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Preferred Drug List

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January 2012

Preferred Drug List

The Preferred Drug List, administered by CVS Caremark on behalf of Marriott International, is a guide within select therapeutic categories for clients, plan members and health care providers. Generics should be considered the first line of prescribing. If there is no generic available, there may be more than one brand-name medicine to treat a condition. These preferred brand-name medicines are listed to help identify products that are clinically appropriate and cost-effective. Generics listed in therapeutic categories are for representational purposes only. This is not an all-inclusive list. This list represents brand products in CAPS and generic products in lowercase italics.

  • PLAN MEMBER
  • HEALTH CARE PROVIDER

Your benefit plan provides you with a prescription benefit program administered by CVS Caremark. Ask your doctor to consider prescribing, when medically appropriate, a preferred medicine from this list. Take this list along when you or a covered family member sees a doctor.
Your patient is covered under a prescription benefit plan administered by CVS Caremark. As a way to help manage health care costs, authorize generic substitution whenever possible. If you believe a brand-name product is necessary, consider prescribing a brand name on this list.

  • Please note:
  • Please note:

Your specific prescription benefit plan design may not cover certain categories, regardless of their appearance in this document.
Generics should be considered the first line of prescribing.

  • •
  • •

This drug list represents a summary of prescription coverage. It is not inclusive and does not guarantee coverage.

•

For specific information regarding your prescription benefit

•

coverage and copay1 information, please visit www.caremark.com or contact a CVS Caremark Customer Care representative.
The member's prescription benefit plan may have a different copay for specific products on the list.

•

Unless specifically indicated, drug list products will include all dosage forms.

•

CVS Caremark may contact your doctor after receiving your

•

prescription to request consideration of a drug list product or generic equivalent. This may result in your doctor prescribing, when medically appropriate, a different brand-name product or generic equivalent in place of your original prescription.
Log in to www.caremark.com to check coverage and copay information for a specific medicine.

•

Any brand drug for which a generic product becomes available may be designated as a non-preferred product.

•

§ PENICILLINS

amoxicillin amoxicillin-clavulanate dicloxacillin penicillin VK nitrofurantoin sulfamethoxazole- trimethoprim

ANGIOTENSIN II RECEPTOR § BETA-BLOCKERS

ANALGESICS

ANTAGONIST / DIRECT RENIN INHIBITOR COMBINATIONS

atenolol carvedilol metoprolol

VISCOSUPPLEMENTS

SYNVISC SYNVISC-ONE

CARDIOVASCULAR

VALTURNA

metoprolol succinate ext-rel nadolol propranolol

BYSTOLIC COREG CR

§ ACE INHIBITORS

ANTI-INFECTIVES

§ TETRACYCLINES

doxycycline hyclate minocycline

ANTILIPEMICS

§ BILE ACID RESINS

cholestyramine fosinopril lisinopril quinapril ramipril

ANTIBACTERIALS

§ CEPHALOSPORINS

cefaclor cefdinir cephalexin

SUPRAX

tetracycline

WELCHOL

§ CALCIUM CHANNEL BLOCKERS
§ ANTIFUNGALS

fluconazole itraconazole terbinafine tablet

CHOLESTEROL

§ ACE INHIBITOR / DIURETIC COMBINATIONS

fosinopril- hydrochlorothiazide lisinopril- hydrochlorothiazide quinapril- hydrochlorothiazide

