2020 Enhanced Formulary
KEY: The 2020 AscellaHealth [INJ], [inj] - Injectable Drug Generic medications contain the Enhanced Formulary list is listed [OTC], [otc] - Over the Counter same active ingredients as their below. Last updated October 2020 [SP], [sp] - Specialty Drug corresponding brand name and subject to change at any time. Brand name drugs are listed in medications, though they may Inclusion on this list does not CAPITAL letters. Example: appear different in shape and color. guarantee coverage. Coverage is ABILIFY. They have been FDA -approved based on your specific benefit plan. Generic drugs are listed in under strict standards. lower-case letters. Example: altavera
phendimetrazine tartrate fenoprofen calcium ADHD/ANTI- phendimetrazine tartrate er flurbiprofen NARCOLEPSY/ANTI- phentermine hcl HUMIRA [INJ] OBESITY/ANOREXIANTS VYVANSE ibuprofen ibuprofen lysine amphetamine salt combo er indomethacin armodafinil AMINOGLYCOSIDES indomethacin er atomoxetine hcl AMIKACIN [INJ] ketoprofen er benzphetamine hcl gentamicin sulfate ketorolac tromethamine caffeine citrated gentamicin sulfate [INJ] leflunomide caffeine/sodium benzoate gentamicin sulfate in ns meclofenamate sodium [INJ] KITABIS PAK mefenamic acid clonidine hcl er neomycin sulfate meloxicam dexmethylphenidate er paromomycin sulfate nabumetone dexmethylphenidate hcl tobramycin sulfate [INJ] naproxen dexmethylphenidate hcl er tobramycin sulfate in ns naproxen sodium dextroamphetamine sulfate oxaprozin dextroamphetamine sulfate piroxicam er ANALGESICS - ANTI- sulindac diethylpropion hcl INFLAMMATORY tolmetin sodium guanfacine er XELJANZ celecoxib methamphetamine hcl XELJANZ XR diclofenac potassium methylphenidate cd methylphenidate er diclofenac sodium methylphenidate hcl diclofenac methylphenidate hcl er (cd) sodium/misoprostol del rel methylphenidate la ENBREL [INJ] modafinil etodolac ANALGESICS - etodolac er MYDAYIS NonNarcotic 1 November 2020
2020 Enhanced Formulary
acetaminophen- oxycodone w/aspirin atovaquone diphenhydramine oxycodone/acetaminophen bacitracin butalbital compound OXYCONTIN bacitracin [INJ] butalbital/apap/caffeine oxymorphone hcl clindamycin hcl butalbital/aspirin/caffeine oxymorphone hcl er clindamycin palmitate hcl choline mag trisalicylate remifentanil hcl clindamycin phosphate [INJ] clonidine [INJ] ROXYBOND CLINDAMYCIN PHOSPHATE diflunisal SUBOXONE [INJ] SALICYLAMIDE sufentil 50mcg/ml ampul clindamycin salsalate [INJ] phosphate/dextrose [INJ] tramadol hcl colistimethate [INJ] tramadol hcl er CUBICIN RF
ANALGESICS - OPIOID tramadol/acetaminophen dapsone acetaminophen/codeine XTAMPZA ER daptomycin alfentanil hcl [INJ] ZUBSOLV imipenem-cilastatin [INJ] BELBUCA linezolid buprenorphine [INJ] metronidazole ANDROGENS-ANABOLIC buprenorphine/naloxone pentamidine isethionate butalbital danazol polymyxin b sulfate [INJ] compound/codeine oxandrolone sulfamethoxazole/trimethop butalbital/caff/apap/codeine testosterone cypionate [INJ] rim butorphanol [INJ] testosterone enanthate [INJ] tigecycline codeine sulfate testosterone gel tinidazole dihydrocodeine/aspirin/caffe trimethoprim ine XIFAXAN fentanyl citrate ANORECTAL AGENTS hydrocodone bitartrate er CORTIFOAM ANTIANGINAL AGENTS hydrocodone/acetaminophe hydrocortisone/pramoxine n lidocaine-hc DILATRATE-SR hydrocodone/ibuprofen pramcort isosorbide dinitrate hydromorphone hcl isosorbide mononitrate levorphanol tartrate isosorbide mononitrate er meperidine hcl ANTHELMINTICS minitran methadone hcl nitroglycerin ALBENZA morphine sulfate nitroglycerin er praziquantel morphine sulfate cr nitroglycerin spray morphine sulfate er nitroglycerin tablets nalbuphine hcl [INJ] ANTI-INFECTIVE AGENTS - ranolazine er oxycodone hcl MISC. oxycodone hcl/ibuprofen 2 November 2020
