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2027 EmblemHealth Formulary Changes
10/26/2026
Effective Date: Jan. 1, 2027
The table below describes all formulary changes going into effect for our Medicare members in 2027. For our Commercial members, this table highlights the most highly impacted drugs. For a comprehensive listing of all plans see: Summary of Companies, Lines of Business, Networks & Benefit Plans.
See the applicable 2027 plan formularies for all coverage rules:
Note: Affected members were notified of these changes separately.
- City of NY PPO
- City of NY HMO
- Commercial Small Group/Essential/Individual Plans
- Commercial Large Group
- Medicare Advantage Plans
- Medicare CNY PDP (City Retirees’ Prescription Drug Plan Only)
EmblemHealth City of New York PPO (NYCE PPO) Drugs Removed From Formulary In 2027 | ||
DRUG CLASS | NON-COVERED | FORMULARY ALTERNATIVES |
ACNE AGENTS: | ALTRENO, TWYNEO | ABSORICA LD, ADAPALENE/BENZOYL PEROXIDE GEL 0.1-2.5%, ISOTRETINOIN PRODUCTS (INCLUDING: ACCUTANE CAPSULE, AMNESTEEM CAPSULE, CLARAVIS CAPSULE, ISOTRETINOIN CAPSULE, ZENATANE CAPSULE), TRETINOIN CREAM, TRETINOIN GEL 0.01% |
ACNE AGENTS: | CABTREO, ISOTRETINOIN 25MG, ISOTRETINOIN 35MG, TRETINOIN GEL 0.05%, TRETINOIN GEL 0.025%, TRETINOIN MICROSPHERE GEL, TRETINOIN MICROSPHERE GEL 0.1%, TRETINOIN MICROSPHERE GEL 0.04%, ADAPALENE CREAM, ADAPALENE GEL, ADAPALENE PAD, ADAPALENE SOLUTION, ADAPALENE/BENZOYL PEROXIDE GEL 0.3-2.5% | ABSORICA LD, ADAPALENE/BENZOYL PEROXIDE GEL 0.1-2.5%, ISOTRETINOIN PRODUCTS (INCLUDING: ACCUTANE CAPSULE, AMNESTEEM CAPSULE, CLARAVIS CAPSULE, ISOTRETINOIN CAPSULE, ZENATANE CAPSULE), TRETINOIN CREAM, TRETINOIN GEL 0.01%, AKLIEF |
ACNE AGENTS: | ADAPALENE CREAM, ADAPALENE GEL, ADAPALENE PAD, ADAPALENE SOLUTION, ADAPALENE/BENZOYL PEROXIDE GEL 0.3-2.5% | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. THE FOLLOWING PRESCRIPTION ALTERNATIVES ARE AVAILABLE: ADAPALENE/BENZOYL PEROXIDE GEL 0.1-2.5%, TRETINOIN CREAM, TRETINOIN GEL 0.01% |
ACNE AND ROSACEA AGENTS | CLINDAMYCIN GEL (GENERIC CLINDAGEL), EPSOLAY, FINACEA FOAM, NORITATE CREAM | AZELAIC ACID GEL, BRIMONIDINE GEL, CLINDAMYCIN GEL (GENERIC CLEOCIN-T), CLINDAMYCIN LOTION, CLINDAMYCIN SOLUTION, CLINDAMYCIN/BENZOYL PEROXIDE GEL (REFRIGERATED), ERYTHROMYCIN SOLUTION, IVERMECTIN CREAM, METRONIDAZOLE CREAM, METRONIDAZOLE GEL, NEUAC, ZILXI |
ACNE AND ROSACEA AGENTS: | AZELEX, CLINDAMYCIN FOAM, CLINDAMYCIN/BENZOYL PEROXIDE GEL, CLINDAMYCIN/TRETINOIN GEL, DAPSONE GEL, ERYTHROMYCIN/BENZOYL PEROXIDE GEL, METRONIDAZOLE LOTION, OXYMETAZOLINE | AZELAIC ACID GEL, BRIMONIDINE GEL, CLINDAMYCIN GEL (GENERIC CLEOCIN-T), CLINDAMYCIN LOTION, CLINDAMYCIN SOLUTION, CLINDAMYCIN/BENZOYL PEROXIDE GEL (REFRIGERATED), IVERMECTIN CREAM, METRONIDAZOLE CREAM, METRONIDAZOLE GEL, NEUAC, ZILXI, AMZEEQ, WINLEVI |
AGENTS FOR PAINFUL INTERCOURSE | INTRAROSA, OSPHENA | ESTRADIOL CREAM, ESTRADIOL VAGINAL TABLET, ESTRING, PREMARIN CREAM, YUVAFEM VAGINAL TABLET |
ALZHEIMER'S AGENTS | MEMANTINE ER CAPSULE, MEMANTINE/DONEPEZIL, NAMZARIC, ZUNVEYL | DONEPEZIL TABLET, MEMANTINE SOLUTION, MEMANTINE TABLET, RIVASTIGMINE PATCH |
ANTIANGINAL AGENTS | ISOSORBIDE DINITRATE TABLET 40MG | ISOSORBIDE DINITRATE TABLET (EXCEPT 40MG), ISOSORBIDE MONONITRATE ER, NITROGLYCERIN LINGUAL SPRAY, NITROGLYCERIN SL TABLET, RANOLAZINE ER TABLET |
ANTIBIOTICS: | LIKMEZ, METRONIDAZOLE TABLET 125MG | METRONIDAZOLE TABLET 250MG, METRONIDAZOLE TABLET 500MG |
ANTIBIOTICS: | METRONIDAZOLE CAPSULE 375MG | METRONIDAZOLE TABLET |
ANTIBIOTICS: | SEYSARA, TETRACYCLINE TABLET 250MG, TETRACYCLINE TABLET 500MG | DOXYCYCLINE HYCLATE, DOXYCYCLINE MONOHYDRATE, MINOCYCLINE CAPSULE, TETRACYCLINE CAPSULE |
ANTIBIOTICS: | DORYX MPC, DOXYCYCLINE (GENERIC ORACEA), DOXYCYCLINE HYCLATE 75 MG, DOXYCYCLINE HYCLATE ER TABLET, DOXYCYCLINE HYCLATE TABLET 50MG, DOXYCYCLINE HYCLATE TABLET 75MG, DOXYCYCLINE HYCLATE TABLET 150MG, DOXYCYCLINE MONOHYDRATE CAPSULE 75MG, DOXYCYCLINE MONOHYDRATE CAPSULE 150MG, MINOCYCLINE ER TABLET (AUTHORIZED GENERIC OF SOLODYN), MINOCYCLINE ER TABLET (GENERIC SOLODYN), MINOCYCLINE TABLET, TARGADOX | DOXYCYCLINE HYCLATE, DOXYCYCLINE MONOHYDRATE, MINOCYCLINE CAPSULE, TETRACYCLINE CAPSULE, EMROSI |
ANTIBIOTICS: | BLUJEPA, NITROFURANTOIN SUSPENSION 50MG/5ML, ORLYNVAH, PIVYA | FOSFOMYCIN, METHENAMINE, NITROFURANTOIN MACROCRYSTAL, NITROFURANTOIN SUSPENSION 25MG/5ML, TRIMETHOPRIM/SULFAMETHOXAZOLE |
ANTICOAGULANTS | SAVAYSA | DABIGATRAN, ELIQUIS, RIVAROXABAN, XARELTO |
ANTICONVULSANTS: BENZODIAZEPINES | SYMPAZAN | CLOBAZAM, CLONAZEPAM |
ANTICONVULSANTS: GABAPENTINOIDS | GABAPENTIN CAPSULE 200MG, RELGAABI CAPSULE 200MG | GABAPENTIN CAPSULE 100MG, GABAPENTIN CAPSULE 300MG, GABAPENTIN CAPSULE 400MG GABAPENTIN DAILY, GABAPENTIN SOLUTION, GABAPENTIN TABLET, RELGAABI CAPSULE 300MG, RELGAABI CAPSULE 400MG |
ANTICONVULSANTS: GABAPENTINOIDS | GABARONE | GABAPENTIN CAPSULE 100MG, GABAPENTIN CAPSULE 300MG, GABAPENTIN CAPSULE 400MG, GABAPENTIN DAILY, GABAPENTIN SOLUTION, GABAPENTIN TABLET, RELGAABI CAPSULE 300MG, RELGAABI CAPSULE 400MG |
ANTICONVULSANTS: OTHERS | ELEPSIA XR, LEVETIRACETAM (AUTHORIZED GENERIC OF SPRITAM), TOPIRAMATE SOLUTION | LEVETIRACETAM, LEVETIRACETAM ER, TOPIRAMATE, TOPIRAMATE SPRINKLE ER |
ANTICONVULSANTS: OTHERS | TOPIRAMATE ER CAPSULE, VIGAFYDE | TOPIRAMATE SPRINKLE CAPSULE, VIGABATRIN POWDER PACK |
ANTICONVULSANTS: SODIUM CHANNEL BLOCKERS | MOTPOLY XR, ZONISADE SUSPENSION | LACOSAMIDE TABLET, ZONISAMIDE CAPSULE |
ANTICONVULSANTS: SODIUM CHANNEL BLOCKERS | LAMOTRIGINE ODT, SUBVENITE | LAMOTRIGINE CHEWABLE TABLET, LAMOTRIGINE TABLET |
ANTIDEPRESSANTS | APLENZIN, BUPROPION ER (AUTHORIZED GENERIC OF FORFIVO XL), DRIZALMA SPRINKLE, DULOXETINE DR 80MG, DULOXETINE DR 90MG, DULOXETINE DR 120MG, RALDESY, VENLAFAXINE ER 112.5MG | BUPROPION SR, BUPROPION XL, DESVENLAFAXINE ER, DULOXETINE, TRAZODONE TABLETS, VENLAFAXINE, VENLAFAXINE ER CAPSULE, VILAZODONE |
ANTIDEPRESSANTS: OTHER | DESVENLAFAXINE ER 50MG, DESVENLAFAXINE ER 100MG, DULOXETINE ER, EXXUA, VENLAFAXINE ER | BUPROPION SR, BUPROPION XL, DESVENLAFAXINE SUCCINATE ER, DULOXETINE, VENLAFAXINE, VENLAFAXINE ER CAPSULE, VILAZODONE |
ANTIDEPRESSANTS: | CITALOPRAM CAPSULE 30MG, ESCITALOPRAM CAPSULE 15MG, FLUOXETINE TABLET (GENERIC SARAFEM), FLUOXETINE TABLET 60MG, FLUVOXAMINE ER CAPSULE, PAROXETINE CAPSULE 7.5MG, PAROXETINE ER TABLET, PAROXETINE SUSPENSION, SERTRALINE CAPSULE | CITALOPRAM, ESCITALOPRAM, FLUOXETINE CAPSULE, FLUOXETINE TABLET, FLUVOXAMINE, PAROXETINE, SERTRALINE CONCENTRATE, SERTRALINE TABLET |
ANTIDIARRHEALS | MYTESI | DIPHENOXYLATE/ATROPINE |
ANTIFUNGALS: AZOLES | TOLSURA, VIVJOA | FLUCONAZOLE, ITRACONAZOLE, KETOCONAZOLE, NOXAFIL PACKET, POSACONAZOLE DR, POSACONAZOLE SUSPENSION, VORICONAZOLE |
ANTIHISTAMINES | CETIRIZINE SOLUTION, CLARINEX-D, DESLORATADINE ODT, DESLORATADINE SOLUTION, DESLORATADINE TABLET, LEVOCETIRIZINE SOLUTION, LEVOCETIRIZINE TABLET | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. |
ANTIMALARIALS | SOVUNA | HYDROXYCHLOROQUINE |
ANTINAUSEA AND VOMITING AGENTS | GRANISOL | GRANISETRON TABLET, SCOPOLAMINE PATCH |
ANTIPLATELET AGENTS | YOSPRALA | ASPIRIN, OMEPRAZOLE CAPSULE, PANTOPRAZOLE TABLET |
ANTIVIRALS: | LEDIPASVIR/SOFOSBUVIR, SOFOSBUVIR/VELPATASVIR | EPCLUSA, HARVONI, MAVYRET, SOVALDI, VOSEVI |
ASTHMA/COPD: | BEVESPI, DUAKLIR, FLUTICASONE FUROATE/VILANTEROL, FLUTICASONE PROPIONATE/SALMETEROL HFA, UMECLIDINIUM/VILANTEROL | ADVAIR HFA, AIRSUPRA, ANORO ELLIPTA, BREO ELLIPTA, BREYNA (GENERIC SYMBICORT), BREZTRI, BUDESONIDE/FORMOTEROL (GENERIC SYMBICORT), COMBIVENT, DULERA, FLUTICASONE PROPIONATE/SALMETEROL AEROSOL (AUTHORIZED GENERIC OF AIRDUO), FLUTICASONE PROPIONATE/SALMETEROL DISKUS (GENERIC ADVAIR DISKUS), STIOLTO, TRELEGY, WIXELA |
ASTHMA: | ALVESCO, BECLOMETHASONE (AUTHORIZED GENERIC OF QVAR), FLUTICASONE FUROATE, FLUTICASONE PROPIONATE DISKUS, FLUTICASONE PROPIONATE HFA, PULMICORT INHALER | ARNUITY ELLIPTA, ASMANEX, BUDESONIDE NEBULIZED SOLUTION, QVAR REDIHALER |
ASTHMA: | LEVALBUTEROL HFA (AUTHORIZED GENERIC OF XOPENEX), PROAIR RESPICLICK, XOPENEX HFA | ALBUTEROL HFA |
ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) AND NARCOLEPSY | AMPHETAMINE ER TABLET, AMPHETAMINE TABLET, AMPHETAMINE XR ODT, AMPHETAMINE/DEXTROAMPHETAMINE ER CAPSULE (GENERIC MYDAYIS), ARYNTA, ATONCY, COTEMPLA XR-ODT, DYANAVEL XR SUSP, DYANAVEL XR TABLET, METHYLPHENIDATE ER CAPSULE (GENERIC APTENSIO XR), METHYLPHENIDATE ER TABLET (AUTHORIZED GENERIC OF RELEXXII), METHYLPHENIDATE PATCH, ONYDA XR, QELBREE, RELEXXII, XELSTRYM | AMPHETAMINE/DEXTROAMPHETAMINE, AMPHETAMINE/DEXTROAMPHETAMINE XR, ARMODAFINIL, ATOMOXETINE, AZSTARYS, CLONIDINE ER TABLET, DEXMETHYLPHENIDATE ER, DEXTROAMPHETAMINE, DEXTROAMPHETAMINE SOLUTION, JORNAY PM, LISDEXAMFETAMINE, METHYLPHENIDATE, METHYLPHENIDATE ER (GENERIC CONCERTA), MODAFINIL, QUILLICHEW ER, QUILLIVANT XR SUSPENSION, SODIUM OXYBATE, SUNOSI |
BENZODIAZEPINES | ALPRAZOLAM INTENSOL, ALPRAZOLAM ODT, LOREEV XR | ALPRAZOLAM TABLET, CHLORDIAZEPOXIDE, CLORAZEPATE, DIAZEPAM SOLUTION, DIAZEPAM TABLET, LORAZEPAM SOLUTION, LORAZEPAM TABLET, OXAZEPAM |
BLADDER INCONTINENCE | DARIFENACIN ER, FESOTERODINE ER, OXYBUTYNIN 2.5MG | MIRABEGRON TABLET, MYRBETRIQ GRANULES, MYRBETRIQ TABLET, OXYBUTYNIN, OXYBUTYNIN ER, OXYBUTYNIN SYRUP, SOLIFENACIN TABLET, TOLTERODINE, TOLTERODINE ER, TROSPIUM, TROSPIUM ER |
BPH/ENLARGED PROSTATE | CARDURA XL, DUTASTERIDE/TAMSULOSIN, ENTADFI, TEZRULY | ALFUZOSIN ER, DUTASTERIDE, FINASTERIDE, SILODOSIN, TADALAFIL 5MG, TAMSULOSIN, TERAZOSIN |
COMPLEMENT INHIBITORS | VOYDEYA | EMPAVELI, FABHALTA |
COPD: | TIOTROPIUM (GENERIC SPIRIVA HANDIHALER), TUDORZA, UMECLIDINIUM (AUTHORIZED GENERIC OF INCRUSE ELLIPTA), YUPELRI | INCRUSE ELLIPTA, SPIRIVA RESPIMAT |
COPD:PHOSPHODIESTERASE INHIBITORS | OHTUVAYRE | ROFLUMILAST |
CORTICOSTEROIDS | TARPEYO | BUDESONIDE DR CAPSULE |
CORTICOSTEROIDS | AGAMREE, ALKINDI, CORTISONE, DEFLAZACORT, DEXAMETHASONE 1.5MG, DEXAMETHASONE 6 DAY, DEXAMETHASONE 10 DAY, DEXAMETHASONE 13 DAY, DEXLYT, EOHILIA, HEMADY, HIDEX, JAYTHARI, KHINDIVI, KYMBEE, ORAPRED ODT, PREDNISOLONE ODT, PREDNISOLONE SOLUTION (10MG/5ML AND 20MG/5ML), PREDNISOLONE TABLET 5MG, PREDNISONE DR, PREDNISONE INTENSOL 5MG/ML, PYQVI, TAPERDEX 6 DAY, TAPERDEX 7 DAY, TAPERDEX 12 DAY | BUDESONIDE DR CAPSULE, DEXAMETHASONE, HYDROCORTISONE, METHYLPREDNISOLONE, PREDNISOLONE SOLUTION (EXCEPT 10MG/5ML AND 20MG/5ML), PREDNISONE, PREDNISONE SOLUTION 5MG/5ML |
CUSHING'S DISEASE | RECORLEV | KETOCONAZOLE TABLET |
DIABETES: | MIGLITOL | ACARBOSE |
DIABETES: | METFORMIN ER MODIFIED RELEASE (GENERIC GLUMETZA), METFORMIN ER OSMOTIC (GENERIC FORTAMET), METFORMIN SOLUTION (GENERIC RIOMET), METFORMIN TABLET 625MG, METFORMIN TABLET 750MG | METFORMIN, METFORMIN ER (GENERIC GLUCOPHAGE XR) |
DIABETES: | ALOGLIPTIN/METFORMIN, ALOGLIPTIN/PIOGLITAZONE, DAPAGLIFLOZIN/SAXAGLIPTIN (AUTHORIZED GENERIC OF QTERN), INVOKAMET, INVOKAMET XR, JENTADUETO, JENTADUETO XR, SAXAGLIPTIN/METFORMIN XR, SEGLUROMET, SITAGLIPTIN/METFORMIN (AUTHORIZED GENERIC OF ZITUVIMET), SITAGLIPTIN/METFORMIN ER (AUTHORIZED GENERIC OF ZITUVIMET XR), STEGLUJAN, ZITUVIMET, ZITUVIMET XR | DAPAGLIFLOZIN/METFORMIN ER, GLIPIZIDE/METFORMIN, GLYBURIDE/METFORMIN, GLYXAMBI, PIOGLITAZONE/METFORMIN, SITAGLIPTIN PHOSPHATE/METFORMIN, SITAGLIPTIN PHOSPHATE/METFORMIN ER, SYNJARDY, SYNJARDY XR, TRIJARDY XR, XIGDUO XR 2.5MG/1000MG |
DIABETES: | PIOGLITAZONE/GLIMEPIRIDE | DAPAGLIFLOZIN/METFORMIN ER, GLIPIZIDE/METFORMIN, GLYBURIDE/METFORMIN, GLYXAMBI, PIOGLITAZONE/METFORMIN, SITAGLIPTIN PHOSPHATE/METFORMIN, SITAGLIPTIN PHOSPHATE/METFORMIN ER, SYNJARDY, SYNJARDY XR, TRIJARDY XR, XIGDUO XR 2.5MG/1000MG |
DIABETES: | FREESTYLE LIBRE | DEXCOM |
DIABETES: | ALOGLIPTIN, BRYNOVIN, SAXAGLIPTIN, SITAGLIPTIN (AUTHORIZED GENERIC OF ZITUVIO), TRADJENTA, ZITUVIO | SITAGLIPTIN PHOSPHATE |
DIABETES: | LIRAGLUTIDE | MOUNJARO, OZEMPIC INJECTION, OZEMPIC PILL, TRULICITY |
DIABETES: | LIFESCAN (ONETOUCH), NIPRO (TRUETEST, TRUETRACK), ROCHE (ACCU-CHEK) | ABBOTT (FREESTYLE, PRECISION), ASCENSIA (CONTOUR) |
DIABETES: | BASAGLAR, INSULIN GLARGINE (BIOLOGIC BY WINTHROP), INSULIN GLARGINE-YFGN (BIOLOGIC BY CIVICA), LANTUS, REZVOGLAR | HUMULIN N, HUMULIN R U-500, INSULIN GLARGINE-YFGN, NOVOLIN N, SEMGLEE-YFGN, TOUJEO, TRESIBA |
DIABETES: | INSULIN LISPRO MIX | HUMALOG MIX, HUMULIN 70/30, NOVOLIN 70/30, NOVOLOG MIX |
DIABETES: | ADMELOG, AFREZZA, APIDRA, INSULIN LISPRO, KIRSTY, MERILOG | FIASP, HUMALOG, HUMULIN R, LYUMJEV, NOVOLIN R, NOVOLOG |
DIABETES: | BEXAGLIFLOZIN, BRENZAVVY, INVOKANA, STEGLATRO | DAPAGLIFLOZIN, JARDIANCE |
DRY EYES | CEQUA, CYCLOSPORINE (GENERIC RESTASIS), MIEBO, VEVYE, XIIDRA | EYSUVIS, RESTASIS SINGLE-DOSE VIALS |
EXCESSIVE SWEATING | QBREXZA, SOFDRA | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. |
FIBROMYALGIA AGENTS | MILNACIPRAN | DULOXETINE, GABAPENTIN, PREGABALIN, HORIZANT, TONMYA |
FIRST-GENERATION ANTIHISTAMINES | CARBINOXAMINE ER SUSPENSION, CARBINOXAMINE SOLUTION, CARBINOXAMINE TABLET 6MG, CARBZAH, CLEMASTINE SYRUP, CLEMSZA, CORPHENA, KARBINAL, RYCLORA, RYVENT | CARBINOXAMINE TABLET 4MG, CYPROHEPTADINE SYRUP, CYPROHEPTADINE TABLET |
FISH OIL | ICOSAPENT ETHYL (GENERIC VASCEPA), OMEGA-3-ACID ETHYL ESTERS CAPSULE | VASCEPA |
GALLSTONE DISSOUTION AGENTS | RELTONE, URSODIOL CAPSULE 200MG, URSODIOL CAPSULE 400MG, URSOLIGN | URSODIOL CAPSULE 300MG, URSODIOL TABLET |
GLAUCOMA: | BRIMONIDINE SOLUTION 0.1%, IOPIDINE | BRIMONIDINE SOLUTION 0.2%, SIMBRINZA |
GLAUCOMA: | BRIMONIDINE/TIMOLOL, DORZOLAMIDE/TIMOLOL PRESERVATIVE-FREE, TIMOLOL (GENERIC ISTALOL), TIMOLOL (GENERIC TIMOPTIC OCUDOSE), TIMOLOL 0.5% (GENERIC BETIMOL 0.5%), TIMOLOL GEL | DORZOLAMIDE SOLUTION, DORZOLAMIDE/TIMOLOL SOLUTION, TIMOLOL SOLUTION |
