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InterQual® Criteria Drug List

The following drug list is provided as a tool to assist users of Change Healthcare’s products by categorizing drug names and classes mentioned within the criteria and notes. It is organized using a combined alphabetical listing of common generic and trade names with their associated chemical class (e.g., Beta-Blockers) and functional class (e.g., Antihypertensive). Multi-drug combinations are represented using slashes. For a more comprehensive listing of available agents, users are referred to standard drug references.

Drug Name Class

abacavir Reverse Transcriptase Inhibitor

abatacept Immunomodulators

Abbokinase Thrombolytic Agent

Antiplatelest agent, GP IIb/IIIa

Abelcet Antifungals

Abilify Antipsychotics

abotulinumtoxin A Neuromuscular blockers

acamprosate Alcohol Abstinence Enhancers

acarbose Diabetic Agents

Accolate Antileukotrienes

Accupril ACE Inhibitors

acebutolol Beta-Blockers

Aceon ACE Inhibitors

acetaminophen/codeine Analgesics, Opiates

Carbonic Anhydrase Inhibitors, Diuretics

acetohexamide Diabetic Agents, Sulfonylureas

acetylcysteine Antidote, Mucolytic

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 1 Drug List

Drug Name Class

Achromycin Anti-Infectives

Aciphex Proton Pump Inhibitors

Aclasta Bisphosphonates

Actemra Immunomodulator, Rheumatic agent

Acthar Corticosteroids, Hormonal Agents

Actimmune Immunomodulators

Activase Thrombolytics

Actonel Bisphosphonates

Actoplus Met Diabetic Agents, Thiazolidinediones

Actos Diabetic Agents

acyclovir Anti-Herpes Agents, Antivirals

Adalat Calcium Channel Blockers

adalimumab Immunomodulators, Rheumatic Agents

adapalene Acne Agents,

Adderall Amphetamines, CNS Stimulants

Adenocard Antiarrhythmics

adenosine Antiarrhythmics

Adipex-P Appetite Suppressants, Stimulants

Adrenalin Bronchodilators, Vasopressors

Adrenaline chloride Alpha-Agonists, Vasopressors

adrenocorticotropic hormone (ACTH) Corticosteroid, Hormonal Agents

Adriamycin Chemotherapeutic Agents, Anthracyclines

Adrucil Chemotherapeutic Agents, Pyrimidine Antagonists

Advair Anti-Inflammatory, Beta-Agonists

Advicor Lipid Regulating Agents

Aerobid Corticosteroids

Aggrastat Antiplatelet Agents

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 2 Drug List

Drug Name Class

Aggrenox Antiplatelet Agents

Agrylin Antiplatelet Agents

A-hydroCort Corticosteroids

albendazole Anti-Infectives, Anthelmintics

Albenza Anti-Infectives, Anthelmintics

albumin 5% Volume Expanders

Albuminar-5 Volume Expanders

Albutein 5% Volume Expanders

albuterol Beta-Agonists, Bronchodilators

albuterol sulfate/ipratropium bromide Anticholinergic, Bronchodilator

Aldactone Antihypertensives, Diuretics

Aldara Dermatologic Agents, Immunomodulators

aldesleukin Chemotherapeutic Agents

Aldomet Antihypertensives

alemtuzumab Chemotherapeutic Agent, Monoclonal Antibody

alendronate Bisphosphonates

Alesse Hormonal Agents, Oral Contraceptive

Alfenta Analgesics, Opiates

alfentanil Analgesics, Opiates

Alferon N Immunomodulators

alfuzosin Alpha-Blockers

Alimta Antimetabolite, Chemotherapeutic Agents

alitretinoin Chemotherapeutic Agents, Retinoids

Alkeran Antineoplastic Alkylating Agent

Allegra Antihistamines, Peripherally Selective

allopurinol Anti-Gout Agents, Xanthine Oxidase Inhibitors

almotriptan Serotonin Agonists

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 3 Drug List

Drug Name Class

Alogliptin DPP-4 inhibitors

Aloxi Antiemetics

alprazolam Antianxiety Agents, Benzodiazepines

alprostadil Impotence Agents, analogue

Altace ACE Inhibitors

Alteplace Thrombolytic Agent

/t-PA Thrombolytics, Tissue Plasminogen Activators

altretamine Chemotherapeutic Agents, Alkylating Agents

Alupent Beta-Agonists, Bronchodilators

amantadine Anti-Infectives, Antiviral, Parkinson's Agent

Amaryl Diabetic Agents, Sulfonylureas

Amatine Antihypotensive, Vasopressor

Ambien Nonbarbiturates, Sedatives

Amerge Serotonin Agonists

Amevive immunodepressants

amifostine Chemotherapeutic Agents, Cytoprotectives

amikacin Aminoglycosides, Anti-Infectives

Amikin Aminoglycosides, Anti-Infectives

amiloride Diuretics

aminophylline Asthma Agents, Bronchodilators

amiodarone Antiarrhythmics

amitriptyline Tricyclic Antidepressants

amlodipine Calcium Channel Blockers

amobarbital Barbiturates, Sedatives

amoxapine Tricyclic Antidepressants

amoxicillin Anti-Infectives, Penicillins

amoxicillin clavulanate Aminopenicillins, Anti-Infectives

Amoxil Anti-Infectives, Penicillins

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 4 Drug List

Drug Name Class

amphetamine mixed salts Amphetamines, Stimulants

amphotericin B Anti-Infective, Antifungals

ampicillin Anti-Infectives, Penicillins

ampicillin/sulbactam Aminopenicillins, Anti-Infectives

amrinone Inotropene Vasodilator

Amytal Barbiturates, Sedatives

Anafranil Tricyclic Antidepressants

anagrelide Antiplatelet Agents

anakinra Immunomodulators, Rheumatic Agents

Anaprox NSAIDs

Ancef Anti-Infectives, Cephalosporins

Ancobon Anti-Infectives, Antifungals

Anectine Neuromuscular Blockers, Depolarizing

anhydrous morphine Antidiarrheal, Neonatal Drug Withdrawal Therapy (Off Label)

anidulafungin Anti-Infectives, Antifungals

Ansaid NSAIDs

Antabuse Alcohol Sensitizing Agents

anthralin Anti-Psoratic, Dermatologic Agents

Antilirium Cholinergic Agents

Antivert Antihistamines

Anturane Uricosuric agent

Anzemet Antiemetics

Apidra Insulins

apixiban Non-vitamin K oral

Aplenzin Antidepressants

Apokyn Parkinson’s Agents

apomorphine Parkinson’s Agents

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 5 Drug List

Drug Name Class

aprepitant Antiemetics

Apresoline Antihypertensives, Vasodilators

Apri Hormonal Agents, Oral Contraceptive

Aquacare Dermatologic Agents

Aquachloral Sedatives, Non-Barbiturate

Aralen Anti-Infectives, Anti-Malarials, Amebicide

Aramine Adrenergic Agents, Vasopressors

Aranesp Hematopoetic Growth Factor

Arava Rheumatic Agents

Arduan Neuromuscular Blockers

Aredia Bisphosphonates

Argatroban

Aricept Cognitive Enhancers

aripiprazole Antipsychotics

Aristocort Corticosteroids

Arixtra Anticoagulants

Arranon Chemotherapeutic Agents, DNA Demethylation Agents

Arthrotec NSAIDs, Prostaglandin analogue

Asacol Aminosalicytates (5-ASA)

asenapine Antipsychotics

asparaginase Chemotherapeutic Agents

Astelin Antihistamines

Astramorph Analgesics, Narcotic

Atacand Angiotensin Blocker

atanazar Protease inhibitor

Atarax Antihistamines, Non-Selective

atenolol Beta-Blockers

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 6 Drug List

Drug Name Class

Ativan Antianxiety Agents, Anticonvulsants, Benzodiazepines

atomoxetine Selective Norepinephrine Reuptake Inhibitors (SNRI)

atorvastatin Lipid Regulating Agents

atovaquone Anti-Infectives, Antiprotozoals

Atromid-S Lipid Regulating Agents

Anticholinergics

Atrovent Anticholinergics, Bronchodilators

Augmentin Aminopenicillins, Anti-Infectives

auranofin Gold Compounds, Anti-Rheumatic

aurothioglucose Gold Compounds, Anti-Rheumatic

Avandamet Diabetic Agents

Avandaryl Diabetic Agents

Avandia Diabetic Agents, Thiazolidinediones

Avapro Angiotensin Receptor Blocker

Avastin Chemotherapeutic Agents, Monoclonal Antibody

Avelox Anti-Infectives, Fluroquinolones

Avita Acne Agents, Retinoids

Avodart Androgen Antagonists

Avonex Immunomodulators

azacitidine Chemotherapeutic Agents, DNA Demethylation Agents

Azactam Anti-Infectives, Monobactams

azatadine Antihistamines

azathioprine Immunosuppressants

azelaic acid Anti-Infectives, Dermatologic Agent

azelastine Antihistamines

Azelex Anti-Infectives, Dermatologic Agent

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 7 Drug List

Drug Name Class

Azilect Monamine Oxidase-B Inhibitor

azithromycin Anti-Infectives, Macrolides

Azmacort Corticosteroids

AZT (zidovudine) Antiretrovirals, NRTI

aztreonam Anti-Infectives, Monobactams

Azulfidine Aminosalicytates (5-ASA)