2020 Enhanced Formulary
ANTIANXIETY AGENTS ADVAIR HFA zafirlukast ALBUTEROL alprazolam albuterol sulfate alprazolam er albuterol sulfate hfa ANTICOAGULANTS alprazolam odt aminophylline [INJ] bivalirudin buspirone hcl ANORO ELLIPTA ELIQUIS chlordiazepoxide hcl ARCAPTA NEOHALER enoxaparin sodium [INJ] clorazepate dipotassium ARNUITY ELLIPTA fondaparinux sodium diazepam ASMANEX, HFA heparin lock flush [INJ] droperidol [INJ] BREO ELLIPTA heparin sodium in 0.45% nacl hydroxyzine hcl COMBIVENT RESPIMAT [INJ] hydroxyzine pamoate DALIRESP heparin sodium in 5% lorazepam FLOVENT DISKUS dextrose [INJ] oxazepam FLOVENT HFA heparin sodium syringe
fluticasone-salmeterol warfarin sodium ANTIARRHYTHMICS INCRUSE ELLIPTA XARELTO ipratropium bromide adenosine [INJ] ipratropium/albuterol amiodarone hcl nebulization ANTICONVULSANTS dofetilide ipratropium-albuterol carbamazepine flecainide acetate levalbuterol hcl carbamazepine er ibutilide fumarate [INJ] metaproterenol sulfate clobazam lidocaine hcl in 7.5% montelukast sodium clonazepam dextrose [INJ] PERFOROMIST [INJ] clonazepam odt mexiletine hcl PROAIR RESPICLICK diazepam rectal gel procainamide hcl [INJ] PULMICORT FLEXHALER divalproex sodium propafenone hcl QVAR divalproex sodium er propafenone hcl er QVAR REDIHALER ethosuximide quinidine gluconate [INJ] SEREVENT DISKUS felbamate quinidine gluconate er SPIRIVA HANDIHALER fosphenytoin sodium quinidine sulfate SPIRIVA RESPIMAT gabapentin QUINIDINE SULFATE STIOLTO RESPIMAT lamotrigine SYMBICORT lamotrigine er terbutaline sulfate levetiracetam theophylline anhydrous levetiracetam er drops er 12 hr ANTIASTHMATIC AND oxcarbazepine theophylline anhydrous er BRONCHODILATOR phenytoin TRELEGY ELLIPTA AGENTS phenytoin sodium wixela inhub pregabalin primidone 3 November 2020
2020 Enhanced Formulary
ROWEEPRA venlafaxine hcl NOVOLOG FLEXPEN ROWEEPRA XR venlafaxine hcl er NOVOLOG MIX 70-30 tiagabine hcl ONGLYZA topiramate OZEMPIC valproate sodium ANTIDIABETICS pioglitazone hcl valproic acid acarbose pioglitazone/glimepiride VALPROIC ACID BAQSIMI pioglitazone/metformin vigabatrin BYETTA [INJ] repaglinide zonisamide FARXIGA repaglinide/metformin FIASP SOLIQUA 100-33 FIASP FLEXTOUCH tolazamide ANTIDEPRESSANTS glimepiride tolbutamide amitriptyline hcl glipizide TOUJEO MAX SOLOSTAR amoxapine 150mg glipizide er TOUJEO SOLOSTAR amoxapine 25mg GLUCAGON TRADJENTA bupropion hcl glyburide TRESIBA bupropion hcl er glyburide micronized TRESIBA FLEXTOUCH bupropion hcl xl er glyburide/metformin TRULICITY bupropion sr HUMULIN R 500 UNITS [INJ] VICTOZA [INJ] citalopram hbr HUMULIN R U-500 KWIKPEN XIGDUO XR clomipramine hcl insulin lispro XULTOPHY 100-3.6 desipramine hcl INVOKAMET desvenlafaxine succinate er INVOKAMET XR ANTIDIARRHEALS doxepin hcl INVOKANA duloxetine JANUMET diphenoxylate/atropine escitalopram oxalate JANUMET XR opium FETZIMA JANUVIA paregoric fluoxetine JENTADUETO fluvoxamine maleate er JENTADUETO XR imipramine hcl LANTUS [INJ] ANTIDOTES imipramine pamoate LANTUS SOLOSTAR [INJ] deferasirox mirtazapine LEVEMIR [INJ] deferiprone mirtazapine disintegrating LEVEMIR, FLEXTOUCH deferoxamine [INJ] nortriptyline hcl metformin hcl flumazenil [INJ] paroxetine hcl metformin hcl er fomepizole paroxetine hcl er nateglinide naloxone hcl [INJ] phenelzine sulfate NOVOLIN 70-30 naltrexone hydrochloride tranylcypromine sulfate NOVOLIN N NARCAN trazodone hcl NOVOLIN R physostigmine salicylate [INJ] trimipramine maleate NOVOLOG [INJ] PHYSOSTIGMINE SALICYLATE 4 November 2020
2020 Enhanced Formulary