GLAUCOMA: | BRINZOLAMIDE | DORZOLAMIDE SOLUTION |
GLAUCOMA: | BIMATOPROST 0.03%, IYUZEH, OMLONTI, TAFLUPROST, XELPROS | BIMATOPROST 0.01%, LATANOPROST SOLUTION |
GLAUCOMA: | TRAVOPROST, ZOLYMBUS | LATANOPROST, BIMATOPROST 0.01%, VYZULTA |
GOUT | ALLOPURINOL 200MG, COLCHICINE CAPSULE, FEBUXOSTAT, GLOPERBA | ALLOPURINOL, COLCHICINE TABLET (GENERIC COLCRYS), PROBENECID, PROBENECID/COLCHICINE |
HEART FAILURE: SGLT2 AND SGLT1 INHIBITOR | INPEFA | DAPAGLIFLOZIN, JARDIANCE |
HELICOBACTER PYLORI | BISMUTH SUBCITRATE/METRONIDAZOLE/TETRACYCLINE, VOQUEZNA DUAL PAK, VOQUEZNA TRIPLE PAK | AMOXICILLIN, CLARITHROMYCIN, METRONIDAZOLE, OMEPRAZOLE, PANTOPRAZOLE, TALICIA, TETRACYCLINE |
HELICOBACTER PYLORI | AMOXICILLIN/CLARITHROMYCIN/LANSOPRAZOLE | AMOXICILLIN, CLARITHROMYCIN, METRONIDAZOLE, OMEPRAZOLE, PANTOPRAZOLE, TALICIA, TETRACYCLINE, VOQUEZNA |
HEREDITARY TYROSINEMIA TYPE 1 AGENTS | HARLIKU | NITISINONE CAPSULE, NITYR, ORFADIN SUSPENSION |
HIGH BLOOD PRESSURE: | AZILSARTAN, EDARBYCLOR, TELMISARTAN/HCTZ, VALSARTAN SOLUTION | CANDESARTAN, CANDESARTAN/HCTZ, IRBESARTAN, IRBESARTAN/HCTZ, LOSARTAN, LOSARTAN/HCTZ, OLMESARTAN, OLMESARTAN/HCTZ, TELMISARTAN, VALSARTAN, VALSARTAN/HCTZ, ARBLI |
HIGH BLOOD PRESSURE: | BISOPROLOL 2.5MG, CARVEDILOL ER, HEMANGEOL, INDERAL XL, INNOPRAN XL, KAPSPARGO, LABETALOL TABLET 400MG, LOPRESSOR, METOPROLOL 12.5MG, SOTYLIZE SOLUTION, TIMOLOL TABLET 5MG, TIMOLOL TABLET 10MG, TIMOLOL TABLET 20MG | ATENOLOL, BISOPROLOL, CARVEDILOL, LABETALOL, METOPROLOL, NEBIVOLOL, PROPRANOLOL SOLUTION 20MG/5ML, PROPRANOLOL SOLUTION 40MG/5ML, PROPRANOLOL TABLET |
HIGH BLOOD PRESSURE: | CONJUPRI, DILTIAZEM ER CAPSULE 360MG, DILTIAZEM ER TABLET, ISRADIPINE, KATERZIA, LEVAMLODIPINE, MATZIM LA, NICARDIPINE, NISOLDIPINE ER, NORLIQVA, SDAMLO, SULAR, VERAPAMIL ER CAPSULE | AMLODIPINE, CARTIA XT, DILTIAZEM ER CAPSULE (EXCEPT 360MG), FELODIPINE ER, NIFEDIPINE, VERAPAMIL, VERAPAMIL ER |
HIGH BLOOD PRESSURE: | AMLODIPINE/VALSARTAN/HCTZ, PRESTALIA, TRANDOLAPRIL/VERAPAMIL, WIDAPLIK | AMLODIPINE/BENAZEPRIL, AMLODIPINE/OLMESARTAN, AMLODIPINE/VALSARTAN, OLMESARTAN/AMLODIPINE/HCTZ |
HIGH BLOOD PRESSURE: | ALISKIREN TABLET | ENALAPRIL, IRBESARTAN, LISINOPRIL, LOSARTAN, VALSARTAN |
HIGH BLOOD PRESSURE: | TRYVIO | EPLERENONE, SPIRONOLACTONE TABLET, BAXFENDY |
HIGH BLOOD PRESSURE: | HEMICLOR, INZIRQO, THALITONE | CHLORTHALIDONE, HYDROCHLOROTHIAZIDE, INDAPAMIDE, METOLAZONE |
HIGH CHOLESTEROL: | CHOLESTYRAMINE LIGHT POWDER PACKETS, CHOLESTYRAMINE POWDER PACKETS, COLESEVELAM PACKETS, PREVALITE PACKETS | CHOLESTYRAMINE LIGHT POWDER, CHOLESTYRAMINE POWDER, COLESEVELAM TABLET, PREVALITE POWDER |
HIGH CHOLESTEROL: | AMLODIPINE/ATORVASTATIN, ATORVALIQ, FLOLIPID, FLUVASTATIN CAPSULE, FLUVASTATIN ER TABLET, PITAVASTATIN, ZYPITAMAG | ATORVASTATIN, EZETIMIBE/SIMVASTATIN, LOVASTATIN, PRAVASTATIN, ROSUVASTATIN, SIMVASTATIN |
HIV | PIFELTRO | TALK TO YOUR DOCTOR ABOUT CLINICALLY APPROPRIATE ALTERNATIVES. EXAMPLES OF COVERED ALTERNATIVES INCLUDE: BIKTARVY, DESCOVY, DOVATO, EFAVIRENZ, EMTRICITABINE/TENOFOVIR DISOPROXIL FUMARATE (GENERIC TRUVADA), GENVOYA, JULUCA, NEVIRAPINE |
HUNTINGTON'S DISEASE & TARDIVE DYSKINESIA | AUSTEDO | INGREZZA |
HYPERKALEMIA AGENTS | VELTASSA | LOKELMA, SODIUM POLYSTYRENE SULFONATE |
HYPNOTICS: | FLURAZEPAM, QUAZEPAM, TEMAZEPAM (7.5MG AND 22.5MG) | ESTAZOLAM, LORAZEPAM, TEMAZEPAM (EXCEPT 7.5MG AND 22.5MG) |
HYPNOTICS: | DAYVIGO, DOXEPIN (GENERIC SILENOR), QUVIVIQ, RAMELTEON | BELSOMRA, ESZOPICLONE, TASIMELTEON, ZALEPLON, ZOLPIDEM, ZOLPIDEM ER |
INFLAMMATORY BOWEL AGENTS | BUDESONIDE ER TABLET, DIPENTUM, MESALAMINE ER CAPSULE 250MG, MESALAMINE ER CAPSULE 500MG | BALSALAZIDE, BUDESONIDE DR CAPSULE, MESALAMINE DR TABLET 1.2GM, MESALAMINE DR TABLET 800MG, MESALAMINE ENEMA, MESALAMINE ER CAPSULE 0.375GM (GENERIC APRISO), MESALAMINE SUPPOSITORY, SULFASALAZINE |
KIDNEY CANCER | PAZOPANIB 400MG | PAZOPANIB 200MG |
LAXATIVES: | CLENPIQ, PEG 3350/KCL/NACL/NA SULFATE/NA ASCORBATE-C (GENERIC MOVIPREP), PLENVU, SUFLAVE | GAVILYTE-G SOLUTION, GAVILYTE-N SOLUTION, PEG 3350/ELECTROLYTES SOLUTION, PEG-3350/NACL/NABICARBONATE/KCL SOLUTION, SODIUM SULFATE/POTASSIUM SULFATE/MAGNESIUM SULFATE (GENERIC SUPREP) |
LAXATIVES: | IBSRELA, LINZESS, LUBIPROSTONE, PRUCALOPRIDE | MOVANTIK, SYMPROIC, TRULANCE |
LONG-ACTING BETA AGONISTS | FORMOTEROL NEBULIZED SOLUTION | ARFORMOTEROL NEBULIZED SOLUTION, SEREVENT, STRIVERDI |
LOOP DIURETICS | ENBUMYST | BUMETANIDE, FUROSEMIDE, TORSEMIDE |
LOOP DIURETICS | ETHACRYNIC ACID, FUROSEMIDE SOLUTION 8MG/ML, SOAANZ | BUMETANIDE, FUROSEMIDE TABLET, TORSEMIDE, FUROSCIX, LASIX ONYU |
MENOPAUSAL SYMPTOMS: NON-HORMONAL | LYNKUET, VEOZAH | CITALOPRAM, DESVENLAFAXINE ER, DULOXETINE, ESCITALOPRAM, GABAPENTIN, OXYBUTYNIN, PAROXETINE, VENLAFAXINE |
MENTAL HEALTH | BYSANTI, COBENFY, OPIPZA | ARIPIPRAZOLE, ASENAPINE, LURASIDONE, OLANZAPINE, PALIPERIDONE ER, QUETIAPINE ER, QUETIAPINE FUMARATE, REXULTI, RISPERIDONE, VRAYLAR, ZIPRASIDONE |
MENTAL HEALTH | NUPLAZID, OLANZAPINE/FLUOXETINE, QUETIAPINE 150MG | ARIPIPRAZOLE, ASENAPINE, CLOZAPINE, FLUOXETINE, LURASIDONE, OLANZAPINE, PALIPERIDONE ER, QUETIAPINE (EXCEPT 150MG), QUETIAPINE ER, REXULTI, RISPERIDONE, VRAYLAR, ZIPRASIDONE, CAPLYTA, LYBALVI |
MIGRAINE PRODUCTS: OTHERS | TRUDHESA | DICLOFENAC TABLET, DIHYDROERGOTAMINE INJECTION SOLUTION |
MIGRAINE PRODUCTS: TRIPTANS | SYMBRAVO | ELETRIPTAN, NARATRIPTAN, RIZATRIPTAN, SUMATRIPTAN, ZOLMITRIPTAN TABLET |
MIGRAINE PRODUCTS: | ZAVZPRET | NURTEC ODT, QULIPTA, UBRELVY |
MIGRAINE PRODUCTS: | CAFERGOT, DICLOFENAC PACKET, DIHYDROERGOTAMINE NASAL (GENERIC MIGRANAL), ELYXB, ERGOTAMINE/CAFFEINE | DICLOFENAC TABLET, DIHYDROERGOTAMINE INJECTION SOLUTION |
MULTIPLE SCLEROSIS | BAFIERTAM, PONVORY, TASCENSO ODT | CLADRIBINE, DIMETHYL FUMARATE, FINGOLIMOD, MAYZENT, TERIFLUNOMIDE, VUMERITY, ZEPOSIA |
MUSCLE RELAXANTS | ATMEKSI, BACLOFEN 5MG TABLET, BACLOFEN 15MG TABLET, BACLOFEN ORAL SOLUTION 5MG/5ML, BACLOFEN ORAL SOLUTION 10MG/5ML, BACLOFEN ORAL SUSPENSION, CHLORZOXAZONE 250MG, CHLORZOXAZONE 375MG, CHLORZOXAZONE 750MG, CYCLOBENZAPRINE 7.5MG TABLET, CYCLOBENZAPRINE ER CAPSULE (GENERIC AMRIX), DANTROLENE, FEXMID, METAXALONE TABLET 400MG, METAXALONE TABLET 640MG, METAXALONE TABLET 800MG, METHOCARBAMOL TABLET 1000MG, NORGESIC, NORGESIC FORTE, ONTRALFY, ORPHENGESIC, ORPHENGESIC FORTE, TANLOR, TIZANIDINE CAPSULE, TIZANIDINE CAPSULE 8MG, ZANAFLEX | BACLOFEN TABLET, CHLORZOXAZONE 500MG, CYCLOBENZAPRINE TABLET, METHOCARBAMOL TABLET, TIZANIDINE TABLET |
NASAL STEROIDS | FLUNISOLIDE NASAL, MOMETASONE NASAL, OMNARIS, QNASL | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. THE FOLLOWING PRESCRIPTION ALTERNATIVE IS AVAILABLE: FLUTICASONE NASAL |
NASAL: | AZELASTINE/FLUTICASONE NASAL (GENERIC DYMISTA), RYALTRIS, FLUNISOLIDE NASAL, MOMETASONE NASAL, OMNARIS, QNASL | AZELASTINE NASAL 0.1 %, FLUTICASONE NASAL, XHANCE |
NONSTEROIDAL ANTI-INFLAMMATORY AGENTS (NSAIDS) | COMBOGESIC, IBUPROFEN SUSPENSION | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. |
OPHTHALMIC: | BEPOTASTINE, EPINASTINE SOLUTION, OLOPATADINE SOLUTION, VERKAZIA, ZERVIATE | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. THE FOLLOWING PRESCRIPTION ALTERNATIVE IS AVAILABLE: AZELASTINE SOLUTION |
OPHTHALMIC: | AZASITE, CILOXAN OINTMENT, TOBREX OINTMENT, ZIRGAN | BESIVANCE, CIPROFLOXACIN SOLUTION, ERYTHROMYCIN OINTMENT, GENTAMICIN SOLUTION, MOXIFLOXACIN SOLUTION, NATACYN, OFLOXACIN SOLUTION, TOBRAMYCIN SOLUTION, TRIFLURIDINE SOLUTION |
OPHTHALMIC: | ACUVAIL, BROMFENAC 0.07%, NEVANAC | DICLOFENAC SOLUTION |
OPHTHALMIC: | ACULAR, BROMFENAC 0.09%, BROMFENAC 0.075% | DICLOFENAC, ILEVRO |
OPHTHALMIC: | TOBRADEX OINTMENT | NEOMYCIN/POLYMYXIN/DEXAMETHASONE OINTMENT, NEOMYCIN/POLYMYXIN/DEXAMETHASONE SUSPENSION, TOBRAMYCIN/DEXAMETHASONE SUSPENSION |
OPHTHALMIC: | LOTEPREDNOL/OBRAMYCIN, NEOMYCIN/POLYMYXIN/HYDROCORTISONE, TOBRADEX ST | NEOMYCIN/POLYMYXIN/DEXAMETHASONE OINTMENT, NEOMYCIN/POLYMYXIN/DEXAMETHASONE SUSPENSION, TOBRAMYCIN/DEXAMETHASONE SUSPENSION |
OPHTHALMIC: | BYQLOVI, CLOBETASOL SUSPENSION 0.05%, DIFLUPREDNATE, FML FORTE, INVELTYS, PRED MILD | DEXAMETHASONE SOLUTION, FLUOROMETHOLONE SUSPENSION 0.1%, LOTEMAX OINTMENT, LOTEMAX SM GEL, LOTEPREDNOL GEL, LOTEPREDNOL SUSPENSION, PREDNISOLONE SUSPENSION 1% |
OSTEOPOROSIS AGENTS: BISPHOSPHONATES | ALENDRONATE SOLUTION, BINOSTO, FOSAMAX PLUS D, RISEDRONATE 5MG, RISEDRONATE DR | ALENDRONATE TABLET, IBANDRONATE, RISEDRONATE |
OTIC: | CIPROFLOXACIN/FLUOCINOLONE, CIPROFLOXACIN/HYDROCORTISONE, CORTISPORIN-TC, OTOVEL, XTORO | CIPROFLOXACIN SOLUTION, CIPROFLOXACIN/DEXAMETHASONE SUSPENSION, FLUOCINOLONE OIL, NEOMYCIN/POLYMYXIN/HYDROCORTISONE SOLUTION, NEOMYCIN/POLYMYXIN/HYDROCORTISONE SUSPENSION, OFLOXACIN SOLUTION |
PAIN: | VYSCOXA | CELECOXIB |
PAIN: | BUPRENORPHINE PATCH, OXYCONTIN | BELBUCA, FENTANYL PATCH, MORPHINE ER, OXYCODONE, XTAMPZA ER |
PAIN: | ACETAMINOPHEN/CAFFEINE/DIHYDROCODEINE, HYDROCODONE ER (AUTHORIZED GENERIC OF ZOHYDRO), HYDROCODONE/ACETAMINOPHEN 5-300MG, HYDROCODONE/ACETAMINOPHEN 7.5-300MG, HYDROCODONE/ACETAMINOPHEN 10-300MG, HYDROCODONE BITARTRATE ER, LEVORPHANOL, MORPHINE ER CAPSULE (AUTHORIZED GENERIC OF AVINZA), NALOCET, OXYCODONE CAPSULE 5MG, OXYCODONE/ACETAMINOPHEN SOLUTION (AUTHORIZED GENERIC OF PROLATE), OXYCODONE TABLET 5MG (AUTHORIZED GENERIC OF ROXYBOND), OXYCODONE TABLET 10MG (AUTHORIZED GENERIC OF ROXYBOND), OXYCODONE TABLET 15MG, (AUTHORIZED GENERIC OF ROXYBOND), OXYCODONE TABLET 30MG (AUTHORIZED GENERIC OF ROXYBOND), OXYCODONE/ACETAMINOPHEN 2.5-300MG, OXYCODONE/ACETAMINOPHEN 5-300MG, OXYCODONE/ACETAMINOPHEN 7.5-300MG, OXYCODONE/ACETAMINOPHEN 10-300MG, OXYMORPHONE ER, PROLATE, ROXYBOND, TREZIX, XYVONA | BELBUCA, FENTANYL PATCH, HYDROCODONE/ACETAMINOPHEN, MORPHINE ER, OXYCODONE, OXYCODONE/ACETAMINOPHEN, XTAMPZA ER |
PAIN: | PREGABALIN ER | DULOXETINE, GABAPENTIN, PREGABALIN |
PAIN: | COXANTO, DICLOFENAC CAPSULE, DICLOFENAC ER TABLET, DICLOFENAC TABLET 25MG, FENOPROFEN CAPSULE 200MG, FENOPROFEN CAPSULE 300MG, FENOPROFEN CAPSULE 400MG, FENOPRON, FLURBIPROFEN, IBUPROFEN 300MG, IBUPROFEN/FAMOTIDINE, INDOCIN, INDOMETHACIN SUSPENSION, KETOPROFEN, KETOPROFEN ER, LOFENA, LURBIRO, MECLOFENAMATE, MEFENAMIC ACID, MELOXICAM CAPSULE, MELOXICAM ORAL SUSPENSION, NAPROXEN CR, NAPROXEN EC, NAPROXEN ORAL SUSPENSION, NAPROXEN/ESOMEPRAZOLE (GENERIC VIMOVO), ORUDIS, OXAPROZIN 300MG, RELAFEN DS, SPRIX NASAL, TOLECTIN, TOLMETIN, ZYBIC | DICLOFENAC TABLET, IBUPROFEN TABLET, INDOMETHACIN CAPSULE, MELOXICAM TABLET, NAPROXEN TABLET, OXAPROZIN 600MG |
PAIN: | CONZIP, TAPENTADOL SOLUTION, TAPENTADOL TABLET, TRAMADOL ER CAPSULE, TRAMADOL SOLUTION, TRAMADOL TABLET 25MG, TRAMADOL TABLET 75MG, TRAMADOL TABLET 100MG | NUCYNTA ER, TRAMADOL ER TABLET, TRAMADOL TABLET 50MG |
PANCREATIC ENZYMES | PANCREAZE, PERTZYE, VIOKACE | CREON, ZENPEP |
PARKINSON'S AGENTS | CARBIDOPA/LEVODOPA CR (AUTHORIZED GENERIC OF RYTARY), CREXONT, DHIVY | CARBIDOPA/LEVODOPA |
PARKINSON'S AGENTS | AMANTADINE TABLET, GOCOVRI, NOURIANZ, ONGENTYS, PRAMIPEXOLE ER, ROPINIROLE ER, XADAGO, ZELAPAR | AMANTADINE CAPSULE, AMANTADINE SYRUP, ENTACAPONE TABLET, INBRIJA, PRAMIPEXOLE TABLET, RASAGILINE TABLET, ROPINIROLE TABLET, SELEGILINE CAPSULE, SELEGILINE TABLET, TOLCAPONE TABLET |
PEPTIC ULCER DISEASE | DICYCLOMINE TABLET 40MG, GLYCATE | DICYCLOMINE TABLET, METHSCOPOLAMINE, OMEPRAZOLE CAPSULE |
PHENYLKETONURIA | JAVYGTOR POWDER PACKET, JAVYGTOR TABLET, ZELVYSIA | SAPROPTERIN POWDER PACKET, SAPROPTERIN TABLET |
POTASSIUM-SPARING DIURETICS | SPIRONOLACTONE SUSPENSION | SPIRONOLACTONE TABLET |
POTASSIUM SUPPLEMENTS | POKONZA, POTASSIUM POWDER PACKET 40 MEQ | POTASSIUM CHLORIDE |
PULMONARY HTN: VASODILATORS | OPSYNVI, TADLIQ | AMBRISENTAN, BOSENTAN, MACITENTAN, SILDENAFIL SUSPENSION, SILDENAFIL TABLET, TADALAFIL 20MG, UPTRAVI |
SCABICIDES AND PEDICULICIDES | CROTAN LOTION, EURAX, PRURADIK LOTION | PERMETHRIN CREAM |
SLEEP AIDS: | EDLUAR, ZOLPIDEM CAPSULE 7.5MG, ZOLPIDEM SL | BELSOMRA, ESZOPICLONE, TASIMELTEON, ZALEPLON, ZOLPIDEM, ZOLPIDEM ER, HETLIOZ LQ |
STEROIDS, RECTAL AND INTRARECTAL | ANUSOL HC | BUDESONIDE RECTAL FOAM, HYDROCORTISONE ENEMA, HYDROCORTISONE PERINANAL CREAM, PROCTO-MED, PROCTOSOL, PROCTOZONE, ANUCORT HC, HEMMOREX, HYDROCORTISONE SUPPOSITORY |
THROMBOCYTOPENIA AGENTS | ALVAIZ, WAYRILZ | DOPTELET, ELTROMBOPAG OLAMINE TABLET |
TOPICAL ANESTHETICS | PLIAGLIS, ZTLIDO | LIDOCAINE OINTMENT 5%, LIDOCAINE PATCH 5%, LIDOCAINE SOLUTION 4%, LIDOCAINE/PRILOCAINE |
TOPICAL ANTIFUNGALS | CLOTRIMAZOLE CREAM, CLOTRIMAZOLE SOLUTION | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. |
TOPICAL: ATOPIC DERMATITIS | ZORYVE CREAM 0.15% | DESONIDE CREAM, DESONIDE OINTMENT, EUCRISA, FLUOCINONIDE, FLUTICASONE, TACROLIMUS OINTMENT |
TOPICAL: ATOPIC DERMATITIS | PIMECROLIMUS CREAM | DESONIDE CREAM, DESONIDE OINTMENT, EUCRISA, FLUOCINONIDE, FLUTICASONE, TACROLIMUS OINTMENT, OPZELURA, VTAMA |
TOPICAL: | TAVABOROLE (GENERIC KERYDIN) | CICLODAN, CICLOPIROX CREAM, CICLOPIROX GEL, CICLOPIROX NAIL LACQUER, CICLOPIROX SHAMPOO, CICLOPIROX SOLUTION, ECONAZOLE CREAM, JUBLIA, KETOCONAZOLE CREAM, KETOCONAZOLE SHAMPOO |
TOPICAL: | CLOTRIMAZOLE/BETAMETHASONE LOTION, ECONAZOLE FOAM, ECOZA, ERTACZO, EXELDERM, KETOCONAZOLE FOAM, KETODAN FOAM, LULICONAZOLE CREAM, LUZU, NAFTIFINE CREAM 1%, NAFTIFINE CREAM 2%, NAFTIFINE GEL, OXICONAZOLE CREAM, OXISTAT, SULCONAZOLE (AUTHORIZED GENERIC OF EXELDERM), TAVABOROLE | CICLODAN, CICLOPIROX, CLOTRIMAZOLE/BETAMETHASONE CREAM, ECONAZOLE CREAM, JUBLIA, KETOCONAZOLE CREAM, KETOCONAZOLE SHAMPOO |