ABSORPTION INHIBITORS

amlodipine diltiazem ext-rel nifedipine ext-rel verapamil ext-rel

ZETIA

§ ERYTHROMYCINS / MACROLIDES

azithromycin clarithromycin clarithromycin ext-rel erythromycins

§ FIBRATES

ANTIVIRALS

§ HERPES AGENTS

acyclovir valacyclovir fenofibrate

TRICOR TRILIPIX

CALCIUM CHANNEL BLOCKER / ANTILIPEMIC COMBINATIONS

§ HMG-CoA REDUCTASE INHIBITORS

pravastatin simvastatin

CRESTOR LIPITOR
CADUET

§ ANGIOTENSIN II RECEPTOR ANTAGONISTS / DIURETIC COMBINATIONS

losartan / losartan- hydrochlorothiazide

BENICAR / BENICAR HCT DIOVAN / DIOVAN HCT MICARDIS /

§ INFLUENZA AGENTS
§ FLUOROQUINOLONES

§ DIGITALIS GLYCOSIDES

digoxin amantadine rimantadine

RELENZA TAMIFLU

ciprofloxacin ext-rel ciprofloxacin tablet levofloxacin

AVELOX CIPRO SUSPENSION

DIRECT RENIN INHIBITORS / DIURETIC COMBINATIONS
§ MISCELLANEOUS

clindamycin metronidazole

NIACINS / COMBINATIONS

TEKTURNA / TEKTURNA HCT
NIASPAN SIMCOR
MICARDIS HCT

Your specific prescription benefit plan design may not cover certain categories, regardless of their appearance in this document. For specific information, visit www.caremark.com or contact a CVS Caremark Customer Care representative.

DIRECT RENIN INHIBITOR / CALCIUM CHANNEL BLOCKER COMBINATIONS
MULTIPLE SCLEROSIS AGENTS

AVONEX BETASERON COPAXONE
BD INSULIN SYRINGES AND NEEDLES

HUMAN GROWTH HORMONES

NORDITROPIN

RESPIRATORY

ANAPHYLAXIS TREATMENT AGENTS

EPIPEN
ONETOUCH STRIPS AND KITS 3
TEKAMLO

§ PROGESTINS, ORAL

medroxyprogesterone

PROMETRIUM

CALCIUM REGULATORS

§ BISPHOSPHONATES

alendronate

ACTONEL BONIVA

DIRECT RENIN INHIBITOR / CALCIUM CHANNEL BLOCKER / DIURETIC COMBINATIONS

EPIPEN JR

ENDOCRINE AND
METABOLIC

§ ANTICHOLINERGICS

SPIRIVA

SELECTIVE ESTROGEN RECEPTOR MODULATORS

EVISTA

ANDROGENS

ANDRODERM ANDROGEL
AMTURNIDE

§ ANTICHOLINERGIC / BETA AGONIST COMBINATIONS

ipratropium-albuterol inhalation solution

COMBIVENT

§ DIURETICS

furosemide hydrochlorothiazide metolazone spironolactone- hydrochlorothiazide torsemide

§ CALCITONINS

calcitonin-salmon

§ THYROID SUPPLEMENTS

levothyroxine

SYNTHROID

ANTIDIABETICS

§ BIGUANIDES

metformin

PARATHYROID HORMONES

FORTEO

BETA AGONISTS, INHALANTS

§ SHORT ACTING

GASTROINTESTINAL

metformin ext-rel

CONTRACEPTIVES

§ MONOPHASIC

ethinyl estradiol- drospirenone

BEYAZ LO LOESTRIN FE LOESTRIN 24 FE

§ H2 RECEPTOR ANTAGONISTS

ranitidine

§ BIGUANIDE / SULFONYLUREA COMBINATIONS

triamterene- hydrochlorothiazide albuterol

PROAIR HFA PROVENTIL HFA VENTOLIN HFA

glipizide-metformin

CENTRAL NERVOUS
SYSTEM

§ PROTON PUMP INHIBITORS

lansoprazole omeprazole omeprazole-sodium bicarbonate capsule pantoprazole

DEXILANT

DIPEPTIDYL PEPTIDASE-4 (DPP-4) INHIBITORS

JANUVIA

ANTIDEPRESSANTS

LONG ACTING

FORADIL SEREVENT

§ SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIs)

