DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 1

APPENDIX A - PRODUCT NAME INDEX

** A **

ABACAVIR SULFATE, ABACAVIR SULFATE

ABACAVIR SULFATE AND LAMIVUDINE, ABACAVIR SULFATE

ABACAVIR SULFATE, LAMIVUDINE AND ZIDOVUDINE, ABACAVIR SULFATE

ABELCET, AMPHOTERICIN B

ABILIFY, ARIPIPRAZOLE

ABILIFY ASIMTUFII, ARIPIPRAZOLE

ABILIFY MAINTENA KIT, ARIPIPRAZOLE

ABILIFY MYCITE KIT, ARIPIPRAZOLE

ABIRATERONE ACETATE, ABIRATERONE ACETATE

ABLYSINOL, ALCOHOL

ABRAXANE, PACLITAXEL

ABREVA, DOCOSANOL (OTC)

ABSORICA, ISOTRETINOIN

ABSORICA LD, ISOTRETINOIN

ACAMPROSATE CALCIUM, ACAMPROSATE CALCIUM

ACANYA, BENZOYL PEROXIDE

ACARBOSE, ACARBOSE

ACCOLATE, ZAFIRLUKAST

ACCRUFER, FERRIC MALTOL

ACEBUTOLOL HYDROCHLORIDE, ACEBUTOLOL HYDROCHLORIDE

ACEPHEN, ACETAMINOPHEN (OTC)

ACETADOTE, ACETYLCYSTEINE

ACETAMINOPHEN, ACETAMINOPHEN (OTC)

ACETAMINOPHEN, ACETAMINOPHEN

ACETAMINOPHEN AND CODEINE PHOSPHATE, ACETAMINOPHEN

ACETAMINOPHEN AND IBUPROFEN, ACETAMINOPHEN (OTC)

ACETAMINOPHEN, ASPIRIN AND CAFFEINE, ACETAMINOPHEN (OTC)

ACETAZOLAMIDE, ACETAZOLAMIDE

ACETAZOLAMIDE SODIUM, ACETAZOLAMIDE SODIUM

ACETIC ACID, ACETIC ACID, GLACIAL

ACETIC ACID 0.25% IN PLASTIC CONTAINER, ACETIC ACID, GLACIAL

ACETYLCYSTEINE, ACETYLCYSTEINE

ACIPHEX, RABEPRAZOLE SODIUM

ACITRETIN, ACITRETIN

ACTHAR GEL, CORTICOTROPIN

ACTICLATE, DOXYCYCLINE HYCLATE

ACTIGALL, URSODIOL

ACTIQ, FENTANYL CITRATE

ACTIVELLA, ESTRADIOL

ACTONEL, RISEDRONATE SODIUM

ACTOPLUS MET, METFORMIN HYDROCHLORIDE

ACTOS, PIOGLITAZONE HYDROCHLORIDE

ACULAR, KETOROLAC TROMETHAMINE

ACULAR LS, KETOROLAC TROMETHAMINE

ACUVAIL, KETOROLAC TROMETHAMINE

ACYCLOVIR, ACYCLOVIR

ACYCLOVIR SODIUM, ACYCLOVIR SODIUM

ACZONE, DAPSONE

ADAPALENE, ADAPALENE (OTC)

ADAPALENE, ADAPALENE

ADAPALENE AND BENZOYL PEROXIDE, ADAPALENE

ADASUVE, LOXAPINE

ADCIRCA, TADALAFIL

ADDERALL XR 10, AMPHETAMINE ASPARTATE

ADDERALL XR 15, AMPHETAMINE ASPARTATE

ADDERALL XR 20, AMPHETAMINE ASPARTATE

ADDERALL XR 25, AMPHETAMINE ASPARTATE

ADDERALL XR 30, AMPHETAMINE ASPARTATE

ADDERALL XR 5, AMPHETAMINE ASPARTATE

ADDYI, FLIBANSERIN

ADEFOVIR DIPIVOXIL, ADEFOVIR DIPIVOXIL

ADEMPAS, RIOCIGUAT

ADENOSINE, ADENOSINE

ADIPEX-P, PHENTERMINE HYDROCHLORIDE

ADLARITY, DONEPEZIL HYDROCHLORIDE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 2

APPENDIX A - PRODUCT NAME INDEX

** A **

ADRENACLICK, EPINEPHRINE

ADRENALIN, EPINEPHRINE

ADREVIEW, IOBENGUANE SULFATE I-123

ADVAIR DISKUS 100/50, FLUTICASONE PROPIONATE

ADVAIR DISKUS 250/50, FLUTICASONE PROPIONATE

ADVAIR DISKUS 500/50, FLUTICASONE PROPIONATE

ADVAIR HFA, FLUTICASONE PROPIONATE

ADVIL, IBUPROFEN (OTC)

ADVIL, IBUPROFEN SODIUM (OTC)

ADVIL ALLERGY AND CONGESTION RELIEF, CHLORPHENIRAMINE MALEATE (OTC)

ADVIL ALLERGY SINUS, CHLORPHENIRAMINE MALEATE (OTC)

ADVIL COLD AND SINUS, IBUPROFEN (OTC)

ADVIL CONGESTION RELIEF, IBUPROFEN (OTC)

ADVIL DUAL ACTION WITH ACETAMINOPHEN, ACETAMINOPHEN (OTC)

ADVIL LIQUI-GELS, IBUPROFEN (OTC)

ADVIL MIGRAINE LIQUI-GELS, IBUPROFEN (OTC)

ADVIL MULTI-SYMPTOM COLD & FLU, CHLORPHENIRAMINE MALEATE (OTC)

ADVIL PM, DIPHENHYDRAMINE CITRATE (OTC)

ADVIL PM, DIPHENHYDRAMINE HYDROCHLORIDE (OTC)

ADZENYS XR-ODT, AMPHETAMINE

AEMCOLO, RIFAMYCIN SODIUM

AFINITOR, EVEROLIMUS

AFINITOR DISPERZ, EVEROLIMUS

AFIRMELLE, ETHINYL ESTRADIOL

AGAMREE, VAMOROLONE

AGGRASTAT, TIROFIBAN HYDROCHLORIDE

AGRYLIN, ANAGRELIDE HYDROCHLORIDE

AIRDUO DIGIHALER, FLUTICASONE PROPIONATE

AIRDUO RESPICLICK, FLUTICASONE PROPIONATE

AIRSUPRA, ALBUTEROL SULFATE

AK-FLUOR 10%, FLUORESCEIN SODIUM

AK-FLUOR 25%, FLUORESCEIN SODIUM

AKEEGA, ABIRATERONE ACETATE

AKLIEF, TRIFAROTENE

AKOVAZ, EPHEDRINE SULFATE

AKPENTOLATE, CYCLOPENTOLATE HYDROCHLORIDE

AKTEN, LIDOCAINE HYDROCHLORIDE

AKYNZEO, FOSNETUPITANT CHLORIDE HYDROCHLORIDE

AKYNZEO, NETUPITANT

ALA-CORT, HYDROCORTISONE

ALA-SCALP, HYDROCORTISONE

ALAVERT, LORATADINE (OTC)

ALAWAY, KETOTIFEN FUMARATE (OTC)

ALBENDAZOLE, ALBENDAZOLE

ALBUTEROL SULFATE, ALBUTEROL SULFATE

ALBUTEROL SULFATE AND IPRATROPIUM BROMIDE, ALBUTEROL SULFATE

ALCAINE, PROPARACAINE HYDROCHLORIDE

ALCLOMETASONE DIPROPIONATE, ALCLOMETASONE DIPROPIONATE

ALDACTAZIDE, HYDROCHLOROTHIAZIDE

ALDACTONE, SPIRONOLACTONE

ALECENSA, ALECTINIB HYDROCHLORIDE

ALENDRONATE SODIUM, ALENDRONATE SODIUM

ALEVE, NAPROXEN SODIUM (OTC)

ALEVE PM, DIPHENHYDRAMINE HYDROCHLORIDE (OTC)

ALFENTA, ALFENTANIL HYDROCHLORIDE

ALFENTANIL, ALFENTANIL HYDROCHLORIDE

ALFUZOSIN HYDROCHLORIDE, ALFUZOSIN HYDROCHLORIDE

ALIMTA, PEMETREXED DISODIUM

ALINIA, NITAZOXANIDE

ALISKIREN HEMIFUMARATE, ALISKIREN HEMIFUMARATE

ALKINDI SPRINKLE, HYDROCORTISONE

ALLEGRA ALLERGY, FEXOFENADINE HYDROCHLORIDE (OTC)

ALLEGRA HIVES, FEXOFENADINE HYDROCHLORIDE (OTC)

ALLEGRA-D 12 HOUR ALLERGY AND CONGESTION, FEXOFENADINE HYDROCHLORIDE (OTC)

ALLEGRA-D 24 HOUR ALLERGY AND CONGESTION, FEXOFENADINE HYDROCHLORIDE (OTC)
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 3

APPENDIX A - PRODUCT NAME INDEX

** A **

ALLI, ORLISTAT (OTC)

ALLOPURINOL, ALLOPURINOL

ALLOPURINOL SODIUM, ALLOPURINOL SODIUM

ALLZITAL, ACETAMINOPHEN

ALMOTRIPTAN MALATE, ALMOTRIPTAN MALATE

ALOMIDE, LODOXAMIDE TROMETHAMINE

ALOPRIM, ALLOPURINOL SODIUM

ALOSETRON HYDROCHLORIDE, ALOSETRON HYDROCHLORIDE

ALPHAGAN P, BRIMONIDINE TARTRATE

ALPRAZOLAM, ALPRAZOLAM

ALPROSTADIL, ALPROSTADIL

ALREX, LOTEPREDNOL ETABONATE

ALTABAX, RETAPAMULIN

ALTACE, RAMIPRIL

ALTAFLUOR BENOX, BENOXINATE HYDROCHLORIDE

ALTAVERA, ETHINYL ESTRADIOL

ALTOPREV, LOVASTATIN

ALTRENO, TRETINOIN

ALUNBRIG, BRIGATINIB

ALVAIZ, ELTROMBOPAG CHOLINE

ALVESCO, CICLESONIDE

ALVIMOPAN, ALVIMOPAN

ALYACEN 1/35, ETHINYL ESTRADIOL

ALYACEN 7/7/7, ETHINYL ESTRADIOL

ALYQ, TADALAFIL

AMABELZ, ESTRADIOL

AMANTADINE HYDROCHLORIDE, AMANTADINE HYDROCHLORIDE

AMARYL, GLIMEPIRIDE

AMBIEN, ZOLPIDEM TARTRATE

AMBIEN CR, ZOLPIDEM TARTRATE

AMBISOME, AMPHOTERICIN B

AMBRISENTAN, AMBRISENTAN

AMCINONIDE, AMCINONIDE

AMELUZ, AMINOLEVULINIC ACID HYDROCHLORIDE

AMICAR, AMINOCAPROIC ACID

AMIDATE, ETOMIDATE

AMIKACIN SULFATE, AMIKACIN SULFATE

AMILORIDE HYDROCHLORIDE, AMILORIDE HYDROCHLORIDE

AMILORIDE HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, AMILORIDE HYDROCHLORIDE

AMINO ACIDS, AMINO ACIDS

AMINOACETIC ACID 1.5% IN PLASTIC CONTAINER, GLYCINE

AMINOCAPROIC ACID, AMINOCAPROIC ACID

AMINOCAPROIC ACID IN PLASTIC CONTAINER, AMINOCAPROIC ACID

AMINOPHYLLINE, AMINOPHYLLINE

AMINOSYN II 10% IN PLASTIC CONTAINER, AMINO ACIDS

AMINOSYN II 15% IN PLASTIC CONTAINER, AMINO ACIDS

AMINOSYN-PF 10%, AMINO ACIDS

AMINOSYN-PF 7%, AMINO ACIDS

AMIODARONE HYDROCHLORIDE, AMIODARONE HYDROCHLORIDE

AMITIZA, LUBIPROSTONE

AMITRIPTYLINE HYDROCHLORIDE, AMITRIPTYLINE HYDROCHLORIDE

AMLODIPINE AND OLMESARTAN MEDOXOMIL, AMLODIPINE BESYLATE

AMLODIPINE BESYLATE, AMLODIPINE BESYLATE

AMLODIPINE BESYLATE AND ATORVASTATIN CALCIUM, AMLODIPINE BESYLATE

AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE, AMLODIPINE BESYLATE

AMLODIPINE BESYLATE AND VALSARTAN, AMLODIPINE BESYLATE

AMLODIPINE BESYLATE, VALSARTAN AND HYDROCHLOROTHIAZIDE, AMLODIPINE BESYLATE

AMMONIA N 13, AMMONIA N-13

AMMONIUM CHLORIDE IN PLASTIC CONTAINER, AMMONIUM CHLORIDE

AMMONIUM LACTATE, AMMONIUM LACTATE

AMMONUL, SODIUM BENZOATE

AMNESTEEM, ISOTRETINOIN

AMONDYS 45, CASIMERSEN

AMOXAPINE, AMOXAPINE

AMOXICILLIN, AMOXICILLIN
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 4

APPENDIX A - PRODUCT NAME INDEX

** A **

AMOXICILLIN AND CLAVULANATE POTASSIUM, AMOXICILLIN

AMOXICILLIN PEDIATRIC, AMOXICILLIN

AMOXIL, AMOXICILLIN

AMPHETAMINE SULFATE, AMPHETAMINE SULFATE

AMPHOTERICIN B, AMPHOTERICIN B

AMPICILLIN AND SULBACTAM, AMPICILLIN SODIUM

AMPICILLIN SODIUM, AMPICILLIN SODIUM

AMPICILLIN TRIHYDRATE, AMPICILLIN/AMPICILLIN TRIHYDRATE

AMPYRA, DALFAMPRIDINE

AMRINONE LACTATE, INAMRINONE LACTATE

AMRIX, CYCLOBENZAPRINE HYDROCHLORIDE

AMVUTTRA, VUTRISIRAN SODIUM

AMYVID, FLORBETAPIR F-18

AMZEEQ, MINOCYCLINE HYDROCHLORIDE

AN-SULFUR COLLOID, TECHNETIUM TC-99M SULFUR COLLOID KIT

ANAFRANIL, CLOMIPRAMINE HYDROCHLORIDE

ANAGRELIDE HYDROCHLORIDE, ANAGRELIDE HYDROCHLORIDE

ANAPROX DS, NAPROXEN SODIUM

ANASTROZOLE, ANASTROZOLE

ANCOBON, FLUCYTOSINE

ANDROGEL, TESTOSTERONE

ANDROID 25, METHYLTESTOSTERONE

ANECTINE, SUCCINYLCHOLINE CHLORIDE

ANEXSIA 5/325, ACETAMINOPHEN

ANEXSIA 7.5/325, ACETAMINOPHEN

ANGELIQ, DROSPIRENONE

ANGIOMAX, BIVALIRUDIN

ANGIOMAX RTU, BIVALIRUDIN

ANNOVERA, ETHINYL ESTRADIOL

ANORO ELLIPTA, UMECLIDINIUM BROMIDE

ANTARA (MICRONIZED), FENOFIBRATE

ANTHELIOS 20, AVOBENZONE (OTC)

ANTHELIOS 40, AVOBENZONE (OTC)

ANTHELIOS SX, AVOBENZONE (OTC)

ANTIVERT, MECLIZINE HYDROCHLORIDE

ANUSOL HC, HYDROCORTISONE

ANZEMET, DOLASETRON MESYLATE

APHEXDA, MOTIXAFORTIDE ACETATE

APIXABAN, APIXABAN

APLENZIN, BUPROPION HYDROBROMIDE

APOKYN, APOMORPHINE HYDROCHLORIDE

APOMORPHINE HYDROCHLORIDE, APOMORPHINE HYDROCHLORIDE

APONVIE, APREPITANT

APRACLONIDINE HYDROCHLORIDE, APRACLONIDINE HYDROCHLORIDE

APREMILAST, APREMILAST

APREPITANT, APREPITANT

APRETUDE, CABOTEGRAVIR

APRISO, MESALAMINE

APTENSIO XR, METHYLPHENIDATE HYDROCHLORIDE

APTIOM, ESLICARBAZEPINE ACETATE

APTIVUS, TIPRANAVIR

AQUASOL A, VITAMIN A PALMITATE

ARAKODA, TAFENOQUINE SUCCINATE

ARANELLE, ETHINYL ESTRADIOL

ARAVA, LEFLUNOMIDE

ARAZLO, TAZAROTENE

ARESTIN, MINOCYCLINE HYDROCHLORIDE

ARFORMOTEROL TARTRATE, ARFORMOTEROL TARTRATE

ARGATROBAN, ARGATROBAN

ARGATROBAN IN SODIUM CHLORIDE, ARGATROBAN

ARICEPT, DONEPEZIL HYDROCHLORIDE

ARIDOL KIT, MANNITOL

ARIKAYCE KIT, AMIKACIN SULFATE

ARIMIDEX, ANASTROZOLE

ARIPIPRAZOLE, ARIPIPRAZOLE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 5

APPENDIX A - PRODUCT NAME INDEX

** A **

ARISTADA, ARIPIPRAZOLE LAUROXIL

ARISTADA INITIO KIT, ARIPIPRAZOLE LAUROXIL

ARIXTRA, FONDAPARINUX SODIUM

ARMODAFINIL, ARMODAFINIL

ARMONAIR DIGIHALER, FLUTICASONE PROPIONATE

ARNUITY ELLIPTA, FLUTICASONE FUROATE

AROMASIN, EXEMESTANE

ARRANON, NELARABINE

ARSENIC TRIOXIDE, ARSENIC TRIOXIDE

ARTESUNATE, ARTESUNATE

ARTHROTEC, DICLOFENAC SODIUM

ASCLERA, POLIDOCANOL

ASCOR, ASCORBIC ACID

ASENAPINE MALEATE, ASENAPINE MALEATE

ASHLYNA, ETHINYL ESTRADIOL

ASMANEX HFA, MOMETASONE FUROATE

ASMANEX TWISTHALER, MOMETASONE FUROATE

ASPIRIN AND DIPYRIDAMOLE, ASPIRIN

ASPRUZYO SPRINKLE, RANOLAZINE

ASTAGRAF XL, TACROLIMUS

ASTEPRO ALLERGY, AZELASTINE HYDROCHLORIDE (OTC)

ATACAND, CANDESARTAN CILEXETIL

ATACAND HCT, CANDESARTAN CILEXETIL

ATAZANAVIR SULFATE, ATAZANAVIR SULFATE

ATELVIA, RISEDRONATE SODIUM

ATENOLOL, ATENOLOL

ATENOLOL AND CHLORTHALIDONE, ATENOLOL

ATHENTIA NEXT, LEVONORGESTREL (OTC)

ATIVAN, LORAZEPAM

ATOMOXETINE HYDROCHLORIDE, ATOMOXETINE HYDROCHLORIDE

ATORVALIQ, ATORVASTATIN CALCIUM

ATORVASTATIN CALCIUM, ATORVASTATIN CALCIUM

ATOVAQUONE, ATOVAQUONE

ATOVAQUONE AND PROGUANIL HYDROCHLORIDE, ATOVAQUONE

ATRACURIUM BESYLATE, ATRACURIUM BESYLATE

ATRACURIUM BESYLATE PRESERVATIVE FREE, ATRACURIUM BESYLATE

ATRALIN, TRETINOIN

ATRIPLA, EFAVIRENZ

ATROPINE SULFATE, ATROPINE SULFATE

ATROVENT HFA, IPRATROPIUM BROMIDE

AUBAGIO, TERIFLUNOMIDE

AUGMENTIN '125', AMOXICILLIN

AUGMENTIN '250', AMOXICILLIN

AUGMENTIN '875', AMOXICILLIN

AUGMENTIN ES-600, AMOXICILLIN

AUGTYRO, REPOTRECTINIB

AUROVELA 1.5/30, ETHINYL ESTRADIOL

AUROVELA 1/20, ETHINYL ESTRADIOL

AUROVELA 24 FE, ETHINYL ESTRADIOL

AUROVELA FE 1.5/30, ETHINYL ESTRADIOL

AUROVELA FE 1/20, ETHINYL ESTRADIOL

AURYXIA, FERRIC CITRATE

AUSTEDO, DEUTETRABENAZINE

AUSTEDO XR, DEUTETRABENAZINE

AUVELITY, BUPROPION HYDROCHLORIDE

AUVI-Q, EPINEPHRINE

AVAGARD, ALCOHOL (OTC)

AVAGE, TAZAROTENE

AVALIDE, HYDROCHLOROTHIAZIDE

AVAPRO, IRBESARTAN

AVEED, TESTOSTERONE UNDECANOATE

AVIANE-28, ETHINYL ESTRADIOL

AVITA, TRETINOIN

AVODART, DUTASTERIDE

AVYCAZ, AVIBACTAM SODIUM
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 6

APPENDIX A - PRODUCT NAME INDEX

** A **

AXID AR, NIZATIDINE (OTC)

AXUMIN, FLUCICLOVINE F-18

AYUNA, ETHINYL ESTRADIOL

AYVAKIT, AVAPRITINIB

AZACITIDINE, AZACITIDINE

AZACTAM, AZTREONAM

AZASAN, AZATHIOPRINE

AZASITE, AZITHROMYCIN

AZATHIOPRINE, AZATHIOPRINE

AZATHIOPRINE SODIUM, AZATHIOPRINE SODIUM

AZEDRA, IOBENGUANE I-131

AZELAIC ACID, AZELAIC ACID

AZELASTINE HYDROCHLORIDE, AZELASTINE HYDROCHLORIDE

AZELASTINE HYDROCHLORIDE AND FLUTICASONE PROPIONATE, AZELASTINE HYDROCHLORIDE

AZELEX, AZELAIC ACID

AZILECT, RASAGILINE MESYLATE

AZITHROMYCIN, AZITHROMYCIN

AZOPT, BRINZOLAMIDE

AZOR, AMLODIPINE BESYLATE

AZSTARYS, DEXMETHYLPHENIDATE HYDROCHLORIDE

AZTREONAM, AZTREONAM

AZULFIDINE, SULFASALAZINE

AZULFIDINE EN-TABS, SULFASALAZINE

** B **

BACITRACIN, BACITRACIN

BACITRACIN ZINC AND POLYMYXIN B SULFATE, BACITRACIN ZINC

BACITRACIN-NEOMYCIN-POLYMYXIN W/ HYDROCORTISONE ACETATE, BACITRACIN ZINC

BACLOFEN, BACLOFEN

BACTERIOSTATIC SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, SODIUM CHLORIDE

BACTERIOSTATIC WATER FOR INJECTION IN PLASTIC CONTAINER, STERILE WATER FOR INJECTION

BACTOCILL IN PLASTIC CONTAINER, OXACILLIN SODIUM

BACTRIM, SULFAMETHOXAZOLE

BACTRIM DS, SULFAMETHOXAZOLE

BAFIERTAM, MONOMETHYL FUMARATE

BAL, DIMERCAPROL

BALANCED SALT, CALCIUM CHLORIDE

BALCOLTRA, ETHINYL ESTRADIOL

BALSALAZIDE DISODIUM, BALSALAZIDE DISODIUM

BALVERSA, ERDAFITINIB

BALZIVA-28, ETHINYL ESTRADIOL

BANZEL, RUFINAMIDE

BAQSIMI, GLUCAGON

BARACLUDE, ENTECAVIR

BARHEMSYS, AMISULPRIDE

BAXDELA, DELAFLOXACIN MEGLUMINE

BEKYREE, DESOGESTREL

BELBUCA, BUPRENORPHINE HYDROCHLORIDE

BELEODAQ, BELINOSTAT

BELRAPZO, BENDAMUSTINE HYDROCHLORIDE

BELSOMRA, SUVOREXANT

BENAZEPRIL HYDROCHLORIDE, BENAZEPRIL HYDROCHLORIDE

BENAZEPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, BENAZEPRIL HYDROCHLORIDE