[INJ] NYSTATIN LIPOFEN VISTOGARD posaconazole LIVALO terbinafine lovastatin TERBINAFINE niacin er ANTIDOTES AND SPECIFIC voriconazole omega-3-acid ethyl esters ANTAGONISTS pravastatin sodium rosuvastatin methylene blue [INJ] ANTIHISTAMINES simvastatin arbinoxa VASCEPA ANTIEMETICS carbinoxamine cetirizine syrup aprepitant ANTIHYPERTENSIVES dimenhydrinate [INJ] clemastine fumarate dronabinol cyproheptadine hcl aliskiren fumarate fosaprepitant desloratadine amlodipine/olmesartan granisetron hcl desloratadine disintegrating amlodipine/valsartan meclizine hcl tablets amlodipine/valsartan/hctz ondansetron hcl dexchlorpheniramine atenolol/chlorthalidone ondansetron odt maleate er benazepril hcl palonosetron hcl diphenhydramine [INJ] benazepril/hctz SANCUSO diphenhydramine hcl bisoprolol fumarate/hctz scopolamine patch levocetirizine candesartan cilexetil trimethobenzamide hcl dihydrochloride candesartan/hydrochlorothia VARUBI promethazine hcl zide promethegan captopril captopril/hydrochlorothiazid ANTIFUNGALS e
ANTIHYPERLIPIDEMICS clonidine hcl amphotericin [INJ] doxazosin mesylate caspofungin acetate atorvastatin calcium enalapril maleate CRESEMBA cholestyramine enalapril maleate/hctz fluconazole cholestyramine light enalaprilat [INJ] fluconazole in dextrose colesevelam hcl eplerenone fluconazole in saline colestipol hcl fosinopril sodium flucytosine ezetimibe fosinopril/hydrochlorothiazid griseofulvin ezetimibe/simvastatin e griseofulvin ultramicrosize fenofibrate guanfacine hcl itraconazole FENOFIBRATE hydralazine hcl ketoconazole fenofibric acid irbesartan micafungin sodium fenofibric acid dr irbesartan/hydrochlorothiazi nystatin fluvastatin sodium gemfibrozil de 5 November 2020
2020 Enhanced Formulary
lisinopril mefloquine hcl dacarbazine [INJ] lisinopril/hctz primaquine dactinomycin [INJ] losartan potassium pyrimethamine daunorubicin [INJ] losartan/hydrochlorothiazide quinine sulfate decitabine [INJ] methyldopa DEPO-PROVERA 400 MG/ML methyldopa/hydrochlorothia [INJ] zide ANTIMYASTHENIC dexrazoxane [INJ] methyldopate hcl [INJ] AGENTS doxorubicin hcl [INJ] metoprolol/hydrochlorothiaz guanidine hcl doxorubicin hcl liposomal ide neostigmine methylsulfate [INJ] metyrosine [INJ] ELIGARD minoxidil pyridostigmine bromide EMCYT moexipril hcl epirubicin hcl [INJ] moexipril/hydrochlorothiazid erlotinib hcl e ANTIMYCOBACTERIAL etoposide nadolol-bendroflumethiazide AGENTS everolimus olmesartan medoxomil exemestane ethambutol hcl olmesartan medoxomil/hctz floxuridine [INJ] isoniazid olmesartan/amlodipine/hctz fludarabine phosphate [INJ] pyrazinamide perindopril erbumine flutamide rifabutin phentolamine mesylate [INJ] fulvestrant prazosin hcl HEXALEN propranolol/hctz ANTINEOPLASTICS AND hydroxyprogesterone quinapril ADJUNCTIVE THERAPIES caproate quinapril/hydrochlorothiazid hydroxyurea e abiraterone acetate IBRANCE ramipril amifostine [INJ] ifosfamide-mesna reserpine anastrozole imatinib mesylate terazosin hcl ARRANON [INJ] INTRON A [INJ] trandolapril arsenic trioxide lapatinib ditosylate trandolapril/verapamil er azacitidine [INJ] letrozole valsartan bicalutamide leucovorin calcium valsartan/ bleomycin [INJ] LEUKERAN hydrochlorothiazide capecitabine levoleucovorin calcium [INJ] carboplatin [INJ] LUPRON DEPOT 11.25MG ANTIMALARIALS cisplatin [INJ] [INJ] CISPLATIN POWDER [INJ] LUPRON DEPOT 3.75MG atovaquone/proguanil hcl cladribine [INJ] LYSODREN chloroquine phosphate cyclophosphamide [INJ] MATULANE hydroxychloroquine sulfate cytarabine [INJ] megestrol acetate 6 November 2020
2020 Enhanced Formulary
