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Preferred Drug List Kansas State Employee ANALGESICS Second Generation cefprozil Health Plan NSAIDs cefuroxime axetil diclofenac sodium delayed-rel Preferred Drug List diflunisal Third Generation etodolac cefdinir 2021 ibuprofen cefixime (SUPRAX) meloxicam nabumetone Erythromycins/Macrolides naproxen sodium tabs azithromycin naproxen tabs clarithromycin oxaprozin clarithromycin ext-rel sulindac erythromycin delayed-rel erythromycin ethylsuccinate NSAIDs, COMBINATIONS erythromycin stearate diclofenac sodium delayed-rel/misoprostol fidaxomicin (DIFICID) Effective 04/01/2021 NSAIDs, TOPICAL Fluoroquinolones diclofenac sodium gel 1% ciprofloxacin For questions or additional information, diclofenac sodium soln levofloxacin access the State of Kansas website at moxifloxacin http://www.kdheks.gov/hcf/sehp or call COX-2 INHIBITORS Penicillins the Kansas State Employees Prescription celecoxib amoxicillin Drug Program at 1-800-294-6324. amoxicillin/clavulanate The Preferred Drug List is subject to change. GOUT amoxicillin/clavulanate ext-rel To locate covered prescriptions online, allopurinol ampicillin access the State of Kansas website at colchicine tabs dicloxacillin http://www.kdheks.gov/hcf/sehp for the probenecid penicillin VK most current drug list. colchicine (MITIGARE) Tetracyclines What is a Preferred Drug List? OPIOID ANALGESICS doxycycline hyclate A Preferred Drug List is a list of safe and buprenorphine transdermal minocycline cost-effective drugs, chosen by a committee codeine/acetaminophen tetracycline of physicians and pharmacists. Drug lists fentanyl transdermal have been used in hospitals for many years fentanyl transmucosal lozenge to help ensure quality drug use. The Kansas ANTIFUNGALS hydrocodone ext-rel State Employees Preferred Drug List will be clotrimazole troches hydrocodone/acetaminophen continually revised to reflect the changing fluconazole hydromorphone drug market. griseofulvin ultramicrosize hydromorphone ext-rel itraconazole Should I ask my physician to switch my methadone nystatin current medications to a medication that morphine terbinafine tabs is on the Preferred Drug List? morphine ext-rel voriconazole Many of your medications will already be on morphine supp oxycodone caps 5 mg the Preferred Drug List. However, if you ANTIMALARIALS have a medication that is not, ask your oxycodone concentrate 20 mg/mL oxycodone soln 5 mg/5 mL atovaquone/proguanil physician to choose a similar Preferred Drug chloroquine List product for you to use. oxycodone tabs 5 mg, 15 mg, 30 mg oxycodone/acetaminophen 5/325 mefloquine Should I use generics? tramadol * There are many medications on the market tramadol ext-rel ANTITUBERCULAR AGENTS that do not come in generic form. For those buprenorphine (BELBUCA) ethambutol drugs that do, your pharmacist should fentanyl sublingual spray (SUBSYS) isoniazid suggest safe and effective generic oxycodone ext-rel (XTAMPZA ER) pyrazinamide alternatives. tapentadol (NUCYNTA) rifampin tapentadol ext-rel (NUCYNTA ER) This document is subject to state-specific ANTIVIRALS regulations and rules, including, but not * Listing does not include NDC 52817019610. Drug products are identified by unique numerical product Cytomegalovirus Agents limited to, those regarding generic identifiers, called National Drug Codes (NDC), which substitution, controlled substance schedules, identify the manufacturer, strength, dosage form, valganciclovir preference for brands and mandatory formulation and package size. generics whenever applicable. Herpes Agents ANTI-INFECTIVES acyclovir caps, tabs Boldface type indicates generic availability; famciclovir boldface may not apply to every strength or ANTIBACTERIALS valacyclovir dosage form under the listed generic name. Cephalosporins First Generation Influenza Agents cefadroxil oseltamivir cephalexin zanamivir (RELENZA) 1 MISCELLANEOUS perindopril flecainide clindamycin quinapril propafenone dapsone ramipril propafenone ext-rel ivermectin trandolapril sotalol linezolid dronedarone (MULTAQ) metronidazole ACE INHIBITOR/CALCIUM CHANNEL nitrofurantoin ext-rel BLOCKER COMBINATIONS ANTILIPEMICS nitrofurantoin macrocrystals amlodipine/benazepril ACL Inhibitors/Combinations nitrofurantoin susp * trandolapril/verapamil ext-rel bempedoic acid (NEXLETOL) pyrimethamine bempedoic acid/ezetimibe (NEXLIZET) sulfamethoxazole/trimethoprim sulfamethoxazole/trimethoprim DS ACE INHIBITOR/DIURETIC tinidazole COMBINATIONS Bile Acid Resins trimethoprim benazepril/hydrochlorothiazide cholestyramine vancomycin caps captopril/hydrochlorothiazide colesevelam mebendazole chewable (EMVERM) enalapril/hydrochlorothiazide colestipol rifaximin 550 mg (XIFAXAN) fosinopril/hydrochlorothiazide lisinopril/hydrochlorothiazide Cholesterol Absorption Inhibitors * Listing does not include NDC 