BENDAMUSTINE HYDROCHLORIDE, BENDAMUSTINE HYDROCHLORIDE

BENDEKA, BENDAMUSTINE HYDROCHLORIDE

BENICAR, OLMESARTAN MEDOXOMIL

BENICAR HCT, HYDROCHLOROTHIAZIDE

BENTYL, DICYCLOMINE HYDROCHLORIDE

BENTYL PRESERVATIVE FREE, DICYCLOMINE HYDROCHLORIDE

BENZAMYCIN, BENZOYL PEROXIDE

BENZNIDAZOLE, BENZNIDAZOLE

BENZONATATE, BENZONATATE

BENZPHETAMINE HYDROCHLORIDE, BENZPHETAMINE HYDROCHLORIDE

BENZTROPINE MESYLATE, BENZTROPINE MESYLATE

BEPOTASTINE BESILATE, BEPOTASTINE BESILATE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 7

APPENDIX A - PRODUCT NAME INDEX

** B **

BEPREVE, BEPOTASTINE BESILATE

BESIVANCE, BESIFLOXACIN HYDROCHLORIDE

BETA-VAL, BETAMETHASONE VALERATE

BETADINE, POVIDONE-IODINE

BETAGAN, LEVOBUNOLOL HYDROCHLORIDE

BETAINE, BETAINE

BETAMETHASONE ACETATE AND BETAMETHASONE SODIUM PHOSPHATE, BETAMETHASONE ACETATE

BETAMETHASONE DIPROPIONATE, BETAMETHASONE DIPROPIONATE

BETAMETHASONE VALERATE, BETAMETHASONE VALERATE

BETAPACE, SOTALOL HYDROCHLORIDE

BETAPACE AF, SOTALOL HYDROCHLORIDE

BETAXOLOL HYDROCHLORIDE, BETAXOLOL HYDROCHLORIDE

BETHANECHOL CHLORIDE, BETHANECHOL CHLORIDE

BETHKIS, TOBRAMYCIN

BETIMOL, TIMOLOL

BETOPTIC, BETAXOLOL HYDROCHLORIDE

BETOPTIC S, BETAXOLOL HYDROCHLORIDE

BEVESPI AEROSPHERE, FORMOTEROL FUMARATE

BEXAROTENE, BEXAROTENE

BEYAZ, DROSPIRENONE

BICALUTAMIDE, BICALUTAMIDE

BICILLIN C-R, PENICILLIN G BENZATHINE

BICILLIN C-R 900/300, PENICILLIN G BENZATHINE

BICILLIN L-A, PENICILLIN G BENZATHINE

BICNU, CARMUSTINE

BIDIL, HYDRALAZINE HYDROCHLORIDE

BIJUVA, ESTRADIOL

BIKTARVY, BICTEGRAVIR SODIUM

BILTRICIDE, PRAZIQUANTEL

BIMATOPROST, BIMATOPROST

BINOSTO, ALENDRONATE SODIUM

BIORPHEN, PHENYLEPHRINE HYDROCHLORIDE

BIOSCRUB, CHLORHEXIDINE GLUCONATE (OTC)

BISMUTH SUBCITRATE POTASSIUM, METRONIDAZOLE AND TETRACYCLINE HYDROCHLORIDE, BISMUTH

BISMUTH SUBSALICYLATE, METRONIDAZOLE AND TETRACYCLINE HYDROCHLORIDE, BISMUTH SUBSALICYLATE

BISOPROLOL FUMARATE, BISOPROLOL FUMARATE

BISOPROLOL FUMARATE AND HYDROCHLOROTHIAZIDE, BISOPROLOL FUMARATE

BIVALIRUDIN, BIVALIRUDIN

BLEOMYCIN SULFATE, BLEOMYCIN SULFATE

BLISOVI 24 FE, ETHINYL ESTRADIOL

BLISOVI FE 1.5/30, ETHINYL ESTRADIOL

BLISOVI FE 1/20, ETHINYL ESTRADIOL

BLOXIVERZ, NEOSTIGMINE METHYLSULFATE

BLUDIGO, INDIGOTINDISULFONATE SODIUM

BONJESTA, DOXYLAMINE SUCCINATE

BONSITY, TERIPARATIDE

BONTRIL PDM, PHENDIMETRAZINE TARTRATE

BORTEZOMIB, BORTEZOMIB

BOSENTAN, BOSENTAN

BOSULIF, BOSUTINIB MONOHYDRATE

BRAFTOVI, ENCORAFENIB

BRENZAVVY, BEXAGLIFLOZIN

BREO ELLIPTA, FLUTICASONE FUROATE

BRETHINE, TERBUTALINE SULFATE

BREVIBLOC, ESMOLOL HYDROCHLORIDE

BREVIBLOC DOUBLE STRENGTH IN PLASTIC CONTAINER, ESMOLOL HYDROCHLORIDE

BREVIBLOC IN PLASTIC CONTAINER, ESMOLOL HYDROCHLORIDE

BREVITAL SODIUM, METHOHEXITAL SODIUM

BREXAFEMME, IBREXAFUNGERP CITRATE

BREXPIPRAZOLE, BREXPIPRAZOLE

BREYNA, BUDESONIDE

BREZTRI AEROSPHERE, BUDESONIDE

BRIDION, SUGAMMADEX SODIUM

BRIELLYN, ETHINYL ESTRADIOL

BRILINTA, TICAGRELOR
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 8

APPENDIX A - PRODUCT NAME INDEX

** B **

BRIMONIDINE TARTRATE, BRIMONIDINE TARTRATE

BRIMONIDINE TARTRATE AND TIMOLOL MALEATE, BRIMONIDINE TARTRATE

BRINZOLAMIDE, BRINZOLAMIDE

BRISDELLE, PAROXETINE MESYLATE

BRIVIACT, BRIVARACETAM

BRIXADI, BUPRENORPHINE

BROMFED-DM, BROMPHENIRAMINE MALEATE

BROMFENAC SODIUM, BROMFENAC SODIUM

BROMOCRIPTINE MESYLATE, BROMOCRIPTINE MESYLATE

BROMPHENIRAMINE MALEATE, PSEUDOEPHEDRINE HYDROCHLORIDE AND DEXTROMETHORPHAN HYDROBROMIDE,

BROMSITE, BROMFENAC SODIUM

BRONCHITOL, MANNITOL

BROVANA, ARFORMOTEROL TARTRATE

BRUKINSA, ZANUBRUTINIB

BRYHALI, HALOBETASOL PROPIONATE

BSS, CALCIUM CHLORIDE

BSS PLUS, CALCIUM CHLORIDE

BUDESONIDE, BUDESONIDE (OTC)

BUDESONIDE, BUDESONIDE

BUMETANIDE, BUMETANIDE

BUMEX, BUMETANIDE

BUPHENYL, SODIUM PHENYLBUTYRATE

BUPIVACAINE HYDROCHLORIDE, BUPIVACAINE HYDROCHLORIDE

BUPIVACAINE HYDROCHLORIDE AND EPINEPHRINE, BUPIVACAINE HYDROCHLORIDE

BUPIVACAINE HYDROCHLORIDE PRESERVATIVE FREE, BUPIVACAINE HYDROCHLORIDE

BUPRENORPHINE, BUPRENORPHINE

BUPRENORPHINE HYDROCHLORIDE, BUPRENORPHINE HYDROCHLORIDE

BUPRENORPHINE HYDROCHLORIDE AND NALOXONE HYDROCHLORIDE, BUPRENORPHINE HYDROCHLORIDE

BUPROPION HYDROCHLORIDE, BUPROPION HYDROCHLORIDE

BUSPIRONE HYDROCHLORIDE, BUSPIRONE HYDROCHLORIDE

BUSULFAN, BUSULFAN

BUSULFEX, BUSULFAN

BUTALBITAL AND ACETAMINOPHEN, ACETAMINOPHEN

BUTALBITAL, ACETAMINOPHEN AND CAFFEINE, ACETAMINOPHEN

BUTALBITAL, ACETAMINOPHEN, CAFFEINE AND CODEINE PHOSPHATE, ACETAMINOPHEN

BUTALBITAL, ASPIRIN AND CAFFEINE, ASPIRIN

BUTALBITAL, ASPIRIN, CAFFEINE, AND CODEINE PHOSPHATE, ASPIRIN

BUTAPAP, ACETAMINOPHEN

BUTENAFINE HYDROCHLORIDE, BUTENAFINE HYDROCHLORIDE (OTC)

BUTORPHANOL TARTRATE, BUTORPHANOL TARTRATE

BUTORPHANOL TARTRATE PRESERVATIVE FREE, BUTORPHANOL TARTRATE

BUTRANS, BUPRENORPHINE

BYDUREON BCISE, EXENATIDE SYNTHETIC

BYETTA, EXENATIDE SYNTHETIC

BYFAVO, REMIMAZOLAM BESYLATE

BYLVAY, ODEVIXIBAT

BYSTOLIC, NEBIVOLOL HYDROCHLORIDE

** C **

CABAZITAXEL, CABAZITAXEL

CABENUVA KIT, CABOTEGRAVIR

CABERGOLINE, CABERGOLINE

CABOMETYX, CABOZANTINIB S-MALATE

CABTREO, ADAPALENE

CADUET, AMLODIPINE BESYLATE

CAFCIT, CAFFEINE CITRATE

CAFFEINE CITRATE, CAFFEINE CITRATE

CALCIPOTRIENE, CALCIPOTRIENE

CALCIPOTRIENE AND BETAMETHASONE DIPROPIONATE, BETAMETHASONE DIPROPIONATE

CALCIPOTRIENE AND BETHAMETHASONE DIPROPIONATE, BETAMETHASONE DIPROPIONATE

CALCITONIN-SALMON, CALCITONIN SALMON

CALCITRIOL, CALCITRIOL

CALCIUM ACETATE, CALCIUM ACETATE

CALCIUM CHLORIDE 10%, CALCIUM CHLORIDE

CALCIUM CHLORIDE 10% IN PLASTIC CONTAINER, CALCIUM CHLORIDE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 9

APPENDIX A - PRODUCT NAME INDEX

** C **

CALCIUM GLUCONATE, CALCIUM GLUCONATE

CALCIUM GLUCONATE IN SODIUM CHLORIDE, CALCIUM GLUCONATE

CALDOLOR, IBUPROFEN

CALQUENCE, ACALABRUTINIB

CALQUENCE, ACALABRUTINIB MALEATE

CAMBIA, DICLOFENAC POTASSIUM

CAMCEVI KIT, LEUPROLIDE MESYLATE

CAMILA, NORETHINDRONE

CAMPTOSAR, IRINOTECAN HYDROCHLORIDE

CAMZYOS, MAVACAMTEN

CANASA, MESALAMINE

CANCIDAS, CASPOFUNGIN ACETATE

CANDESARTAN CILEXETIL, CANDESARTAN CILEXETIL

CANDESARTAN CILEXETIL AND HYDROCHLOROTHIAZIDE, CANDESARTAN CILEXETIL

CAPECITABINE, CAPECITABINE

CAPEX, FLUOCINOLONE ACETONIDE

CAPITAL SOLEIL 15, AVOBENZONE (OTC)

CAPLYTA, LUMATEPERONE TOSYLATE

CAPRELSA, VANDETANIB

CAPTOPRIL, CAPTOPRIL

CAPTOPRIL AND HYDROCHLOROTHIAZIDE, CAPTOPRIL

CARAC, FLUOROURACIL

CARAFATE, SUCRALFATE

CARBAGLU, CARGLUMIC ACID

CARBAMAZEPINE, CARBAMAZEPINE

CARBATROL, CARBAMAZEPINE

CARBIDOPA, CARBIDOPA

CARBIDOPA AND LEVODOPA, CARBIDOPA

CARBIDOPA, LEVODOPA AND ENTACAPONE, CARBIDOPA

CARBINOXAMINE MALEATE, CARBINOXAMINE MALEATE

CARBOCAINE, MEPIVACAINE HYDROCHLORIDE

CARBOPLATIN, CARBOPLATIN

CARBOPROST TROMETHAMINE, CARBOPROST TROMETHAMINE

CARDENE IN 0.83% SODIUM CHLORIDE IN PLASTIC CONTAINER, NICARDIPINE HYDROCHLORIDE

CARDENE IN 0.86% SODIUM CHLORIDE IN PLASTIC CONTAINER, NICARDIPINE HYDROCHLORIDE

CARDENE IN 4.8% DEXTROSE IN PLASTIC CONTAINER, NICARDIPINE HYDROCHLORIDE

CARDIOGEN-82, RUBIDIUM CHLORIDE RB-82

CARDIOLITE, TECHNETIUM TC-99M SESTAMIBI KIT

CARDIOPLEGIC IN PLASTIC CONTAINER, CALCIUM CHLORIDE

CARDIZEM, DILTIAZEM HYDROCHLORIDE

CARDIZEM CD, DILTIAZEM HYDROCHLORIDE

CARDIZEM LA, DILTIAZEM HYDROCHLORIDE

CARDURA, DOXAZOSIN MESYLATE

CARDURA XL, DOXAZOSIN MESYLATE

CARFILZOMIB, CARFILZOMIB

CARGLUMIC ACID, CARGLUMIC ACID

CARISOPRODOL, CARISOPRODOL

CARMUSTINE, CARMUSTINE

CARNITOR, LEVOCARNITINE

CARNITOR SF, LEVOCARNITINE

CAROSPIR, SPIRONOLACTONE

CARTEOLOL HYDROCHLORIDE, CARTEOLOL HYDROCHLORIDE

CARTIA XT, DILTIAZEM HYDROCHLORIDE

CARVEDILOL, CARVEDILOL

CARVEDILOL PHOSPHATE, CARVEDILOL PHOSPHATE

CASODEX, BICALUTAMIDE

CASPOFUNGIN ACETATE, CASPOFUNGIN ACETATE

CASPORYN HC, HYDROCORTISONE

CATAFLAM, DICLOFENAC POTASSIUM

CATAPRES-TTS-1, CLONIDINE

CATAPRES-TTS-2, CLONIDINE

CATAPRES-TTS-3, CLONIDINE

CAVERJECT, ALPROSTADIL

CAVERJECT IMPULSE, ALPROSTADIL

CAYSTON, AZTREONAM
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 10

APPENDIX A - PRODUCT NAME INDEX

** C **

CEFACLOR, CEFACLOR

CEFADROXIL, CEFADROXIL/CEFADROXIL HEMIHYDRATE

CEFAZOLIN AND DEXTROSE, CEFAZOLIN SODIUM

CEFAZOLIN IN PLASTIC CONTAINER, CEFAZOLIN SODIUM

CEFAZOLIN SODIUM, CEFAZOLIN SODIUM

CEFDINIR, CEFDINIR

CEFEPIME AND DEXTROSE IN DUPLEX CONTAINER, CEFEPIME HYDROCHLORIDE

CEFEPIME HYDROCHLORIDE, CEFEPIME HYDROCHLORIDE

CEFEPIME HYDROCHLORIDE IN PLASTIC CONTAINER, CEFEPIME HYDROCHLORIDE

CEFEPIME IN PLASTIC CONTAINER, CEFEPIME HYDROCHLORIDE

CEFIXIME, CEFIXIME

CEFOTETAN, CEFOTETAN DISODIUM

CEFOXITIN, CEFOXITIN SODIUM

CEFOXITIN AND DEXTROSE IN DUPLEX CONTAINER, CEFOXITIN SODIUM

CEFOXITIN IN PLASTIC CONTAINER, CEFOXITIN SODIUM

CEFPODOXIME PROXETIL, CEFPODOXIME PROXETIL

CEFPROZIL, CEFPROZIL

CEFTAZIDIME, CEFTAZIDIME

CEFTRIAXONE, CEFTRIAXONE SODIUM

CEFTRIAXONE AND DEXTROSE IN DUPLEX CONTAINER, CEFTRIAXONE SODIUM

CEFTRIAXONE IN PLASTIC CONTAINER, CEFTRIAXONE SODIUM

CEFTRIAXONE SODIUM, CEFTRIAXONE SODIUM

CEFUROXIME AXETIL, CEFUROXIME AXETIL

CEFUROXIME SODIUM, CEFUROXIME SODIUM

CELEBREX, CELECOXIB

CELECOXIB, CELECOXIB

CELESTONE SOLUSPAN, BETAMETHASONE ACETATE

CELEXA, CITALOPRAM HYDROBROMIDE

CELLCEPT, MYCOPHENOLATE MOFETIL

CELLCEPT, MYCOPHENOLATE MOFETIL HYDROCHLORIDE

CELONTIN, METHSUXIMIDE

CENTANY, MUPIROCIN

CEPHALEXIN, CEPHALEXIN

CEQUA, CYCLOSPORINE

CERDELGA, ELIGLUSTAT TARTRATE

CEREBYX, FOSPHENYTOIN SODIUM

CERETEC, TECHNETIUM TC-99M EXAMETAZIME KIT

CERIANNA, FLUOROESTRADIOL F-18

CERUBIDINE, DAUNORUBICIN HYDROCHLORIDE

CERVIDIL, DINOPROSTONE

CESAMET, NABILONE

CETIRIZINE HYDROCHLORIDE, CETIRIZINE HYDROCHLORIDE (OTC)

CETIRIZINE HYDROCHLORIDE, CETIRIZINE HYDROCHLORIDE

CETIRIZINE HYDROCHLORIDE ALLERGY, CETIRIZINE HYDROCHLORIDE (OTC)

CETIRIZINE HYDROCHLORIDE AND PSEUDOEPHEDRINE HYDROCHLORIDE, CETIRIZINE HYDROCHLORIDE

CETIRIZINE HYDROCHLORIDE HIVES, CETIRIZINE HYDROCHLORIDE (OTC)

CETIRIZINE HYDROCHLORIDE HIVES RELIEF, CETIRIZINE HYDROCHLORIDE (OTC)

CETRAXAL, CIPROFLOXACIN HYDROCHLORIDE

CETRORELIX ACETATE, CETRORELIX ACETATE

CETROTIDE, CETRORELIX ACETATE

CEVIMELINE HYDROCHLORIDE, CEVIMELINE HYDROCHLORIDE

CHABELINA FE, ETHINYL ESTRADIOL

CHEMET, SUCCIMER

CHENODIOL, CHENODIOL

CHG SCRUB, CHLORHEXIDINE GLUCONATE (OTC)

CHILDREN'S ADVIL, IBUPROFEN (OTC)

CHILDREN'S ADVIL ALLERGY SINUS, CHLORPHENIRAMINE MALEATE (OTC)

CHILDREN'S ADVIL COLD, IBUPROFEN (OTC)

CHILDREN'S ADVIL-FLAVORED, IBUPROFEN (OTC)

CHILDREN'S ALAWAY, KETOTIFEN FUMARATE (OTC)

CHILDREN'S ALLEGRA ALLERGY, FEXOFENADINE HYDROCHLORIDE (OTC)

CHILDREN'S ASTEPRO ALLERGY, AZELASTINE HYDROCHLORIDE (OTC)

CHILDREN'S CETIRIZINE HYDROCHLORIDE ALLERGY, CETIRIZINE HYDROCHLORIDE (OTC)

CHILDREN'S CETIRIZINE HYDROCHLORIDE HIVES RELIEF, CETIRIZINE HYDROCHLORIDE (OTC)

CHILDREN'S CLARITIN, LORATADINE (OTC)
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 11

APPENDIX A - PRODUCT NAME INDEX

** C **

CHILDREN'S FEXOFENADINE HYDROCHLORIDE ALLERGY, FEXOFENADINE HYDROCHLORIDE (OTC)

CHILDREN'S FEXOFENADINE HYDROCHLORIDE HIVES, FEXOFENADINE HYDROCHLORIDE (OTC)

CHILDREN'S IBUPROFEN, IBUPROFEN (OTC)

CHILDREN'S MOTRIN, IBUPROFEN (OTC)

CHILDREN'S MOTRIN COLD, IBUPROFEN (OTC)

CHILDREN'S ZYRTEC ALLERGY, CETIRIZINE HYDROCHLORIDE (OTC)

CHILDREN'S ZYRTEC HIVES RELIEF, CETIRIZINE HYDROCHLORIDE (OTC)

CHIRHOSTIM, SECRETIN SYNTHETIC HUMAN

CHLORAMPHENICOL SODIUM SUCCINATE, CHLORAMPHENICOL SODIUM SUCCINATE

CHLORAPREP ONE-STEP, CHLORHEXIDINE GLUCONATE (OTC)

CHLORAPREP ONE-STEP FREPP, CHLORHEXIDINE GLUCONATE (OTC)

CHLORAPREP ONE-STEP SEPP, CHLORHEXIDINE GLUCONATE (OTC)

CHLORAPREP SINGLE SWABSTICK, CHLORHEXIDINE GLUCONATE (OTC)

CHLORAPREP TRIPLE SWABSTICK, CHLORHEXIDINE GLUCONATE (OTC)

CHLORAPREP WITH TINT, CHLORHEXIDINE GLUCONATE (OTC)

CHLORDIAZEPOXIDE AND AMITRIPTYLINE HYDROCHLORIDE, AMITRIPTYLINE HYDROCHLORIDE

CHLORDIAZEPOXIDE HYDROCHLORIDE, CHLORDIAZEPOXIDE HYDROCHLORIDE

CHLORDIAZEPOXIDE HYDROCHLORIDE AND CLIDINIUM BROMIDE, CHLORDIAZEPOXIDE HYDROCHLORIDE

CHLORHEXIDINE GLUCONATE, CHLORHEXIDINE GLUCONATE (OTC)

CHLORHEXIDINE GLUCONATE, CHLORHEXIDINE GLUCONATE

CHLOROPROCAINE HYDROCHLORIDE, CHLOROPROCAINE HYDROCHLORIDE

CHLOROQUINE PHOSPHATE, CHLOROQUINE PHOSPHATE

CHLOROTHIAZIDE SODIUM, CHLOROTHIAZIDE SODIUM

CHLORPHENIRAMINE MALEATE, CHLORPHENIRAMINE MALEATE (OTC)

CHLORPROMAZINE HYDROCHLORIDE, CHLORPROMAZINE HYDROCHLORIDE

CHLORTHALIDONE, CHLORTHALIDONE

CHLORZOXAZONE, CHLORZOXAZONE

CHOLBAM, CHOLIC ACID

CHOLESTYRAMINE, CHOLESTYRAMINE

CHOLESTYRAMINE LIGHT, CHOLESTYRAMINE

CHOLETEC, TECHNETIUM TC-99M MEBROFENIN KIT

CHOLINE C-11, CHOLINE C-11

CHROMIC CHLORIDE IN PLASTIC CONTAINER, CHROMIC CHLORIDE

CIALIS, TADALAFIL

CIBINQO, ABROCITINIB

CICLOPIROX, CICLOPIROX

CIDA-STAT, CHLORHEXIDINE GLUCONATE (OTC)

CIDOFOVIR, CIDOFOVIR

CILOSTAZOL, CILOSTAZOL

CILOXAN, CIPROFLOXACIN HYDROCHLORIDE

CIMDUO, LAMIVUDINE

CIMETIDINE, CIMETIDINE (OTC)

