JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 1 APPENDIX A - PRODUCT NAME INDEX ** A ** ABACAVIR SULFATE, ABACAVIR SULFATE ABACAVIR SULFATE AND LAMIVUDINE, ABACAVIR SULFATE ABACAVIR SULFATE, LAMIVUDINE AND ZIDOVUDINE, ABACAVIR SULFATE ABELCET, AMPHOTERICIN B ABILIFY, ARIPIPRAZOLE ABILIFY MAINTENA KIT, ARIPIPRAZOLE ABILIFY MYCITE KIT, ARIPIPRAZOLE ABIRATERONE ACETATE, ABIRATERONE ACETATE ABLYSINOL, ALCOHOL ABRAXANE, PACLITAXEL ABREVA, DOCOSANOL (OTC) ABSORICA, ISOTRETINOIN ABSORICA LD, ISOTRETINOIN ACAMPROSATE CALCIUM, ACAMPROSATE CALCIUM ACANYA, BENZOYL PEROXIDE ACARBOSE, ACARBOSE ACCOLATE, ZAFIRLUKAST ACCRUFER, FERRIC MALTOL ACCUNEB, ALBUTEROL SULFATE ACCUPRIL, QUINAPRIL HYDROCHLORIDE ACCURETIC, HYDROCHLOROTHIAZIDE ACEBUTOLOL HYDROCHLORIDE, ACEBUTOLOL HYDROCHLORIDE ACEPHEN, ACETAMINOPHEN (OTC) ACETADOTE, ACETYLCYSTEINE ACETAMINOPHEN, ACETAMINOPHEN (OTC) ACETAMINOPHEN, ACETAMINOPHEN ACETAMINOPHEN AND CODEINE PHOSPHATE, ACETAMINOPHEN ACETAMINOPHEN, ASPIRIN AND CAFFEINE, ACETAMINOPHEN (OTC) ACETAMINOPHEN, CAFFEINE AND DIHYDROCODEINE BITARTRATE, ACETAMINOPHEN ACETAZOLAMIDE, ACETAZOLAMIDE ACETAZOLAMIDE SODIUM, ACETAZOLAMIDE SODIUM ACETIC ACID, ACETIC ACID, GLACIAL ACETIC ACID 0.25% IN PLASTIC CONTAINER, ACETIC ACID, GLACIAL ACETYLCYSTEINE, ACETYLCYSTEINE ACHROMYCIN V, TETRACYCLINE HYDROCHLORIDE ACIPHEX, RABEPRAZOLE SODIUM ACITRETIN, ACITRETIN ACTICLATE, DOXYCYCLINE HYCLATE ACTIGALL, URSODIOL ACTIQ, FENTANYL CITRATE ACTIVELLA, ESTRADIOL ACTONEL, RISEDRONATE SODIUM ACTOPLUS MET, METFORMIN HYDROCHLORIDE ACTOS, PIOGLITAZONE HYDROCHLORIDE ACULAR, KETOROLAC TROMETHAMINE ACULAR LS, KETOROLAC TROMETHAMINE ACUVAIL, KETOROLAC TROMETHAMINE ACYCLOVIR, ACYCLOVIR ACYCLOVIR SODIUM, ACYCLOVIR SODIUM ACZONE, DAPSONE ADAPALENE, ADAPALENE (OTC) ADAPALENE, ADAPALENE ADAPALENE AND BENZOYL PEROXIDE, ADAPALENE ADASUVE, LOXAPINE ADCIRCA, TADALAFIL ADDERALL XR 10, AMPHETAMINE ASPARTATE ADDERALL XR 15, AMPHETAMINE ASPARTATE ADDERALL XR 20, AMPHETAMINE ASPARTATE ADDERALL XR 25, AMPHETAMINE ASPARTATE ADDERALL XR 30, AMPHETAMINE ASPARTATE ADDERALL XR 5, AMPHETAMINE ASPARTATE ADDYI, FLIBANSERIN ADEFOVIR DIPIVOXIL, ADEFOVIR DIPIVOXIL ADEMPAS, RIOCIGUAT ADENOSINE, ADENOSINE JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 2 APPENDIX A - PRODUCT NAME INDEX ** A ** ADHANSIA XR, METHYLPHENIDATE HYDROCHLORIDE ADIPEX-P, PHENTERMINE HYDROCHLORIDE ADRENACLICK, EPINEPHRINE ADRENALIN, EPINEPHRINE ADREVIEW, IOBENGUANE