bacitracin Anti-Infectives

baclofen Muscle Relaxants

Bactrim Anti-Infectives

Bactroban Anti-Infectives

basilximab Immunosuppressants

BCG vaccine Chemotherapeutic Agents

beclomethasone Corticosteroids

Beclovent Corticosteroids

Benadryl Antiemetics, Antihistamines

benazepril ACE Inhibitors

Benicar Angiotensin Receptor Blocker

Bentyl Anticholinergics

Benzamycin Acne Agents

benzoyl peroxide Acne Agents

benzoyl peroxide and hydrocortisone Acne Agents

benztropine Anticholinergics, Parkinson’s Agents

Beraprost Synthetic Prostaglandin

betamethasone Corticosteroids

betamethasone dipropionate Dermatologic Agents

Betapace Antiarrhythmics, Beta-Blockers

Betaseron Immunomodulators

Beta-Blockers

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 8 Drug List

Drug Name Class

bethanechol Cholinergic Agents

bevacizumab Monoclonal Antibody

bexarotene Chemotherapeutic Agents, Retinoids

Biaxin Anti-Infectives, Macrolides

bicalutumide Androgen Antagonists

bichloracetic acid Keratolytic Agents

Bicillin Anti-Infectives, Penicillins

BiCNU Alkylating Agents, Chemotherapeutic Agents

bifonazole Antifungals, Anti-Infectives

Biltricide Anti-Infectives, Anthelmintics

bisacodyl Laxatives, Stimulant Laxatives

bisoprolol Beta-Blockers

Blenoxane Antibiotics, Chemotherapeutic Agents

bleomycin Antibiotics, Chemotherapeutic Agents

Blocadren Beta-Blockers

Boniva Bisphosphonates

bortezomib Chemotherapeutic Agents, Proteasome Inhibitor

Botox Neuromuscular Blockers

botulinum toxin type A Neuromuscular Blockers

Branchedchain amino acids (BCAA) amino acid supplement

Brethine Beta-Agonists, Bronchodilators, Tocolytics

bretylium tosylate Antiarrhythmic

Bretylol Antiarrhythmic

Brevibloc Antiarrhythmics, Beta-Blockers

Bromfed Antihistamines, Decongestants

bromocriptine Parkinson’s Agents

brompheniramine/pseudoephedrine Antihistamines, Decongestants

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 9 Drug List

Drug Name Class

budesonide Corticosteroids

bumetanide Diuretics, Loop Diuretics

Bumex Diuretics, Loop Diuretics

bupivacaine Anesthetics, Local

Buprenex Analgesics, Opiate Agonist-Antagonists

buprenorphine Analgesics, Opiate Agonist-Antagonists

bupropion Antidepressants

bupropion hydrobromide Antidepressants

BuSpar Antianxiety Agents

buspirone Antianxiety Agents

busulfan Alkylating Agents, Chemotherapeutic Agents

butabarbital Barbiturates, Sedatives

butalbital/caffeine/acetaminophen Analgesics

butalbital/caffeine/ Analgesics

butorphanol Agonis-Antagonists, Analgesics, Opiates

Byetta Incretin

cabergoline Endocrine Metobolic Agents

Cafergot Ergotamine Compounds

Calan Calcium Channel Blockers

calcipotriene Anti-Psoratic, Dermatologic Agents

calcitonin Anti-Resorptives

calcium acetate Fluid and Electrolyte Replacement, Mineral

calcium chloride Fluid and Electrolyte Replacement, Mineral

calcium gluceptate Fluid and Electrolyte Replacement, Mineral

calcium gluconate Fluid and Electrolyte Replacement, Mineral

Campath Chemotherapeutic Agents, Monoclonal Antibody

Campral Alcohol Abstinence Enhancers

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 10 Drug List

Drug Name Class

Camptosar Chemotherapeutic Agents, DNA Topoisomerase Inihibitors

Cancidas Anti-Infectives, Antifungals

candesartan Angiotensin Receptor Blocker

cantharidin Anti-Infectives

Capastat Sulfate Anti-Infectives, Antituberculosis Agents

capecitabine Chemotherapeutic Agents, Antimetabolite

Capoten ACE Inhibitors

capreomycin Anti-Infectives, Antituberculosis Agents

capsaicin Counterirritant, Dermatologic Agents

captopril ACE Inhibitors

carbamazepine Anticonvulsants, Mood Stabilizers

carbidopa/levodopa Parkinson’s Agents

carbinoxamine Antihistamines, Non-Selective

Carbocaine Anesthetics, Local

carboplatin Chemotherapeutic Agents, Platinum Co- ordination Complex

Prostaglandin analogue, Uterine active Agents

Cardene Calcium Channel Blockers

Cardioquin Antiarrhythmics

Cardizem Calcium Channel Blockers

Cardura Alpha-Blockers

carisoprodol Muscle Relaxants

carmustine Alkylating Agents, Chemotherapeutic Agents

Beta-Blockers

Cartrol Beta-Blockers

carvedilol Alph-Beta Blocking Agents, Beta-Blockers

Casodex Androgen Antagonists

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 11 Drug List

Drug Name Class

caspofungin Anti-Infectives, Antifungals

Cataflam NSAIDs

Catapres Antihypertensives, Centrally-Acting

Caverject Impotence Agents, Prostaglandin analogue

Ceclor Anti-Infectives, Cephalosporins

Cedax Anti-Infectives, Cephalosporins

CeeNU Alkylating Agents, Chemotherapeutic Agents

cefaclor Anti-Infectives, Cephalosporins

cefadroxil Anti-Infectives, Cephalosporins

cefazolin Anti-Infectives, Cephalosporins

cefdinir Anti-Infectives, Cephalosporins

cefditoren Anti-Infectives, Cephalosporins

cefepime Anti-Infectives, Cephalosporins

cefixime Anti-Infectives, Cephalosporins

Cefizox Anti-Infectives, Cephalosporins

Cefobid Anti-Infectives, Cephalosporins

cefoperazone Anti-Infectives, Cephalosporins

Cefotan Anti-Infectives, Cephalosporins

cefotaxime Anti-Infectives, Cephalosporins

cefotetan Anti-Infectives, Cephalosporins

cefoxitin Anti-Infectives, Cephalosporins

cefpodoxime Anti-Infectives, Cephalosporins

cefprozil Anti-Infectives, Cephalosporins

ceftazidime Anti-Infectives, Cephalosporins

ceftibuten Anti-Infectives, Cephalosporins

Ceftin Anti-Infectives, Cephalosporins

ceftizoxime Anti-Infectives, Cephalosporins

ceftriaxone Anti-Infectives, Cephalosporins

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 12 Drug List

Drug Name Class

cefuroxime Anti-Infectives, Cephalosporins

Cefzil Anti-Infectives, Cephalosporins

Celebrex NSAIDs, Selective COX-2 Inhibitors

NSAIDs, Selective COX-2 Inhibitors

Celestone Corticosteroids

Celexa Antidepressants, SSRIs

CellCept Immunosuppressants

Celontin Anticonvulsants, Succinimides

Cena K Fluid and Electrolyte Replacement

cephalexin Anti-Infectives, Cephalosporins

cephradrine Anti-Infectives, Cephalosporins

Cerebyx Anticonvulsants, Hydantoins

Cerezyme replacement

Cerubidine Chemotherapeutic Agents, Anthracyclines

Cervidil Prostaglandin analogue

cetirizine Antihistamines

cetuximab Chemotherapeutic Agents, Monoclonal Antibody

cevimeline Cholinergic Agents

chloral hydrate Sedatives, Non-Barbiturate

chlorambucil Alkylating Agents, Chemotherapeutic Agents

chloramphenicol Anti-Infectives

chlordiazepoxide Antianxiety Agents, Benzodiazepines

Chloromycetin Anti-Infectives

chloroprocaine Anesthetics, Local

chloroquine Anti-Malarials

chloroquine phosphate Amebicide

chlorothiazide Diuretics, Thiazides

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 13 Drug List

Drug Name Class

chlorpheniramine Antihistamines, Non-Selective

chlorpromazine Antiemetics, Antipsychotics

chlorpropamide Diabetic Agents, Sulfonylureas

chlorthalidone Diuretics, Thiazides

chlorzoxazone Muscle Relaxants

cholestyramine Lipid Regulating Agents

Cialis Impotence Agents

ciclopirox Antifungals, Anti-Infectives

cilastatin Anti-Infectives, Carbapenems

Antiplatelet Agents

Histamine receptor antagonist

Cimzia Immunomodulator, Rheumatic agent

Cinobac Anti-Infectives, Quinolones

cinoxacin Anti-Infectives, Quinolones

Cipro Anti-Infectives, Fluroquinolones

ciprofloxacin Anti-Infectives, Fluroquinolones

cisatracurium Neuromuscular Blockers,

cisplatin Chemotherapeutic Agents, Platinum Co- ordination Complex

citalopram Antidepressants, SSRIs

Citrucel Laxatives, Bulk Producing

cladribine Chemotherapeutic Agents, Antimetabolite

Claforan Anti-Infectives, Cephalosporins

Clarinex Antihistamines, Piperidine

clarithromycin Anti-Infectives, Macrolides

Cleocin Acne Agents, Anti-Infectives, Lincosamides

Climara Hormonal Agents

clindamycin Acne Agents, Anti-Infectives, Lincosamides

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 14 Drug List

Drug Name Class

Clinoril NSAIDs

clobetasol Corticosteroids, Dermatologic Agents

clofarabine Chemotherapeutic Agents, Antimetabolite

clofibrate Lipid Regulating Agents

Clolar Chemotherapeutic Agents, Antimetabolite

clomipramine Tricyclic Antidepressants

clonazepam Antianxiety Agents, Anticonvulsants, Benzodiazepines

Antihypertensives, Centrally-Acting

Antiplatelet Agents

clorazepate Benzodiazepines, Sedatives

clotrimazole Antifungals, Anti-Infectives

cloxacillin Anti-Infectives, Penicillins

Cloxapen Anti-Infectives, Penicillins

clozapine Antipsychotics, Dibenamines

Clozaril Antipsychotics

codeine Analgesics, Opiates

Cogentin Anticholinergics, Parkinson’s Agents

Cognex Cognitive Enhancers

colchicine Anti-Gout Agents

colesevelam Lipid Regulating Agents

Colestid Lipid Regulating Agents

colestipol Lipid Regulating Agents

colistimethate Anti-Infectives

Coly-Mycin M Anti-Infectives

Colyte Bowel Evacuants, Laxatives

Combivent Anticolinergics, Bronchodilators

Compazine Antiemetics, Neuroleptic

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 15 Drug List

Drug Name Class

Comtan Parkinson’s Agents

Concerta Stimulants

Condylox Dermatologic Agents

conivaptan Vasopressin antagonists

Copaxone Immunomodulators, Immunosuppressants

Cordarone Antiarrhythmics

Coreg Beta-Blockers

Corgard Beta-Blockers

Corlopam Vasoactive

cortisone acetate Corticosteroids

Cortone Corticosteroids

Cortrosyn Hormonal Agents, Adrenocorticosteroid

Corvert Antiarrhythmics

Cosmegen Antibiotics, Chemotherapeutic Agents

cosyntropin Hormonal Agents, Adrenocorticosteroid

Coumadin Anticoagulants

Cozaar Angiotensin Receptor Blocker

Crestor Lipid Regulating Agents

Crinone Hormonal Agents, Progestins

Crixivan Protease inhibitor

cromolyn Antiallergic, Asthma Agents, Mast Cell Stabilizer

Crystodigin Cardiac Glycosides

Cubicin Anti-Infectives

Cyclessa Hormonal Agents, Oral Contraceptive

cyclobenzaprine Muscle Relaxants

cyclophosphamide Alkylating Agents, Chemotherapeutic Agents

cycloserine Anti-Infectives, Antituberculosis Agents

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 16 Drug List

Drug Name Class

cyclosporine Immunosuppressants

Cyklokapron Antifibrinolytic

Cymbalta Antidepressants, Selective Serotonin and Norepinephrine Reuptake Inhibitor (SSNRI)

cyproheptadine Antihistamines, Non-Selective, Piperidines

cytarabine Chemotherapeutic Agents, Antimetabolite

Cytomel Thyroid Agents

Cytosar-U Chemotherapeutic Agents, Antimetabolite

Cytotec Prostaglandin analogue

Cytovene Anti-Infectives, Antiviral

Cytoxan Alkylating Agents, Chemotherapeutic Agents

Non-vitamin K oral anticoagulant

dacarbazine Alkylating Agents, Chemotherapeutic Agents

daclizumab Immunosuppressants

dactinomycin Antibiotics, Chemotherapeutic Agents

Dalmane Benzodiazepines, Non-Barbiturates

dalteparin Anticoagulants

danazol Hormonal Agents

Danocrine Hormonal Agents

Dantrium Skeletal Muscle Relaxants

dantrolene Skeletal Muscle Relaxants

dapagliflozin SGLT2 inhibitors

dapsone Anti-Infectives, Leprostatic

daptomycin Anti-Infectives, Leptopeptides

Daraprim Anti-Infectives, Anti-Malarials

daunorubicin Chemotherapeutic Agents, Antimetabolite

Daypro NSAIDs

Daytrana Stimulants

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 17 Drug List

Drug Name Class

DDAVP Hormonal Agents

Decadron Anti-Emetic, Anti-Inflammatory, Corticosteroids

Decadron Phosphate Corticosteroids

Decaject Corticosteroids

Declomycin Anti-Infectives, Tetracyclines

Deltasone Corticosteroids

Demadex Diuretics, Loop Diuretics

demeclocycline Anti-Infectives, Tetracyclines

Demerol Analgesics, Opiates

Demulen Hormonal Agents, Oral Contraceptive

denileukin diftitox Chemotherapeutic Agents, Response Modifier

denosumab RANK inhibitor

Depakene Anticonvulsants, Mood Stabilizers

Depakote Anticonvulsants, Mood Stabilizers

Depen Rheumatic Agents

Depoject Corticosteroids

Depo-Medrol Corticosteroids

Depo-Provera Hormonal Agents

Derbac-M pediculoside

Desferal Chelating Agents

desferoxamine Chelating Agents

desipramine Tricyclic Antidepressants

desloratadine Antihistamines, Piperidine

desmopressin Hormonal Agents

Desoxyn CNS Stimulants, Stimulants

desvenlafaxine Antidepressants, Serotonin Norepinephrine Reuptake Inhibitors (SNRI)