citalopram fluoxetine paroxetine paroxetine ext-rel sertraline

LEXAPRO VIIBRYD

§ TRIPHASIC

ethinyl estradiol- norgestimate

ORTHO TRI-CYCLEN LO
ONGLYZA

DIPEPTIDYL PEPTIDASE-4 (DPP-4) INHIBITOR / BIGUANIDE COMBINATIONS

JANUMET KOMBIGLYZE XR

§ LEUKOTRIENE RECEPTOR ANTAGONISTS

zafirlukast

NEXIUM

FOUR PHASE

NATAZIA
SINGULAIR

GENITOURINARY

§ NASAL ANTIHISTAMINES

azelastine

ASTEPRO

§ EXTENDED CYCLE

ethinyl estradiol- levonorgestrel

§ BENIGN PROSTATIC HYPERPLASIA

doxazosin finasteride tamsulosin terazosin

INCRETIN MIMETIC AGENTS

BYETTA VICTOZA

§ SEROTONIN

LOSEASONIQUE

§ NASAL STEROIDS

flunisolide fluticasone triamcinolone

NASONEX VERAMYST

NOREPINEPHRINE REUPTAKE INHIBITORS (SNRIs) 2
INSULINS

APIDRA HUMULIN R U-500 LANTUS LEVEMIR

TRANSDERMAL

ORTHO EVRA
AVODART

RAPAFLO

venlafaxine

VAGINAL

NUVARING

venlafaxine ext-rel

CYMBALTA PRISTIQ

§ URINARY ANTISPASMODICS

oxybutynin oxybutynin ext-rel trospium

DETROL DETROL LA ENABLEX
NOVOLIN NOVOLOG

ESTROGENS

§ ORAL

estradiol estropipate

ENJUVIA PREMARIN

STEROID / BETA AGONIST COMBINATIONS

ADVAIR DULERA SYMBICORT

§ MISCELLANEOUS AGENTS

bupropion bupropion ext-rel mirtazapine

INSULIN SENSITIZERS

ACTOS

INSULIN SENSITIZER / BIGUANIDE COMBINATIONS

§ STEROID INHALANTS

GELNIQUE VESICARE
ACTOPLUS MET

§ TRANSDERMAL

estradiol

EVAMIST VIVELLE-DOT

budesonide inhalation suspension

ASMANEX FLOVENT PULMICORT FLEXHALER QVAR

§ HYPNOTICS, NONBENZODIAZEPINES

zolpidem zolpidem ext-rel

INSULIN SENSITIZER / SULFONYLUREA COMBINATIONS

HEMATOLOGIC

§ ANTICOAGULANTS

warfarin

COUMADIN PRADAXA XARELTO
DUETACT

§ ESTROGEN / PROGESTINS, ORAL

estradiol-norethindrone

PREMPHASE PREMPRO

MIGRAINE

§ SELECTIVE SEROTONIN AGONISTS

naratriptan sumatriptan

MAXALT ZOMIG

§ MEGLITINIDES

nateglinide

PRANDIN

TOPICAL

DERMATOLOGY

§ ACNE

adapalene clindamycin solution clindamycin-benzoyl peroxide erythromycin solution erythromycin-benzoyl peroxide

IMMUNOLOGIC
AGENTS

§ SULFONYLUREAS

glimepiride glipizide

FERTILITY REGULATORS

OVULATION STIMULANTS, GONADOTROPINS

BRAVELLE FOLLISTIM AQ

BIOLOGIC DISEASE- MODIFYING AGENTS

ENBREL HUMIRA

SELECTIVE SEROTONIN AGONIST / NONSTEROIDAL ANTI-INFLAMMATORY DRUG (NSAID) COMBINATIONS

TREXIMET

glipizide ext-rel

SUPPLIES

ACCU-CHEK STRIPS AND KITS 3

tretinoin

ACANYA

Your specific prescription benefit plan design may not cover certain categories, regardless of their appearance in this document. For specific information, visit www.caremark.com or contact a CVS Caremark Customer Care representative.

DIFFERIN DUAC EPIDUO RETIN-A MICRO VELTIN

OPHTHALMIC

§ BETA-BLOCKERS, NONSELECTIVE

timolol maleate solution

BETIMOL

BETA-BLOCKERS, SELECTIVE

BETOPTIC S

§ PROSTAGLANDINS

latanoprost

LUMIGAN

§ SYMPATHOMIMETICS

brimonidine 0.2%

ALPHAGAN P
TRAVATAN Z

QUICK REFERENCE DRUG LIST

ciprofloxacin ext-rel ciprofloxacin tablet citalopram clarithromycin clarithromycin ext-rel clindamycin clindamycin solution clindamycin-benzoyl peroxide

COMBIVENT COPAXONE

fluconazole flunisolide fluoxetine fluticasone

FOLLISTIM AQ FORADIL FORTEO

fosinopril fosinopril- hydrochlorothiazide furosemide metformin metformin ext-rel metolazone