SULFATE I-123 ADVAIR DISKUS 100/50, FLUTICASONE PROPIONATE ADVAIR DISKUS 250/50, FLUTICASONE PROPIONATE ADVAIR DISKUS 500/50, FLUTICASONE PROPIONATE ADVAIR HFA, FLUTICASONE PROPIONATE ADVIL, IBUPROFEN (OTC) ADVIL, IBUPROFEN SODIUM (OTC) ADVIL ALLERGY AND CONGESTION RELIEF, CHLORPHENIRAMINE MALEATE (OTC) ADVIL ALLERGY SINUS, CHLORPHENIRAMINE MALEATE (OTC) ADVIL COLD AND SINUS, IBUPROFEN (OTC) ADVIL CONGESTION RELIEF, IBUPROFEN (OTC) ADVIL DUAL ACTION WITH ACETAMINOPHEN, ACETAMINOPHEN (OTC) ADVIL LIQUI-GELS, IBUPROFEN (OTC) ADVIL MIGRAINE LIQUI-GELS, IBUPROFEN (OTC) ADVIL MULTI-SYMPTOM COLD & FLU, CHLORPHENIRAMINE MALEATE (OTC) ADVIL PM, DIPHENHYDRAMINE CITRATE (OTC) ADVIL PM, DIPHENHYDRAMINE HYDROCHLORIDE (OTC) ADZENYS ER, AMPHETAMINE ADZENYS XR-ODT, AMPHETAMINE AEMCOLO, RIFAMYCIN SODIUM AFINITOR, EVEROLIMUS AFINITOR DISPERZ, EVEROLIMUS AFIRMELLE, ETHINYL ESTRADIOL AGGRASTAT, TIROFIBAN HYDROCHLORIDE AGGRENOX, ASPIRIN AGRYLIN, ANAGRELIDE HYDROCHLORIDE AIRDUO DIGIHALER, FLUTICASONE PROPIONATE AIRDUO RESPICLICK, FLUTICASONE PROPIONATE AK-FLUOR 10%, FLUORESCEIN SODIUM AK-FLUOR 25%, FLUORESCEIN SODIUM AKBETA, LEVOBUNOLOL HYDROCHLORIDE AKLIEF, TRIFAROTENE AKOVAZ, EPHEDRINE SULFATE AKPENTOLATE, CYCLOPENTOLATE HYDROCHLORIDE AKTEN, LIDOCAINE HYDROCHLORIDE AKTOB, TOBRAMYCIN AKYNZEO, FOSNETUPITANT CHLORIDE HYDROCHLORIDE AKYNZEO, NETUPITANT ALA-CORT, HYDROCORTISONE ALA-SCALP, HYDROCORTISONE ALAVERT, LORATADINE (OTC) ALAWAY, KETOTIFEN FUMARATE (OTC) ALBENDAZOLE, ALBENDAZOLE ALBENZA, ALBENDAZOLE ALBUTEROL SULFATE, ALBUTEROL SULFATE ALBUTEROL SULFATE AND IPRATROPIUM BROMIDE, ALBUTEROL SULFATE ALCAINE, PROPARACAINE HYDROCHLORIDE ALCLOMETASONE DIPROPIONATE, ALCLOMETASONE DIPROPIONATE ALDACTAZIDE, HYDROCHLOROTHIAZIDE ALDACTONE, SPIRONOLACTONE ALDARA, IMIQUIMOD ALECENSA, ALECTINIB HYDROCHLORIDE ALENDRONATE SODIUM, ALENDRONATE SODIUM ALEVE, NAPROXEN SODIUM (OTC) ALEVE PM, DIPHENHYDRAMINE HYDROCHLORIDE (OTC) ALEVE-D SINUS & COLD, NAPROXEN SODIUM (OTC) ALFENTA, ALFENTANIL HYDROCHLORIDE ALFENTANIL, ALFENTANIL HYDROCHLORIDE ALFUZOSIN HYDROCHLORIDE, ALFUZOSIN HYDROCHLORIDE ALIMTA, PEMETREXED DISODIUM ALINIA, NITAZOXANIDE JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 3 APPENDIX A - PRODUCT NAME INDEX ** A ** ALIQOPA, COPANLISIB DIHYDROCHLORIDE ALISKIREN HEMIFUMARATE, ALISKIREN HEMIFUMARATE ALKINDI SPRINKLE, HYDROCORTISONE ALLEGRA ALLERGY, FEXOFENADINE HYDROCHLORIDE (OTC) ALLEGRA-D 12 