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 18 Drug List

Drug Name Class

Detrol Anticholinergics

dexamethasone Anti-Emetic, Anti-Inflammatory, Corticosteroids

dexchlorpheniramine Antihistamines, Non-Selective

Dexedrine Appetite Suppressants, Stimulants

dexmethylphenidate Stimulants

dexrazoxane Chemotherapeutic Agents, Cytoprotectives

dextran Volume Expanders

Dextran 40 Volume Expanders

dextroamphetamine Appetite Suppressants, Stimulants

DHE-45 Ergotamine Compounds

Diabinese Diabetic Agents, Sulfonylureas

Diamox Carbonic Anhydrase Inhibitors, Diuretics

diazepam Antianxiety Agents, Anticonvulsants, Benzodiazepines, Muscle Relaxants

diazoxide Antihypertensives

dichlorphenamide Diuretics

NSAIDs

diclofenac sodium/misoprotol NSAIDs, Prostaglandin analogue

dicloxacillin Anti-Infectives, Penicillins

dicyclomine Anticholinergics

Didronel Bisphosphonates

diethylcarbamazine Anthelmintics

diethylpropion Appetite Suppressants

diethylstilbestrol (DES) Hormones & Synthetic Substitutes

Differin Acne Agents, Retinoids

Diflucan Anti-Infectives, Antifungals

diflunisal NSAIDs

digitoxin Cardiac Glycosides

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 19 Drug List

Drug Name Class

digoxin Cardiac Glycosides

dihydroergotamine Ergotamine Compounds

Dilacor Calcium Channel Blockers

Dilantin Anticonvulsants

Dilatrate Nitrates

Dilaudid Analgesics, Opiates

Dilor Bronchodilators, Xanthine Derivatives

diltiazem Calcium Channel Blockers

dinoprostone Prostaglandin analogue

Diovan Angiotensin Receptor Blocker

Dipentum Aminosalicytates (5-ASA)

diphenhydramine Antiemetics, Antihistamines

diphenoxylate/atropine loperamide Antidiarrheals

Diprolene Corticosteroids, Dermatologic Agents

Antiplatelet Agents

Disalcid NSAIDs

disopyramide Antiarrhythmics

disulfiram Alcohol Sensitizing Agent

Ditropan Anticholinergics

Diuril Diuretics, Thiazides

divalproex sodium Anticonvulsants, Mood Stabilizers

dobutamine Adrenergic Agents, Inotropic Agents, Vasopressors

Dobutrex Adrenergic Agents, Inotropic Agents, Vasopressors

docetaxel Chemotherapeutic Agents, Antmetabolite

dofetilide Antiarrhythmics

dolasteron Antiemetics, Serotonin Antagonist

Dolobid NSAIDs

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 20 Drug List

Drug Name Class

Dolophine Analgesics, Opiates

domperidone Prokinetic

donepezil Cognitive Enhancers

dopamine Adrenergic Agents, Vasopressors

Dopram Stimulants

Doral Benzodiazepines, Non-Barbiturates

Doribax Anti-Infectives, Beta-lactam

doripenem Anti-Infectives, Beta-lactam

dornase alpha Mucolytic

Doryx Anti-Infectives, Tetracyclines

Dostinex Endocrine Metobolic Agents

Dovonex Dermatologic Agents, Anti-Psoratic

doxacurium Neuromuscular Blockers

doxapram Stimulants

doxazosin Alpha-Blockers

doxepin Antianxiety Agents, Tricyclic Antidepressants

doxorubicin Anthracyclines, Chemotherapeutic Agents

doxycycline Anti-Infectives, Tetracyclines

dronabinol Antiemetics

dronedarone Antiarrhythmic

droperidol Antiemetics

Thombolytics

DTIC-Dome Alkylating Agents, Chemotherapeutic Agents

duloxetine Antidepressants, Selective Serotonin and Norepinephrine Reuptake Inhibitor (SSNRI)