TOPICAL: | DICLOFENAC PATCH, DICLOFENAC SOLUTION 2%, FLECTOR PATCH, LICART PATCH | DICLOFENAC SOLUTION 1.5% |
TOPICAL: | DICLOFENAC 1% GEL | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. THE FOLLOWING PRESCRIPTION ALTERNATIVE IS AVAILABLE: DICLOFENAC 1.5% SOLUTION |
TOPICAL: | DOXEPIN CREAM | BETAMETHASONE VALERATE CREAM, BETAMETHASONE VALERATE OINTMENT, TRIAMCINOLONE CREAM, TRIAMCINOLONE OINTMENT |
TOPICAL: | PENCICLOVIR, XERESE | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. |
TOPICAL: | AMCINONIDE, BETAMETHASONE FOAM, BRYHALI LOTION, CLOBETASOL CREAM 0.025%, CLOBETASOL FOAM (GENERIC OLUX E), CLOBETASOL LOTION, CLOBETASOL SHAMPOO, CLOBETASOL SPRAY, CLOCORTOLONE, CLODAN, CORDRAN, DESONIDE GEL, DESONIDE LOTION, DESOXIMETASONE CREAM, DESOXIMETASONE GEL, DESOXIMETASONE OINTMENT, DESOXIMETASONE SPRAY, DIFLORASONE CREAM 0.05%, DIFLORASONE OINTMENT 0.05%, EVESSE, FLUOCINOLONE CREAM 0.025%, FLURANDRENOLIDE, FLUTICASONE LOTION, HALCINONIDE, HALOBETASOL FOAM, HALOBETASOL LOTION, HALOBETASOL OINTMENT, HYDROCORTISONE BUTYRATE, HYDROCORTISONE BUTYRATE LOTION, HYDROCORTISONE LOTION 2%, HYDROCORTISONE SOLUTION 2.5%, HYDROCORTISONE VALERATE OINTMENT 0.2%, IMPOYZ CREAM, LEXETTE, MICORT HC, SERNIVO, TEXACORT, TOVET, TRIAMCINOLONE OINTMENT 0.05%, TRIAMCINOLONE SPRAY, ULTRAVATE | ALCLOMETASONE, BETAMETHASONE CREAM, BETAMETHASONE LOTION, BETAMETHASONE OINTMENT, CLOBETASOL CREAM, CLOBETASOL FOAM, CLOBETASOL GEL, CLOBETASOL OINTMENT, CLOBETASOL SOLUTION, DESONIDE CREAM, DESONIDE OINTMENT, FLUOCINOLONE, FLUTICASONE CREAM, FLUTICASONE OINTMENT, HALOBETASOL CREAM, HYDROCORTISONE CREAM, HYDROCORTISONE VALERATE, MOMETASONE, TRIAMCINOLONE CREAM, TRIAMCINOLONE LOTION 0.1%, TRIAMCINOLONE OINTMENT |
TOPICAL: | CALCIPOTRIENE/BETAMETHASONE OINTMENT, CALCIPOTRIENE/BETAMETHASONE SUSPENSION, WYNZORA, ZORYVE CREAM 0.3% | CALCIPOTRIENE CREAM, CLOBETASOL CREAM, CLOBETASOL OINTMENT, CLOBETASOL SOLUTION, ENSTILAR, HALOBETASOL CREAM, TAZAROTENE CREAM, TAZAROTENE GEL |
TOPICAL: | ARAZLO LOTION, TAZAROTENE FOAM | TAZAROTENE CREAM, TAZAROTENE GEL |
TOPICAL: | CALCIPOTRIENE FOAM, CALCIPOTRIENE OINTMENT, CALCITRIOL OINTMENT, PELLIX, SORILUX FOAM, VECTICAL OINTMENT | CALCIPOTRIENE CREAM |
ULCER DRUGS: | CIMETIDINE SOLUTION, CIMETIDINE TABLET, FAMOTIDINE TABLET 20MG, NIZATIDINE CAPSULE 150MG, NIZATIDINE CAPSULE 300MG, RANITIDINE | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. THE FOLLOWING PRESCRIPTION ALTERNATIVES ARE AVAILABLE: FAMOTIDINE SUSPENSION, FAMOTIDINE TABLET 40MG |
ULCER DRUGS: | DEXLANSOPRAZOLE, ESOMEPRAZOLE, KONVOMEP, LANSOPRAZOLE, OMEPRAZOLE/SODIUM BICARBONATE, PANTOPRAZOLE POWDER PACKET, PRILOSEC POWDER PACKET, RABEPRAZOLE, RABEPRAZOLE DR | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. THE FOLLOWING PRESCRIPTION ALTERNATIVES ARE AVAILABLE: ESOMEPRAZOLE DR 40MG CAPSULE, ESOMEPRAZOLE POWDER PACKET, LANSOPRAZOLE DR 30MG CAPSULE, OMEPRAZOLE CAPSULE, PANTOPRAZOLE TABLET |
ULCER DRUGS: | SUCRALFATE SUSPENSION (GENERIC CARAFATE) | SUCRALFATE TABLET |
UREA CYCLE DISORDER | OLPRUVA | GLYCEROL PHENYLBUTYRATE, SODIUM PHENYLBUTYRATE POWDER, SODIUM PHENYLBUTYRATE TABLET |
VAGINAL: | CLEOCIN SUPPOSITORY, XACIATO | CLINDAMYCIN VAGINAL CREAM, METRONIDAZOLE VAGINAL GEL |
VAGINAL: | FEMRING, IMVEXXY | ESTRADIOL CREAM, ESTRADIOL VAGINAL TABLET, ESTRING, PREMARIN CREAM, YUVAFEM VAGINAL TABLET |
VAGINAL: | CRINONE 4%, CRINONE 8% | ENDOMETRIN, MEDROXYPROGESTERONE, NORETHINDRONE |
VASCULITIS | TAVNEOS | AZATHIOPRINE |
VASOPRESSIN RECEPTOR ANTAGONISTS | TOLVAPTAN (GENERIC JYNARQUE) | JYNARQUE, TOLVAPTAN (GENERIC SAMSCA) |
VISION ENHANCEMENT | PILOCARPINE SOLUTION 1.25%, QLOSI, UPNEEQ, VIZZ, YUVEZZI | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT CLINICALLY APPROPRIATE OPTIONS. |
VITAMIN D | CALCITRIOL SOLUTION, DOXERCALCIFEROL, PARICALCITOL | CALCITRIOL CAPSULE, RAYALDEE |
WEIGHT LOSS AND WEIGHT MANAGEMENT | CONTRAVE | FOUNDAYO, LIRAGLUTIDE (GENERIC SAXENDA), PHENTERMINE, PHENTERMINE/TOPIRAMATE, WEGOVY INJECTION, WEGOVY PILL, ZEPBOUND |
WILSON'S DISEASE | CUVRIOR, GALZIN, PENICILLAMINE CAPSULE | PENICILLAMINE TABLET, TRIENTINE 250MG, TRIENTINE 500MG |
EmblemHealth City of New York HMO Drugs Removed From Formulary In 2027 | ||
DRUG CLASS | NON-COVERED | FORMULARY ALTERNATIVES |
ACNE AGENTS: | ALTRENO, TWYNEO | ABSORICA LD, ADAPALENE/BENZOYL PEROXIDE GEL 0.1-2.5%, ISOTRETINOIN PRODUCTS (INCLUDING: ACCUTANE CAPSULE, AMNESTEEM CAPSULE, CLARAVIS CAPSULE, ISOTRETINOIN CAPSULE, ZENATANE CAPSULE), TRETINOIN CREAM, TRETINOIN GEL 0.01% |
ACNE AGENTS: | CABTREO, ISOTRETINOIN 25MG, ISOTRETINOIN 35MG, TRETINOIN GEL 0.05%, TRETINOIN GEL 0.025%, TRETINOIN MICROSPHERE GEL, TRETINOIN MICROSPHERE GEL 0.1%, TRETINOIN MICROSPHERE GEL 0.04%, ADAPALENE CREAM, ADAPALENE GEL, ADAPALENE PAD, ADAPALENE SOLUTION, ADAPALENE/BENZOYL PEROXIDE GEL 0.3-2.5% | ABSORICA LD, ADAPALENE/BENZOYL PEROXIDE GEL 0.1-2.5%, ISOTRETINOIN PRODUCTS (INCLUDING: ACCUTANE CAPSULE, AMNESTEEM CAPSULE, CLARAVIS CAPSULE, ISOTRETINOIN CAPSULE, ZENATANE CAPSULE), TRETINOIN CREAM, TRETINOIN GEL 0.01%, AKLIEF |
ACNE AGENTS: | ADAPALENE CREAM, ADAPALENE GEL, ADAPALENE PAD, ADAPALENE SOLUTION, ADAPALENE/BENZOYL PEROXIDE GEL 0.3-2.5% | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. THE FOLLOWING PRESCRIPTION ALTERNATIVES ARE AVAILABLE: ADAPALENE/BENZOYL PEROXIDE GEL 0.1-2.5%, TRETINOIN CREAM, TRETINOIN GEL 0.01% |
ACNE AND ROSACEA AGENTS | CLINDAMYCIN GEL (GENERIC CLINDAGEL), EPSOLAY, FINACEA FOAM, NORITATE CREAM | AZELAIC ACID GEL, BRIMONIDINE GEL, CLINDAMYCIN GEL (GENERIC CLEOCIN-T), CLINDAMYCIN LOTION, CLINDAMYCIN SOLUTION, CLINDAMYCIN/BENZOYL PEROXIDE GEL (REFRIGERATED), ERYTHROMYCIN SOLUTION, IVERMECTIN CREAM, METRONIDAZOLE CREAM, METRONIDAZOLE GEL, NEUAC, ZILXI |
ACNE AND ROSACEA AGENTS: | AZELEX, CLINDAMYCIN FOAM, CLINDAMYCIN/BENZOYL PEROXIDE GEL, CLINDAMYCIN/TRETINOIN GEL, DAPSONE GEL, ERYTHROMYCIN/BENZOYL PEROXIDE GEL, METRONIDAZOLE LOTION, OXYMETAZOLINE | AZELAIC ACID GEL, BRIMONIDINE GEL, CLINDAMYCIN GEL (GENERIC CLEOCIN-T), CLINDAMYCIN LOTION, CLINDAMYCIN SOLUTION, CLINDAMYCIN/BENZOYL PEROXIDE GEL (REFRIGERATED), IVERMECTIN CREAM, METRONIDAZOLE CREAM, METRONIDAZOLE GEL, NEUAC, ZILXI, AMZEEQ, WINLEVI |
AGENTS FOR PAINFUL INTERCOURSE | INTRAROSA, OSPHENA | ESTRADIOL CREAM, ESTRADIOL VAGINAL TABLET, ESTRING, PREMARIN CREAM, YUVAFEM VAGINAL TABLET |
ALZHEIMER'S AGENTS | MEMANTINE ER CAPSULE, MEMANTINE/DONEPEZIL, NAMZARIC, ZUNVEYL | DONEPEZIL TABLET, MEMANTINE SOLUTION, MEMANTINE TABLET, RIVASTIGMINE PATCH |
ANTIANGINAL AGENTS | ISOSORBIDE DINITRATE TABLET 40MG | ISOSORBIDE DINITRATE TABLET (EXCEPT 40MG), ISOSORBIDE MONONITRATE ER, NITROGLYCERIN LINGUAL SPRAY, NITROGLYCERIN SL TABLET, RANOLAZINE ER TABLET |
ANTIBIOTICS: | LIKMEZ, METRONIDAZOLE TABLET 125MG | METRONIDAZOLE TABLET 250MG, METRONIDAZOLE TABLET 500MG |
ANTIBIOTICS: | METRONIDAZOLE CAPSULE 375MG | METRONIDAZOLE TABLET |
ANTIBIOTICS: | SEYSARA, TETRACYCLINE TABLET 250MG, TETRACYCLINE TABLET 500MG | DOXYCYCLINE HYCLATE, DOXYCYCLINE MONOHYDRATE, MINOCYCLINE CAPSULE, TETRACYCLINE CAPSULE |
ANTIBIOTICS: | DORYX MPC, DOXYCYCLINE (GENERIC ORACEA), DOXYCYCLINE HYCLATE 75 MG, DOXYCYCLINE HYCLATE ER TABLET, DOXYCYCLINE HYCLATE TABLET 50MG, DOXYCYCLINE HYCLATE TABLET 75MG, DOXYCYCLINE HYCLATE TABLET 150MG, DOXYCYCLINE MONOHYDRATE CAPSULE 75MG, DOXYCYCLINE MONOHYDRATE CAPSULE 150MG, MINOCYCLINE ER TABLET (AUTHORIZED GENERIC OF SOLODYN), MINOCYCLINE ER TABLET (GENERIC SOLODYN), MINOCYCLINE TABLET, TARGADOX | DOXYCYCLINE HYCLATE, DOXYCYCLINE MONOHYDRATE, MINOCYCLINE CAPSULE, TETRACYCLINE CAPSULE, EMROSI |
ANTIBIOTICS: | BLUJEPA, NITROFURANTOIN SUSPENSION 50MG/5ML, ORLYNVAH, PIVYA | FOSFOMYCIN, METHENAMINE, NITROFURANTOIN MACROCRYSTAL, NITROFURANTOIN SUSPENSION 25MG/5ML, TRIMETHOPRIM/SULFAMETHOXAZOLE |
ANTICOAGULANTS | SAVAYSA | DABIGATRAN, ELIQUIS, RIVAROXABAN, XARELTO |
ANTICONVULSANTS: BENZODIAZEPINES | SYMPAZAN | CLOBAZAM, CLONAZEPAM |
ANTICONVULSANTS: GABAPENTINOIDS | GABAPENTIN CAPSULE 200MG, RELGAABI CAPSULE 200MG | GABAPENTIN CAPSULE 100MG, GABAPENTIN CAPSULE 300MG, GABAPENTIN CAPSULE 400MG, GABAPENTIN DAILY, GABAPENTIN SOLUTION, GABAPENTIN TABLET, RELGAABI CAPSULE 300MG, RELGAABI CAPSULE 400MG |
ANTICONVULSANTS: GABAPENTINOIDS | GABARONE | GABAPENTIN CAPSULE 100MG, GABAPENTIN CAPSULE 300MG, GABAPENTIN CAPSULE 400MG ,GABAPENTIN DAILY, GABAPENTIN SOLUTION, GABAPENTIN TABLET, RELGAABI CAPSULE 300MG, RELGAABI CAPSULE 400MG |
ANTICONVULSANTS: OTHERS | ELEPSIA XR, LEVETIRACETAM (AUTHORIZED GENERIC OF SPRITAM), TOPIRAMATE SOLUTION | LEVETIRACETAM, LEVETIRACETAM ER, TOPIRAMATE, TOPIRAMATE SPRINKLE ER |
ANTICONVULSANTS: OTHERS | TOPIRAMATE ER CAPSULE, VIGAFYDE | TOPIRAMATE SPRINKLE CAPSULE, VIGABATRIN POWDER PACK |
ANTICONVULSANTS: SODIUM CHANNEL BLOCKERS | MOTPOLY XR, ZONISADE SUSPENSION | LACOSAMIDE TABLET, ZONISAMIDE CAPSULE |
ANTICONVULSANTS: SODIUM CHANNEL BLOCKERS | LAMOTRIGINE ODT, SUBVENITE | LAMOTRIGINE CHEWABLE TABLET, LAMOTRIGINE TABLET |
ANTIDEPRESSANTS | APLENZIN, BUPROPION ER (AUTHORIZED GENERIC OF FORFIVO XL), DRIZALMA SPRINKLE, DULOXETINE DR 80MG, DULOXETINE DR 90MG, DULOXETINE DR 120MG, RALDESY, VENLAFAXINE ER 112.5MG | BUPROPION SR, BUPROPION XL, DESVENLAFAXINE ER, DULOXETINE, TRAZODONE TABLETS, VENLAFAXINE, VENLAFAXINE ER CAPSULE, VILAZODONE |
ANTIDEPRESSANTS: OTHER | DESVENLAFAXINE ER 50MG, DESVENLAFAXINE ER 100MG, DULOXETINE ER, EXXUA, VENLAFAXINE ER | BUPROPION SR, BUPROPION XL, DESVENLAFAXINE SUCCINATE ER, DULOXETINE, VENLAFAXINE, VENLAFAXINE ER CAPSULE, VILAZODONE |
ANTIDEPRESSANTS: | CITALOPRAM CAPSULE 30MG, ESCITALOPRAM CAPSULE 15MG, FLUOXETINE TABLET (GENERIC SARAFEM), FLUOXETINE TABLET 60MG, FLUVOXAMINE ER CAPSULE, PAROXETINE CAPSULE 7.5MG, PAROXETINE ER TABLET, PAROXETINE SUSPENSION, SERTRALINE CAPSULE | CITALOPRAM, ESCITALOPRAM, FLUOXETINE CAPSULE, FLUOXETINE TABLET, FLUVOXAMINE, PAROXETINE, SERTRALINE CONCENTRATE, SERTRALINE TABLET |
ANTIDIARRHEALS | MYTESI | DIPHENOXYLATE/ATROPINE |
ANTIFUNGALS: AZOLES | TOLSURA, VIVJOA | FLUCONAZOLE, ITRACONAZOLE, KETOCONAZOLE, NOXAFIL PACKET, POSACONAZOLE DR, POSACONAZOLE SUSPENSION, VORICONAZOLE |
ANTIHISTAMINES | CETIRIZINE SOLUTION, CLARINEX-D, DESLORATADINE ODT, DESLORATADINE SOLUTION, DESLORATADINE TABLET, LEVOCETIRIZINE SOLUTION, LEVOCETIRIZINE TABLET | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS |
ANTIMALARIALS | SOVUNA | HYDROXYCHLOROQUINE |
ANTINAUSEA AND VOMITING AGENTS | GRANISOL | GRANISETRON TABLET, SCOPOLAMINE PATCH |
ANTIPLATELET AGENTS | YOSPRALA | ASPIRIN, OMEPRAZOLE CAPSULE, PANTOPRAZOLE TABLET |
ANTIVIRALS: | LEDIPASVIR/SOFOSBUVIR, SOFOSBUVIR/VELPATASVIR | EPCLUSA, HARVONI, MAVYRET, SOVALDI, VOSEVI |
ASTHMA/COPD: | BEVESPI, DUAKLIR, FLUTICASONE FUROATE/VILANTEROL, FLUTICASONE PROPIONATE/SALMETEROL HFA, UMECLIDINIUM/VILANTEROL | ADVAIR HFA, AIRSUPRA, ANORO ELLIPTA, BREO ELLIPTA, BREYNA (GENERIC SYMBICORT), BREZTRI, BUDESONIDE/FORMOTEROL (GENERIC SYMBICORT), COMBIVENT, DULERA, FLUTICASONE PROPIONATE/SALMETEROL AEROSOL (AUTHORIZED GENERIC OF AIRDUO), FLUTICASONE PROPIONATE/SALMETEROL DISKUS (GENERIC ADVAIR DISKUS), STIOLTO, TRELEGY, WIXELA |
ASTHMA: | ALVESCO, BECLOMETHASONE (AUTHORIZED GENERIC OF QVAR), FLUTICASONE FUROATE, FLUTICASONE PROPIONATE DISKUS, FLUTICASONE PROPIONATE HFA, PULMICORT INHALER | ARNUITY ELLIPTA, ASMANEX, BUDESONIDE NEBULIZED SOLUTION, QVAR REDIHALER |
ASTHMA: | LEVALBUTEROL HFA (AUTHORIZED GENERIC OF XOPENEX), PROAIR RESPICLICK, XOPENEX HFA | ALBUTEROL HFA |
ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) AND NARCOLEPSY | AMPHETAMINE ER TABLET, AMPHETAMINE TABLET, AMPHETAMINE XR ODT, AMPHETAMINE/DEXTROAMPHETAMINE ER CAPSULE (GENERIC MYDAYIS), ARYNTA, ATONCY, COTEMPLA XR-ODT, DYANAVEL XR SUSP, DYANAVEL XR TABLET, METHYLPHENIDATE ER CAPSULE (GENERIC APTENSIO XR), METHYLPHENIDATE ER TABLET (AUTHORIZED GENERIC OF RELEXXII), METHYLPHENIDATE PATCH, ONYDA XR, QELBREE, RELEXXII, XELSTRYM | AMPHETAMINE/DEXTROAMPHETAMINE, AMPHETAMINE/DEXTROAMPHETAMINE XR, ARMODAFINIL, ATOMOXETINE, AZSTARYS, CLONIDINE ER TABLET, DEXMETHYLPHENIDATE ER, DEXTROAMPHETAMINE, DEXTROAMPHETAMINE SOLUTION, JORNAY PM, LISDEXAMFETAMINE, METHYLPHENIDATE, METHYLPHENIDATE ER (GENERIC CONCERTA), MODAFINIL, QUILLICHEW ER, QUILLIVANT XR SUSPENSION, SODIUM OXYBATE, SUNOSI |
BENZODIAZEPINES | ALPRAZOLAM INTENSOL, ALPRAZOLAM ODT, LOREEV XR | ALPRAZOLAM TABLET, CHLORDIAZEPOXIDE, CLORAZEPATE, DIAZEPAM SOLUTION, DIAZEPAM TABLET, LORAZEPAM SOLUTION, LORAZEPAM TABLET, OXAZEPAM |
BLADDER INCONTINENCE | DARIFENACIN ER, FESOTERODINE ER, OXYBUTYNIN 2.5MG | MIRABEGRON TABLET, MYRBETRIQ GRANULES, MYRBETRIQ TABLET, OXYBUTYNIN, OXYBUTYNIN ER, OXYBUTYNIN SYRUP, SOLIFENACIN TABLET, TOLTERODINE, TOLTERODINE ER, TROSPIUM, TROSPIUM ER |
BPH/ENLARGED PROSTATE | CARDURA XL, DUTASTERIDE/TAMSULOSIN, ENTADFI, TEZRULY | ALFUZOSIN ER, DUTASTERIDE, FINASTERIDE, SILODOSIN, TADALAFIL 5MG, TAMSULOSIN, TERAZOSIN |
COMPLEMENT INHIBITORS | VOYDEYA | EMPAVELI, FABHALTA |
COPD: | TIOTROPIUM (GENERIC SPIRIVA HANDIHALER), TUDORZA, UMECLIDINIUM (AUTHORIZED GENERIC OF INCRUSE ELLIPTA), YUPELRI | INCRUSE ELLIPTA, SPIRIVA RESPIMAT |
COPD:PHOSPHODIESTERASE INHIBITORS | OHTUVAYRE | ROFLUMILAST |
CORTICOSTEROIDS | TARPEYO | BUDESONIDE DR CAPSULE |
CORTICOSTEROIDS | AGAMREE, ALKINDI, CORTISONE, DEFLAZACORT, DEXAMETHASONE 1.5MG, DEXAMETHASONE 6 DAY, DEXAMETHASONE 10 DAY, DEXAMETHASONE 13 DAY, DEXLYT, EOHILIA, HEMADY, HIDEX, JAYTHARI, KHINDIVI, KYMBEE, ORAPRED ODT, PREDNISOLONE ODT, PREDNISOLONE SOLUTION (10MG/5ML AND 20MG/5ML), PREDNISOLONE TABLET 5MG, PREDNISONE DR, PREDNISONE INTENSOL 5MG/ML, PYQVI, TAPERDEX 6 DAY, TAPERDEX 7 DAY, TAPERDEX 12 DAY | BUDESONIDE DR CAPSULE, DEXAMETHASONE, HYDROCORTISONE, METHYLPREDNISOLONE, PREDNISOLONE SOLUTION (EXCEPT 10MG/5ML AND 20MG/5ML), PREDNISONE, PREDNISONE SOLUTION 5MG/5ML |
