITINIB
IRINOTECAN HYDROCHLORIDE, IRINOTECAN HYDROCHLORIDE
ISENTRESS, RALTEGRAVIR POTASSIUM
ISENTRESS HD, RALTEGRAVIR POTASSIUM
ISIBLOOM, DESOGESTREL
ISOFLURANE, ISOFLURANE
ISOLYTE P IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE
ISOLYTE S IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE
ISOLYTE S PH 7.4 IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE
ISONIAZID, ISONIAZID
ISOPROTERENOL HYDROCHLORIDE, ISOPROTERENOL HYDROCHLORIDE
ISOPTO ATROPINE, ATROPINE SULFATE
ISOPTO CARPINE, PILOCARPINE HYDROCHLORIDE
ISORDIL, ISOSORBIDE DINITRATE
ISOSORBIDE DINITRATE, ISOSORBIDE DINITRATE
ISOSORBIDE DINITRATE AND HYDRALAZINE HYDROCHLORIDE, HYDRALAZINE HYDROCHLORIDE
ISOSORBIDE MONONITRATE, ISOSORBIDE MONONITRATE
ISOSULFAN BLUE, ISOSULFAN BLUE
ISOTRETINOIN, ISOTRETINOIN
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 29

APPENDIX A - PRODUCT NAME INDEX

** I **
ISOVUE-200, IOPAMIDOL
ISOVUE-250, IOPAMIDOL
ISOVUE-300, IOPAMIDOL
ISOVUE-370, IOPAMIDOL
ISOVUE-M 200, IOPAMIDOL
ISOVUE-M 300, IOPAMIDOL
ISRADIPINE, ISRADIPINE
ISTALOL, TIMOLOL MALEATE
ISTODAX, ROMIDEPSIN
ISTURISA, OSILODROSTAT PHOSPHATE
ITRACONAZOLE, ITRACONAZOLE
IVABRADINE HYDROCHLORIDE, IVABRADINE HYDROCHLORIDE
IVERMECTIN, IVERMECTIN (OTC)
IVERMECTIN, IVERMECTIN
IVY BLOCK, BENTOQUATAM (OTC)
IXEMPRA KIT, IXABEPILONE
IYUZEH, LATANOPROST
** J **
JADENU, DEFERASIROX
JADENU SPRINKLE, DEFERASIROX
JAIMIESS, ETHINYL ESTRADIOL
JAKAFI, RUXOLITINIB PHOSPHATE
JALYN, DUTASTERIDE
JANTOVEN, WARFARIN SODIUM
JANUMET, METFORMIN HYDROCHLORIDE
JANUMET XR, METFORMIN HYDROCHLORIDE
JANUVIA, SITAGLIPTIN PHOSPHATE
JARDIANCE, EMPAGLIFLOZIN
JATENZO, TESTOSTERONE UNDECANOATE
JAYPIRCA, PIRTOBRUTINIB
JELMYTO, MITOMYCIN
JENCYCLA, NORETHINDRONE
JENTADUETO, LINAGLIPTIN
JENTADUETO XR, LINAGLIPTIN
JESDUVROQ, DAPRODUSTAT
JEVTANA KIT, CABAZITAXEL
JOENJA, LENIOLISIB PHOSPHATE
JORNAY PM, METHYLPHENIDATE HYDROCHLORIDE
JUBLIA, EFINACONAZOLE
JULUCA, DOLUTEGRAVIR SODIUM
JUNEL 1.5/30, ETHINYL ESTRADIOL
JUNEL 1/20, ETHINYL ESTRADIOL
JUNEL FE 1.5/30, ETHINYL ESTRADIOL
JUNEL FE 1/20, ETHINYL ESTRADIOL
JUNIOR STRENGTH ADVIL, IBUPROFEN (OTC)
JUNIOR STRENGTH MOTRIN, IBUPROFEN (OTC)
JUXTAPID, LOMITAPIDE MESYLATE
JYNARQUE, TOLVAPTAN
** K **
KABIVEN IN PLASTIC CONTAINER, AMINO ACIDS
KAITLIB FE, ETHINYL ESTRADIOL
KALETRA, LOPINAVIR
KALEXATE, SODIUM POLYSTYRENE SULFONATE
KALLIGA, DESOGESTREL
KALYDECO, IVACAFTOR
KAPSPARGO SPRINKLE, METOPROLOL SUCCINATE
KAPVAY, CLONIDINE HYDROCHLORIDE
KARBINAL ER, CARBINOXAMINE MALEATE
KARIVA, DESOGESTREL
KATERZIA, AMLODIPINE BENZOATE
KAZANO, ALOGLIPTIN BENZOATE
KELNOR, ETHINYL ESTRADIOL
KENALOG-10, TRIAMCINOLONE ACETONIDE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 30

APPENDIX A - PRODUCT NAME INDEX

** K **
KENALOG-40, TRIAMCINOLONE ACETONIDE
KENALOG-80, TRIAMCINOLONE ACETONIDE
KENGREAL, CANGRELOR
KEPPRA, LEVETIRACETAM
KEPPRA XR, LEVETIRACETAM
KERENDIA, FINERENONE
KERYDIN, TAVABOROLE
KETALAR, KETAMINE HYDROCHLORIDE
KETAMINE HYDROCHLORIDE, KETAMINE HYDROCHLORIDE
KETOCONAZOLE, KETOCONAZOLE
KETOPROFEN, KETOPROFEN
KETOROLAC TROMETHAMINE, KETOROLAC TROMETHAMINE
KETOROLAC TROMETHAMINE AND PHENYLEPHRINE HYDROCHLORIDE, KETOROLAC TROMETHAMINE
KETOTIFEN FUMARATE, KETOTIFEN FUMARATE (OTC)
KETOZOLE, KETOCONAZOLE
KEVEYIS, DICHLORPHENAMIDE
KHAPZORY, LEVOLEUCOVORIN
KIMIDESS, DESOGESTREL
KIMYRSA, ORITAVANCIN DIPHOSPHATE
KINEVAC, SINCALIDE
KIONEX, SODIUM POLYSTYRENE SULFONATE
KISQALI, RIBOCICLIB SUCCINATE
KISQALI FEMARA CO-PACK (COPACKAGED), LETROZOLE
KITABIS PAK, TOBRAMYCIN
KLARON, SULFACETAMIDE SODIUM
KLISYRI, TIRBANIBULIN
KLONOPIN, CLONAZEPAM
KLOR-CON, POTASSIUM CHLORIDE
KLOR-CON M10, POTASSIUM CHLORIDE
KLOR-CON M15, POTASSIUM CHLORIDE
KLOR-CON M20, POTASSIUM CHLORIDE
KLOXXADO, NALOXONE HYDROCHLORIDE
KOMBIGLYZE XR, METFORMIN HYDROCHLORIDE
KONVOMEP, OMEPRAZOLE
KORLYM, MIFEPRISTONE
KORSUVA, DIFELIKEFALIN ACETATE
KOSELUGO, SELUMETINIB SULFATE
KOVANAZE, OXYMETAZOLINE HYDROCHLORIDE
KRAZATI, ADAGRASIB
KRINTAFEL, TAFENOQUINE SUCCINATE
KURVELO, ETHINYL ESTRADIOL
KUVAN, SAPROPTERIN DIHYDROCHLORIDE
KYBELLA, DEOXYCHOLIC ACID
KYLEENA, LEVONORGESTREL
KYNMOBI, APOMORPHINE HYDROCHLORIDE
KYPROLIS, CARFILZOMIB
KYZATREX, TESTOSTERONE UNDECANOATE
** L **
LABETALOL HYDROCHLORIDE, LABETALOL HYDROCHLORIDE
LABETALOL HYDROCHLORIDE IN DEXTROSE, LABETALOL HYDROCHLORIDE
LABETALOL HYDROCHLORIDE IN SODIUM CHLORIDE, LABETALOL HYDROCHLORIDE
LACOSAMIDE, LACOSAMIDE
LACRISERT, HYDROXYPROPYL CELLULOSE
LACTATED RINGER'S AND DEXTROSE 5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE
LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE
LACTULOSE, LACTULOSE
LAMICTAL, LAMOTRIGINE
LAMICTAL CD, LAMOTRIGINE
LAMICTAL ODT, LAMOTRIGINE
LAMICTAL XR, LAMOTRIGINE
LAMISIL, TERBINAFINE HYDROCHLORIDE (OTC)
LAMISIL AT, TERBINAFINE (OTC)
LAMISIL AT, TERBINAFINE HYDROCHLORIDE (OTC)
LAMIVUDINE, LAMIVUDINE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 31

APPENDIX A - PRODUCT NAME INDEX

** L **
LAMIVUDINE AND ZIDOVUDINE, LAMIVUDINE
LAMOTRIGINE, LAMOTRIGINE
LAMPIT, NIFURTIMOX
LANORINAL, ASPIRIN
LANOXIN, DIGOXIN
LANOXIN PEDIATRIC, DIGOXIN
LANREOTIDE ACETATE, LANREOTIDE ACETATE
LANSOPRAZOLE, LANSOPRAZOLE (OTC)
LANSOPRAZOLE, LANSOPRAZOLE
LANSOPRAZOLE, AMOXICILLIN AND CLARITHROMYCIN (COPACKAGED), AMOXICILLIN
LANTHANUM CARBONATE, LANTHANUM CARBONATE
LAPATINIB DITOSYLATE, LAPATINIB DITOSYLATE
LARIN 1.5/30, ETHINYL ESTRADIOL
LARIN 1/20, ETHINYL ESTRADIOL
LARIN 24 FE, ETHINYL ESTRADIOL
LARIN FE 1.5/30, ETHINYL ESTRADIOL
LARIN FE 1/20, ETHINYL ESTRADIOL
LAROTID, AMOXICILLIN
LARYNG-O-JET KIT, LIDOCAINE HYDROCHLORIDE
LASIX, FUROSEMIDE
LASTACAFT, ALCAFTADINE (OTC)
LATANOPROST, LATANOPROST
LATISSE, BIMATOPROST
LATUDA, LURASIDONE HYDROCHLORIDE
LEFLUNOMIDE, LEFLUNOMIDE
LENALIDOMIDE, LENALIDOMIDE
LENVIMA, LENVATINIB MESYLATE
LEQVIO, INCLISIRAN SODIUM
LERIBANE, ETHINYL ESTRADIOL
LESCOL XL, FLUVASTATIN SODIUM
LESSINA-28, ETHINYL ESTRADIOL
LETAIRIS, AMBRISENTAN
LETROZOLE, LETROZOLE
LEUCOVORIN CALCIUM, LEUCOVORIN CALCIUM
LEUCOVORIN CALCIUM PRESERVATIVE FREE, LEUCOVORIN CALCIUM
LEUKERAN, CHLORAMBUCIL
LEUPROLIDE ACETATE, LEUPROLIDE ACETATE
LEVALBUTEROL HYDROCHLORIDE, LEVALBUTEROL HYDROCHLORIDE
LEVETIRACETAM, LEVETIRACETAM
LEVETIRACETAM IN SODIUM CHLORIDE, LEVETIRACETAM
LEVO-T, LEVOTHYROXINE SODIUM **
LEVOBUNOLOL HYDROCHLORIDE, LEVOBUNOLOL HYDROCHLORIDE
LEVOCARNITINE, LEVOCARNITINE
LEVOCARNITINE SF, LEVOCARNITINE
LEVOCETIRIZINE DIHYDROCHLORIDE, LEVOCETIRIZINE DIHYDROCHLORIDE (OTC)
LEVOCETIRIZINE DIHYDROCHLORIDE, LEVOCETIRIZINE DIHYDROCHLORIDE
LEVOCETIRIZINE HYDROCHLORIDE, LEVOCETIRIZINE DIHYDROCHLORIDE
LEVOFLOXACIN, LEVOFLOXACIN
LEVOFLOXACIN IN DEXTROSE 5% IN PLASTIC CONTAINER, LEVOFLOXACIN
LEVOLET, LEVOTHYROXINE SODIUM **
LEVOLEUCOVORIN CALCIUM, LEVOLEUCOVORIN CALCIUM
LEVOMILNACIPRAN HYDROCHLORIDE, LEVOMILNACIPRAN HYDROCHLORIDE
LEVONEST, ETHINYL ESTRADIOL
LEVONORGESTREL, LEVONORGESTREL (OTC)
LEVONORGESTREL AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL
LEVONORGESTREL AND ETHINYL ESTRADIOL AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL
LEVOPHED, NOREPINEPHRINE BITARTRATE
LEVORA 0.15/30-28, ETHINYL ESTRADIOL
LEVORPHANOL TARTRATE, LEVORPHANOL TARTRATE
LEVOTHYROXINE SODIUM, LEVOTHYROXINE SODIUM
LEVOTHYROXINE SODIUM, LEVOTHYROXINE SODIUM **
LEVOXYL, LEVOTHYROXINE SODIUM **
LEVULAN, AMINOLEVULINIC ACID HYDROCHLORIDE
LEXAPRO, ESCITALOPRAM OXALATE
LEXETTE, HALOBETASOL PROPIONATE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 32

APPENDIX A - PRODUCT NAME INDEX

** L **
LEXISCAN, REGADENOSON
LEXIVA, FOSAMPRENAVIR CALCIUM
LIALDA, MESALAMINE
LIBRAX, CHLORDIAZEPOXIDE HYDROCHLORIDE
LIBRIUM, CHLORDIAZEPOXIDE HYDROCHLORIDE
LICART, DICLOFENAC EPOLAMINE
LIDEX, FLUOCINONIDE
LIDOCAINE, LIDOCAINE
LIDOCAINE AND PRILOCAINE, LIDOCAINE
LIDOCAINE HYDROCHLORIDE, LIDOCAINE HYDROCHLORIDE
LIDOCAINE HYDROCHLORIDE 0.2% AND DEXTROSE 5% IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE
LIDOCAINE HYDROCHLORIDE 0.4% AND DEXTROSE 5% IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE
LIDOCAINE HYDROCHLORIDE 0.8% AND DEXTROSE 5% IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE
LIDOCAINE HYDROCHLORIDE 5% AND DEXTROSE 7.5%, LIDOCAINE HYDROCHLORIDE
LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE, EPINEPHRINE
LIDOCAINE HYDROCHLORIDE IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE
LIDOCAINE HYDROCHLORIDE PRESERVATIVE FREE, LIDOCAINE HYDROCHLORIDE
LIDOCAINE HYDROCHLORIDE PRESERVATIVE FREE IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE
LIDOCAINE HYDROCHLORIDE VISCOUS, LIDOCAINE HYDROCHLORIDE
LIDOCAINE VISCOUS, LIDOCAINE HYDROCHLORIDE
LIDODERM, LIDOCAINE
LIGNOSPAN FORTE, EPINEPHRINE BITARTRATE
LIGNOSPAN STANDARD, EPINEPHRINE BITARTRATE
LILETTA, LEVONORGESTREL
LINAGLIPTIN, LINAGLIPTIN
LINAGLIPTIN AND METFORMIN HYDROCHLORIDE, LINAGLIPTIN
LINCOCIN, LINCOMYCIN HYDROCHLORIDE
LINCOMYCIN HYDROCHLORIDE, LINCOMYCIN HYDROCHLORIDE
LINEZOLID, LINEZOLID
LINEZOLID IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, LINEZOLID
LINZESS, LINACLOTIDE
LIORESAL, BACLOFEN
LIOTHYRONINE SODIUM, LIOTHYRONINE SODIUM
LIPIODOL, ETHIODIZED OIL
LIPITOR, ATORVASTATIN CALCIUM
LIPOFEN, FENOFIBRATE
LIQREV, SILDENAFIL CITRATE
LIQUID E-Z-PAQUE, BARIUM SULFATE
LISINOPRIL, LISINOPRIL
LISINOPRIL AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE
LITFULO, RITLECITINIB TOSYLATE
LITHIUM CARBONATE, LITHIUM CARBONATE
LITHIUM CITRATE, LITHIUM CITRATE
LITHOBID, LITHIUM CARBONATE
LITHOSTAT, ACETOHYDROXAMIC ACID
LIVALO, PITAVASTATIN CALCIUM
LIVMARLI, MARALIXIBAT CHLORIDE
LIVTENCITY, MARIBAVIR
LO LOESTRIN FE, ETHINYL ESTRADIOL
LO SIMPESSE, ETHINYL ESTRADIOL
LO-MALMOREDE, ETHINYL ESTRADIOL
LO-ZUMANDIMINE, DROSPIRENONE
LOCAMETZ, GALLIUM GA-68 GOZETOTIDE
LOCHOLEST, CHOLESTYRAMINE
LOCHOLEST LIGHT, CHOLESTYRAMINE
LOCOID, HYDROCORTISONE BUTYRATE
LOCOID LIPOCREAM, HYDROCORTISONE BUTYRATE
LODOCO, COLCHICINE
LODOSYN, CARBIDOPA
LOGILIA, ULIPRISTAL ACETATE
LOKELMA, SODIUM ZIRCONIUM CYCLOSILICATE
LOMAIRA, PHENTERMINE HYDROCHLORIDE
LOMOTIL, ATROPINE SULFATE
LONHALA MAGNAIR KIT, GLYCOPYRROLATE
LONSURF, TIPIRACIL HYDROCHLORIDE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 33