DuoFilm Dermatologic Agents

DuoPlant Dermatologic Agents

Duphalac Hyperosmotic Agents, Laxatives, Synthetic Disaccharide

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 21 Drug List

Drug Name Class

Duragesic Analgesics, Opiates

Duramorph Analgesics, Opiates

Duricef Anti-Infectives, Cephalosporins

dutasteride Androgen Antagonists

Dyazide Diuretics

Dynacin Anti-Infectives, Tetracyclines

DynaCirc Calcium Channel Blockers

dyphylline Bronchodilators, Xanthine Derivatives

Dyrenium Diuretics,

Dysport Neuromuscular blockers

E.E.S. Anti-Infectives, Macrolides

Echothiophate Miotics

econazole Antifungals, Anti-Infectives

Edecrin Diuretics, Loop Diuretics

edetate disodium (EDTA) Chelating Agents

Factor Xa Inhibitor, Non-vitamin K oral anticoagulant

edrophonium Cholinergic Agents

efalizumab Immunosuppressants

Effexor Antidepressants, SNRI

Effient Inhibitor

eflornithine Dermatologic Agent

Elavil Tricyclic Antidepressants

Eldepryl Parkinson’s Agents

eletriptan Serotonin Agonists

Eleyso Enzyme replacement

Elimite Dermatologic Agents, Scabacide/Pediculoside

Elitek Chemotherapeutic Agents, Antimetabolite

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 22 Drug List

Drug Name Class

Ellence Anthracyclines, Chemotherapeutic Agents

Eloxatin Chemotherapeutic Agents, Platinum Co- ordination Complex

Elspar Chemotherapeutic Agents, Enzyme

Emcyt Alkylating Agents, Chemotherapeutic Agents

Emend Antiemetics

Eminase Thrombolytics

empaglifozin SGLT2 inhibitors

Emsam Monoamine Oxidase Inhibitors (MAOIs), Parkinson’s Agents

enalapril ACE Inhibitors

Enbrel Immunomodulators, Rheumatic Agents

Enduron Diuretics, Thiazides

enoxaparin Anticoagulants

entacapone Parkinson’s Agents

Entex LA Decongestants

Entresto Angiotensin Receptor Blocker

ephedrine Bronchodilators, Vasopressors

epinephrine Alpha-Agonists, Bronchodilators, Vasopressors

epirubicin Anthracyclines, Chemotherapeutic Agents

epoetin alfa Hematopoietic Growth Factor

Epogen Hematopoietic Growth Factor

epoprostenol Prostaglandin analogue

eprosartan Angiotensin Receptor Blocker

Antiplatelest agent, GP IIb/IIIa

Equetro Anticonvulsants, Mood Stabilizer

Eraxis Antifungals

Erbitux Chemotherapeutic Agents, Monoclonal Antibody

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 23 Drug List

Drug Name Class

Ergomar Ergotamine Compounds

ergonovine Oxytocics

Ergostat Ergotamine Compounds

ergotamine tartrate Ergotamine Compounds

ergotamine tartrate/caffeine Ergotamine Compounds

erlotinib Chemotherapeutic Agents, Epidermal Growth Factor Inhibitor

ertapenem Anti-Infectives, Carbapenems

Erythrocin Anti-Infectives, Macrolides

erythromycin Anti-Infectives, Carbapenems

erythromycin and benzoyl peroxide Acne Agents

escitalopram Antidepressants, SSRIs

Esgic Analgesics, Non-Narcotic

Esidrix Diuretics, Thiazides

Eskalith Mood Stabilizers

esmolol Antiarrhythmics, Beta-Blockers

Proton Pump Inhibitors

estazolam Benzodiazepines

Estrace Hormonal Agents

Estraderm Hormonal Agents

estramustine Alkylating Agents, Chemotherapeutic Agents

Estratab Hormonal Agents

estrogen Hormonal Agents

eszopiclone Sedatives, Non-Barbiturate

etanercept Immunomodulators, Rheumatic Agents

ethacrynic acid Diuretics, Loop Diuretics

ethambutol Anti-Infectives, Antituberculosis Agents

ethosuximide Anticonvulsants, Succinimides

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 24 Drug List

Drug Name Class

ethotoin Anticonvulsants, Hydantoins

Ethyol Chemotherapeutic Agents, Cytoprotectives

etidronate Bisphosphonates

NSAIDs

etoposide/VP-16 Chemotherapeutic Agents, Podopyllotoxin Derivatives

Eulexin Chemotherapeutic Agents, Androgen Antagonists

Evista Anti-Resorptives, Hormonal Agents

Evoxac Cholinergic Agents

Exelon Cognitive Enhancers

exenatide Diabetic Agents, Incretin Mimetic Agents, GLP-1 receptor agonists

Exubera Diabetic Agents, Insulins

ezetimibe Lipid Regulating Agents

ezetimibe/simvastatin Lipid Regulating Agents

Fabrazyme Endocrine metabolic agent

Factive Anti-Infectives, Fluroquinolones

famciclovir Anti-Herpes Agents, Anti-Infectives

GI Agent, H2 Blockers

Famvir Anti-Herpes Agents, Anti-Infectives

Fanapt Antipsychotics

Fansidar Anti-Infective, Anti-Malarials

felbamate Anticonvulsants

Felbatol Anticonvulsants

Feldene NSAIDs

felodipine Calcium Channel Blockers

fendolopam Vasoactive

fenofibrate Lipid Regulating Agents

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 25 Drug List

Drug Name Class

NSAIDs

fentanyl Analgesics, Opiates

fexofenadine Antihistamines

finasteride Androgen Antagonists

Finevin Acne Agents

Fioricet Analgesics, Non-Narcotic

Fiorinal Analgesics, Non-Narcotic

Flagyl Anti-Infectives, Amebicide, Antiprotozoals

flecainide Antiarrhythmics

Flexeril Muscle Relaxants

Flolan Prostaglandin analogue

Flomax Alpha-Blockers

Flonase Corticosteroids

Flovent Corticosteroids

Floxin Anti-Infectives, Fluroquinolones

floxuridine Chemotherapeutic Agents, Antimetabolite

fluconazole Anti-Infectives, Antifungals

flucytosine Anti-Infectives, Antifungals

Fludara Chemotherapeutic Agents, Antimetabolite

fludarabine Chemotherapeutic Agents, Antimetabolite

fludrocortisone Adrenocorticosteroid

Flumadine Anti-Infectives, Antiviral Agents

flunisolide Corticosteroids

fluorouracil/5-FU Chemotherapeutic Agents, Antimetabolite

fluoxetine Antidepressants, SSRIs

fluphenazine Antipsychotics

flurazepam Benzodiazepines

NSAIDs

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 26 Drug List

Drug Name Class

flutamide Androgen Antagonists, Chemotherapeutic Agents

fluticasone Corticosteroids

fluvastatin Lipid Regulating Agents

fluvoxamine Antidepressants, SSRIs

Focalin Stimulants

Folinic acid Antineoplastic Adjunct

Anticoagulants

Foradil Beta-Agonists, Bronchodilators

Foradil Aerolizer Beta-Agonists, Bronchodilators

formoterol Beta-Agonists, Bronchodilators

Fortaz Anti-Infectives, Cephalosporins

Forteo Parathyroid hormone

Fosamax Bisphosphonates

foscarnet Anti-Infectives, Antiviral Agents

Foscavir Anti-Infectives, Antiviral Agents

fosfomycin Anti-Infectives

fosinopril ACE Inhibitors

fosphenytoin Anticonvulsants, Hydantoins

Fragmin Anticoagulants

Frova Serotonin Agonists

frovatriptan Serotonin Agonists

FUDR Chemotherapeutic Agents, Antimetabolite

Fulvicin Anti-Infectives, Antifungals

Fungizone Anti-Infectives, Antifungals

furazolidone Anti-Infectives, Antiprotazoans

furosemide Diuretics, Loop Diuretics

Furoxone Anti-Infectives, Antiprotazoans

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 27 Drug List

Drug Name Class

fusidic acid Anti-Infectives

gabapentin Anticonvulsants, Mood Stabilizers

Gabitril Anticonvulsants

galantamine Cognitive Enhancers

gamma-globulin Immunomodulators

Gammar-P.I.V. Immunomodulators

ganciclovir Anti-Infectives, Antiviral Agents

gefitinib Chemotherapeutic Agents, Epidermal Growth Factor Inhibitor

gemcitabine Chemotherapeutic Agents, Antimetabolite

gemfibrozil Lipid Regulating Agents

gemifloxacin Anti-Infectives, Fluroquinolones

gemtuzumab Chemotherapeutic Agents, Monoclonal Antibody

Gemzar Chemotherapeutic Agents, Antimetabolite

gentamicin Aminoglycosides, Anti-Infectives

Gentran 40 Volume Expanders

Gentran 70 Volume Expanders

Geodon Antipsychotics

glatiramer acetate Immunomodulators, Immunosupressants

Gleevec Chemotherapeutic Agents, Protein-Tyrosine Kinase Inhibitor

Diabetic Agents, Sulfonylureas

glipizide Diabetic Agents, Sulfonylureas

glipizide/metformin Diabetic Agents

Glucophage Diabetic Agents, Biguanides

Glucotrol Diabetic Agents, Sulfonylureas

Glucovance Diabetic Agents

glyburide Diabetic Agents, Sulfonylureas

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 28 Drug List

Drug Name Class

glyburide/metformin Diabetic Agents

glycerin suppository Laxatives

GlycoLax Laxatives

glycopyrrolate Anticholinergics, Antispasmodics

Glynase Diabetic Agents, Sulfonylureas

Glyset Diabetic Agents, Alpha-Glucosidase Inhibitors

gold sodium thiomalate Anti-Rheumatic Agents, Gold Compounds

Go-Lytely Bowel Evacuants, Laxatives

goserelin acetate Chemotherapeutic Agents, GnRH Agonists

granisetron Antiemetics, Serotonin Antagonist

griseofulvin Anti-Infectives, Antifungals

Gris-peg Anti-Infectives, Antifungals

Antihypertensives

guanfacine Antihypertensives

Halaven Microtubule Inhibitor, Antineoplastic Agent

Halcion Benzodiazepines, Non-Barbiturates

Haldol Antipsychotics

Haldol Decanoate Antipsychotics

halobetasol Corticosteroids, Dermatologic Agents

haloperidol Antipsychotics

Healon Osteoarthritis Agents

Hemabate Prostaglandin analogue, Uterine Active Agents

Anticoagulants

Herceptin Chemotherapeutic Agents, Monoclonal Antibody

Hespan Volume Expanders

hetastarch Volume Expanders

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 29 Drug List

Drug Name Class

Hetrazan Anthelmintics

Hexalen Alkylating Agents, Chemotherapeutic Agents

Hiprex Anti-Infectives, Methenamines

Humalog Diabetic Agents, Insulins

Humira Immunomodulators, Rheumatic Agents

Humulin Diabetes Agents, Insulins

Hyalgan Osteoarthritis Agents

Hycamtin Chemotherapeutic Agents, DNA Topoisomerase Inihibitors

hydralazine Antihypertensives, Vasodilators

Hydrea Chemotherapeutic Agents, Ureas

hydrochlorothiazide Diuretics, Thiazides

hydrocodone w/ APAP Analgesics, Opiates

hydrocodone/acetaminophen Analgesics, Opiates

Hydrocortone (hydrocortisone) Corticosteroids

HydroDIURIL Diuretics, Thiazides

hydromorphone Analgesics, Opiates

Hydropres Antihypertensives

hydroxychloroquine Anti-Infectives, Anti-Malarials, Rheumatic Agents

hydroxyurea Chemotherapeutic Agents, Ureas

hydroxyzine Antianxiety Agents, Antiemetics, Antihistamines

Hygroton Diuretics, Thiazides

hylan G-F 20 Osteoarthritis Agents

hyoscyamine Anticholinergics

Hyperstat Antihypertensives

Hytrin Alpha-Blockers

ibandronate sodium Bisphosphonates

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 30 Drug List

Drug Name Class

ibritumomab Chemotherapeutic Agents, Monoclonal Antibody

ibutilide Antiarrhythmics

idarubicin Anthracyclines, Chemotherapeutic Agents

Ifex Alkylating Agents, Chemotherapeutic Agents

ifosfamide Alkylating Agents, Chemotherapeutic Agents

Iletin II Diabetic Agents, Insulins

iloperidone Antipsychotics

Prostaglandin Analogue, Vasodilators

imatinib Chemotherapeutic Agents, Protein-Tyrosine Kinase Inhibitor

imipenem/cilastatin Anti-Infectives, Carbapenems

imipramine Tricyclic Antidepressants

imiquimod Dermatologic Agents, Immunomodulators

Imitrex Serotonin Agonists

Imodium Anti-diarrheal

Imotil Anti-diarrheal

Imuran Immunosuppressants

inamrinone Inotropic Agents

Inapsine Antiemetics

indapamide Diuretics, Thiazides

Inderal Beta-Blockers

indinavir Protease inhibitor

Indocin NSAIDs

indomethacin NSAIDs

Infergen Immunomodulators

infliximab Immunomodulators, Rheumatic Agents

Innohep Anticoagulants

Inocor Inotropene Vasodilator

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 31 Drug List

Drug Name Class

insulin Diabetic Agents, Insulins

insulin aspart Diabetic Agents, Insulins

insulin aspart protamine and insulin aspart Diabetic Agents, Insulins

insulin detemir Diabetic Agents, Insulins

insulin glargine Diabetic Agents, Insulins

insulin glulisine Diabetic Agents, Insulins

insulin lispro Diabetic Agents, Insulins

insulin lispro protamine and insulin lispro Diabetic Agents, Insulins

Intal Antiallergic, Asthma Agents, Mast Cell Stabilizer

Integrilin Antiplatelet Agents

interferon alfa-2b/ribavirin Immunomodulators

interferon alfa-N3 Immunomodulators

interferon alpha-2a Immunomodulators

interferon alpha-2b Immunomodulators

interferon alphacon-1 Immunomodulators

interferon beta 1-b Immunomodulators

interferon beta-1A Immunomodulators

interferon gamma-1b Immunomodulators

Intron A Immunomodulators

Invanz Anti-Infectives, Carbapenems

Invega Antipsychotics, Benzisoxazole Derivative

iodine Anti-Infectives

Iodopen Fluid and Electrolyte Replacement

iodoquinol Amebicide, Anti-Infectives

Ionamin Appetite Suppressants

ipecac Emetics

ipratropium bromide Anticholinergics, Bronchodilators

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 32 Drug List

Drug Name Class

irbesartan Angiotensin Receptor Blocker

Iressa Chemotherapeutic Agents, Epidermal Growth Factor Inhibitor

irinotecan Chemotherapeutic Agents, DNA Topoisomerase Inihibitors

Isentress Integrase inhibitor

Ismo Nitrates

isoetharine Bronchodilators

isometheptene/dichloralphenazone/acetaminophen Analgesics