CUSHING'S DISEASE | RECORLEV | KETOCONAZOLE TABLET |
DIABETES: | MIGLITOL | ACARBOSE |
DIABETES: | METFORMIN ER MODIFIED RELEASE (GENERIC GLUMETZA), METFORMIN ER OSMOTIC (GENERIC FORTAMET), METFORMIN SOLUTION (GENERIC RIOMET), METFORMIN TABLET 625MG, METFORMIN TABLET 750MG | METFORMIN, METFORMIN ER (GENERIC GLUCOPHAGE XR) |
DIABETES: | ALOGLIPTIN/METFORMIN, ALOGLIPTIN/PIOGLITAZONE, DAPAGLIFLOZIN/SAXAGLIPTIN (AUTHORIZED GENERIC OF QTERN), INVOKAMET, INVOKAMET XR, JENTADUETO, JENTADUETO XR, SAXAGLIPTIN/METFORMIN XR, SEGLUROMET, SITAGLIPTIN/METFORMIN (AUTHORIZED GENERIC OF ZITUVIMET), SITAGLIPTIN/METFORMIN ER (AUTHORIZED GENERIC OF ZITUVIMET XR), STEGLUJAN, ZITUVIMET, ZITUVIMET XR | DAPAGLIFLOZIN/METFORMIN ER, GLIPIZIDE/METFORMIN, GLYBURIDE/METFORMIN, GLYXAMBI, PIOGLITAZONE/METFORMIN, SITAGLIPTIN PHOSPHATE/METFORMIN, SITAGLIPTIN PHOSPHATE/METFORMIN ER, SYNJARDY, SYNJARDY XR, TRIJARDY XR, XIGDUO XR 2.5MG/1000MG |
DIABETES: | PIOGLITAZONE/GLIMEPIRIDE | DAPAGLIFLOZIN/METFORMIN ER, GLIPIZIDE/METFORMIN, GLYBURIDE/METFORMIN, GLYXAMBI, PIOGLITAZONE/METFORMIN, SITAGLIPTIN PHOSPHATE/METFORMIN, SITAGLIPTIN PHOSPHATE/METFORMIN ER, SYNJARDY, SYNJARDY XR, TRIJARDY XR, XIGDUO XR 2.5MG/1000MG |
DIABETES: | FREESTYLE LIBRE | DEXCOM |
DIABETES: | ALOGLIPTIN, BRYNOVIN, SAXAGLIPTIN, SITAGLIPTIN (AUTHORIZED GENERIC OF ZITUVIO), TRADJENTA, ZITUVIO | SITAGLIPTIN PHOSPHATE |
DIABETES: | LIRAGLUTIDE | MOUNJARO, OZEMPIC INJECTION, OZEMPIC PILL, TRULICITY |
DIABETES: | LIFESCAN (ONETOUCH), NIPRO (TRUETEST, TRUETRACK), ROCHE (ACCU-CHEK) | ABBOTT (FREESTYLE, PRECISION), ASCENSIA (CONTOUR) |
DIABETES: | BASAGLAR, INSULIN GLARGINE (BIOLOGIC BY WINTHROP), INSULIN GLARGINE-YFGN (BIOLOGIC BY CIVICA), LANTUS, REZVOGLAR | HUMULIN N, HUMULIN R U-500, INSULIN GLARGINE-YFGN, NOVOLIN N, SEMGLEE-YFGN, TOUJEO, TRESIBA |
DIABETES: | INSULIN LISPRO MIX | HUMALOG MIX, HUMULIN 70/30, NOVOLIN 70/30, NOVOLOG MIX |
DIABETES: | ADMELOG, AFREZZA, APIDRA, INSULIN LISPRO, KIRSTY, MERILOG | FIASP, HUMALOG, HUMULIN R, LYUMJEV, NOVOLIN R, NOVOLOG |
DIABETES: | BEXAGLIFLOZIN, BRENZAVVY, INVOKANA, STEGLATRO | DAPAGLIFLOZIN, JARDIANCE |
DRY EYES | CEQUA, CYCLOSPORINE (GENERIC RESTASIS), MIEBO, VEVYE, XIIDRA | EYSUVIS, RESTASIS SINGLE-DOSE VIALS |
EXCESSIVE SWEATING | QBREXZA, SOFDRA | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS |
FIBROMYALGIA AGENTS | MILNACIPRAN | DULOXETINE, GABAPENTIN, PREGABALIN, HORIZANT, TONMYA |
FIRST-GENERATION ANTIHISTAMINES | CARBINOXAMINE ER SUSPENSION, CARBINOXAMINE SOLUTION, CARBINOXAMINE TABLET 6MG, CARBZAH, CLEMASTINE SYRUP, CLEMSZA, CORPHENA, KARBINAL, RYCLORA, RYVENT | CARBINOXAMINE TABLET 4MG, CYPROHEPTADINE SYRUP, CYPROHEPTADINE TABLET |
FISH OIL | ICOSAPENT ETHYL (GENERIC VASCEPA), OMEGA-3-ACID ETHYL ESTERS CAPSULE | VASCEPA |
GALLSTONE DISSOUTION AGENTS | RELTONE, URSODIOL CAPSULE 200MG, URSODIOL CAPSULE 400MG, URSOLIGN | URSODIOL CAPSULE 300MG, URSODIOL TABLET |
GLAUCOMA: | BRIMONIDINE SOLUTION 0.1%, IOPIDINE | BRIMONIDINE SOLUTION 0.2%, SIMBRINZA |
GLAUCOMA: | BRIMONIDINE/TIMOLOL, DORZOLAMIDE/TIMOLOL PRESERVATIVE FREE, TIMOLOL (GENERIC ISTALOL), TIMOLOL (GENERIC TIMOPTIC OCUDOSE), TIMOLOL 0.5% (GENERIC BETIMOL 0.5%), TIMOLOL GEL | DORZOLAMIDE SOLUTION, DORZOLAMIDE/TIMOLOL SOLUTION, TIMOLOL SOLUTION |
GLAUCOMA: | BRINZOLAMIDE | DORZOLAMIDE SOLUTION |
GLAUCOMA: | BIMATOPROST 0.03%, IYUZEH, OMLONTI, TAFLUPROST, XELPROS | BIMATOPROST 0.01%, LATANOPROST SOLUTION |
GLAUCOMA: | TRAVOPROST, ZOLYMBUS | LATANOPROST, BIMATOPROST 0.01%, VYZULTA |
GOUT | ALLOPURINOL 200MG, COLCHICINE CAPSULE, FEBUXOSTAT, GLOPERBA | ALLOPURINOL, COLCHICINE TABLET (GENERIC COLCRYS), PROBENECID, PROBENECID/COLCHICINE |
HEART FAILURE: SGLT2 AND SGLT1 INHIBITOR | INPEFA | DAPAGLIFLOZIN, JARDIANCE |
HELICOBACTER PYLORI | BISMUTH SUBCITRATE/METRONIDAZOLE/TETRACYCLINE, VOQUEZNA DUAL PAK, VOQUEZNA TRIPLE PAK | AMOXICILLIN, CLARITHROMYCIN, METRONIDAZOLE, OMEPRAZOLE, PANTOPRAZOLE, TALICIA, TETRACYCLINE |
HELICOBACTER PYLORI | AMOXICILLIN/CLARITHROMYCIN/LANSOPRAZOLE | AMOXICILLIN, CLARITHROMYCIN, METRONIDAZOLE, OMEPRAZOLE, PANTOPRAZOLE, TALICIA, TETRACYCLINE, VOQUEZNA |
HEREDITARY TYROSINEMIA TYPE 1 AGENTS | HARLIKU | NITISINONE CAPSULE, NITYR, ORFADIN SUSPENSION |
HIGH BLOOD PRESSURE: | AZILSARTAN, EDARBYCLOR, TELMISARTAN/HCTZ, VALSARTAN SOLUTION | CANDESARTAN, CANDESARTAN/HCTZ, IRBESARTAN, IRBESARTAN/HCTZ, LOSARTAN, LOSARTAN/HCTZ, OLMESARTAN, OLMESARTAN/HCTZ, TELMISARTAN, VALSARTAN, VALSARTAN/HCTZ, ARBLI |
HIGH BLOOD PRESSURE: | BISOPROLOL 2.5MG, CARVEDILOL ER, HEMANGEOL, INDERAL XL, INNOPRAN XL, KAPSPARGO, LABETALOL TABLET 400MG, LOPRESSOR, METOPROLOL 12.5MG, SOTYLIZE SOLUTION, TIMOLOL TABLET 5MG, TIMOLOL TABLET 10MG, TIMOLOL TABLET 20MG | ATENOLOL, BISOPROLOL, CARVEDILOL, LABETALOL, METOPROLOL, NEBIVOLOL, PROPRANOLOL SOLUTION 20MG/5ML, PROPRANOLOL SOLUTION 40MG/5ML, PROPRANOLOL TABLET |
HIGH BLOOD PRESSURE: | CONJUPRI, DILTIAZEM ER CAPSULE 360MG, DILTIAZEM ER TABLET, ISRADIPINE, KATERZIA, LEVAMLODIPINE, MATZIM LA, NICARDIPINE, NISOLDIPINE ER, NORLIQVA, SDAMLO, SULAR, VERAPAMIL ER CAPSULE | AMLODIPINE, CARTIA XT, DILTIAZEM ER CAPSULE (EXCEPT 360MG), FELODIPINE ER, NIFEDIPINE, VERAPAMIL, VERAPAMIL ER |
HIGH BLOOD PRESSURE: | AMLODIPINE/VALSARTAN/HCTZ, PRESTALIA, TRANDOLAPRIL/VERAPAMIL, WIDAPLIK | AMLODIPINE/BENAZEPRIL, AMLODIPINE/OLMESARTAN, AMLODIPINE/VALSARTAN, OLMESARTAN/AMLODIPINE/HCTZ |
HIGH BLOOD PRESSURE: | ALISKIREN TABLET | ENALAPRIL, IRBESARTAN, LISINOPRIL, LOSARTAN, VALSARTAN |
HIGH BLOOD PRESSURE: | TRYVIO | EPLERENONE, SPIRONOLACTONE TABLET, BAXFENDY |
HIGH BLOOD PRESSURE: | HEMICLOR, INZIRQO, THALITONE | CHLORTHALIDONE, HYDROCHLOROTHIAZIDE, INDAPAMIDE, METOLAZONE |
HIGH CHOLESTEROL: | CHOLESTYRAMINE LIGHT POWDER PACKETS, CHOLESTYRAMINE POWDER PACKETS, COLESEVELAM PACKETS, PREVALITE PACKETS | CHOLESTYRAMINE LIGHT POWDER, CHOLESTYRAMINE POWDER, COLESEVELAM TABLET, PREVALITE POWDER |
HIGH CHOLESTEROL: | AMLODIPINE/ATORVASTATIN, ATORVALIQ, FLOLIPID, FLUVASTATIN CAPSULE, FLUVASTATIN ER TABLET, PITAVASTATIN, ZYPITAMAG | ATORVASTATIN, EZETIMIBE/SIMVASTATIN, LOVASTATIN, PRAVASTATIN, ROSUVASTATIN, SIMVASTATIN |
HIV | PIFELTRO | TALK TO YOUR DOCTOR ABOUT CLINICALLY APPROPRIATE ALTERNATIVES. EXAMPLES OF COVERED ALTERNATIVES INCLUDE: BIKTARVY, DESCOVY, DOVATO, EFAVIRENZ, EMTRICITABINE/TENOFOVIR DISOPROXIL FUMARATE (GENERIC TRUVADA), GENVOYA, JULUCA, NEVIRAPINE |
HUNTINGTON'S DISEASE & TARDIVE DYSKINESIA | AUSTEDO | INGREZZA |
HYPERKALEMIA AGENTS | VELTASSA | LOKELMA, SODIUM POLYSTYRENE SULFONATE |
HYPNOTICS: | FLURAZEPAM, QUAZEPAM, TEMAZEPAM (7.5MG AND 22.5MG) | ESTAZOLAM, LORAZEPAM, TEMAZEPAM (EXCEPT 7.5MG AND 22.5MG) |
HYPNOTICS: | DAYVIGO, DOXEPIN (GENERIC SILENOR), QUVIVIQ, RAMELTEON | BELSOMRA, ESZOPICLONE, TASIMELTEON, ZALEPLON, ZOLPIDEM, ZOLPIDEM ER |
INFLAMMATORY BOWEL AGENTS | BUDESONIDE ER TABLET, DIPENTUM, MESALAMINE ER CAPSULE 250MG, MESALAMINE ER CAPSULE 500MG | BALSALAZIDE, BUDESONIDE DR CAPSULE, MESALAMINE DR TABLET 1.2GM, MESALAMINE DR TABLET 800MG, MESALAMINE ENEMA, MESALAMINE ER CAPSULE 0.375GM (GENERIC APRISO), MESALAMINE SUPPOSITORY, SULFASALAZINE |
KIDNEY CANCER | PAZOPANIB 400MG | PAZOPANIB 200MG |
LAXATIVES: | CLENPIQ, PEG 3350/KCL/NACL/NA SULFATE/NA ASCORBATE-C (GENERIC MOVIPREP), PLENVU, SUFLAVE | GAVILYTE-G SOLUTION, GAVILYTE-N SOLUTION, PEG 3350/ELECTROLYTES SOLUTION, PEG-3350/NACL/NABICARBONATE/KCL SOLUTION, SODIUM SULFATE/POTASSIUM SULFATE/MAGNESIUM SULFATE (GENERIC SUPREP) |
LAXATIVES: | IBSRELA, LINZESS, LUBIPROSTONE, PRUCALOPRIDE, | MOVANTIK, SYMPROIC, TRULANCE |
LONG-ACTING BETA AGONISTS | FORMOTEROL NEBULIZED SOLUTION | ARFORMOTEROL NEBULIZED SOLUTION, SEREVENT, STRIVERDI |
LOOP DIURETICS | ENBUMYST | BUMETANIDE, FUROSEMIDE, TORSEMIDE |
LOOP DIURETICS | ETHACRYNIC ACID, FUROSEMIDE SOLUTION 8MG/ML, SOAANZ | BUMETANIDE, FUROSEMIDE TABLET, TORSEMIDE, FUROSCIX, LASIX ONYU |
MENOPAUSAL SYMPTOMS: NON-HORMONAL | LYNKUET, VEOZAH | CITALOPRAM, DESVENLAFAXINE ER, DULOXETINE, ESCITALOPRAM, GABAPENTIN, OXYBUTYNIN, PAROXETINE, VENLAFAXINE |
MENTAL HEALTH | BYSANTI, COBENFY, OPIPZA | ARIPIPRAZOLE, ASENAPINE, LURASIDONE, OLANZAPINE, PALIPERIDONE ER, QUETIAPINE ER, QUETIAPINE FUMARATE, REXULTI, RISPERIDONE, VRAYLAR, ZIPRASIDONE |
MENTAL HEALTH | NUPLAZID, OLANZAPINE/FLUOXETINE, QUETIAPINE 150MG | ARIPIPRAZOLE, ASENAPINE, CLOZAPINE, FLUOXETINE, LURASIDONE, OLANZAPINE, PALIPERIDONE ER, QUETIAPINE (EXCEPT 150MG), QUETIAPINE ER, REXULTI, RISPERIDONE, VRAYLAR, ZIPRASIDONE, CAPLYTA, LYBALVI |
MIGRAINE PRODUCTS: OTHERS | TRUDHESA | DICLOFENAC TABLET, DIHYDROERGOTAMINE INJECTION SOLUTION |
MIGRAINE PRODUCTS: TRIPTANS | SYMBRAVO | ELETRIPTAN, NARATRIPTAN, RIZATRIPTAN, SUMATRIPTAN, ZOLMITRIPTAN TABLET |
MIGRAINE PRODUCTS: | ZAVZPRET | NURTEC ODT, QULIPTA, UBRELVY |
MIGRAINE PRODUCTS: | CAFERGOT, DICLOFENAC PACKET, DIHYDROERGOTAMINE NASAL (GENERIC MIGRANAL), ELYXB, ERGOTAMINE/CAFFEINE | DICLOFENAC TABLET, DIHYDROERGOTAMINE INJECTION SOLUTION |
MULTIPLE SCLEROSIS | BAFIERTAM, PONVORY, TASCENSO ODT | CLADRIBINE, DIMETHYL FUMARATE, FINGOLIMOD, MAYZENT, TERIFLUNOMIDE, VUMERITY, ZEPOSIA |
MUSCLE RELAXANTS | ATMEKSI, BACLOFEN 5MG TABLET, BACLOFEN 15MG TABLET, BACLOFEN ORAL SOLUTION 5MG/5ML, BACLOFEN ORAL SOLUTION 10MG/5ML, BACLOFEN ORAL SUSPENSION, CHLORZOXAZONE 250MG, CHLORZOXAZONE 375MG, CHLORZOXAZONE 750MG, CYCLOBENZAPRINE 7.5MG TABLET, CYCLOBENZAPRINE ER CAPSULE (GENERIC AMRIX), DANTROLENE, FEXMID, METAXALONE TABLET 400MG, METAXALONE TABLET 640MG, METAXALONE TABLET 800MG, METHOCARBAMOL TABLET 1000MG, NORGESIC, NORGESIC FORTE, ONTRALFY, ORPHENGESIC, ORPHENGESIC FORTE, TANLOR, TIZANIDINE CAPSULE, TIZANIDINE CAPSULE 8MG, ZANAFLEX | BACLOFEN TABLET, CHLORZOXAZONE 500MG, CYCLOBENZAPRINE TABLET, METHOCARBAMOL TABLET, TIZANIDINE TABLET |
NASAL STEROIDS | FLUNISOLIDE NASAL, MOMETASONE NASAL, OMNARIS, QNASL | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. THE FOLLOWING PRESCRIPTION ALTERNATIVE IS AVAILABLE: FLUTICASONE NASAL |
NASAL: | AZELASTINE/FLUTICASONE NASAL (GENERIC DYMISTA), RYALTRIS, FLUNISOLIDE NASAL, MOMETASONE NASAL, OMNARIS, QNASL | AZELASTINE NASAL 0.1 %, FLUTICASONE NASAL, XHANCE |
NONSTEROIDAL ANTI-INFLAMMATORY AGENTS (NSAIDS) | COMBOGESIC, IBUPROFEN SUSPENSION | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. |
OPHTHALMIC: | BEPOTASTINE, EPINASTINE SOLUTION, OLOPATADINE SOLUTION, VERKAZIA, ZERVIATE | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. THE FOLLOWING PRESCRIPTION ALTERNATIVE IS AVAILABLE: AZELASTINE SOLUTION |
OPHTHALMIC: | AZASITE, CILOXAN OINTMENT, TOBREX OINTMENT, ZIRGAN | BESIVANCE, CIPROFLOXACIN SOLUTION, ERYTHROMYCIN OINTMENT, GENTAMICIN SOLUTION, MOXIFLOXACIN SOLUTION, NATACYN, OFLOXACIN SOLUTION, TOBRAMYCIN SOLUTION, TRIFLURIDINE SOLUTION |
OPHTHALMIC: | ACUVAIL, BROMFENAC 0.07%, NEVANAC | DICLOFENAC SOLUTION |
OPHTHALMIC: | ACULAR, BROMFENAC 0.09%, BROMFENAC 0.075% | DICLOFENAC, ILEVRO |
OPHTHALMIC: | TOBRADEX OINTMENT | NEOMYCIN/POLYMYXIN/DEXAMETHASONE OINTMENT, NEOMYCIN/POLYMYXIN/DEXAMETHASONE SUSPENSION, TOBRAMYCIN/DEXAMETHASONE SUSPENSION |
OPHTHALMIC: | LOTEPREDNOL/OBRAMYCIN, NEOMYCIN/POLYMYXIN/HYDROCORTISONE, TOBRADEX ST | NEOMYCIN/POLYMYXIN/DEXAMETHASONE OINTMENT, NEOMYCIN/POLYMYXIN/DEXAMETHASONE SUSPENSION, TOBRAMYCIN/DEXAMETHASONE SUSPENSION |
OPHTHALMIC: | BYQLOVI, CLOBETASOL SUSPENSION 0.05%, DIFLUPREDNATE, FML FORTE, INVELTYS, PRED MILD | DEXAMETHASONE SOLUTION, FLUOROMETHOLONE SUSPENSION 0.1%, LOTEMAX OINTMENT, LOTEMAX SM GEL, LOTEPREDNOL GEL, LOTEPREDNOL SUSPENSION, PREDNISOLONE SUSPENSION 1% |
OSTEOPOROSIS AGENTS: BISPHOSPHONATES | ALENDRONATE SOLUTION, BINOSTO, FOSAMAX PLUS D, RISEDRONATE 5MG, RISEDRONATE DR | ALENDRONATE TABLET, IBANDRONATE, RISEDRONATE |
OTIC: | CIPROFLOXACIN/FLUOCINOLONE, CIPROFLOXACIN/HYDROCORTISONE, CORTISPORIN-TC, OTOVEL, XTORO | CIPROFLOXACIN SOLUTION, CIPROFLOXACIN/DEXAMETHASONE SUSPENSION, FLUOCINOLONE OIL, NEOMYCIN/POLYMYXIN/HYDROCORTISONE SOLUTION, NEOMYCIN/POLYMYXIN/HYDROCORTISONE SUSPENSION, OFLOXACIN SOLUTION |
PAIN: | VYSCOXA | CELECOXIB |
PAIN: | BUPRENORPHINE PATCH, OXYCONTIN | BELBUCA, FENTANYL PATCH, MORPHINE ER, OXYCODONE, XTAMPZA ER |
PAIN: | ACETAMINOPHEN/CAFFEINE/DIHYDROCODEINE, HYDROCODONE ER (AUTHORIZED GENERIC OF ZOHYDRO), HYDROCODONE/ACETAMINOPHEN 5-300MG, HYDROCODONE/ACETAMINOPHEN 7.5-300MG, HYDROCODONE/ACETAMINOPHEN 10-300MG, HYDROCODONE BITARTRATE ER, LEVORPHANOL, MORPHINE ER CAPSULE (AUTHORIZED GENERIC OF AVINZA), NALOCET, OXYCODONE CAPSULE 5MG, OXYCODONE/ACETAMINOPHEN SOLUTION (AUTHORIZED GENERIC OF PROLATE), OXYCODONE TABLET 5MG (AUTHORIZED GENERIC OF ROXYBOND), OXYCODONE TABLET 10MG (AUTHORIZED GENERIC OF ROXYBOND), OXYCODONE TABLET 15MG, (AUTHORIZED GENERIC OF ROXYBOND), OXYCODONE TABLET 30MG (AUTHORIZED GENERIC OF ROXYBOND), OXYCODONE/ACETAMINOPHEN 2.5-300MG, OXYCODONE/ACETAMINOPHEN 5-300MG, OXYCODONE/ACETAMINOPHEN 7.5-300MG, OXYCODONE/ACETAMINOPHEN 10-300MG, OXYMORPHONE ER, PROLATE, ROXYBOND, TREZIX, XYVONA | BELBUCA, FENTANYL PATCH, HYDROCODONE/ACETAMINOPHEN, MORPHINE ER, OXYCODONE, OXYCODONE/ACETAMINOPHEN, XTAMPZA ER |
PAIN: | PREGABALIN ER | DULOXETINE, GABAPENTIN, PREGABALIN |