HOUR ALLERGY AND CONGESTION, FEXOFENADINE HYDROCHLORIDE (OTC) ALLEGRA-D 24 HOUR ALLERGY AND CONGESTION, FEXOFENADINE HYDROCHLORIDE (OTC) ALLI, ORLISTAT (OTC) ALLOPURINOL, ALLOPURINOL ALLOPURINOL SODIUM, ALLOPURINOL SODIUM ALLZITAL, ACETAMINOPHEN ALMOTRIPTAN MALATE, ALMOTRIPTAN MALATE ALOCRIL, NEDOCROMIL SODIUM ALOMIDE, LODOXAMIDE TROMETHAMINE ALOPRIM, ALLOPURINOL SODIUM ALORA, ESTRADIOL ALOSETRON HYDROCHLORIDE, ALOSETRON HYDROCHLORIDE ALPHAGAN P, BRIMONIDINE TARTRATE ALPRAZOLAM, ALPRAZOLAM ALPROSTADIL, ALPROSTADIL ALREX, LOTEPREDNOL ETABONATE ALTABAX, RETAPAMULIN ALTACE, RAMIPRIL ALTAFLUOR BENOX, BENOXINATE HYDROCHLORIDE ALTAVERA, ETHINYL ESTRADIOL ALTOPREV, LOVASTATIN ALTRENO, TRETINOIN ALUNBRIG, BRIGATINIB ALVESCO, CICLESONIDE ALVIMOPAN, ALVIMOPAN ALYACEN 1/35, ETHINYL ESTRADIOL ALYACEN 7/7/7, ETHINYL ESTRADIOL ALYQ, TADALAFIL AMABELZ, ESTRADIOL AMANTADINE HYDROCHLORIDE, AMANTADINE HYDROCHLORIDE AMARYL, GLIMEPIRIDE AMBIEN, ZOLPIDEM TARTRATE AMBIEN CR, ZOLPIDEM TARTRATE AMBISOME, AMPHOTERICIN B AMBRISENTAN, AMBRISENTAN AMCINONIDE, AMCINONIDE AMELUZ, AMINOLEVULINIC ACID HYDROCHLORIDE AMERGE, NARATRIPTAN HYDROCHLORIDE AMICAR, AMINOCAPROIC ACID AMIDATE, ETOMIDATE AMIFOSTINE, AMIFOSTINE AMIKACIN SULFATE, AMIKACIN SULFATE AMILORIDE HYDROCHLORIDE, AMILORIDE HYDROCHLORIDE AMILORIDE HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, AMILORIDE HYDROCHLORIDE AMINO ACIDS, AMINO ACIDS AMINOACETIC ACID 1.5% IN PLASTIC CONTAINER, GLYCINE AMINOCAPROIC ACID, AMINOCAPROIC ACID AMINOCAPROIC ACID IN PLASTIC CONTAINER, AMINOCAPROIC ACID AMINOPHYLLINE, AMINOPHYLLINE AMINOSYN II 10% IN PLASTIC CONTAINER, AMINO ACIDS AMINOSYN II 15% IN PLASTIC CONTAINER, AMINO ACIDS AMINOSYN-PF 10%, AMINO ACIDS AMINOSYN-PF 7%, AMINO ACIDS AMIODARONE HYDROCHLORIDE, AMIODARONE HYDROCHLORIDE AMITIZA, LUBIPROSTONE AMITRIPTYLINE HYDROCHLORIDE, AMITRIPTYLINE HYDROCHLORIDE AMLODIPINE AND OLMESARTAN MEDOXOMIL, AMLODIPINE BESYLATE AMLODIPINE BESYLATE, AMLODIPINE BESYLATE AMLODIPINE BESYLATE AND ATORVASTATIN CALCIUM, AMLODIPINE BESYLATE AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE, AMLODIPINE BESYLATE AMLODIPINE BESYLATE AND VALSARTAN, AMLODIPINE BESYLATE JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 4 APPENDIX A - PRODUCT NAME INDEX ** A ** AMLODIPINE BESYLATE, VALSARTAN AND HYDROCHLOROTHIAZIDE, AMLODIPINE BESYLATE AMMONIA N 13, AMMONIA N-13 AMMONIUM CHLORIDE IN PLASTIC CONTAINER, AMMONIUM CHLORIDE