Anti-Infectives, Antituberculosis Agents

isoproterenol Adrenergic Agents, Bronchodilators, Vasopressors

Isoptin Calcium Channel Blockers

IsoptoCarpine Cholinergic Agents

Isordil Nitrates

isosorbide dinitrate Nitrates

isosorbide mononitrate Nitrates

isotretinoin Acne Agents, Retinoids

isoxsuprine Vasodilators

isradipine Calcium Channel Blockers

Isuprel Adrenergic Agents, Bronchodilators, Vasopressors

itraconazole Anti-Infectives, Antifungals

ivermectin Anthelmintics, Anti-Infectives

Ixempra Microtubule Inhibitor, Antineoplastic Agent

Jadelle Hormonal Agents

Januvia Incretin

Jevtana Taxane, Antineoplastic Agent

kanamycin Aminoglycosides, Anti-Infectives

Kantrex Aminoglycosides, Anti-Infectives

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 33 Drug List

Drug Name Class

Kaochlor 10% Fluid and Electrolyte Replacement

Keflex Anti-Infectives, Cephalosporins

Kefzol Anti-Infectives, Cephalosporins

Kemadrin Anticholinergics, Parkinson’s Agents

Kemstro Muscle Relaxants

Keppra Anticonvulsants

Kerlone Beta-Blockers

Ketek Anti-Infectives, Ketolides

ketoconazole Anti-Infectives, Antifungals

Analgesics, NSAIDs

Kineret Immunomodulators, Rheumatic Agents

Klonopin Antianxiety Agents, Anticonvulsants, Benzodiazepines

Kwell Dermatologic Agents, Scabicies/Pediculosides

Kytril Antiemetics, Serotonin Antagonist

Lornithine Laspartate (LOLA) amino acid supplement

labetalol Beta-Blockers

Lactugal Laxatives, Synthetic Disaccharide

lactulose Laxatives, Synthetic Disaccharide

Lamictal Anticonvulsants, Mood Stabilizers

Lamisil Anti-Infectives, Antifungals

lamotrigine Anticonvulsants, Mood Stabilizers

Laniazid Anti-Infectives, Antituberculosis Agents

Lanoxin Cardiac Glycosides

Proton Pump Inhibitors

Lantus Insulins

Lariam Anti-Infectives, Anti-Malarials

Larodopa Parkinson’s Agents

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 34 Drug List

Drug Name Class

Lasix Diuretics, Loop Diuretics

Latuda Antipsychotic

leflunomide Immunomodulators, Rheumatic Agents

Lente Anti-Diabetic Agents, Insulins

Lescol Lipid Regulating Agents

leucovorin Chemotherapeutic Agents, Vitamins, Antineoplastic Adjunct

leucovorin calcium Chemotherapeutic Agents, Vitamins

Leukeran Alkylating Agents, Chemotherapeutic Agents

leuprolide acetate GnRH Agonists

Leustatin Chemotherapeutic Agents, Antimetabolite

levabuterol hydrochloride Beta-Agonists, Bronchodilators

levamisole Chemotherapeutic Agents

Levaquin Anti-Infectives, Fluroquinolones

Levatol Beta-Blockers

Levemir Anti-Diabetic Agents, Insulins

levetiracetam Anticonvulsants

Levitra Impotence Agents

levodopa Parkinson’s Agents

Levo-Dromoran Analgesics, Opiates

levofloxacin Anti-Infectives, Fluroquinolones

levonorgestrel Hormonal Agents

Levophed Adrenergic Agents, Vasopressors

levorphanol Analgesics, Opiates

Levothroid Thyroid Agents

levothyroxine sodium Thyroid Agents

Levoxyl Thyroid Agents

Levsin Anticholinergics

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 35 Drug List

Drug Name Class

Levsinex Anticholinergics

Lexapro Antidepressants, SSRIs

Librium Antianxiety Agents, Benzodiazepines

lidocaine Anesthetics, Local; Antiarrhythmics

linagliptin DPP-4 inhibitors

Lincocin Anti-Infectives, Lincosamides

lincomycin Anti-Infectives, Lincosamides

lindane Dermatologic Agents, Scabicies/Pediculosides

linezolid Anti-Infectives, Oxazolidinones

Lioresal Muscle Relaxants

liothyronine Thyroid Agents

liotrix Thyroid Agents

Lipitor Lipid Regulating Agents

lisdexamfetamine dimesylate Stimulants

lisinopril ACE Inhibitors

lithium Mood Stabilizers

Lithobid Mood Stabilizers

Lithonate Mood Stabilizers

lixisenatide GLP-1 receptor agonists

Lo/Ovral Hormonal Agents, Oral Contraceptive

Loestrin Hormonal Agents, Oral Contraceptive

Lomotil Antidiarrheals

lomustine Alkylating Agents, Chemotherapeutic Agents

Loniten Antihypertensives, Vasodilators

loperamide Anti-diarrheal

Lopid Lipid Regulating Agents

Lopressor Beta-Blockers

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 36 Drug List

Drug Name Class

Lopurin Anti-Gout Agents

lorazepam Antianxiety Agents, Anticonvulsants, Benzodiazepines

Lortab Analgesics, Opiates

losartan Angiotensin Receptor Blocker

Lotensin ACE Inhibitors

lovastatin Lipid Regulating Agents

Lovenox Anticoagulants

loxapine Antipsychotics

Loxitane Antipsychotics

Lozol Diuretics, Thiazides

Lufyllin Bronchodilators, Xanthines

Lunesta Sedatives, Non-Barbiturate

Lupron GnRH Agonists

lurasidone Antipsychotic

Luvox Antidepressants

Lyrica Anticonvulsants

Lysodren Chemotherapeutic Agents

Macrodantin Anti-Infectives, Nitrofurans

mafenide acetate Anti-Infectives

magnesium chloride (MgCl) Fluid and Electrolyte Replacement, Minerals

magnesium citrate, magnesium hydroxide Laxatives

Magnesium sulfate Fluid and Electrolyte Replacement, Minerals, Tocolytics

mannitol Diuretics, Osmotic Diuretics

maprotiline Antidepressants

maraviroc CCR5 Entry Inhibitors

Marax Bronchodilators

Marcaine Anesthetics, Local

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 37 Drug List

Drug Name Class

Marinol Antiemetics

Matulane Chemotherapeutic Agents, Methylhydrazine Derivatives

Mavik ACE Inhibitors

Maxair Beta-Agonists, Bronchodilators

Maxalt Serotonin Agonists

Maxipime Anti-Infectives, Cephalosporins

Maxzide Diuretics

Mebaral Anticonvulsants, Sedatives, Barbiturates

mebendazole Anthelmintics, Anti-Infectives

mechlorethamine Alkylating Agents, Chemotherapeutic Agents

meclizine Antiemetics, Antihistamines

meclofenamate NSAIDs

medroxyprogesterone Hormonal Agents

NSAIDs

mefloquine Anti-Infectives, Anti-Malarials

Mefoxin Anti-Infectives, Cephalosporins

NSAIDs

melphalan Alkylating Agents, Chemotherapeutic Agents

memantine Cognitive Enhancers

Menest Hormonal Agents

meperidine Analgesics, Opiates

mephobarbital Anticonvulsants, Barbiturates, Sedatives

mepivacaine Anesthetics, Local

Mepron Anti-Infectives, Anti-Malarials

mercaptopurine Chemotherapeutic Agents, Antimetabolite

Meridia Appetite Suppressants

meropenem Anti-Infectives, Carbapenems

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 38 Drug List

Drug Name Class

Merrem Anti-Infectives, Carbapenems

mesalamine Aminosalicytates (5-ASA)

mesna Chemotherapeutic Agents, Cytoprotectives

Mesnex Chemotherapeutic Agents, Cytoprotectives

Mestinon Cholinergic Agents

Metadate Stimulants

Metaglip Diabetic Agents

metaproterenol Beta-Agonists

metaraminol Adrenergic Agents, Vasopressors

metaxalone Muscle Relaxants,

metformin Diabetic Agents, Biguanides

methacholine Cholinergic Agents

methadone Analgesics, Opiates

Methadose Analgesics, Opiates

methamphetamine Stimulants

methamphetamine hydrochloride CNS Stimulants

methenamine Anti-Infectives, Methanamines

Methergine Oxytocics

methicillin Anti-Infectives, Penicillins

methimazole Thyroid Antagonists

methocarbamol Muscle Relaxants

methotrexate Chemotherapeutic Agents, Folic Acid Antagonists

methsuximide Anticonvulsants

methyclothiazide Diuretics, Thiazides

methylcellulose Laxatives

methyldopa Antihypertensives

methylene blue Monoamine Oxidase Inhibitors

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 39 Drug List

Drug Name Class

methylergonovine Oxytocics

methylphenidate Stimulants

methylprednisolone Corticosteroids

metoclopramide Antiemetics, Prokinetic Agents

metolazone Diuretics, Thiazides

metoprolol Beta-Blockers

metproterenol Bronchodilators

metronidazole Amebicide, Anti-Infectives, Antiprotozoals

Mevacor Lipid Regulating Agents

mexiletine Antiarrhythmics

Mexitil Antiarrhythmics

Miacalcin Anti-Resorptives

micafungin Anti-Infectives, Antifungals

Micardis Angiotensin Receptor Blocker

miconazole Anti-Infectives, Antifungals

Micronase Diabetic Agents, Sulfonylureas

Midamor Diuretics

midazolam Benzodiazepines

midodrine HCL Antihypotensive, Vasopressor

Midrin Analgesics

Mifeprex Antiprogestin

Antiprogestin

miglitol Diabetic Agents, Alpha-Glucosidase Inhibitors

Migranal Ergotamine Compounds

milnacipran Anti-depressant

milrinone Inotropic Agents

Minipress Alpha-Blockers, Antihypertensives

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 40 Drug List

Drug Name Class

Minirin Hormonal Agents

Minocin Anti-Infectives, Tetracyclines

minocycline Anti-Infectives, Tetracyclines

minoxidil Antihypertensives, Dermatologic Agents, Vasodilators

Mintezol Anthelmintics, Anti-Infectives

MiraLax Bowel Evacuants, Laxatives

Mirapex Parkinson’s Agents

Mircette Hormonal Agents, Oral Contraceptive

Mirena Hormonal Agents

mirtazapine Antidepressants

Prostaglandin analogue

Mithracin Chemotherapeutic Agents

mitomycin Antibiotics, Chemotherapeutic Agents

mitotane Chemotherapeutic Agents

mitoxantrone Anthracenediones, Chemotherapeutic Agents, Immunomodulators

Mivacron Neuromuscular Blockers

mivacurium Neuromuscular Blockers

Moban Antipsychotics

Mobic NSAIDs

modafinil CNS Stimulants

Modicon Hormonal Agents, Oral Contraceptive

moexipril ACE Inhibitors

molindone Antipsychotics

Monistat Anti-Infectives, Antifungals

Monodox Anti-Infectives, Tetracyclines

Monoket Nitrates

Monopril ACE Inhibitors

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 41 Drug List

Drug Name Class

montelukast Antileukotrienes

Monurol Anti-Infectives

morphine Analgesics, Opiates

Morphine Sulfate Analgesics, Opiates

Motilium Prokinetic

Motrin NSAIDs

moxifloxacin Anti-Infectives, Fluroquinolones

MS Contin Analgesics, Opiates

MSIR Analgesics, Opiates

Mucomyst Antidote for Acetaminophen Overdose, Mucolytic

Multaq Antiarrhythmic

mupirocin Anti-Infectives

muromonab-CD3 Immunosuppressants

muromonab-CN3 Immunosuppressants

Muse Impotence Agents

Mustargen Alkylating Agents, Chemotherapeutic Agents

Mutamycin Antibiotics, Chemotherapeutic Agents

Myambutol Anti-Infectives, Antituberculosis Agents

Mycamine Anti-Infectives, Antifungals

Mycobutin Anti-Infectives, Antituberculosis Agents

mycophenolate Immunosuppressants

Myleran Alkylating Agents, Chemotherapeutic Agents

Mylotarg Chemotherapeutic Agents, Monoclonal Antibody

Myobloc Neuromuscular blockers

Mysoline Anticonvulsants

NSAIDs

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 42 Drug List

Drug Name Class

N-Acetylcysteine (NAC) Antidote for Acetaminophen Overdose, Mucolytic

nadolol Beta-Blockers

nafarelin Hormonal Agents

nafcillin Anti-Infectives, Penicillins

naftifine Antifungals, Anti-Infectives

nalbuphine Analgesics, Opiates

Nalfon NSAIDs

nalidixic acid Anti-Infectives, Quinolones

naloxone Narcotic Antagonists

naltrexone Narcotic Antagonists

Namenda Cognitive Enhancers

Naprosyn NSAIDs

NSAIDs

naratriptan Serotonin Agonists

Narcan Narcotic Antagonists

Nardil Monoamine Oxidase Inhibitors (MAOIs)

Naropin Anesthetics, Local

natalizumab Immunomodulators

nateglinide Diabetic Agents, Meglitamides

Natrecor Endogenous B-type Natriuretic Peptide (hBNP), Vasodilators

Natroba pediculoside

Navane Antipsychotics

Navelbine Chemotherapeutic Agents, Antimetabolite

NebuPent Anti-Infectives, Antiprotazoans

nedocromil Antiallergic, Asthma Agents

nefazodone Antidepressants

NegGram Anti-Infectives, Quinolones

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 43 Drug List

Drug Name Class

nelarabine Chemotherapeutic Agents, DNA Demylation Agents

Nembutal Barbiturates, Sedatives

neomycin Aminoglycosides, Anti-Infectives

Neoral Immunosuppressants

Neosar Alkylating Agents, Chemotherapeutic Agents

Cholinergic Agents

Nesacaine Anesthetics, Local

nesiritide Endogenous B-type Natriuretic Peptide (hBNP), Vasodilators

Neulasta Colony Stimulating Factor

Neupogen Colony Stimulating Factor

Neurontin Anticonvulsants, Mood Stabilizers

NeuTrexin Anti-infectives, Folate Antagonist

Nexium Proton Pump Inhibitors

niacin Lipid Regulating Agents

niacin/lovastatin Lipid Regulating Agents

niacinamide Nutritional supplements, Vitamins

Niaspan Lipid Regulating Agents

nicardipine Calcium Channel Blockers

nifedipine Calcium Channel Blockers

Nilandron Androgen Antagonists, Chemotherapeutic Agents

nilutamide Androgen Antagonists, Chemotherapeutic Agents

Nimbex Neuromuscular Blockers

nimodipine Calcium Channel Blockers

Nipent Chemotherapeutic Agents, Purine Anologs

Nipride Antihypertensives

nisoldipine Calcium Channel Blockers

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 44 Drug List

Drug Name Class

nitrazepam Anti-Anxiety Agents, Anticonvulsants

Nitro-Bid Nitrates, Vasoactive (IV)