APPENDIX A - PRODUCT NAME INDEX

** L **
LOPERAMIDE HYDROCHLORIDE, LOPERAMIDE HYDROCHLORIDE (OTC)
LOPERAMIDE HYDROCHLORIDE, LOPERAMIDE HYDROCHLORIDE
LOPERAMIDE HYDROCHLORIDE AND SIMETHICONE, LOPERAMIDE HYDROCHLORIDE (OTC)
LOPID, GEMFIBROZIL
LOPINAVIR AND RITONAVIR, LOPINAVIR
LOPRESSOR, METOPROLOL TARTRATE
LOPRESSOR HCT, HYDROCHLOROTHIAZIDE
LOPROX, CICLOPIROX
LOPURIN, ALLOPURINOL
LORATADINE, LORATADINE (OTC)
LORATADINE AND PSEUDOEPHEDRINE SULFATE, LORATADINE (OTC)
LORATADINE REDIDOSE, LORATADINE (OTC)
LORAZEPAM, LORAZEPAM
LORAZEPAM INTENSOL, LORAZEPAM
LORBRENA, LORLATINIB
LOREEV XR, LORAZEPAM
LORYNA, DROSPIRENONE
LOSARTAN POTASSIUM, LOSARTAN POTASSIUM
LOSARTAN POTASSIUM AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE
LOSEASONIQUE, ETHINYL ESTRADIOL
LOTEMAX, LOTEPREDNOL ETABONATE
LOTEMAX SM, LOTEPREDNOL ETABONATE
LOTENSIN, BENAZEPRIL HYDROCHLORIDE
LOTENSIN HCT, BENAZEPRIL HYDROCHLORIDE
LOTEPREDNOL ETABONATE, LOTEPREDNOL ETABONATE
LOTREL, AMLODIPINE BESYLATE
LOTRIMIN ULTRA, BUTENAFINE HYDROCHLORIDE (OTC)
LOTRONEX, ALOSETRON HYDROCHLORIDE
LOVASTATIN, LOVASTATIN
LOVAZA, OMEGA-3-ACID ETHYL ESTERS
LOVENOX, ENOXAPARIN SODIUM
LOVENOX (PRESERVATIVE FREE), ENOXAPARIN SODIUM
LOW-OGESTREL-28, ETHINYL ESTRADIOL
LOXAPINE SUCCINATE, LOXAPINE SUCCINATE
LUBIPROSTONE, LUBIPROSTONE
LUCEMYRA, LOFEXIDINE HYDROCHLORIDE
LUMAKRAS, SOTORASIB
LUMASON, SULFUR HEXAFLUORIDE LIPID-TYPE A MICROSPHERES
LUMI-SPORYN, BACITRACIN ZINC
LUMIFY, BRIMONIDINE TARTRATE (OTC)
LUMIGAN, BIMATOPROST
LUMRYZ, SODIUM OXYBATE
LUNESTA, ESZOPICLONE
LUPKYNIS, VOCLOSPORIN
LUPRON DEPOT, LEUPROLIDE ACETATE
LUPRON DEPOT-PED KIT, LEUPROLIDE ACETATE
LURASIDONE HYDROCHLORIDE, LURASIDONE HYDROCHLORIDE
LUTATHERA, LUTETIUM LU 177 DOTATATE
LUTRATE DEPOT KIT, LEUPROLIDE ACETATE
LUVOX, FLUVOXAMINE MALEATE
LUXIQ, BETAMETHASONE VALERATE
LUZU, LULICONAZOLE
LYBALVI, OLANZAPINE
LYMPHOSEEK KIT, TECHNETIUM TC-99M TILMANOCEPT
LYNPARZA, OLAPARIB
LYPQOZET, ATORVASTATIN CALCIUM
LYRICA, PREGABALIN
LYRICA CR, PREGABALIN
LYSODREN, MITOTANE
LYSTEDA, TRANEXAMIC ACID
LYTGOBI, FUTIBATINIB
LYVISPAH, BACLOFEN
** M **
M-ZOLE 3 COMBINATION PACK, MICONAZOLE NITRATE (OTC)
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 34

APPENDIX A - PRODUCT NAME INDEX

** M **
MACROBID, NITROFURANTOIN
MACRODANTIN, NITROFURANTOIN, MACROCRYSTALLINE
MAGNESIUM SULFATE, MAGNESIUM SULFATE
MAGNESIUM SULFATE IN DEXTROSE 5% IN PLASTIC CONTAINER, MAGNESIUM SULFATE
MAGNESIUM SULFATE IN PLASTIC CONTAINER, MAGNESIUM SULFATE
MALARONE, ATOVAQUONE
MALARONE PEDIATRIC, ATOVAQUONE
MALATHION, MALATHION
MALMOREDE, ETHINYL ESTRADIOL
MANGANESE CHLORIDE IN PLASTIC CONTAINER, MANGANESE CHLORIDE
MANNITOL 10% IN PLASTIC CONTAINER, MANNITOL
MANNITOL 15% IN PLASTIC CONTAINER, MANNITOL
MANNITOL 20% IN PLASTIC CONTAINER, MANNITOL
MANNITOL 25%, MANNITOL
MANNITOL 5% IN PLASTIC CONTAINER, MANNITOL
MARAVIROC, MARAVIROC
MARCAINE, BUPIVACAINE HYDROCHLORIDE
MARCAINE HYDROCHLORIDE, BUPIVACAINE HYDROCHLORIDE
MARCAINE HYDROCHLORIDE PRESERVATIVE FREE, BUPIVACAINE HYDROCHLORIDE
MARCAINE HYDROCHLORIDE W/ EPINEPHRINE, BUPIVACAINE HYDROCHLORIDE
MARCAINE HYDROCHLORIDE W/ EPINEPHRINE PRESERVATIVE FREE, BUPIVACAINE HYDROCHLORIDE
MARINOL, DRONABINOL
MARLISSA, ETHINYL ESTRADIOL
MARPLAN, ISOCARBOXAZID
MATULANE, PROCARBAZINE HYDROCHLORIDE
MAVENCLAD, CLADRIBINE
MAVYRET, GLECAPREVIR
MAXALT, RIZATRIPTAN BENZOATE
MAXALT-MLT, RIZATRIPTAN BENZOATE
MAXIDEX, DEXAMETHASONE
MAXIPIME, CEFEPIME HYDROCHLORIDE
MAXITROL, DEXAMETHASONE
MAXZIDE, HYDROCHLOROTHIAZIDE
MAXZIDE-25, HYDROCHLOROTHIAZIDE
MAYZENT, SIPONIMOD
MD-GASTROVIEW, DIATRIZOATE MEGLUMINE
MECAMYLAMINE HYDROCHLORIDE, MECAMYLAMINE HYDROCHLORIDE
MECLIZINE HYDROCHLORIDE, MECLIZINE HYDROCHLORIDE
MECLOFENAMATE SODIUM, MECLOFENAMATE SODIUM
MEDROL, METHYLPREDNISOLONE
MEDROXYPROGESTERONE ACETATE, MEDROXYPROGESTERONE ACETATE
MEFENAMIC ACID, MEFENAMIC ACID
MEFLOQUINE HYDROCHLORIDE, MEFLOQUINE HYDROCHLORIDE
MEGACE ES, MEGESTROL ACETATE
MEGESTROL ACETATE, MEGESTROL ACETATE
MEKINIST, TRAMETINIB DIMETHYL SULFOXIDE
MEKTOVI, BINIMETINIB
MELAMISA, DROSPIRENONE
MELOXICAM, MELOXICAM
MELPHALAN, MELPHALAN
MELPHALAN HYDROCHLORIDE, MELPHALAN HYDROCHLORIDE
MEMANTINE HYDROCHLORIDE, MEMANTINE HYDROCHLORIDE
MEN'S ROGAINE, MINOXIDIL (OTC)
MENEST, ESTROGENS, ESTERIFIED
MENOSTAR, ESTRADIOL
MENTAX, BUTENAFINE HYDROCHLORIDE
MEPERIDINE HYDROCHLORIDE, MEPERIDINE HYDROCHLORIDE
MEPERIDINE HYDROCHLORIDE PRESERVATIVE FREE, MEPERIDINE HYDROCHLORIDE
MEPROBAMATE, MEPROBAMATE
MEPRON, ATOVAQUONE
MERCAPTOPURINE, MERCAPTOPURINE
MEROPENEM, MEROPENEM
MEROPENEM AND SODIUM CHLORIDE IN DUPLEX CONTAINER, MEROPENEM
MERREM, MEROPENEM
MERZEE, ETHINYL ESTRADIOL
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 35

APPENDIX A - PRODUCT NAME INDEX

** M **
MESALAMINE, MESALAMINE
MESNA, MESNA
MESNEX, MESNA
MESTINON, PYRIDOSTIGMINE BROMIDE
METADATE CD, METHYLPHENIDATE HYDROCHLORIDE
METAPROTERENOL SULFATE, METAPROTERENOL SULFATE
METARAMINOL BITARTRATE, METARAMINOL BITARTRATE
METASTRON, STRONTIUM CHLORIDE SR-89
METAXALONE, METAXALONE
METFORMIN HYDROCHLORIDE, METFORMIN HYDROCHLORIDE
METHADONE HYDROCHLORIDE, METHADONE HYDROCHLORIDE
METHADONE HYDROCHLORIDE INTENSOL, METHADONE HYDROCHLORIDE
METHADOSE, METHADONE HYDROCHLORIDE
METHAMPHETAMINE HYDROCHLORIDE, METHAMPHETAMINE HYDROCHLORIDE
METHAZOLAMIDE, METHAZOLAMIDE
METHENAMINE HIPPURATE, METHENAMINE HIPPURATE
METHERGINE, METHYLERGONOVINE MALEATE
METHIMAZOLE, METHIMAZOLE
METHOCARBAMOL, METHOCARBAMOL
METHOTREXATE PRESERVATIVE FREE, METHOTREXATE SODIUM
METHOTREXATE SODIUM, METHOTREXATE SODIUM
METHOTREXATE SODIUM PRESERVATIVE FREE, METHOTREXATE SODIUM
METHOXSALEN, METHOXSALEN
METHSCOPOLAMINE BROMIDE, METHSCOPOLAMINE BROMIDE
METHSUXIMIDE, METHSUXIMIDE
METHYLERGONOVINE MALEATE, METHYLERGONOVINE MALEATE
METHYLIN, METHYLPHENIDATE HYDROCHLORIDE
METHYLIN ER, METHYLPHENIDATE HYDROCHLORIDE
METHYLPHENIDATE, METHYLPHENIDATE
METHYLPHENIDATE HYDROCHLORIDE, METHYLPHENIDATE HYDROCHLORIDE
METHYLPREDNISOLONE, METHYLPREDNISOLONE
METHYLPREDNISOLONE ACETATE, METHYLPREDNISOLONE ACETATE
METHYLPREDNISOLONE SODIUM SUCCINATE, METHYLPREDNISOLONE SODIUM SUCCINATE
METHYLTESTOSTERONE, METHYLTESTOSTERONE
METOCLOPRAMIDE, METOCLOPRAMIDE HYDROCHLORIDE
METOCLOPRAMIDE HYDROCHLORIDE, METOCLOPRAMIDE HYDROCHLORIDE
METOLAZONE, METOLAZONE
METOPIRONE, METYRAPONE
METOPROLOL SUCCINATE, METOPROLOL SUCCINATE
METOPROLOL TARTRATE, METOPROLOL TARTRATE
METOPROLOL TARTRATE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE
METRO I.V. IN PLASTIC CONTAINER, METRONIDAZOLE
METROCREAM, METRONIDAZOLE
METROGEL, METRONIDAZOLE
METROGEL-VAGINAL, METRONIDAZOLE
METROLOTION, METRONIDAZOLE
METRONIDAZOLE, METRONIDAZOLE
METRONIDAZOLE IN PLASTIC CONTAINER, METRONIDAZOLE
METYROSINE, METYROSINE
MEXILETINE HYDROCHLORIDE, MEXILETINE HYDROCHLORIDE
MIACALCIN, CALCITONIN SALMON
MIBELAS 24 FE, ETHINYL ESTRADIOL
MICAFUNGIN, MICAFUNGIN SODIUM
MICAFUNGIN SODIUM, MICAFUNGIN SODIUM
MICARDIS, TELMISARTAN
MICARDIS HCT, HYDROCHLOROTHIAZIDE
MICONAZOLE 3, MICONAZOLE NITRATE (OTC)
MICONAZOLE 3 COMBINATION PACK, MICONAZOLE NITRATE (OTC)
MICONAZOLE 7, MICONAZOLE NITRATE (OTC)
MICONAZOLE NITRATE, MICONAZOLE NITRATE (OTC)
MICONAZOLE NITRATE, MICONAZOLE NITRATE
MICONAZOLE NITRATE COMBINATION PACK, MICONAZOLE NITRATE (OTC)
MICORT-HC, HYDROCORTISONE ACETATE
MICROZIDE, HYDROCHLOROTHIAZIDE
MIDAMOR, AMILORIDE HYDROCHLORIDE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 36

APPENDIX A - PRODUCT NAME INDEX

** M **
MIDAZOLAM HYDROCHLORIDE, MIDAZOLAM HYDROCHLORIDE
MIDAZOLAM HYDROCHLORIDE PRESERVATIVE FREE, MIDAZOLAM HYDROCHLORIDE
MIDAZOLAM IN 0.8% SODIUM CHLORIDE, MIDAZOLAM
MIDAZOLAM IN 0.9% SODIUM CHLORIDE, MIDAZOLAM
MIDODRINE HYDROCHLORIDE, MIDODRINE HYDROCHLORIDE
MIDOL LIQUID GELS, IBUPROFEN (OTC)
MIEBO, PERFLUOROHEXYLOCTANE
MIFEPREX, MIFEPRISTONE
MIFEPRISTONE, MIFEPRISTONE
MIGERGOT, CAFFEINE
MIGLITOL, MIGLITOL
MIGLUSTAT, MIGLUSTAT
MIGRANAL, DIHYDROERGOTAMINE MESYLATE
MILI, ETHINYL ESTRADIOL
MILRINONE LACTATE, MILRINONE LACTATE
MILRINONE LACTATE IN DEXTROSE 5%, MILRINONE LACTATE
MILRINONE LACTATE IN DEXTROSE 5% IN PLASTIC CONTAINER, MILRINONE LACTATE
MILRINONE LACTATE IN PLASTIC CONTAINER, MILRINONE LACTATE
MINIPRESS, PRAZOSIN HYDROCHLORIDE
MINIVELLE, ESTRADIOL
MINOCIN, MINOCYCLINE HYDROCHLORIDE
MINOCYCLINE HYDROCHLORIDE, MINOCYCLINE HYDROCHLORIDE
MINOLIRA, MINOCYCLINE HYDROCHLORIDE
MINOXIDIL, MINOXIDIL (OTC)
MINOXIDIL, MINOXIDIL
MINOXIDIL (FOR MEN), MINOXIDIL (OTC)
MINOXIDIL (FOR WOMEN), MINOXIDIL (OTC)
MINOXIDIL EXTRA STRENGTH (FOR MEN), MINOXIDIL (OTC)
MIOCHOL-E, ACETYLCHOLINE CHLORIDE
MIOSTAT, CARBACHOL
MIRABEGRON, MIRABEGRON
MIRALAX, POLYETHYLENE GLYCOL 3350 (OTC)
MIRAPEX ER, PRAMIPEXOLE DIHYDROCHLORIDE
MIRENA, LEVONORGESTREL
MIRTAZAPINE, MIRTAZAPINE
MIRVASO, BRIMONIDINE TARTRATE
MISOPROSTOL, MISOPROSTOL
MITIGARE, COLCHICINE
MITIGO, MORPHINE SULFATE
MITOMYCIN, MITOMYCIN
MITOSOL, MITOMYCIN
MITOXANTRONE HYDROCHLORIDE, MITOXANTRONE HYDROCHLORIDE
MIVACURIUM CHLORIDE, MIVACURIUM CHLORIDE
MOBIC, MELOXICAM
MODAFINIL, MODAFINIL
MOEXIPRIL HYDROCHLORIDE, MOEXIPRIL HYDROCHLORIDE
MOEXIPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE
MOLINDONE HYDROCHLORIDE, MOLINDONE HYDROCHLORIDE
MOMETASONE FUROATE, MOMETASONE FUROATE (OTC)
MOMETASONE FUROATE, MOMETASONE FUROATE
MONISTAT 1 COMBINATION PACK, MICONAZOLE NITRATE (OTC)
MONISTAT 3, MICONAZOLE NITRATE (OTC)
MONISTAT 3, MICONAZOLE NITRATE
MONISTAT 3 COMBINATION PACK, MICONAZOLE NITRATE (OTC)
MONISTAT 3 COMBINATION PACK (PREFILLED), MICONAZOLE NITRATE (OTC)
MONISTAT 7, MICONAZOLE NITRATE (OTC)
MONISTAT 7 COMBINATION PACK, MICONAZOLE NITRATE (OTC)
MONO-LINYAH, ETHINYL ESTRADIOL
MONOBASIC SODIUM PHOSPHATE AND DIBASIC SODIUM PHOSPHATE, SODIUM PHOSPHATE, DIBASIC,
MONODOX, DOXYCYCLINE
MONOFERRIC, FERRIC DERISOMALTOSE
MONOKET, ISOSORBIDE MONONITRATE
MONTELUKAST SODIUM, MONTELUKAST SODIUM
MONUROL, FOSFOMYCIN TROMETHAMINE
MORPHINE SULFATE, MORPHINE SULFATE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 37