QVAR

A

ACANYA ACCU-CHEK STRIPS AND

R

metoprolol ramipril

ranitidine

RAPAFLO RELENZA RETIN-A MICRO

rimantadine

KITS 3

metoprolol succinate ext-rel metronidazole

MICARDIS MICARDIS HCT

minocycline

ACTONEL ACTOPLUS MET ACTOS

acyclovir adapalene mirtazapine

ADVAIR

albuterol

S
N

COREG CR COUMADIN CRESTOR CYMBALTA
SEREVENT

sertraline

SIMCOR

simvastatin

SINGULAIR SPIRIVA

spironolactone- hydrochlorothiazide sulfamethoxazole- trimethoprim sumatriptan

SUPRAX SYMBICORT SYNTHROID SYNVISC

alendronate

ALPHAGAN P

amantadine amlodipine amoxicillin amoxicillin-clavulanate

AMTURNIDE ANDRODERM ANDROGEL APIDRA ASMANEX ASTEPRO

atenolol

AVELOX AVODART AVONEX

G

nadolol

GELNIQUE

glimepiride glipizide glipizide ext-rel glipizide-metformin naratriptan

NASONEX NATAZIA

nateglinide

NEXIUM

D

DETROL DETROL LA DEXILANT

dicloxacillin

DIFFERIN

digoxin diltiazem ext-rel

DIOVAN DIOVAN HCT

doxazosin doxycycline hyclate

DUAC
NIASPAN

H

nifedipine ext-rel nitrofurantoin

NORDITROPIN NOVOLIN NOVOLOG NUVARING
HUMIRA HUMULIN R U-500

hydrochlorothiazide

I

ipratropium-albuterol inhalation solution itraconazole

O

SYNVISC-ONE

omeprazole azelastine

azithromycin

T

omeprazole-sodium bicarbonate capsule

ONETOUCH STRIPS AND KITS 3 ONGLYZA ORTHO EVRA ORTHO TRI-CYCLEN LO

oxybutynin oxybutynin ext-rel

DUETACT DULERA

J

TAMIFLU

tamsulosin

TEKAMLO TEKTURNA TEKTURNA HCT

terazosin terbinafine tablet tetracycline timolol maleate solution torsemide

B

JANUMET JANUVIA
BD INSULIN SYRINGES

AND NEEDLES BENICAR BENICAR HCT BETASERON BETIMOL BETOPTIC S BEYAZ BONIVA

E

ENABLEX ENBREL ENJUVIA EPIDUO EPIPEN EPIPEN JR

erythromycin solution erythromycin-benzoyl peroxide erythromycins estradiol

K

KOMBIGLYZE XR

L

lansoprazole

LANTUS

latanoprost

P

pantoprazole paroxetine paroxetine ext-rel penicillin VK

PRADAXA PRANDIN

pravastatin

PREMARIN PREMPHASE PREMPRO PRISTIQ PROAIR HFA PROMETRIUM

propranolol

PROVENTIL HFA PULMICORT FLEXHALER
TRAVATAN Z

tretinoin

BRAVELLE
LEVEMIR

TREXIMET

triamcinolone triamterene- hydrochlorothiazide

TRICOR

brimonidine 0.2% budesonide inhalation suspension bupropion bupropion ext-rel

BYETTA

levofloxacin levothyroxine

LEXAPRO LIPITOR

lisinopril estradiol-norethindrone estropipate ethinyl estradiol- drospirenone ethinyl estradiol- levonorgestrel ethinyl estradiol- norgestimate

EVAMIST
TRILIPIX

trospium lisinopril-

BYSTOLIC

hydrochlorothiazide

LO LOESTRIN FE LOESTRIN 24 FE

losartan

V
C

valacyclovir

VALTURNA VELTIN
CADUET

calcitonin-salmon carvedilol cefaclor cefdinir cephalexin cholestyramine

CIPRO SUSPENSION

losartan- hydrochlorothiazide

LOSEASONIQUE LUMIGAN
EVISTA

venlafaxine venlafaxine ext-rel

VENTOLIN HFA VERAMYST

verapamil ext-rel

VESICARE

F
Q

fenofibrate finasteride

FLOVENT

M

quinapril quinapril- hydrochlorothiazide

MAXALT

medroxyprogesterone

VICTOZA

Your specific prescription benefit plan design may not cover certain categories, regardless of their appearance in this document. For specific information, visit www.caremark.com or contact a CVS Caremark Customer Care representative.