CIMETIDINE, CIMETIDINE

CIMETIDINE HYDROCHLORIDE, CIMETIDINE HYDROCHLORIDE

CINACALCET HYDROCHLORIDE, CINACALCET HYDROCHLORIDE

CINVANTI, APREPITANT

CIPRO, CIPROFLOXACIN

CIPRO, CIPROFLOXACIN HYDROCHLORIDE

CIPRO HC, CIPROFLOXACIN HYDROCHLORIDE

CIPRODEX, CIPROFLOXACIN

CIPROFLOXACIN, CIPROFLOXACIN

CIPROFLOXACIN AND DEXAMETHASONE, CIPROFLOXACIN

CIPROFLOXACIN EXTENDED RELEASE, CIPROFLOXACIN

CIPROFLOXACIN HYDROCHLORIDE, CIPROFLOXACIN HYDROCHLORIDE

CIPROFLOXACIN IN DEXTROSE 5% IN PLASTIC CONTAINER, CIPROFLOXACIN

CIS-MDP, TECHNETIUM TC-99M MEDRONATE KIT

CIS-PYRO, TECHNETIUM TC-99M PYROPHOSPHATE KIT

CISATRACURIUM BESYLATE, CISATRACURIUM BESYLATE

CISATRACURIUM BESYLATE PRESERVATIVE FREE, CISATRACURIUM BESYLATE

CISPLATIN, CISPLATIN

CITALOPRAM HYDROBROMIDE, CITALOPRAM HYDROBROMIDE

CITANEST FORTE DENTAL, EPINEPHRINE BITARTRATE

CLADRIBINE, CLADRIBINE

CLARAVIS, ISOTRETINOIN

CLARINEX, DESLORATADINE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 12

APPENDIX A - PRODUCT NAME INDEX

** C **

CLARINEX-D 12 HOUR, DESLORATADINE

CLARISCAN, GADOTERATE MEGLUMINE

CLARITHROMYCIN, CLARITHROMYCIN

CLARITIN, LORATADINE (OTC)

CLARITIN HIVES RELIEF, LORATADINE (OTC)

CLARITIN HIVES RELIEF REDITAB, LORATADINE (OTC)

CLARITIN REDITABS, LORATADINE (OTC)

CLARITIN-D, LORATADINE (OTC)

CLARITIN-D 24 HOUR, LORATADINE (OTC)

CLEMASTINE FUMARATE, CLEMASTINE FUMARATE

CLENPIQ, CITRIC ACID

CLEOCIN, CLINDAMYCIN PALMITATE HYDROCHLORIDE

CLEOCIN, CLINDAMYCIN PHOSPHATE

CLEOCIN HYDROCHLORIDE, CLINDAMYCIN HYDROCHLORIDE

CLEOCIN PHOSPHATE, CLINDAMYCIN PHOSPHATE

CLEOCIN T, CLINDAMYCIN PHOSPHATE

CLEVIPREX, CLEVIDIPINE

CLIMARA, ESTRADIOL

CLIMARA PRO, ESTRADIOL

CLINDA-DERM, CLINDAMYCIN PHOSPHATE

CLINDAGEL, CLINDAMYCIN PHOSPHATE

CLINDAMYCIN HYDROCHLORIDE, CLINDAMYCIN HYDROCHLORIDE

CLINDAMYCIN PALMITATE HYDROCHLORIDE, CLINDAMYCIN PALMITATE HYDROCHLORIDE

CLINDAMYCIN PHOSPHATE, CLINDAMYCIN PHOSPHATE

CLINDAMYCIN PHOSPHATE AND BENZOYL PEROXIDE, BENZOYL PEROXIDE

CLINDAMYCIN PHOSPHATE AND TRETINOIN, CLINDAMYCIN PHOSPHATE

CLINDAMYCIN PHOSPHATE IN 0.9% SODIUM CHLORIDE, CLINDAMYCIN PHOSPHATE

CLINDAMYCIN PHOSPHATE IN 5% DEXTROSE IN PLASTIC CONTAINER, CLINDAMYCIN PHOSPHATE

CLINDAMYCIN PHOSPHATE IN DEXTROSE 5%, CLINDAMYCIN PHOSPHATE

CLINDESSE, CLINDAMYCIN PHOSPHATE

CLINDETS, CLINDAMYCIN PHOSPHATE

CLINIMIX 2.75/10 SULFITE FREE IN DEXTROSE 10% IN PLASTIC CONTAINER, AMINO ACIDS

CLINIMIX 2.75/25 SULFITE FREE IN DEXTROSE 25% IN PLASTIC CONTAINER, AMINO ACIDS

CLINIMIX 2.75/5 SULFITE FREE IN DEXTROSE 5% IN PLASTIC CONTAINER, AMINO ACIDS

CLINIMIX 4.25/10 SULFITE FREE IN DEXTROSE 10% IN PLASTIC CONTAINER, AMINO ACIDS

CLINIMIX 4.25/20 SULFITE FREE IN DEXTROSE 20% IN PLASTIC CONTAINER, AMINO ACIDS

CLINIMIX 4.25/25 SULFITE FREE IN DEXTROSE 25% IN PLASTIC CONTAINER, AMINO ACIDS

CLINIMIX 4.25/5 SULFITE FREE IN DEXTROSE 5% IN PLASTIC CONTAINER, AMINO ACIDS

CLINIMIX 5/10 SULFITE FREE IN DEXTROSE 10% IN PLASTIC CONTAINER, AMINO ACIDS

CLINIMIX 5/15 SULFITE FREE IN DEXTROSE 15% IN PLASTIC CONTAINER, AMINO ACIDS

CLINIMIX 5/20 SULFITE FREE IN DEXTROSE 20% IN PLASTIC CONTAINER, AMINO ACIDS

CLINIMIX 5/25 SULFITE FREE IN DEXTROSE 25% IN PLASTIC CONTAINER, AMINO ACIDS

CLINIMIX 5/35 SULFITE FREE IN DEXTROSE 35% IN PLASTIC CONTAINER, AMINO ACIDS

CLINIMIX E 2.75/10 SULFITE FREE W/ ELECT IN DEXTROSE 10% W/ CALCIUM IN PLASTIC CONTAINER,

CLINIMIX E 2.75/25 SULFITE FREE W/ ELECT IN DEXTROSE 25% W/ CALCIUM IN PLASTIC CONTAINER,

CLINIMIX E 2.75/5 SULFITE FREE W/ ELECT IN DEXTROSE 5% W/ CALCIUM IN PLASTIC CONTAINER,

CLINIMIX E 4.25/10 SULFITE FREE W/ ELECT IN DEXTROSE 10% W/ CALCIUM IN PLASTIC CONTAINER,

CLINIMIX E 4.25/20 SULFITE FREE W/ ELECT IN DEXTROSE 20% W/ CALCIUM IN PLASTIC CONTAINER,

CLINIMIX E 4.25/25 SULFITE FREE W/ ELECT IN DEXTROSE 25% W/ CALCIUM IN PLASTIC CONTAINER,

CLINIMIX E 4.25/5 SULFITE FREE W/ ELECT IN DEXTROSE 5% W/ CALCIUM IN PLASTIC CONTAINER,

CLINIMIX E 5/10 SULFITE FREE W/ ELECT IN DEXTROSE 10% W/ CALCIUM IN PLASTIC CONTAINER,

CLINIMIX E 5/15 SULFITE FREE W/ ELECT IN DEXTROSE 15% W/ CALCIUM IN PLASTIC CONTAINER,

CLINIMIX E 5/20 SULFITE FREE W/ ELECT IN 20% DEXTROSE W/ CALCIUM IN PLASTIC CONTAINER,

CLINIMIX E 5/25 SULFITE FREE W/ ELECT IN DEXTROSE 25% W/ CALCIUM IN PLASTIC CONTAINER,

CLINIMIX E 5/35 SULFITE FREE W/ ELECT IN DEXTROSE 35% W/ CALCIUM IN PLASTIC CONTAINER,

CLINISOL 15% SULFITE FREE IN PLASTIC CONTAINER, AMINO ACIDS

CLINOLIPID 20%, OLIVE OIL

CLOBAZAM, CLOBAZAM

CLOBETASOL PROPIONATE, CLOBETASOL PROPIONATE

CLOBETASOL PROPIONATE (EMOLLIENT), CLOBETASOL PROPIONATE

CLOBEX, CLOBETASOL PROPIONATE

CLOCORTOLONE PIVALATE, CLOCORTOLONE PIVALATE

CLODERM, CLOCORTOLONE PIVALATE

CLOFARABINE, CLOFARABINE

CLOLAR, CLOFARABINE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 13

APPENDIX A - PRODUCT NAME INDEX

** C **

CLOMIPHENE CITRATE, CLOMIPHENE CITRATE

CLOMIPRAMINE HYDROCHLORIDE, CLOMIPRAMINE HYDROCHLORIDE

CLONAZEPAM, CLONAZEPAM

CLONIDINE, CLONIDINE

CLONIDINE HYDROCHLORIDE, CLONIDINE HYDROCHLORIDE

CLOPIDOGREL BISULFATE, CLOPIDOGREL BISULFATE

CLORAZEPATE DIPOTASSIUM, CLORAZEPATE DIPOTASSIUM

CLOTRIMAZOLE, CLOTRIMAZOLE (OTC)

CLOTRIMAZOLE, CLOTRIMAZOLE

CLOTRIMAZOLE AND BETAMETHASONE DIPROPIONATE, BETAMETHASONE DIPROPIONATE

CLOZAPINE, CLOZAPINE

CLOZARIL, CLOZAPINE

COARTEM, ARTEMETHER

CODEINE SULFATE, CODEINE SULFATE

COL-PROBENECID, COLCHICINE

COLAZAL, BALSALAZIDE DISODIUM

COLCHICINE, COLCHICINE

COLCRYS, COLCHICINE

COLESEVELAM HYDROCHLORIDE, COLESEVELAM HYDROCHLORIDE

COLESTID, COLESTIPOL HYDROCHLORIDE

COLESTIPOL HYDROCHLORIDE, COLESTIPOL HYDROCHLORIDE

COLISTIMETHATE SODIUM, COLISTIMETHATE SODIUM

COLOCORT, HYDROCORTISONE

COLY-MYCIN M, COLISTIMETHATE SODIUM

COLY-MYCIN S, COLISTIN SULFATE

COLYTE WITH FLAVOR PACKS, POLYETHYLENE GLYCOL 3350

COMBIGAN, BRIMONIDINE TARTRATE

COMBIPATCH, ESTRADIOL

COMBIVENT RESPIMAT, ALBUTEROL SULFATE

COMBIVIR, LAMIVUDINE

COMBOGESIC IV, ACETAMINOPHEN

COMETRIQ, CABOZANTINIB S-MALATE

COMPLERA, EMTRICITABINE

COMPRO, PROCHLORPERAZINE

COMTAN, ENTACAPONE

CONCERTA, METHYLPHENIDATE HYDROCHLORIDE

CONDYLOX, PODOFILOX

CONRAY, IOTHALAMATE MEGLUMINE

CONTRAVE, BUPROPION HYDROCHLORIDE

CONZIP, TRAMADOL HYDROCHLORIDE

COPAXONE, GLATIRAMER ACETATE

COPIKTRA, DUVELISIB

CORDRAN, FLURANDRENOLIDE

COREG, CARVEDILOL

COREG CR, CARVEDILOL PHOSPHATE

CORGARD, NADOLOL

CORLANOR, IVABRADINE

CORLANOR, IVABRADINE HYDROCHLORIDE

CORLOPAM, FENOLDOPAM MESYLATE

CORMAX, CLOBETASOL PROPIONATE

CORPHEDRA, EPHEDRINE SULFATE

CORTEF, HYDROCORTISONE

CORTENEMA, HYDROCORTISONE

CORTIFOAM, HYDROCORTISONE ACETATE

CORTROSYN, COSYNTROPIN

CORVERT, IBUTILIDE FUMARATE

COSELA, TRILACICLIB DIHYDROCHLORIDE

COSMEGEN, DACTINOMYCIN

COSOPT, DORZOLAMIDE HYDROCHLORIDE

COSOPT PF, DORZOLAMIDE HYDROCHLORIDE

COSYNTROPIN, COSYNTROPIN

COTELLIC, COBIMETINIB FUMARATE

COTEMPLA XR-ODT, METHYLPHENIDATE

COXANTO, OXAPROZIN

COZAAR, LOSARTAN POTASSIUM
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 14

APPENDIX A - PRODUCT NAME INDEX

** C **

CRESEMBA, ISAVUCONAZONIUM SULFATE

CRESTOR, ROSUVASTATIN CALCIUM

CRINONE, PROGESTERONE

CROMOLYN SODIUM, CROMOLYN SODIUM (OTC)

CROMOLYN SODIUM, CROMOLYN SODIUM

CROTAN, CROTAMITON

CRYSELLE, ETHINYL ESTRADIOL

CUPRIC CHLORIDE, CUPRIC CHLORIDE

CUPRIC CHLORIDE IN PLASTIC CONTAINER, CUPRIC CHLORIDE

CUPRIC SULFATE, CUPRIC SULFATE

CUPRIMINE, PENICILLAMINE

CUVPOSA, GLYCOPYRROLATE

CUVRIOR, TRIENTINE TETRAHYDROCHLORIDE

CYANOCOBALAMIN, CYANOCOBALAMIN

CYANOKIT, HYDROXOCOBALAMIN

CYCLESSA, DESOGESTREL

CYCLOBENZAPRINE HYDROCHLORIDE, CYCLOBENZAPRINE HYDROCHLORIDE

CYCLOGYL, CYCLOPENTOLATE HYDROCHLORIDE

CYCLOMYDRIL, CYCLOPENTOLATE HYDROCHLORIDE

CYCLOPHOSPHAMIDE, CYCLOPHOSPHAMIDE

CYCLOSET, BROMOCRIPTINE MESYLATE

CYCLOSPORINE, CYCLOSPORINE

CYKLOKAPRON, TRANEXAMIC ACID

CYMBALTA, DULOXETINE HYDROCHLORIDE

CYONANZ, ETHINYL ESTRADIOL

CYPROHEPTADINE HYDROCHLORIDE, CYPROHEPTADINE HYDROCHLORIDE

CYSTADANE, BETAINE

CYSTADROPS, CYSTEAMINE HYDROCHLORIDE

CYSTAGON, CYSTEAMINE BITARTRATE

CYSTARAN, CYSTEAMINE HYDROCHLORIDE

CYSTO-CONRAY II, IOTHALAMATE MEGLUMINE

CYSTOGRAFIN, DIATRIZOATE MEGLUMINE

CYSTOGRAFIN DILUTE, DIATRIZOATE MEGLUMINE

CYSVIEW KIT, HEXAMINOLEVULINATE HYDROCHLORIDE

CYTALUX, PAFOLACIANINE SODIUM

CYTARABINE, CYTARABINE

CYTOMEL, LIOTHYRONINE SODIUM

CYTOTEC, MISOPROSTOL

CYTOXAN, CYCLOPHOSPHAMIDE

** D **

DABIGATRAN ETEXILATE MESYLATE, DABIGATRAN ETEXILATE MESYLATE

DACARBAZINE, DACARBAZINE

DACTINOMYCIN, DACTINOMYCIN

DALFAMPRIDINE, DALFAMPRIDINE

DALIRESP, ROFLUMILAST

DALVANCE, DALBAVANCIN HYDROCHLORIDE

DANAZOL, DANAZOL

DANTRIUM, DANTROLENE SODIUM

DANTROLENE SODIUM, DANTROLENE SODIUM

DAPSONE, DAPSONE

DAPTOMYCIN, DAPTOMYCIN

DAPTOMYCIN IN 0.9% SODIUM CHLORIDE, DAPTOMYCIN

DARAPRIM, PYRIMETHAMINE

DARIFENACIN, DARIFENACIN HYDROBROMIDE

DARIFENACIN HYDROBROMIDE, DARIFENACIN HYDROBROMIDE

DARUNAVIR, DARUNAVIR

DASETTA 1/35, ETHINYL ESTRADIOL

DASETTA 7/7/7, ETHINYL ESTRADIOL

DATSCAN, IOFLUPANE I-123

DAUNORUBICIN HYDROCHLORIDE, DAUNORUBICIN HYDROCHLORIDE

DAURISMO, GLASDEGIB MALEATE

DAYBUE, TROFINETIDE

DAYPRO, OXAPROZIN

DAYSEE, ETHINYL ESTRADIOL
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 15

APPENDIX A - PRODUCT NAME INDEX

** D **

DAYTRANA, METHYLPHENIDATE

DAYVIGO, LEMBOREXANT

DDAVP, DESMOPRESSIN ACETATE

DECITABINE, DECITABINE

DEFENCATH, HEPARIN SODIUM

DEFERASIROX, DEFERASIROX

DEFERIPRONE, DEFERIPRONE

DEFEROXAMINE MESYLATE, DEFEROXAMINE MESYLATE

DEFINITY, PERFLUTREN

DEFINITY RT, PERFLUTREN

DEFITELIO, DEFIBROTIDE SODIUM

DELESTROGEN, ESTRADIOL VALERATE

DELFLEX W/ DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DELFLEX W/ DEXTROSE 1.5% LOW MAGNESIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DELFLEX W/ DEXTROSE 1.5% LOW MAGNESIUM LOW CALCIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DELFLEX W/ DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DELFLEX W/ DEXTROSE 2.5% LOW MAGNESIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DELFLEX W/ DEXTROSE 2.5% LOW MAGNESIUM LOW CALCIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DELFLEX W/ DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DELFLEX W/ DEXTROSE 4.25% LOW MAGNESIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DELFLEX W/ DEXTROSE 4.25% LOW MAGNESIUM LOW CALCIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DELSTRIGO, DORAVIRINE

DELSYM, DEXTROMETHORPHAN POLISTIREX (OTC)

DELZICOL, MESALAMINE

DEMECLOCYCLINE HYDROCHLORIDE, DEMECLOCYCLINE HYDROCHLORIDE

DEMEROL, MEPERIDINE HYDROCHLORIDE

DEMSER, METYROSINE

DENAVIR, PENCICLOVIR

DEOXYCHOLIC ACID, DEOXYCHOLIC ACID

DEPAKOTE, DIVALPROEX SODIUM

DEPAKOTE ER, DIVALPROEX SODIUM

DEPEN, PENICILLAMINE

DEPO-ESTRADIOL, ESTRADIOL CYPIONATE

DEPO-MEDROL, METHYLPREDNISOLONE ACETATE

DEPO-PROVERA, MEDROXYPROGESTERONE ACETATE

DEPO-SUBQ PROVERA 104, MEDROXYPROGESTERONE ACETATE

DEPO-TESTOSTERONE, TESTOSTERONE CYPIONATE

DERMA-SMOOTHE/FS, FLUOCINOLONE ACETONIDE

DERMABET, BETAMETHASONE VALERATE

DERMOTIC, FLUOCINOLONE ACETONIDE

DESCOVY, EMTRICITABINE

DESFERAL, DEFEROXAMINE MESYLATE

DESFLURANE, DESFLURANE

DESIPRAMINE HYDROCHLORIDE, DESIPRAMINE HYDROCHLORIDE

DESLORATADINE, DESLORATADINE

DESLORATADINE AND PSEUDOEPHEDRINE SULFATE 24 HOUR, DESLORATADINE

DESMOPRESSIN ACETATE, DESMOPRESSIN ACETATE

DESMOPRESSIN ACETATE (NEEDS NO REFRIGERATION), DESMOPRESSIN ACETATE

DESOGESTREL AND ETHINYL ESTRADIOL, DESOGESTREL

DESONIDE, DESONIDE

DESOWEN, DESONIDE

DESOXIMETASONE, DESOXIMETASONE

DESOXYN, METHAMPHETAMINE HYDROCHLORIDE

DESVENLAFAXINE, DESVENLAFAXINE

DESVENLAFAXINE SUCCINATE, DESVENLAFAXINE SUCCINATE

DETECTNET, COPPER CU-64 DOTATATE

DETROL, TOLTERODINE TARTRATE

DETROL LA, TOLTERODINE TARTRATE

DEXAMETHASONE, DEXAMETHASONE

DEXAMETHASONE INTENSOL, DEXAMETHASONE

DEXAMETHASONE SODIUM PHOSPHATE, DEXAMETHASONE SODIUM PHOSPHATE

DEXAMETHASONE SODIUM PHOSPHATE PRESERVATIVE FREE, DEXAMETHASONE SODIUM PHOSPHATE

DEXASPORIN, DEXAMETHASONE

DEXCHLORPHENIRAMINE MALEATE, DEXCHLORPHENIRAMINE MALEATE

DEXEDRINE, DEXTROAMPHETAMINE SULFATE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 16

APPENDIX A - PRODUCT NAME INDEX

** D **

DEXILANT, DEXLANSOPRAZOLE

DEXLANSOPRAZOLE, DEXLANSOPRAZOLE

DEXMEDETOMIDINE HYDROCHLORIDE, DEXMEDETOMIDINE HYDROCHLORIDE

DEXMETHYLPHENIDATE HYDROCHLORIDE, DEXMETHYLPHENIDATE HYDROCHLORIDE

DEXRAZOXANE HYDROCHLORIDE, DEXRAZOXANE HYDROCHLORIDE

DEXTENZA, DEXAMETHASONE

DEXTROAMP SACCHARATE, AMP ASPARTATE, DEXTROAMP SULFATE AND AMP SULFATE, AMPHETAMINE

DEXTROAMPHETAMINE SULFATE, DEXTROAMPHETAMINE SULFATE

DEXTROMETHORPHAN HYDROBROMIDE AND QUINIDINE SULFATE, DEXTROMETHORPHAN HYDROBROMIDE

DEXTROMETHORPHAN POLISTIREX, DEXTROMETHORPHAN POLISTIREX (OTC)

DEXTROSE 10% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 10% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 10% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 2.5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 2.5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 2.5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 2.5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 2.5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 2.5% IN HALF-STRENGTH LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DEXTROSE 20% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 25%, DEXTROSE

DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 30% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 40% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 5% AND ELECTROLYTE NO. 48 IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DEXTROSE 5% AND POTASSIUM CHLORIDE 0.075%, DEXTROSE

DEXTROSE 5% AND POTASSIUM CHLORIDE 0.075% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 5% AND POTASSIUM CHLORIDE 0.15%, DEXTROSE

DEXTROSE 5% AND POTASSIUM CHLORIDE 0.15% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 5% AND POTASSIUM CHLORIDE 0.224% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 5% AND POTASSIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 5% AND SODIUM CHLORIDE 0.225%, DEXTROSE

DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 5% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 5% AND SODIUM CHLORIDE 0.45%, DEXTROSE

DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 5% AND SODIUM CHLORIDE 0.9%, DEXTROSE

DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 5% IN LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 5% IN SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 5% IN SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 5% IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 5% IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 10MEQ, DEXTROSE

DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 15MEQ (K), DEXTROSE

DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 20MEQ, DEXTROSE

DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 20MEQ (K), DEXTROSE

DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 30MEQ, DEXTROSE

DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 40MEQ, DEXTROSE

DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 5MEQ, DEXTROSE

DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 5MEQ (K), DEXTROSE

DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 10MEQ IN PLASTIC CONTAINER,

DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 15MEQ IN PLASTIC CONTAINER,

DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 20MEQ IN PLASTIC CONTAINER,

DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 30MEQ IN PLASTIC CONTAINER,

DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 40MEQ IN PLASTIC CONTAINER,

DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 5MEQ IN PLASTIC CONTAINER,
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 17

APPENDIX A - PRODUCT NAME INDEX

** D **

DEXTROSE 5%, SODIUM CHLORIDE 0.45% AND POTASSIUM CHLORIDE 20MEQ (K) IN PLASTIC CONTAINER,

DEXTROSE 50%, DEXTROSE

DEXTROSE 50% IN PLASTIC CONTAINER, DEXTROSE

DEXTROSE 70% IN PLASTIC CONTAINER, DEXTROSE

DEXYCU KIT, DEXAMETHASONE

DHIVY, CARBIDOPA

DIABETA, GLYBURIDE

DIACOMIT, STIRIPENTOL

DIANEAL LOW CALCIUM W/ DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DIANEAL LOW CALCIUM W/ DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DIANEAL LOW CALCIUM W/ DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DIANEAL LOW CALCIUM W/DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DIANEAL LOW CALCIUM W/DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DIANEAL LOW CALCIUM W/DEXTROSE 3.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DIANEAL LOW CALCIUM W/DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DIANEAL PD-2 W/ DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DIANEAL PD-2 W/ DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DIANEAL PD-2 W/ DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE

DIASTAT, DIAZEPAM

DIASTAT ACUDIAL, DIAZEPAM

DIATRIZOATE MEGLUMINE AND DIATRIZOATE SODIUM, DIATRIZOATE MEGLUMINE

DIAZEPAM, DIAZEPAM

DIAZEPAM INTENSOL, DIAZEPAM

DIAZOXIDE, DIAZOXIDE

DIBENZYLINE, PHENOXYBENZAMINE HYDROCHLORIDE

DICHLORPHENAMIDE, DICHLORPHENAMIDE

DICLEGIS, DOXYLAMINE SUCCINATE

DICLOFENAC POTASSIUM, DICLOFENAC POTASSIUM

DICLOFENAC SODIUM, DICLOFENAC SODIUM (OTC)

DICLOFENAC SODIUM, DICLOFENAC SODIUM

DICLOFENAC SODIUM AND MISOPROSTOL, DICLOFENAC SODIUM

DICLOXACILLIN SODIUM, DICLOXACILLIN SODIUM

DICYCLOMINE HYDROCHLORIDE, DICYCLOMINE HYDROCHLORIDE

DICYCLOMINE HYDROCHLORIDE (PRESERVATIVE FREE), DICYCLOMINE HYDROCHLORIDE

DIETHYLPROPION HYDROCHLORIDE, DIETHYLPROPION HYDROCHLORIDE

DIFFERIN, ADAPALENE (OTC)

DIFFERIN, ADAPALENE

DIFICID, FIDAXOMICIN

DIFLORASONE DIACETATE, DIFLORASONE DIACETATE

DIFLUCAN, FLUCONAZOLE

DIFLUNISAL, DIFLUNISAL

DIFLUPREDNATE, DIFLUPREDNATE

DIGOXIN, DIGOXIN

DIHYDROERGOTAMINE MESYLATE, DIHYDROERGOTAMINE MESYLATE

DILANTIN, PHENYTOIN

DILANTIN, PHENYTOIN SODIUM

DILANTIN-125, PHENYTOIN

DILAUDID, HYDROMORPHONE HYDROCHLORIDE

DILTIAZEM HYDROCHLORIDE, DILTIAZEM HYDROCHLORIDE

DIMENHYDRINATE, DIMENHYDRINATE

DIMETHYL FUMARATE, DIMETHYL FUMARATE

DIOVAN, VALSARTAN

DIOVAN HCT, HYDROCHLOROTHIAZIDE

DIPENTUM, OLSALAZINE SODIUM

DIPHENHYDRAMINE HYDROCHLORIDE, DIPHENHYDRAMINE HYDROCHLORIDE

DIPHENHYDRAMINE HYDROCHLORIDE PRESERVATIVE FREE, DIPHENHYDRAMINE HYDROCHLORIDE

DIPHENOXYLATE HYDROCHLORIDE AND ATROPINE SULFATE, ATROPINE SULFATE

DIPRIVAN, PROPOFOL

DIPROLENE, BETAMETHASONE DIPROPIONATE

DIPYRIDAMOLE, DIPYRIDAMOLE

DISOPYRAMIDE PHOSPHATE, DISOPYRAMIDE PHOSPHATE

DISULFIRAM, DISULFIRAM

DIURIL, CHLOROTHIAZIDE

DIVALPROEX SODIUM, DIVALPROEX SODIUM

DIVIGEL, ESTRADIOL
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 18

APPENDIX A - PRODUCT NAME INDEX

** D **

DOBUTAMINE HYDROCHLORIDE, DOBUTAMINE HYDROCHLORIDE

DOBUTAMINE HYDROCHLORIDE IN DEXTROSE 5% IN PLASTIC CONTAINER, DOBUTAMINE HYDROCHLORIDE

DOCETAXEL, DOCETAXEL

DOCOSANOL, DOCOSANOL (OTC)

DODEX, CYANOCOBALAMIN

DOFETILDE, DOFETILIDE

DOFETILIDE, DOFETILIDE

DOJOLVI, TRIHEPTANOIN

DOLISHALE, ETHINYL ESTRADIOL

DONEPEZIL HYDROCHLORIDE, DONEPEZIL HYDROCHLORIDE

DOPAMINE HYDROCHLORIDE, DOPAMINE HYDROCHLORIDE

DOPAMINE HYDROCHLORIDE IN DEXTROSE 5% IN PLASTIC CONTAINER, DOPAMINE HYDROCHLORIDE

DOPRAM, DOXAPRAM HYDROCHLORIDE

DOPTELET, AVATROMBOPAG MALEATE

DORAL, QUAZEPAM

DORYX, DOXYCYCLINE HYCLATE

DORYX MPC, DOXYCYCLINE HYCLATE

DORZOLAMIDE HYDROCHLORIDE, DORZOLAMIDE HYDROCHLORIDE

DORZOLAMIDE HYDROCHLORIDE AND TIMOLOL MALEATE, DORZOLAMIDE HYDROCHLORIDE

DOTAREM, GADOTERATE MEGLUMINE

DOVATO, DOLUTEGRAVIR SODIUM

DOVONEX, CALCIPOTRIENE

DOXAPRAM HYDROCHLORIDE, DOXAPRAM HYDROCHLORIDE

DOXAZOSIN MESYLATE, DOXAZOSIN MESYLATE

DOXEPIN HYDROCHLORIDE, DOXEPIN HYDROCHLORIDE

DOXERCALCIFEROL, DOXERCALCIFEROL

DOXIL (LIPOSOMAL), DOXORUBICIN HYDROCHLORIDE

DOXORUBICIN HYDROCHLORIDE, DOXORUBICIN HYDROCHLORIDE

DOXORUBICIN HYDROCHLORIDE (LIPOSOMAL), DOXORUBICIN HYDROCHLORIDE

DOXY 100, DOXYCYCLINE HYCLATE

DOXY 200, DOXYCYCLINE HYCLATE

DOXYCYCLINE, DOXYCYCLINE

DOXYCYCLINE, DOXYCYCLINE HYCLATE

DOXYCYCLINE HYCLATE, DOXYCYCLINE HYCLATE

DOXYLAMINE SUCCINATE, DOXYLAMINE SUCCINATE (OTC)

DOXYLAMINE SUCCINATE AND PYRIDOXINE HYDROCHLORIDE, DOXYLAMINE SUCCINATE

DRAX EXAMETAZIME, TECHNETIUM TC-99M EXAMETAZIME KIT

DRAXIMAGE DTPA, TECHNETIUM TC-99M PENTETATE KIT

DRAXIMAGE MDP-25, TECHNETIUM TC-99M MEDRONATE

DRISDOL, ERGOCALCIFEROL

DRONABINOL, DRONABINOL

DROPERIDOL, DROPERIDOL

DROSPIRENONE AND ETHINYL ESTRADIOL, DROSPIRENONE

DROSPIRENONE, ETHINYL ESTRADIOL AND LEVOMEFOLATE CALCIUM, DROSPIRENONE

DROXIA, HYDROXYUREA

DROXIDOPA, DROXIDOPA

DSUVIA, SUFENTANIL CITRATE

DUAC, BENZOYL PEROXIDE

DUAKLIR PRESSAIR, ACLIDINIUM BROMIDE

DUAVEE, BAZEDOXIFENE ACETATE

DUETACT, GLIMEPIRIDE

DUEXIS, FAMOTIDINE

DULERA, FORMOTEROL FUMARATE

DULOXETINE HYDROCHLORIDE, DULOXETINE HYDROCHLORIDE

DUOBRII, HALOBETASOL PROPIONATE

DUODOTE, ATROPINE

DUOPA, CARBIDOPA

DURACLON, CLONIDINE HYDROCHLORIDE

DURAMORPH PF, MORPHINE SULFATE

DURAPREP, IODINE POVACRYLEX (OTC)

DUREZOL, DIFLUPREDNATE

DURYSTA, BIMATOPROST

DUTASTERIDE, DUTASTERIDE

DUTASTERIDE AND TAMSULOSIN HYDROCHLORIDE, DUTASTERIDE

DUVOID, BETHANECHOL CHLORIDE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 19

APPENDIX A - PRODUCT NAME INDEX

** D **

DYANAVEL XR, AMPHETAMINE

DYANAVEL XR 10, AMPHETAMINE

DYANAVEL XR 15, AMPHETAMINE

DYANAVEL XR 20, AMPHETAMINE

DYANAVEL XR 5, AMPHETAMINE

DYCLOPRO, DYCLONINE HYDROCHLORIDE

DYMISTA, AZELASTINE HYDROCHLORIDE

DYRENIUM, TRIAMTERENE

** E **

E-Z SCRUB 201, POVIDONE-IODINE (OTC)

E-Z SCRUB 241, POVIDONE-IODINE (OTC)

E-Z-HD, BARIUM SULFATE

E-Z-PAQUE, BARIUM SULFATE

E.E.S., ERYTHROMYCIN ETHYLSUCCINATE

E.E.S. 400, ERYTHROMYCIN ETHYLSUCCINATE

EC-NAPROSYN, NAPROXEN

ECONAZOLE NITRATE, ECONAZOLE NITRATE

ECOZA, ECONAZOLE NITRATE

EDARBI, AZILSARTAN KAMEDOXOMIL

EDARBYCLOR, AZILSARTAN KAMEDOXOMIL

EDECRIN, ETHACRYNATE SODIUM

EDECRIN, ETHACRYNIC ACID

EDETATE CALCIUM DISODIUM, EDETATE CALCIUM DISODIUM

EDEX, ALPROSTADIL

EDLUAR, ZOLPIDEM TARTRATE

EDURANT, RILPIVIRINE HYDROCHLORIDE

EFAVIRENZ, EFAVIRENZ

EFAVIRENZ, EMTRICITABINE, AND TENOFOVIR DISOPROXIL FUMARATE, EFAVIRENZ

EFAVIRENZ, LAMIVUDINE AND TENOFOVIR DISOPROXIL FUMARATE, EFAVIRENZ

EFAVIRENZ; EMTRICITABINE AND TENOFOVIR DISOPROXIL FUMARATE, EFAVIRENZ

EFFEXOR XR, VENLAFAXINE HYDROCHLORIDE

EFFIENT, PRASUGREL HYDROCHLORIDE

EFINACONAZOLE, EFINACONAZOLE

EFUDEX, FLUOROURACIL

EGATEN, TRICLABENDAZOLE

ELCYS, CYSTEINE HYDROCHLORIDE

ELESTRIN, ESTRADIOL

ELETRIPTAN HYDROBROMIDE, ELETRIPTAN HYDROBROMIDE

ELIDEL, PIMECROLIMUS

ELIGARD KIT, LEUPROLIDE ACETATE

ELIGLUSTAT TARTRATE, ELIGLUSTAT TARTRATE

ELIMITE, PERMETHRIN

ELINEST, ETHINYL ESTRADIOL

ELIQUIS, APIXABAN

ELIXOPHYLLIN, THEOPHYLLINE

ELLA, ULIPRISTAL ACETATE

ELLENCE, EPIRUBICIN HYDROCHLORIDE

ELLIOTTS B SOLUTION, CALCIUM CHLORIDE

ELMIRON, PENTOSAN POLYSULFATE SODIUM

ELOXATIN, OXALIPLATIN

ELUCIREM, GADOPICLENOL

ELURYNG, ETHINYL ESTRADIOL

ELYXYB, CELECOXIB

EMBELINE, CLOBETASOL PROPIONATE

EMCYT, ESTRAMUSTINE PHOSPHATE SODIUM

EMEND, APREPITANT

EMEND, FOSAPREPITANT DIMEGLUMINE

EMERPHED, EPHEDRINE SULFATE

EMFLAZA, DEFLAZACORT

EMPAVELI, PEGCETACOPLAN

EMSAM, SELEGILINE

EMTRICITABINE, EMTRICITABINE

EMTRICITABINE AND TENOFOVIR DISOPROXIL FUMARATE, EMTRICITABINE

EMTRICITABINE AND TENOFOVIR DISOPROXIL FUMARATE, EMTRICITABINE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 20

APPENDIX A - PRODUCT NAME INDEX

** E **

EMTRIVA, EMTRICITABINE

EMVERM, MEBENDAZOLE

EMZAHH, NORETHINDRONE

ENALAPRIL MALEATE, ENALAPRIL MALEATE

ENALAPRIL MALEATE AND HYDROCHLOROTHIAZIDE, ENALAPRIL MALEATE

ENALAPRILAT, ENALAPRILAT

ENDARI, L-GLUTAMINE

ENDOMETRIN, PROGESTERONE

ENILLORING, ETHINYL ESTRADIOL

ENOXAPARIN SODIUM, ENOXAPARIN SODIUM

ENOXAPARIN SODIUM (PRESERVATIVE FREE), ENOXAPARIN SODIUM

ENPRESSE-28, ETHINYL ESTRADIOL

ENSKYCE, DESOGESTREL

ENSTILAR, BETAMETHASONE DIPROPIONATE

ENTACAPONE, ENTACAPONE

ENTADFI, FINASTERIDE

ENTECAVIR, ENTECAVIR

ENTERO VU 24%, BARIUM SULFATE

ENTOCORT EC, BUDESONIDE

ENTRESTO, SACUBITRIL

ENVARSUS XR, TACROLIMUS

EOVIST, GADOXETATE DISODIUM

EPANED, ENALAPRIL MALEATE

EPCLUSA, SOFOSBUVIR

EPHEDRINE SULFATE, EPHEDRINE SULFATE

EPIDIOLEX, CANNABIDIOL

EPIDUO, ADAPALENE

EPIDUO FORTE, ADAPALENE

EPIFOAM, HYDROCORTISONE ACETATE

EPINASTINE HYDROCHLORIDE, EPINASTINE HYDROCHLORIDE

EPINEPHRINE, EPINEPHRINE

EPINEPHRINE (AUTOINJECTOR), EPINEPHRINE

EPIPEN, EPINEPHRINE

EPIPEN JR., EPINEPHRINE

EPIRUBICIN HYDROCHLORIDE, EPIRUBICIN HYDROCHLORIDE

EPITOL, CARBAMAZEPINE

EPIVIR, LAMIVUDINE

EPIVIR-HBV, LAMIVUDINE

EPLERENONE, EPLERENONE

EPOPROSTENOL SODIUM, EPOPROSTENOL SODIUM

EPRONTIA, TOPIRAMATE

EPSOLAY, BENZOYL PEROXIDE

EPTIFIBATIDE, EPTIFIBATIDE

EPZICOM, ABACAVIR SULFATE

EQUETRO, CARBAMAZEPINE

ERAXIS, ANIDULAFUNGIN

ERGOCALCIFEROL, ERGOCALCIFEROL

ERGOLOID MESYLATES, ERGOLOID MESYLATES

ERGOMAR, ERGOTAMINE TARTRATE

ERGOTAMINE TARTRATE AND CAFFEINE, CAFFEINE

ERIVEDGE, VISMODEGIB

ERLEADA, APALUTAMIDE

ERLOTINIB HYDROCHLORIDE, ERLOTINIB HYDROCHLORIDE

ERMEZA, LEVOTHYROXINE SODIUM

ERRIN, NORETHINDRONE

ERTACZO, SERTACONAZOLE NITRATE

ERTAPENEM SODIUM, ERTAPENEM SODIUM

ERY-TAB, ERYTHROMYCIN

ERYC, ERYTHROMYCIN

ERYGEL, ERYTHROMYCIN

ERYPED, ERYTHROMYCIN ETHYLSUCCINATE

ERYTHRA-DERM, ERYTHROMYCIN

ERYTHROCIN, ERYTHROMYCIN LACTOBIONATE

ERYTHROCIN STEARATE, ERYTHROMYCIN STEARATE

ERYTHROMYCIN, ERYTHROMYCIN
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 21

APPENDIX A - PRODUCT NAME INDEX

** E **

ERYTHROMYCIN AND BENZOYL PEROXIDE, BENZOYL PEROXIDE

ERYTHROMYCIN ETHYLSUCCINATE, ERYTHROMYCIN ETHYLSUCCINATE

ERYTHROMYCIN LACTOBIONATE, ERYTHROMYCIN LACTOBIONATE

ESBRIET, PIRFENIDONE

ESCITALOPRAM OXALATE, ESCITALOPRAM OXALATE

ESLICARBAZEPINE ACETATE, ESLICARBAZEPINE ACETATE

ESMOLOL HYDROCHLORIDE, ESMOLOL HYDROCHLORIDE

ESMOLOL HYDROCHLORIDE DOUBLE STRENGTH IN PLASTIC CONTAINER, ESMOLOL HYDROCHLORIDE

ESMOLOL HYDROCHLORIDE IN PLASTIC CONTAINER, ESMOLOL HYDROCHLORIDE

ESOMEPRAZOLE MAGNESIUM, ESOMEPRAZOLE MAGNESIUM (OTC)

ESOMEPRAZOLE MAGNESIUM, ESOMEPRAZOLE MAGNESIUM

ESOMEPRAZOLE SODIUM, ESOMEPRAZOLE SODIUM

ESTARYLLA, ETHINYL ESTRADIOL

ESTAZOLAM, ESTAZOLAM

ESTRACE, ESTRADIOL

ESTRADIOL, ESTRADIOL

ESTRADIOL AND NORETHINDRONE ACETATE, ESTRADIOL

ESTRADIOL AND NORGESTIMATE, ESTRADIOL

ESTRADIOL VALERATE, ESTRADIOL VALERATE

ESTRING, ESTRADIOL

ESTROGEL, ESTRADIOL

ESZOPICLONE, ESZOPICLONE

ETHACRYNATE SODIUM, ETHACRYNATE SODIUM

ETHACRYNIC ACID, ETHACRYNIC ACID

ETHAMBUTOL HYDROCHLORIDE, ETHAMBUTOL HYDROCHLORIDE

ETHAMOLIN, ETHANOLAMINE OLEATE

ETHINYL ESTRADIOL AND NORELGESTROMIN, ETHINYL ESTRADIOL

ETHINYL ESTRADIOL; ETONOGESTREL, ETHINYL ESTRADIOL

ETHOSUXIMIDE, ETHOSUXIMIDE

ETHYNODIOL DIACETATE AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL

ETHYOL, AMIFOSTINE

ETODOLAC, ETODOLAC

ETOMIDATE, ETOMIDATE

ETOPOPHOS PRESERVATIVE FREE, ETOPOSIDE PHOSPHATE

ETOPOSIDE, ETOPOSIDE

ETRAVIRINE, ETRAVIRINE

EUCRISA, CRISABOROLE

EURAX, CROTAMITON

EUTHYROX, LEVOTHYROXINE SODIUM **

EVAMIST, ESTRADIOL

EVEKEO, AMPHETAMINE SULFATE

EVEKEO ODT, AMPHETAMINE SULFATE

EVEROLIMUS, EVEROLIMUS

EVISTA, RALOXIFENE HYDROCHLORIDE

EVOMELA, MELPHALAN HYDROCHLORIDE

EVOTAZ, ATAZANAVIR SULFATE

EVOXAC, CEVIMELINE HYDROCHLORIDE

EVRYSDI, RISDIPLAM

EXCEDRIN (MIGRAINE RELIEF), ACETAMINOPHEN (OTC)

EXELDERM, SULCONAZOLE NITRATE

EXELON, RIVASTIGMINE

EXEM FOAM KIT, AIR POLYMER-TYPE A

EXEMESTANE, EXEMESTANE

EXFORGE, AMLODIPINE BESYLATE

EXFORGE HCT, AMLODIPINE BESYLATE

EXIDINE, CHLORHEXIDINE GLUCONATE (OTC)

EXJADE, DEFERASIROX

EXKIVITY, MOBOCERTINIB SUCCINATE

EXONDYS 51, ETEPLIRSEN

EXPAREL, BUPIVACAINE

EXSERVAN, RILUZOLE

EXTENDED PHENYTOIN SODIUM, PHENYTOIN SODIUM

EXTINA, KETOCONAZOLE

EXTRANEAL, ICODEXTRIN

EXXUA, GEPIRONE HYDROCHLORIDE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 22

APPENDIX A - PRODUCT NAME INDEX

** E **

EYSUVIS, LOTEPREDNOL ETABONATE

EZETIMIBE, EZETIMIBE

EZETIMIBE AND SIMVASTATIN, EZETIMIBE

** F **

FABHALTA, IPTACOPAN HYDROCHLORIDE

FABIOR, TAZAROTENE

FALLBACK SOLO, LEVONORGESTREL (OTC)

FALMINA, ETHINYL ESTRADIOL

FAMCICLOVIR, FAMCICLOVIR

FAMOTIDINE, FAMOTIDINE (OTC)

FAMOTIDINE, FAMOTIDINE

FAMOTIDINE PRESERVATIVE FREE, FAMOTIDINE

FAMOTIDINE PRESERVATIVE FREE IN PLASTIC CONTAINER, FAMOTIDINE

FAMOTIDINE, CALCIUM CARBONATE, AND MAGNESIUM HYDROXIDE, CALCIUM CARBONATE (OTC)

FANAPT, ILOPERIDONE

FARESTON, TOREMIFENE CITRATE

FARXIGA, DAPAGLIFLOZIN

FASLODEX, FULVESTRANT

FEBUXOSTAT, FEBUXOSTAT

FELBAMATE, FELBAMATE

FELBATOL, FELBAMATE

FELDENE, PIROXICAM

FELODIPINE, FELODIPINE

FEMARA, LETROZOLE

FEMRING, ESTRADIOL ACETATE

FENOFIBRATE, FENOFIBRATE

FENOFIBRATE (MICRONIZED), FENOFIBRATE

FENOFIBRIC ACID, CHOLINE FENOFIBRATE

FENOGLIDE, FENOFIBRATE

FENOLDOPAM MESYLATE, FENOLDOPAM MESYLATE

FENOPROFEN CALCIUM, FENOPROFEN CALCIUM

FENSOLVI KIT, LEUPROLIDE ACETATE

FENTANYL CITRATE, FENTANYL CITRATE

FENTANYL CITRATE PRESERVATIVE FREE, FENTANYL CITRATE

FENTANYL-100, FENTANYL

FENTANYL-12, FENTANYL

FENTANYL-25, FENTANYL

FENTANYL-37, FENTANYL

FENTANYL-50, FENTANYL

FENTANYL-62, FENTANYL

FENTANYL-75, FENTANYL

FENTANYL-87, FENTANYL

FENTORA, FENTANYL CITRATE

FERAHEME, FERUMOXYTOL

FERRIPROX, DEFERIPRONE

FERRLECIT, FERRIC OXYHYDROXIDE

FERUMOXYTOL, FERUMOXYTOL

FESOTERODINE FUMARATE, FESOTERODINE FUMARATE

FETROJA, CEFIDEROCOL SULFATE TOSYLATE

FETZIMA, LEVOMILNACIPRAN HYDROCHLORIDE

FEXINIDAZOLE, FEXINIDAZOLE

FEXOFENADINE HYDROCHLORIDE, FEXOFENADINE HYDROCHLORIDE (OTC)

FEXOFENADINE HYDROCHLORIDE, FEXOFENADINE HYDROCHLORIDE

FEXOFENADINE HYDROCHLORIDE ALLERGY, FEXOFENADINE HYDROCHLORIDE (OTC)