APPENDIX A - PRODUCT NAME INDEX

** M **
MOTEGRITY, PRUCALOPRIDE SUCCINATE
MOTOFEN, ATROPINE SULFATE
MOTPOLY XR, LACOSAMIDE
MOTRIN IB, IBUPROFEN (OTC)
MOUNJARO, TIRZEPATIDE
MOVANTIK, NALOXEGOL OXALATE
MOVIPREP, ASCORBIC ACID
MOXIDECTIN, MOXIDECTIN
MOXIFLOXACIN HYDROCHLORIDE, MOXIFLOXACIN HYDROCHLORIDE
MOXIFLOXACIN HYDROCHLORIDE IN SODIUM CHLORIDE 0.8% IN PLASTIC CONTAINER, MOXIFLOXACIN
MOZOBIL, PLERIXAFOR
MPI INDIUM DTPA IN 111, INDIUM IN-111 PENTETATE DISODIUM
MS CONTIN, MORPHINE SULFATE
MUCINEX, GUAIFENESIN (OTC)
MUCINEX D, GUAIFENESIN (OTC)
MUCINEX DM, DEXTROMETHORPHAN HYDROBROMIDE (OTC)
MULPLETA, LUSUTROMBOPAG
MULTAQ, DRONEDARONE HYDROCHLORIDE
MULTIHANCE, GADOBENATE DIMEGLUMINE
MULTIHANCE MULTIPACK, GADOBENATE DIMEGLUMINE
MULTIPLE ELECTROLYTES INJECTION TYPE 1 USP PH 5.5, MAGNESIUM CHLORIDE
MULTIPLE ELECTROLYTES INJECTION TYPE 1 USP PH 7.4, MAGNESIUM CHLORIDE
MULTRYS, CUPRIC SULFATE
MUPIROCIN, MUPIROCIN
MUPIROCIN, MUPIROCIN CALCIUM
MUSE, ALPROSTADIL
MYAMBUTOL, ETHAMBUTOL HYDROCHLORIDE
MYCAMINE, MICAFUNGIN SODIUM
MYCAPSSA, OCTREOTIDE ACETATE
MYCOBUTIN, RIFABUTIN
MYCOPHENOLATE MOFETIL, MYCOPHENOLATE MOFETIL
MYCOPHENOLATE MOFETIL HYDROCHLORIDE, MYCOPHENOLATE MOFETIL HYDROCHLORIDE
MYCOPHENOLIC SODIUM, MYCOPHENOLIC SODIUM
MYDAYIS, AMPHETAMINE ASPARTATE
MYDCOMBI, PHENYLEPHRINE HYDROCHLORIDE
MYDRIACYL, TROPICAMIDE
MYFEMBREE, ESTRADIOL
MYFORTIC, MYCOPHENOLIC SODIUM
MYKACET, NYSTATIN
MYLERAN, BUSULFAN
MYORISAN, ISOTRETINOIN
MYOVIEW, TECHNETIUM TC-99M TETROFOSMIN KIT
MYOVIEW 30ML, TECHNETIUM TC-99M TETROFOSMIN KIT
MYRBETRIQ, MIRABEGRON
MYRBETRIQ GRANULES, MIRABEGRON
MYSOLINE, PRIMIDONE
MYTESI, CROFELEMER
MYZILRA, ETHINYL ESTRADIOL
** N **
NABUMETONE, NABUMETONE
NADOLOL, NADOLOL
NAFCILLIN SODIUM, NAFCILLIN SODIUM
NAFTIFINE HYDROCHLORIDE, NAFTIFINE HYDROCHLORIDE
NAFTIN, NAFTIFINE HYDROCHLORIDE
NALBUPHINE HYDROCHLORIDE, NALBUPHINE HYDROCHLORIDE
NALFON, FENOPROFEN CALCIUM
NALLPEN IN PLASTIC CONTAINER, NAFCILLIN SODIUM
NALMEFENE HYDROCHLORIDE, NALMEFENE HYDROCHLORIDE
NALOXONE, NALOXONE HYDROCHLORIDE
NALOXONE HYDROCHLORIDE, NALOXONE HYDROCHLORIDE
NALOXONE HYDROCHLORIDE AND PENTAZOCINE HYDROCHLORIDE, NALOXONE HYDROCHLORIDE
NALTREXONE, NALTREXONE
NALTREXONE HYDROCHLORIDE, NALTREXONE HYDROCHLORIDE
NAMENDA, MEMANTINE HYDROCHLORIDE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 38

APPENDIX A - PRODUCT NAME INDEX

** N **
NAMENDA XR, MEMANTINE HYDROCHLORIDE
NAMZARIC, DONEPEZIL HYDROCHLORIDE
NAPHAZOLINE HYDROCHLORIDE AND PHENIRAMINE MALEATE, NAPHAZOLINE HYDROCHLORIDE (OTC)
NAPHCON-A, NAPHAZOLINE HYDROCHLORIDE (OTC)
NAPRELAN, NAPROXEN SODIUM
NAPROSYN, NAPROXEN
NAPROXEN, NAPROXEN
NAPROXEN AND ESOMEPRAZOLE MAGNESIUM, ESOMEPRAZOLE MAGNESIUM
NAPROXEN SODIUM, NAPROXEN SODIUM (OTC)
NAPROXEN SODIUM, NAPROXEN SODIUM
NAPROXEN SODIUM AND DIPHENHYDRAMINE HYDROCHLORIDE, DIPHENHYDRAMINE HYDROCHLORIDE (OTC)
NAPROXEN SODIUM AND PSEUDOEPHEDRINE HYDROCHLORIDE, NAPROXEN SODIUM (OTC)
NARATRIPTAN, NARATRIPTAN HYDROCHLORIDE
NARCAN, NALOXONE HYDROCHLORIDE (OTC)
NARDIL, PHENELZINE SULFATE
NAROPIN, ROPIVACAINE HYDROCHLORIDE
NASACORT ALLERGY 24 HOUR, TRIAMCINOLONE ACETONIDE (OTC)
NASCOBAL, CYANOCOBALAMIN
NASONEX 24HR ALLERGY, MOMETASONE FUROATE (OTC)
NATACYN, NATAMYCIN
NATAZIA, DIENOGEST
NATEGLINIDE, NATEGLINIDE
NATESTO, TESTOSTERONE
NATROBA, SPINOSAD
NAYZILAM, MIDAZOLAM
NEBIVOLOL HYDROCHLORIDE, NEBIVOLOL HYDROCHLORIDE
NEBUPENT, PENTAMIDINE ISETHIONATE
NEFAZODONE HYDROCHLORIDE, NEFAZODONE HYDROCHLORIDE
NELARABINE, NELARABINE
NEMBUTAL SODIUM, PENTOBARBITAL SODIUM
NEO-SYNALAR, FLUOCINOLONE ACETONIDE
NEOMYCIN AND POLYMYXIN B SULFATE, NEOMYCIN SULFATE
NEOMYCIN AND POLYMYXIN B SULFATES AND BACITRACIN ZINC, BACITRACIN ZINC
NEOMYCIN AND POLYMYXIN B SULFATES AND DEXAMETHASONE, DEXAMETHASONE
NEOMYCIN AND POLYMYXIN B SULFATES AND GRAMICIDIN, GRAMICIDIN
NEOMYCIN AND POLYMYXIN B SULFATES AND HYDROCORTISONE, HYDROCORTISONE
NEOMYCIN AND POLYMYXIN B SULFATES, BACITRACIN ZINC AND HYDROCORTISONE, BACITRACIN ZINC
NEOMYCIN SULFATE, NEOMYCIN SULFATE
NEOPROFEN, IBUPROFEN LYSINE
NEORAL, CYCLOSPORINE
NEOSPORIN, GRAMICIDIN
NEOSPORIN G.U. IRRIGANT, NEOMYCIN SULFATE
NEOSTIGMINE METHYLSULFATE, NEOSTIGMINE METHYLSULFATE
NEOSTIGMINE METHYSULFATE, NEOSTIGMINE METHYLSULFATE
NEPHROSCAN, TECHNETIUM TC-99M SUCCIMER
NERLYNX, NERATINIB MALEATE
NESACAINE, CHLOROPROCAINE HYDROCHLORIDE
NESACAINE-MPF, CHLOROPROCAINE HYDROCHLORIDE
NESINA, ALOGLIPTIN BENZOATE
NETSPOT, GALLIUM DOTATATE GA-68
NEUPRO, ROTIGOTINE
NEURACEQ, FLORBETABEN F-18
NEUROLITE, TECHNETIUM TC-99M BICISATE KIT
NEURONTIN, GABAPENTIN
NEVANAC, NEPAFENAC
NEVIRAPINE, NEVIRAPINE
NEXAVAR, SORAFENIB TOSYLATE
NEXESTA FE, ETHINYL ESTRADIOL
NEXICLON XR, CLONIDINE
NEXIUM, ESOMEPRAZOLE MAGNESIUM
NEXIUM 24HR, ESOMEPRAZOLE MAGNESIUM (OTC)
NEXIUM IV, ESOMEPRAZOLE SODIUM
NEXLETOL, BEMPEDOIC ACID
NEXLIZET, BEMPEDOIC ACID
NEXPLANON, ETONOGESTREL
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 39

APPENDIX A - PRODUCT NAME INDEX

** N **
NEXTERONE, AMIODARONE HYDROCHLORIDE
NEXTSTELLIS, DROSPIRENONE
NIACIN, NIACIN
NIACOR, NIACIN
NICARDIPINE HYDROCHLORIDE, NICARDIPINE HYDROCHLORIDE
NICARDIPINE HYDROCHLORIDE IN 0.9% SODIUM CHLORIDE, NICARDIPINE HYDROCHLORIDE
NICODERM CQ, NICOTINE (OTC)
NICORETTE, NICOTINE POLACRILEX (OTC)
NICORETTE (MINT), NICOTINE POLACRILEX (OTC)
NICOTINE, NICOTINE (OTC)
NICOTINE POLACRILEX, NICOTINE POLACRILEX (OTC)
NICOTROL, NICOTINE
NIFEDIPINE, NIFEDIPINE
NIKKI, DROSPIRENONE
NILANDRON, NILUTAMIDE
NILUTAMIDE, NILUTAMIDE
NIMBEX, CISATRACURIUM BESYLATE
NIMBEX PRESERVATIVE FREE, CISATRACURIUM BESYLATE
NIMODIPINE, NIMODIPINE
NINLARO, IXAZOMIB CITRATE
NIPENT, PENTOSTATIN
NIPRIDE RTU IN SODIUM CHLORIDE 0.9%, SODIUM NITROPRUSSIDE
NISOLDIPINE, NISOLDIPINE
NITAZOXANIDE, NITAZOXANIDE
NITHIODOTE, SODIUM NITRITE
NITISINONE, NITISINONE
NITRO-DUR, NITROGLYCERIN
NITROFURANTOIN, NITROFURANTOIN
NITROFURANTOIN, NITROFURANTOIN, MACROCRYSTALLINE
NITROFURANTOIN (MONOHYDRATE/MACROCRYSTALS), NITROFURANTOIN
NITROGLYCERIN, NITROGLYCERIN
NITROGLYCERIN IN DEXTROSE 5%, NITROGLYCERIN
NITROLINGUAL PUMPSPRAY, NITROGLYCERIN
NITROMIST, NITROGLYCERIN
NITROSTAT, NITROGLYCERIN
NITYR, NITISINONE
NIX, PERMETHRIN (OTC)
NIZATIDINE, NIZATIDINE
NIZORAL ANTI-DANDRUFF, KETOCONAZOLE (OTC)
NOCDURNA, DESMOPRESSIN ACETATE
NOR-QD, NORETHINDRONE
NOREPINEPHRINE BITARTRATE, NOREPINEPHRINE BITARTRATE
NOREPINEPHRINE BITARTRATE IN 0.9% SODIUM CHLORIDE, NOREPINEPHRINE BITARTRATE
NOREPINEPHRINE BITARTRATE IN 5% DEXTROSE, NOREPINEPHRINE BITARTRATE
NORETHINDRONE, NORETHINDRONE
NORETHINDRONE ACETATE, NORETHINDRONE ACETATE
NORETHINDRONE ACETATE AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL
NORETHINDRONE ACETATE AND ETHINYL ESTRADIOL AND FERROUS FUMARATE, ETHINYL ESTRADIOL
NORETHINDRONE AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL
NORETHINDRONE AND ETHINYL ESTRADIOL (10/11), ETHINYL ESTRADIOL
NORETHINDRONE AND ETHINYL ESTRADIOL AND FERROUS FUMARATE, ETHINYL ESTRADIOL
NORGESTIMATE AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL
NORITATE, METRONIDAZOLE
NORLIQVA, AMLODIPINE BESYLATE
NORMOCARB HF 25, MAGNESIUM CHLORIDE
NORMOCARB HF 35, MAGNESIUM CHLORIDE
NORMOSOL-M AND DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE
NORMOSOL-R AND DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE
NORMOSOL-R IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE
NORPACE, DISOPYRAMIDE PHOSPHATE
NORPACE CR, DISOPYRAMIDE PHOSPHATE
NORPRAMIN, DESIPRAMINE HYDROCHLORIDE
NORTHERA, DROXIDOPA
NORTREL 0.5/35-28, ETHINYL ESTRADIOL
NORTREL 1/35-21, ETHINYL ESTRADIOL
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 40

APPENDIX A - PRODUCT NAME INDEX

** N **
NORTREL 1/35-28, ETHINYL ESTRADIOL
NORTREL 7/7/7, ETHINYL ESTRADIOL
NORTRIPTYLINE HYDROCHLORIDE, NORTRIPTYLINE HYDROCHLORIDE
NORVASC, AMLODIPINE BESYLATE
NORVIR, RITONAVIR
NOURIANZ, ISTRADEFYLLINE
NOXAFIL, POSACONAZOLE
NOXAFIL POWDERMIX KIT, POSACONAZOLE
NOXIVENT, NITRIC OXIDE
NUBEQA, DAROLUTAMIDE
NUCYNTA, TAPENTADOL HYDROCHLORIDE
NUCYNTA ER, TAPENTADOL HYDROCHLORIDE
NUEDEXTA, DEXTROMETHORPHAN HYDROBROMIDE
NULIBRY, FOSDENOPTERIN HYDROBROMIDE
NULYTELY, POLYETHYLENE GLYCOL 3350
NULYTELY-FLAVORED, POLYETHYLENE GLYCOL 3350
NUMBRINO, COCAINE HYDROCHLORIDE
NUPLAZID, PIMAVANSERIN TARTRATE
NURTEC ODT, RIMEGEPANT SULFATE
NUTRILIPID 10%, SOYBEAN OIL
NUTRILIPID 20%, SOYBEAN OIL
NUVARING, ETHINYL ESTRADIOL
NUVESSA, METRONIDAZOLE
NUVIGIL, ARMODAFINIL
NUZYRA, OMADACYCLINE TOSYLATE
NYLIA 1/35, ETHINYL ESTRADIOL
NYLIA 7/7/7, ETHINYL ESTRADIOL
NYMALIZE, NIMODIPINE
NYSTATIN, NYSTATIN
NYSTATIN AND TRIAMCINOLONE ACETONIDE, NYSTATIN
NYSTOP, NYSTATIN
** O **
OBETICHOLIC ACID, OBETICHOLIC ACID
OCALIVA, OBETICHOLIC ACID
OCTREOSCAN, INDIUM IN-111 PENTETREOTIDE KIT
OCTREOTIDE ACETATE, OCTREOTIDE ACETATE
OCTREOTIDE ACETATE (PRESERVATIVE FREE), OCTREOTIDE ACETATE
OCUFLOX, OFLOXACIN
ODEFSEY, EMTRICITABINE
ODOMZO, SONIDEGIB PHOSPHATE
OFEV, NINTEDANIB ESYLATE
OFLOXACIN, OFLOXACIN
OGEN 5, ESTROPIPATE
OLANZAPINE, OLANZAPINE
OLANZAPINE AND FLUOXETINE HYDROCHLORIDE, FLUOXETINE HYDROCHLORIDE
OLINVYK, OLICERIDINE
OLMESARTAN MEDOXOMIL, OLMESARTAN MEDOXOMIL
OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE
OLMESARTAN MEDOXOMIL, AMLODIPINE AND HYDROCHLOROTHIAZIDE, AMLODIPINE BESYLATE
OLOPATADINE HYDROCHLORIDE, OLOPATADINE HYDROCHLORIDE (OTC)
OLOPATADINE HYDROCHLORIDE, OLOPATADINE HYDROCHLORIDE
OLPRUVA, SODIUM PHENYLBUTYRATE
OLUMIANT, BARICITINIB
OLUX, CLOBETASOL PROPIONATE
OLUX E, CLOBETASOL PROPIONATE
OMEGA-3-ACID ETHYL ESTERS, OMEGA-3-ACID ETHYL ESTERS
OMEGAVEN, FISH OIL TRIGLYCERIDES
OMEPRAZOLE, OMEPRAZOLE (OTC)
OMEPRAZOLE, OMEPRAZOLE
OMEPRAZOLE AND SODIUM BICARBONATE, OMEPRAZOLE (OTC)
OMEPRAZOLE AND SODIUM BICARBONATE, OMEPRAZOLE
OMEPRAZOLE MAGNESIUM, OMEPRAZOLE MAGNESIUM (OTC)
OMIDRIA, KETOROLAC TROMETHAMINE
OMNARIS, CICLESONIDE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 41