VIIBRYD VIVELLE-DOT

zolpidem zolpidem ext-rel

ZOMIG

  • W
  • X
  • Z

warfarin

WELCHOL
XARELTO

zafirlukast

ZETIA

PREFERRED ALTERNATIVES LIST

  • DRUG NAME(S)
  • PREFERRED ALTERNATIVE(S)*
  • DRUG NAME(S)
  • PREFERRED ALTERNATIVE(S)*

estradiol, estropipate, ENJUVIA, PREMARIN fenofibrate, TRICOR, TRILIPIX

ANDRODERM, ANDROGEL

metformin ext-rel

ACIPHEX

lansoprazole, omeprazole, omeprazole- sodium bicarbonate capsule, pantoprazole

FEMTRACE FENOGLIDE
ADVICOR

ALORA
SIMCOR
FIRST TESTOSTERONE

FORTAMET estradiol, EVAMIST, VIVELLE-DOT
ALTOPREV ALVESCO

pravastatin

  • FORTESTA
  • ANDRODERM, ANDROGEL

alendronate

ASMANEX, FLOVENT, PULMICORT FLEXHALER, QVAR
FOSAMAX PLUS D

  • FREESTYLE STRIPS AND KITS
  • ACCU-CHEK STRIPS AND KITS 3,

ONETOUCH STRIPS AND KITS 3
ANGELIQ

estradiol-norethindrone, PREMPHASE, PREMPRO

ARMOUR THYROID ASCENSIA STRIPS AND KITS

levothyroxine, SYNTHROID

FROVA

sumatriptan

ACCU-CHEK STRIPS AND KITS 3, ONETOUCH STRIPS AND KITS 3
GLUMETZA HUMALOG HUMALOG MIX 50/50 HUMALOG MIX 75/25 HUMULIN

metformin ext-rel

NOVOLOG
ATACAND, ATACAND HCT

losartan, losartan-hydrochlorothiazide, BENICAR,

BENICAR HCT, DIOVAN, DIOVAN HCT, MICARDIS, MICARDIS HCT
NOVOLOG MIX 70/30 NOVOLOG MIX 70/30
ATELVIA

alendronate 70 mg

NOVOLIN
ATROVENT HFA

AVAPRO, AVALIDE AXERT
SPIRIVA
INNOPRAN XL

ISTALOL

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  • Disclaimer: Price Listing Does Not Guarantee Coverage

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    West Virginia Medicaid State Maximum Allowable Cost (SMAC) List Effective 5/1/2020 Disclaimer: Price listing does not guarantee coverage Generic Name Prev. SMAC Price Prev. Effective Current SMAC Current Effective Date Price Date 0.9 % SODIUM CHLORIDE INJECTION VIAL (ML) 0.9 % 0.05712 08/12/2014 0.9 % SODIUM CHLORIDE INTRAVENOUS INTRAVENOUS SOLUTION 0.9 % 0.00196 03/06/2015 0.00196 08/21/2015 0.9 % SODIUM CHLORIDE INTRAVENOUS PIGGYBACK WITH THREADED 0.03505 01/30/2015 0.03505 08/21/2015 PORT (ML) 0.9 % SODIUM CHLORIDE INTRAVENOUS PIGGYBACK WITH VIAL PORT 0.04175 07/18/2014 (NON-THREADED) ABACAVIR SULFATE ORAL TABLET 300 MG 1.77633 11/24/2017 1.77633 11/25/2017 ABIRATERONE ACETATE ORAL TABLET 250 MG 3.78000 02/21/2020 4.56040 02/24/2020 ACAMPROSATE CALCIUM ORAL TABLET, DELAYED RELEASE (ENTERIC 0.67426 02/21/2020 0.74145 04/09/2020 COATED) 333 MG ACARBOSE ORAL TABLET 100 MG 0.18990 03/02/2018 0.13000 11/16/2018 ACARBOSE ORAL TABLET 25 MG 0.23329 08/21/2015 0.13994 08/25/2017 ACARBOSE ORAL TABLET 50 MG 0.14640 05/25/2018 0.12500 11/16/2018 ACEBUTOLOL HCL ORAL CAPSULE 200 MG 0.40001 06/04/2019 0.60776 10/07/2019 ACEBUTOLOL HCL ORAL CAPSULE 400 MG 0.26000 03/27/2015 0.26000 08/21/2015 ACETAMINOPHEN ORAL CAPSULE 500 MG 0.01093 08/12/2014 ACETAMINOPHEN ORAL DROPS 80MG/0.8ML 0.17160 10/11/2013 0.17160 08/21/2015 ACETAMINOPHEN ORAL LIQUID (ML) 160 MG/5ML 0.00932 09/27/2013 0.00932 08/21/2015 ACETAMINOPHEN ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 160 0.02137 08/21/2015 0.02033 02/17/2017 MG/5ML ACETAMINOPHEN ORAL SUSPENSION, ORAL (FINAL DOSE FORM)
  • These Highlights Do Not Include All the Information Needed to Use PRASTERA® Safely and Effectively