FEXOFENADINE HYDROCHLORIDE AND PSEUDOEPHEDRINE HYDROCHLORIDE, FEXOFENADINE HYDROCHLORIDE

FEXOFENADINE HYDROCHLORIDE HIVES, FEXOFENADINE HYDROCHLORIDE (OTC)

FILSPARI, SPARSENTAN

FILSUVEZ, BIRCH TRITERPENES

FINACEA, AZELAIC ACID

FINASTERIDE, FINASTERIDE

FINGOLIMOD HYDROCHLORIDE, FINGOLIMOD HYDROCHLORIDE

FINTEPLA, FENFLURAMINE HYDROCHLORIDE

FINZALA, ETHINYL ESTRADIOL

FIORICET W/ CODEINE, ACETAMINOPHEN
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 23

APPENDIX A - PRODUCT NAME INDEX

** F **

FIRAZYR, ICATIBANT ACETATE

FIRDAPSE, AMIFAMPRIDINE PHOSPHATE

FIRMAGON, DEGARELIX ACETATE

FIRVANQ KIT, VANCOMYCIN HYDROCHLORIDE

FLAC, FLUOCINOLONE ACETONIDE

FLAGYL, METRONIDAZOLE

FLAGYL I.V. RTU IN PLASTIC CONTAINER, METRONIDAZOLE

FLAREX, FLUOROMETHOLONE ACETATE

FLAVORED COLESTID, COLESTIPOL HYDROCHLORIDE

FLAVOXATE HYDROCHLORIDE, FLAVOXATE HYDROCHLORIDE

FLECAINIDE ACETATE, FLECAINIDE ACETATE

FLECTOR, DICLOFENAC EPOLAMINE

FLEQSUVY, BACLOFEN

FLOLAN, EPOPROSTENOL SODIUM

FLOLIPID, SIMVASTATIN

FLOMAX, TAMSULOSIN HYDROCHLORIDE

FLONASE ALLERGY RELIEF, FLUTICASONE PROPIONATE (OTC)

FLONASE SENSIMIST ALLERGY RELIEF, FLUTICASONE FUROATE (OTC)

FLOVENT DISKUS 100, FLUTICASONE PROPIONATE

FLOVENT DISKUS 250, FLUTICASONE PROPIONATE

FLOVENT DISKUS 50, FLUTICASONE PROPIONATE

FLOVENT HFA, FLUTICASONE PROPIONATE

FLOXURIDINE, FLOXURIDINE

FLUCINOLONE ACETONIDE, FLUOCINOLONE ACETONIDE

FLUCONAZOLE, FLUCONAZOLE

FLUCONAZOLE IN SODIUM CHLORIDE 0.9%, FLUCONAZOLE

FLUCONAZOLE IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, FLUCONAZOLE

FLUCYTOSINE, FLUCYTOSINE

FLUDARABINE PHOSPHATE, FLUDARABINE PHOSPHATE

FLUDEOXYGLUCOSE F18, FLUDEOXYGLUCOSE F-18

FLUDROCORTISONE ACETATE, FLUDROCORTISONE ACETATE

FLUMAZENIL, FLUMAZENIL

FLUNISOLIDE, FLUNISOLIDE

FLUOCINOLONE ACETONIDE, FLUOCINOLONE ACETONIDE

FLUOCINONIDE, FLUOCINONIDE

FLUOCINONIDE ACETONIDE, FLUOCINOLONE ACETONIDE

FLUOCINONIDE EMULSIFIED BASE, FLUOCINONIDE

FLUORESCEIN SODIUM, FLUORESCEIN SODIUM

FLUORESCEIN SODIUM AND BENOXINATE HYDROCHLORIDE, BENOXINATE HYDROCHLORIDE

FLUORESCITE, FLUORESCEIN SODIUM

FLUORODOPA F18, FLUORODOPA F-18

FLUOROMETHOLONE, FLUOROMETHOLONE

FLUOROURACIL, FLUOROURACIL

FLUOXETINE HYDROCHLORIDE, FLUOXETINE HYDROCHLORIDE

FLUPHENAZINE DECANOATE, FLUPHENAZINE DECANOATE

FLUPHENAZINE HYDROCHLORIDE, FLUPHENAZINE HYDROCHLORIDE

FLURANDRENOLIDE, FLURANDRENOLIDE

FLURAZEPAM HYDROCHLORIDE, FLURAZEPAM HYDROCHLORIDE

FLURBIPROFEN, FLURBIPROFEN

FLURBIPROFEN SODIUM, FLURBIPROFEN SODIUM

FLUTAMIDE, FLUTAMIDE

FLUTICASONE PROPIONATE, FLUTICASONE PROPIONATE (OTC)

FLUTICASONE PROPIONATE, FLUTICASONE PROPIONATE

FLUTICASONE PROPIONATE AND SALMETEROL XINAFOATE, FLUTICASONE PROPIONATE

FLUVASTATIN SODIUM, FLUVASTATIN SODIUM

FLUVOXAMINE MALEATE, FLUVOXAMINE MALEATE

FML, FLUOROMETHOLONE

FML FORTE, FLUOROMETHOLONE

FOCALIN, DEXMETHYLPHENIDATE HYDROCHLORIDE

FOCALIN XR, DEXMETHYLPHENIDATE HYDROCHLORIDE

FOCINVEZ, FOSAPREPITANT DIMEGLUMINE

FOLIC ACID, FOLIC ACID

FOLOTYN, PRALATREXATE

FOMEPIZOLE, FOMEPIZOLE

FONDAPARINUX SODIUM, FONDAPARINUX SODIUM
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 24

APPENDIX A - PRODUCT NAME INDEX

** F **

FORANE, ISOFLURANE

FORFIVO XL, BUPROPION HYDROCHLORIDE

FORMOTEROL FUMARATE, FORMOTEROL FUMARATE

FORTAMET, METFORMIN HYDROCHLORIDE

FORTEO, TERIPARATIDE

FORTESTA, TESTOSTERONE

FOSAMAX, ALENDRONATE SODIUM

FOSAMAX PLUS D, ALENDRONATE SODIUM

FOSAMPRENAVIR CALCIUM, FOSAMPRENAVIR CALCIUM

FOSAPREPITANT DIMEGLUMINE, FOSAPREPITANT DIMEGLUMINE

FOSCARNET SODIUM, FOSCARNET SODIUM

FOSCAVIR, FOSCARNET SODIUM

FOSFOMYCIN TROMETHAMINE, FOSFOMYCIN TROMETHAMINE

FOSINOPRIL SODIUM, FOSINOPRIL SODIUM

FOSINOPRIL SODIUM AND HYDROCHLOROTHIAZIDE, FOSINOPRIL SODIUM

FOSPHENYTOIN SODIUM, FOSPHENYTOIN SODIUM

FOSRENOL, LANTHANUM CARBONATE

FOTIVDA, TIVOZANIB HYDROCHLORIDE

FRAGMIN, DALTEPARIN SODIUM

FROVA, FROVATRIPTAN SUCCINATE

FROVATRIPTAN SUCCINATE, FROVATRIPTAN SUCCINATE

FRUZAQLA, FRUQUINTINIB

FULVESTRANT, FULVESTRANT

FULVICIN P/G, GRISEOFULVIN, ULTRAMICROCRYSTALLINE

FULVICIN P/G 165, GRISEOFULVIN, ULTRAMICROCRYSTALLINE

FULVICIN P/G 330, GRISEOFULVIN, ULTRAMICROCRYSTALLINE

FULVICIN-U/F, GRISEOFULVIN, MICROCRYSTALLINE

FURADANTIN, NITROFURANTOIN

FUROSCIX, FUROSEMIDE

FUROSEMIDE, FUROSEMIDE

FUSILEV, LEVOLEUCOVORIN CALCIUM

FUZEON, ENFUVIRTIDE

FYARRO, SIROLIMUS

FYAVOLV, ETHINYL ESTRADIOL

FYCOMPA, PERAMPANEL

FYREMADEL, GANIRELIX ACETATE

** G **

GABAPENTIN, GABAPENTIN

GABITRIL, TIAGABINE HYDROCHLORIDE

GABLOFEN, BACLOFEN

GADAVIST, GADOBUTROL

GADOBUTROL, GADOBUTROL

GADOTERATE MEGLUMINE, GADOTERATE MEGLUMINE

GALAFOLD, MIGALASTAT HYDROCHLORIDE

GALANTAMINE HYDROBROMIDE, GALANTAMINE HYDROBROMIDE

GALLIUM CITRATE GA 67, GALLIUM CITRATE GA-67

GALLIUM GA 68 EDOTREOTIDE, GALLIUM GA-68 EDOTREOTIDE

GALLIUM GA 68 GOZETOTIDE, GALLIUM GA-68 GOZETOTIDE

GALZIN, ZINC ACETATE

GANCICLOVIR SODIUM, GANCICLOVIR SODIUM

GANIRELIX ACETATE, GANIRELIX ACETATE

GANZYK-RTU, GANCICLOVIR

GASTROCROM, CROMOLYN SODIUM

GASTROGRAFIN, DIATRIZOATE MEGLUMINE

GATIFLOXACIN, GATIFLOXACIN

GATTEX KIT, TEDUGLUTIDE RECOMBINANT

GAVRETO, PRALSETINIB

GEFITINIB, GEFITINIB

GEMCITABINE HYDROCHLORIDE, GEMCITABINE HYDROCHLORIDE

GEMFIBROZIL, GEMFIBROZIL

GEMMILY, ETHINYL ESTRADIOL

GEMTESA, VIBEGRON

GENERLAC, LACTULOSE

GENGRAF, CYCLOSPORINE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 25

APPENDIX A - PRODUCT NAME INDEX

** G **

GENOSYL, NITRIC OXIDE

GENTAMICIN SULFATE, GENTAMICIN SULFATE

GENTAMICIN SULFATE IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, GENTAMICIN SULFATE

GENVOYA, COBICISTAT

GEODON, ZIPRASIDONE HYDROCHLORIDE

GEODON, ZIPRASIDONE MESYLATE

GIAPREZA, ANGIOTENSIN II ACETATE

GILDAGIA, ETHINYL ESTRADIOL

GILDESS 24 FE, ETHINYL ESTRADIOL

GILENYA, FINGOLIMOD HYDROCHLORIDE

GILOTRIF, AFATINIB DIMALEATE

GIMOTI, METOCLOPRAMIDE HYDROCHLORIDE

GIVLAARI, GIVOSIRAN SODIUM

GLATIRAMER ACETATE, GLATIRAMER ACETATE

GLATOPA, GLATIRAMER ACETATE

GLEEVEC, IMATINIB MESYLATE

GLEOLAN, AMINOLEVULINIC ACID HYDROCHLORIDE

GLEOSTINE, LOMUSTINE

GLIADEL, CARMUSTINE

GLIMEPIRIDE, GLIMEPIRIDE

GLIPIZIDE, GLIPIZIDE

GLIPIZIDE AND METFORMIN HYDROCHLORIDE, GLIPIZIDE

GLOFIL-125, IOTHALAMATE SODIUM I-125

GLOPERBA, COLCHICINE

GLUCAGEN, GLUCAGON HYDROCHLORIDE

GLUCAGON, GLUCAGON

GLUCAGON, GLUCAGON HYDROCHLORIDE

GLUCOTROL XL, GLIPIZIDE

GLUMETZA, METFORMIN HYDROCHLORIDE

GLYBURIDE, GLYBURIDE

GLYBURIDE (MICRONIZED), GLYBURIDE

GLYBURIDE AND METFORMIN HYDROCHLORIDE, GLYBURIDE

GLYCINE 1.5% IN PLASTIC CONTAINER, GLYCINE

GLYCOPYRROLATE, GLYCOPYRROLATE

GLYDO, LIDOCAINE HYDROCHLORIDE

GLYNASE, GLYBURIDE

GLYRX-PF, GLYCOPYRROLATE

GLYSET, MIGLITOL

GLYXAMBI, EMPAGLIFLOZIN

GOCOVRI, AMANTADINE HYDROCHLORIDE

GOLYTELY, POLYETHYLENE GLYCOL 3350

GOPRELTO, COCAINE HYDROCHLORIDE

GRALISE, GABAPENTIN

GRANISETRON HYDROCHLORIDE, GRANISETRON HYDROCHLORIDE

GRANISETRON HYDROCHLORIDE PRESERVATIVE FREE, GRANISETRON HYDROCHLORIDE

GRIS-PEG, GRISEOFULVIN, ULTRAMICROSIZE

GRISEOFULVIN, GRISEOFULVIN, MICROSIZE

GRISEOFULVIN, ULTRAMICROSIZE, GRISEOFULVIN, ULTRAMICROSIZE

GRISEOFULVIN,ULTRAMICROSIZE, GRISEOFULVIN, ULTRAMICROSIZE

GUAIFENESIN, GUAIFENESIN (OTC)

GUAIFENESIN AND DEXTROMETHORPHAN HYDROBROMIDE, DEXTROMETHORPHAN HYDROBROMIDE (OTC)

GUAIFENESIN AND PSEUDOEPHEDRINE HYDROCHLORIDE, GUAIFENESIN (OTC)

GUANFACINE HYDROCHLORIDE, GUANFACINE HYDROCHLORIDE

GVOKE HYPOPEN, GLUCAGON

GVOKE KIT, GLUCAGON

GVOKE PFS, GLUCAGON

GYNAZOLE-1, BUTOCONAZOLE NITRATE

** H **

HABITROL, NICOTINE (OTC)

HAILEY 1.5/30, ETHINYL ESTRADIOL

HAILEY 24 FE, ETHINYL ESTRADIOL

HAILEY FE 1.5/30, ETHINYL ESTRADIOL

HAILEY FE 1/20, ETHINYL ESTRADIOL

HALAVEN, ERIBULIN MESYLATE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 26

APPENDIX A - PRODUCT NAME INDEX

** H **

HALCINONIDE, HALCINONIDE

HALCION, TRIAZOLAM

HALDOL, HALOPERIDOL DECANOATE

HALOBETASOL PROPIONATE, HALOBETASOL PROPIONATE

HALOETTE, ETHINYL ESTRADIOL

HALOG, HALCINONIDE

HALOPERIDOL, HALOPERIDOL

HALOPERIDOL, HALOPERIDOL LACTATE

HALOPERIDOL DECANOATE, HALOPERIDOL DECANOATE

HARVONI, LEDIPASVIR

HEATHER, NORETHINDRONE

HECTOROL, DOXERCALCIFEROL

HEMABATE, CARBOPROST TROMETHAMINE

HEMADY, DEXAMETHASONE

HEMANGEOL, PROPRANOLOL HYDROCHLORIDE

HEPARIN SODIUM, HEPARIN SODIUM

HEPARIN SODIUM 1,000 UNITS AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, HEPARIN SODIUM

HEPARIN SODIUM 1,000 UNITS IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, HEPARIN SODIUM

HEPARIN SODIUM 10,000 UNITS IN DEXTROSE 5% IN PLASTIC CONTAINER, HEPARIN SODIUM

HEPARIN SODIUM 12,500 UNITS IN DEXTROSE 5% IN PLASTIC CONTAINER, HEPARIN SODIUM

HEPARIN SODIUM 12,500 UNITS IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, HEPARIN SODIUM

HEPARIN SODIUM 2,000 UNITS AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, HEPARIN SODIUM

HEPARIN SODIUM 2,000 UNITS IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, HEPARIN SODIUM

HEPARIN SODIUM 20,000 UNITS IN DEXTROSE 5% IN PLASTIC CONTAINER, HEPARIN SODIUM

HEPARIN SODIUM 25,000 UNITS IN DEXTROSE 5% IN PLASTIC CONTAINER, HEPARIN SODIUM

HEPARIN SODIUM 25,000 UNITS IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, HEPARIN SODIUM

HEPARIN SODIUM IN PLASTIC CONTAINER, HEPARIN SODIUM

HEPARIN SODIUM PRESERVATIVE FREE, HEPARIN SODIUM

HEPSERA, ADEFOVIR DIPIVOXIL

HEPZATO, MELPHALAN HYDROCHLORIDE

HER STYLE, LEVONORGESTREL (OTC)

HETLIOZ, TASIMELTEON

HETLIOZ LQ, TASIMELTEON

HIBICLENS, CHLORHEXIDINE GLUCONATE (OTC)

HIBISTAT, CHLORHEXIDINE GLUCONATE (OTC)

HICON, SODIUM IODIDE I-131

HIPREX, METHENAMINE HIPPURATE

HOMATROPINE METHYLBROMIDE AND HYDROCODONE BITARTRATE, HOMATROPINE METHYLBROMIDE

HORIZANT, GABAPENTIN ENACARBIL

HYCAMTIN, TOPOTECAN HYDROCHLORIDE

HYCODAN, HOMATROPINE METHYLBROMIDE

HYDRA-ZIDE, HYDRALAZINE HYDROCHLORIDE

HYDRALAZINE HYDROCHLORIDE, HYDRALAZINE HYDROCHLORIDE

HYDREA, HYDROXYUREA

HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE

HYDROCODONE, HYDROCODONE BITARTRATE

HYDROCODONE BITARTRATE, HYDROCODONE BITARTRATE

HYDROCODONE BITARTRATE AND ACETAMINOPHEN, ACETAMINOPHEN

HYDROCODONE BITARTRATE AND ASPIRIN, ASPIRIN

HYDROCODONE BITARTRATE AND HOMATROPINE METHYLBROMIDE, HOMATROPINE METHYLBROMIDE

HYDROCODONE BITARTRATE AND IBUPROFEN, HYDROCODONE BITARTRATE

HYDROCODONE BITARTRATE, CHLORPHENIRAMINE MALEATE AND PSEUDOEPHEDRINE HYDROCHLORIDE,

HYDROCODONE POLISTIREX AND CHLORPHENIRAMINE POLISTIREX, CHLORPHENIRAMINE POLISTIREX

HYDROCORTISONE, HYDROCORTISONE

HYDROCORTISONE AND ACETIC ACID, ACETIC ACID, GLACIAL

HYDROCORTISONE BUTYRATE, HYDROCORTISONE BUTYRATE

HYDROCORTISONE IN ABSORBASE, HYDROCORTISONE

HYDROCORTISONE VALERATE, HYDROCORTISONE VALERATE

HYDROMORPHONE HYDROCHLORIDE, HYDROMORPHONE HYDROCHLORIDE

HYDROXOCOBALAMIN, HYDROXOCOBALAMIN

HYDROXYCHLOROQUINE SULFATE, HYDROXYCHLOROQUINE SULFATE

HYDROXYUREA, HYDROXYUREA

HYDROXYZINE HYDROCHLORIDE, HYDROXYZINE HYDROCHLORIDE

HYDROXYZINE PAMOATE, HYDROXYZINE PAMOATE

HYFTOR, SIROLIMUS
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 27

APPENDIX A - PRODUCT NAME INDEX

** H **

HYSINGLA ER, HYDROCODONE BITARTRATE

HYZAAR, HYDROCHLOROTHIAZIDE

** I **

IBANDRONATE SODIUM, IBANDRONATE SODIUM

IBRANCE, PALBOCICLIB

IBSRELA, TENAPANOR HYDROCHLORIDE

IBUPROFEN, IBUPROFEN (OTC)

IBUPROFEN, IBUPROFEN

IBUPROFEN AND DIPHENHYDRAMINE CITRATE, DIPHENHYDRAMINE CITRATE (OTC)

IBUPROFEN AND DIPHENHYDRAMINE HYDROCHLORIDE, DIPHENHYDRAMINE HYDROCHLORIDE (OTC)

IBUPROFEN AND FAMOTIDINE, FAMOTIDINE

IBUPROFEN AND PHENYLEPHRINE HYDROCHLORIDE, IBUPROFEN (OTC)

IBUPROFEN AND PSEUDOEPHEDRINE HYDROCHLORIDE, IBUPROFEN (OTC)

IBUPROFEN LYSINE, IBUPROFEN LYSINE

IBUPROHM COLD AND SINUS, IBUPROFEN (OTC)

IBUTILIDE FUMARATE, IBUTILIDE FUMARATE

ICATIBANT ACETATE, ICATIBANT ACETATE

ICLEVIA, ETHINYL ESTRADIOL

ICLUSIG, PONATINIB HYDROCHLORIDE

ICOSAPENT ETHYL, ICOSAPENT ETHYL

IDAMYCIN PFS, IDARUBICIN HYDROCHLORIDE

IDARUBICIN HYDROCHLORIDE, IDARUBICIN HYDROCHLORIDE

IDHIFA, ENASIDENIB MESYLATE

IDKIT:HP, CITRIC ACID

IDOSE TR, TRAVOPROST

IFEX, IFOSFAMIDE

IFOSFAMIDE, IFOSFAMIDE

IGALMI, DEXMEDETOMIDINE HYDROCHLORIDE

IHEEZO, CHLOROPROCAINE HYDROCHLORIDE

ILEVRO, NEPAFENAC

ILLUCCIX, GALLIUM GA-68 GOZETOTIDE

ILUVIEN, FLUOCINOLONE ACETONIDE

IMATINIB MESYLATE, IMATINIB MESYLATE

IMBRUVICA, IBRUTINIB

IMCIVREE, SETMELANOTIDE ACETATE

IMIPENEM AND CILASTATIN, CILASTATIN SODIUM

IMIPRAMINE HYDROCHLORIDE, IMIPRAMINE HYDROCHLORIDE

IMIPRAMINE PAMOATE, IMIPRAMINE PAMOATE

IMIQUIMOD, IMIQUIMOD

IMITREX, SUMATRIPTAN

IMITREX, SUMATRIPTAN SUCCINATE

IMITREX STATDOSE, SUMATRIPTAN SUCCINATE

IMMPHENTIV, PHENYLEPHRINE HYDROCHLORIDE

IMODIUM A-D, LOPERAMIDE HYDROCHLORIDE (OTC)

IMODIUM MULTI-SYMPTOM RELIEF, LOPERAMIDE HYDROCHLORIDE (OTC)

IMPAVIDO, MILTEFOSINE

IMPOYZ, CLOBETASOL PROPIONATE

IMURAN, AZATHIOPRINE

IMVEXXY, ESTRADIOL

INBRIJA, LEVODOPA

INCASSIA, NORETHINDRONE

INCRUSE ELLIPTA, UMECLIDINIUM BROMIDE

INDAPAMIDE, INDAPAMIDE

INDERAL LA, PROPRANOLOL HYDROCHLORIDE

INDIUM IN 111 CHLORIDE, INDIUM IN-111 CHLORIDE

INDIUM IN 111 OXYQUINOLINE, INDIUM IN-111 OXYQUINOLINE

INDOCIN, INDOMETHACIN

INDOCYANINE GREEN, INDOCYANINE GREEN

INDOMETHACIN, INDOMETHACIN

INDOMETHACIN SODIUM, INDOMETHACIN SODIUM

INFANT'S ADVIL, IBUPROFEN (OTC)

INFANTS' FEVERALL, ACETAMINOPHEN (OTC)

INFED, FERRIC OXYHYDROXIDE

INFUMORPH, MORPHINE SULFATE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 28