PAIN: | COXANTO, DICLOFENAC CAPSULE, DICLOFENAC ER TABLET, DICLOFENAC TABLET 25MG, FENOPROFEN CAPSULE 200MG, FENOPROFEN CAPSULE 300MG, FENOPROFEN CAPSULE 400MG, FENOPRON, FLURBIPROFEN, IBUPROFEN 300MG, IBUPROFEN/FAMOTIDINE, INDOCIN, INDOMETHACIN SUSPENSION, KETOPROFEN, KETOPROFEN ER, LOFENA, LURBIRO, MECLOFENAMATE, MEFENAMIC ACID, MELOXICAM CAPSULE, MELOXICAM ORAL SUSPENSION, NAPROXEN CR, NAPROXEN EC, NAPROXEN ORAL SUSPENSION, NAPROXEN/ESOMEPRAZOLE (GENERIC VIMOVO), ORUDIS, OXAPROZIN 300MG, RELAFEN DS, SPRIX NASAL, TOLECTIN, TOLMETIN, ZYBIC | DICLOFENAC TABLET, IBUPROFEN TABLET, INDOMETHACIN CAPSULE, MELOXICAM TABLET, NAPROXEN TABLET, OXAPROZIN 600MG |
PAIN: | CONZIP, TAPENTADOL SOLUTION, TAPENTADOL TABLET, TRAMADOL ER CAPSULE, TRAMADOL SOLUTION, TRAMADOL TABLET 25MG, TRAMADOL TABLET 75MG, TRAMADOL TABLET 100MG | NUCYNTA ER, TRAMADOL ER TABLET, TRAMADOL TABLET 50MG |
PANCREATIC ENZYMES | PANCREAZE, PERTZYE, VIOKACE | CREON, ZENPEP |
PARKINSON'S AGENTS | CARBIDOPA/LEVODOPA CR (AUTHORIZED GENERIC OF RYTARY), CREXONT, DHIVY | CARBIDOPA/LEVODOPA |
PARKINSON'S AGENTS | AMANTADINE TABLET, GOCOVRI, NOURIANZ, ONGENTYS, PRAMIPEXOLE ER, ROPINIROLE ER, XADAGO, ZELAPAR | AMANTADINE CAPSULE, AMANTADINE SYRUP, ENTACAPONE TABLET, INBRIJA, PRAMIPEXOLE TABLET, RASAGILINE TABLET, ROPINIROLE TABLET, SELEGILINE CAPSULE, SELEGILINE TABLET, TOLCAPONE TABLET |
PEPTIC ULCER DISEASE | DICYCLOMINE TABLET 40MG, GLYCATE | DICYCLOMINE TABLET, METHSCOPOLAMINE, OMEPRAZOLE CAPSULE |
PHENYLKETONURIA | JAVYGTOR POWDER PACKET, JAVYGTOR TABLET, ZELVYSIA | SAPROPTERIN POWDER PACKET, SAPROPTERIN TABLET |
POTASSIUM-SPARING DIURETICS | SPIRONOLACTONE SUSPENSION | SPIRONOLACTONE TABLET |
POTASSIUM SUPPLEMENTS | POKONZA, POTASSIUM POWDER PACKET 40 MEQ | POTASSIUM CHLORIDE |
PULMONARY HTN: VASODILATORS | OPSYNVI, TADLIQ | AMBRISENTAN, BOSENTAN, MACITENTAN, SILDENAFIL SUSPENSION, SILDENAFIL TABLET, TADALAFIL 20MG, UPTRAVI |
SCABICIDES AND PEDICULICIDES | CROTAN LOTION, EURAX, PRURADIK LOTION | PERMETHRIN CREAM |
SLEEP AIDS: | EDLUAR, ZOLPIDEM CAPSULE 7.5MG, ZOLPIDEM SL | BELSOMRA, ESZOPICLONE, TASIMELTEON, ZALEPLON, ZOLPIDEM, ZOLPIDEM ER, HETLIOZ LQ |
STEROIDS, RECTAL AND INTRARECTAL | ANUSOL HC | BUDESONIDE RECTAL FOAM, HYDROCORTISONE ENEMA, HYDROCORTISONE PERINANAL CREAM, PROCTO-MED, PROCTOSOL, PROCTOZONE, ANUCORT HC, HEMMOREX, HYDROCORTISONE SUPPOSITORY |
THROMBOCYTOPENIA AGENTS | ALVAIZ, WAYRILZ | DOPTELET, ELTROMBOPAG OLAMINE TABLET |
TOPICAL ANESTHETICS | PLIAGLIS, ZTLIDO | LIDOCAINE OINTMENT 5%, LIDOCAINE PATCH 5%, LIDOCAINE SOLUTION 4%, LIDOCAINE/PRILOCAINE |
TOPICAL ANTIFUNGALS | CLOTRIMAZOLE CREAM, CLOTRIMAZOLE SOLUTION | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. |
TOPICAL: ATOPIC DERMATITIS | ZORYVE CREAM 0.15% | DESONIDE CREAM, DESONIDE OINTMENT, EUCRISA, FLUOCINONIDE, FLUTICASONE, TACROLIMUS OINTMENT |
TOPICAL: ATOPIC DERMATITIS | PIMECROLIMUS CREAM | DESONIDE CREAM, DESONIDE OINTMENT, EUCRISA, FLUOCINONIDE, FLUTICASONE, TACROLIMUS OINTMENT, OPZELURA, VTAMA |
TOPICAL: | TAVABOROLE (GENERIC KERYDIN) | CICLODAN, CICLOPIROX CREAM, CICLOPIROX GEL, CICLOPIROX NAIL LACQUER, CICLOPIROX SHAMPOO, CICLOPIROX SOLUTION, ECONAZOLE CREAM, JUBLIA, KETOCONAZOLE CREAM, KETOCONAZOLE SHAMPOO |
TOPICAL: | CLOTRIMAZOLE/BETAMETHASONE LOTION, ECONAZOLE FOAM, ECOZA, ERTACZO, EXELDERM, KETOCONAZOLE FOAM, KETODAN FOAM, LULICONAZOLE CREAM, LUZU, NAFTIFINE CREAM 1%, NAFTIFINE CREAM 2%, NAFTIFINE GEL, OXICONAZOLE CREAM, OXISTAT, SULCONAZOLE (AUTHORIZED GENERIC OF EXELDERM), TAVABOROLE | CICLODAN, CICLOPIROX, CLOTRIMAZOLE/BETAMETHASONE CREAM, ECONAZOLE CREAM, JUBLIA, KETOCONAZOLE CREAM, KETOCONAZOLE SHAMPOO |
TOPICAL: | DICLOFENAC PATCH, DICLOFENAC SOLUTION 2%, FLECTOR PATCH, LICART PATCH | DICLOFENAC SOLUTION 1.5% |
TOPICAL: | DICLOFENAC 1% GEL | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. THE FOLLOWING PRESCRIPTION ALTERNATIVE IS AVAILABLE: DICLOFENAC 1.5% SOLUTION |
TOPICAL: | DOXEPIN CREAM | BETAMETHASONE VALERATE CREAM, BETAMETHASONE VALERATE OINTMENT, TRIAMCINOLONE CREAM, TRIAMCINOLONE OINTMENT |
TOPICAL: | PENCICLOVIR, XERESE | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. |
TOPICAL: | AMCINONIDE, BETAMETHASONE FOAM, BRYHALI LOTION, CLOBETASOL CREAM 0.025%, CLOBETASOL FOAM (GENERIC OLUX E), CLOBETASOL LOTION, CLOBETASOL SHAMPOO, CLOBETASOL SPRAY, CLOCORTOLONE, CLODAN, CORDRAN, DESONIDE GEL, DESONIDE LOTION, DESOXIMETASONE CREAM, DESOXIMETASONE GEL, DESOXIMETASONE OINTMENT, DESOXIMETASONE SPRAY, DIFLORASONE CREAM 0.05%, DIFLORASONE OINTMENT 0.05%, EVESSE, FLUOCINOLONE CREAM 0.025%, FLURANDRENOLIDE, FLUTICASONE LOTION, HALCINONIDE, HALOBETASOL FOAM, HALOBETASOL LOTION, HALOBETASOL OINTMENT, HYDROCORTISONE BUTYRATE, HYDROCORTISONE BUTYRATE LOTION, HYDROCORTISONE LOTION 2%, HYDROCORTISONE SOLUTION 2.5%, HYDROCORTISONE VALERATE OINTMENT 0.2%, IMPOYZ CREAM, LEXETTE, MICORT HC, SERNIVO, TEXACORT, TOVET, TRIAMCINOLONE OINTMENT 0.05%, TRIAMCINOLONE SPRAY, ULTRAVATE | ALCLOMETASONE, BETAMETHASONE CREAM, BETAMETHASONE LOTION, BETAMETHASONE OINTMENT, CLOBETASOL CREAM, CLOBETASOL FOAM, CLOBETASOL GEL, CLOBETASOL OINTMENT, CLOBETASOL SOLUTION, DESONIDE CREAM, DESONIDE OINTMENT, FLUOCINOLONE, FLUTICASONE CREAM, FLUTICASONE OINTMENT, HALOBETASOL CREAM, HYDROCORTISONE CREAM, HYDROCORTISONE VALERATE, MOMETASONE, TRIAMCINOLONE CREAM, TRIAMCINOLONE LOTION 0.1%, TRIAMCINOLONE OINTMENT |
TOPICAL: | CALCIPOTRIENE/BETAMETHASONE OINTMENT, CALCIPOTRIENE/BETAMETHASONE SUSPENSION, WYNZORA, ZORYVE CREAM 0.3% | CALCIPOTRIENE CREAM, CLOBETASOL CREAM, CLOBETASOL OINTMENT, CLOBETASOL SOLUTION, ENSTILAR, HALOBETASOL CREAM, TAZAROTENE CREAM, TAZAROTENE GEL |
TOPICAL: | ARAZLO LOTION, TAZAROTENE FOAM | TAZAROTENE CREAM, TAZAROTENE GEL |
TOPICAL: | CALCIPOTRIENE FOAM, CALCIPOTRIENE OINTMENT, CALCITRIOL OINTMENT, PELLIX, SORILUX FOAM, VECTICAL OINTMENT | CALCIPOTRIENE CREAM |
ULCER DRUGS: | CIMETIDINE SOLUTION, CIMETIDINE TABLET, FAMOTIDINE TABLET 20MG, NIZATIDINE CAPSULE 150MG, NIZATIDINE CAPSULE 300MG, RANITIDINE | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. THE FOLLOWING PRESCRIPTION ALTERNATIVES ARE AVAILABLE: FAMOTIDINE SUSPENSION, FAMOTIDINE TABLET 40MG |
ULCER DRUGS: | DEXLANSOPRAZOLE, ESOMEPRAZOLE, KONVOMEP, LANSOPRAZOLE, OMEPRAZOLE/SODIUM BICARBONATE, PANTOPRAZOLE POWDER PACKET, PRILOSEC POWDER PACKET, RABEPRAZOLE, RABEPRAZOLE DR | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. THE FOLLOWING PRESCRIPTION ALTERNATIVES ARE AVAILABLE: ESOMEPRAZOLE DR 40MG CAPSULE, ESOMEPRAZOLE POWDER PACKET, LANSOPRAZOLE DR 30MG CAPSULE, OMEPRAZOLE CAPSULE, PANTOPRAZOLE TABLET |
ULCER DRUGS: | SUCRALFATE SUSPENSION (GENERIC CARAFATE) | SUCRALFATE TABLET |
UREA CYCLE DISORDER | OLPRUVA | GLYCEROL PHENYLBUTYRATE, SODIUM PHENYLBUTYRATE POWDER, SODIUM PHENYLBUTYRATE TABLET |
VAGINAL: | CLEOCIN SUPPOSITORY, XACIATO | CLINDAMYCIN VAGINAL CREAM, METRONIDAZOLE VAGINAL GEL |
VAGINAL: | FEMRING, IMVEXXY | ESTRADIOL CREAM, ESTRADIOL VAGINAL TABLET, ESTRING, PREMARIN CREAM, YUVAFEM VAGINAL TABLET |
VAGINAL: | CRINONE 4%, CRINONE 8% | ENDOMETRIN, MEDROXYPROGESTERONE, NORETHINDRONE |
VASCULITIS | TAVNEOS | AZATHIOPRINE |
VASOPRESSIN RECEPTOR ANTAGONISTS | TOLVAPTAN (GENERIC JYNARQUE) | JYNARQUE, TOLVAPTAN (GENERIC SAMSCA) |
VISION ENHANCEMENT | PILOCARPINE SOLUTION 1.25%, QLOSI, UPNEEQ, VIZZ, YUVEZZI | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT CLINICALLY APPROPRIATE OPTIONS. |
VITAMIN D | CALCITRIOL SOLUTION, DOXERCALCIFEROL, PARICALCITOL | CALCITRIOL CAPSULE, RAYALDEE |
WEIGHT LOSS AND WEIGHT MANAGEMENT | CONTRAVE | FOUNDAYO, LIRAGLUTIDE (GENERIC SAXENDA), PHENTERMINE, PHENTERMINE/TOPIRAMATE, WEGOVY INJECTION, WEGOVY PILL, ZEPBOUND |
WILSON'S DISEASE | CUVRIOR, GALZIN, PENICILLAMINE CAPSULE | PENICILLAMINE TABLET, TRIENTINE 250MG, TRIENTINE 500MG |
EmblemHealth Small Group/Essential/Individual Plans Drugs Removed From Formulary In 2027 | ||
DRUG CLASS | NON-COVERED | FORMULARY ALTERNATIVES |
ADHD AND NARCOLEPSY | ADZENYS XR-ODT, AMPHETAMINE/DEXTROAMPHETAMINE ER (GENERIC MYDAYIS), DESOXYN, ZENZEDI, COTEMPLA XR-ODT, METHYLPHENIDATE, METHYLPHENIDATE HCL ER (LA), METHYLPHENIDATE HCL ER (OSM), METHYLPHENIDATE HCL ER (XR), QELBREE | amphetamine/dextroamphetamine, amphetamine/dextroamphetamine XR, armodafinil, atomoxetine, AZSTARYS, dexmethylphenidate ER, dextroamphetamine solution, dextroamphetamine, JORNAY PM, methylphenidate, methylphenidate ER (generic CONCERTA), modafinil, QUILLICHEW ER, QUILLIVANT XR SUSPENSION, SUNOSI, LUMRYZ, SODIUM OXYBATE (authorized generic of XYREM by Hikma), XYWAV |
ALZHEIMER'S AGENTS | ERGOLOID MESYLATES, MEMANTINE HCL ER CAPS, NAMZARIC, ADLARITY | DONEPEZIL TABLET, MEMANTINE TABLET, MEMANTINE SOLUTION, RIVASTIGMINE PATCH, LEQEMBI IQLIK |
Analgesics | NUCYNTA | TAPENTADOL TAB |
ANTIARRHYTHMICS | AMIODARONE HCL, BETAPACE, RYTHMOL, TIKOSYN | AMIODARONE HCL 200mg, SOTALOL AF TAB 120MG, PROPRANOLOL SOL 20MG/5ML, PROPRANOLOL TAB 80MG, PROPRANOLOL CAP 80MG ER, PINDOLOL TAB 5MG, DOFETILIDE CAP |
ANTICONVULSANTS | APTIOM, ELEPSIA XR, FYCOMPA, LAMOTRIGINE ODT, MOTOPOLY XR, ONFI, TOPIRAMATE ER CAP | LEVETIRACETAM, LEVETIRACETAM ER, TOPIRAMATE, TOPIRAMATE ER, TOPIRAMATE SPRINKLE ER, LACOSAMIDE TABLET, ZONISAMIDE CAPSULE, PERAMPANEL TAB, CLOBAZAM SUS, FELBAMATE SUS, BRIVARACETAM, OXCARBAZEPINE TAB ER |
ANTICONVULSANTS: BENZODIAZEPINES | SYMPAZAN | clobazam, clonazepam
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ANTIDIABETIC AGENTS | BYETTA, CYCLOSET, LIRAGLUTIDE, ONGLYZA, PIOGLITAZONE HCL-GLIMEPIRIDE, RIOMET, SAXAGLIPTIN HCL, SAXAGLIPTIN HCL/METFORMIN HCL ER, SEGLUROMET, STEGLATRO, SYMLINPEN 120, SYMLINPEN 60, FARXIGA, JANUMET, JANUMET XR, XIGDUO XR | GLYXAMBI, pioglitazone/metformin, SYNJARDY, SYNJARDY XR, TRIJARDY XR, metformin, metformin ER (generic GLUCOPHAGE XR), MOUNJARO, OZEMPIC, RYBELSUS, TRULICITY, BYDUREON, ALOGLIPTAN, DAPAGLIFLOZIN, DAPAGLIFLOZIN/METFORMIN ER, SITAGLIPTIN, SITAGLIPTIN/METFORMIN
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ANTIGOUT | ALLOPURINOL 200MG, ULORIC | Allopurinol 100mg & 300mg, colchicine tablet (generic COLCRYS), probenecid, probenecid/colchicine, FEBUXOSTAT |
ANTI-INFECTIVE | PRIFTIN | RIFAPENTINE TAB 150MG |
ANTILEUKOTRIENES | MONTELUKAST SODIUM GRANULESPACKET 4 MG, ZYFLO | montelukast sodium chew tab, montelukast sodium tab, zafirlukast tab 10 mg, 20 mg (Accolate) |
BETA BLOCKERS | SOTYLIZE, INDERAL LA, INNOPRAN XL, TENORMIN, BETAPACE | atenolol, bisoprolol, carvedilol, HEMANGEOL, labetalol, metoprolol, nebivolol, PROPRANOLOL SOLUTION, propranolol tablet |
BPH | CARDURA XL, DUTASTERIDE/TAMSULOSIN HCL | alfuzosin ER, dutasteride, finasteride, silodosin capsule, tadalafil 5mg, tamsulosin, terazosin |
CALCIUM CHANNEL BLOCKERS | CARDIZEM, ISRADIPINE, NICARDIPINE HCL, NISOLDIPINE ER, DILTIAZEM HCL CD, DILTIAZEM HCL ER TABS, VERAPAMIL HCL ER CAPS, VERAPAMIL HCL SR | amlodipine, diltiazem ER capsule), felodipine ER, nifedipine, verapamil, verapamil ER tabs (Calan sr), ISOSORBIDE TABS |
CARDIOVASCULAR AGENTS | ALISKIREN, AMLODIPINE BESYLATE/ATORVASTATIN CALCIUM, CADUET, CAPTOPRIL/HYDROCHLOROTHIAZIDE, ENTRESTO, TELMISARTAN/HYDROCHLOROTHIAZIDE, TRANDOLAPRIL/VERAPAMIL HCL ER, PRESTALIA, amlodipine/valsartan/HCTZ | enalapril, irbesartan, lisinopril, losartan, valsartan, amlodipine/benazepril, amlodipine/olmesartan, amlodipine/valsartan, olmesartan/amlodipine/HCTZ, KERENDIA, MYQORZO |
COPD & BRONCHODILATORS | YUPELRI, FORMOTEROL FUMARATE | INCRUSE ELLIPTA, SPIRIVA HANDIHALER, SPIRIVA RESPIMAT, ATROVENT, ARFORMOTEROL NEB 15/2ML, SEREVENT DIS AER 50MCG, STRIVERDI AER 2.5MCG, IPRATROPIUM SOL 0.02%INH, BREZTRI |
CYSTIC FIBROSIS AGENTS | BRONCHITOL | PULMOZYME SOL 1MG/ML, ACETYLCYST SOL 20% |
DIURETICS | ETHACRYNIC ACID, FUROSEMIDE ORAL SOLN 8 MG/ML | bumetanide, furosemide solution 10mg/mL, furosemide tablet, torsemide, LASIX ONYU |
ELECTROLYTE/MINERAL/ METAL MODIFIERS | FERRIPROX TWICE-A-DAY | DEFERIPRONE TAB 1000MG, DEFERIPRONE TAB 500MG |
FIBROMYALGIA AGENTS | SAVELLA, PREGABALIN ER | duloxetine, pregabalin, GRALISE, HORIZANT, MILNACIPRAN |
GENETIC, ENZYME, OR PROTEIN DISORDER | DOJOLVI, OLPRUVA, PANCREAZE, VIOKACE, XURIDEN | sodium phenylbutyrate powder, sodium phenylbutyrate tablet PHEBURANE, RAVICTI CREON, ZENPEP |
H2 ANTAGONISTS | CIMETIDINE, CIMETIDINE HCL SOLN 300 MG/5ML, FAMOTIDINE TAB 20 MG, NIZATIDINE | FAMOTIDINE TAB 40MG, FAMOTIDINE SUS 40MG/5ML |
HIGH CHOLESTEROL | FENOFIBRATE CAP 43 & 130MG, FENOFIBRATE TAB 40 & 120MG, FENOFIBRIC ACID DR, FIBRICOR, FLOLIPID, FLUVASTATIN, LESCOL XL, PITAVASTATIN CALCIUM, ZYPITAMAG, CHOLESTYRAMINE, CHOLESTYRAMINE LIGHT, COLESEVELAM HCL PACKET FOR SUSP 3.75GM, OMEGA-3-ACID ETHYL ESTERS, ROSZET | atorvastatin tablet, ezetimibe/simvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin, cholestyramine powder, cholestyramine light powder, colesevelam tablet, prevalite powder, FENOFIBRATE CAP 67MG, FENOFIBRATE CAP 67MG, FENOFIBRATE TAB 145MG, FENOFIBRATE TAB 160MG, FENOFIBRATE TAB 48MG, FENOFIBRATE TAB 54MG, REDEMPLO
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HIV | COMBIVIR, EMTRIVA, EPIVIR, KALETRA | EMTRIC/RILPI TAB TENOF DF, ABACA/LAMIVU TAB 600-300, LAMIVUD/ZIDO TAB 150-300, TRUVADA TAB 100-150, EFAVIR/LAMIV TAB TENOFOVI, ODEFSEY TAB, BIKTARVY TAB, DELSTRIGO TAB, TRIUMEQ TAB, COMPLERA TAB, IDVYNSO |
HORMONAL AGENTS | ANNOVERA, LEVONORGESTREL/ETHINYL ESTRADIOL/FERROUS BISGLYCINATE, MERZEE, PREMARIN, YAZ | NUVARING MIS, ZAFEMY DIS 150/35, TRI-LO- TAB SPRINTEC, ENPRESSE-28 TAB, SRONYX TAB, NORTREL TAB 1/35, AVIANE TAB, NORGEST/ETHI TAB ESTRADIO, ETHY ETH EST TAB 1-35, TRI-NYMYO TAB, AUROVELA TAB 1/20, ISIBLOOM TAB, AZURETTE TAB, CONJ ESTROGN TAB |
HORMONAL AGENTS, STIMULANT/ REPLACEMENT/ MODIFYING (PITUITARY) | NGENLA, NOCDURNA, SEROSTIM | GENOTROPIN, OMNITROPE, SKYTROFA, desmopressin acetate tab 0.1 mg,0.2 mg (Ddavp)