Nitro-Dur Nitrates

nitrofurantoin Anti-Infectives, Nitrofurans

nitroglycerin (IV) Nitrates, Vasoactive (IV)

Nitropress Antihypertensives

nitroprusside Antihypertensives

Nitrostat Nitrates

Nix Dermatologic Agents, Scabicies/Pediculosides

Nizoral Anti-Infectives, Antifungals

Nolahist Antihistamines, Piperidines, Non-Selective

norepinephrine Adrenergic Agents, Vasopressors

Norflex Muscle Relaxants, Parkinson’s Agents

norfloxacin Anti-Infectives, Fluroquinolones

Norinyl Hormonal Agents, Oral Contraceptive

Normodyne Beta-Blockers

Noroxin Anti-Infectives, Fluroquinolones

Norpace Antiarrhythmics

Norplant Hormonal Agents

Norpramin Tricyclic Antidepressants

nortriptyline Tricyclic Antidepressants

Norvasc Calcium Channel Blockers

Novantrone Anthracenediones, Chemotherapeutic Agents, Immunomodulators

Novocain Anesthetics, Local

Novolin Diabetic Agents, Insulins

NovoLog Diabetic Agents, Insulins

NPH Diabetic Agents, Insulins

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 45 Drug List

Drug Name Class

Nubain Analgesics, Opiates

Numorphan Analgesics, Opiates

Nuprin NSAIDs

nystatin Anti-Infectives, Antifungals

octreotide Antidiarrheals, Hormonal Agents

ondanestron Antiemetics, Serotonin Antagonist

ofloxacin Anti-Infectives, Fluroquinolones

Ogen Hormonal Agents

OKT3 Immunosupressant

olanzapine Antipsychotics

Oleptro Antidepressants

olmesartan Angiotensin Receptor Blocker

olsalazine Aminosalicytates (5-ASA)

omalizumab Monoclonal antibodies

PPI Inhibitor

Omnicef Anti-Infectives, Cephalosporins

Oncaspar Chemotherapeutic Agents,

ondanestron Antiemetics, Serotonin Antagonist

Ontak Biological Response Modifiers, Chemotherapeutic Agents

Oramorph Analgesics, Opiates

Orap Antipsychotics

Orasone Corticosteroids

Orencia Immunomodulators

Orinase Diabetic Agents, Sulfonylureas

orphenadrine Muscle Relaxants

orphenadrine citrate Muscle Relaxants

Ortho-Cept Hormonal Agents, Oral Contraceptive

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 46 Drug List

Drug Name Class

Ortho-Novum Hormonal Agents, Oral Contraceptive

Ortho-Tricyclen Hormonal Agents, Oral Contraceptive

oseltamivir Anti-Viral

Osmitrol Diuretics, Osmotic Diuretics

Ovide pediculoside

oxacillin Anti-Infectives, Penicillins

oxaliplatin Chemotherapeutic Agents, Platinum Co- ordination Complex

NSAIDs

oxazepam Antianxiety Agents, Benzodiazepines

oxcarbazepine Anticonvulsants

oxybutynin Anticholinergics

oxycodone Analgesics, Opiates

oxycodone/acetaminophen Analgesics

oxycodone/aspirin Analgesics

OxyContin Analgesics, Opiates

oxymetazoline Decongestants, Ophthalmics

oxymorphone Analgesics, Opiates

oxytetracycline Anti-Infectives, Tetracyclines

Oxytocics

Pacerone Antiarrhythmics

paclitaxel Chemotherapeutic Agents, Antimetabolite

paliperidone Antipsychotics

palonosetron Antiemetics

Pamelor Tricyclic Antidepressants

pamidronate Bisphosphonates

pancuronium Neuromuscular Blockers

panitumumab Chemotherapeutic Agents, Monoclonal Antibody

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 47 Drug List

Drug Name Class

Panretin Dematological Agents, Retinoids

Proton Pump Inhibitors

papaverine Vasodilators

Paraflex Muscle Relaxants

Parafon Forte DSC Muscle Relaxants

Paraplatin Chemotherapeutic Agents, Platinum Co- ordination Complex

Paregoric Antidiarrheals, Neonatal Drug Withdrawal Therapy (Off Label)

Parlodel Parkinson’s Agents

Parnate Monoamine Oxidase Inhibitors (MAOIs)

paromomycin Amebicide, Anti-Infectives

paroxetine Antidepressants, SSRIs

Paxil Antidepressants, SSRIs

PBZ Antihistamines

Pediapred Corticosteroids

Peganone Anticonvulsants, Hydantoins

pegaspargase Chemotherapeutic Agents, Enzymes

Pegasys Immunomodulators

peginterferon alfa-2a Immunomodulators

peginterferon alfa-2B Immunomodulators

PEG-Intron Immunomodulators

pemetrexed Chemotherapeutic Agents, Antimetabolite

Pen VK Anti-Infectives, Penicillins

penbutolol Beta-Blockers

penicillamine Rheumatic Agents

penicillin G Anti-Infectives, Penicillins

penicillin V potassium Anti-Infectives, Penicillins

Pentam Anti-Infectives, Antiprotazoans

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 48 Drug List

Drug Name Class

pentamidine Anti-Infectives, Antiprotazoans

Pentasa Aminosalicytates (5-ASA)

pentazocine Analgesics, Opiates

pentobarbital Anticonvulsants, Barbiturates, Sedatives

pentostatin Chemotherapeutic Agents, Antimetabolite

pentoxifylline Hematologic Agents

Percocet Analgesics, Opiates

Percodan Analgesics, Opiates

Periactin Antihistamines, Non-Selective, Piperidine

Peri-Colace Laxatives

perindopril ACE Inhibitors

Perjeta HER-2 Receptor Antagonist

permethrin Dermatologic Agents, Scabicies/Pediculosides

perphenazine Antipsychotics

Persantine Antiplatelet Agents

Pexeva Antidepressants, SSRIs

phenazopyridine Urogesic

phenelzine Monoamine Oxidase Inhibitors (MAOIs)

Phenergan Antiemetics, Antihistamines

phenindamine Antihistamines, Piperidines, Non-Selective

phenobarbital Anticonvulsants, Barbiturates, Sedatives

phenoxybenzamine Antihypertensives

phentermine hydrochloride Appetite Suppressants

phentolamine Antihypertensives

phenylephrine Adrenergic Agents, Alpha-Agonists, Vasopressors

phenylephrine/guaifenesin Decongestants

phenytoin Anticonvulsants

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 49 Drug List

Drug Name Class

phospholine iodine Miotics

Cholinergic Agents

Pilocar Cholinergic Agents

Cholinergic Agents

pimecrolimus Calcineurin Inhibitors

pimozide Antipsychotics

pindolol Beta-Blockers

pioglitazone Diabetic Agents, Thiazolidinediones

pioglitazone/metformin Diabetic Agents, Thiazolidinediones

piperacillin Anti-Infectives, Extended Spectrum Penicillins

piperacillin/tazobactam Anti-Infectives, Extended Spectrum Penicillins

pirbuterol Beta-Agonists, Bronchodilators

NSAIDs

pirubuterol Beta-Agonists, Bronchodilators

Pitocin Oxytocics

Pitressin Hormonal Agents

Plan B Hormonal Agents

Plaquenil Anti-Infectives, Anti-Malarials, Rheumatic Agents

Plasmanate Volume Expanders

Plasma-Plex Volume Expanders

Platinol Chemotherapeutic Agents, Platinum Co- ordination Complex

Plavix Antiplatelet Agents

Plendil Calcium Channel Blockers

Pletal Antiplatelet Agents

Podoben Dermatologic Agents, Destructive Agents

Podocon Dermatologic Agents, Destructive Agents

podofilox Dermatologic Agents, Destructive Agents

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 50 Drug List

Drug Name Class

Podofin Dermatologic Agents, Destructive Agents

podophyllin Dermatologic Agents, Destructive Agents

podophyllum Dermatologic Agents, Destructive Agents

Polaramine Antihistamines

polyethylene glycol-electrolyte solution Bowel Evacuants, Laxatives

Polymixin B Anti-Infectives

polymyxin Anti-Infectives

polythiazide Diuretics, Thiazides

Ponstel NSAIDs

Pontocaine Anesthetics, Local

potassium acetate Fluid and Electrolyte Replacement

potassium chloride Fluid and Electrolyte Replacement

potassium iodide Thyroid Antagonists

pramipexole Parkinson’s Agents

pramlintide Diabetic Agents, Amylin Analogs

Prandin Diabetic Agents, Meglitanides

Platelet Inhibitor

Pravachol Lipid Regulating Agents

pravastatin Lipid Regulating Agents

praziquantel Anthelmintics, Anti-Infectives

prazosin Alpha-Blockers

Precose Alpha-Glucosidase Inhibitors, Diabetic Agents

PredForte Corticosteroids

prednisolone Corticosteroids

prednisone Corticosteroids

pregabalin Anticonvulsants

Prevacid Proton Pump Inhibitors

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 51 Drug List

Drug Name Class

Prilosec PPI Inhibitor

Primacor Inotropic Agents

primaquine Anti-Infectives, Anti-Malarials

Primaxin Anti-Infectives, Carbapenems

primidone Anti-Anxiety Agents, Anticonvulsants

Principen Anti-Infectives, Penicillins

Prinivil ACE Inhibitors

Prioderm pediculoside

Pristiq Antidepressants, Serotonin Norepinephrine Reuptake Inhibitors (SNRI)