APPENDIX A - PRODUCT NAME INDEX

** O **
OMNIPAQUE 12, IOHEXOL
OMNIPAQUE 140, IOHEXOL
OMNIPAQUE 180, IOHEXOL
OMNIPAQUE 240, IOHEXOL
OMNIPAQUE 300, IOHEXOL
OMNIPAQUE 350, IOHEXOL
OMNIPAQUE 9, IOHEXOL
OMNIPRED, PREDNISOLONE ACETATE
OMNISCAN, GADODIAMIDE
ONDANSETRON, ONDANSETRON
ONDANSETRON HYDROCHLORIDE, ONDANSETRON HYDROCHLORIDE
ONDANSETRON HYDROCHLORIDE PRESERVATIVE FREE, ONDANSETRON HYDROCHLORIDE
ONEXTON, BENZOYL PEROXIDE
ONFI, CLOBAZAM
ONGENTYS, OPICAPONE
ONGLYZA, SAXAGLIPTIN HYDROCHLORIDE
ONIVYDE, IRINOTECAN HYDROCHLORIDE
ONPATTRO, PATISIRAN SODIUM
ONSURA, ETHINYL ESTRADIOL
ONUREG, AZACITIDINE
ONZETRA XSAIL, SUMATRIPTAN SUCCINATE
OPCICON ONE-STEP, LEVONORGESTREL (OTC)
OPCON-A, NAPHAZOLINE HYDROCHLORIDE (OTC)
OPSUMIT, MACITENTAN
OPTIRAY 300, IOVERSOL
OPTIRAY 320, IOVERSOL
OPTIRAY 350, IOVERSOL
OPTISON, ALBUMIN HUMAN
OPVEE, NALMEFENE HYDROCHLORIDE
OPZELURA, RUXOLITINIB PHOSPHATE
ORABLOC, ARTICAINE HYDROCHLORIDE
ORACEA, DOXYCYCLINE
ORAPRED ODT, PREDNISOLONE SODIUM PHOSPHATE
ORAQIX, LIDOCAINE
ORAVERSE, PHENTOLAMINE MESYLATE
ORAVIG, MICONAZOLE
ORBACTIV, ORITAVANCIN DIPHOSPHATE
ORENITRAM, TREPROSTINIL DIOLAMINE
ORFADIN, NITISINONE
ORGOVYX, RELUGOLIX
ORIAHNN (COPACKAGED), ELAGOLIX SODIUM,ESTRADIOL,NORETHINDRONE ACETATE
ORILISSA, ELAGOLIX SODIUM
ORKAMBI, IVACAFTOR
ORLADEYO, BEROTRALSTAT HYDROCHLORIDE
ORPHENADRINE CITRATE, ORPHENADRINE CITRATE
ORPHENGESIC, ASPIRIN
ORPHENGESIC FORTE, ASPIRIN
ORSERDU, ELACESTRANT DIHYDROCHLORIDE
ORTIKOS, BUDESONIDE
ORVATEN, MIDODRINE HYDROCHLORIDE
OSELTAMIVIR PHOSPHATE, OSELTAMIVIR PHOSPHATE
OSENI, ALOGLIPTIN BENZOATE
OSMITROL 10% IN WATER, MANNITOL
OSMITROL 10% IN WATER IN PLASTIC CONTAINER, MANNITOL
OSMITROL 15% IN WATER, MANNITOL
OSMITROL 15% IN WATER IN PLASTIC CONTAINER, MANNITOL
OSMITROL 20% IN WATER, MANNITOL
OSMITROL 20% IN WATER IN PLASTIC CONTAINER, MANNITOL
OSMITROL 5% IN WATER, MANNITOL
OSMITROL 5% IN WATER IN PLASTIC CONTAINER, MANNITOL
OSMOLEX ER, AMANTADINE HYDROCHLORIDE
OSMOPREP, SODIUM PHOSPHATE, DIBASIC, ANHYDROUS
OSPHENA, OSPEMIFENE
OTEZLA, APREMILAST
OTICAIR, HYDROCORTISONE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 42

APPENDIX A - PRODUCT NAME INDEX

** O **
OTOVEL, CIPROFLOXACIN HYDROCHLORIDE
OTREXUP, METHOTREXATE
OXACILLIN SODIUM, OXACILLIN SODIUM
OXALIPLATIN, OXALIPLATIN
OXAPROZIN, OXAPROZIN
OXAYDO, OXYCODONE HYDROCHLORIDE
OXAZEPAM, OXAZEPAM
OXBRYTA, VOXELOTOR
OXCARBAZEPINE, OXCARBAZEPINE
OXICONAZOLE NITRATE, OXICONAZOLE NITRATE
OXISTAT, OXICONAZOLE NITRATE
OXLUMO, LUMASIRAN SODIUM
OXSORALEN-ULTRA, METHOXSALEN
OXTELLAR XR, OXCARBAZEPINE
OXYBUTYNIN CHLORIDE, OXYBUTYNIN CHLORIDE
OXYCET, ACETAMINOPHEN
OXYCODONE AND ACETAMINOPHEN, ACETAMINOPHEN
OXYCODONE AND ASPIRIN, ASPIRIN
OXYCODONE HYDROCHLORIDE, OXYCODONE HYDROCHLORIDE
OXYCONTIN, OXYCODONE HYDROCHLORIDE
OXYMORPHONE HYDROCHLORIDE, OXYMORPHONE HYDROCHLORIDE
OXYTOCIN, OXYTOCIN
OXYTROL, OXYBUTYNIN
OXYTROL FOR WOMEN, OXYBUTYNIN (OTC)
OZEMPIC, SEMAGLUTIDE
OZOBAX, BACLOFEN
OZURDEX, DEXAMETHASONE
** P **
PACERONE, AMIODARONE HYDROCHLORIDE
PACLITAXEL, PACLITAXEL
PALIPERIDONE, PALIPERIDONE
PALONOSETRON HYDROCHLORIDE, PALONOSETRON HYDROCHLORIDE
PAMELOR, NORTRIPTYLINE HYDROCHLORIDE
PAMIDRONATE DISODIUM, PAMIDRONATE DISODIUM
PANCURONIUM BROMIDE, PANCURONIUM BROMIDE
PANDEL, HYDROCORTISONE PROBUTATE
PANRETIN, ALITRETINOIN
PANTOPRAZOLE SODIUM, PANTOPRAZOLE SODIUM
PARAGARD T 380A, COPPER
PARICALCITOL, PARICALCITOL
PARLODEL, BROMOCRIPTINE MESYLATE
PARNATE, TRANYLCYPROMINE SULFATE
PAROMOMYCIN SULFATE, PAROMOMYCIN SULFATE
PAROXETINE, PAROXETINE HYDROCHLORIDE
PAROXETINE HYDROCHLORIDE, PAROXETINE HYDROCHLORIDE
PAROXETINE MESYLATE, PAROXETINE MESYLATE
PARSABIV, ETELCALCETIDE
PASER, AMINOSALICYLIC ACID
PATADAY ONCE DAILY RELIEF, OLOPATADINE HYDROCHLORIDE (OTC)
PATADAY TWICE DAILY RELIEF, OLOPATADINE HYDROCHLORIDE (OTC)
PAXIL, PAROXETINE HYDROCHLORIDE
PAXIL CR, PAROXETINE HYDROCHLORIDE
PAXLOVID (COPACKAGED), NIRMATRELVIR
PEDIAPRED, PREDNISOLONE SODIUM PHOSPHATE
PEDMARK, SODIUM THIOSULFATE
PEG 3350 AND ELECTROLYTES, POLYETHYLENE GLYCOL 3350
PEG-3350, POTASSIUM CHLORIDE, SODIUM BICARBONATE, SODIUM CHLORIDE, POLYETHYLENE GLYCOL
PEG-3350, SODIUM SULFATE, SODIUM CHLORIDE, POTASSIUM CHLORIDE, SODIUM ASCORBATE AND
PEMAZYRE, PEMIGATINIB
PEMETREXED, PEMETREXED
PEMETREXED, PEMETREXED DISODIUM
PEMETREXED DISODIUM, PEMETREXED DISODIUM
PEMETREXED DITROMETHAMINE, PEMETREXED DITROMETHAMINE
PEMFEXY, PEMETREXED
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 43

APPENDIX A - PRODUCT NAME INDEX

** P **
PENCICLOVIR, PENCICLOVIR
PENICILLAMINE, PENICILLAMINE
PENICILLIN G POTASSIUM, PENICILLIN G POTASSIUM
PENICILLIN G POTASSIUM IN PLASTIC CONTAINER, PENICILLIN G POTASSIUM
PENICILLIN G PROCAINE, PENICILLIN G PROCAINE
PENICILLIN G SODIUM, PENICILLIN G SODIUM
PENICILLIN V POTASSIUM, PENICILLIN V POTASSIUM
PENICILLIN-VK, PENICILLIN V POTASSIUM
PENNSAID, DICLOFENAC SODIUM
PENTAM, PENTAMIDINE ISETHIONATE
PENTAMIDINE ISETHIONATE, PENTAMIDINE ISETHIONATE
PENTASA, MESALAMINE
PENTOBARBITAL SODIUM, PENTOBARBITAL SODIUM
PENTOLAIR, CYCLOPENTOLATE HYDROCHLORIDE
PENTOSTATIN, PENTOSTATIN
PENTOXIFYLLINE, PENTOXIFYLLINE
PEPCID AC, FAMOTIDINE (OTC)
PEPCID COMPLETE, CALCIUM CARBONATE (OTC)
PERCOCET, ACETAMINOPHEN
PERCODAN, ASPIRIN
PERFOROMIST, FORMOTEROL FUMARATE
PERIDEX, CHLORHEXIDINE GLUCONATE
PERIKABIVEN IN PLASTIC CONTAINER, AMINO ACIDS
PERINDOPRIL ERBUMINE, PERINDOPRIL ERBUMINE
PERIOGARD, CHLORHEXIDINE GLUCONATE
PERMETHRIN, PERMETHRIN (OTC)
PERMETHRIN, PERMETHRIN
PERPHENAZINE, PERPHENAZINE
PERPHENAZINE AND AMITRIPTYLINE HYDROCHLORIDE, AMITRIPTYLINE HYDROCHLORIDE
PERSANTINE, DIPYRIDAMOLE
PERSERIS KIT, RISPERIDONE
PFIZERPEN, PENICILLIN G POTASSIUM
PHEBURANE, SODIUM PHENYLBUTYRATE
PHENDIMETRAZINE TARTRATE, PHENDIMETRAZINE TARTRATE
PHENELZINE SULFATE, PHENELZINE SULFATE
PHENOXYBENZAMINE HYDROCHLORIDE, PHENOXYBENZAMINE HYDROCHLORIDE
PHENTERMINE HYDROCHLORIDE, PHENTERMINE HYDROCHLORIDE
PHENTOLAMINE MESYLATE, PHENTOLAMINE MESYLATE
PHENYLEPHRINE HYDROCHLORIDE, PHENYLEPHRINE HYDROCHLORIDE
PHENYLEPHRINE HYDROCHLORIDE AND PROMETHAZINE HYDROCHLORIDE, PHENYLEPHRINE HYDROCHLORIDE
PHENYTEK, PHENYTOIN SODIUM
PHENYTOIN, PHENYTOIN
PHENYTOIN SODIUM, PHENYTOIN SODIUM
PHEXXI, CITRIC ACID
PHILITH, ETHINYL ESTRADIOL
PHOSLO GELCAPS, CALCIUM ACETATE
PHOSPHOLINE IODIDE, ECHOTHIOPHATE IODIDE
PHOTOFRIN, PORFIMER SODIUM
PHOTREXA, RIBOFLAVIN 5'-PHOSPHATE
PHOTREXA VISCOUS IN DEXTRAN 20%, RIBOFLAVIN 5'-PHOSPHATE
PHOXILLUM B22K 4/0 IN PLASTIC CONTAINER, CALCIUM CHLORIDE
PHOXILLUM BK 4/2.5 IN PLASTIC CONTAINER, CALCIUM CHLORIDE
PHYSIOLYTE IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE
PHYSIOSOL IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE
PHYTONADIONE, PHYTONADIONE
PIFELTRO, DORAVIRINE
PILOCARPINE HYDROCHLORIDE, PILOCARPINE HYDROCHLORIDE
PIMECROLIMUS, PIMECROLIMUS
PIMOZIDE, PIMOZIDE
PIMTREA, DESOGESTREL
PINDOLOL, PINDOLOL
PIOGLITAZONE HYDROCHLORIDE, PIOGLITAZONE HYDROCHLORIDE
PIOGLITAZONE HYDROCHLORIDE AND GLIMEPIRIDE, GLIMEPIRIDE
PIOGLITAZONE HYDROCHLORIDE AND METFORMIN HYDROCHLORIDE, METFORMIN HYDROCHLORIDE
PIPERACILLIN, PIPERACILLIN SODIUM
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 44

APPENDIX A - PRODUCT NAME INDEX

** P **
PIPERACILLIN AND TAZOBACTAM, PIPERACILLIN SODIUM
PIQRAY, ALPELISIB
PIRFENIDONE, PIRFENIDONE
PIROXICAM, PIROXICAM
PITAVASTATIN CALCIUM, PITAVASTATIN CALCIUM
PITOCIN, OXYTOCIN
PLAN B ONE-STEP, LEVONORGESTREL (OTC)
PLAQUENIL, HYDROXYCHLOROQUINE SULFATE
PLASMA-LYTE 148 IN WATER IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE
PLASMA-LYTE A IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE
PLAVIX, CLOPIDOGREL BISULFATE
PLEGISOL IN PLASTIC CONTAINER, CALCIUM CHLORIDE
PLENVU, ASCORBIC ACID
PLIAGLIS, LIDOCAINE
PLUVICTO, LUTETIUM LU-177 VIPIVOTIDE TETRAXETAN
PODOFILOX, PODOFILOX
POLMON, DEXCHLORPHENIRAMINE MALEATE
POLOCAINE, MEPIVACAINE HYDROCHLORIDE
POLOCAINE-MPF, MEPIVACAINE HYDROCHLORIDE
POLYETHYLENE GLYCOL 3350, POLYETHYLENE GLYCOL 3350 (OTC)
POLYETHYLENE GLYCOL 3350 AND ELECTROLYTES, POLYETHYLENE GLYCOL 3350
POLYMYXIN B SULFATE, POLYMYXIN B SULFATE
POMALYST, POMALIDOMIDE
PONSTEL, MEFENAMIC ACID
PONVORY, PONESIMOD
PORTIA-28, ETHINYL ESTRADIOL
POSACONAZOLE, POSACONAZOLE
POSIMIR, BUPIVACAINE
POSLUMA, FLOTUFOLASTAT F-18 GALLIUM
POTASSIUM ACETATE, POTASSIUM ACETATE
POTASSIUM CHLORIDE, POTASSIUM CHLORIDE
POTASSIUM CHLORIDE 0.037% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.037% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.037% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.075% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.075% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.075% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.075% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.11% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.11% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.11% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.11% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.149% IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM
POTASSIUM CHLORIDE 0.15% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.15% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.15% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.15% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER,
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 45