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IMMUNOLOGICAL AGENTS | ACTEMRA, TALTZ, TAVNEOS, VELSIPITY, VOYDEYA, CYLTEZO, XELJANZ/XR, SELSARDI, HUMIRA | TYENNE, ADALIMUMAB biosimilars LOW WAC (YUFLYMA, Hyrimoz, Hadlima, & SIMLANDI), ENTYVIO, OMVOH, RINVOQ, SIMPONI 100mg, SKYRIZI, ZEPOSIA, CIMZIA, ZYMFENTRA, TOFACITINIB, TOFACITINIB ER, BIMZELX, ICOTYDE |
IMMUNOSUPPRESSANTS | RASUVO, OTREXUP | methotrexate injection, methotrexate tablet, REDITREX, TACROLIMUS, AZATHIOPRINE, SIROLIMUS, CYCLOSPORINE MODIFIED, MYCOPHENOLATE MOFETIL |
INFLAMMATORY BOWEL AGENTS | MESALAMINE ER CAP 500MG, PENTASA, LIALDA, DELZICOL, APRISO, AZULFIDINE | balsalazide capsule, budesonide capsule, mesalamine enema, mesalamine DR capsule 400mg, mesalamine DR tablet 1.2gm, mesalamine ER capsule 0.375gm (generic APRISO), sulfasalazine tablet |
INSULINS | BASAGLAR KWIKPEN, BASAGLAR TEMPO PEN | HUMULIN N, HUMULIN R U-500, LEVEMIR, NOVOLIN N, SEMGLEE-YFGN, TOUJEO, TRESIBA |
LAXATIVES: CIC, IBS-C, OIC | LACTULOSE Packets, AMITIZA, LINZESS | LUBIPROSTONE CAP 24MCG, TRULANCE TAB 3MG, ENULOSE SOL 10GM/15, GENERLAC SOL 10GM/15, LACTULOSE SOL 10GM/15, CONSTULOSE SOL 10GM/15, IBSRELA TAB 50MG, MOTEGRITY TAB 1MG |
MENTAL HEALTH | ABILIFY, ABILIFY MYCITE, COBENFY, GEODON, INVEGA, LATUDA, LYBALVI, OLANZAPINE-FLUOXETINE, OPIPZA, QUETIAPINE, RISPERAL, SAPHRIS, SEROQUEL, SYMBYAX, ZYPREXA | ARIPIPRAZOLE, ARIPIPRAZOLE TAB ODT, QUETIAPINE TAB ER, OLANZAPINE TAB, QUETIAPINE TAB, RISPERIDONE TAB, RISPERIDONE TAB ODT, ZIPRASIDONE CAP, PALIPERIDONE TAB ER, ASENAPINE SUB, OLANZAPINE TAB ODT, LURASIDONE TAB, REXULTI TAB, EQUETRO CAP, FANAPT TAB, VRAYLAR CAP, OLANZA/FLUOX CAP, LURASIDONE TAB, ABILIFY MYCI TAB, CAPLYTA CAP, LYBALVI TAB, CLOZAPINE TAB, PALIPERIDONE TAB, REXULTI TAB
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METABOLIC BONE DISEASE | BINOSTO, CALCITRIOL ORAL SOLN 1 MCG/ML, DOXERCALCIFEROL, FOSAMAX PLUS D, PARICALCITOL, RISEDRONATE SODIUM DR, ZEMPLAR | calcitriol capsule, RAYALDEE, ALENDRONATE TAB 70MG, IBANDRONATE TAB 150MG, risedronate sodium tab 5 mg,30 mg, 35 mg, 150 mg (Actonel)
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MINERALOCORTICOID RECEPTOR ANTAGONISTS | SPIRONOLACTONE SUSP 25 MG/5ML | spironolactone tab 25mg, 50mg, 100mg
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MULTIPLE SCLEROSIS | BAFIERTAM, PONVORY | AVONEX, BETASERON, dimethyl fumarate, fingolimod, glatiramer, glatopa, KESIMPTA, MAVENCLAD, MAYZENT, PLEGRIDY, REBIF, teriflunomide, VUMERITY, ZEPOSIA, GILENYA 0.25mg |
NSAIDS | ANAPROX DS, ARHTORTEC, CELEBREX, FENOPROFEN CALCIUM, IBUPROFEN/FAMOTIDINE, INDOMETHACIN SUPPOS 50 MG, INDOMETHACIN SUSP 25 MG/5ML, KETOPROFEN, KETOPROFEN ER, LOFENA, MELOXICAM CAP, NAPROXEN SUSP, NAPROXEN TAB EC, NAPROXEN DR, NAPROXEN SODIUM CR, NAPROXEN SODIUM ER, NAPROXEN/ESOMEPRAZOLE MAGNESIUM (GENERIC VIMOVO), TOLECTIN 600, TOLMETIN SODIUM, ZORVOLEX | diclofenac tablet, ibuprofen tablet, indomethacin capsule, meloxicam tablet, naproxen tablet, oxaprozin 600mg, KEOTROLAC |
OPHTHALMIC AGENTS | ALPHAGAN P, BETOPTIC-S, CEQUA, DORZOLAMIDE HCL/TIMOLOL MALEATE PF, MIEBO, PHOSPHOLINE IODIDE, TAFLUPROST, TIMOLOL HEMIHYDRATE, TIMOLOL MALEATE, TIMOLOL MALEATE OPHTHALMIC GEL FORMING, TRAVOPROST, TROPICAMIDE, VEVYE, VERKAZYA, XIIDRA, zYLET | EYSUVIS, RESTASIS SINGLE DOSE VIALS, TYRVAYA, apraclonidine solution, brimonidine solution 0.2%, SIMBRINZA, betaxolol solution, dorzolamide solution, dorzolamide/timolol solution, timolol solution, latanoprost, LUMIGAN, VYZULTA, BRIMONIDINE TARTRATE/TIMOLOL MALEATE, LOTEPR/TOBRA SUS
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PARKINSON AGENTS | AMANTADINE HCL TAB, NOURIANZ, ONGENTYS | amantadine capsule, amantadine syrup, entacapone tablet, INBRIJA, KYNMOBI, pramipexole tablet, rasagiline tablet, ropinirole tablet, selegiline capsule, selegiline tablet, tolcapone tablet, ROPINORELE |
PARKINSON'S AGENTS | PRAMIPEXOLE DIHYDROCHLORIDE ER, ROPINIROLE ER, CREXONT | amantadine capsule, amantadine syrup, entacapone tablet, INBRIJA, KYNMOBI, pramipexole tablet, rasagiline tablet, ropinirole tablet, selegiline capsule, selegiline tablet, tolcapone tablet, carbidopa & levodopa tab er25-100 mg, 50-200 mg (Sinemet cr) |
PHOSPHATE BINDERS | XPHOZAH, AURYXIA, VELTASSA, VELPHORO | calcium acetate, lanthanum carbonate, sevelamer carbonate, sevelamer, FERRIC CITRATE TAB 1 GM |
PHOSPHODIESTERASE INHIBITORS | THEOPHYLLINE TAB ER 100MG & 200MG | theophylline tab er 12hr 300 mg,450 mg, theophylline tab er 24hr 400mg, 600 mg |
PRIMARY BILIARY CHOLANGITIS (PBC) | OCALIVA, URSODIOL CAP 200MG & 400MG | URSODIOL TAB 250MG, URSODIOL CAP 300MG, URSODIOL TAB 500MG |
PROTECTANTS | SUCRALFATE SUSP 1 GM/10ML | sucralfate tablet
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PROTON PUMP INHIBITORS | DEXLANSOPRAZOLE, LANSOPRAZOLE, OMEPRAZOLE/SODIUM BICARBONATE, PANTOPRAZOLE SODIUM SUSP PACKET, RABEPRAZOLE SODIUM, ZEGERID | OMEPRAZOLE CAP 20MG, PANTOPRAZOLE TAB 20MG, ESOMEPRAZOLE GRA 40MG DR, NEXIUM GRA 5MG DR, ESOMEPRAZOLE CAP
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PULMONARY HTN | OPSYNVI | TADALAFIL TAB, ALYQ TAB, AMBRISENTAN TAB, BOSENTAN TAB, SILDENAFIL TAB, SILDENAFIL SUS 10MG/ML, UPTRAVI TAB |
TESTOSTERONE PRODUCTS | TESTOSTERONE, VOGELXO, TESTIM | testosterone gel (generic ANDROGEL), testosterone gel 1.62% pump (generic ANDROGEL), testosterone solution, testosterone cypionate solution, testosterone enanthate solution, testosterone topical solution (generic AXIRON) |
TRICYCLICS | IMIPRAMINE PAMOATE | imipramine hcl tab 10mg, 25mg, 50mg (Tofranil) |
URINARY INCONTINENCE | AVODART, FESOTERODINE FUMARATE ER, FLOMAX, OXYTROL, TOVIAZ | mirabegron, mirabegron GRANULES, MYRBETRIQ TABLET, oxybutynin, oxybutynin ER, oxybutynin syrup, solifenacin tablet, tolterodine, tolterodine ER, trospium, trospium ER, GEMTESA |
VASODILATORS | ISOSORBIDE DINITRATE, NITROSTAT | ISOSORB MONO TAB 30MG ER, ISOSORB MONO TAB 60MG ER, ISOSORB MONO TAB 120MG ER, NITROGLYCER DIS 0.1MG/HR, NITROGLYCERIN |
VITAMIN B12 | cyanocobalamin nasal spray | cyanocobalamin injection? |
EmblemHealth Commercial Large Group Drugs Removed From Formulary In 2027 | ||
DRUG CLASS | NON-COVERED | FORMULARY ALTERNATIVES |
ACNE AGENTS: | ALTRENO, TWYNEO | ABSORICA LD, ADAPALENE/BENZOYL PEROXIDE GEL 0.1-2.5%, ISOTRETINOIN PRODUCTS (INCLUDING: ACCUTANE CAPSULE, AMNESTEEM CAPSULE, CLARAVIS CAPSULE, ISOTRETINOIN CAPSULE, ZENATANE CAPSULE), TRETINOIN CREAM, TRETINOIN GEL 0.01% |
ACNE AGENTS: | CABTREO, ISOTRETINOIN 25MG, ISOTRETINOIN 35MG, TRETINOIN GEL 0.05%, TRETINOIN GEL 0.025%, TRETINOIN MICROSPHERE GEL, TRETINOIN MICROSPHERE GEL 0.1%, TRETINOIN MICROSPHERE GEL 0.04%, ADAPALENE CREAM, ADAPALENE GEL, ADAPALENE PAD, ADAPALENE SOLUTION, ADAPALENE/BENZOYL PEROXIDE GEL 0.3-2.5% | ABSORICA LD, ADAPALENE/BENZOYL PEROXIDE GEL 0.1-2.5%, ISOTRETINOIN PRODUCTS (INCLUDING: ACCUTANE CAPSULE, AMNESTEEM CAPSULE, CLARAVIS CAPSULE, ISOTRETINOIN CAPSULE, ZENATANE CAPSULE), TRETINOIN CREAM, TRETINOIN GEL 0.01%, AKLIEF |
ACNE AGENTS: | ADAPALENE CREAM, ADAPALENE GEL, ADAPALENE PAD, ADAPALENE SOLUTION, ADAPALENE/BENZOYL PEROXIDE GEL 0.3-2.5% | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. THE FOLLOWING PRESCRIPTION ALTERNATIVES ARE AVAILABLE: ADAPALENE/BENZOYL PEROXIDE GEL 0.1-2.5%, TRETINOIN CREAM, TRETINOIN GEL 0.01% |
ACNE AND ROSACEA AGENTS | CLINDAMYCIN GEL (GENERIC CLINDAGEL), EPSOLAY, FINACEA FOAM, NORITATE CREAM | AZELAIC ACID GEL, BRIMONIDINE GEL, CLINDAMYCIN GEL (GENERIC CLEOCIN-T), CLINDAMYCIN LOTION, CLINDAMYCIN SOLUTION, CLINDAMYCIN/BENZOYL PEROXIDE GEL (REFRIGERATED), ERYTHROMYCIN SOLUTION, IVERMECTIN CREAM, METRONIDAZOLE CREAM, METRONIDAZOLE GEL, NEUAC, ZILXI |
ACNE AND ROSACEA AGENTS: | AZELEX, CLINDAMYCIN FOAM, CLINDAMYCIN/BENZOYL PEROXIDE GEL, CLINDAMYCIN/TRETINOIN GEL, DAPSONE GEL, ERYTHROMYCIN/BENZOYL PEROXIDE GEL, METRONIDAZOLE LOTION, OXYMETAZOLINE | AZELAIC ACID GEL, BRIMONIDINE GEL, CLINDAMYCIN GEL (GENERIC CLEOCIN-T), CLINDAMYCIN LOTION, CLINDAMYCIN SOLUTION, CLINDAMYCIN/BENZOYL PEROXIDE GEL (REFRIGERATED), IVERMECTIN CREAM, METRONIDAZOLE CREAM, METRONIDAZOLE GEL, NEUAC, ZILXI, AMZEEQ, WINLEVI |
AGENTS FOR PAINFUL INTERCOURSE | INTRAROSA, OSPHENA | ESTRADIOL CREAM, ESTRADIOL VAGINAL TABLET, ESTRING, PREMARIN CREAM, YUVAFEM VAGINAL TABLET |
ALLERGIC REACTION (ANAPHYLAXIS) THERAPY | NEFFY | AUVI-Q, EPINEPHRINE SOLUTION (GENERIC EPIPEN) |
ALZHEIMER'S AGENTS | MEMANTINE ER CAPSULE, MEMANTINE/DONEPEZIL, NAMZARIC, ZUNVEYL | DONEPEZIL TABLET, MEMANTINE SOLUTION, MEMANTINE TABLET, RIVASTIGMINE PATCH |
ANTIANGINAL AGENTS | ISOSORBIDE DINITRATE TABLET 40MG | ISOSORBIDE DINITRATE TABLET (EXCEPT 40MG), ISOSORBIDE MONONITRATE ER, NITROGLYCERIN LINGUAL SPRAY, NITROGLYCERIN SL TABLET, RANOLAZINE ER TABLET |
ANTIBIOTICS: | LIKMEZ, METRONIDAZOLE TABLET 125MG | METRONIDAZOLE TABLET 250MG, METRONIDAZOLE TABLET 500MG |
ANTIBIOTICS: | METRONIDAZOLE CAPSULE 375MG | METRONIDAZOLE TABLET |
ANTIBIOTICS: | SEYSARA, TETRACYCLINE TABLET 250MG, TETRACYCLINE TABLET 500MG | DOXYCYCLINE HYCLATE, DOXYCYCLINE MONOHYDRATE, MINOCYCLINE CAPSULE, TETRACYCLINE CAPSULE |
ANTIBIOTICS: | DORYX MPC, DOXYCYCLINE (GENERIC ORACEA), DOXYCYCLINE HYCLATE 75 MG, DOXYCYCLINE HYCLATE ER TABLET, DOXYCYCLINE HYCLATE TABLET 50MG, DOXYCYCLINE HYCLATE TABLET 75MG, DOXYCYCLINE HYCLATE TABLET 150MG, DOXYCYCLINE MONOHYDRATE CAPSULE 75MG, DOXYCYCLINE MONOHYDRATE CAPSULE 150MG, MINOCYCLINE ER TABLET (AUTHORIZED GENERIC OF SOLODYN), MINOCYCLINE ER TABLET (GENERIC SOLODYN), MINOCYCLINE TABLET, TARGADOX | DOXYCYCLINE HYCLATE, DOXYCYCLINE MONOHYDRATE, MINOCYCLINE CAPSULE, TETRACYCLINE CAPSULE, EMROSI |
ANTIBIOTICS: | BLUJEPA, NITROFURANTOIN SUSPENSION 50MG/5ML, ORLYNVAH, PIVYA | FOSFOMYCIN, METHENAMINE, NITROFURANTOIN MACROCRYSTAL, NITROFURANTOIN SUSPENSION 25MG/5ML, TRIMETHOPRIM/SULFAMETHOXAZOLE |
ANTICOAGULANTS | SAVAYSA | DABIGATRAN, ELIQUIS, RIVAROXABAN, XARELTO |
ANTICONVULSANTS: BENZODIAZEPINES | SYMPAZAN | CLOBAZAM, CLONAZEPAM |
ANTICONVULSANTS: GABAPENTINOIDS | GABAPENTIN CAPSULE 200MG, RELGAABI CAPSULE 200MG | GABAPENTIN CAPSULE 100MG, GABAPENTIN CAPSULE 300MG, GABAPENTIN CAPSULE 400MG, GABAPENTIN DAILY, GABAPENTIN SOLUTION, GABAPENTIN TABLET, RELGAABI CAPSULE 300MG, RELGAABI CAPSULE 400MG |
ANTICONVULSANTS: GABAPENTINOIDS | GABARONE | GABAPENTIN CAPSULE 100MG, GABAPENTIN CAPSULE 300MG, GABAPENTIN CAPSULE 400MG, GABAPENTIN DAILY, GABAPENTIN SOLUTION, GABAPENTIN TABLET, RELGAABI CAPSULE 300MG, RELGAABI CAPSULE 400MG |
ANTICONVULSANTS: OTHERS | ELEPSIA XR, LEVETIRACETAM (AUTHORIZED GENERIC OF SPRITAM), TOPIRAMATE SOLUTION | LEVETIRACETAM, LEVETIRACETAM ER, TOPIRAMATE, TOPIRAMATE SPRINKLE ER |
ANTICONVULSANTS: OTHERS | TOPIRAMATE ER CAPSULE, VIGAFYDE | TOPIRAMATE SPRINKLE CAPSULE, VIGABATRIN POWDER PACK |
ANTICONVULSANTS: SODIUM CHANNEL BLOCKERS | MOTPOLY XR, ZONISADE SUSPENSION | LACOSAMIDE TABLET, ZONISAMIDE CAPSULE |
ANTICONVULSANTS: SODIUM CHANNEL BLOCKERS | LAMOTRIGINE ODT, SUBVENITE | LAMOTRIGINE CHEWABLE TABLET, LAMOTRIGINE TABLET |
ANTIDEPRESSANTS | APLENZIN, BUPROPION ER (AUTHORIZED GENERIC OF FORFIVO XL), DRIZALMA SPRINKLE, DULOXETINE DR 80MG, DULOXETINE DR 90MG, DULOXETINE DR 120MG, RALDESY, VENLAFAXINE ER 112.5MG | BUPROPION SR, BUPROPION XL, DESVENLAFAXINE ER, DULOXETINE, TRAZODONE TABLETS, VENLAFAXINE, VENLAFAXINE ER CAPSULE, VILAZODONE |
ANTIDEPRESSANTS: OTHER | DESVENLAFAXINE ER 50MG, DESVENLAFAXINE ER 100MG, DULOXETINE ER, EXXUA, VENLAFAXINE ER | BUPROPION SR, BUPROPION XL, DESVENLAFAXINE SUCCINATE ER, DULOXETINE, VENLAFAXINE, VENLAFAXINE ER CAPSULE, VILAZODONE |
ANTIDEPRESSANTS: | CITALOPRAM CAPSULE 30MG, ESCITALOPRAM CAPSULE 15MG, FLUOXETINE TABLET (GENERIC SARAFEM), FLUOXETINE TABLET 60MG, FLUVOXAMINE ER CAPSULE, PAROXETINE CAPSULE 7.5MG, PAROXETINE ER TABLET, PAROXETINE SUSPENSION, SERTRALINE CAPSULE | CITALOPRAM, ESCITALOPRAM, FLUOXETINE CAPSULE, FLUOXETINE TABLET, FLUVOXAMINE, PAROXETINE, SERTRALINE CONCENTRATE, SERTRALINE TABLET |
ANTIDIARRHEALS | MYTESI | DIPHENOXYLATE/ATROPINE |
ANTIFUNGALS: AZOLES | TOLSURA, VIVJOA | FLUCONAZOLE, ITRACONAZOLE, KETOCONAZOLE, NOXAFIL PACKET, POSACONAZOLE DR, POSACONAZOLE SUSPENSION, VORICONAZOLE |
ANTIHISTAMINES | CETIRIZINE SOLUTION, CLARINEX-D, DESLORATADINE ODT, DESLORATADINE SOLUTION, DESLORATADINE TABLET, LEVOCETIRIZINE SOLUTION, LEVOCETIRIZINE TABLET | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. |
ANTIMALARIALS | SOVUNA | HYDROXYCHLOROQUINE |
ANTIMYASTHENIC AGENTS | ZILBRYSQ | PYRIDOSTIGMINE |
ANTINAUSEA AND VOMITING AGENTS | GRANISOL, NEREUS, ONDANSETRON ODT 16MG, SANCUSO, SYNDROS SOLUTION | APREPITANT CAPSULE, DRONABINOL CAPSULE, GRANISETRON TABLET, ONDANSETRON TABLET, SCOPOLAMINE PATCH |
ANTI-NAUSEA AND VOMITING AGENTS | AKYNZEO | ONDANSETRON, VARUBI |
ANTIPLATELET AGENTS | YOSPRALA | ASPIRIN, OMEPRAZOLE CAPSULE, PANTOPRAZOLE TABLET |
ANTIRHEUMATICS | OTREXUP | METHOTREXATE INJECTION, METHOTREXATE TABLET, RASUVO |
ANTIRHEUMATICS | JYLAMVO, TREXALL, XATMEP | METHOTREXATE INJECTION, METHOTREXATE TABLET, RASUVO |
ANTIVIRALS: | LEDIPASVIR/SOFOSBUVIR, SOFOSBUVIR/VELPATASVIR | EPCLUSA, HARVONI, MAVYRET, SOVALDI, VOSEVI |
ASTHMA/COPD: | BEVESPI, DUAKLIR, FLUTICASONE FUROATE/VILANTEROL, FLUTICASONE PROPIONATE/SALMETEROL HFA, UMECLIDINIUM/VILANTEROL | ADVAIR HFA, AIRSUPRA, ANORO ELLIPTA, BREO ELLIPTA, BREYNA (GENERIC SYMBICORT), BREZTRI, BUDESONIDE/FORMOTEROL (GENERIC SYMBICORT), COMBIVENT, DULERA, FLUTICASONE PROPIONATE/SALMETEROL AEROSOL (AUTHORIZED GENERIC OF AIRDUO), FLUTICASONE PROPIONATE/SALMETEROL DISKUS (GENERIC ADVAIR DISKUS), STIOLTO, TRELEGY, WIXELA |