Pro-Banthine Anticholinergics

probenecid Anti-Gout Agents, Uricosuric Agents

procainamide Antiarrhythmics

procaine Anesthetics, Local

procarbazine Chemotherapeutic Agents, Methylhydrazine Derivatives

Procardia Calcium Channel Blockers

prochlorperazine Antiemetics, Neuroleptic

Procrit Hematopoietic Growth Factor

procyclidine Anticholinergics, Parkinson’s Agents

Progestasert Contraceptive, Hormonal Agents, Intruterine Progesterone

progesterone Hormonal Agents

progestin Hormonal Agents

Prograf Immunosuppressants

Proleukin Biological Response Modifiers, Chemotherapeutic Agents

Prolia RANK Ligand Inhibitor

Prolixin Antipsychotics

promethazine Antiemetics, Antihistamines

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 52 Drug List

Drug Name Class

Prometrium Hormonal Agents

Pronestyl Antiarrhythmics

propafenone Antiarrhythmics

propantheline Anticholinergics

Propecia Androgen Antagonists

propranolol Beta-Blockers

propylthiouracil (PTU) Thyroid Antagonists

Proscar Androgen Antagonists

Synthetic Prostaglandin

Prostacyclin Flolan Synthetic Prostaglandin

Prostigmin Cholinergic Agents

Protenate Volume Expanders

Protonix Proton Pump Inhibitors

protriptyline Tricyclic Antidepressants

Provenge Immunomodulator, Antineoplastic Agent

Proventil Beta-Agonists, Bronchodilators

Provocholine Cholinergic Agents

Prozac Antidepressants, SSRIs

psyllium Laxatives, Bulk Producing

Pulmozyme Mucolytic

Purinethol Chemotherapeutic Agents, Antimetabolite

pyrantel Anthelmintics, Anti-Infectives

Pyrazinamide Anti-Infectives

pyrethrin Dermatologic Agents, Scabicies/Pediculosides

Pyridium Urogesic

pyridostigmine Cholinergic Agents

pyrimethamine Anti-Infectives, Anti-Malarials

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 53 Drug List

Drug Name Class

quazepam Benzodiazepines, Non-Barbiturates

Quellada-M pediculoside

Questran Bile Acid Sequesterants, Lipid Regulating Agents

quetiapine Antipsychotics

Quibron Bronchodilators

Quinaglute Antiarrhythmics

quinapril ACE Inhibitors

Quinidex Antiarrhythmics

quinidine Antiarrhythmics

quinine Anti-Infectives, Anti-Malarials

quinupristin/dalfopristin Anti-Infectives, Streptogramins

QVAR Corticosteroids

rabeprozole Proton Pump Inhibitors

racemic epinephrine Bronchodilators

raloxifene Anti-Resorptives, Hormonal Agents

raltegravir Integrase inhibitor

ramipril ACE Inhibitors

H2 Blockers

Rapamune Immunosuppressants

Raptiva Immunosuppressants

rasagiline Monamine Oxidase-B Inhibitor

rasburicase Chemotherapeutic Agents, Antimetabolite

Razadyne Cognitive Enhancers

Rebetron Immunomodulators

Rebif Immunomodulators

Reclast Bisphosphonates

Reglan Antiemetics, Prokinetic Agents

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 54 Drug List

Drug Name Class

Regular Iletin Insulins

Relafen NSAIDs

Relpax Serotonin Agonists

Rember Monoamine Oxidase Inhibitors

Remeron Antidepressants

Remicade Immunomodulators, Rheumatic Agents

remifentanil Analgesics, Opiates

Remodulin Synthetic Prostaglandin

Renese Diuretics, Thiazides

Renova Dematologic Agents, Retinoids

ReoPro Antiplatelet Agents

repaglinide Diabetic Agents, Meglitanides

Requip Parkinson’s Agents

reserpine Antihypertensives

Restasis Immunosuppressants

Restoril Benzodiazepines, Sedatives, Non-Barbiturate

retapamulin Anti-Infectives

Retavase Thrombolytics, Tissue Plasminogen Activators

Thrombolytics, Tissue Plasminogen Activators

Retin-A Dermatologic Agents, Retinoids

retinoic acid (isotretinoin) Dermatologic Agents, Retinoids

Retrovir Anti-Infectives, Antiretroviral, NRTI

ReVia Narcotic Antagonists

Revlimid Immunomodulators

Reyataz Protease inhibitor

Rhinocort Corticosteroids

ribavirin Anti-Infectives, Antiviral Agents

Ridaura Anti-Rheumatic Agents, Gold Compounds

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 55 Drug List

Drug Name Class

rifabutin Anti-Infectives, Antituberculosis Agents

Rifadin Anti-Infectives, Antituberculosis Agents

rifampin Anti-Infectives, Antituberculosis Agents

rifaximin Antibiotic

Rilutek ALS Agents

riluzole ALS Agents

rimabotulinumtoxin B Neuromuscular blockers

rimantadine Anti-Infectives, Antiviral Agents

Ringer’s injection, lactated Volume Expanders

Ringer’s lactate solution Volume Expanders

risendronate Bisphosphonates

Risperdal Antipsychotics

risperidone Antipsychotics

Ritalin Stimulants

ritodrine Tocolytics

Rituxan Neuromuscular Blockers

rituximab Monoclonal Antibody

Non-vitamin K oral anticoagulant

rivastigmine Cognitive Enhancers

rizatriptan Serotonin Agonists

Robaxin Muscle Relaxants

Robinul Anticholinergics

Rocephin Anti-Infectives, Cephalosporins

rocuronium Neuromuscular Blockers

Rogaine Dermatologic Agents

ropinirole Parkinson’s Agents

ropivacaine Anesthetics, Local

rosiglitazone Diabetic Agents, Thiazolidinediones

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 56 Drug List

Drug Name Class

rosuvastatin Lipid Regulating Agents

Rovamycin Antibiotic

Rowasa Aminosalicytates (5-ASA)

Roxanol Analgesics, Opiates

Roxicet Analgesics, Opiates

Roxicodone Analgesics, Opiates

Rt-PA Thrombolytic Agent

Rubex Antracyclines, Chemotherapeutic Agents

Rythmol Antiarrhythmics

Dermatologic Agents, Keratolytic Agents

salmeterol Beta-Agonists, Bronchodilators

salmeterol/fluticasone Anti-Inflammatory, Beta-Agonists

NSAIDs

Sandimmune Immunosuppressants

Sandostatin Antidiarrheals, Hormonal Agents

Saphris Antipsychotics

Savella Anti-depressant

saxagliptin DPP-4 inhibitors

scopolamine Anticholinergics, Antiemetics

scopolamine/hyoscine Anticholinergics

secobarbital Barbiturates, Sedatives

Seconal Barbiturates, Sedatives

Sectral Beta-Blockers

selegiline Monoamine Oxidase Inhibitors (MAOIs), Parkinson’s Agents

sulfide Dermatologic Agents, Anti-Psoratic

Selzentry CCR5 Entry Inhibitors

Sensorcaine Anesthetics, Local

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 57 Drug List

Drug Name Class

Septra Anti-Infectives

Serax Antianxiety Agents, Benzodiazepines

Serevent Beta-Agonists, Bronchodilators

Seromycin Anti-Infectives, Antituberculosis Agents

Seroquel Antipsychotics

sertraline Antidepressants, SSRIs

sibutramine Appetite Suppressants

sildenafil Impotence Agents

Silvadene Antimicrobial

Simponi Immunomodulator, Rheumatic agent

Simulect Immunosuppressants

simvastatin Lipid Regulating Agents

Sinemet Parkinson’s Agents

Sinequan Antianxiety Agents, Tricyclic Antidepressants

Singulair Antileukotrienes

sirolimus Immunosuppressants

sitigliptin Incretin

Skelaxin Muscle Relaxants

Skelid Bisphosphonates

Slo-Niacin Lipid Regulating Agents

Slow-Mag Fluid and Electrolyte Replacement

sodium acetate Fluid and Electrolyte Replacement

sodium bicarbonate Fluid and Electrolyte Replacement

sodium chloride 0.45%/0.9% Fluid and Electrolyte Replacement, Volume Expanders

sodium chloride 3% hypertonic Fluid and Electrolyte Replacement, Volume Expanders

sodium hyaluronate Osteoarthritis Agents

sodium oxybate CNS depressant

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 58 Drug List

Drug Name Class

sodium phosphate Fluid and Electrolyte Replacement

sodium phosphates Laxatives

sodium sulfacetamide Acne Agents, Dermatologic Agents

Solfoton Anticonvulsants, Barbiturates, Sedatives

Solganal Anti-Rheumatic Agents, Gold Compounds

Solu-Cortef Corticosteroids

Solu-Medrol Corticosteroids

Soma Muscle Relaxants

somastatin Antidiarrheals, Hormonal Agents

Sonata Sedatives, Non-Barbiturate

sorbitol Laxatives

Sorbitrate Nitrates

sotalol Beta-Blockers

spectinomycin Anti-Infectives

Spectracef Anti-Infectives

spiramycin Antibiotic

Spiriva Anticholingerics, Bronchodilators

spironolactone Antihypertensives, Diuretics

Sporanox Anti-Infectives, Antifungals

Sprycel Chemotherapeutic Agents, Protein-Tyrosine Kinase Inhibitor

SSKI Thyroid Antagonists

Stadol Analgesics, Opiates

Staphcillin Anti-Infectives, Penicillins

Starlix Diabetic Agents, Meglitanides

Stavzor Anticonvulsant, Mood Stabilizer

Stelara Monoclonal antibody

Stelazine Antipsychotics

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 59 Drug List

Drug Name Class

Stilbestrol Hormones & Synthetic Substitutes

Strattera Selective Norepinephrine Reuptake Inhibitor (SNRI)

Streptase Thrombolytics

Thrombolytics

streptomycin Aminoglycosides, Anti-Infectives

Streptomycin Sulfate Aminoglycosides, Anti-Infectives

streptozocin Alkyating Agents, Chemotherapeutic Agents

Stromectol Anthelmintics, Anti-Infectives

Sublimaze Analgesics, Opiates

Suboxone Opiate Agonist-Antagonists

Subutex Opiate Agonist-Antagonists

succinylcholine Neuromuscular Blockers, Depolarizing

Sufenta Analgesics, Opiates

sufentanil Analgesics, Opiates

Sular Calcium Channel Blockers

sulfadiazine Antimicrobial

sulfadoxine/pyrimethamine Anti-Infectives, Anti-Malarials

sulfamethoxazole Anti-Infectives

Sulfamylon Anti-Infectives

sulfanilamide Antibacterial

sulfasalazine Aminosalicytates (5-ASA)