    These Highlights Do Not Include All the Information Needed to Use PRASTERA® Safely and Effectively

    PRASTERA- prasterone and ibuprofen Health Science Funding, LLC Disclaimer: This drug has not been found by FDA to be safe and effective, and this labeling has not been approved by FDA. For further information about unapproved drugs, click here. ---------- HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use PRASTERA® safely and effectively. See full prescribing information for PRASTERA® . PRASTERA® prasterone oral softgels 200mg are for oral use only. Initial U.S. Approval INDICATIONS AND USAGE PRASTERA® prasterone 200 mg oral softgels is indicated in female patients with mild to moderate, active (SLEDAI ≥2) systemic lupus erythematosus (SLE) to restore serum 5-dehydroandrosterone sulfate to levels typical of women without SLE. In Phase III clinical trials in female patients with mild to moderate active SLE, prasterone 200 mg was associated with reduced risk of auto-immune flare, reduced risk of breast cancer and reduced risk of death from any cause. (§§1, 6.2, 6.4, 6.5) DOSAGE AND ADMINISTRATION The recommended dose is one (1) softgel daily. (§2) DOSAGE FORMS AND STRENGTHS 200mg oral softgel capsules supplied in a convenience package with ibuprofen oral tablets 400mg. (§3) CONTRAINDICATIONS Known hypersensitivity to any of its ingredients. (§4) Undiagnosed abnormal genital bleeding. (§4) Known, suspected or history of breast cancer. (§4, §6.5) History of, or known, deep vein thrombosis, pulmonary embolism, arterial thromboembolic disease (e.g., stroke, myocardial infarction). (§4) Hypercholesterolemia or ischemic heart disease. (§4, §7.2.4) Hepatic or renal impairment (pharmacokinetic data lacking). (§4, §7.2) Breast-feeding or known or suspected pregnancy.
  • OGEN® Estropipate Tablets, USP

    OGEN® Estropipate Tablets, USP

    PATIENT INFORMATION (Updated July 2006) OGEN® estropipate tablets, USP Read this PATIENT INFORMATION before you start taking OGEN and read what you get each time you refill OGEN. There may be new information. This information does not take the place of talking to your health care provider about your medical condition or your treatment. WHAT IS THE MOST IMPORTANT INFORMATION I SHOULD KNOW ABOUT OGEN (AN ESTROGEN HORMONE)? • Estrogens increase the chances of getting cancer of the uterus. Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterine (womb). Your health care provider should check any unusual vaginal bleeding to find out the cause. • Do not use estrogens with or without progestins to prevent heart disease, heart attacks or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer and blood clots. You and your health care provider should talk regularly about whether you still need treatment with OGEN. What is OGEN? OGEN is a medicine that contains estrogen hormones. What is OGEN used for? OGEN is used during and after menopause to: • reduce moderate or severe hot flashes. Estrogens are hormones made by a woman’s ovaries. The ovaries normally stop making estrogens when a woman is between 45 to 55 years old. This drop in body estrogen levels causes the “change of life” or menopause (the end of monthly menstrual periods). Sometimes, both ovaries are removed during an operation before natural menopause takes place.
  • DUAVEE® (Conjugated Estrogens-Bazedoxifene) Oral Tablet

