Drug Class
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Drugs in Class
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Branded Topical Prescription Acne Products
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Branded Prescription Acne Cleansers
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Branded Prescription Acne Kits
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Aldara 5% cream, Carac 0.5% cream, Efudex 5% cream, Fluorouracil 0.5% cream, Fluorouracil 2% solution, Fluorouracil 5% cream, Fluorouracil 5% solution, Imiquimod 5% cream, Picato 0.015% gel, Picato 0.05% gel, Zyclara 2.5% cream, Zyclara 3.75% cream
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Katerzia, Norvasc
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Atacand, Atacand HCT, Avalide, Avapro, Azor, Benicar, Benicar HCT, Cozaar, Diovan, Diovan HCT, Edarbi, Edarbyclor, Exforge, Exforge HCT, Hyzaar, Micardis, Micardis HCT, Prexxartan, Teveten, Teveten HCT, Tribenzor, Twynsta
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Aplenzin, Brintellix, Brisdelle, Budeprion SR, Budeprion XL, Celexa, Cymbalta, Desvenlafaxine extended-release tablets (brand product), Desvenlafaxine fumarate extended-release tablets (brand product), Effexor XR, Fetzima, Fluoxetine 60 mg tablets, Forfivo XL, Khedezla, Lexapro, Luvox CR, Paxil, Paxil CR, Pexeva, Pristiq, Prozac, Prozac Weekly, Remeron, Sarafem, Savella, Venlafaxine extended-release tablets (Brand Product), Viibryd, Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zoloft
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Ciclodan 8% Kit, CNL 8 Nail Kit, Jublia, Kerydin, Pedipirox-4 Nail Kit, Penlac
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Rexulti
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Elidel, Eucrisa, generic tacrolimus 0.03% or 0.1% ointment, Protopic
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Addderall XR, Aptensio XR, Concerta, Daytrana, Dexedrine Spansules, Dyanavel XR, Focalin XR, Metadate CD, QuiliChew ER and IR, Ritalin LA and SR, Vyvanse, Adzenys ER suspension, Adzenys XR-ODT, Cotempla XR-ODT, Methylphenidate 72 mg ER (brand), Mydayis, Qullivant XR
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Branded Beta-blockers and Beta-blocker Combinations
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Proventil HFA, Xopenex HFA
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Cholestyramine, Colesevelam, Colestid, Colestipol, Prevalite, Questran, Welchol
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Actonel, Atelvia, Binosto, Boniva, Fosamax, Fosamax Plus D
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Belbuca, Butrans, Subutex
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Branded Contraceptives
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Nascobal
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Celebrex, Celecoxib
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Adlyxin, Ozempic, Tanzeum, Victoza
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Novolin 70/30, Novolin N, Novolin R
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Admelog, Apidra, Apidra Solostar, Novolog, Novolog Mix 70/30, Fiasp, NovoLog PenFill, NovoLog Flexpen, Novolog 70/30 FlexPen
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Farxiga, Invokana, Invokamet, Jardiance, Xigduo XR, Synjardy, Segluromet, Steglatro
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Glyxambi, Qtern, Steglujan
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All products targeted except listed preferred. For members using the National Preferred/National Preferred Plus Formulary: Lifescan (e.g., OneTouch Ultra, OneTouch Verio) are PREFERRED, For members using the Basic/Basic Plus Formulary: Abbott (e.g., Freestyle, Freestyle Lite, Freestyle InsuLinx, Freestyle Neo), Lifescan (e.g., OneTouch Ultra, OneTouch Verio), other Abbott (Optium EZ, Optium, Precision PCX, Precision PCX Plus, Precision Point of Care, Precision Q-I-D, Precision Xtra, Ultima) are PREFERRED
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Kazano, Kombiglyze XR, Nesina, Onglyza, Oseni (alogliptin and pioglitazone)
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epinephrine auto-injector pen (lineage), Epipen, Epipen Jr.