70408023932. Drug quinapril/hydrochlorothiazide ezetimibe products are identified by unique numerical product identifiers, called National Drug Codes (NDC), which identify the manufacturer, strength, dosage form, ADRENOLYTICS, CENTRAL Fibrates formulation and package size. fenofibrate * clonidine clonidine transdermal fenofibric acid delayed-rel ANTINEOPLASTIC AGENTS guanfacine gemfibrozil ALKYLATING AGENTS * Listing does not include fenofibrate capsule 50 mg, 130 cyclophosphamide caps ALDOSTERONE RECEPTOR mg; fenofibrate tablet 40 mg, 120 mg. melphalan ANTAGONISTS busulfan (MYLERAN) eplerenone HMG-CoA Reductase chlorambucil (LEUKERAN) spironolactone Inhibitors/Combinations atorvastatin ANTIMETABOLITES ALPHA BLOCKERS ezetimibe/simvastatin mercaptopurine doxazosin fluvastatin methotrexate (TREXALL) terazosin lovastatin thioguanine (TABLOID) pravastatin rosuvastatin ANGIOTENSIN II RECEPTOR simvastatin HORMONAL ANTINEOPLASTIC AGENTS ANTAGONISTS/DIURETIC Antiandrogens COMBINATIONS Niacins bicalutamide candesartan niacin ext-rel flutamide candesartan/hydrochlorothiazide irbesartan Omega-3 Fatty Acids Antiestrogens irbesartan/hydrochlorothiazide omega-3 acid ethyl esters tamoxifen losartan icosapent ethyl (VASCEPA) losartan/hydrochlorothiazide Aromatase Inhibitors olmesartan BETA-BLOCKERS anastrozole olmesartan/hydrochlorothiazide atenolol exemestane telmisartan bisoprolol letrozole telmisartan/hydrochlorothiazide carvedilol valsartan carvedilol phosphate ext-rel valsartan/hydrochlorothiazide Progestins labetalol megestrol acetate tabs metoprolol succinate ext-rel ANGIOTENSIN II RECEPTOR metoprolol tartrate MISCELLANEOUS ANTAGONIST/CALCIUM CHANNEL nadolol etoposide BLOCKER COMBINATIONS pindolol hydroxyurea amlodipine/olmesartan propranolol tretinoin caps amlodipine/telmisartan propranolol ext-rel mitotane (LYSODREN) amlodipine/valsartan nebivolol (BYSTOLIC) procarbazine (MATULANE) uridine triacetate (VISTOGARD) ANGIOTENSIN II RECEPTOR BETA-BLOCKER/DIURETIC COMBINATIONS CARDIOVASCULAR ANTAGONIST/CALCIUM CHANNEL BLOCKER/DIURETIC COMBINATIONS atenolol/chlorthalidone bisoprolol/hydrochlorothiazide amlodipine/valsartan/hydrochlorothiazide ACE INHIBITORS metoprolol/hydrochlorothiazide olmesartan/amlodipine/hydrochlorothiazide benazepril captopril enalapril ANTIARRHYTHMICS CALCIUM CHANNEL BLOCKERS fosinopril amiodarone Dihydropyridines lisinopril disopyramide amlodipine 2 felodipine ext-rel Transdermal ANTIDEPRESSANTS nifedipine ext-rel nitroglycerin transdermal Monoamine Oxidase Inhibitors (MAOIs) phenelzine Nondihydropyridines MISCELLANEOUS tranylcypromine diltiazem ext-rel * hydralazine verapamil ext-rel methyldopa Selective Serotonin Reuptake Inhibitors midodrine * Listing does not include generics for CARDIZEM LA (SSRIs) ranolazine ext-rel citalopram CALCIUM CHANNEL escitalopram CENTRAL NERVOUS SYSTEM fluoxetine * BLOCKER/ANTILIPEMIC COMBINATIONS paroxetine HCl amlodipine/atorvastatin ANTIANXIETY paroxetine HCl ext-rel Benzodiazepines sertraline DIGITALIS GLYCOSIDES alprazolam vortioxetine (TRINTELLIX) digoxin 0.125 mg, 0.25 mg clonazepam digoxin ped elixir diazepam * Listing does not include fluoxetine tablet 60 mg, lorazepam fluoxetine tablet (generics for SARAFEM). DIRECT RENIN INHIBITORS/DIURETIC oxazepam Serotonin Norepinephrine Reuptake COMBINATIONS Miscellaneous Inhibitors (SNRIs) aliskiren buspirone desvenlafaxine ext-rel aliskiren/hydrochlorothiazide (TEKTURNA HCT) clomipramine duloxetine delayed-rel fluvoxamine venlafaxine DIURETICS venlafaxine ext-rel Carbonic Anhydrase Inhibitors ANTICONVULSANTS Tricyclic Antidepressants (TCAs) acetazolamide carbamazepine amitriptyline acetazolamide ext-rel carbamazepine ext-rel desipramine methazolamide clobazam doxepin diazepam rectal gel imipramine HCl Loop Diuretics divalproex sodium delayed-rel nortriptyline bumetanide divalproex sodium ext-rel furosemide ethosuximide torsemide gabapentin Miscellaneous Agents lamotrigine bupropion Potassium-sparing Diuretics lamotrigine ext-rel bupropion ext-rel mirtazapine amiloride lamotrigine orally disintegrating tabs trazodone triamterene levetiracetam levetiracetam ext-rel Thiazides and Thiazide-like Diuretics oxcarbazepine ANTIPARKINSONIAN AGENTS chlorthalidone phenobarbital amantadine hydrochlorothiazide phenytoin benztropine indapamide phenytoin sodium extended bromocriptine metolazone primidone carbidopa/levodopa rufinamide carbidopa/levodopa ext-rel tiagabine Diuretic Combinations carbidopa/levodopa orally disintegrating tabs topiramate carbidopa/levodopa/entacapone amiloride/hydrochlorothiazide topiramate ext-rel * entacapone spironolactone/hydrochlorothiazide valproic acid pramipexole triamterene/hydrochlorothiazide zonisamide pramipexole ext-rel cenobamate (XCOPRI) rasagiline HEART FAILURE diazepam nasal spray (VALTOCO) ropinirole isosorbide
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