ASTHMA: | ALVESCO, BECLOMETHASONE (AUTHORIZED GENERIC OF QVAR), FLUTICASONE FUROATE, FLUTICASONE PROPIONATE DISKUS, FLUTICASONE PROPIONATE HFA, PULMICORT INHALER | ARNUITY ELLIPTA, ASMANEX, BUDESONIDE NEBULIZED SOLUTION, QVAR REDIHALER |
ASTHMA: | LEVALBUTEROL HFA (AUTHORIZED GENERIC OF XOPENEX), PROAIR RESPICLICK, XOPENEX HFA | ALBUTEROL HFA |
ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) AND NARCOLEPSY | AMPHETAMINE ER TABLET, AMPHETAMINE TABLET, AMPHETAMINE XR ODT, AMPHETAMINE/DEXTROAMPHETAMINE ER CAPSULE (GENERIC MYDAYIS), ARYNTA, ATONCY, COTEMPLA XR-ODT, DYANAVEL XR SUSP, DYANAVEL XR TABLET, METHYLPHENIDATE ER CAPSULE (GENERIC APTENSIO XR), METHYLPHENIDATE ER TABLET (AUTHORIZED GENERIC OF RELEXXII), METHYLPHENIDATE PATCH, ONYDA XR, QELBREE, RELEXXII, XELSTRYM | AMPHETAMINE/DEXTROAMPHETAMINE, AMPHETAMINE/DEXTROAMPHETAMINE XR, ARMODAFINIL, ATOMOXETINE, AZSTARYS, CLONIDINE ER TABLET, DEXMETHYLPHENIDATE ER, DEXTROAMPHETAMINE, DEXTROAMPHETAMINE SOLUTION, JORNAY PM, LISDEXAMFETAMINE, METHYLPHENIDATE, METHYLPHENIDATE ER (GENERIC CONCERTA), MODAFINIL, QUILLICHEW ER, QUILLIVANT XR SUSPENSION, SODIUM OXYBATE, SUNOSI |
BENZODIAZEPINES | ALPRAZOLAM INTENSOL, ALPRAZOLAM ODT, LOREEV XR | ALPRAZOLAM TABLET, CHLORDIAZEPOXIDE, CLORAZEPATE, DIAZEPAM SOLUTION, DIAZEPAM TABLET, LORAZEPAM SOLUTION, LORAZEPAM TABLET, OXAZEPAM |
BIOLOGIC AGENTS: | ADALIMUMAB BIOSIMILARS (EXCEPT ADALIMUMAB-AATY, ADALIMUMAB-ADAZ, HADLIMA, SIMLANDI), USTEKINUMAB BIOSIMILARS (EXCEPT STEQEYMA, YESINTEK), VELSIPITY | ADALIMUMAB-AATY, ADALIMUMAB-ADAZ, ENTYVIO, HADLIMA, HUMIRA, OMVOH, RINVOQ, SIMLANDI, SIMPONI 100MG, SKYRIZI, STELARA, STEQEYMA, TOFACITINIB, TOFACITINIB XR, TREMFYA, YESINTEK, ZEPOSIA |
BIOLOGIC AGENTS: | ADALIMUMAB BIOSIMILARS (EXCEPT ADALIMUMAB-AATY, ADALIMUMAB-ADAZ, HADLIMA, SIMLANDI), SILIQ, SIMPONI 50MG, TALTZ, USTEKINUMAB BIOSIMILARS (EXCEPT STEQEYMA, YESINTEK) | ADALIMUMAB-AATY, ADALIMUMAB-ADAZ, COSENTYX, ENBREL, HADLIMA, HUMIRA, ICOTYDE, OTEZLA, RINVOQ, RINVOQ LQ, SIMLANDI, SKYRIZI, SOTYKTU, STELARA, STEQEYMA, TOFACITINIB, TOFACITINIB XR, TREMFYA, YESINTEK |
BIOLOGIC AGENTS: | ACTEMRA, ADALIMUMAB BIOSIMILARS (EXCEPT ADALIMUMAB-AATY, ADALIMUMAB-ADAZ, HADLIMA, SIMLANDI), KINERET, SIMPONI 50MG | ADALIMUMAB-AATY, ADALIMUMAB-ADAZ, AVTOZMA, ENBREL, HADLIMA, HUMIRA, RINVOQ, RINVOQ LQ, SIMLANDI, TOFACITINIB, TOFACITINIB XR, TYENNE |
BLADDER INCONTINENCE | DARIFENACIN ER, FESOTERODINE ER, OXYBUTYNIN 2.5MG | MIRABEGRON TABLET, MYRBETRIQ GRANULES, MYRBETRIQ TABLET, OXYBUTYNIN, OXYBUTYNIN ER, OXYBUTYNIN SYRUP, SOLIFENACIN TABLET, TOLTERODINE, TOLTERODINE ER, TROSPIUM, TROSPIUM ER |
BPH/ENLARGED PROSTATE | CARDURA XL, DUTASTERIDE/TAMSULOSIN, ENTADFI, TEZRULY | ALFUZOSIN ER, DUTASTERIDE, FINASTERIDE, SILODOSIN, TADALAFIL 5MG, TAMSULOSIN, TERAZOSIN |
CHRONIC MYELOID LEUKEMIA | CAVHANZA, DANZITEN, IMKELDI, NILOTINIB D-TARTRATE, PHYRAGO | BOSUTINIB, DASATINIB TABLET, ICLUSIG, IMATINIB TABLET, NILOTINIB HCL CAPSULE, SCEMBLIX |
COMPLEMENT INHIBITORS | VOYDEYA | EMPAVELI, FABHALTA |
COPD: | TIOTROPIUM (GENERIC SPIRIVA HANDIHALER), TUDORZA, UMECLIDINIUM (AUTHORIZED GENERIC OF INCRUSE ELLIPTA), YUPELRI | INCRUSE ELLIPTA, SPIRIVA RESPIMAT |
COPD:PHOSPHODIESTERASE INHIBITORS | OHTUVAYRE | ROFLUMILAST |
CORTICOSTEROIDS | TARPEYO | BUDESONIDE DR CAPSULE |
CORTICOSTEROIDS | AGAMREE, ALKINDI, CORTISONE, DEFLAZACORT, DEXAMETHASONE 1.5MG, DEXAMETHASONE 6 DAY, DEXAMETHASONE 10 DAY, DEXAMETHASONE 13 DAY, DEXLYT, EOHILIA, HEMADY, HIDEX, JAYTHARI, KHINDIVI, KYMBEE, ORAPRED ODT, PREDNISOLONE ODT, PREDNISOLONE SOLUTION (10MG/5ML AND 20MG/5ML), PREDNISOLONE TABLET 5MG, PREDNISONE DR, PREDNISONE INTENSOL 5MG/ML, PYQVI, TAPERDEX 6 DAY, TAPERDEX 7 DAY, TAPERDEX 12 DAY | BUDESONIDE DR CAPSULE, DEXAMETHASONE, HYDROCORTISONE, METHYLPREDNISOLONE, PREDNISOLONE SOLUTION (EXCEPT 10MG/5ML AND 20MG/5ML), PREDNISONE, PREDNISONE SOLUTION 5MG/5ML |
CUSHING'S DISEASE | RECORLEV | KETOCONAZOLE TABLET |
DIABETES: | MIGLITOL | ACARBOSE |
DIABETES: | METFORMIN ER MODIFIED RELEASE (GENERIC GLUMETZA), METFORMIN ER OSMOTIC (GENERIC FORTAMET), METFORMIN SOLUTION (GENERIC RIOMET), METFORMIN TABLET 625MG, METFORMIN TABLET 750MG | METFORMIN, METFORMIN ER (GENERIC GLUCOPHAGE XR) |
DIABETES: | ALOGLIPTIN/METFORMIN, ALOGLIPTIN/PIOGLITAZONE, DAPAGLIFLOZIN/SAXAGLIPTIN (AUTHORIZED GENERIC OF QTERN), INVOKAMET, INVOKAMET XR, JENTADUETO, JENTADUETO XR, SAXAGLIPTIN/METFORMIN XR, SEGLUROMET, SITAGLIPTIN/METFORMIN (AUTHORIZED GENERIC OF ZITUVIMET), SITAGLIPTIN/METFORMIN ER (AUTHORIZED GENERIC OF ZITUVIMET XR), STEGLUJAN, ZITUVIMET, ZITUVIMET XR | DAPAGLIFLOZIN/METFORMIN ER, GLIPIZIDE/METFORMIN, GLYBURIDE/METFORMIN, GLYXAMBI, PIOGLITAZONE/METFORMIN, SITAGLIPTIN PHOSPHATE/METFORMIN, SITAGLIPTIN PHOSPHATE/METFORMIN ER, SYNJARDY, SYNJARDY XR, TRIJARDY XR, XIGDUO XR 2.5MG/1000MG |
DIABETES: | PIOGLITAZONE/GLIMEPIRIDE | DAPAGLIFLOZIN/METFORMIN ER, GLIPIZIDE/METFORMIN, GLYBURIDE/METFORMIN, GLYXAMBI, PIOGLITAZONE/METFORMIN, SITAGLIPTIN PHOSPHATE/METFORMIN, SITAGLIPTIN PHOSPHATE/METFORMIN ER, SYNJARDY, SYNJARDY XR, TRIJARDY XR, XIGDUO XR 2.5MG/1000MG |
DIABETES: | FREESTYLE LIBRE | DEXCOM |
DIABETES: | ALOGLIPTIN, BRYNOVIN, SAXAGLIPTIN, SITAGLIPTIN (AUTHORIZED GENERIC OF ZITUVIO), TRADJENTA, ZITUVIO | SITAGLIPTIN PHOSPHATE |
DIABETES: | LIRAGLUTIDE | MOUNJARO, OZEMPIC INJECTION, OZEMPIC PILL, TRULICITY |
DIABETES: | LIFESCAN (ONETOUCH), NIPRO (TRUETEST, TRUETRACK), ROCHE (ACCU-CHEK) | ABBOTT (FREESTYLE, PRECISION), ASCENSIA (CONTOUR) |
DIABETES: | BASAGLAR, INSULIN GLARGINE (BIOLOGIC BY WINTHROP), INSULIN GLARGINE-YFGN (BIOLOGIC BY CIVICA), LANTUS, REZVOGLAR | HUMULIN N, HUMULIN R U-500, INSULIN GLARGINE-YFGN, NOVOLIN N, SEMGLEE-YFGN, TOUJEO, TRESIBA |
DIABETES: | INSULIN LISPRO MIX | HUMALOG MIX, HUMULIN 70/30, NOVOLIN 70/30, NOVOLOG MIX |
DIABETES: | ADMELOG, AFREZZA, APIDRA, INSULIN LISPRO, KIRSTY, MERILOG | FIASP, HUMALOG, HUMULIN R, LYUMJEV, NOVOLIN R, NOVOLOG |
DIABETES: | BEXAGLIFLOZIN, BRENZAVVY, INVOKANA, STEGLATRO | DAPAGLIFLOZIN, JARDIANCE |
DRY EYES | CEQUA, CYCLOSPORINE (GENERIC RESTASIS), MIEBO, VEVYE, XIIDRA | EYSUVIS, RESTASIS SINGLE-DOSE VIALS |
EXCESSIVE SWEATING | QBREXZA, SOFDRA | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. |
FIBROMYALGIA AGENTS | MILNACIPRAN | DULOXETINE, GABAPENTIN, PREGABALIN, HORIZANT, TONMYA |
FIRST-GENERATION ANTIHISTAMINES | CARBINOXAMINE ER SUSPENSION, CARBINOXAMINE SOLUTION, CARBINOXAMINE TABLET 6MG, CARBZAH, CLEMASTINE SYRUP, CLEMSZA, CORPHENA, KARBINAL, RYCLORA, RYVENT | CARBINOXAMINE TABLET 4MG, CYPROHEPTADINE SYRUP, CYPROHEPTADINE TABLET, PROMETHAZINE |
FISH OIL | ICOSAPENT ETHYL (GENERIC VASCEPA), OMEGA-3-ACID ETHYL ESTERS CAPSULE | VASCEPA |
GALLSTONE DISSOUTION AGENTS | RELTONE, URSODIOL CAPSULE 200MG, URSODIOL CAPSULE 400MG, URSOLIGN | URSODIOL CAPSULE 300MG, URSODIOL TABLET |
GASTROPARESIS AGENTS | GIMOTI | METOCLOPRAMIDE SOLUTION, METOCLOPRAMIDE TABLET |
GLAUCOMA: | BRIMONIDINE SOLUTION 0.1%, IOPIDINE | BRIMONIDINE SOLUTION 0.2%, SIMBRINZA |
GLAUCOMA: | BRIMONIDINE/TIMOLOL, DORZOLAMIDE/TIMOLOL PRESERVATIVE-FREE, TIMOLOL (GENERIC ISTALOL), TIMOLOL (GENERIC TIMOPTIC OCUDOSE), TIMOLOL 0.5% (GENERIC BETIMOL 0.5%), TIMOLOL GEL | DORZOLAMIDE SOLUTION, DORZOLAMIDE/TIMOLOL SOLUTION, TIMOLOL SOLUTION |
GLAUCOMA: | BRINZOLAMIDE | DORZOLAMIDE SOLUTION |
GLAUCOMA: | BIMATOPROST 0.03%, IYUZEH, OMLONTI, TAFLUPROST, XELPROS | BIMATOPROST 0.01%, LATANOPROST SOLUTION |
GLAUCOMA: | TRAVOPROST, ZOLYMBUS | LATANOPROST, BIMATOPROST 0.01%, VYZULTA |
GOUT | ALLOPURINOL 200MG, COLCHICINE CAPSULE, FEBUXOSTAT, GLOPERBA | ALLOPURINOL, COLCHICINE TABLET (GENERIC COLCRYS), PROBENECID, PROBENECID/COLCHICINE |
GROWTH HORMONES | HUMATROPE, NGENLA, NORDITROPIN, SEROSTIM, SOGROYA, ZOMACTON | GENOTROPIN, OMNITROPE |
HEART FAILURE: SGLT2 AND SGLT1 INHIBITOR | INPEFA | DAPAGLIFLOZIN, JARDIANCE |
HELICOBACTER PYLORI | BISMUTH SUBCITRATE/METRONIDAZOLE/TETRACYCLINE, VOQUEZNA DUAL PAK, VOQUEZNA TRIPLE PAK | AMOXICILLIN, CLARITHROMYCIN, METRONIDAZOLE, OMEPRAZOLE, PANTOPRAZOLE, TALICIA, TETRACYCLINE |
HELICOBACTER PYLORI | AMOXICILLIN/CLARITHROMYCIN/LANSOPRAZOLE | AMOXICILLIN, CLARITHROMYCIN, METRONIDAZOLE, OMEPRAZOLE, PANTOPRAZOLE, TALICIA, TETRACYCLINE, VOQUEZNA |
HEMATOLOGICAL: | ARMLUPEG, FILKRI, GRANIX, NEULASTA, NEUPOGEN, NYPOZI, NYVEPRIA, RELEUKO, STIMUFEND, ZIEXTENZO | FULPHILA, FYLNETRA, NIVESTYM, UDENYCA, UDENYCA ON-BODY, ZARXIO |
HEREDITARY ANGIODEMA: ACUTE AGENTS | EKTERLY | ICATIBANT |
HEREDITARY ANGIODEMA: ACUTE AGENTS | SAJAZIR | ICATIBANT |
HEREDITARY TYROSINEMIA TYPE 1 AGENTS | HARLIKU | NITISINONE CAPSULE, NITYR, ORFADIN SUSPENSION |
HIGH BLOOD PRESSURE: | AZILSARTAN, EDARBYCLOR, TELMISARTAN/HCTZ, VALSARTAN SOLUTION | CANDESARTAN, CANDESARTAN/HCTZ, IRBESARTAN, IRBESARTAN/HCTZ, LOSARTAN, LOSARTAN/HCTZ, OLMESARTAN, OLMESARTAN/HCTZ, TELMISARTAN, VALSARTAN, VALSARTAN/HCTZ, ARBLI |
HIGH BLOOD PRESSURE: | BISOPROLOL 2.5MG, CARVEDILOL ER, HEMANGEOL, INDERAL XL, INNOPRAN XL, KAPSPARGO, LABETALOL TABLET 400MG, LOPRESSOR, METOPROLOL 12.5MG, SOTYLIZE SOLUTION, TIMOLOL TABLET 5MG, TIMOLOL TABLET 10MG, TIMOLOL TABLET 20MG | ATENOLOL, BISOPROLOL, CARVEDILOL, LABETALOL, METOPROLOL, NEBIVOLOL, PROPRANOLOL SOLUTION 20MG/5ML, PROPRANOLOL SOLUTION 40MG/5ML, PROPRANOLOL TABLET |
HIGH BLOOD PRESSURE: | CONJUPRI, DILTIAZEM ER CAPSULE 360MG, DILTIAZEM ER TABLET, ISRADIPINE, KATERZIA, LEVAMLODIPINE, MATZIM LA, NICARDIPINE, NISOLDIPINE ER, NORLIQVA, SDAMLO, SULAR, VERAPAMIL ER CAPSULE | AMLODIPINE, CARTIA XT, DILTIAZEM ER CAPSULE (EXCEPT 360MG), FELODIPINE ER, NIFEDIPINE, VERAPAMIL, VERAPAMIL ER |
HIGH BLOOD PRESSURE: | AMLODIPINE/VALSARTAN/HCTZ, PRESTALIA, TRANDOLAPRIL/VERAPAMIL, WIDAPLIK | AMLODIPINE/BENAZEPRIL, AMLODIPINE/OLMESARTAN, AMLODIPINE/VALSARTAN, OLMESARTAN/AMLODIPINE/HCTZ |
HIGH BLOOD PRESSURE: | ALISKIREN TABLET | ENALAPRIL, IRBESARTAN, LISINOPRIL, LOSARTAN, VALSARTAN |
HIGH BLOOD PRESSURE: | TRYVIO | EPLERENONE, SPIRONOLACTONE TABLET, BAXFENDY |
HIGH BLOOD PRESSURE: | HEMICLOR, INZIRQO, THALITONE | CHLORTHALIDONE, HYDROCHLOROTHIAZIDE, INDAPAMIDE, METOLAZONE |
HIGH CHOLESTEROL: | CHOLESTYRAMINE LIGHT POWDER PACKETS, CHOLESTYRAMINE POWDER PACKETS, COLESEVELAM PACKETS, PREVALITE PACKETS | CHOLESTYRAMINE LIGHT POWDER, CHOLESTYRAMINE POWDER, COLESEVELAM TABLET, PREVALITE POWDER |
HIGH CHOLESTEROL: | LEROCHOL, PRALUENT | REPATHA |
HIGH CHOLESTEROL: | AMLODIPINE/ATORVASTATIN, ATORVALIQ, FLOLIPID, FLUVASTATIN CAPSULE, FLUVASTATIN ER TABLET, PITAVASTATIN, ZYPITAMAG | ATORVASTATIN, EZETIMIBE/SIMVASTATIN, LOVASTATIN, PRAVASTATIN, ROSUVASTATIN, SIMVASTATIN |
HIV | PIFELTRO | TALK TO YOUR DOCTOR ABOUT CLINICALLY APPROPRIATE ALTERNATIVES. EXAMPLES OF COVERED ALTERNATIVES INCLUDE: BIKTARVY, DESCOVY, DOVATO, EFAVIRENZ, EMTRICITABINE/TENOFOVIR DISOPROXIL FUMARATE (GENERIC TRUVADA), GENVOYA, JULUCA, NEVIRAPINE |
HUNTINGTON'S DISEASE & TARDIVE DYSKINESIA | AUSTEDO | INGREZZA |
HYPERKALEMIA AGENTS | VELTASSA | LOKELMA, SODIUM POLYSTYRENE SULFONATE |
HYPNOTICS: | FLURAZEPAM, QUAZEPAM, TEMAZEPAM (7.5MG AND 22.5MG) | ESTAZOLAM, LORAZEPAM, TEMAZEPAM (EXCEPT 7.5MG AND 22.5MG) |
HYPNOTICS: | DAYVIGO, DOXEPIN (GENERIC SILENOR), QUVIVIQ, RAMELTEON | BELSOMRA, ESZOPICLONE, TASIMELTEON, ZALEPLON, ZOLPIDEM, ZOLPIDEM ER |
INFLAMMATORY BOWEL AGENTS | BUDESONIDE ER TABLET, DIPENTUM, MESALAMINE ER CAPSULE 250MG, MESALAMINE ER CAPSULE 500MG | BALSALAZIDE, BUDESONIDE DR CAPSULE, MESALAMINE DR TABLET 1.2GM, MESALAMINE DR TABLET 800MG, MESALAMINE ENEMA, MESALAMINE ER CAPSULE 0.375GM (GENERIC APRISO), MESALAMINE SUPPOSITORY, SULFASALAZINE |
KIDNEY CANCER | PAZOPANIB 400MG | PAZOPANIB 200MG |
LAXATIVES: | CLENPIQ, PEG 3350/KCL/NACL/NA SULFATE/NA ASCORBATE-C (GENERIC MOVIPREP), PLENVU, SUFLAVE | GAVILYTE-G SOLUTION, GAVILYTE-N SOLUTION, PEG 3350/ELECTROLYTES SOLUTION, PEG-3350/NACL/NABICARBONATE/KCL SOLUTION, SODIUM SULFATE/POTASSIUM SULFATE/MAGNESIUM SULFATE (GENERIC SUPREP) |
LAXATIVES: | IBSRELA, LINZESS, LUBIPROSTONE, PRUCALOPRIDE, RELISTOR | MOVANTIK, SYMPROIC, TRULANCE |
LONG-ACTING BETA AGONISTS | FORMOTEROL NEBULIZED SOLUTION | ARFORMOTEROL NEBULIZED SOLUTION, SEREVENT, STRIVERDI |
LOOP DIURETICS | ENBUMYST | BUMETANIDE, FUROSEMIDE, TORSEMIDE |
LOOP DIURETICS | ETHACRYNIC ACID, FUROSEMIDE SOLUTION 8MG/ML, SOAANZ | BUMETANIDE, FUROSEMIDE TABLET, TORSEMIDE, FUROSCIX, LASIX ONYU |
MENOPAUSAL SYMPTOMS: NON-HORMONAL | LYNKUET, VEOZAH | CITALOPRAM, DESVENLAFAXINE ER, DULOXETINE, ESCITALOPRAM, GABAPENTIN, OXYBUTYNIN, PAROXETINE, VENLAFAXINE |
MENTAL HEALTH | BYSANTI, COBENFY, OPIPZA | ARIPIPRAZOLE, ASENAPINE, LURASIDONE, OLANZAPINE, PALIPERIDONE ER, QUETIAPINE ER, QUETIAPINE FUMARATE, REXULTI, RISPERIDONE, VRAYLAR, ZIPRASIDONE |
MENTAL HEALTH | NUPLAZID, OLANZAPINE/FLUOXETINE, QUETIAPINE 150MG | ARIPIPRAZOLE, ASENAPINE, CLOZAPINE, FLUOXETINE, LURASIDONE, OLANZAPINE, PALIPERIDONE ER, QUETIAPINE (EXCEPT 150MG),QUETIAPINE ER, REXULTI, RISPERIDONE, VRAYLAR, ZIPRASIDONE, CAPLYTA, LYBALVI |
MIGRAINE PRODUCTS: OTHERS | TRUDHESA | DICLOFENAC TABLET, DIHYDROERGOTAMINE INJECTION SOLUTION |
MIGRAINE PRODUCTS: TRIPTANS | SYMBRAVO | ELETRIPTAN, NARATRIPTAN, RIZATRIPTAN, SUMATRIPTAN, ZOLMITRIPTAN TABLET |
MIGRAINE PRODUCTS: | ZAVZPRET | AIMOVIG, AJOVY, EMGALITY, NURTEC ODT, QULIPTA, UBRELVY |
MIGRAINE PRODUCTS: | BREKIYA, CAFERGOT, DICLOFENAC PACKET, DIHYDROERGOTAMINE NASAL (GENERIC MIGRANAL), ELYXB, ERGOTAMINE/CAFFEINE | DICLOFENAC TABLET, DIHYDROERGOTAMINE INJECTION SOLUTION |