APPENDIX A - PRODUCT NAME INDEX

** P **
POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE
POTASSIUM CHLORIDE 0.15% IN SODIUM CHLORIDE 0.45%, POTASSIUM CHLORIDE
POTASSIUM CHLORIDE 0.15% IN SODIUM CHLORIDE 0.9%, POTASSIUM CHLORIDE
POTASSIUM CHLORIDE 0.15% IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE
POTASSIUM CHLORIDE 0.22% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.22% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.22% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.22% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.3% AND SODIUM CHLORIDE 0.9%, POTASSIUM CHLORIDE
POTASSIUM CHLORIDE 0.3% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.3% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.3% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.3% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 0.3% IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE
POTASSIUM CHLORIDE 10MEQ, POTASSIUM CHLORIDE
POTASSIUM CHLORIDE 10MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 10MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 10MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45%, DEXTROSE
POTASSIUM CHLORIDE 10MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 10MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 10MEQ IN PLASTIC CONTAINER, POTASSIUM CHLORIDE
POTASSIUM CHLORIDE 15MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 20MEQ, POTASSIUM CHLORIDE
POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45%, DEXTROSE
POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9%, DEXTROSE
POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE
POTASSIUM CHLORIDE 20MEQ IN PLASTIC CONTAINER, POTASSIUM CHLORIDE
POTASSIUM CHLORIDE 20MEQ IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE
POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45%, DEXTROSE
POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 30MEQ IN PLASTIC CONTAINER, POTASSIUM CHLORIDE
POTASSIUM CHLORIDE 40MEQ, POTASSIUM CHLORIDE
POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45%, DEXTROSE
POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9%, DEXTROSE
POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 40MEQ IN PLASTIC CONTAINER, POTASSIUM CHLORIDE
POTASSIUM CHLORIDE 40MEQ IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE
POTASSIUM CHLORIDE 5MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM
POTASSIUM CHLORIDE 5MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE 5MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,
POTASSIUM CHLORIDE IN PLASTIC CONTAINER, POTASSIUM CHLORIDE
POTASSIUM CITRATE, POTASSIUM CITRATE
POTASSIUM IODIDE, POTASSIUM IODIDE (OTC)
POTASSIUM PHOSPHATES, POTASSIUM PHOSPHATE, DIBASIC
POVIDONE IODINE, POVIDONE-IODINE (OTC)
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 46

APPENDIX A - PRODUCT NAME INDEX

** P **
PRADAXA, DABIGATRAN ETEXILATE MESYLATE
PRAMIPEXOLE DIHYDROCHLORIDE, PRAMIPEXOLE DIHYDROCHLORIDE
PRAMOSONE, HYDROCORTISONE ACETATE
PRASUGREL, PRASUGREL HYDROCHLORIDE
PRAVASTATIN SODIUM, PRAVASTATIN SODIUM
PRAZIQUANTEL, PRAZIQUANTEL
PRAZOSIN HYDROCHLORIDE, PRAZOSIN HYDROCHLORIDE
PRE-OP, HEXACHLOROPHENE
PRE-OP II, HEXACHLOROPHENE
PRECEDEX, DEXMEDETOMIDINE HYDROCHLORIDE
PRED FORTE, PREDNISOLONE ACETATE
PRED MILD, PREDNISOLONE ACETATE
PREDNICARBATE, PREDNICARBATE
PREDNISOLONE, PREDNISOLONE
PREDNISOLONE SODIUM PHOSPHATE, PREDNISOLONE SODIUM PHOSPHATE
PREDNISONE, PREDNISONE
PREDNISONE INTENSOL, PREDNISONE
PREGABALIN, PREGABALIN
PRELONE, PREDNISOLONE
PREMARIN, ESTROGENS, CONJUGATED
PREMASOL 10% IN PLASTIC CONTAINER, AMINO ACIDS
PREMASOL 6% IN PLASTIC CONTAINER, AMINO ACIDS
PREMPHASE 14/14, ESTROGENS, CONJUGATED
PREMPRO, ESTROGENS, CONJUGATED
PREPIDIL, DINOPROSTONE
PRESTALIA, AMLODIPINE BESYLATE
PRETOMANID, PRETOMANID
PREVACID, LANSOPRAZOLE
PREVACID 24 HR, LANSOPRAZOLE (OTC)
PREVALITE, CHOLESTYRAMINE
PREVANTICS MAXI SWABSTICK, CHLORHEXIDINE GLUCONATE (OTC)
PREVANTICS SWAB, CHLORHEXIDINE GLUCONATE (OTC)
PREVANTICS SWABSTICK, CHLORHEXIDINE GLUCONATE (OTC)
PREVDUO, GLYCOPYRROLATE
PREVIFEM, ETHINYL ESTRADIOL
PREVYMIS, LETERMOVIR
PREZCOBIX, COBICISTAT
PREZISTA, DARUNAVIR
PRIALT, ZICONOTIDE ACETATE
PRIFTIN, RIFAPENTINE
PRILOCAINE HYDROCHLORIDE, PRILOCAINE HYDROCHLORIDE
PRILOCAINE HYDROCHLORIDE AND EPINEPHRINE BITARTRATE, EPINEPHRINE BITARTRATE
PRILOSEC, OMEPRAZOLE MAGNESIUM
PRILOSEC OTC, OMEPRAZOLE MAGNESIUM (OTC)
PRIMAQUINE, PRIMAQUINE PHOSPHATE
PRIMAQUINE PHOSPHATE, PRIMAQUINE PHOSPHATE
PRIMATENE MIST, EPINEPHRINE (OTC)
PRIMAXIN, CILASTATIN SODIUM
PRIMIDONE, PRIMIDONE
PRISMASOL B22GK 4/0 IN PLASTIC CONTAINER, CALCIUM CHLORIDE
PRISMASOL BGK 0/2.5 IN PLASTIC CONTAINER, CALCIUM CHLORIDE
PRISMASOL BGK 2/0 IN PLASTIC CONTAINER, CALCIUM CHLORIDE
PRISMASOL BGK 2/3.5 IN PLASTIC CONTAINER, CALCIUM CHLORIDE
PRISMASOL BGK 4/0/1.2 IN PLASTIC CONTAINER, CALCIUM CHLORIDE
PRISMASOL BGK 4/2.5 IN PLASTIC CONTAINER, CALCIUM CHLORIDE
PRISMASOL BK 0/0/1.2 IN PLASTIC CONTAINER, CALCIUM CHLORIDE
PRISTIQ, DESVENLAFAXINE SUCCINATE
PROAIR DIGIHALER, ALBUTEROL SULFATE
PROAIR HFA, ALBUTEROL SULFATE
PROAIR RESPICLICK, ALBUTEROL SULFATE
PROBALAN, PROBENECID
PROBENECID, PROBENECID
PROBENECID AND COLCHICINE, COLCHICINE
PROCAINAMIDE HYDROCHLORIDE, PROCAINAMIDE HYDROCHLORIDE
PROCARDIA, NIFEDIPINE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 47

APPENDIX A - PRODUCT NAME INDEX

** P **
PROCARDIA XL, NIFEDIPINE
PROCHLORPERAZINE, PROCHLORPERAZINE
PROCHLORPERAZINE EDISYLATE, PROCHLORPERAZINE EDISYLATE
PROCHLORPERAZINE MALEATE, PROCHLORPERAZINE MALEATE
PROCOMP, PROCHLORPERAZINE MALEATE
PROCTOFOAM HC, HYDROCORTISONE ACETATE
PROCYSBI, CYSTEAMINE BITARTRATE
PROGESTERONE, PROGESTERONE
PROGLYCEM, DIAZOXIDE
PROGRAF, TACROLIMUS
PROHANCE, GADOTERIDOL
PROHANCE MULTIPACK, GADOTERIDOL
PROLENSA, BROMFENAC SODIUM
PROMACTA, ELTROMBOPAG OLAMINE
PROMACTA KIT, ELTROMBOPAG OLAMINE
PROMETH HYDROCHLORIDE,PHENYLEPHRINE HYDROCHLORIDE W/CODEINE PHOSPHATE, CODEINE PHOSPHATE
PROMETHAZINE DM, DEXTROMETHORPHAN HYDROBROMIDE
PROMETHAZINE HYDROCHLORIDE, PROMETHAZINE HYDROCHLORIDE
PROMETHAZINE HYDROCHLORIDE AND CODEINE PHOSPHATE, CODEINE PHOSPHATE
PROMETHAZINE HYDROCHLORIDE AND DEXTROMETHORPHAN HYDROBROMIDE, DEXTROMETHORPHAN
PROMETHAZINE HYDROCHLORIDE AND PHENYLEPHRINE HYDROCHLORIDE, PHENYLEPHRINE HYDROCHLORIDE
PROMETHAZINE HYDROCHLORIDE, PHENYLEPHRINE HYDROCHLORIDE W/CODEINE PHOSPHATE, CODEINE
PROMETHAZINE HYDROCHLORIDE,PHENYLEPHRINE HYDROCHLORIDE W/CODEINE PHOSPHATE, CODEINE
PROMETHAZINE PLAIN, PROMETHAZINE HYDROCHLORIDE
PROMETHAZINE W/ DEXTROMETHORPHAN, DEXTROMETHORPHAN HYDROBROMIDE
PROMETHAZINE WITH CODEINE, CODEINE PHOSPHATE
PROMETHEGAN, PROMETHAZINE HYDROCHLORIDE
PROMETRIUM, PROGESTERONE
PROPAFENONE HYDROCHLORIDE, PROPAFENONE HYDROCHLORIDE
PROPARACAINE HYDROCHLORIDE, PROPARACAINE HYDROCHLORIDE
PROPECIA, FINASTERIDE
PROPOFOL, PROPOFOL
PROPRANOLOL HYDROCHLORIDE, PROPRANOLOL HYDROCHLORIDE
PROPYLTHIOURACIL, PROPYLTHIOURACIL
PROSCAR, FINASTERIDE
PROSOL 20% SULFITE FREE IN PLASTIC CONTAINER, AMINO ACIDS
PROSTIN VR PEDIATRIC, ALPROSTADIL
PROTAMINE SULFATE, PROTAMINE SULFATE
PROTONIX, PANTOPRAZOLE SODIUM
PROTONIX IV, PANTOPRAZOLE SODIUM
PROTOPAM CHLORIDE, PRALIDOXIME CHLORIDE
PROTOPIC, TACROLIMUS
PROTRIPTYLINE HYDROCHLORIDE, PROTRIPTYLINE HYDROCHLORIDE
PROVAYBLUE, METHYLENE BLUE
PROVENTIL-HFA, ALBUTEROL SULFATE
PROVERA, MEDROXYPROGESTERONE ACETATE
PROVIGIL, MODAFINIL
PROVOCHOLINE, METHACHOLINE CHLORIDE
PROZAC, FLUOXETINE HYDROCHLORIDE
PSEUDOEPHEDRINE HYDROCHLORIDE, PSEUDOEPHEDRINE HYDROCHLORIDE (OTC)
PULMICORT FLEXHALER, BUDESONIDE
PULMICORT RESPULES, BUDESONIDE
PUR-WASH, PURIFIED WATER (OTC)
PURIFIED CORTROPHIN GEL, CORTICOTROPIN
PURINETHOL, MERCAPTOPURINE
PURIXAN, MERCAPTOPURINE
PYLARIFY, PIFLUFOLASTAT F-18
PYLERA, BISMUTH SUBCITRATE POTASSIUM
PYRAZINAMIDE, PYRAZINAMIDE
PYRIDOSTIGMINE BROMIDE, PYRIDOSTIGMINE BROMIDE
PYRIDOXINE HYDROCHLORIDE, PYRIDOXINE HYDROCHLORIDE
PYRIMETHAMINE, PYRIMETHAMINE
PYRUKYND, MITAPIVAT SULFATE
PYTEST, UREA, C-14
PYTEST KIT, UREA, C-14
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 48

APPENDIX A - PRODUCT NAME INDEX

** Q **
QALSODY, TOFERSEN
QBRELIS, LISINOPRIL
QBREXZA, GLYCOPYRRONIUM TOSYLATE
QDOLO, TRAMADOL HYDROCHLORIDE
QELBREE, VILOXAZINE HYDROCHLORIDE
QINLOCK, RIPRETINIB
QNASL, BECLOMETHASONE DIPROPIONATE
QOLIANA, BRIMONIDINE TARTRATE
QSYMIA, PHENTERMINE HYDROCHLORIDE
QTERN, DAPAGLIFLOZIN
QUALAQUIN, QUININE SULFATE
QUARTETTE, ETHINYL ESTRADIOL
QUASENSE, ETHINYL ESTRADIOL
QUDEXY XR, TOPIRAMATE
QUELICIN, SUCCINYLCHOLINE CHLORIDE
QUETIAPINE FUMARATE, QUETIAPINE FUMARATE
QUILLICHEW ER, METHYLPHENIDATE HYDROCHLORIDE
QUILLIVANT XR, METHYLPHENIDATE HYDROCHLORIDE
QUINAPRIL HYDROCHLORIDE, QUINAPRIL HYDROCHLORIDE
QUINAPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE
QUINIDINE GLUCONATE, QUINIDINE GLUCONATE
QUINIDINE SULFATE, QUINIDINE SULFATE
QUININE SULFATE, QUININE SULFATE
QULIPTA, ATOGEPANT
QUTENZA, CAPSAICIN
QUVIVIQ, DARIDOREXANT HYDROCHLORIDE
QUZYTTIR, CETIRIZINE HYDROCHLORIDE
QVAR REDIHALER, BECLOMETHASONE DIPROPIONATE
** R **
R-GENE 10, ARGININE HYDROCHLORIDE
RABEPRAZOLE SODIUM, RABEPRAZOLE SODIUM
RADICAVA, EDARAVONE
RADICAVA ORS, EDARAVONE
RADIOGARDASE (PRUSSIAN BLUE), FERRIC HEXACYANOFERRATE(II)
RADIOGENIX SYSTEM, TECHNETIUM TC-99M SODIUM PERTECHNETATE GENERATOR
RALOXIFENE HYDROCHLORIDE, RALOXIFENE HYDROCHLORIDE
RAMELTEON, RAMELTEON
RAMIPRIL, RAMIPRIL
RANITIDINE HYDROCHLORIDE, RANITIDINE HYDROCHLORIDE (OTC)
RANITIDINE HYDROCHLORIDE, RANITIDINE HYDROCHLORIDE
RANOLAZINE, RANOLAZINE
RAPAFLO, SILODOSIN
RAPAMUNE, SIROLIMUS
RAPIVAB, PERAMIVIR
RASAGILINE MESYLATE, RASAGILINE MESYLATE
RASUVO, METHOTREXATE
RAVICTI, GLYCEROL PHENYLBUTYRATE
RAYALDEE, CALCIFEDIOL
RAYOS, PREDNISONE
RAZADYNE ER, GALANTAMINE HYDROBROMIDE
READI-CAT 2, BARIUM SULFATE
READI-CAT 2 SMOOTHIE, BARIUM SULFATE
READYPREP CHG, CHLORHEXIDINE GLUCONATE (OTC)
RECARBRIO, CILASTATIN SODIUM
RECLAST, ZOLEDRONIC ACID
RECORLEV, LEVOKETOCONAZOLE
RECTIV, NITROGLYCERIN
REDITREX, METHOTREXATE
REGADENOSON, REGADENOSON
REGLAN, METOCLOPRAMIDE HYDROCHLORIDE
REGONOL, PYRIDOSTIGMINE BROMIDE
RELENZA, ZANAMIVIR
RELEXXII, METHYLPHENIDATE HYDROCHLORIDE
RELISTOR, METHYLNALTREXONE BROMIDE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 49

APPENDIX A - PRODUCT NAME INDEX

** R **
RELPAX, ELETRIPTAN HYDROBROMIDE
RELYVRIO, SODIUM PHENYLBUTYRATE
REMERON, MIRTAZAPINE
REMERON SOLTAB, MIRTAZAPINE
REMIFENTANIL HYDROCHLORIDE, REMIFENTANIL HYDROCHLORIDE
REMODULIN, TREPROSTINIL
RENACIDIN, CITRIC ACID
RENAGEL, SEVELAMER HYDROCHLORIDE
RENOVA, TRETINOIN
RENVELA, SEVELAMER CARBONATE
REPAGLINIDE, REPAGLINIDE
RESTASIS, CYCLOSPORINE
RESTASIS MULTIDOSE, CYCLOSPORINE
RESTORIL, TEMAZEPAM
RETEVMO, SELPERCATINIB
RETIN-A, TRETINOIN
RETIN-A MICRO, TRETINOIN
RETIN-A-MICRO, TRETINOIN
RETISERT, FLUOCINOLONE ACETONIDE
RETROVIR, ZIDOVUDINE
REVATIO, SILDENAFIL CITRATE
REVLIMID, LENALIDOMIDE
REVONTO, DANTROLENE SODIUM
REXTOVY, NALOXONE HYDROCHLORIDE
REXULTI, BREXPIPRAZOLE
REYATAZ, ATAZANAVIR SULFATE
REYVOW, LASMIDITAN SUCCINATE
REZIPRES, EPHEDRINE HYDROCHLORIDE
REZLIDHIA, OLUTASIDENIB
REZUROCK, BELUMOSUDIL MESYLATE
REZZAYO, REZAFUNGIN ACETATE
RHINOCORT ALLERGY, BUDESONIDE (OTC)
RHOFADE, OXYMETAZOLINE HYDROCHLORIDE
RHOPRESSA, NETARSUDIL MESYLATE
RIBAVIRIN, RIBAVIRIN
RIDAURA, AURANOFIN
RIFABUTIN, RIFABUTIN
RIFADIN, RIFAMPIN
RIFAMPIN, RIFAMPIN
RILUTEK, RILUZOLE
RILUZOLE, RILUZOLE
RIMACTANE, RIFAMPIN
RIMANTADINE HYDROCHLORIDE, RIMANTADINE HYDROCHLORIDE
RIMSO-50, DIMETHYL SULFOXIDE
RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE
RINVOQ, UPADACITINIB
RIOCIGUAT, RIOCIGUAT
RISEDRONATE SODIUM, RISEDRONATE SODIUM
RISPERDAL, RISPERIDONE
RISPERDAL CONSTA, RISPERIDONE
RISPERIDONE, RISPERIDONE
RITALIN, METHYLPHENIDATE HYDROCHLORIDE
RITALIN LA, METHYLPHENIDATE HYDROCHLORIDE
RITONAVIR, RITONAVIR
RIVASTIGMINE, RIVASTIGMINE
RIVASTIGMINE TARTRATE, RIVASTIGMINE TARTRATE
RIZAFILM, RIZATRIPTAN BENZOATE
RIZATRIPTAN BENZOATE, RIZATRIPTAN BENZOATE
ROBAXIN, METHOCARBAMOL
ROBINUL, GLYCOPYRROLATE
ROBINUL FORTE, GLYCOPYRROLATE
ROCALTROL, CALCITRIOL
ROCKLATAN, LATANOPROST
ROCURONIUM BROMIDE, ROCURONIUM BROMIDE
ROFLUMILAST, ROFLUMILAST
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 50