melphalan hcl trihexyphenidyl hcl abacavir mercaptopurine abacavir/lamivudine MESNEX ANTIPSYCHOTICS/ANTIM abacavir/lamivudine/zidovud MESNEX 400MG TABLET ANIC AGENTS ine methotrexate acyclovir mitomycin ABILIFY MAINTENA, ER adefovir dipivoxil MYLERAN aripiprazole odt atazanavir sulfate capsule NEXAVAR aripiprazole tablets cidofovir [INJ] nilutamide chlorpromazine [INJ] didanosine ONTAK [INJ] clozapine efavirenz SPRYCEL clozapine odt efavirenz/emtricitab/tenofov SUTENT fluphenazine decanoate [INJ] ir TABLOID fluphenazine hcl efavirenz/lamivudine/tenofo tamoxifen citrate haloperidol vir TASIGNA haloperidol decanoate [INJ] emtricitabine temsirolimus haloperidol lactate [INJ] entecavir toremifene citrate lithium carbonate famciclovir VORAXAZE [INJ] lithium carbonate er fosamprenavir calcium XALKORI loxapine succinate lamivudine hbv XTANDI olanzapine lamivudine/zidovudine olanzapine odt lopinavir/ritonavir PERSERIS oseltamivir phosphate
ANTIPARKINSON AGENTS prochlorperazine edisylate PEGASYS [INJ] [INJ] amantadine hcl PEGASYS PROCLICK [INJ] prochlorperazine maleate benztropine [INJ] ribavirin inh quetiapine fumarate benztropine mesylate rimantadine hcl quetiapine fumarate er carbidopa/levodopa ritonavir risperidone carbidopa/levodopa er stavudine thioridazine hcl carbidopa/levodopa odt SUSTIVA thiothixene tenofovir disoproxil 300mg trifluoperazine hcl tablet carbidopa/levodopa/ ziprasidone hcl TRUVADA entacapone valacyclovir entacapone ANTISEPTICS & valganciclovir hcl pramipexole er zidovudine DISINFECTANTS rasagiline mesylate ropinirole hcl chlorhexidine gluconate ASSORTED CLASSES ropinirole hcl er selegiline hcl alprostadil [INJ] ANTIVIRALS azathioprine 7 November 2020
2020 Enhanced Formulary
azathioprine sodium [INJ] Calcitonin Gene-Related epoprostenol [INJ] CELLCEPT 500MG VIAL [INJ] Peptide (CGRP) Receptor isoxsuprine hcl cyclosporine [INJ] Antag OPSUMIT DEPEN papaverine hcl [INJ] ETHAMOLIN AIMOVIG papaverine hcl er everolimus EMGALITY sildenafil citrate (pah) mycophenolate acid del rel NURTEC sildenafil citrate tablet mycophenolic acid del rel UBRELVY tadalafil penicillamine treprostinil sodium sirolimus CALCIUM CHANNEL sodium polystyrene BLOCKERS sulfonate Cephalosporin Combinations tacrolimus amlodipine besylate THALOMID diltiazem [INJ] AVYCAZ diltiazem 24hr cd diltiazem er BETA BLOCKERS diltiazem er 24 hour CEPHALOSPORINS acebutolol hcl diltiazem hcl cefaclor atenolol felodipine er cefazolin [INJ] betaxolol hcl isradipine cefdinir bisoprolol fumarate nicardipine hcl cefepime [INJ] BYSTOLIC nimodipine cefotaxime [INJ] carvedilol er verapamil er cefotetan [INJ] labetalol hcl verapamil er pm cefoxitin [INJ] metoprolol succinate er verapamil hcl [INJ] cefoxitin/dextrose [INJ] metoprolol tartrate cefpodoxime proxetil nadolol CARDIOTONICS cefprozil pindolol ceftazidime propranolol hcl digoxin ceftibuten propranolol hcl er milrinone in 5% dextrose ceftriaxone [INJ] sotalol milrinone lactate [INJ] cefuroxime axetil timolol maleate cefuroxime sodium cephalexin CARDIOVASCULAR
BIOLOGICALS MISC AGENTS - MISC. CONTRACEPTIVES GRASTEK ADEMPAS ambrisentan altavera amlodipine-atorvastatin alyacen bosentan amethia
8 November 2020
2020 Enhanced Formulary
amethia lo kariva tilia fe amethyst kelnor 1-35 tri-estarylla apri kurvelo tri-legest fe aranelle leena tri-linyah aubra [INJ] lessina trinessa aviane levonorgestrel trivora azurette levora velivet balziva LO LOESTRIN FE vestura briellyn loryna viorele camrese low-ogestrel wera camrese lo lutera wymzya fe caziant lyza zarah chateal marlissa zenchent cryselle microgestin zenchent fe cyclafem microgestin fe zeosa dasetta MINASTRIN 24 FE zovia daysee mono-linyah drospirenone/eth mononessa estra/levomef myzilra CORTICOSTEROIDS elinest NATAZIA a-hydrocort [INJ] eluryng ring necon BETAMETHASONE emoquette nora-be BETAMETHASONE ACETATE enpresse norethindrone/eth BETAMETHASONE SODIUM enskyce estradiol/iron PHOSPHATE errin norethindrone/ethinyl budesonide estarylla estradiol budesonide ec etonogestrel-ethinyl norethin-eth estra ferrous budesonide er estradiol ring fum cortisone acetate falmina nortrel dexamethasone gianvi ocella dexamethasone sodium gildagia ogestrel phosphate gildess orsythia fludrocortisone acetate gildess fe philith methylprednisolone heather pirmella methylprednisolone acetate introvale portia [INJ] jencycla quasense methylprednisolone sod succ jolessa reclipsen [INJ] jolivette sprintec prednisolone junel sronyx prednisolone sodium junel fe syeda phosphate 9 November 2020