    DUAVEE® (Conjugated Estrogens-Bazedoxifene) Oral Tablet

    PHARMACY COVERAGE GUIDELINES ORIGINAL EFFECTIVE DATE: 11/17/2016 SECTION: DRUGS LAST REVIEW DATE: 11/19/2020 LAST CRITERIA REVISION DATE: 11/19/2020 ARCHIVE DATE: DUAVEE® (conjugated estrogens-bazedoxifene) oral tablet Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Pharmacy Coverage Guideline must be read in its entirety to determine coverage eligibility, if any. This Pharmacy Coverage Guideline provides information related to coverage determinations only and does not imply that a service or treatment is clinically appropriate or inappropriate. The provider and the member are responsible for all decisions regarding the appropriateness of care. Providers should provide BCBSAZ complete medical rationale when requesting any exceptions to these guidelines. The section identified as “Description” defines or describes a service, procedure, medical device or drug and is in no way intended as a statement of medical necessity and/or coverage. The section identified as “Criteria” defines criteria to determine whether a service, procedure, medical device or drug is considered medically necessary or experimental or investigational. State or federal mandates, e.g., FEP program, may dictate that any drug, device or biological product approved by the U.S. Food and Drug Administration (FDA) may not be considered experimental or investigational and thus the drug, device or biological product may be assessed only on the basis of medical necessity. Pharmacy Coverage Guidelines are subject to change as new information becomes available. For purposes of this Pharmacy Coverage Guideline, the terms "experimental" and "investigational" are considered to be interchangeable.
  • Bioidentical Hormones: an Evidence-Based Review for Primary Care Providers

    Bioidentical Hormones: an Evidence-Based Review for Primary Care Providers

    REVIEW Bioidentical Hormones: An Evidence-Based Review for Primary Care Providers Eileen Conaway, DO Context: Since 2002, when the US Food and Drug Adminis - combination with estrogen for the management of vasomotor tration (FDA) placed a black box warning on women’s hor - symptoms. Dehydroepiandrosterone is not FDA approved, mone replacement products, women and their providers but small-scale studies indicate it may improve bone min - have been struggling with whether to proceed with hormone eral density. Data are conflicting about efficacy in improving replacement therapy. Out of the controversy has grown a sexual dysfunction. There is an abundance of misleading popular movement promoting the use of bioidentical hor - information available in the media and on the Internet for mones. Many providers are still unsure if they want to rec - our patients. Compounded bioidenticals and salivary hor - ommend these products and, if so, how to use them appro - mone testing are unnecessary, are not standardized, and priately. should be avoided. Objective: To inform primary care providers (eg, physicians, Conclusion: Bioidentical hormones that are approved by the physician assistants, nurse practitioners) about current data on FDA may be preferred over standard hormone replacement the safety and efficacy of bioidentical hormone replacement because of their physiologic benefits and safety profile. therapy and to provide a context for patient perceptions. J Am Osteopath Assoc . 2011;111(3):153-164 Methods: Literature published between 1999 and 2009 was reviewed through MD Consult’s Medline and Ovid search n the aftermath of the unexpected adverse results of the engines. A Google search of popular media was also per - IWomen’s Health Initiative (WHI) trial 1 in 2002, women formed using the same terms.
  • Recent Advances in the Analysis of Steroid Hormones and Related Drugs

    Recent Advances in the Analysis of Steroid Hormones and Related Drugs

    ANALYTICAL SCIENCES MAY 2004, VOL. 20 767 2004 © The Japan Society for Analytical Chemistry Reviews Recent Advances in the Analysis of Steroid Hormones and Related Drugs Sándor GÖRÖG Gedeon Richter Ltd., P.O.B. 27, H-1475 Budapest, Hungary The development during the last 15 years and the state-of-the-art in the analysis of bulk steroid hormone drugs and hormone-like structures and pharmaceutical formulations made thereof are summarized. Other steroids (sterols, bile acids, cardiac glycosides, vitamins D) as well as biological-clinical aspects and pharmacokinetic and metabolic studies are excluded from this review. The state-of-the-art is summarized based on comparisons of monographs in the latest editions of the European Pharmacopoeia, United States Pharmacopoeia and the Japanese Pharmacopoeia. This is followed by sections dealing with new developments in the methodology for the fields of spectroscopic and spectrophotometric, chromatographic, electrophoretic and hyphenated techniques as well electroanalytical methods. The review is terminated by two problem-oriented sections: examples on impurity and degradation profiling as well as enantiomeric analysis. (Received January 14, 2004; Accepted February 2, 2004) 1 Introduction 767 4·3 Supercritical fluid chromatography (SFC) 2 Steroid Hormone Drugs in Pharmacopoeias 768 4·4 High-performance liquid chromatography 2·1 Assay of bulk drug materials (HPLC) and HPLC-MS 2·2 Related impurities test of bulk drug materials 5 Electrophoretic and Related Methods 776 2·3 Assay of steroid hormone formulations