APPENDIX A - PRODUCT NAME INDEX

** R **
ROGAINE (FOR MEN), MINOXIDIL (OTC)
ROGAINE (FOR WOMEN), MINOXIDIL (OTC)
ROGAINE EXTRA STRENGTH (FOR MEN), MINOXIDIL (OTC)
ROMIDEPSIN, ROMIDEPSIN
ROPINIROLE HYDROCHLORIDE, ROPINIROLE HYDROCHLORIDE
ROPIVACAINE HYDROCHLORIDE, ROPIVACAINE HYDROCHLORIDE
ROSUVASTATIN CALCIUM, ROSUVASTATIN CALCIUM
ROWASA, MESALAMINE
ROXICODONE, OXYCODONE HYDROCHLORIDE
ROXYBOND, OXYCODONE HYDROCHLORIDE
ROZEREM, RAMELTEON
ROZLYTREK, ENTRECTINIB
RUBRACA, RUCAPARIB CAMSYLATE
RUBY-FILL, RUBIDIUM CHLORIDE RB-82
RUFINAMIDE, RUFINAMIDE
RUKOBIA, FOSTEMSAVIR TROMETHAMINE
RYALTRIS, MOMETASONE FUROATE
RYANODEX, DANTROLENE SODIUM
RYBELSUS, SEMAGLUTIDE
RYDAPT, MIDOSTAURIN
RYKINDO, RISPERIDONE
RYTARY, CARBIDOPA
RYTHMOL SR, PROPAFENONE HYDROCHLORIDE
** S **
SABRIL, VIGABATRIN
SAFYRAL, DROSPIRENONE
SALAGEN, PILOCARPINE HYDROCHLORIDE
SALONPAS, MENTHOL (OTC)
SAMSCA, TOLVAPTAN
SANCUSO, GRANISETRON
SANDIMMUNE, CYCLOSPORINE
SANDOSTATIN, OCTREOTIDE ACETATE
SANDOSTATIN LAR, OCTREOTIDE ACETATE
SAPHRIS, ASENAPINE MALEATE
SAPROPTERIN DIHYDROCHLORIDE, SAPROPTERIN DIHYDROCHLORIDE
SAVAYSA, EDOXABAN TOSYLATE
SAVELLA, MILNACIPRAN HYDROCHLORIDE
SAXENDA, LIRAGLUTIDE RECOMBINANT
SCANDONEST L, LEVONORDEFRIN
SCANDONEST PLAIN, MEPIVACAINE HYDROCHLORIDE
SCEMBLIX, ASCIMINIB HYDROCHLORIDE
SCENESSE, AFAMELANOTIDE
SCLEROSOL, TALC
SCOPOLAMINE, SCOPOLAMINE
SEASONALE, ETHINYL ESTRADIOL
SEASONIQUE, ETHINYL ESTRADIOL
SECUADO, ASENAPINE
SEGLENTIS, CELECOXIB
SEGLUROMET, ERTUGLIFLOZIN
SEIZALAM, MIDAZOLAM HYDROCHLORIDE
SELEGILINE HYDROCHLORIDE, SELEGILINE HYDROCHLORIDE
SELENIOUS ACID, SELENIOUS ACID
SELENIUM SULFIDE, SELENIUM SULFIDE
SELZENTRY, MARAVIROC
SENSIPAR, CINACALCET HYDROCHLORIDE
SENSORCAINE, BUPIVACAINE HYDROCHLORIDE
SEPTOCAINE, ARTICAINE HYDROCHLORIDE
SEPTRA, SULFAMETHOXAZOLE
SEPTRA DS, SULFAMETHOXAZOLE
SEREVENT, SALMETEROL XINAFOATE
SERNIVO, BETAMETHASONE DIPROPIONATE
SEROMYCIN, CYCLOSERINE
SEROQUEL, QUETIAPINE FUMARATE
SEROQUEL XR, QUETIAPINE FUMARATE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 51

APPENDIX A - PRODUCT NAME INDEX

** S **
SERTRALINE HYDROCHLORIDE, SERTRALINE HYDROCHLORIDE
SETLAKIN, ETHINYL ESTRADIOL
SEVELAMER CARBONATE, SEVELAMER CARBONATE
SEVELAMER HYDROCHLORIDE, SEVELAMER HYDROCHLORIDE
SEVOFLURANE, SEVOFLURANE
SEYSARA, SARECYCLINE HYDROCHLORIDE
SEZABY, PHENOBARBITAL SODIUM
SFROWASA, MESALAMINE
SIGNIFOR, PASIREOTIDE DIASPARTATE
SIGNIFOR LAR KIT, PASIREOTIDE PAMOATE
SIKLOS, HYDROXYUREA
SILDENAFIL CITRATE, SILDENAFIL CITRATE
SILENOR, DOXEPIN HYDROCHLORIDE
SILODOSIN, SILODOSIN
SILVADENE, SILVER SULFADIAZINE
SIMBRINZA, BRIMONIDINE TARTRATE
SIMLIYA, DESOGESTREL
SIMPESSE, ETHINYL ESTRADIOL
SIMVASTATIN, SIMVASTATIN
SINCALIDE, SINCALIDE
SINE-AID IB, IBUPROFEN (OTC)
SINEMET, CARBIDOPA
SINGULAIR, MONTELUKAST SODIUM
SINUVA, MOMETASONE FUROATE
SIROLIMUS, SIROLIMUS
SIRTURO, BEDAQUILINE FUMARATE
SITAVIG, ACYCLOVIR
SIVEXTRO, TEDIZOLID PHOSPHATE
SKELAXIN, METAXALONE
SKLICE, IVERMECTIN (OTC)
SKYCLARYS, OMAVELOXOLONE
SKYLA, LEVONORGESTREL
SLYND, DROSPIRENONE
SMOFLIPID 20%, FISH OIL
SOAANZ, TORSEMIDE
SODIUM ACETATE, SODIUM ACETATE
SODIUM BICARBONATE, SODIUM BICARBONATE
SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, SODIUM CHLORIDE
SODIUM CHLORIDE 0.9%, SODIUM CHLORIDE
SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, SODIUM CHLORIDE
SODIUM CHLORIDE 0.9% IN STERILE PLASTIC CONTAINER, SODIUM CHLORIDE
SODIUM CHLORIDE 14.6%, SODIUM CHLORIDE
SODIUM CHLORIDE 23.4%, SODIUM CHLORIDE
SODIUM CHLORIDE 3% IN PLASTIC CONTAINER, SODIUM CHLORIDE
SODIUM CHLORIDE 5% IN PLASTIC CONTAINER, SODIUM CHLORIDE
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE, FERRIC OXYHYDROXIDE
SODIUM FLUORIDE F-18, SODIUM FLUORIDE F-18
SODIUM IODIDE I 123, SODIUM IODIDE I-123
SODIUM IODIDE I 131, SODIUM IODIDE I-131
SODIUM NITRITE, SODIUM NITRITE
SODIUM NITROPRUSSIDE, SODIUM NITROPRUSSIDE
SODIUM PHENYLACETATE AND SODIUM BENZOATE, SODIUM BENZOATE
SODIUM PHENYLBUTYRATE, SODIUM PHENYLBUTYRATE
SODIUM PHOSPHATES, SODIUM PHOSPHATE, DIBASIC, HEPTAHYDRATE
SODIUM PHOSPHATES IN PLASTIC CONTAINER, SODIUM PHOSPHATE, DIBASIC, HEPTAHYDRATE
SODIUM PICOSULFATE, MAGNESIUM OXIDE AND ANHYDROUS CITRIC ACID, CITRIC ACID
SODIUM POLYSTYRENE SULFONATE, SODIUM POLYSTYRENE SULFONATE
SODIUM SULFATE, POTASSIUM SULFATE AND MAGNESIUM SULFATE, MAGNESIUM SULFATE
SODIUM TETRADECYL SULFATE, SODIUM TETRADECYL SULFATE
SODIUM THIOSULFATE, SODIUM THIOSULFATE
SOJOURN, SEVOFLURANE
SOLIFENACIN SUCCINATE, SOLIFENACIN SUCCINATE
SOLODYN, MINOCYCLINE HYDROCHLORIDE
SOLOSEC, SECNIDAZOLE
SOLTAMOX, TAMOXIFEN CITRATE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 52

APPENDIX A - PRODUCT NAME INDEX

** S **
SOLU-CORTEF, HYDROCORTISONE SODIUM SUCCINATE
SOLU-MEDROL, METHYLPREDNISOLONE SODIUM SUCCINATE
SOLUPREP S, CHLORHEXIDINE GLUCONATE (OTC)
SOMA, CARISOPRODOL
SOMATULINE DEPOT, LANREOTIDE ACETATE
SONATA, ZALEPLON
SOOLANTRA, IVERMECTIN
SORAFENIB TOSYLATE, SORAFENIB TOSYLATE
SORBITOL 3% IN PLASTIC CONTAINER, SORBITOL
SORBITOL 3.3% IN PLASTIC CONTAINER, SORBITOL
SORBITOL-MANNITOL IN PLASTIC CONTAINER, MANNITOL
SORILUX, CALCIPOTRIENE
SORINE, SOTALOL HYDROCHLORIDE
SOTALOL HYDROCHLORIDE, SOTALOL HYDROCHLORIDE
SOTRADECOL, SODIUM TETRADECYL SULFATE
SOTYKTU, DEUCRAVACITINIB
SOTYLIZE, SOTALOL HYDROCHLORIDE
SOVALDI, SOFOSBUVIR
SPINRAZA, NUSINERSEN SODIUM
SPIRIVA, TIOTROPIUM BROMIDE
SPIRIVA RESPIMAT, TIOTROPIUM BROMIDE
SPIRONOLACTONE, SPIRONOLACTONE
SPIRONOLACTONE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE
SPORANOX, ITRACONAZOLE
SPRAVATO, ESKETAMINE HYDROCHLORIDE
SPRINTEC, ETHINYL ESTRADIOL
SPRITAM, LEVETIRACETAM
SPRIX, KETOROLAC TROMETHAMINE
SPRYCEL, DASATINIB
SPS, SODIUM POLYSTYRENE SULFONATE
SPY AGENT GREEN KIT, INDOCYANINE GREEN
SSD, SILVER SULFADIAZINE
STALEVO 100, CARBIDOPA
STALEVO 125, CARBIDOPA
STALEVO 150, CARBIDOPA
STALEVO 200, CARBIDOPA
STALEVO 50, CARBIDOPA
STALEVO 75, CARBIDOPA
STEGLATRO, ERTUGLIFLOZIN
STEGLUJAN, ERTUGLIFLOZIN
STENDRA, AVANAFIL
STERILE WATER, STERILE WATER FOR IRRIGATION
STERILE WATER FOR INJECTION, STERILE WATER FOR INJECTION
STERILE WATER FOR INJECTION IN PLASTIC CONTAINER, STERILE WATER FOR INJECTION
STERILE WATER IN PLASTIC CONTAINER, STERILE WATER FOR IRRIGATION
STERITALC, TALC
STIE-CORT, HYDROCORTISONE
STIOLTO RESPIMAT, OLODATEROL HYDROCHLORIDE
STIVARGA, REGORAFENIB
STRATTERA, ATOMOXETINE HYDROCHLORIDE
STREPTOMYCIN SULFATE, STREPTOMYCIN SULFATE
STRIBILD, COBICISTAT
STRIVERDI RESPIMAT, OLODATEROL HYDROCHLORIDE
STROMECTOL, IVERMECTIN
STRONTIUM CHLORIDE SR-89, STRONTIUM CHLORIDE SR-89
SUBLIMAZE PRESERVATIVE FREE, FENTANYL CITRATE
SUBLOCADE, BUPRENORPHINE
SUBOXONE, BUPRENORPHINE HYDROCHLORIDE
SUCCINYLCHOLINE CHLORIDE, SUCCINYLCHOLINE CHLORIDE
SUCRALFATE, SUCRALFATE
SUDAFED 24 HOUR, PSEUDOEPHEDRINE HYDROCHLORIDE (OTC)
SUFENTA PRESERVATIVE FREE, SUFENTANIL CITRATE
SUFENTANIL CITRATE, SUFENTANIL CITRATE
SUFLAVE, MAGNESIUM SULFATE
SUGAMMADEX SODIUM, SUGAMMADEX SODIUM
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 53

APPENDIX A - PRODUCT NAME INDEX

** S **
SULAR, NISOLDIPINE
SULFACETAMIDE SODIUM, SULFACETAMIDE SODIUM
SULFACETAMIDE SODIUM AND PREDNISOLONE SODIUM PHOSPHATE, PREDNISOLONE SODIUM PHOSPHATE
SULFADIAZINE, SULFADIAZINE
SULFAMETHOXAZOLE AND TRIMETHOPRIM, SULFAMETHOXAZOLE
SULFAMYLON, MAFENIDE ACETATE
SULFASALAZINE, SULFASALAZINE
SULFATRIM PEDIATRIC, SULFAMETHOXAZOLE
SULINDAC, SULINDAC
SUMATRIPTAN, SUMATRIPTAN
SUMATRIPTAN AND NAPROXEN SODIUM, NAPROXEN SODIUM
SUMATRIPTAN SUCCINATE, SUMATRIPTAN SUCCINATE
SUNITINIB MALATE, SUNITINIB MALATE
SUNLENCA, LENACAPAVIR SODIUM
SUNOSI, SOLRIAMFETOL HYDROCHLORIDE
SUPPRELIN LA, HISTRELIN ACETATE
SUPRANE, DESFLURANE
SUPRAX, CEFIXIME
SUPREP BOWEL PREP KIT, MAGNESIUM SULFATE
SUSTOL, GRANISETRON
SUTAB, MAGNESIUM SULFATE
SUTENT, SUNITINIB MALATE
SYEDA, DROSPIRENONE
SYFOVRE, PEGCETACOPLAN
SYMBICORT, BUDESONIDE
SYMBICORT AEROSPHERE, BUDESONIDE
SYMBYAX, FLUOXETINE HYDROCHLORIDE
SYMDEKO (COPACKAGED), IVACAFTOR
SYMFI, EFAVIRENZ
SYMFI LO, EFAVIRENZ
SYMJEPI, EPINEPHRINE
SYMLIN, PRAMLINTIDE ACETATE
SYMPAZAN, CLOBAZAM
SYMPROIC, NALDEMEDINE TOSYLATE
SYMTUZA, COBICISTAT
SYNALAR, FLUOCINOLONE ACETONIDE
SYNAREL, NAFARELIN ACETATE
SYNDROS, DRONABINOL
SYNERCID, DALFOPRISTIN
SYNJARDY, EMPAGLIFLOZIN
SYNJARDY XR, EMPAGLIFLOZIN
SYNRIBO, OMACETAXINE MEPESUCCINATE
SYNTHROID, LEVOTHYROXINE SODIUM **
SYPRINE, TRIENTINE HYDROCHLORIDE
** T **
TABRECTA, CAPMATINIB HYDROCHLORIDE
TACLONEX, BETAMETHASONE DIPROPIONATE
TACROLIMUS, TACROLIMUS
TADALAFIL, TADALAFIL
TADLIQ, TADALAFIL
TAFINLAR, DABRAFENIB MESYLATE
TAFLUPROST, TAFLUPROST
TAGAMET HB, CIMETIDINE (OTC)
TAGITOL V, BARIUM SULFATE
TAGRISSO, OSIMERTINIB MESYLATE
TALC, TALC
TALICIA, AMOXICILLIN
TALZENNA, TALAZOPARIB TOSYLATE
TAMIFLU, OSELTAMIVIR PHOSPHATE
TAMOXIFEN CITRATE, TAMOXIFEN CITRATE
TAMSULOSIN HYDROCHLORIDE, TAMSULOSIN HYDROCHLORIDE
TARGRETIN, BEXAROTENE
TARPEYO, BUDESONIDE
TASCENSO ODT, FINGOLIMOD LAURYL SULFATE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 54