2020 Enhanced Formulary
prednisone azelaic fluorouracil triamcinolone benzoyl peroxide fluticasone propionate veripred 20 betamethasone dipropionate halobetasol propionate augment hpr betamethasone valerate hpr plus
COUGH/COLD/ALLERGY calcipotriene hydrocortisone acetylcysteine calcipotriene-betameth hydrocortisone acetate benzonatate diprop hydrocortisone butyrate brompheniramine/pseudoep calcitriol [INJ] hydrocortisone hedrine ciclopirox butyrate/emoll chlorphen/pse/dm tannate clindamycin phosphate hydrocortisone valerate D- topical hydroquinone cream CHLORPHENIRA/PSE/CHLOP clindamycin phos-tretinoin hydroquinone er cream HEDIAN 12.5CPD-1DCPM- clindamycin/benzoyl imiquimod 30PSE peroxide isotretinoin dihydrocodeine/bpm/pe clobetasol e ivermectin DM/PHENYLEPH/CHLORPHE clobetasol propionate lactic acid NIRAMINE 10PEH-4CPM- clotrimazole LACTIC ACID 88 TO 92 % 20DM clotrimazole/betamethasone lidocaine hydrocodone/homatropine cocaine hcl lidocaine hcl phenylephrine/chlorphenira COCAINE HCL lidocaine/prilocaine mine 10peh-4cpm COSENTYX lindane promethazine vc/codeine dapsone gel mafenide acetate promethazine w/codeine desonide malathion promethazine/dextromethor desoximetasone mb hydrogel phan diclofenac epolamine metronidazole pseudoephedrine hcl er diclofenac sodium gel mometasone furoate diflorasone diacetate mupirocin econazole nitrate nystatin w/triamcinolone DERMATOLOGICALS eletone ONEXTON emulsion sb OXSORALEN 1% LOTION acitretin EPIDUO permethrin acyclovir EPIDUO FORTE podofilox adapalene cream, gel erythromycin solution primecrolimus adapalene-benzoyl peroxide erythromycin-benzoyl pruclair gel peroxide prumyx alclometasone dipropionate ETHYL ALCOHOL prutect alphaquin hp FLECTOR salicylic acid amcinonide fluocinolone acetonide SALICYLIC ACID ammonium lactate fluocinonide selenium sulfide avo cream 10 November 2020
2020 Enhanced Formulary
silver sulfadiazine DIGESTIVE AIDS alendronate sodium SKYRIZI cabergoline sodium sulfacetamide/sulfur CREON calcitonin salmon nasal sonafine pancrelipase cinacalcet hcl STELARA [INJ] SUCRAID clomiphene citrate sulfacetamide sodium VIOKACE desmopressin acetate [INJ] TARGRETIN GEL ZENPEP DEL-REL doxercalciferol tazarotene cream etidronate disodium TAZORAC GEL DIURETICS FOLLISTIM AQ tl-cermide FORTEO [INJ] tretinoin acetazolamide GENOTROPIN tretinoin microsphere acetazolamide er ibandronate [INJ] urea amiloride hcl levocarnitine UREAM POWDER, BEADS amiloride hcl w/hctz LUPRON DEPOT-PED [INJ] bumetanide nitisinone chlorothiazide NORDITROPIN
DIAGNOSTIC PRODUCTS chlorothiazide sodium [INJ] octreotide acetate candin chlorthalidone OMNITROPE cosyntropin [INJ] ethacrynate sodium ORILISSA md-gastroview furosemide paricalcitol TUBERSOL [INJ] hydrochlorothiazide PROLIA indapamide risedronate dr mannitol risedronate sodium DIAGNOSTICS & methazolamide sapropterin dihydrochloride MISCELLANEOUS AGENTS methyclothiazide sodium phenylbutyrate metolazone tolvaptan neomycin-polymyxin b [INJ] spironolactone TYMLOS UVA URSI LEAF FLUID spironolactone/hctz vasopressin [INJ] EXTRACT torsemide vasopressin-ns
zoledronic acid
DIETARY Dopamine and PRODUCTS/DIETARY Norepinephrine Reuptake Estrogen-Progestin-GnRH MANAGEMENT Inhibitors (DNRIs) Antagonist PRODUCTS SUNOSI ORIAHNN folbic foltanx metafolbic ENDOCRINE AND Estrogen-Selective metafolbic plus METABOLIC AGENTS - Estrogen Receptor MISC. Modulator Comb 11 November 2020