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Levitra, Staxyn, Stendra, Viagra
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Expendable
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Allzital, Amrix, Astagraf XL, Bupap, Carospir, dexamethasone 1.5 mg tablet dose packs (generic), DexPak, Durlaza, Envarsus XR, Esgic, Fexmid, Fioricet, Fiorinal, Flowtuss, Hycofenix, lidocaine 7% and tetracaine 7% cream (brand), LoCort, Lorzone, Obredon, Oleptro ER, Procysbi, Rayos, Sitavig, Taperdex, Tussicaps, Tuzistra XR, Vanatol LQ and Vanatol S, Vituz, Yosprala, Zileuton, Zodex, Zonacort, Zyflo, Zyflo CR (zileuton ER)
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Gralise, Horizant, Lyrica, Neurontin
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Alphagan P 0.15%, Iopidine 0.5% and 1%
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Istalol, Betagan, Timoptic, Timoptic XE, Timoptic Ocudose
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Trusopt
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Cosopt
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Allopurinol, Duzallo, Probenecid, Probenecid/Colchicine, Uloric, Zurampic
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Dependent on genotype (Epclusa, Harvoni, Mavyret, Viekira Pak/XR, Vosevi, Technivie, Daklinza, Sovaldi, Zepatier)
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Altoprev, Caduet, Crestor, Livalo, Lescol, Lescol XL, Lipitor, Mevacor, Pravachol, Zocor
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ClimaraPro
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Ambien, Ambien CR, Belsomra, Edular, Intermezzo, Lunesta, Rozerem, Silenor, Sonata, Zolpimist
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Bravelle, Follistim AQ, Gonal-F and Gonal-F RFF
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Ganirelix
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Asacol, Asacol HD, Azulfidine/Azulfidine Entab, Colazal, Delzicol, Dipentum, Giazo, Lialda, Mesalamine 800mg
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Alvesco, Aerospan
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Beconase AQ, Dymista, Nasonex, Omnaris, Qnasl, Rhinocort , Ticalast, Veramyst, Xhance, Zetonna
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Absorica
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Kisqali/Kisqali Femara Co-pack
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Brovana
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Otrexup, Rasuvo, Xatmep
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Branded NSAIDs and topical diclofenac gel
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Alrex, Bepreve, Elestat, Emadine, Lastacaft, Pataday, Patanol, Pazeo, Zerviate
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Acular, Acular LS, Acuvail, Nevanac
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Xalatan, Xelpros, Vyzulta, Zioptan
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Flarex, FML Forte, FML S.O.P, Maxidex, Pred Mild
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Cetraxal
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Darifenacin ER, Detrol, Detrol LA, Ditropan XL, Enablex, Gelnique, Myrbetriq, Oxybutynin, Oxybutynin ER, Oxytrol, Tolterodine, Tolterodine ER, Toviaz, Trospium, Trospium ER, Vesicare
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Pancreaze, Pertzye, Ultresa
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Aciphex, Aciphex Sprinkle, Dexilant, Esomeprazole, Lansoprazole, Nexium, Omeprazole, Omeprazole/Sodium Bicarbonate, Pantoprazole, Prevacid, Prevacid 24HR, Prevacid SoluTab, Prilosec, Protonix, Rabeprazole, Zegerid
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Acticlate, Adoxa, Alodox, Avidoxy, Dynacin, Minocin, Minocycline ER, Monodox, Morgidox, Oracea, Solodyn, Vibramycin, Doxycline IR-DR, Ximino
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Altabax, Bactroban (mupirocin cream), Centany, Xepi
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Branded Topical Corticosteriods
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Finacea, MetroCream, MetroGel, MetroLotion, Noritate Cream, Rosadan, Soolantra
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Elestrin, Estrasorb, EstroGel
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Alsuma, Amerge, Axert, Frova, Imitrex, Imitrex STATdose Pen, Imitrex STATdose System, Maxalt, Maxalt MLT, Onzetra Xsail, Zecuity, Relpax, Sumavel, Treximet, Zembrace, Zomig, Zomig-ZMT
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Vytorin, Zetia
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