APPENDIX A - PRODUCT NAME INDEX

** T **
TASIGNA, NILOTINIB HYDROCHLORIDE
TASIMELTEON, TASIMELTEON
TASMAR, TOLCAPONE
TAUVID, FLORTAUCIPIR F-18
TAVABOROLE, TAVABOROLE
TAVALISSE, FOSTAMATINIB DISODIUM
TAVNEOS, AVACOPAN
TAXOTERE, DOCETAXEL
TAYTULLA, ETHINYL ESTRADIOL
TAZAROTENE, TAZAROTENE
TAZICEF, CEFTAZIDIME
TAZORAC, TAZAROTENE
TAZTIA XT, DILTIAZEM HYDROCHLORIDE
TAZVERIK, TAZEMETOSTAT HYDROBROMIDE
TECFIDERA, DIMETHYL FUMARATE
TECHNELITE, TECHNETIUM TC-99M SODIUM PERTECHNETATE GENERATOR
TECHNESCAN, TECHNETIUM TC-99M OXIDRONATE KIT
TECHNESCAN MAG3, TECHNETIUM TC-99M MERTIATIDE KIT
TECHNESCAN PYP KIT, TECHNETIUM TC-99M PYROPHOSPHATE KIT
TECHNETIUM TC 99M MERTIATIDE KIT, TECHNETIUM TC-99M MERTIATIDE KIT
TECHNETIUM TC 99M SESTAMIBI, TECHNETIUM TC-99M SESTAMIBI KIT
TECHNETIUM TC-99M MEBROFENIN, TECHNETIUM TC-99M MEBROFENIN KIT
TECHNETIUM TC-99M MEDRONATE KIT, TECHNETIUM TC-99M MEDRONATE KIT
TECHNETIUM TC99M MERTIATIDE KIT, TECHNETIUM TC-99M MERTIATIDE KIT
TEFLARO, CEFTAROLINE FOSAMIL
TEGRETOL, CARBAMAZEPINE
TEGRETOL-XR, CARBAMAZEPINE
TEGSEDI, INOTERSEN SODIUM
TEKTURNA, ALISKIREN HEMIFUMARATE
TELMISARTAN, TELMISARTAN
TELMISARTAN AND AMLODIPINE, AMLODIPINE BESYLATE
TELMISARTAN AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE
TEMAZEPAM, TEMAZEPAM
TEMBEXA, BRINCIDOFOVIR
TEMODAR, TEMOZOLOMIDE
TEMOZOLOMIDE, TEMOZOLOMIDE
TEMSIROLIMUS, TEMSIROLIMUS
TENOFOVIR ALAFENAMIDE, TENOFOVIR ALAFENAMIDE FUMARATE
TENOFOVIR DISOPROXIL FUMARATE, TENOFOVIR DISOPROXIL FUMARATE
TENORETIC 100, ATENOLOL
TENORETIC 50, ATENOLOL
TENORMIN, ATENOLOL
TEPADINA, THIOTEPA
TEPMETKO, TEPOTINIB HYDROCHLORIDE
TERAZOSIN HYDROCHLORIDE, TERAZOSIN HYDROCHLORIDE
TERBINAFINE HYDROCHLORIDE, TERBINAFINE HYDROCHLORIDE (OTC)
TERBINAFINE HYDROCHLORIDE, TERBINAFINE HYDROCHLORIDE
TERBUTALINE SULFATE, TERBUTALINE SULFATE
TERCONAZOLE, TERCONAZOLE
TERIFLUNOMIDE, TERIFLUNOMIDE
TERIL, CARBAMAZEPINE
TERLIVAZ, TERLIPRESSIN ACETATE
TESSALON, BENZONATATE
TESTIM, TESTOSTERONE
TESTOPEL, TESTOSTERONE
TESTOSTERONE, TESTOSTERONE
TESTOSTERONE CYPIONATE, TESTOSTERONE CYPIONATE
TESTOSTERONE ENANTHATE, TESTOSTERONE ENANTHATE
TETRABENAZINE, TETRABENAZINE
TETRACAINE HYDROCHLORIDE, TETRACAINE HYDROCHLORIDE
TETRACYCLINE HYDROCHLORIDE, TETRACYCLINE HYDROCHLORIDE
TEXACORT, HYDROCORTISONE
THALIDOMIDE, THALIDOMIDE
THALITONE, CHLORTHALIDONE
THALLOUS CHLORIDE TL 201, THALLOUS CHLORIDE TL-201
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 55

APPENDIX A - PRODUCT NAME INDEX

** T **
THALOMID, THALIDOMIDE
THAM, TROMETHAMINE
THEO-24, THEOPHYLLINE
THEOPHYLLINE, THEOPHYLLINE
THEOPHYLLINE 0.04% AND DEXTROSE 5% IN PLASTIC CONTAINER, THEOPHYLLINE
THEOPHYLLINE 0.08% AND DEXTROSE 5% IN PLASTIC CONTAINER, THEOPHYLLINE
THEOPHYLLINE 0.16% AND DEXTROSE 5% IN PLASTIC CONTAINER, THEOPHYLLINE
THEOPHYLLINE 0.32% AND DEXTROSE 5% IN PLASTIC CONTAINER, THEOPHYLLINE
THERMAZENE, SILVER SULFADIAZINE
THEROXIDIL, MINOXIDIL (OTC)
THIAMINE HYDROCHLORIDE, THIAMINE HYDROCHLORIDE
THIOGUANINE, THIOGUANINE
THIOLA, TIOPRONIN
THIOLA EC, TIOPRONIN
THIORIDAZINE HYDROCHLORIDE, THIORIDAZINE HYDROCHLORIDE
THIOTEPA, THIOTEPA
THIOTHIXENE, THIOTHIXENE
THYQUIDITY, LEVOTHYROXINE SODIUM
THYRO-TABS, LEVOTHYROXINE SODIUM **
THYROSAFE, POTASSIUM IODIDE (OTC)
TIAGABINE HYDROCHLORIDE, TIAGABINE HYDROCHLORIDE
TIAZAC, DILTIAZEM HYDROCHLORIDE
TIBSOVO, IVOSIDENIB
TICAGRELOR, TICAGRELOR
TICLOPIDINE HYDROCHLORIDE, TICLOPIDINE HYDROCHLORIDE
TIGAN, TRIMETHOBENZAMIDE HYDROCHLORIDE
TIGECYCLINE, TIGECYCLINE
TIGLUTIK KIT, RILUZOLE
TIKOSYN, DOFETILIDE
TIMOLOL MALEATE, TIMOLOL MALEATE
TIMOPTIC, TIMOLOL MALEATE
TIMOPTIC IN OCUDOSE, TIMOLOL MALEATE
TIMOPTIC-XE, TIMOLOL MALEATE
TINDAMAX, TINIDAZOLE
TINIDAZOLE, TINIDAZOLE
TIOCONAZOLE, TIOCONAZOLE (OTC)
TIOPRONIN, TIOPRONIN
TIOTROPIUM BROMIDE, TIOTROPIUM BROMIDE
TIPIRACIL HYDROCHLORIDE AND TRIFLURIDINE, TIPIRACIL HYDROCHLORIDE
TIROFIBAN HYDROCHLORIDE, TIROFIBAN HYDROCHLORIDE
TIROSINT, LEVOTHYROXINE SODIUM
TIROSINT-SOL, LEVOTHYROXINE SODIUM
TIS-U-SOL, MAGNESIUM SULFATE
TIS-U-SOL IN PLASTIC CONTAINER, MAGNESIUM SULFATE
TISSUEBLUE, BRILLIANT BLUE G
TIVICAY, DOLUTEGRAVIR SODIUM
TIVICAY PD, DOLUTEGRAVIR SODIUM
TIZANIDINE HYDROCHLORIDE, TIZANIDINE HYDROCHLORIDE
TLANDO, TESTOSTERONE UNDECANOATE
TOBI, TOBRAMYCIN
TOBI PODHALER, TOBRAMYCIN
TOBRADEX, DEXAMETHASONE
TOBRADEX ST, DEXAMETHASONE
TOBRAMYCIN, TOBRAMYCIN
TOBRAMYCIN AND DEXAMETHASONE, DEXAMETHASONE
TOBRAMYCIN SULFATE, TOBRAMYCIN SULFATE
TOBRAMYCIN SULFATE (PHARMACY BULK), TOBRAMYCIN SULFATE
TOBRAMYCIN SULFATE IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, TOBRAMYCIN SULFATE
TOBREX, TOBRAMYCIN
TOFACITINIB CITRATE, TOFACITINIB CITRATE
TOFRANIL, IMIPRAMINE HYDROCHLORIDE
TOLAK, FLUOROURACIL
TOLCAPONE, TOLCAPONE
TOLMETIN SODIUM, TOLMETIN SODIUM
TOLSURA, ITRACONAZOLE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 56

APPENDIX A - PRODUCT NAME INDEX

** T **
TOLTERODINE TARTRATE, TOLTERODINE TARTRATE
TOLVAPTAN, TOLVAPTAN
TOPAMAX, TOPIRAMATE
TOPICORT, DESOXIMETASONE
TOPIRAMATE, TOPIRAMATE
TOPOTECAN HYDROCHLORIDE, TOPOTECAN HYDROCHLORIDE
TOPROL-XL, METOPROLOL SUCCINATE
TOREMIFENE CITRATE, TOREMIFENE CITRATE
TORISEL, TEMSIROLIMUS
TORSEMIDE, TORSEMIDE
TOSYMRA, SUMATRIPTAN
TOVIAZ, FESOTERODINE FUMARATE
TPN ELECTROLYTES IN PLASTIC CONTAINER, CALCIUM CHLORIDE
TPOXX, TECOVIRIMAT
TRACLEER, BOSENTAN
TRADJENTA, LINAGLIPTIN
TRALEMENT, CUPRIC SULFATE
TRAMADOL HYDROCHLORIDE, TRAMADOL HYDROCHLORIDE
TRAMADOL HYDROCHLORIDE AND ACETAMINOPHEN, ACETAMINOPHEN
TRANDATE, LABETALOL HYDROCHLORIDE
TRANDOLAPRIL, TRANDOLAPRIL
TRANDOLAPRIL AND VERAPAMIL HYDROCHLORIDE, TRANDOLAPRIL
TRANEXAMIC ACID, TRANEXAMIC ACID
TRANSDERM SCOP, SCOPOLAMINE
TRANXENE, CLORAZEPATE DIPOTASSIUM
TRANYLCYPROMINE SULFATE, TRANYLCYPROMINE SULFATE
TRAVASOL 10% IN PLASTIC CONTAINER, AMINO ACIDS
TRAVASOL 5.5% IN PLASTIC CONTAINER, AMINO ACIDS
TRAVASOL 8.5% IN PLASTIC CONTAINER, AMINO ACIDS
TRAVATAN Z, TRAVOPROST
TRAVOPROST, TRAVOPROST
TRAZODONE HYDROCHLORIDE, TRAZODONE HYDROCHLORIDE
TREANDA, BENDAMUSTINE HYDROCHLORIDE
TRECATOR, ETHIONAMIDE
TRELEGY ELLIPTA, FLUTICASONE FUROATE
TRELSTAR, TRIPTORELIN PAMOATE
TREPROSTINIL, TREPROSTINIL
TRETINOIN, TRETINOIN
TREXALL, METHOTREXATE SODIUM
TREXIMET, NAPROXEN SODIUM
TREZIX, ACETAMINOPHEN
TRI LO SPRINTEC, ETHINYL ESTRADIOL
TRI-ESTARYLLA, ETHINYL ESTRADIOL
TRI-LEGEST 21, ETHINYL ESTRADIOL
TRI-LEGEST FE, ETHINYL ESTRADIOL
TRI-LINYAH, ETHINYL ESTRADIOL
TRI-LO-ESTARYLLA, ETHINYL ESTRADIOL
TRI-LO-LINYAH, ETHINYL ESTRADIOL
TRI-LO-MILI, ETHINYL ESTRADIOL
TRI-LUMA, FLUOCINOLONE ACETONIDE
TRI-MILI, ETHINYL ESTRADIOL
TRI-NORINYL 28-DAY, ETHINYL ESTRADIOL
TRI-SPRINTEC, ETHINYL ESTRADIOL
TRIACIN-C, CODEINE PHOSPHATE
TRIAMCINOLONE ACETONIDE, TRIAMCINOLONE ACETONIDE (OTC)
TRIAMCINOLONE ACETONIDE, TRIAMCINOLONE ACETONIDE
TRIAMTERENE, TRIAMTERENE
TRIAMTERENE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE
TRIANEX, TRIAMCINOLONE ACETONIDE
TRIAZOLAM, TRIAZOLAM
TRIBENZOR, AMLODIPINE BESYLATE
TRICOR, FENOFIBRATE
TRIDERM, TRIAMCINOLONE ACETONIDE
TRIENTINE HYDROCHLORIDE, TRIENTINE HYDROCHLORIDE
TRIESENCE, TRIAMCINOLONE ACETONIDE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 57

APPENDIX A - PRODUCT NAME INDEX

** T **
TRIFLUOPERAZINE HYDROCHLORIDE, TRIFLUOPERAZINE HYDROCHLORIDE
TRIFLURIDINE, TRIFLURIDINE
TRIGLIDE, FENOFIBRATE
TRIHEXYPHENIDYL HYDROCHLORIDE, TRIHEXYPHENIDYL HYDROCHLORIDE
TRIJARDY XR, EMPAGLIFLOZIN
TRIKAFTA (COPACKAGED), ELEXACAFTOR, IVACAFTOR, TEZACAFTOR
TRILEPTAL, OXCARBAZEPINE
TRILIPIX, CHOLINE FENOFIBRATE
TRIMETHOBENZAMIDE HYDROCHLORIDE, TRIMETHOBENZAMIDE HYDROCHLORIDE
TRIMETHOPRIM, TRIMETHOPRIM
TRIMETHOPRIM SULFATE AND POLYMYXIN B SULFATE, POLYMYXIN B SULFATE
TRIMIPRAMINE MALEATE, TRIMIPRAMINE MALEATE
TRINTELLIX, VORTIOXETINE HYDROBROMIDE
TRIPTODUR KIT, TRIPTORELIN PAMOATE
TRISENOX, ARSENIC TRIOXIDE
TRIUMEQ, ABACAVIR SULFATE
TRIUMEQ PD, ABACAVIR SULFATE
TRIVAGIZOLE 3, CLOTRIMAZOLE (OTC)
TRIVORA-28, ETHINYL ESTRADIOL
TRIZIVIR, ABACAVIR SULFATE
TROKENDI XR, TOPIRAMATE
TROPHAMINE, AMINO ACIDS
TROPHAMINE 10%, AMINO ACIDS
TROPICACYL, TROPICAMIDE
TROPICAMIDE, TROPICAMIDE
TROSPIUM CHLORIDE, TROSPIUM CHLORIDE
TRUDHESA, DIHYDROERGOTAMINE MESYLATE
TRULANCE, PLECANATIDE
TRUVADA, EMTRICITABINE
TUDORZA PRESSAIR, ACLIDINIUM BROMIDE
TUKYSA, TUCATINIB
TURALIO, PEXIDARTINIB HYDROCHLORIDE
TUXARIN ER, CHLORPHENIRAMINE MALEATE
TWIRLA, ETHINYL ESTRADIOL
TWYNEO, BENZOYL PEROXIDE
TYBLUME, ETHINYL ESTRADIOL
TYBOST, COBICISTAT
TYDEMY, DROSPIRENONE
TYGACIL, TIGECYCLINE
TYKERB, LAPATINIB DITOSYLATE
TYLENOL, ACETAMINOPHEN (OTC)
TYMLOS, ABALOPARATIDE
TYRVAYA, VARENICLINE TARTRATE
TYVASO, TREPROSTINIL
TYVASO DPI, TREPROSTINIL
TYZINE, TETRAHYDROZOLINE HYDROCHLORIDE
** U **
UBRELVY, UBROGEPANT
UCERIS, BUDESONIDE
ULORIC, FEBUXOSTAT
ULTANE, SEVOFLURANE
ULTIVA, REMIFENTANIL HYDROCHLORIDE
ULTRA-TECHNEKOW FM, TECHNETIUM TC-99M SODIUM PERTECHNETATE GENERATOR
ULTRATAG, TECHNETIUM TC-99M RED BLOOD CELL KIT
ULTRAVATE, HALOBETASOL PROPIONATE
ULTRAVIST (PHARMACY BULK), IOPROMIDE
ULTRAVIST 300, IOPROMIDE
ULTRAVIST 370, IOPROMIDE
UNASYN, AMPICILLIN SODIUM
UNISOM, DOXYLAMINE SUCCINATE (OTC)
UNITHROID, LEVOTHYROXINE SODIUM **
UPNEEQ, OXYMETAZOLINE HYDROCHLORIDE
UPTRAVI, SELEXIPAG
UREX, METHENAMINE HIPPURATE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 58