2020 Enhanced Formulary
DUAVEE sulfasalazine albumin [INJ] sulfasalazine dr anagrelide hydrochloride ursodiol aspirin / dipyridamole er
ESTROGENS VELPHORO BRILINTA estradiol patch cilostazol estradiol tablet/cream clopidogrel GENERAL ANESTHETICS estradiol valerate [INJ] dipyridamole [INJ] estradiol/norethindrone etomidate [INJ] eptifibatide acetate ketamine hcl [INJ] hetastarch w/sodium estrogen/methyltestosteron propofol chloride [INJ] e icatibant acetate estropipate pentoxifylline PREMARIN GENITOURINARY AGENTS prasugrel hcl PREMPHASE - MISCELLANEOUS protamine sulfate [INJ]
PREMPRO acetic acid irrigation
alfuzosin hcl er HEMATOPOIETIC AGENTS FLUOROQUINOLONES AMINOACETIC ACID finasteride centratex ciprofloxacin glycine DROXIA ciprofloxacin er phenazopyridine hcl EPOGEN ciprofloxacin suspension potassium citrate er fabb ciprofloxacin/dextrose [INJ] silodosin ferocon levofloxacin/d5w [INJ] tamsulosin hcl er 24 hr ferraplus 90 moxifloxacin hcl ferrocite plus ofloxacin ferrogels forte ofloxacin tablets Glycopeptides folbee folic acid vancomycin hcl [INJ] folplex 2.2 VANCOMYCIN HCL [INJ] GASTROINTESTINAL hematinic plus
AGENTS - MISC. hematinic with folic acid hematogen AMITIZA GOUT AGENTS hematogen fa balsalazide disodium allopurinol hematogen forte calcium acetate allopurinol sodium hemetab lanthanum carbonate febuxostat hydroxocobalamin LINZESS probenecid iferex 150 forte mesalamine multigen metoclopramide hcl multigen folic MOVANTIK HEMATOLOGICAL AGENTS multigen plus sevelamer carbonate - MISC. NEULASTA [INJ] 12 November 2020
2020 Enhanced Formulary
NEUPOGEN [INJ] CLENPIQ FREESTYLE FREEDOM KIT poly-iron 150 forte lactulose FREESTYLE FREEDOM LITE polysaccharide iron forte peg 3350-electrolyte FREESTYLE FREEDOM LITE PROCRIT [INJ] polyethylene glycol METER se-tan plus POLYETHYLENE GLYCOL FREESTYLE INSULINX taron forte SUPREP FREESTYLE INSULINX therapeutic hematinic GLUCOSE SYSTEM tl gard rx FREESTYLE INSULINX TEST tl icon LOCAL ANESTHETICS- STRIPS tl-hem 150 er 24 hr Parenteral FREESTYLE LITE METER tricon bupivacaine hcl FREESTYLE LITE TEST STRIPS trigels-f forte bupivacaine/dextrose [INJ] FREESTYLE TEST STRIPS ZARXIO [INJ] bupivacaine/epinephrine MINIMED [INJ] MINIMED RESERVOIR NOVOFINE HEMOSTATICS chloroprocaine [INJ] lidocaine hcl w/epinephrine NOVOFINE AUTOCOVER tranexamic acid [INJ] ONE TOUCH ULTRA 2 ropivacaine ONE TOUCH ULTRA TEST sensorcaine STRIPS Hepatitis C Agent - sensorcaine 5mg/ml vial [INJ] ONE TOUCH VERIO
Combinations ONE TOUCH VERIO FLEX ONE TOUCH VERIO IQ EPCLUSA MACROLIDES ONE TOUCH VERIO SYNC HARVONI PRECISION XTRA B-KETONE MAVYRET azithromycin [INJ] STRIPS VOSEVI clarithromycin PRECISION XTRA MONITOR clarithromycin er PRECISION XTRA TEST STRIPS erythromycin PRODIGY INSULIN SYRINGE HYPNOTICS erythromycin del rel PRODIGY PEN NEEDLE erythromycin ethylsuccinate flurazepam hcl SOFT TOUCH erythromycin stearate midazolam hcl phenobarbital erythromycin/sulfisoxazole ramelteon MIGRAINE PRODUCTS temazepam MEDICAL DEVICES dihydroergotamine mesylate triazolam eletriptan hbr zaleplon ACCU-CHEK SOFTCLIX ergoloid mesylates zolpidem tartrate LANCETS DEVICE ergotamine-caffeine zolpidem tartrate er FORA LANCING DEVICE naratriptan hcl FREESTYLE CONTROL REYVOW SOLUTION LAXATIVES rizatriptan 13 November 2020
2020 Enhanced Formulary
