Microsoft word - aps_formulary_4q2009.doc

BRAND GENERIC BRAND
ANTIHISTAMINE / DECONGESTANTS
Other Anti-Infectives. . . . . . . . . . . . . . . . . . . . . .
Prescription Drug
Formulary
Nitrofurantoin generic/Macrodantin Pyrazinamide Pyrazinamide INTRODUCTION
EXPECTORANT AND COUGH PRODUCTS---------
This condensed formulary is designed to serve as Antifungal Agents. . . . . . . . . . . . . . . . . . . . . . . . . .
a reference guide and assist in the selection of Griseofulvin Microsize Susp generics only cost-effective pharmaceutical products. The formulary is not intended to be a substitute for your clinical knowledge and judgment. In all cases, the prescriber is expected to select appropriate drug therapy for the individual patient Promethazine/Codeine or DM generics only Promethazine/Phenylephrine generics only Promethazine/Phenylephrine/ generics only ANTIVIRALS ---------------------------------------------------
The APS National Pharmacy and Therapeutics Triprolidine/Pseudoephedrine/ generics only Committee will regularly review the formulary to ensure it meets the needs of both patients and NASAL CORTICOSTEROIDS ----------------------------
providers. Thank you in advance for your NASAL ANTIHISTAMINES --------------------------------
ANTIDIABETIC AGENTS
OTHER NASAL AGENTS ---------------------------------
INSULINS ------------------------------------------------------
Rapid-Acting Insulins . . . . . . . . . . . . . . . . . . . . . . .
ANTI-INFECTIVE AGENTS (ORAL)
ANTHELMINTICS --------------------------------------------
All self-administered drugs specifically indicated for the treatment of HIV and its opportunistic infections ANTIBIOTICS--------------------------------------------------
Cephalosporins. . . . . . . . . . . . . . . . . . . . . . . . . . . .
ANTINEOPLASTIC AND IMMUNOSUPPRESSIVE
Intermediate-Acting Insulins . . . . . . . . . . . . . . . . .
All self-administered FDA-approved antineoplastic and immunosuppressive agents are on formulary. AUTONOMIC & CENTRAL NERVOUS SYSTEM
Ketolides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ALZHEIMER’S AGENTS -----------------------------------
Long-Acting Insulins . . . . . . . . . . . . . . . . . . . . . . . .
Macrolides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ANALGESICS, NARCOTIC -------------------------------
ORAL --------------------------------------------------------------
Erythromycin Ethylsuccinate generics only Penicillins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Quinolones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sulfonamides . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
OTHER ANTIDIABETIC AGENTS ------------------------
ANALGESICS, NONSTEROIDAL ANTI-
Tetracyclines . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
INFLAMMATORY ------------------------------------------
BRAND GENERIC BRAND GENERIC BRAND
PSYCHOTHERAPEUTIC AGENTS -----------------------
Antidepressants . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ANTICOAGULANTS/ANTITHROMBOTICS ------------
ANALGESICS, SALICYLATES --------------------------
ANTICONVULSANTS -------------------------------------
ANTILIPEMICS ---------------------------------------------------
Antimanic Agent . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Antipsychotic Agents . . . . . . . . . . . . . . . . . . . . . . . .
CALCIUM CHANNEL BLOCKERS -------------------------
ANTIPARKINSON AGENTS ------------------------------
COMBINATION ANTIHYPERTENSIVES ------------------
CARDIOVASCULAR AGENTS
ANXIOLYTICS, SEDATIVES, AND HYPNOTICS -----
ALDOSTERONE ANTAGONISTS -------------------------
ANGIOTENSIN II ANTAGONISTS -------------------------
DIURETICS -------------------------------------------------------
ANGIOTENSIN CONVERTING ENZYME INHIBITORS
CEREBRAL STIMULANTS --------------------------------
ANTI-ADRENERGIC AGENTS – BETA-BLOCKERS -- VASODILATORS -------------------------------------------------
DMARDS --------------------------------------------------------
ANTI-ADRENERGIC BLOCKERS – CENTRALLY
ACTING -------------------------------------------------------------
MIGRAINE AGENTS------------------------------------------
ANTI-ADRENERGIC BLOCKERS – PERIPHERALLY
ACTING-------------------------------------------------------------
CONTRACEPTIVES
MONOPHASIC --------------------------------------------------
ANTIARRHYTHMICS ------------------------------------------
OBSESSIVE COMPULSIVE DISORDER AGENTS---
BRAND GENERIC BRAND GENERIC BRAND
TOPICAL ANTI-INFLAMMATORY AGENTS -------------
BOWEL EVACUANTS ------------------------------------------
Low Potency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
DIGESTANTS -----------------------------------------------------
Intermediate Potency . . . . . . . . . . . . . . . . . . . . . . . . .