APPENDIX A - PRODUCT NAME INDEX

** I **

INFUVITE ADULT, ALPHA-TOCOPHEROL ACETATE

INFUVITE PEDIATRIC, ASCORBIC ACID

INFUVITE PEDIATRIC (PHARMACY BULK PACKAGE), ASCORBIC ACID

INGREZZA, VALBENAZINE TOSYLATE

INJECTAFER, FERRIC CARBOXYMALTOSE

INLYTA, AXITINIB

INNOPRAN XL, PROPRANOLOL HYDROCHLORIDE

INOMAX, NITRIC OXIDE

INPEFA, SOTAGLIFLOZIN

INQOVI, CEDAZURIDINE

INREBIC, FEDRATINIB HYDROCHLORIDE

INSPRA, EPLERENONE

INTELENCE, ETRAVIRINE

INTRALIPID 20%, SOYBEAN OIL

INTRALIPID 30%, SOYBEAN OIL

INTRAROSA, PRASTERONE

INTROVALE, ETHINYL ESTRADIOL

INTUNIV, GUANFACINE HYDROCHLORIDE

INVANZ, ERTAPENEM SODIUM

INVEGA, PALIPERIDONE

INVEGA HAFYERA, PALIPERIDONE PALMITATE

INVEGA SUSTENNA, PALIPERIDONE PALMITATE

INVEGA TRINZA, PALIPERIDONE PALMITATE

INVELTYS, LOTEPREDNOL ETABONATE

INVOKAMET, CANAGLIFLOZIN

INVOKAMET XR, CANAGLIFLOZIN

INVOKANA, CANAGLIFLOZIN

IODIXANOL, IODIXANOL

IOFLUPANE I-123, IOFLUPANE I-123

IONOSOL MB AND DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE

IOPAMIDOL, IOPAMIDOL

IOPIDINE, APRACLONIDINE HYDROCHLORIDE

IOSAT, POTASSIUM IODIDE (OTC)

IPRATROPIUM BROMIDE, IPRATROPIUM BROMIDE

IRBESARTAN, IRBESARTAN

IRBESARTAN AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE

IRESSA, GEFITINIB

IRINOTECAN HYDROCHLORIDE, IRINOTECAN HYDROCHLORIDE

ISENTRESS, RALTEGRAVIR POTASSIUM

ISENTRESS HD, RALTEGRAVIR POTASSIUM

ISIBLOOM, DESOGESTREL

ISOFLURANE, ISOFLURANE

ISOLYTE P IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE

ISOLYTE S IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE

ISOLYTE S PH 7.4 IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE

ISONIAZID, ISONIAZID

ISOPROTERENOL HYDROCHLORIDE, ISOPROTERENOL HYDROCHLORIDE

ISOPTO ATROPINE, ATROPINE SULFATE

ISOPTO CARPINE, PILOCARPINE HYDROCHLORIDE

ISORDIL, ISOSORBIDE DINITRATE

ISOSORBIDE DINITRATE, ISOSORBIDE DINITRATE

ISOSORBIDE DINITRATE AND HYDRALAZINE HYDROCHLORIDE, HYDRALAZINE HYDROCHLORIDE

ISOSORBIDE MONONITRATE, ISOSORBIDE MONONITRATE

ISOSULFAN BLUE, ISOSULFAN BLUE

ISOTRETINOIN, ISOTRETINOIN

ISOVUE-200, IOPAMIDOL

ISOVUE-250, IOPAMIDOL

ISOVUE-300, IOPAMIDOL

ISOVUE-370, IOPAMIDOL

ISOVUE-M 200, IOPAMIDOL

ISOVUE-M 300, IOPAMIDOL

ISRADIPINE, ISRADIPINE

ISTALOL, TIMOLOL MALEATE

ISTODAX, ROMIDEPSIN

ISTURISA, OSILODROSTAT PHOSPHATE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 29

APPENDIX A - PRODUCT NAME INDEX

** I **

ITRACONAZOLE, ITRACONAZOLE

IVABRADINE HYDROCHLORIDE, IVABRADINE HYDROCHLORIDE

IVERMECTIN, IVERMECTIN (OTC)

IVERMECTIN, IVERMECTIN

IVY BLOCK, BENTOQUATAM (OTC)

IWILFIN, EFLORNITHINE HYDROCHLORIDE

IXEMPRA KIT, IXABEPILONE

IYUZEH, LATANOPROST

IZERVAY, AVACINCAPTAD PEGOL SODIUM

** J **

JADENU, DEFERASIROX

JADENU SPRINKLE, DEFERASIROX

JAIMIESS, ETHINYL ESTRADIOL

JAKAFI, RUXOLITINIB PHOSPHATE

JALYN, DUTASTERIDE

JANTOVEN, WARFARIN SODIUM

JANUMET, METFORMIN HYDROCHLORIDE

JANUMET XR, METFORMIN HYDROCHLORIDE

JANUVIA, SITAGLIPTIN PHOSPHATE

JARDIANCE, EMPAGLIFLOZIN

JATENZO, TESTOSTERONE UNDECANOATE

JAYPIRCA, PIRTOBRUTINIB

JELMYTO, MITOMYCIN

JENCYCLA, NORETHINDRONE

JENTADUETO, LINAGLIPTIN

JENTADUETO XR, LINAGLIPTIN

JESDUVROQ, DAPRODUSTAT

JEVTANA KIT, CABAZITAXEL

JOENJA, LENIOLISIB PHOSPHATE

JORNAY PM, METHYLPHENIDATE HYDROCHLORIDE

JUBLIA, EFINACONAZOLE

JULUCA, DOLUTEGRAVIR SODIUM

JUNEL 1.5/30, ETHINYL ESTRADIOL

JUNEL 1/20, ETHINYL ESTRADIOL

JUNEL FE 1.5/30, ETHINYL ESTRADIOL

JUNEL FE 1/20, ETHINYL ESTRADIOL

JUNIOR STRENGTH ADVIL, IBUPROFEN (OTC)

JUNIOR STRENGTH MOTRIN, IBUPROFEN (OTC)

JUXTAPID, LOMITAPIDE MESYLATE

JYLAMVO, METHOTREXATE

JYNARQUE, TOLVAPTAN

** K **

KABIVEN IN PLASTIC CONTAINER, AMINO ACIDS

KAITLIB FE, ETHINYL ESTRADIOL

KALETRA, LOPINAVIR

KALEXATE, SODIUM POLYSTYRENE SULFONATE

KALLIGA, DESOGESTREL

KALYDECO, IVACAFTOR

KAPSPARGO SPRINKLE, METOPROLOL SUCCINATE

KARBINAL ER, CARBINOXAMINE MALEATE

KARIVA, DESOGESTREL

KATERZIA, AMLODIPINE BENZOATE

KAZANO, ALOGLIPTIN BENZOATE

KELNOR, ETHINYL ESTRADIOL

KENALOG-10, TRIAMCINOLONE ACETONIDE

KENALOG-40, TRIAMCINOLONE ACETONIDE

KENALOG-80, TRIAMCINOLONE ACETONIDE

KENGREAL, CANGRELOR

KEPPRA, LEVETIRACETAM

KEPPRA XR, LEVETIRACETAM

KERENDIA, FINERENONE

KERYDIN, TAVABOROLE

KETALAR, KETAMINE HYDROCHLORIDE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 30

APPENDIX A - PRODUCT NAME INDEX

** K **

KETAMINE HYDROCHLORIDE, KETAMINE HYDROCHLORIDE

KETOCONAZOLE, KETOCONAZOLE

KETOPROFEN, KETOPROFEN

KETOROLAC TROMETHAMINE, KETOROLAC TROMETHAMINE

KETOROLAC TROMETHAMINE AND PHENYLEPHRINE HYDROCHLORIDE, KETOROLAC TROMETHAMINE

KETOTIFEN FUMARATE, KETOTIFEN FUMARATE (OTC)

KETOZOLE, KETOCONAZOLE

KEVEYIS, DICHLORPHENAMIDE

KHAPZORY, LEVOLEUCOVORIN

KIMIDESS, DESOGESTREL

KIMYRSA, ORITAVANCIN DIPHOSPHATE

KINEVAC, SINCALIDE

KIONEX, SODIUM POLYSTYRENE SULFONATE

KISQALI, RIBOCICLIB SUCCINATE

KISQALI FEMARA CO-PACK (COPACKAGED), LETROZOLE

KITABIS PAK, TOBRAMYCIN

KLARON, SULFACETAMIDE SODIUM

KLISYRI, TIRBANIBULIN

KLONOPIN, CLONAZEPAM

KLOR-CON, POTASSIUM CHLORIDE

KLOR-CON M10, POTASSIUM CHLORIDE

KLOR-CON M15, POTASSIUM CHLORIDE

KLOR-CON M20, POTASSIUM CHLORIDE

KLOXXADO, NALOXONE HYDROCHLORIDE

KONVOMEP, OMEPRAZOLE

KORLYM, MIFEPRISTONE

KORSUVA, DIFELIKEFALIN ACETATE

KOSELUGO, SELUMETINIB SULFATE

KOVANAZE, OXYMETAZOLINE HYDROCHLORIDE

KRAZATI, ADAGRASIB

KRINTAFEL, TAFENOQUINE SUCCINATE

KURVELO, ETHINYL ESTRADIOL

KUVAN, SAPROPTERIN DIHYDROCHLORIDE

KYBELLA, DEOXYCHOLIC ACID

KYLEENA, LEVONORGESTREL

KYPROLIS, CARFILZOMIB

KYZATREX, TESTOSTERONE UNDECANOATE

** L **

LABETALOL HYDROCHLORIDE, LABETALOL HYDROCHLORIDE

LABETALOL HYDROCHLORIDE IN DEXTROSE, LABETALOL HYDROCHLORIDE

LABETALOL HYDROCHLORIDE IN SODIUM CHLORIDE, LABETALOL HYDROCHLORIDE

LACOSAMIDE, LACOSAMIDE

LACRISERT, HYDROXYPROPYL CELLULOSE

LACTATED RINGER'S AND DEXTROSE 5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE

LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE

LACTULOSE, LACTULOSE

LAMICTAL, LAMOTRIGINE

LAMICTAL CD, LAMOTRIGINE

LAMICTAL ODT, LAMOTRIGINE

LAMICTAL XR, LAMOTRIGINE

LAMISIL, TERBINAFINE HYDROCHLORIDE (OTC)

LAMISIL AT, TERBINAFINE (OTC)

LAMISIL AT, TERBINAFINE HYDROCHLORIDE (OTC)

LAMIVUDINE, LAMIVUDINE

LAMIVUDINE AND ZIDOVUDINE, LAMIVUDINE

LAMOTRIGINE, LAMOTRIGINE

LAMPIT, NIFURTIMOX

LANORINAL, ASPIRIN

LANOXIN, DIGOXIN

LANOXIN PEDIATRIC, DIGOXIN

LANREOTIDE ACETATE, LANREOTIDE ACETATE

LANSOPRAZOLE, LANSOPRAZOLE (OTC)

LANSOPRAZOLE, LANSOPRAZOLE

LANSOPRAZOLE, AMOXICILLIN AND CLARITHROMYCIN (COPACKAGED), AMOXICILLIN
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 31

APPENDIX A - PRODUCT NAME INDEX

** L **

LANTHANUM CARBONATE, LANTHANUM CARBONATE

LAPATINIB DITOSYLATE, LAPATINIB DITOSYLATE

LARIN 1.5/30, ETHINYL ESTRADIOL

LARIN 1/20, ETHINYL ESTRADIOL

LARIN 24 FE, ETHINYL ESTRADIOL

LARIN FE 1.5/30, ETHINYL ESTRADIOL

LARIN FE 1/20, ETHINYL ESTRADIOL

LAROTID, AMOXICILLIN

LARYNG-O-JET KIT, LIDOCAINE HYDROCHLORIDE

LASIX, FUROSEMIDE

LASTACAFT, ALCAFTADINE (OTC)

LATANOPROST, LATANOPROST

LATISSE, BIMATOPROST

LATUDA, LURASIDONE HYDROCHLORIDE

LEFLUNOMIDE, LEFLUNOMIDE

LENALIDOMIDE, LENALIDOMIDE

LENVIMA, LENVATINIB MESYLATE

LEQVIO, INCLISIRAN SODIUM

LERIBANE, ETHINYL ESTRADIOL

LESCOL XL, FLUVASTATIN SODIUM

LESSINA-28, ETHINYL ESTRADIOL

LETAIRIS, AMBRISENTAN

LETROZOLE, LETROZOLE

LEUCOVORIN CALCIUM, LEUCOVORIN CALCIUM

LEUCOVORIN CALCIUM PRESERVATIVE FREE, LEUCOVORIN CALCIUM

LEUKERAN, CHLORAMBUCIL

LEUPROLIDE ACETATE, LEUPROLIDE ACETATE

LEUPROLIDE ACETATE FOR DEPOT SUSPENSION, LEUPROLIDE ACETATE

LEVALBUTEROL HYDROCHLORIDE, LEVALBUTEROL HYDROCHLORIDE

LEVETIRACETAM, LEVETIRACETAM

LEVETIRACETAM IN SODIUM CHLORIDE, LEVETIRACETAM

LEVO-T, LEVOTHYROXINE SODIUM **

LEVOBUNOLOL HYDROCHLORIDE, LEVOBUNOLOL HYDROCHLORIDE

LEVOCARNITINE, LEVOCARNITINE

LEVOCARNITINE SF, LEVOCARNITINE

LEVOCETIRIZINE DIHYDROCHLORIDE, LEVOCETIRIZINE DIHYDROCHLORIDE (OTC)

LEVOCETIRIZINE DIHYDROCHLORIDE, LEVOCETIRIZINE DIHYDROCHLORIDE

LEVOCETIRIZINE HYDROCHLORIDE, LEVOCETIRIZINE DIHYDROCHLORIDE

LEVOFLOXACIN, LEVOFLOXACIN

LEVOFLOXACIN IN DEXTROSE 5% IN PLASTIC CONTAINER, LEVOFLOXACIN

LEVOLET, LEVOTHYROXINE SODIUM **

LEVOLEUCOVORIN CALCIUM, LEVOLEUCOVORIN CALCIUM

LEVOMILNACIPRAN HYDROCHLORIDE, LEVOMILNACIPRAN HYDROCHLORIDE

LEVONEST, ETHINYL ESTRADIOL

LEVONORGESTREL, LEVONORGESTREL (OTC)

LEVONORGESTREL AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL

LEVONORGESTREL AND ETHINYL ESTRADIOL AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL

LEVONORGESTREL AND ETHINYL ESTRADIOL AND FERROUS FUMARATE, ETHINYL ESTRADIOL

LEVOPHED, NOREPINEPHRINE BITARTRATE

LEVORA 0.15/30-28, ETHINYL ESTRADIOL

LEVORPHANOL TARTRATE, LEVORPHANOL TARTRATE

LEVOTHYROXINE SODIUM, LEVOTHYROXINE SODIUM

LEVOTHYROXINE SODIUM, LEVOTHYROXINE SODIUM **

LEVOXYL, LEVOTHYROXINE SODIUM **

LEVULAN, AMINOLEVULINIC ACID HYDROCHLORIDE

LEXAPRO, ESCITALOPRAM OXALATE

LEXETTE, HALOBETASOL PROPIONATE

LEXISCAN, REGADENOSON

LEXIVA, FOSAMPRENAVIR CALCIUM

LIALDA, MESALAMINE

LIBRAX, CHLORDIAZEPOXIDE HYDROCHLORIDE

LIBRIUM, CHLORDIAZEPOXIDE HYDROCHLORIDE

LICART, DICLOFENAC EPOLAMINE

LIDEX, FLUOCINONIDE

LIDOCAINE, LIDOCAINE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 32

APPENDIX A - PRODUCT NAME INDEX

** L **

LIDOCAINE AND PRILOCAINE, LIDOCAINE

LIDOCAINE HYDROCHLORIDE, LIDOCAINE HYDROCHLORIDE

LIDOCAINE HYDROCHLORIDE 0.2% AND DEXTROSE 5% IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE

LIDOCAINE HYDROCHLORIDE 0.4% AND DEXTROSE 5% IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE

LIDOCAINE HYDROCHLORIDE 0.8% AND DEXTROSE 5% IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE

LIDOCAINE HYDROCHLORIDE 5% AND DEXTROSE 7.5%, LIDOCAINE HYDROCHLORIDE

LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE, EPINEPHRINE

LIDOCAINE HYDROCHLORIDE IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE

LIDOCAINE HYDROCHLORIDE PRESERVATIVE FREE, LIDOCAINE HYDROCHLORIDE

LIDOCAINE HYDROCHLORIDE PRESERVATIVE FREE IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE

LIDOCAINE HYDROCHLORIDE VISCOUS, LIDOCAINE HYDROCHLORIDE

LIDOCAINE VISCOUS, LIDOCAINE HYDROCHLORIDE

LIDODERM, LIDOCAINE

LIFITEGRAST, LIFITEGRAST

LIGNOSPAN FORTE, EPINEPHRINE BITARTRATE

LIGNOSPAN STANDARD, EPINEPHRINE BITARTRATE

LIKMEZ, METRONIDAZOLE

LILETTA, LEVONORGESTREL

LINAGLIPTIN, LINAGLIPTIN

LINAGLIPTIN AND METFORMIN HYDROCHLORIDE, LINAGLIPTIN

LINCOCIN, LINCOMYCIN HYDROCHLORIDE

LINCOMYCIN HYDROCHLORIDE, LINCOMYCIN HYDROCHLORIDE

LINEZOLID, LINEZOLID

LINEZOLID IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, LINEZOLID

LINZESS, LINACLOTIDE

LIORESAL, BACLOFEN

LIOTHYRONINE SODIUM, LIOTHYRONINE SODIUM

LIPIODOL, ETHIODIZED OIL

LIPITOR, ATORVASTATIN CALCIUM

LIPOFEN, FENOFIBRATE

LIQREV, SILDENAFIL CITRATE

LIQUID E-Z-PAQUE, BARIUM SULFATE

LISDEXAMFETAMINE DIMESYLATE, LISDEXAMFETAMINE DIMESYLATE

LISINOPRIL, LISINOPRIL

LISINOPRIL AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE

LITFULO, RITLECITINIB TOSYLATE

LITHIUM CARBONATE, LITHIUM CARBONATE

LITHIUM CITRATE, LITHIUM CITRATE

LITHOBID, LITHIUM CARBONATE

LITHOSTAT, ACETOHYDROXAMIC ACID

LIVALO, PITAVASTATIN CALCIUM

LIVMARLI, MARALIXIBAT CHLORIDE

LIVTENCITY, MARIBAVIR

LO LOESTRIN FE, ETHINYL ESTRADIOL

LO SIMPESSE, ETHINYL ESTRADIOL

LO-MALMOREDE, ETHINYL ESTRADIOL

LO-ZUMANDIMINE, DROSPIRENONE

LOCAMETZ, GALLIUM GA-68 GOZETOTIDE

LOCHOLEST, CHOLESTYRAMINE

LOCHOLEST LIGHT, CHOLESTYRAMINE

LOCOID, HYDROCORTISONE BUTYRATE

LOCOID LIPOCREAM, HYDROCORTISONE BUTYRATE

LODOCO, COLCHICINE

LODOSYN, CARBIDOPA

LOGILIA, ULIPRISTAL ACETATE

LOKELMA, SODIUM ZIRCONIUM CYCLOSILICATE

LOMAIRA, PHENTERMINE HYDROCHLORIDE

LOMOTIL, ATROPINE SULFATE

LONSURF, TIPIRACIL HYDROCHLORIDE

LOPERAMIDE HYDROCHLORIDE, LOPERAMIDE HYDROCHLORIDE (OTC)

LOPERAMIDE HYDROCHLORIDE, LOPERAMIDE HYDROCHLORIDE

LOPERAMIDE HYDROCHLORIDE AND SIMETHICONE, LOPERAMIDE HYDROCHLORIDE (OTC)

LOPID, GEMFIBROZIL

LOPINAVIR AND RITONAVIR, LOPINAVIR

LOPRESSOR, METOPROLOL TARTRATE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 33

APPENDIX A - PRODUCT NAME INDEX

** L **

LOPRESSOR HCT, HYDROCHLOROTHIAZIDE

LOPROX, CICLOPIROX

LOPURIN, ALLOPURINOL

LORATADINE, LORATADINE (OTC)

LORATADINE AND PSEUDOEPHEDRINE SULFATE, LORATADINE (OTC)

LORATADINE REDIDOSE, LORATADINE (OTC)

LORAZEPAM, LORAZEPAM

LORAZEPAM INTENSOL, LORAZEPAM

LORBRENA, LORLATINIB

LOREEV XR, LORAZEPAM

LORYNA, DROSPIRENONE

LOSARTAN POTASSIUM, LOSARTAN POTASSIUM

LOSARTAN POTASSIUM AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE

LOSEASONIQUE, ETHINYL ESTRADIOL

LOTEMAX, LOTEPREDNOL ETABONATE

LOTEMAX SM, LOTEPREDNOL ETABONATE

LOTENSIN, BENAZEPRIL HYDROCHLORIDE

LOTENSIN HCT, BENAZEPRIL HYDROCHLORIDE

LOTEPREDNOL ETABONATE, LOTEPREDNOL ETABONATE

LOTREL, AMLODIPINE BESYLATE

LOTRIMIN ULTRA, BUTENAFINE HYDROCHLORIDE (OTC)

LOTRONEX, ALOSETRON HYDROCHLORIDE

LOVASTATIN, LOVASTATIN

LOVAZA, OMEGA-3-ACID ETHYL ESTERS

LOVENOX, ENOXAPARIN SODIUM

LOVENOX (PRESERVATIVE FREE), ENOXAPARIN SODIUM

LOW-OGESTREL-28, ETHINYL ESTRADIOL

LOXAPINE SUCCINATE, LOXAPINE SUCCINATE

LUBIPROSTONE, LUBIPROSTONE

LUCEMYRA, LOFEXIDINE HYDROCHLORIDE

LUMAKRAS, SOTORASIB

LUMASON, SULFUR HEXAFLUORIDE LIPID-TYPE A MICROSPHERES

LUMI-SPORYN, BACITRACIN ZINC

LUMIFY, BRIMONIDINE TARTRATE (OTC)

LUMIGAN, BIMATOPROST

LUMRYZ, SODIUM OXYBATE

LUNESTA, ESZOPICLONE

LUPKYNIS, VOCLOSPORIN

LUPRON DEPOT, LEUPROLIDE ACETATE

LUPRON DEPOT-PED KIT, LEUPROLIDE ACETATE

LURASIDONE HYDROCHLORIDE, LURASIDONE HYDROCHLORIDE

LUTATHERA, LUTETIUM LU 177 DOTATATE

LUVOX, FLUVOXAMINE MALEATE

LUZU, LULICONAZOLE

LYBALVI, OLANZAPINE

LYMPHOSEEK KIT, TECHNETIUM TC-99M TILMANOCEPT

LYNPARZA, OLAPARIB

LYPQOZET, ATORVASTATIN CALCIUM

LYRICA, PREGABALIN

LYRICA CR, PREGABALIN

LYSODREN, MITOTANE

LYSTEDA, TRANEXAMIC ACID

LYTGOBI, FUTIBATINIB

LYVISPAH, BACLOFEN

** M **

M-ZOLE 3 COMBINATION PACK, MICONAZOLE NITRATE (OTC)

MACITENTAN, MACITENTAN

MACROBID, NITROFURANTOIN

MACRODANTIN, NITROFURANTOIN, MACROCRYSTALLINE

MAGNESIUM SULFATE, MAGNESIUM SULFATE

MAGNESIUM SULFATE IN DEXTROSE 5% IN PLASTIC CONTAINER, MAGNESIUM SULFATE

MAGNESIUM SULFATE IN PLASTIC CONTAINER, MAGNESIUM SULFATE

MALARONE, ATOVAQUONE

MALARONE PEDIATRIC, ATOVAQUONE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 34