sulfinpyrazone Uricosuric Agents

NSAIDs

sumatriptan Serotonin Agonists

Sumycin Anti-Infectives, Tetracyclines

sunitinib Chemotherapeutic Agents, Protein-Tyrosine Kinase Inhibitor

Surmontil Tricyclic Antidepressants

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 60 Drug List

Drug Name Class

Sutent Chemotherapeutic Agents, Protein-Tyrosine Kinase Inhibitor

Symbyax SSRI & Antipsychotic

Symlin Diabetic Agents, Amylin Analogs

Symmetrel Anti-Infectives, Parkinson’s Agents

Synagis Monoclonal antibody

Synarel Hormonal Agents

Synercid Anti-Infectives, Streptogramins

Synvisc Osteoarthritis Agents

tacrine Cognitive Enhancers

tacrolimus Immunosuppressants

tadalafil Impotence Agents

Tagamet Histamine receptor antagonist

Talwin Analgesics, Opiates

Tambocor Antiarrhythmics

Tamiflu Anti-Viral

tamoxifen Chemotherapeutic Agents, Hormonal Agents

tamsulosin Alpha-Blockers

Tapazole Thyroid Antagonists

Tarceva Chemotherapeutic Agents, Epidermal Growth Factor Inhibitor

Targretin Chemotherapeutic Agents, Retinoids

Tasigna Chemotherapeutic Agents, Protein-Tyrosine Kinase Inhibitor

Tasmar Parkinson’s Agents

Taxol Antimitotic Agent, Chemotherapeutic Agents

Taxotere Antimitotic Agent, Chemotherapeutic Agents

tazarotene Dermatologic Agents, Retinoids

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 61 Drug List

Drug Name Class

Tazicef Anti-Infectives, Cephalosporins

Tazidime Anti-Infectives, Cephalosporins

Tazorac Dermatologic Agents, Retinoids

Tegretol Anticonvulsants, Mood Stabilizers

telithromycin Anti-Infectives, Ketolides

telmisartan Angiotensin Receptor Blocker

temazepam Benzodiazepines, Sedatives, Non-Barbiturate

Temodar Chemotherapeutic Agents, Imidazotetrazine Derivatives

Temovate Dermatologic Agents, Anti-Inflamatory, Corticosteroids

temozolomide Chemotherapeutic Agents, Imidazotetrazine Derivatives

Thombolytics

Tenex Antihypertensives,

teniposide Chemotherapeutic Agents, Epipopophyllotoxins

Tenormin Beta-Blockers

Tensilon Cholinergic Agents

Tenuate Appetite Suppressants

terazosin Alpha-Blockers,

terbinafine Anti-Infectives, Antifungals

terbutaline Beta-Agonists, Bronchodilators, Tocolytics

teriparatide Parathyroid hormone

Terramycin Anti-Infectives, Tetracyclines

Teslac Chemotherapeutic Agents, Hormones

testolactone Chemotherapeutic Agents, Hormones

tetracaine Anesthetics, Local

tetracycline Anti-Infectives, Tetracyclines

Teveten Angiotensin Receptor Blocker

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 62 Drug List

Drug Name Class

thalidomide Immunosuppressants

Thalomid Immunosuppressants

Theo-Dur Bronchodilators

Theolair Bronchodilators

theophylline Bronchodilators

TheraCys Biological Response Modifiers, Chemotherapeutic Agents

thiabendazole Anti-Infectives, Anthelmintics

thiethylperazine Antiemetics

thioguanine Chemotherapeutic Agents, Antimetabolite

thioridazine Antipsychotics

Thiosulfil Antibacterial

thiotepa Alkyating Agents, Chemotherapeutic Agents

thiothixene Antipsychotics, Thioxanthene Derivatives

Thorazine Antiemetics, Antipsychotics

Thyroid (thyroid) Thyroid Agents

Thyrolar Thyroid Agents

tiagabine Anticonvulsants

Ticar Anti-Infectives, Extended Spectrum Penicillins

ticarcillin Anti-Infectives, Extended Spectrum Penicillins

ticarcillin/clavulante Anti-Infectives, Extended Spectrum Penicillins

Ticlid Antiplatelet Agents

Antiplatelet Agents

Tigan Antiemetics

tigecycline Anti-Infectives, Glycylcyclines

Tikosyn Antiarrhythmics

Tilade Antiallergic, Asthma Agents

tiludronate Bisphosphonates

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 63 Drug List

Drug Name Class

Timentin Anti-Infectives, Extended Spectrum Penicillins

Beta-Blockers

tincture of opium Antidiarrheals

tinzaparin Anticoagulants

tiotropium bromide Anticholingerics, Bronchodilators

Antiplatelest agent, GP IIb/IIIa

tizanidine Muscle Relaxants

TNKase Thombolytics

tobramycin Anti-Infectives, Aminoglycosides

tocainide Antiarrhythmics

Tofranil Tricyclic Antidepressants

tolazamide Diabetic Agents, Sulfonylureas

tolbutamide Diabetic Agents, Sulfonylureas

tolcapone Parkinson’s Agents

Tolectin NSAIDs

NSAIDs

tolterodine Anticholinergics

tolvaptan Vasopressin antagonists

Tonocard Antiarrhythmics

topiramate Anticonvulsants

Topomax Anticonvulsants

topotecan Chemotherapeutic Agents, DNA Topoisomerase Inihibitors

Toprol Beta-Blockers

Toradol Analgesics, NSAIDs

Torecan Antiemetics

torsemide Diuretics, Loop Diuretics

Tracrium Neuromuscular Blockers

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 64 Drug List

Drug Name Class

tramadol Analgesics

Trandate Beta-Blockers

trandolapril ACE Inhibitors

tranexamic acid Antifibrinolytic

Transderm nitro Nitrates

Transderm Scop Anticholinergics

Tranxene Benzodiazepines, Sedatives

Monoamine Oxidase Inhibitors (MAOIs)

trastuzumab Chemotherapeutic Agents, Monoclonal Antibody

trazodone Antidepressants

Trental Hematologic Agents

Prostaglandin

tretinoin Chemotherapeutic Agents, Dermatologic Agents, Retinoids

triamcinolone acetonide Corticosteroids

triamterene Diuretics

triamterene/hydrochlorothiazide Diuretics

triazolam Benzodiazepines, Non-Barbiturates

trichloroacetic acid Dermatologic Agents, Destructive Agents

TriCor Lipid Regulating Agents

TriDil

trifluoperazine Antipsychotics

trihexyphenidyl Anticholinergics, Parkinson’s Agents

Trileptal Anticonvulsants

trimethobenzamide Anti-Infectives, Antiemetics

trimethoprim Anti-Infectives, Folate Antagonist

trimethoprim-sulfamethoxazole Anti-Infectives

trimetrexate Anti-Infectives, Folate Antagonist

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 65 Drug List

Drug Name Class

trimipramine Tricyclic Antidepressants

Trimpex Anti-Infectives, Folate Antagonist

Tri-Norinyl Hormonal Agents, Oral Contraceptive

tripelennamine Antihistamines

Trobicin Anti-Infectives, Spectinomycins

tubocurarine Neuromuscular Blockers

Tygacil Anti-Infectives, Glycylclyclines

Tylenol #3 Analgesics, Opiates

Tysabri Immunomodulators

Ultiva Analgesics, Opiates

Ultralente Insulins

Ultram Analgesics

Ultravate Corticosteroids, Dermatologic Agents

Unasyn Anti-Infectives, Penicillins

Unipen Anti-Infectives, Penicillins

Uniprost Synthetic Prostaglandin

Univasc ACE Inhibitors

uracil mustard Alkyating Agents, Chemotherapeutic Agents

Urecholine Cholinergic Agents

Thrombolytic Agent

Uroxatral Alpha-Blockers

UT-15 Synthetic Prostaglandin

valacyclovir Anti-Infectives, Antiviral Agents

Valcyte Anti-Infectives, Antiviral Agents

NSAIDs

valganiciclovir Anti-Infectives, Antiviral Agents

Valium Antianxiety Agents, Anticonvulsants, Benzodiazepines, Muscle Relaxants

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 66 Drug List

Drug Name Class

valproic acid Anticonvulsants, Mood Stabilizers

valrubicin Antibiotics, Chemotherapeutic Agents

valsartan Angiotensin Receptor Blocker

valsartan/sacubitril ARNI

Valstar Antibiotics, Chemotherapeutic Agents

Valtrex Anti-Infectives, Antiviral Agents

Vancocin Anti-Infectives

vancomycin Anti-Infectives

Vanoxide-HC Acne Agents

Vantin Anti-Infectives, Cephalosporins

vardenafil HCl Impotence Agents

Vasodilan Vasodilators

vasopressin Hormonal Agents

Vasotec ACE Inhibitors

Vectibix Chemotherapeutic Agents, Monoclonal Antibody

vecuronium Neuromuscular Blockers

Velcade Chemotherapeutic Agents, Proteosome Inhibitors

Velosef Anti-Infectives, Cephalosporins

Velosulin Diabetic Agents, Insulins

venlafaxine Antidepressants, SNRI

Ventavis Prostaglandin analogue, Vasodilators

Ventolin Beta-Agonists

VePesid Chemotherapeutic Agents, Epipopophyllotoxins

verapamil Calcium Channel Blockers

Verelan Calcium Channel Blockers

Vermox Anti-Infectives, Anthelmintics

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 67 Drug List

Drug Name Class

Versed Benzodiazepines

verteporfin Opthamic Phototherapy Agents, Ophthalmics

Vesanoid Chemotherapeutic Agents, Retinoids

Vfend Anti-Infectives, Antifungals

Viagra Impotence Agents

Vibramycin Anti-Infectives, Tetracyclines

Vicodin Analgesics, Opiates

vidarabine Anti-Infectives, Antiviral Agents

Vidaza Chemotherapeutic Agents, DNA Demylation Agents

Viibryd Antidepressant

vilazodone Antidepressant

vinblastine Antimitotic Agent, Chemotherapeutic Agents

vincristine Antimitotic Agent, Chemotherapeutic Agents

vinorelbine Antimitotic Agent, Chemotherapeutic Agents

Vira-A Anti-Infectives, Antiviral Agents

Virazole Anti-Infectives, Antiviral Agents

Vistaril Antianxiety Agents, Antiemetics, Antihistamines

Visudyne Opthamic Phototherapy Agent, Ophthalmics

Vivactil Tricyclic Antidepressants

Vivelle Hormonal Agents

Vivitrol Narcotic Antagonists

Voltaren NSAIDs

voriconazole Anti-Infectives, Antifungals

Vumon Chemotherapeutic Agents, Epipopophyllotoxins

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Drug Name Class

Vytorin Lipid Regulating Agents

Vyvanse Stimulants

Anticoagulants

WelChol Lipid Regulating Agents

Wellbutrin Antidepressants

Wigraine Ergotamine Compounds

Xanax Antianxiety Agents, Benzodiazepines

Xeloda Antimetabolites, Chemotherapeutic Agents

Xgeva RANK ligand inhibitor

Xifaxan Antibiotic

Xolair Monoclonal antibodies

Xopenex Beta-Agonists, Bronchodilators

Xylocaine Antiarrhythmics, Anesthetics Local

Xyrem CNS depressant

Yasmin Hormonal Agents, Oral Contraceptive

Yodoxin Amebicide, Anti-Infectives

yohimbine Impotence Agents

zafirlukast Antileukotrienes

zaleplon Sedatives, Non-Barbiturate

Zanaflex Muscle Relaxants

Zanosar Alkyating Agents, Chemotherapeutic Agents

Zantac H2 Blockers

Zarontin Anticonvulsants, Succinimides

Zaroxolyn Diuretics, Thiazides

Zebeta Beta-Blockers

Zemuron Neuromuscular Blockers

Zenapax Immunosuppressants

Zestril ACE Inhibitors

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 69 Drug List

Drug Name Class

Zetia Lipid Regulating Agents

Zevalin Monoclonal Antibody

Ziagen Nucleoside Reverse Transcriptase Inhibitor

Zinacef Anti-Infectives, Cephalosporins

zinc pyrithione Antifungals, Anti-Infectives

Zinecard Chemotherapeutic Agents, Cytoprotectives

ziprasidone Antipsychotics

Zithromax Anti-Infectives, Macrolides

Zocor Lipid Regulating Agents

Zofran Antiemetics, Serotonin Antagonist

Zoladex GnRH Agonists

zoledronate Bisphosphonates

zoledronic acid Bisphosphonates

zolmitriptan Serotonin Agonists

Zoloft SSRIs, Antidepressants

zolpidem tartrate Sedatives, Non-Barbiturate

Zometa Bisphosphonates

Zomig Serotonin Agonists

Zonegran Anticonvulsants

zonisamide Anticonvulsants

Zostrix Osteoarthritis Agents

Zosyn Anti-Infectives, Extended Spectrum Penicillins

Zovia Hormonal Agents, Oral Contraceptive

Zovirax Anti-Infectives, Antiviral Agents

Zyloprim Anti-Gout Agents, Xanthine Oxidase Inhibitors

Zyprexa Antipsychotics

Zyrtec Antihistamines

Zyvox Anti-Infectives, Oxazolidinones

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 70 Drug List

© 2019 Change Healthcare, LLC and/or its subsidiaries. All Rights Reserved. 71