OTHER GI PRODUCTS ----------------------------------------
High Potency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
BI-PHASIC ---------------------------------------------------------
TRI-PHASIC -------------------------------------------------------
Highest Potency . . . . . . . . . . . . . . . . . . . . . . . . . . . .
GOUT AGENTS
OTHER DERMATOLOGICALS ------------------------------
HORMONES
ANDROGENS ----------------------------------------------------
PROGESTIN ONLY ----------------------------------------------
EMERGENCY CONTRACEPTION --------------------------
ANTIESTROGENS/ANTIANDROGENS -------------------
CONTRACEPTIVE DEVICES ---------------------------------
ESTROGENS --------------------------------------------------
DIAGNOSTICS
CORTICOSTEROIDS
Glucose test strips on formulary include Accu-Chek and Accu-Chek Active, Advantage, Compact, Easy, Instant, and Simplicity products/ Aviva/ Chemstrip BG/ Comfort Curve/ Fast Take/ One Touch/ One Prednisolone Tablets/Liquid generic/Orapred GASTROINTESTINAL AGENTS
DERMATOLOGICALS
ANTIEMETIC/ ANTIVERTIGO --------------------------------
ESTROGEN AND ANDROGEN COMBINATIONS -----
ACNE ----------------------------------------------------------------
ESTROGEN AND PROGESTERONE
COMBINATIONS -----------------------------------------------
Sodium sulfacetamide/Sulfur generics only ANTIBIOTICS -----------------------------------------------------
ANTISPASMODIC/ GI MOTILITY ----------------------------
FERTILITY REGULATORS -----------------------------------
ANTIVIRALS ------------------------------------------------------
Propantheline generic/Pro-Banthine GROWTH HORMONE ------------------------------------------
ANTIULCER -------------------------------------------------------
FUNGICIDES ------------------------------------------------------
PROGESTINS -----------------------------------------------------
SELECTIVE RECEPTOR MODULATORS ----------------
BRAND GENERIC BRAND GENERIC BRAND
URINARY AGENTS
IMMUNOLOGIC AGENTS
OSTEOPOROSIS AGENTS
VAGINAL PREPARATIONS
* All of the following are available at the highest brand copay: Avonex, Betaseron, Copaxone, ANTI-INFECTIVE AND ANTI-INFLAMMATORY
COMBINATIONS -------------------------------------------------
IMPOTENCE AGENTS
OPHTHALMICS
MISCELLANEOUS AGENTS
RESPIRATORY/ASTHMA
ANTI-ALLERGIC AGENTS ------------------------------------
ANTI-ASTHMATIC AGENTS ---------------------------------
Antileukotrienes . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Corticosteroids . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ANTI-GLAUCOMA AGENTS----------------------------------
Fluticasone Inhaler/Rotadisk Flovent/HFA Sympathomimetics . . . . . . . . . . . . . . . . . . . . . . . . .
ANTI-INFECTIVE/ANTIVIRAL AGENTS -------------------
Xanthine Derivatives . . . . . . . . . . . . . . . . . . . . . . . .
OTHER RESPIRATORY/ASTHMA AGENTS ------------
* All of the following are available at the highest ANTI-INFECTIVE AND ANTI-INFLAMMATORY
COMBINATIONS -------------------------------------------------
SKELETAL MUSCLE RELAXANTS
ANTI-INFLAMMATORY AGENTS ---------------------------
Carisoprodol, ASA/Caffeine generics only BETA-BLOCKERS ----------------------------------------------
THYROID AND ANTITHYROID AGENTS
VASOCONSTRICTORS ----------------------------------------
MISCELLANEOUS OPHTHALMIC AGENTS ------------

Source: http://www.altrisk.com/forms/APS_FORMULARY_4Q2009.pdf