APPENDIX A - PRODUCT NAME INDEX

** M **

MALATHION, MALATHION

MALMOREDE, ETHINYL ESTRADIOL

MANGANESE CHLORIDE IN PLASTIC CONTAINER, MANGANESE CHLORIDE

MANNITOL 10% IN PLASTIC CONTAINER, MANNITOL

MANNITOL 15% IN PLASTIC CONTAINER, MANNITOL

MANNITOL 20% IN PLASTIC CONTAINER, MANNITOL

MANNITOL 25%, MANNITOL

MANNITOL 5% IN PLASTIC CONTAINER, MANNITOL

MARAVIROC, MARAVIROC

MARCAINE, BUPIVACAINE HYDROCHLORIDE

MARCAINE HYDROCHLORIDE, BUPIVACAINE HYDROCHLORIDE

MARCAINE HYDROCHLORIDE PRESERVATIVE FREE, BUPIVACAINE HYDROCHLORIDE

MARCAINE HYDROCHLORIDE W/ EPINEPHRINE, BUPIVACAINE HYDROCHLORIDE

MARCAINE HYDROCHLORIDE W/ EPINEPHRINE PRESERVATIVE FREE, BUPIVACAINE HYDROCHLORIDE

MARINOL, DRONABINOL

MARLISSA, ETHINYL ESTRADIOL

MARPLAN, ISOCARBOXAZID

MATULANE, PROCARBAZINE HYDROCHLORIDE

MAVENCLAD, CLADRIBINE

MAVYRET, GLECAPREVIR

MAXALT, RIZATRIPTAN BENZOATE

MAXALT-MLT, RIZATRIPTAN BENZOATE

MAXIDEX, DEXAMETHASONE

MAXITROL, DEXAMETHASONE

MAXZIDE, HYDROCHLOROTHIAZIDE

MAXZIDE-25, HYDROCHLOROTHIAZIDE

MAYZENT, SIPONIMOD

MD-GASTROVIEW, DIATRIZOATE MEGLUMINE

MECAMYLAMINE HYDROCHLORIDE, MECAMYLAMINE HYDROCHLORIDE

MECLIZINE HYDROCHLORIDE, MECLIZINE HYDROCHLORIDE

MECLOFENAMATE SODIUM, MECLOFENAMATE SODIUM

MEDROL, METHYLPREDNISOLONE

MEDROXYPROGESTERONE ACETATE, MEDROXYPROGESTERONE ACETATE

MEFENAMIC ACID, MEFENAMIC ACID

MEFLOQUINE HYDROCHLORIDE, MEFLOQUINE HYDROCHLORIDE

MEGACE ES, MEGESTROL ACETATE

MEGESTROL ACETATE, MEGESTROL ACETATE

MEKINIST, TRAMETINIB DIMETHYL SULFOXIDE

MEKTOVI, BINIMETINIB

MELAMISA, DROSPIRENONE

MELOXICAM, MELOXICAM

MELPHALAN, MELPHALAN

MELPHALAN HYDROCHLORIDE, MELPHALAN HYDROCHLORIDE

MEMANTINE HYDROCHLORIDE, MEMANTINE HYDROCHLORIDE

MEMANTINE HYDROCHLORIDE AND DONEPEZIL HYDROCHLORIDE, DONEPEZIL HYDROCHLORIDE

MEN'S ROGAINE, MINOXIDIL (OTC)

MENEST, ESTROGENS, ESTERIFIED

MENOSTAR, ESTRADIOL

MEPERIDINE HYDROCHLORIDE, MEPERIDINE HYDROCHLORIDE

MEPERIDINE HYDROCHLORIDE PRESERVATIVE FREE, MEPERIDINE HYDROCHLORIDE

MEPROBAMATE, MEPROBAMATE

MEPRON, ATOVAQUONE

MERCAPTOPURINE, MERCAPTOPURINE

MEROPENEM, MEROPENEM

MEROPENEM AND SODIUM CHLORIDE IN DUPLEX CONTAINER, MEROPENEM

MERREM, MEROPENEM

MERZEE, ETHINYL ESTRADIOL

MESALAMINE, MESALAMINE

MESNA, MESNA

MESNEX, MESNA

MESTINON, PYRIDOSTIGMINE BROMIDE

METADATE CD, METHYLPHENIDATE HYDROCHLORIDE

METAPROTERENOL SULFATE, METAPROTERENOL SULFATE

METARAMINOL BITARTRATE, METARAMINOL BITARTRATE

METASTRON, STRONTIUM CHLORIDE SR-89
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 35

APPENDIX A - PRODUCT NAME INDEX

** M **

METAXALONE, METAXALONE

METFORMIN HYDROCHLORIDE, METFORMIN HYDROCHLORIDE

METFORMIN HYDROCHLORIDE; SAXAGLIPTIN HYDROCHLORIDE, METFORMIN HYDROCHLORIDE

METHADONE HYDROCHLORIDE, METHADONE HYDROCHLORIDE

METHADONE HYDROCHLORIDE INTENSOL, METHADONE HYDROCHLORIDE

METHADOSE, METHADONE HYDROCHLORIDE

METHAMPHETAMINE HYDROCHLORIDE, METHAMPHETAMINE HYDROCHLORIDE

METHAZOLAMIDE, METHAZOLAMIDE

METHENAMINE HIPPURATE, METHENAMINE HIPPURATE

METHERGINE, METHYLERGONOVINE MALEATE

METHIMAZOLE, METHIMAZOLE

METHOCARBAMOL, METHOCARBAMOL

METHOTREXATE PRESERVATIVE FREE, METHOTREXATE SODIUM

METHOTREXATE SODIUM, METHOTREXATE SODIUM

METHOTREXATE SODIUM PRESERVATIVE FREE, METHOTREXATE SODIUM

METHOXSALEN, METHOXSALEN

METHSCOPOLAMINE BROMIDE, METHSCOPOLAMINE BROMIDE

METHSUXIMIDE, METHSUXIMIDE

METHYLENE BLUE, METHYLENE BLUE

METHYLERGONOVINE MALEATE, METHYLERGONOVINE MALEATE

METHYLIN, METHYLPHENIDATE HYDROCHLORIDE

METHYLIN ER, METHYLPHENIDATE HYDROCHLORIDE

METHYLPHENIDATE, METHYLPHENIDATE

METHYLPHENIDATE HYDROCHLORIDE, METHYLPHENIDATE HYDROCHLORIDE

METHYLPREDNISOLONE, METHYLPREDNISOLONE

METHYLPREDNISOLONE ACETATE, METHYLPREDNISOLONE ACETATE

METHYLPREDNISOLONE SODIUM SUCCINATE, METHYLPREDNISOLONE SODIUM SUCCINATE

METHYLTESTOSTERONE, METHYLTESTOSTERONE

METOCLOPRAMIDE, METOCLOPRAMIDE HYDROCHLORIDE

METOCLOPRAMIDE HYDROCHLORIDE, METOCLOPRAMIDE HYDROCHLORIDE

METOLAZONE, METOLAZONE

METOPIRONE, METYRAPONE

METOPROLOL SUCCINATE, METOPROLOL SUCCINATE

METOPROLOL TARTRATE, METOPROLOL TARTRATE

METOPROLOL TARTRATE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE

METRO I.V. IN PLASTIC CONTAINER, METRONIDAZOLE

METROCREAM, METRONIDAZOLE

METROGEL, METRONIDAZOLE

METROGEL-VAGINAL, METRONIDAZOLE

METROLOTION, METRONIDAZOLE

METRONIDAZOLE, METRONIDAZOLE

METRONIDAZOLE IN PLASTIC CONTAINER, METRONIDAZOLE

METYROSINE, METYROSINE

MEXILETINE HYDROCHLORIDE, MEXILETINE HYDROCHLORIDE

MIACALCIN, CALCITONIN SALMON

MIBELAS 24 FE, ETHINYL ESTRADIOL

MICAFUNGIN, MICAFUNGIN SODIUM

MICAFUNGIN IN SODIUM CHLORIDE 0.9%, MICAFUNGIN SODIUM

MICAFUNGIN SODIUM, MICAFUNGIN SODIUM

MICARDIS, TELMISARTAN

MICARDIS HCT, HYDROCHLOROTHIAZIDE

MICONAZOLE 3, MICONAZOLE NITRATE (OTC)

MICONAZOLE 3 COMBINATION PACK, MICONAZOLE NITRATE (OTC)

MICONAZOLE 7, MICONAZOLE NITRATE (OTC)

MICONAZOLE NITRATE, MICONAZOLE NITRATE (OTC)

MICONAZOLE NITRATE, MICONAZOLE NITRATE

MICONAZOLE NITRATE COMBINATION PACK, MICONAZOLE NITRATE (OTC)

MICORT-HC, HYDROCORTISONE ACETATE

MICROZIDE, HYDROCHLOROTHIAZIDE

MIDAMOR, AMILORIDE HYDROCHLORIDE

MIDAZOLAM HYDROCHLORIDE, MIDAZOLAM HYDROCHLORIDE

MIDAZOLAM HYDROCHLORIDE PRESERVATIVE FREE, MIDAZOLAM HYDROCHLORIDE

MIDAZOLAM IN 0.8% SODIUM CHLORIDE, MIDAZOLAM

MIDAZOLAM IN 0.9% SODIUM CHLORIDE, MIDAZOLAM

MIDODRINE HYDROCHLORIDE, MIDODRINE HYDROCHLORIDE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 36

APPENDIX A - PRODUCT NAME INDEX

** M **

MIDOL LIQUID GELS, IBUPROFEN (OTC)

MIDOZALAM HYDROCHLORIDE, MIDAZOLAM HYDROCHLORIDE

MIEBO, PERFLUOROHEXYLOCTANE

MIFEPREX, MIFEPRISTONE

MIFEPRISTONE, MIFEPRISTONE

MIGERGOT, CAFFEINE

MIGLITOL, MIGLITOL

MIGLUSTAT, MIGLUSTAT

MIGRANAL, DIHYDROERGOTAMINE MESYLATE

MILI, ETHINYL ESTRADIOL

MILRINONE LACTATE, MILRINONE LACTATE

MILRINONE LACTATE IN DEXTROSE 5%, MILRINONE LACTATE

MILRINONE LACTATE IN DEXTROSE 5% IN PLASTIC CONTAINER, MILRINONE LACTATE

MILRINONE LACTATE IN PLASTIC CONTAINER, MILRINONE LACTATE

MINIPRESS, PRAZOSIN HYDROCHLORIDE

MINIVELLE, ESTRADIOL

MINOCIN, MINOCYCLINE HYDROCHLORIDE

MINOCYCLINE HYDROCHLORIDE, MINOCYCLINE HYDROCHLORIDE

MINOLIRA, MINOCYCLINE HYDROCHLORIDE

MINOXIDIL, MINOXIDIL (OTC)

MINOXIDIL, MINOXIDIL

MINOXIDIL (FOR MEN), MINOXIDIL (OTC)

MINOXIDIL (FOR WOMEN), MINOXIDIL (OTC)

MINOXIDIL EXTRA STRENGTH (FOR MEN), MINOXIDIL (OTC)

MIOCHOL-E, ACETYLCHOLINE CHLORIDE

MIOSTAT, CARBACHOL

MIRABEGRON, MIRABEGRON

MIRALAX, POLYETHYLENE GLYCOL 3350 (OTC)

MIRAPEX ER, PRAMIPEXOLE DIHYDROCHLORIDE

MIRENA, LEVONORGESTREL

MIRTAZAPINE, MIRTAZAPINE

MIRVASO, BRIMONIDINE TARTRATE

MISOPROSTOL, MISOPROSTOL

MITIGARE, COLCHICINE

MITIGO, MORPHINE SULFATE

MITOMYCIN, MITOMYCIN

MITOSOL, MITOMYCIN

MITOXANTRONE HYDROCHLORIDE, MITOXANTRONE HYDROCHLORIDE

MIVACURIUM CHLORIDE, MIVACURIUM CHLORIDE

MOBIC, MELOXICAM

MODAFINIL, MODAFINIL

MOEXIPRIL HYDROCHLORIDE, MOEXIPRIL HYDROCHLORIDE

MOEXIPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE

MOLINDONE HYDROCHLORIDE, MOLINDONE HYDROCHLORIDE

MOMETASONE FUROATE, MOMETASONE FUROATE

MONISTAT 1 COMBINATION PACK, MICONAZOLE NITRATE (OTC)

MONISTAT 3, MICONAZOLE NITRATE (OTC)

MONISTAT 3, MICONAZOLE NITRATE

MONISTAT 3 COMBINATION PACK, MICONAZOLE NITRATE (OTC)

MONISTAT 3 COMBINATION PACK (PREFILLED), MICONAZOLE NITRATE (OTC)

MONISTAT 7, MICONAZOLE NITRATE (OTC)

MONISTAT 7 COMBINATION PACK, MICONAZOLE NITRATE (OTC)

MONO-LINYAH, ETHINYL ESTRADIOL

MONOBASIC SODIUM PHOSPHATE AND DIBASIC SODIUM PHOSPHATE, SODIUM PHOSPHATE, DIBASIC,

MONODOX, DOXYCYCLINE

MONOFERRIC, FERRIC DERISOMALTOSE

MONOKET, ISOSORBIDE MONONITRATE

MONTELUKAST SODIUM, MONTELUKAST SODIUM

MONUROL, FOSFOMYCIN TROMETHAMINE

MORPHINE SULFATE, MORPHINE SULFATE

MOTEGRITY, PRUCALOPRIDE SUCCINATE

MOTOFEN, ATROPINE SULFATE

MOTPOLY XR, LACOSAMIDE

MOTRIN IB, IBUPROFEN (OTC)

MOUNJARO, TIRZEPATIDE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 37

APPENDIX A - PRODUCT NAME INDEX

** M **

MOVANTIK, NALOXEGOL OXALATE

MOVIPREP, ASCORBIC ACID

MOXIDECTIN, MOXIDECTIN

MOXIFLOXACIN HYDROCHLORIDE, MOXIFLOXACIN HYDROCHLORIDE

MOXIFLOXACIN HYDROCHLORIDE IN SODIUM CHLORIDE 0.8% IN PLASTIC CONTAINER, MOXIFLOXACIN

MOZOBIL, PLERIXAFOR

MPI INDIUM DTPA IN 111, INDIUM IN-111 PENTETATE DISODIUM

MS CONTIN, MORPHINE SULFATE

MUCINEX, GUAIFENESIN (OTC)

MUCINEX D, GUAIFENESIN (OTC)

MUCINEX DM, DEXTROMETHORPHAN HYDROBROMIDE (OTC)

MULPLETA, LUSUTROMBOPAG

MULTAQ, DRONEDARONE HYDROCHLORIDE

MULTIHANCE, GADOBENATE DIMEGLUMINE

MULTIHANCE MULTIPACK, GADOBENATE DIMEGLUMINE

MULTIPLE ELECTROLYTES INJECTION TYPE 1 USP PH 5.5, MAGNESIUM CHLORIDE

MULTIPLE ELECTROLYTES INJECTION TYPE 1 USP PH 7.4, MAGNESIUM CHLORIDE

MULTRYS, CUPRIC SULFATE

MUPIROCIN, MUPIROCIN

MUPIROCIN, MUPIROCIN CALCIUM

MUSE, ALPROSTADIL

MYAMBUTOL, ETHAMBUTOL HYDROCHLORIDE

MYCAMINE, MICAFUNGIN SODIUM

MYCAPSSA, OCTREOTIDE ACETATE

MYCOBUTIN, RIFABUTIN

MYCOPHENOLATE MOFETIL, MYCOPHENOLATE MOFETIL

MYCOPHENOLATE MOFETIL HYDROCHLORIDE, MYCOPHENOLATE MOFETIL HYDROCHLORIDE

MYCOPHENOLIC SODIUM, MYCOPHENOLIC SODIUM

MYDAYIS, AMPHETAMINE ASPARTATE

MYDCOMBI, PHENYLEPHRINE HYDROCHLORIDE

MYDRIACYL, TROPICAMIDE

MYFEMBREE, ESTRADIOL

MYFORTIC, MYCOPHENOLIC SODIUM

MYKACET, NYSTATIN

MYLERAN, BUSULFAN

MYORISAN, ISOTRETINOIN

MYOVIEW, TECHNETIUM TC-99M TETROFOSMIN KIT

MYOVIEW 30ML, TECHNETIUM TC-99M TETROFOSMIN KIT

MYRBETRIQ, MIRABEGRON

MYRBETRIQ GRANULES, MIRABEGRON

MYSOLINE, PRIMIDONE

MYTESI, CROFELEMER

MYZILRA, ETHINYL ESTRADIOL

** N **

NABUMETONE, NABUMETONE

NADOLOL, NADOLOL

NAFCILLIN SODIUM, NAFCILLIN SODIUM

NAFTIFINE HYDROCHLORIDE, NAFTIFINE HYDROCHLORIDE

NAFTIN, NAFTIFINE HYDROCHLORIDE

NALBUPHINE HYDROCHLORIDE, NALBUPHINE HYDROCHLORIDE

NALFON, FENOPROFEN CALCIUM

NALLPEN IN PLASTIC CONTAINER, NAFCILLIN SODIUM

NALMEFENE HYDROCHLORIDE, NALMEFENE HYDROCHLORIDE

NALOXONE, NALOXONE HYDROCHLORIDE

NALOXONE HYDROCHLORIDE, NALOXONE HYDROCHLORIDE (OTC)

NALOXONE HYDROCHLORIDE, NALOXONE HYDROCHLORIDE

NALOXONE HYDROCHLORIDE AND PENTAZOCINE HYDROCHLORIDE, NALOXONE HYDROCHLORIDE

NALTREXONE, NALTREXONE

NALTREXONE HYDROCHLORIDE, NALTREXONE HYDROCHLORIDE

NAMENDA, MEMANTINE HYDROCHLORIDE

NAMENDA XR, MEMANTINE HYDROCHLORIDE

NAMZARIC, DONEPEZIL HYDROCHLORIDE

NAPHAZOLINE HYDROCHLORIDE AND PHENIRAMINE MALEATE, NAPHAZOLINE HYDROCHLORIDE (OTC)

NAPHCON-A, NAPHAZOLINE HYDROCHLORIDE (OTC)
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 38

APPENDIX A - PRODUCT NAME INDEX

** N **

NAPRELAN, NAPROXEN SODIUM

NAPROSYN, NAPROXEN

NAPROXEN, NAPROXEN

NAPROXEN AND ESOMEPRAZOLE MAGNESIUM, ESOMEPRAZOLE MAGNESIUM

NAPROXEN SODIUM, NAPROXEN SODIUM (OTC)

NAPROXEN SODIUM, NAPROXEN SODIUM

NAPROXEN SODIUM AND DIPHENHYDRAMINE HYDROCHLORIDE, DIPHENHYDRAMINE HYDROCHLORIDE (OTC)

NAPROXEN SODIUM AND PSEUDOEPHEDRINE HYDROCHLORIDE, NAPROXEN SODIUM (OTC)

NARATRIPTAN, NARATRIPTAN HYDROCHLORIDE

NARCAN, NALOXONE HYDROCHLORIDE (OTC)

NARDIL, PHENELZINE SULFATE

NAROPIN, ROPIVACAINE HYDROCHLORIDE

NASACORT ALLERGY 24 HOUR, TRIAMCINOLONE ACETONIDE (OTC)

NASCOBAL, CYANOCOBALAMIN

NASONEX 24HR ALLERGY, MOMETASONE FUROATE (OTC)

NATACYN, NATAMYCIN

NATAZIA, DIENOGEST

NATEGLINIDE, NATEGLINIDE

NATESTO, TESTOSTERONE

NATROBA, SPINOSAD

NAYZILAM, MIDAZOLAM

NEBIVOLOL HYDROCHLORIDE, NEBIVOLOL HYDROCHLORIDE

NEBUPENT, PENTAMIDINE ISETHIONATE

NEFAZODONE HYDROCHLORIDE, NEFAZODONE HYDROCHLORIDE

NELARABINE, NELARABINE

NEMBUTAL SODIUM, PENTOBARBITAL SODIUM

NEO-SYNALAR, FLUOCINOLONE ACETONIDE

NEOMYCIN AND POLYMYXIN B SULFATE, NEOMYCIN SULFATE

NEOMYCIN AND POLYMYXIN B SULFATES AND BACITRACIN ZINC, BACITRACIN ZINC

NEOMYCIN AND POLYMYXIN B SULFATES AND DEXAMETHASONE, DEXAMETHASONE

NEOMYCIN AND POLYMYXIN B SULFATES AND GRAMICIDIN, GRAMICIDIN

NEOMYCIN AND POLYMYXIN B SULFATES AND HYDROCORTISONE, HYDROCORTISONE

NEOMYCIN AND POLYMYXIN B SULFATES, BACITRACIN ZINC AND HYDROCORTISONE, BACITRACIN ZINC

NEOMYCIN SULFATE, NEOMYCIN SULFATE

NEOPROFEN, IBUPROFEN LYSINE

NEORAL, CYCLOSPORINE

NEOSPORIN, GRAMICIDIN

NEOSPORIN G.U. IRRIGANT, NEOMYCIN SULFATE

NEOSTIGMINE METHYLSULFATE, NEOSTIGMINE METHYLSULFATE

NEOSTIGMINE METHYSULFATE, NEOSTIGMINE METHYLSULFATE

NEPHROSCAN, TECHNETIUM TC-99M SUCCIMER

NERLYNX, NERATINIB MALEATE

NESACAINE, CHLOROPROCAINE HYDROCHLORIDE

NESACAINE-MPF, CHLOROPROCAINE HYDROCHLORIDE

NESINA, ALOGLIPTIN BENZOATE

NETSPOT, GALLIUM DOTATATE GA-68

NEUPRO, ROTIGOTINE

NEURACEQ, FLORBETABEN F-18

NEUROLITE, TECHNETIUM TC-99M BICISATE KIT

NEURONTIN, GABAPENTIN

NEVANAC, NEPAFENAC

NEVIRAPINE, NEVIRAPINE

NEXAVAR, SORAFENIB TOSYLATE

NEXESTA FE, ETHINYL ESTRADIOL

NEXICLON XR, CLONIDINE

NEXIUM, ESOMEPRAZOLE MAGNESIUM

NEXIUM 24HR, ESOMEPRAZOLE MAGNESIUM (OTC)

NEXIUM IV, ESOMEPRAZOLE SODIUM

NEXLETOL, BEMPEDOIC ACID

NEXLIZET, BEMPEDOIC ACID

NEXPLANON, ETONOGESTREL

NEXTERONE, AMIODARONE HYDROCHLORIDE

NEXTSTELLIS, DROSPIRENONE

NIACIN, NIACIN

NIACOR, NIACIN
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 39

APPENDIX A - PRODUCT NAME INDEX

** N **

NICARDIPINE HYDROCHLORIDE, NICARDIPINE HYDROCHLORIDE

NICARDIPINE HYDROCHLORIDE IN 0.9% SODIUM CHLORIDE, NICARDIPINE HYDROCHLORIDE

NICODERM CQ, NICOTINE (OTC)

NICORETTE, NICOTINE POLACRILEX (OTC)

NICORETTE (MINT), NICOTINE POLACRILEX (OTC)

NICOTINE, NICOTINE (OTC)

NICOTINE POLACRILEX, NICOTINE POLACRILEX (OTC)

NICOTROL, NICOTINE

NIFEDIPINE, NIFEDIPINE

NIKKI, DROSPIRENONE

NILANDRON, NILUTAMIDE

NILOTINIB HYDROCHLORIDE, NILOTINIB HYDROCHLORIDE

NILUTAMIDE, NILUTAMIDE

NIMBEX, CISATRACURIUM BESYLATE

NIMBEX PRESERVATIVE FREE, CISATRACURIUM BESYLATE

NIMODIPINE, NIMODIPINE

NINLARO, IXAZOMIB CITRATE

NIPENT, PENTOSTATIN

NIPRIDE RTU IN SODIUM CHLORIDE 0.9%, SODIUM NITROPRUSSIDE

NISOLDIPINE, NISOLDIPINE

NITAZOXANIDE, NITAZOXANIDE

NITHIODOTE, SODIUM NITRITE

NITISINONE, NITISINONE

NITRO-DUR, NITROGLYCERIN

NITROFURANTOIN, NITROFURANTOIN

NITROFURANTOIN, NITROFURANTOIN, MACROCRYSTALLINE

NITROFURANTOIN (MONOHYDRATE/MACROCRYSTALS), NITROFURANTOIN

NITROGLYCERIN, NITROGLYCERIN

NITROGLYCERIN IN DEXTROSE 5%, NITROGLYCERIN

NITROLINGUAL PUMPSPRAY, NITROGLYCERIN

NITROMIST, NITROGLYCERIN

NITROSTAT, NITROGLYCERIN

NITYR, NITISINONE

NIX, PERMETHRIN (OTC)