rizatriptan disintegrating [INJ] hemenatal ob + dha tablets ringers [INJ] inatal advance sumatriptan succinate ringers irrigation inatal ultra TOSYMRA selenium [INJ] LEVOMEFOLATE DHA zolmitriptan sodium acetate [INJ] m.v.i. adult [INJ] zolmitriptan odt sodium lactate [INJ] M.V.I.-12 [INJ] SODIUM PHOSPHATE [INJ] macnatal cn dha sodium phosphate multivitamin w/fluoride & MINERALS & 3mmol/ml vial [INJ] iron ELECTROLYTES multivitamin with fluoride mynatal calcium chloride [INJ] Monobactams CALCIUM CHLORIDE [INJ] mynatal advance calcium gluconate [INJ] AZACTAM-ISO-OSMOTIC mynatal caps CALCIUM GLUCONATE 61MG DEXTROSE [INJ] mynatal plus copper chloride [INJ] aztreonam [INJ] mynatal-z dextrose in lactated ringers mynate 90 plus er dextrose with sodium mynephrocaps MOUTH/THROAT/DENTAL chloride obstetrix dha klor-con AGENTS pnv ob+dha pnv-dha magnesium sulfate [INJ] cevimeline hcl pnv-omega MAGNESIUM SULFATE [INJ] sodium fluoride pnv-select MAGNESIUM SULFATE IN SODIUM FLUORIDE pnv-total DEXTROSE [INJ] manganese [INJ] pr natal 400 manganese sulfate [INJ] MULTIVITAMINS pr natal 400 ec MULTITRACE-5 [INJ] pr natal 430 advanced am/pm nutrilyte [INJ] pr natal 430 ec bal-care dha nutrilyte ii [INJ] prena1 b-complex pot chloride/dextrose/ns prena1 chew complete natal dha [INJ] prenaissance corvita potassium acetate [INJ] prenaissance 90 dha dailyvite POTASSIUM ACETATE [INJ] prenaissance dha elite ob potassium bicarbonate prenaissance harmony dha elite-ob POTASSIUM BICARBONATE prenaissance next folbee plus potassium chl-normal saline prenaissance plus folcaps [INJ] prenaplus folivane-ob potassium chloride prenatabs fa folivane-plus POTASSIUM CHLORIDE prenatabs rx folivane-prx dha nf potassium chloride er prenatal low iron hemenatal ob potassium chloride/dextrose prenatal plus 14 November 2020
2020 Enhanced Formulary
prenatal-u vp-ch plus ENTRESTO relnate dha vp-ch-pnv renal caps vp-heme one rena-vite rx vp-zel NEUROMUSCULAR reno caps zatean-ch AGENTS se-natal 19 zatean-pn dha anectine [INJ] strovite zatean-pn plus riluzole taron-bc taron-c dha tl g-fol os MUSCULOSKELETAL NUTRIENTS tl-care dha THERAPY AGENTS dextrose in water tl-fol 500 er baclofen intralipid tl-select chlorzoxazone triadvance cyclobenzaprine hcl trinatal gt CYCLOBENZAPRINE HCL OPHTHALMIC AGENTS trinatal rx 1 cyclobenzaprine hcl er ALPHAGAN P 0.001% trinate dantrolene sodium apraclonidine ophth solution triphrocaps methocarbamol atropine sulfate triveen-duo dha orphenadrine citrate [INJ] azelastine hcl ophth solution triveen-prx rnf orphenadrine compound bacitracin/polymyxin ophth ultimatecare one SYNVISC-ONE oint ultimatecare one nf tizanidine hcl balanced salt ophth irrigation v-c forte vemavite-prx 2 BESIVANCE vena-bal dha NASAL AGENTS - betaxolol ophth solution venatal-fa SYSTEMIC AND TOPICAL BETOPTIC S vinacal bimatoprost azelastine hcl vinate dha brimonidine ophth solution azelastine-fluticasone vinate ic bromfenac ophth flunisolide nasal spray vinate ii carteolol hcl fluticasone nasal spray vinate one ciprofloxacin ophth solution ipratropium bromide spray vinate-m COMBIGAN mometasone furoate nasal virt-pn cromolyn sodium QNASL virt-pn dha cyclopentolate ophth triamcinolone acetonide virt-pn plus solution virt-select dexamethasone sod phos ophth vol-care rx Neprilysin Inhib (ARNI)- dorzolamide hcl vol-nate Angiotensin II Recept dorzolamide/timolol vol-plus Antag Comb vol-tab rx DUREZOL 15 November 2020
2020 Enhanced Formulary
epinastine hcl trifluridine oxytocin [INJ] erythromycin ointment tropicamide fluorometholone XIIDRA flurbiprofen sodium PASSIVE IMMUNIZING FML S.O.P. AGENTS Ophthalmic Kinase gatifloxacin GAMUNEX [INJ] Inhibitors - Combinations homatropine hydrobromide HOMATROPINE ROCKLATAN