MIGRAINE PRODUCTS: | ALMOTRIPTAN TABLET, FROVATRIPTAN TABLET, IMITREX CARTRIDGE, ONZETRA XSAIL, SUMATRIPTAN/NAPROXEN, TOSYMRA, ZEMBRACE SYMTOUCH, ZOLMITRIPTAN NASAL 2.5MG, ZOLMITRIPTAN NASAL 5MG, ZOLMITRIPTAN ODT, ZOMIG NASAL 2.5MG | ELETRIPTAN, NARATRIPTAN, RIZATRIPTAN ODT, RIZATRIPTAN TABLET, SUMATRIPTAN, SUMATRIPTAN AUTOINJECTOR, ZOLMITRIPTAN TABLET |
MULTIPLE SCLEROSIS | BAFIERTAM, PONVORY, TASCENSO ODT | AVONEX, BETASERON, CLADRIBINE, DIMETHYL FUMARATE, FINGOLIMOD, GLATIRAMER, GLATOPA, KESIMPTA, MAYZENT, PLEGRIDY, REBIF, TERIFLUNOMIDE, VUMERITY, ZEPOSIA |
MUSCLE RELAXANTS | ATMEKSI, BACLOFEN 5MG TABLET, BACLOFEN 15MG TABLET, BACLOFEN ORAL SOLUTION 5MG/5ML, BACLOFEN ORAL SOLUTION 10MG/5ML, BACLOFEN ORAL SUSPENSION, CHLORZOXAZONE 250MG, CHLORZOXAZONE 375MG, CHLORZOXAZONE 750MG, CYCLOBENZAPRINE 7.5MG TABLET, CYCLOBENZAPRINE ER CAPSULE (GENERIC AMRIX), DANTROLENE, FEXMID, METAXALONE TABLET 400MG, METAXALONE TABLET 640MG, METAXALONE TABLET 800MG, METHOCARBAMOL TABLET 1000MG, NORGESIC, NORGESIC FORTE, ONTRALFY, ORPHENGESIC, ORPHENGESIC FORTE, TANLOR, TIZANIDINE CAPSULE, TIZANIDINE CAPSULE 8MG, ZANAFLEX | BACLOFEN TABLET, CHLORZOXAZONE 500MG, CYCLOBENZAPRINE TABLET, METHOCARBAMOL TABLET, ORPHENADRINE, TIZANIDINE TABLET |
NASAL STEROIDS | FLUNISOLIDE NASAL, MOMETASONE NASAL, OMNARIS, QNASL | TALK TO THE PHARMACIST ABOUT OVER-THE-COUNTER OPTIONS. THE FOLLOWING PRESCRIPTION ALTERNATIVE IS AVAILABLE: FLUTICASONE NASAL |
NASAL: | AZELASTINE/FLUTICASONE NASAL (GENERIC DYMISTA), RYALTRIS, FLUNISOLIDE NASAL, MOMETASONE NASAL, OMNARIS, QNASL | AZELASTINE NASAL 0.1 %, FLUTICASONE NASAL, XHANCE |
NONSTEROIDAL ANTI-INFLAMMATORY AGENTS (NSAIDS) | COMBOGESIC, IBUPROFEN SUSPENSION | TALK TO THE PHARMACIST ABOUT OVER-THE-COUNTER OPTIONS. |
OPHTHALMIC: | BEPOTASTINE, EPINASTINE SOLUTION, OLOPATADINE SOLUTION, VERKAZIA, ZERVIATE | TALK TO THE PHARMACIST ABOUT OVER-THE-COUNTER OPTIONS. THE FOLLOWING PRESCRIPTION ALTERNATIVE IS AVAILABLE: AZELASTINE SOLUTION |
OPHTHALMIC: | AZASITE, CILOXAN OINTMENT, TOBREX OINTMENT, ZIRGAN | BESIVANCE, CIPROFLOXACIN SOLUTION, ERYTHROMYCIN OINTMENT, GENTAMICIN SOLUTION, MOXIFLOXACIN SOLUTION, NATACYN, OFLOXACIN SOLUTION, TOBRAMYCIN SOLUTION, TRIFLURIDINE SOLUTION |
OPHTHALMIC: | ACUVAIL, BROMFENAC 0.07%, NEVANAC | DICLOFENAC SOLUTION, KETOROLAC SOLUTION |
OPHTHALMIC: | ACULAR, BROMFENAC 0.09%, BROMFENAC 0.075% | DICLOFENAC, KETOROLAC, ILEVRO |
OPHTHALMIC: | TOBRADEX OINTMENT | NEOMYCIN/POLYMYXIN/DEXAMETHASONE OINTMENT, NEOMYCIN/POLYMYXIN/DEXAMETHASONE SUSPENSION, TOBRAMYCIN/DEXAMETHASONE SUSPENSION |
OPHTHALMIC: | LOTEPREDNOL/OBRAMYCIN, NEOMYCIN/POLYMYXIN/HYDROCORTISONE, TOBRADEX ST | NEOMYCIN/POLYMYXIN/DEXAMETHASONE OINTMENT, NEOMYCIN/POLYMYXIN/DEXAMETHASONE SUSPENSION, TOBRAMYCIN/DEXAMETHASONE SUSPENSION |
OPHTHALMIC: | BYQLOVI, CLOBETASOL SUSPENSION 0.05%, DIFLUPREDNATE, FML FORTE, INVELTYS, PRED MILD | DEXAMETHASONE SOLUTION, FLUOROMETHOLONE SUSPENSION 0.1%, LOTEMAX OINTMENT, LOTEMAX SM GEL, LOTEPREDNOL GEL, LOTEPREDNOL SUSPENSION, PREDNISOLONE SUSPENSION 1% |
OSTEOPOROSIS AGENTS | BONSITY, TERIPARATIDE PEN-INJECTION 560MCG/2.24ML | TERIPARATIDE PEN-INJECTION 560MCG/2.24ML, TYMLOS |
OSTEOPOROSIS AGENTS: BISPHOSPHONATES | ALENDRONATE SOLUTION, BINOSTO, FOSAMAX PLUS D, RISEDRONATE 5MG, RISEDRONATE DR | ALENDRONATE TABLET, IBANDRONATE, RISEDRONATE |
OTIC: | CIPROFLOXACIN/FLUOCINOLONE, CIPROFLOXACIN/HYDROCORTISONE, CORTISPORIN-TC, OTOVEL, XTORO | CIPROFLOXACIN SOLUTION, CIPROFLOXACIN/DEXAMETHASONE SUSPENSION, FLUOCINOLONE OIL, NEOMYCIN/POLYMYXIN/HYDROCORTISONE SOLUTION, NEOMYCIN/POLYMYXIN/HYDROCORTISONE SUSPENSION, OFLOXACIN SOLUTION |
OVULATORY STIMULANTS | CHORIONIC GONADOTROPIN SOLUTION, GONAL-F, NOVAREL | CLOMID, CLOMIPHENE, FOLLISTIM AQ, GANIRELIX, OVIDREL, PREGNYL |
PAIN: | VYSCOXA | CELECOXIB |
PAIN: | BUPRENORPHINE PATCH, OXYCONTIN | BELBUCA, FENTANYL PATCH, HYDROMORPHONE TABLET, MORPHINE ER, OXYCODONE, XTAMPZA ER |
PAIN: | ACETAMINOPHEN/CAFFEINE/DIHYDROCODEINE, HYDROCODONE ER (AUTHORIZED GENERIC OF ZOHYDRO), HYDROCODONE/ACETAMINOPHEN 5-300MG, HYDROCODONE/ACETAMINOPHEN 7.5-300MG, HYDROCODONE/ACETAMINOPHEN 10-300MG, HYDROCODONE BITARTRATE ER, HYDROMORPHONE ER, LEVORPHANOL, MORPHINE ER CAPSULE (AUTHORIZED GENERIC OF AVINZA), NALOCET, OXYCODONE CAPSULE 5MG, OXYCODONE/ACETAMINOPHEN SOLUTION (AUTHORIZED GENERIC OF PROLATE), OXYCODONE TABLET 5MG (AUTHORIZED GENERIC OF ROXYBOND), OXYCODONE TABLET 10MG (AUTHORIZED GENERIC OF ROXYBOND), OXYCODONE TABLET 15MG, (AUTHORIZED GENERIC OF ROXYBOND), OXYCODONE TABLET 30MG (AUTHORIZED GENERIC OF ROXYBOND), OXYCODONE/ACETAMINOPHEN 2.5-300MG, OXYCODONE/ACETAMINOPHEN 5-300MG, OXYCODONE/ACETAMINOPHEN 7.5-300MG, OXYCODONE/ACETAMINOPHEN 10-300MG, OXYMORPHONE ER, PROLATE, ROXYBOND, TREZIX, XYVONA | BELBUCA, FENTANYL PATCH, HYDROCODONE/ACETAMINOPHEN, HYDROMORPHONE, MORPHINE ER, OXYCODONE, OXYCODONE/ACETAMINOPHEN, XTAMPZA ER |
PAIN: | PREGABALIN ER | DULOXETINE, GABAPENTIN, PREGABALIN |
PAIN: | COXANTO, DICLOFENAC CAPSULE, DICLOFENAC ER TABLET, DICLOFENAC TABLET 25MG, FENOPROFEN CAPSULE 200MG, FENOPROFEN CAPSULE 300MG, FENOPROFEN CAPSULE 400MG, FENOPRON, FLURBIPROFEN, IBUPROFEN 300MG, IBUPROFEN/FAMOTIDINE, INDOCIN, INDOMETHACIN SUSPENSION, KETOPROFEN, KETOPROFEN ER, LOFENA, LURBIRO, MECLOFENAMATE, MEFENAMIC ACID, MELOXICAM CAPSULE, MELOXICAM ORAL SUSPENSION, NAPROXEN CR, NAPROXEN EC, NAPROXEN ORAL SUSPENSION, NAPROXEN/ESOMEPRAZOLE (GENERIC VIMOVO), ORUDIS, OXAPROZIN 300MG, RELAFEN DS, SPRIX NASAL, TOLECTIN, TOLMETIN, ZYBIC | DICLOFENAC TABLET, IBUPROFEN TABLET, INDOMETHACIN CAPSULE, MELOXICAM TABLET, NAPROXEN TABLET, OXAPROZIN 600MG |
PAIN: | CONZIP, TAPENTADOL SOLUTION, TAPENTADOL TABLET, TRAMADOL ER CAPSULE, TRAMADOL SOLUTION, TRAMADOL TABLET 25MG, TRAMADOL TABLET 75MG, TRAMADOL TABLET 100MG | NUCYNTA ER, TRAMADOL ER TABLET, TRAMADOL TABLET 50MG |
PANCREATIC ENZYMES | PANCREAZE, PERTZYE, VIOKACE | CREON, ZENPEP |
PARKINSON'S AGENTS | CARBIDOPA/LEVODOPA CR (AUTHORIZED GENERIC OF RYTARY), CREXONT, DHIVY | CARBIDOPA/LEVODOPA |
PARKINSON'S AGENTS | AMANTADINE TABLET, GOCOVRI, NOURIANZ, ONGENTYS, PRAMIPEXOLE ER, ROPINIROLE ER, XADAGO, ZELAPAR | AMANTADINE CAPSULE, AMANTADINE SYRUP, ENTACAPONE TABLET, INBRIJA, PRAMIPEXOLE TABLET, RASAGILINE TABLET, ROPINIROLE TABLET, SELEGILINE CAPSULE, SELEGILINE TABLET, TOLCAPONE TABLET |
PEPTIC ULCER DISEASE | DICYCLOMINE TABLET 40MG, GLYCATE, GLYCOPYRROLATE TABLET 1.5MG | DICYCLOMINE TABLET, GLYCOPYRROLATE, METHSCOPOLAMINE, OMEPRAZOLE CAPSULE |
PHENYLKETONURIA | JAVYGTOR POWDER PACKET, JAVYGTOR TABLET, ZELVYSIA | SAPROPTERIN POWDER PACKET, SAPROPTERIN TABLET |
POTASSIUM-SPARING DIURETICS | SPIRONOLACTONE SUSPENSION | SPIRONOLACTONE TABLET |
POTASSIUM SUPPLEMENTS | POKONZA, POTASSIUM POWDER PACKET 40 MEQ | POTASSIUM CHLORIDE |
PULMONARY HTN: VASODILATORS | OPSYNVI, TADLIQ | AMBRISENTAN, BOSENTAN, MACITENTAN, SILDENAFIL SUSPENSION, SILDENAFIL TABLET, TADALAFIL 20MG, UPTRAVI |
SCABICIDES AND PEDICULICIDES | CROTAN LOTION, EURAX, PRURADIK LOTION | PERMETHRIN CREAM |
SICKLE CELL ANEMIA | DROXIA, XROMI | HYDROXYUREA |
SLEEP AIDS: | EDLUAR, ZOLPIDEM CAPSULE 7.5MG, ZOLPIDEM SL | BELSOMRA, ESZOPICLONE, TASIMELTEON, ZALEPLON, ZOLPIDEM, ZOLPIDEM ER, HETLIOZ LQ |
STEROIDS, RECTAL AND INTRARECTAL | ANUSOL HC | BUDESONIDE RECTAL FOAM, HYDROCORTISONE ENEMA, HYDROCORTISONE PERINANAL CREAM, PROCTO-MED, PROCTOSOL, PROCTOZONE, ANUCORT HC, HEMMOREX, HYDROCORTISONE SUPPOSITORY |
TESTOSTERONE PRODUCTS | JATENZO, KYZATREX, NATESTO, TESTOSTERONE GEL 1% (AUTHORIZED GENERIC OF VOGELXO), TLANDO, VOGELXO | TESTOSTERONE CYPIONATE SOLUTION, TESTOSTERONE GEL 1.62% PUMP (GENERIC ANDROGEL), TESTOSTERONE 1% (GENERIC AXIRON) |
TESTOSTERONE PRODUCTS | TESTOSTERONE GEL 1.62% PACKET | TESTOSTERONE CYPIONATE SOLUTION, TESTOSTERONE GEL 1.62% PUMP (GENERIC ANDROGEL), TESTOSTERONE 1% (GENERIC AXIRON), XYOSTED |
THROMBOCYTOPENIA AGENTS | ALVAIZ, WAYRILZ | DOPTELET, ELTROMBOPAG OLAMINE TABLET |
TOPICAL ANESTHETICS | PLIAGLIS, ZTLIDO | LIDOCAINE OINTMENT 5%, LIDOCAINE PATCH 5%, LIDOCAINE SOLUTION 4%, LIDOCAINE/PRILOCAINE |
TOPICAL ANTIFUNGALS | CLOTRIMAZOLE CREAM, CLOTRIMAZOLE SOLUTION | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. |
TOPICAL: ACTINIC KERATOSIS | FLUOROURACIL CREAM 0.5%, TOLAK | DICLOFENAC GEL 3%, FLUOROURACIL CREAM 5% |
TOPICAL: ATOPIC DERMATITIS | ZORYVE CREAM 0.15% | DESONIDE CREAM, DESONIDE OINTMENT, EUCRISA, FLUOCINONIDE, FLUTICASONE, TACROLIMUS OINTMENT |
TOPICAL: ATOPIC DERMATITIS | PIMECROLIMUS CREAM | DESONIDE CREAM, DESONIDE OINTMENT, EUCRISA, FLUOCINONIDE, FLUTICASONE, TACROLIMUS OINTMENT, OPZELURA, VTAMA |
TOPICAL: | BEXAROTENE GEL, IMIQUIMOD CREAM 3.75%, PANRETIN | DICLOFENAC 3% GEL, FLUOROURACIL 5% CREAM, IMIQUIMOD CREAM 5%, KLISYRI |
TOPICAL: | TAVABOROLE (GENERIC KERYDIN) | CICLODAN, CICLOPIROX CREAM, CICLOPIROX GEL, CICLOPIROX NAIL LACQUER, CICLOPIROX SHAMPOO, CICLOPIROX SOLUTION, ECONAZOLE CREAM, JUBLIA, KETOCONAZOLE CREAM, KETOCONAZOLE SHAMPOO |
TOPICAL: | CLOTRIMAZOLE/BETAMETHASONE LOTION, ECONAZOLE FOAM, ECOZA, ERTACZO, EXELDERM, KETOCONAZOLE FOAM, KETODAN FOAM, LULICONAZOLE CREAM, LUZU, NAFTIFINE CREAM 1%, NAFTIFINE CREAM 2%, NAFTIFINE GEL, OXICONAZOLE CREAM, OXISTAT, SULCONAZOLE (AUTHORIZED GENERIC OF EXELDERM), TAVABOROLE | CICLODAN, CICLOPIROX, CLOTRIMAZOLE/BETAMETHASONE CREAM, ECONAZOLE CREAM, JUBLIA, KETOCONAZOLE CREAM, KETOCONAZOLE SHAMPOO |
TOPICAL: | DICLOFENAC PATCH, DICLOFENAC SOLUTION 2%, FLECTOR PATCH, LICART PATCH | DICLOFENAC SOLUTION 1.5% |
TOPICAL: | DICLOFENAC 1% GEL | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. THE FOLLOWING PRESCRIPTION ALTERNATIVE IS AVAILABLE: DICLOFENAC 1.5% SOLUTION |
TOPICAL: | DOXEPIN CREAM | BETAMETHASONE VALERATE CREAM, BETAMETHASONE VALERATE OINTMENT, TRIAMCINOLONE CREAM, TRIAMCINOLONE OINTMENT |
TOPICAL: | PENCICLOVIR, XERESE | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. |
TOPICAL: | AMCINONIDE, BETAMETHASONE FOAM, BRYHALI LOTION, CLOBETASOL CREAM 0.025%, CLOBETASOL FOAM (GENERIC OLUX E), CLOBETASOL LOTION, CLOBETASOL SHAMPOO, CLOBETASOL SPRAY, CLOCORTOLONE, CLODAN, CORDRAN, DESONIDE GEL, DESONIDE LOTION, DESOXIMETASONE CREAM, DESOXIMETASONE GEL, DESOXIMETASONE OINTMENT, DESOXIMETASONE SPRAY, DIFLORASONE CREAM 0.05%, DIFLORASONE OINTMENT 0.05%, EVESSE, FLUOCINOLONE CREAM 0.025%, FLURANDRENOLIDE, FLUTICASONE LOTION, HALCINONIDE, HALOBETASOL FOAM, HALOBETASOL LOTION, HALOBETASOL OINTMENT, HYDROCORTISONE BUTYRATE, HYDROCORTISONE BUTYRATE LOTION, HYDROCORTISONE LOTION 2%, HYDROCORTISONE SOLUTION 2.5%, HYDROCORTISONE VALERATE OINTMENT 0.2%, IMPOYZ CREAM, LEXETTE, MICORT HC, SERNIVO, TEXACORT, TOVET, TRIAMCINOLONE OINTMENT 0.05%, TRIAMCINOLONE SPRAY, ULTRAVATE | ALCLOMETASONE, BETAMETHASONE CREAM, BETAMETHASONE LOTION, BETAMETHASONE OINTMENT, CLOBETASOL CREAM, CLOBETASOL FOAM, CLOBETASOL GEL, CLOBETASOL OINTMENT, CLOBETASOL SOLUTION, DESONIDE CREAM, DESONIDE OINTMENT, FLUOCINOLONE, FLUTICASONE CREAM, FLUTICASONE OINTMENT, HALOBETASOL CREAM, HYDROCORTISONE CREAM, HYDROCORTISONE VALERATE, MOMETASONE, TRIAMCINOLONE CREAM, TRIAMCINOLONE LOTION 0.1%, TRIAMCINOLONE OINTMENT |
TOPICAL: | CALCIPOTRIENE/BETAMETHASONE OINTMENT, CALCIPOTRIENE/BETAMETHASONE SUSPENSION, WYNZORA, ZORYVE CREAM 0.3% | CALCIPOTRIENE CREAM, CLOBETASOL CREAM, CLOBETASOL OINTMENT, CLOBETASOL SOLUTION, ENSTILAR, HALOBETASOL CREAM, TAZAROTENE CREAM, TAZAROTENE GEL |
TOPICAL: | ARAZLO LOTION, TAZAROTENE FOAM | TAZAROTENE CREAM, TAZAROTENE GEL |
TOPICAL: | CALCIPOTRIENE FOAM, CALCIPOTRIENE OINTMENT, CALCITRIOL OINTMENT, PELLIX, SORILUX FOAM, VECTICAL OINTMENT | CALCIPOTRIENE CREAM |
ULCER DRUGS: | CIMETIDINE SOLUTION, CIMETIDINE TABLET, FAMOTIDINE TABLET 20MG, NIZATIDINE CAPSULE 150MG, NIZATIDINE CAPSULE 300MG, RANITIDINE | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. THE FOLLOWING PRESCRIPTION ALTERNATIVES ARE AVAILABLE: FAMOTIDINE SUSPENSION, FAMOTIDINE TABLET 40MG |
ULCER DRUGS: | DEXLANSOPRAZOLE, ESOMEPRAZOLE, KONVOMEP, LANSOPRAZOLE, OMEPRAZOLE/SODIUM BICARBONATE, PANTOPRAZOLE POWDER PACKET, PRILOSEC POWDER PACKET, RABEPRAZOLE, RABEPRAZOLE DR | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT OVER-THE-COUNTER OPTIONS. THE FOLLOWING PRESCRIPTION ALTERNATIVES ARE AVAILABLE: ESOMEPRAZOLE DR 40MG CAPSULE, ESOMEPRAZOLE POWDER PACKET, LANSOPRAZOLE DR 30MG CAPSULE, OMEPRAZOLE CAPSULE, PANTOPRAZOLE TABLET |
ULCER DRUGS: | SUCRALFATE SUSPENSION (GENERIC CARAFATE) | SUCRALFATE TABLET |
UREA CYCLE DISORDER | OLPRUVA | GLYCEROL PHENYLBUTYRATE, SODIUM PHENYLBUTYRATE POWDER, SODIUM PHENYLBUTYRATE TABLET |
VAGINAL: | CLEOCIN SUPPOSITORY, XACIATO | CLINDAMYCIN VAGINAL CREAM, METRONIDAZOLE VAGINAL GEL |
VAGINAL: | FEMRING, IMVEXXY | ESTRADIOL CREAM, ESTRADIOL VAGINAL TABLET, ESTRING, PREMARIN CREAM, YUVAFEM VAGINAL TABLET |
VAGINAL: | CRINONE 4%, CRINONE 8% | ENDOMETRIN, MEDROXYPROGESTERONE, MEGESTROL, NORETHINDRONE, PROGESTERONE |
VASCULITIS | TAVNEOS | AZATHIOPRINE |
VASOPRESSIN RECEPTOR ANTAGONISTS | TOLVAPTAN (GENERIC JYNARQUE) | JYNARQUE, TOLVAPTAN (GENERIC SAMSCA) |
VISION ENHANCEMENT | PILOCARPINE SOLUTION 1.25%, QLOSI, UPNEEQ, VIZZ, YUVEZZI | TALK TO YOUR PHARMACIST OR DOCTOR ABOUT CLINICALLY APPROPRIATE OPTIONS. |
VITAMIN B12 | CYANOCOBALAMIN NASAL SPRAY | CYANOCOBALAMIN INJECTION |
VITAMIN D | CALCITRIOL SOLUTION, DOXERCALCIFEROL, PARICALCITOL | CALCITRIOL CAPSULE, RAYALDEE |
WEIGHT LOSS AND WEIGHT MANAGEMENT | CONTRAVE | FOUNDAYO, LIRAGLUTIDE (GENERIC SAXENDA), PHENTERMINE, PHENTERMINE/TOPIRAMATE, WEGOVY INJECTION, WEGOVY PILL, ZEPBOUND |
WILSON'S DISEASE | CUVRIOR, GALZIN, PENICILLAMINE CAPSULE | PENICILLAMINE TABLET, TRIENTINE 250MG, TRIENTINE 500MG |
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JP 72987 10/2027
Provider Update