APPENDIX A - PRODUCT NAME INDEX

** U **
UROCIT-K, POTASSIUM CITRATE
UROXATRAL, ALFUZOSIN HYDROCHLORIDE
URSO 250, URSODIOL
URSO FORTE, URSODIOL
URSODIOL, URSODIOL
UVADEX, METHOXSALEN
UZEDY, RISPERIDONE
** V **
VABOMERE, MEROPENEM
VAGIFEM, ESTRADIOL
VAGISTAT-1, TIOCONAZOLE (OTC)
VALACYCLOVIR HYDROCHLORIDE, VALACYCLOVIR HYDROCHLORIDE
VALCHLOR, MECHLORETHAMINE HYDROCHLORIDE
VALCYTE, VALGANCICLOVIR HYDROCHLORIDE
VALGANCICLOVIR HYDROCHLORIDE, VALGANCICLOVIR HYDROCHLORIDE
VALIUM, DIAZEPAM
VALNAC, BETAMETHASONE VALERATE
VALPROATE SODIUM, VALPROATE SODIUM
VALPROIC ACID, VALPROIC ACID
VALRUBICIN, VALRUBICIN
VALSARTAN, VALSARTAN
VALSARTAN AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE
VALSTAR PRESERVATIVE FREE, VALRUBICIN
VALTOCO, DIAZEPAM
VALTREX, VALACYCLOVIR HYDROCHLORIDE
VANCOCIN HYDROCHLORIDE, VANCOMYCIN HYDROCHLORIDE
VANCOCIN HYDROCHLORIDE IN PLASTIC CONTAINER, VANCOMYCIN HYDROCHLORIDE
VANCOMYCIN, VANCOMYCIN
VANCOMYCIN HYDROCHLORIDE, VANCOMYCIN HYDROCHLORIDE
VANCOMYCIN HYDROCHLORIDE IN PLASTIC CONTAINER, VANCOMYCIN HYDROCHLORIDE
VANDAZOLE, METRONIDAZOLE
VANOS, FLUOCINONIDE
VAPRISOL IN 5% DEXTROSE IN PLASTIC CONTAINER, CONIVAPTAN HYDROCHLORIDE
VARDENAFIL HYDROCHLORIDE, VARDENAFIL HYDROCHLORIDE
VARENICLINE TARTRATE, VARENICLINE TARTRATE
VARIBAR HONEY, BARIUM SULFATE
VARIBAR NECTAR, BARIUM SULFATE
VARIBAR PUDDING, BARIUM SULFATE
VARIBAR THIN HONEY, BARIUM SULFATE
VARIBAR THIN LIQUID, BARIUM SULFATE
VARITHENA, POLIDOCANOL
VARUBI, ROLAPITANT HYDROCHLORIDE
VASCEPA, ICOSAPENT ETHYL
VASERETIC, ENALAPRIL MALEATE
VASOPRESSIN, VASOPRESSIN
VASOSTRICT, VASOPRESSIN
VASOTEC, ENALAPRIL MALEATE
VAZALORE, ASPIRIN (OTC)
VAZCULEP, PHENYLEPHRINE HYDROCHLORIDE
VECTICAL, CALCITRIOL
VECURONIUM BROMIDE, VECURONIUM BROMIDE
VEKLURY, REMDESIVIR
VELCADE, BORTEZOMIB
VELETRI, EPOPROSTENOL SODIUM
VELIVET, DESOGESTREL
VELPHORO, FERRIC OXYHYDROXIDE
VELTASSA, PATIROMER SORBITEX CALCIUM
VELTIN, CLINDAMYCIN PHOSPHATE
VEMLIDY, TENOFOVIR ALAFENAMIDE FUMARATE
VENCLEXTA, VENETOCLAX
VENLAFAXINE BESYLATE, VENLAFAXINE BESYLATE
VENLAFAXINE HYDROCHLORIDE, VENLAFAXINE HYDROCHLORIDE
VENOFER, FERRIC OXYHYDROXIDE
VENTAVIS, ILOPROST
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 59

APPENDIX A - PRODUCT NAME INDEX

** V **
VENTOLIN HFA, ALBUTEROL SULFATE
VEOZAH, FEZOLINETANT
VERAPAMIL HYDROCHLORIDE, VERAPAMIL HYDROCHLORIDE
VERDESO, DESONIDE
VEREGEN, SINECATECHINS
VERELAN, VERAPAMIL HYDROCHLORIDE
VERELAN PM, VERAPAMIL HYDROCHLORIDE
VERKAZIA, CYCLOSPORINE
VERQUVO, VERICIGUAT
VERSACLOZ, CLOZAPINE
VERZENIO, ABEMACICLIB
VESICARE, SOLIFENACIN SUCCINATE
VESICARE LS, SOLIFENACIN SUCCINATE
VEVYE, CYCLOSPORINE
VFEND, VORICONAZOLE
VIAGRA, SILDENAFIL CITRATE
VIBATIV, TELAVANCIN HYDROCHLORIDE
VIBERZI, ELUXADOLINE
VIBISONE, CYANOCOBALAMIN
VIBRAMYCIN, DOXYCYCLINE
VIBRAMYCIN, DOXYCYCLINE CALCIUM
VIBRAMYCIN, DOXYCYCLINE HYCLATE
VICTOZA, LIRAGLUTIDE RECOMBINANT
VIDAZA, AZACITIDINE
VIENVA, ETHINYL ESTRADIOL
VIGABATRIN, VIGABATRIN
VIGADRONE, VIGABATRIN
VIGAMOX, MOXIFLOXACIN HYDROCHLORIDE
VIIBRYD, VILAZODONE HYDROCHLORIDE
VIJOICE, ALPELISIB
VILAZODONE HYDROCHLORIDE, VILAZODONE HYDROCHLORIDE
VILTEPSO, VILTOLARSEN
VIMOVO, ESOMEPRAZOLE MAGNESIUM
VIMPAT, LACOSAMIDE
VINBLASTINE SULFATE, VINBLASTINE SULFATE
VINCRISTINE SULFATE PFS, VINCRISTINE SULFATE
VINORELBINE TARTRATE, VINORELBINE TARTRATE
VIORELE, DESOGESTREL
VIRACEPT, NELFINAVIR MESYLATE
VIRAMUNE, NEVIRAPINE
VIRAMUNE XR, NEVIRAPINE
VIRAZOLE, RIBAVIRIN
VIREAD, TENOFOVIR DISOPROXIL FUMARATE
VIROPTIC, TRIFLURIDINE
VISINE, NAPHAZOLINE HYDROCHLORIDE (OTC)
VISINE L.R., OXYMETAZOLINE HYDROCHLORIDE (OTC)
VISIONBLUE, TRYPAN BLUE
VISIPAQUE 270, IODIXANOL
VISIPAQUE 320, IODIXANOL
VISTARIL, HYDROXYZINE PAMOATE
VISTOGARD, URIDINE TRIACETATE
VISUDYNE, VERTEPORFIN
VITAMIN D, ERGOCALCIFEROL
VITAMIN K1, PHYTONADIONE
VITRAKVI, LAROTRECTINIB SULFATE
VIVELLE-DOT, ESTRADIOL
VIVIMUSTA, BENDAMUSTINE HYDROCHLORIDE
VIVITROL, NALTREXONE
VIVJOA, OTESECONAZOLE
VIZAMYL, FLUTEMETAMOL F-18
VIZIMPRO, DACOMITINIB
VOCABRIA, CABOTEGRAVIR SODIUM
VOGELXO, TESTOSTERONE
VOLNEA, DESOGESTREL
VOLTAREN ARTHRITIS PAIN, DICLOFENAC SODIUM (OTC)
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 60

APPENDIX A - PRODUCT NAME INDEX

** V **
VONJO, PACRITINIB CITRATE
VORICONAZOLE, VORICONAZOLE
VOSEVI, SOFOSBUVIR
VOSOL, ACETIC ACID, GLACIAL
VOSOL HC, ACETIC ACID, GLACIAL
VOTRIENT, PAZOPANIB HYDROCHLORIDE
VOXZOGO, VOSORITIDE
VRAYLAR, CARIPRAZINE HYDROCHLORIDE
VTAMA, TAPINAROF
VUITY, PILOCARPINE HYDROCHLORIDE
VUMERITY, DIROXIMEL FUMARATE
VUSION, MICONAZOLE NITRATE
VYDUO, NEBIVOLOL HYDROCHLORIDE
VYFEMLA, ETHINYL ESTRADIOL
VYLEESI (AUTOINJECTOR), BREMELANOTIDE ACETATE
VYNDAMAX, TAFAMIDIS
VYNDAQEL, TAFAMIDIS MEGLUMINE
VYONDYS 53, GOLODIRSEN
VYTORIN, EZETIMIBE
VYVANSE, LISDEXAMFETAMINE DIMESYLATE
VYXEOS, CYTARABINE
VYZULTA, LATANOPROSTENE BUNOD
** W **
WAKIX, PITOLISANT HYDROCHLORIDE
WARFARIN SODIUM, WARFARIN SODIUM
WEGOVY, SEMAGLUTIDE
WELCHOL, COLESEVELAM HYDROCHLORIDE
WELIREG, BELZUTIFAN
WELLBUTRIN SR, BUPROPION HYDROCHLORIDE
WELLBUTRIN XL, BUPROPION HYDROCHLORIDE
WERA, ETHINYL ESTRADIOL
WINLEVI, CLASCOTERONE
WIXELA INHUB, FLUTICASONE PROPIONATE
WOMEN'S ROGAINE, MINOXIDIL (OTC)
WYNZORA, BETAMETHASONE DIPROPIONATE
** X **
XACDURO (COPACKAGED), DURLOBACTAM SODIUM
XACIATO, CLINDAMYCIN PHOSPHATE
XADAGO, SAFINAMIDE MESYLATE
XALATAN, LATANOPROST
XALKORI, CRIZOTINIB
XANAX, ALPRAZOLAM
XANAX XR, ALPRAZOLAM
XARACOLL, BUPIVACAINE HYDROCHLORIDE
XARELTO, RIVAROXABAN
XATMEP, METHOTREXATE SODIUM
XCOPRI, CENOBAMATE
XELJANZ, TOFACITINIB CITRATE
XELJANZ XR, TOFACITINIB CITRATE
XELODA, CAPECITABINE
XELPROS, LATANOPROST
XELSTRYM, DEXTROAMPHETAMINE
XENAZINE, TETRABENAZINE
XENICAL, ORLISTAT
XENLETA, LEFAMULIN ACETATE
XENON XE 133, XENON XE-133
XENOVIEW, XENON XE-129 HYPERPOLARIZED
XEPI, OZENOXACIN
XERAVA, ERAVACYCLINE DIHYDROCHLORIDE
XERESE, ACYCLOVIR
XERMELO, TELOTRISTAT ETIPRATE
XHANCE, FLUTICASONE PROPIONATE
XIFAXAN, RIFAXIMIN
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 61

APPENDIX A - PRODUCT NAME INDEX

** X **
XIGDUO XR, DAPAGLIFLOZIN
XIIDRA, LIFITEGRAST
XIMINO, MINOCYCLINE HYDROCHLORIDE
XIPERE, TRIAMCINOLONE ACETONIDE
XOFIGO, RADIUM RA-223 DICHLORIDE
XOFLUZA, BALOXAVIR MARBOXIL
XOPENEX, LEVALBUTEROL HYDROCHLORIDE
XOPENEX HFA, LEVALBUTEROL TARTRATE
XOSPATA, GILTERITINIB FUMARATE
XPOVIO, SELINEXOR
XTAMPZA ER, OXYCODONE
XTANDI, ENZALUTAMIDE
XULANE, ETHINYL ESTRADIOL
XURIDEN, URIDINE TRIACETATE
XYLOCAINE, LIDOCAINE HYDROCHLORIDE
XYLOCAINE W/ EPINEPHRINE, EPINEPHRINE
XYOSTED (AUTOINJECTOR), TESTOSTERONE ENANTHATE
XYREM, SODIUM OXYBATE
XYWAV, CALCIUM OXYBATE
XYZAL ALLERGY 24HR, LEVOCETIRIZINE DIHYDROCHLORIDE (OTC)
** Y **
YAELA, DROSPIRENONE
YASMIN, DROSPIRENONE
YAZ, DROSPIRENONE
YONDELIS, TRABECTEDIN
YONSA, ABIRATERONE ACETATE
YUPELRI, REVEFENACIN
YUTIQ, FLUOCINOLONE ACETONIDE
** Z **
ZADITOR, KETOTIFEN FUMARATE (OTC)
ZAFIRLUKAST, ZAFIRLUKAST
ZALEPLON, ZALEPLON
ZANAFLEX, TIZANIDINE HYDROCHLORIDE
ZANOSAR, STREPTOZOCIN
ZARONTIN, ETHOSUXIMIDE
ZAVESCA, MIGLUSTAT
ZAVZPRET, ZAVEGEPANT HYDROCHLORIDE
ZEGALOGUE, DASIGLUCAGON HYDROCHLORIDE
ZEGALOGUE (AUTOINJECTOR), DASIGLUCAGON HYDROCHLORIDE
ZEGERID, OMEPRAZOLE
ZEGERID OTC, OMEPRAZOLE (OTC)
ZEJULA, NIRAPARIB TOSYLATE
ZELAPAR, SELEGILINE HYDROCHLORIDE
ZELBORAF, VEMURAFENIB
ZEMBRACE SYMTOUCH, SUMATRIPTAN SUCCINATE
ZEMDRI, PLAZOMICIN SULFATE
ZEMPLAR, PARICALCITOL
ZENATANE, ISOTRETINOIN
ZEPATIER, ELBASVIR
ZEPOSIA, OZANIMOD HYDROCHLORIDE
ZEPZELCA, LURBINECTEDIN
ZERBAXA, CEFTOLOZANE SULFATE
ZERVIATE, CETIRIZINE HYDROCHLORIDE
ZESTORETIC, HYDROCHLOROTHIAZIDE
ZESTRIL, LISINOPRIL
ZETIA, EZETIMIBE
ZETONNA, CICLESONIDE
ZIAC, BISOPROLOL FUMARATE
ZIAGEN, ABACAVIR SULFATE
ZIANA, CLINDAMYCIN PHOSPHATE
ZIDOVUDINE, ZIDOVUDINE
ZILEUTON, ZILEUTON
ZILRETTA, TRIAMCINOLONE ACETONIDE
JUNE 2023 - APPROVED DRUG PRODUCT LIST A - 62

APPENDIX A - PRODUCT NAME INDEX

** Z **
ZILXI, MINOCYCLINE HYDROCHLORIDE
ZIMHI, NALOXONE HYDROCHLORIDE
ZINC CHLORIDE, ZINC CHLORIDE
ZINC CHLORIDE IN PLASTIC CONTAINER, ZINC CHLORIDE
ZINC SULFATE, ZINC SULFATE
ZINGO, LIDOCAINE HYDROCHLORIDE
ZIOPTAN, TAFLUPROST
ZIPRASIDONE HYDROCHLORIDE, ZIPRASIDONE HYDROCHLORIDE
ZIPRASIDONE MESYLATE, ZIPRASIDONE MESYLATE
ZIPSOR, DICLOFENAC POTASSIUM
ZIRGAN, GANCICLOVIR
ZITHROMAX, AZITHROMYCIN
ZOCOR, SIMVASTATIN
ZOKINVY, LONAFARNIB
ZOLADEX, GOSERELIN ACETATE
ZOLEDRONIC, ZOLEDRONIC ACID
ZOLEDRONIC ACID, ZOLEDRONIC ACID
ZOLINZA, VORINOSTAT
ZOLMITRIPTAN, ZOLMITRIPTAN
ZOLOFT, SERTRALINE HYDROCHLORIDE
ZOLPIDEM TARTRATE, ZOLPIDEM TARTRATE
ZOMETA, ZOLEDRONIC ACID
ZOMIG, ZOLMITRIPTAN
ZONALON, DOXEPIN HYDROCHLORIDE
ZONEGRAN, ZONISAMIDE
ZONISADE, ZONISAMIDE
ZONISAMIDE, ZONISAMIDE
ZONTIVITY, VORAPAXAR SULFATE
ZORTRESS, EVEROLIMUS
ZORYVE, ROFLUMILAST
ZOSYN IN PLASTIC CONTAINER, PIPERACILLIN SODIUM
ZOVIA 1/50E-28, ETHINYL ESTRADIOL
ZOVIRAX, ACYCLOVIR
ZTALMY, GANAXOLONE
ZTLIDO, LIDOCAINE
ZUBSOLV, BUPRENORPHINE HYDROCHLORIDE
ZULRESSO, BREXANOLONE
ZUMANDIMINE, DROSPIRENONE
ZURAGARD, ISOPROPYL ALCOHOL (OTC)
ZYCLARA, IMIQUIMOD
ZYDELIG, IDELALISIB
ZYFLO, ZILEUTON
ZYKADIA, CERITINIB
ZYLET, LOTEPREDNOL ETABONATE
ZYLOPRIM, ALLOPURINOL
ZYMAXID, GATIFLOXACIN
ZYNRELEF KIT, BUPIVACAINE
ZYPITAMAG, PITAVASTATIN MAGNESIUM
ZYPREXA, OLANZAPINE
ZYPREXA RELPREVV, OLANZAPINE PAMOATE
ZYPREXA ZYDIS, OLANZAPINE
ZYRTEC ALLERGY, CETIRIZINE HYDROCHLORIDE (OTC)
ZYRTEC-D 12 HOUR, CETIRIZINE HYDROCHLORIDE (OTC)
ZYTIGA, ABIRATERONE ACETATE
ZYVOX, LINEZOLID

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