HYDROBROMIDE PCSK9 Inhibitors ILEVRO PRALUENT PEN ketorolac tromethamine Orexin Receptor PRALUENT SYRINGE drops Antagonists REPATHA PUSHTRONEX latanoprost drops BELSOMRA REPATHA SURECLICK levobunolol hcl drops REPATHA SYRINGE levofloxacin hemihydrate loteprednol etabonate susp OTIC AGENTS LUMIGAN PENICILLINS metipranolol drops ACETIC ACID moxifloxacin hcl acetic acid otic solution amoxicillin neomycin/bacitracin/poly/hc acetic acid/aluminum otic sol amoxicillin/clavulanate er neomycin/polymyxin/gramici acetic acid/hydrocortisone ampicillin [INJ] din otic sol ampicillin/sulbactam [INJ] olopatadine hcl (ophthalmic) antipyrine/benzocaine otic dicloxacillin sodium PAZEO sol nafcillin dextrose [INJ] pilocarpine hcl antipyrine/benzocaine/poly nafcillin sodium [INJ] prednisolone acetate otic sol oxacillin sodium [INJ] prednisolone sodium chloroxylenol/benzocaine/hc penicillin g potassium [INJ] phosphate drops acetate otic susp penicillin g procaine proparacaine hcl ciprofloxacin hcl penicillin g sodium [INJ] RESTASIS CIPROFLOXACIN HCL penicillin v potassium RESTASIS MULTIDOSE ciprofloxacin/dexamethason piperacillin-tazobactam [INJ] RHOPRESSA e neomycin/polymyxin/hc otic sulfacetamide Phosphodiesterase 4 w/prednisolone susp & soln (PDE4) Inhibitors - Topical tetcaine drops ofloxacin otic drops TOBRADEX OINTMENT EUCRISA TOBRADEX ST OXYTOCICS tobramycin sulfate drops PROGESTINS tobramycin/dexamethasone carboprost travoprost methylergonovine maleate 16 November 2020
2020 Enhanced Formulary
medroxyprogesterone FASENRA hyoscyamine sulfate acetate [INJ] hyoscyamine sulfate norethindrone acetate disinegrating tablets progesterone in oil [INJ] Sinus Node Inhibitors hyoscyamine sulfate er progesterone micronized CORLANOR lansoprazole lansoprazole/amoxicillin/clari thromycin PSYCHOTHERAPEUTIC TETRACYCLINES misoprostol AND NEUROLOGICAL nizatidine coremino AGENTS - MISC. omeprazole demeclocycline hcl omeprazole sodium acamprosate calcium doxycycline hyclate bicarbonate amitriptyline/chlordiazepoxi doxycycline monohydrate pantoprazole sodium de minocycline hcl ranitidine hcl AVONEX [INJ] minocycline hcl er sucralfate BETASERON TETRACYCLINE bupropion er (12 hour) XIMINO dalfampridine er URINARY ANTI- dimethyl fumarate INFECTIVES disulfiram THYROID AGENTS donepezil hcl levothyroxine sodium hyophen galantamine LEVOTHYROXINE SODIUM methenamine hippurate GILENYA liothyronine sodium methenamine mandelate memantine methimazole nitrofurantoin memantine dose pack propylthiouracil nitrofurantoin macrocrystal NAMZARIC THERAPY PACK phosphasal NUEDEXTA uretron d-s olanzapine/fluoxetine hcl TOXOIDS urimar-t perphenazine/amitriptyline urin d.s. INFANRIX [INJ] PLEGRIDY urogesic PEDIARIX [INJ] rivastigmine ustell TETANUS DIPHTHERIA SAVELLA TOXOIDS - PED [INJ] tetrabenazine URINARY VUMERITY ANTISPASMODICS XYREM ULCER DRUGS ZEPOSIA bethanechol chloride cimetidine darifenacin er dicyclomine hcl flavoxate hcl RESPIRATORY AGENTS - esomeprazole MYRBETRIQ ER 24 HR MISC. famotidine oxybutynin chloride glycopyrrolate 17 November 2020
2020 Enhanced Formulary
oxybutynin chloride er dopamine hcl [INJ] solifenacin succinate dopamine hcl in 5% dextrose tolterodine tartrate ephedrine sulfate trospium chloride er epinephrine ampule/vial epinephrine auto-injector EPINEPHRINE AUTO-
VACCINES INJECTOR [INJ] AFLURIA midodrine hcl AFLURIA QUAD norepinephrine bitartrate FLUAD [INJ] FLUAD QUAD phenylephrine hcl [INJ] FLUBLOK phenylephrine hcl-ns FLUBLOK QUAD PHENYLEPHRINE HCL-NS FLUCELVAX QUAD SYMJEPI FLULAVAL QUAD FLUMIST VITAMINS FLUZONE HIGH-DOSE FLUZONE QUAD ascorbic acid [INJ] RABAVERT ASCORBIC ACID [INJ] SHINGRIX phytonadione TWINRIX [INJ] PHYTONADIONE VAQTA VIAL pyridoxine hcl VIVOTIF BERNA DEL REL PYRIDOXINE HCL thiamine hcl vitamin a
VAGINAL PRODUCTS VITAMIN A clindamycin phosphate vaginal VITAMINS, HEMATINICS & CRINONE ELECTROLYTES miconazole 1 MICONAZOLE 1 elite-ob 400 PREMARIN CREAM folivane-f terconazole yuvafem X-Linked Hypophosphatemia (XLH) VASOPRESSORS Treatment - Agents dobutamine [INJ] CRYSVITA dobutamine/dextrose [INJ]
18 November 2020