AMMONIUM LACTATE, AMMONIUM LACTATE AMMONUL, SODIUM BENZOATE AMNESTEEM, ISOTRETINOIN AMONDYS 45, CASIMERSEN AMOXAPINE, AMOXAPINE AMOXICILLIN, AMOXICILLIN AMOXICILLIN AND CLAVULANATE POTASSIUM, AMOXICILLIN AMOXICILLIN PEDIATRIC, AMOXICILLIN AMOXIL, AMOXICILLIN AMPHETAMINE SULFATE, AMPHETAMINE SULFATE AMPHOTERICIN B, AMPHOTERICIN B AMPICILLIN AND SULBACTAM, AMPICILLIN SODIUM AMPICILLIN SODIUM, AMPICILLIN SODIUM AMPICILLIN TRIHYDRATE, AMPICILLIN/AMPICILLIN TRIHYDRATE AMPYRA, DALFAMPRIDINE AMRINONE LACTATE, INAMRINONE LACTATE AMRIX, CYCLOBENZAPRINE HYDROCHLORIDE AMYVID, FLORBETAPIR F-18 AMZEEQ, MINOCYCLINE HYDROCHLORIDE AN-SULFUR COLLOID, TECHNETIUM TC-99M SULFUR COLLOID KIT ANAFRANIL, CLOMIPRAMINE HYDROCHLORIDE ANAGRELIDE HYDROCHLORIDE, ANAGRELIDE HYDROCHLORIDE ANAPROX DS, NAPROXEN SODIUM ANASTROZOLE, ANASTROZOLE ANCEF IN PLASTIC CONTAINER, CEFAZOLIN SODIUM ANCOBON, FLUCYTOSINE ANDRODERM, TESTOSTERONE ANDROGEL, TESTOSTERONE ANDROID 25, METHYLTESTOSTERONE ANECTINE, SUCCINYLCHOLINE CHLORIDE ANEXSIA 5/325, ACETAMINOPHEN ANEXSIA 7.5/325, ACETAMINOPHEN ANGELIQ, DROSPIRENONE ANGIOMAX, BIVALIRUDIN ANGIOMAX RTU, BIVALIRUDIN ANJESO, MELOXICAM ANNOVERA, ETHINYL ESTRADIOL ANORO ELLIPTA, UMECLIDINIUM BROMIDE ANTABUSE, DISULFIRAM ANTARA (MICRONIZED), FENOFIBRATE ANTHELIOS 20, AVOBENZONE (OTC) ANTHELIOS 40, AVOBENZONE (OTC) ANTHELIOS SX, AVOBENZONE (OTC) ANTIVERT, MECLIZINE HYDROCHLORIDE ANUSOL HC, HYDROCORTISONE APADAZ, ACETAMINOPHEN APIXABAN, APIXABAN APLENZIN, BUPROPION HYDROBROMIDE APOKYN, APOMORPHINE HYDROCHLORIDE APRACLONIDINE HYDROCHLORIDE, APRACLONIDINE HYDROCHLORIDE APREMILAST, APREMILAST APREPITANT, APREPITANT APRISO, MESALAMINE APTENSIO XR, METHYLPHENIDATE HYDROCHLORIDE APTIOM, ESLICARBAZEPINE ACETATE APTIVUS, TIPRANAVIR AQUASOL A, VITAMIN A PALMITATE ARAKODA, TAFENOQUINE SUCCINATE ARANELLE, ETHINYL ESTRADIOL ARAVA, LEFLUNOMIDE ARAZLO, TAZAROTENE ARESTIN, MINOCYCLINE HYDROCHLORIDE JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 5 APPENDIX A - PRODUCT NAME INDEX ** A ** ARFORMOTEROL TARTRATE, ARFORMOTEROL TARTRATE ARGATROBAN, ARGATROBAN ARGATROBAN IN SODIUM CHLORIDE, ARGATROBAN ARICEPT, DONEPEZIL HYDROCHLORIDE ARIDOL KIT, MANNITOL ARIKAYCE KIT, AMIKACIN SULFATE ARIMIDEX, ANASTROZOLE ARIPIPRAZOLE, ARIPIPRAZOLE ARISTADA, ARIPIPRAZOLE LAUROXIL ARISTADA INITIO KIT, ARIPIPRAZOLE LAUROXIL ARISTOSPAN, TRIAMCINOLONE HEXACETONIDE ARIXTRA, FONDAPARINUX SODIUM ARMODAFINIL, ARMODAFINIL ARMONAIR