NIZATIDINE, NIZATIDINE

NIZORAL ANTI-DANDRUFF, KETOCONAZOLE (OTC)

NOR-QD, NORETHINDRONE

NOREPINEPHRINE BITARTRATE, NOREPINEPHRINE BITARTRATE

NOREPINEPHRINE BITARTRATE IN 0.9% SODIUM CHLORIDE, NOREPINEPHRINE BITARTRATE

NOREPINEPHRINE BITARTRATE IN 5% DEXTROSE, NOREPINEPHRINE BITARTRATE

NORETHINDRONE, NORETHINDRONE

NORETHINDRONE ACETATE, NORETHINDRONE ACETATE

NORETHINDRONE ACETATE AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL

NORETHINDRONE ACETATE AND ETHINYL ESTRADIOL AND FERROUS FUMARATE, ETHINYL ESTRADIOL

NORETHINDRONE AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL

NORETHINDRONE AND ETHINYL ESTRADIOL (10/11), ETHINYL ESTRADIOL

NORETHINDRONE AND ETHINYL ESTRADIOL AND FERROUS FUMARATE, ETHINYL ESTRADIOL

NORGESTIMATE AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL

NORITATE, METRONIDAZOLE

NORLIQVA, AMLODIPINE BESYLATE

NORMOCARB HF 25, MAGNESIUM CHLORIDE

NORMOCARB HF 35, MAGNESIUM CHLORIDE

NORMOSOL-M AND DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE

NORMOSOL-R AND DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE

NORMOSOL-R IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE

NORPACE, DISOPYRAMIDE PHOSPHATE

NORPACE CR, DISOPYRAMIDE PHOSPHATE

NORPRAMIN, DESIPRAMINE HYDROCHLORIDE

NORTHERA, DROXIDOPA

NORTREL 0.5/35-28, ETHINYL ESTRADIOL

NORTREL 1/35-21, ETHINYL ESTRADIOL

NORTREL 1/35-28, ETHINYL ESTRADIOL

NORTREL 7/7/7, ETHINYL ESTRADIOL

NORTRIPTYLINE HYDROCHLORIDE, NORTRIPTYLINE HYDROCHLORIDE

NORVASC, AMLODIPINE BESYLATE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 40

APPENDIX A - PRODUCT NAME INDEX

** N **

NORVIR, RITONAVIR

NOURIANZ, ISTRADEFYLLINE

NOXAFIL, POSACONAZOLE

NOXAFIL POWDERMIX KIT, POSACONAZOLE

NOXIVENT, NITRIC OXIDE

NUBEQA, DAROLUTAMIDE

NUCYNTA, TAPENTADOL HYDROCHLORIDE

NUCYNTA ER, TAPENTADOL HYDROCHLORIDE

NUEDEXTA, DEXTROMETHORPHAN HYDROBROMIDE

NULIBRY, FOSDENOPTERIN HYDROBROMIDE

NULYTELY, POLYETHYLENE GLYCOL 3350

NULYTELY-FLAVORED, POLYETHYLENE GLYCOL 3350

NUMBRINO, COCAINE HYDROCHLORIDE

NUPLAZID, PIMAVANSERIN TARTRATE

NURTEC ODT, RIMEGEPANT SULFATE

NUTRILIPID 10%, SOYBEAN OIL

NUTRILIPID 20%, SOYBEAN OIL

NUVARING, ETHINYL ESTRADIOL

NUVESSA, METRONIDAZOLE

NUVIGIL, ARMODAFINIL

NUZYRA, OMADACYCLINE TOSYLATE

NYLIA 1/35, ETHINYL ESTRADIOL

NYLIA 7/7/7, ETHINYL ESTRADIOL

NYMALIZE, NIMODIPINE

NYSTATIN, NYSTATIN

NYSTATIN AND TRIAMCINOLONE ACETONIDE, NYSTATIN

NYSTOP, NYSTATIN

** O **

OCALIVA, OBETICHOLIC ACID

OCTREOSCAN, INDIUM IN-111 PENTETREOTIDE KIT

OCTREOTIDE ACETATE, OCTREOTIDE ACETATE

OCTREOTIDE ACETATE (PRESERVATIVE FREE), OCTREOTIDE ACETATE

OCUFLOX, OFLOXACIN

ODEFSEY, EMTRICITABINE

ODOMZO, SONIDEGIB PHOSPHATE

OFEV, NINTEDANIB ESYLATE

OFLOXACIN, OFLOXACIN

OGEN 5, ESTROPIPATE

OGSIVEO, NIROGACESTAT HYDROBROMIDE

OJJAARA, MOMELOTINIB DIHYDROCHLORIDE

OLANZAPINE, OLANZAPINE

OLANZAPINE AND FLUOXETINE HYDROCHLORIDE, FLUOXETINE HYDROCHLORIDE

OLINVYK, OLICERIDINE

OLMESARTAN MEDOXOMIL, OLMESARTAN MEDOXOMIL

OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE

OLMESARTAN MEDOXOMIL, AMLODIPINE AND HYDROCHLOROTHIAZIDE, AMLODIPINE BESYLATE

OLOPATADINE HYDROCHLORIDE, OLOPATADINE HYDROCHLORIDE (OTC)

OLOPATADINE HYDROCHLORIDE, OLOPATADINE HYDROCHLORIDE

OLPRUVA, SODIUM PHENYLBUTYRATE

OLUMIANT, BARICITINIB

OMEGA-3-ACID ETHYL ESTERS, OMEGA-3-ACID ETHYL ESTERS

OMEGAVEN, FISH OIL TRIGLYCERIDES

OMEPRAZOLE, OMEPRAZOLE (OTC)

OMEPRAZOLE, OMEPRAZOLE

OMEPRAZOLE AND SODIUM BICARBONATE, OMEPRAZOLE (OTC)

OMEPRAZOLE AND SODIUM BICARBONATE, OMEPRAZOLE

OMEPRAZOLE MAGNESIUM, OMEPRAZOLE MAGNESIUM (OTC)

OMIDRIA, KETOROLAC TROMETHAMINE

OMNARIS, CICLESONIDE

OMNIPAQUE 12, IOHEXOL

OMNIPAQUE 140, IOHEXOL

OMNIPAQUE 180, IOHEXOL

OMNIPAQUE 240, IOHEXOL

OMNIPAQUE 300, IOHEXOL
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 41

APPENDIX A - PRODUCT NAME INDEX

** O **

OMNIPAQUE 350, IOHEXOL

OMNIPAQUE 9, IOHEXOL

OMNIPRED, PREDNISOLONE ACETATE

OMNISCAN, GADODIAMIDE

ONDANSETRON, ONDANSETRON

ONDANSETRON HYDROCHLORIDE, ONDANSETRON HYDROCHLORIDE

ONDANSETRON HYDROCHLORIDE PRESERVATIVE FREE, ONDANSETRON HYDROCHLORIDE

ONEXTON, BENZOYL PEROXIDE

ONFI, CLOBAZAM

ONGENTYS, OPICAPONE

ONIVYDE, IRINOTECAN HYDROCHLORIDE

ONPATTRO, PATISIRAN SODIUM

ONSURA, ETHINYL ESTRADIOL

ONUREG, AZACITIDINE

ONZETRA XSAIL, SUMATRIPTAN SUCCINATE

OPCICON ONE-STEP, LEVONORGESTREL (OTC)

OPCON-A, NAPHAZOLINE HYDROCHLORIDE (OTC)

OPFOLDA, MIGLUSTAT

OPSUMIT, MACITENTAN

OPTIRAY 300, IOVERSOL

OPTIRAY 320, IOVERSOL

OPTIRAY 350, IOVERSOL

OPTISON, ALBUMIN HUMAN

OPVEE, NALMEFENE HYDROCHLORIDE

OPZELURA, RUXOLITINIB PHOSPHATE

ORABLOC, ARTICAINE HYDROCHLORIDE

ORACEA, DOXYCYCLINE

ORAPRED ODT, PREDNISOLONE SODIUM PHOSPHATE

ORAQIX, LIDOCAINE

ORAVERSE, PHENTOLAMINE MESYLATE

ORAVIG, MICONAZOLE

ORBACTIV, ORITAVANCIN DIPHOSPHATE

ORENITRAM, TREPROSTINIL DIOLAMINE

ORFADIN, NITISINONE

ORGOVYX, RELUGOLIX

ORIAHNN (COPACKAGED), ELAGOLIX SODIUM,ESTRADIOL,NORETHINDRONE ACETATE

ORILISSA, ELAGOLIX SODIUM

ORKAMBI, IVACAFTOR

ORLADEYO, BEROTRALSTAT HYDROCHLORIDE

ORPHENADRINE CITRATE, ORPHENADRINE CITRATE

ORPHENGESIC, ASPIRIN

ORPHENGESIC FORTE, ASPIRIN

ORSERDU, ELACESTRANT DIHYDROCHLORIDE

ORVATEN, MIDODRINE HYDROCHLORIDE

OSELTAMIVIR PHOSPHATE, OSELTAMIVIR PHOSPHATE

OSENI, ALOGLIPTIN BENZOATE

OSHIH, ETHINYL ESTRADIOL

OSMITROL 10% IN WATER, MANNITOL

OSMITROL 10% IN WATER IN PLASTIC CONTAINER, MANNITOL

OSMITROL 15% IN WATER, MANNITOL

OSMITROL 15% IN WATER IN PLASTIC CONTAINER, MANNITOL

OSMITROL 20% IN WATER, MANNITOL

OSMITROL 20% IN WATER IN PLASTIC CONTAINER, MANNITOL

OSMITROL 5% IN WATER, MANNITOL

OSMITROL 5% IN WATER IN PLASTIC CONTAINER, MANNITOL

OSMOLEX ER, AMANTADINE HYDROCHLORIDE

OSPHENA, OSPEMIFENE

OTEZLA, APREMILAST

OTICAIR, HYDROCORTISONE

OTOVEL, CIPROFLOXACIN HYDROCHLORIDE

OTREXUP, METHOTREXATE

OXACILLIN SODIUM, OXACILLIN SODIUM

OXALIPLATIN, OXALIPLATIN

OXAPROZIN, OXAPROZIN

OXAZEPAM, OXAZEPAM
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 42

APPENDIX A - PRODUCT NAME INDEX

** O **

OXBRYTA, VOXELOTOR

OXCARBAZEPINE, OXCARBAZEPINE

OXICONAZOLE NITRATE, OXICONAZOLE NITRATE

OXISTAT, OXICONAZOLE NITRATE

OXLUMO, LUMASIRAN SODIUM

OXSORALEN-ULTRA, METHOXSALEN

OXTELLAR XR, OXCARBAZEPINE

OXYBUTYNIN CHLORIDE, OXYBUTYNIN CHLORIDE

OXYCET, ACETAMINOPHEN

OXYCODONE AND ACETAMINOPHEN, ACETAMINOPHEN

OXYCODONE AND ASPIRIN, ASPIRIN

OXYCODONE HYDROCHLORIDE, OXYCODONE HYDROCHLORIDE

OXYCONTIN, OXYCODONE HYDROCHLORIDE

OXYMORPHONE HYDROCHLORIDE, OXYMORPHONE HYDROCHLORIDE

OXYTOCIN, OXYTOCIN

OXYTROL, OXYBUTYNIN

OXYTROL FOR WOMEN, OXYBUTYNIN (OTC)

OZEMPIC, SEMAGLUTIDE

OZOBAX DS, BACLOFEN

OZURDEX, DEXAMETHASONE

** P **

PACERONE, AMIODARONE HYDROCHLORIDE

PACLITAXEL, PACLITAXEL

PALBOCICLIB, PALBOCICLIB

PALIPERIDONE, PALIPERIDONE

PALONOSETRON HYDROCHLORIDE, PALONOSETRON HYDROCHLORIDE

PAMELOR, NORTRIPTYLINE HYDROCHLORIDE

PAMIDRONATE DISODIUM, PAMIDRONATE DISODIUM

PANCURONIUM BROMIDE, PANCURONIUM BROMIDE

PANDEL, HYDROCORTISONE PROBUTATE

PANRETIN, ALITRETINOIN

PANTOPRAZOLE SODIUM, PANTOPRAZOLE SODIUM

PARAGARD T 380A, COPPER

PARICALCITOL, PARICALCITOL

PARLODEL, BROMOCRIPTINE MESYLATE

PARNATE, TRANYLCYPROMINE SULFATE

PAROMOMYCIN SULFATE, PAROMOMYCIN SULFATE

PAROXETINE, PAROXETINE HYDROCHLORIDE

PAROXETINE HYDROCHLORIDE, PAROXETINE HYDROCHLORIDE

PAROXETINE MESYLATE, PAROXETINE MESYLATE

PARSABIV, ETELCALCETIDE

PASER, AMINOSALICYLIC ACID

PATADAY ONCE DAILY RELIEF, OLOPATADINE HYDROCHLORIDE (OTC)

PATADAY TWICE DAILY RELIEF, OLOPATADINE HYDROCHLORIDE (OTC)

PAXIL, PAROXETINE HYDROCHLORIDE

PAXIL CR, PAROXETINE HYDROCHLORIDE

PAXLOVID (COPACKAGED), NIRMATRELVIR

PAZOPANIB HYDROCHLORIDE, PAZOPANIB HYDROCHLORIDE

PEDIAPRED, PREDNISOLONE SODIUM PHOSPHATE

PEDMARK, SODIUM THIOSULFATE

PEG 3350 AND ELECTROLYTES, POLYETHYLENE GLYCOL 3350

PEG-3350, POTASSIUM CHLORIDE, SODIUM BICARBONATE, SODIUM CHLORIDE, POLYETHYLENE GLYCOL

PEG-3350, SODIUM SULFATE, SODIUM CHLORIDE, POTASSIUM CHLORIDE, SODIUM ASCORBATE AND

PEMAZYRE, PEMIGATINIB

PEMETREXED, PEMETREXED

PEMETREXED, PEMETREXED DISODIUM

PEMETREXED DISODIUM, PEMETREXED DISODIUM

PEMETREXED DITROMETHAMINE, PEMETREXED DITROMETHAMINE

PEMFEXY, PEMETREXED

PENCICLOVIR, PENCICLOVIR

PENICILLAMINE, PENICILLAMINE

PENICILLIN G POTASSIUM, PENICILLIN G POTASSIUM

PENICILLIN G POTASSIUM IN PLASTIC CONTAINER, PENICILLIN G POTASSIUM

PENICILLIN G PROCAINE, PENICILLIN G PROCAINE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 43

APPENDIX A - PRODUCT NAME INDEX

** P **

PENICILLIN G SODIUM, PENICILLIN G SODIUM

PENICILLIN V POTASSIUM, PENICILLIN V POTASSIUM

PENICILLIN-VK, PENICILLIN V POTASSIUM

PENNSAID, DICLOFENAC SODIUM

PENTAM, PENTAMIDINE ISETHIONATE

PENTAMIDINE ISETHIONATE, PENTAMIDINE ISETHIONATE

PENTASA, MESALAMINE

PENTOBARBITAL SODIUM, PENTOBARBITAL SODIUM

PENTOLAIR, CYCLOPENTOLATE HYDROCHLORIDE

PENTOSTATIN, PENTOSTATIN

PENTOXIFYLLINE, PENTOXIFYLLINE

PEPCID AC, FAMOTIDINE (OTC)

PEPCID COMPLETE, CALCIUM CARBONATE (OTC)

PERCOCET, ACETAMINOPHEN

PERCODAN, ASPIRIN

PERFOROMIST, FORMOTEROL FUMARATE

PERIDEX, CHLORHEXIDINE GLUCONATE

PERIKABIVEN IN PLASTIC CONTAINER, AMINO ACIDS

PERINDOPRIL ERBUMINE, PERINDOPRIL ERBUMINE

PERIOGARD, CHLORHEXIDINE GLUCONATE

PERMETHRIN, PERMETHRIN (OTC)

PERMETHRIN, PERMETHRIN

PERPHENAZINE, PERPHENAZINE

PERPHENAZINE AND AMITRIPTYLINE HYDROCHLORIDE, AMITRIPTYLINE HYDROCHLORIDE

PERSANTINE, DIPYRIDAMOLE

PERSERIS KIT, RISPERIDONE

PFIZERPEN, PENICILLIN G POTASSIUM

PHEBURANE, SODIUM PHENYLBUTYRATE

PHENDIMETRAZINE TARTRATE, PHENDIMETRAZINE TARTRATE

PHENELZINE SULFATE, PHENELZINE SULFATE

PHENOXYBENZAMINE HYDROCHLORIDE, PHENOXYBENZAMINE HYDROCHLORIDE

PHENTERMINE HYDROCHLORIDE, PHENTERMINE HYDROCHLORIDE

PHENTOLAMINE MESYLATE, PHENTOLAMINE MESYLATE

PHENYLEPHRINE HYDROCHLORIDE, PHENYLEPHRINE HYDROCHLORIDE

PHENYLEPHRINE HYDROCHLORIDE AND PROMETHAZINE HYDROCHLORIDE, PHENYLEPHRINE HYDROCHLORIDE

PHENYTEK, PHENYTOIN SODIUM

PHENYTOIN, PHENYTOIN

PHENYTOIN SODIUM, PHENYTOIN SODIUM

PHEXXI, CITRIC ACID

PHILITH, ETHINYL ESTRADIOL

PHOSLO GELCAPS, CALCIUM ACETATE

PHOSPHOLINE IODIDE, ECHOTHIOPHATE IODIDE

PHOTOFRIN, PORFIMER SODIUM

PHOTREXA, RIBOFLAVIN 5'-PHOSPHATE

PHOTREXA VISCOUS IN DEXTRAN 20%, RIBOFLAVIN 5'-PHOSPHATE

PHOXILLUM B22K 4/0 IN PLASTIC CONTAINER, CALCIUM CHLORIDE

PHOXILLUM BK 4/2.5 IN PLASTIC CONTAINER, CALCIUM CHLORIDE

PHYRAGO, DASATINIB

PHYSIOLYTE IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE

PHYSIOSOL IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE

PHYTONADIONE, PHYTONADIONE

PIFELTRO, DORAVIRINE

PILOCARPINE HYDROCHLORIDE, PILOCARPINE HYDROCHLORIDE

PIMECROLIMUS, PIMECROLIMUS

PIMOZIDE, PIMOZIDE

PIMTREA, DESOGESTREL

PINDOLOL, PINDOLOL

PIOGLITAZONE HYDROCHLORIDE, PIOGLITAZONE HYDROCHLORIDE

PIOGLITAZONE HYDROCHLORIDE AND GLIMEPIRIDE, GLIMEPIRIDE

PIOGLITAZONE HYDROCHLORIDE AND METFORMIN HYDROCHLORIDE, METFORMIN HYDROCHLORIDE

PIPERACILLIN, PIPERACILLIN SODIUM

PIPERACILLIN AND TAZOBACTAM, PIPERACILLIN SODIUM

PIQRAY, ALPELISIB

PIRFENIDONE, PIRFENIDONE

PIROXICAM, PIROXICAM
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 44

APPENDIX A - PRODUCT NAME INDEX

** P **

PITAVASTATIN CALCIUM, PITAVASTATIN CALCIUM

PITOCIN, OXYTOCIN

PLAN B ONE-STEP, LEVONORGESTREL (OTC)

PLAQUENIL, HYDROXYCHLOROQUINE SULFATE

PLASMA-LYTE 148 IN WATER IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE

PLASMA-LYTE A IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE

PLAVIX, CLOPIDOGREL BISULFATE

PLEGISOL IN PLASTIC CONTAINER, CALCIUM CHLORIDE

PLENVU, ASCORBIC ACID

PLERIXAFOR, PLERIXAFOR

PLUVICTO, LUTETIUM LU-177 VIPIVOTIDE TETRAXETAN

PODOFILOX, PODOFILOX

POKONZA, POTASSIUM CHLORIDE

POLMON, DEXCHLORPHENIRAMINE MALEATE

POLOCAINE, MEPIVACAINE HYDROCHLORIDE

POLOCAINE-MPF, MEPIVACAINE HYDROCHLORIDE

POLYETHYLENE GLYCOL 3350, POLYETHYLENE GLYCOL 3350 (OTC)

POLYETHYLENE GLYCOL 3350 AND ELECTROLYTES, POLYETHYLENE GLYCOL 3350

POLYMYXIN B SULFATE, POLYMYXIN B SULFATE

POMALYST, POMALIDOMIDE

PONSTEL, MEFENAMIC ACID

PONVORY, PONESIMOD

PORTIA-28, ETHINYL ESTRADIOL

POSACONAZOLE, POSACONAZOLE

POSIMIR, BUPIVACAINE

POSLUMA, FLOTUFOLASTAT F-18 GALLIUM

POTASSIUM ACETATE, POTASSIUM ACETATE

POTASSIUM CHLORIDE, POTASSIUM CHLORIDE

POTASSIUM CHLORIDE 0.037% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.037% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.037% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.075% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.075% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.075% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.075% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.11% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.11% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.11% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.11% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.149% IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM

POTASSIUM CHLORIDE 0.15% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.15% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.15% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.15% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 45

APPENDIX A - PRODUCT NAME INDEX

** P **

POTASSIUM CHLORIDE 0.15% IN SODIUM CHLORIDE 0.45%, POTASSIUM CHLORIDE

POTASSIUM CHLORIDE 0.15% IN SODIUM CHLORIDE 0.9%, POTASSIUM CHLORIDE

POTASSIUM CHLORIDE 0.15% IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE

POTASSIUM CHLORIDE 0.22% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.22% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.22% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.22% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.3% AND SODIUM CHLORIDE 0.9%, POTASSIUM CHLORIDE

POTASSIUM CHLORIDE 0.3% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.3% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.3% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.3% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 0.3% IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE

POTASSIUM CHLORIDE 10MEQ, POTASSIUM CHLORIDE

POTASSIUM CHLORIDE 10MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 10MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 10MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45%, DEXTROSE

POTASSIUM CHLORIDE 10MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 10MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 10MEQ IN PLASTIC CONTAINER, POTASSIUM CHLORIDE

POTASSIUM CHLORIDE 15MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 20MEQ, POTASSIUM CHLORIDE

POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45%, DEXTROSE

POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9%, DEXTROSE

POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE

POTASSIUM CHLORIDE 20MEQ IN PLASTIC CONTAINER, POTASSIUM CHLORIDE

POTASSIUM CHLORIDE 20MEQ IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE

POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45%, DEXTROSE

POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 30MEQ IN PLASTIC CONTAINER, POTASSIUM CHLORIDE

POTASSIUM CHLORIDE 40MEQ, POTASSIUM CHLORIDE

POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45%, DEXTROSE

POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9%, DEXTROSE

POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 40MEQ IN PLASTIC CONTAINER, POTASSIUM CHLORIDE

POTASSIUM CHLORIDE 40MEQ IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE

POTASSIUM CHLORIDE 5MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM

POTASSIUM CHLORIDE 5MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE 5MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER,

POTASSIUM CHLORIDE IN PLASTIC CONTAINER, POTASSIUM CHLORIDE

POTASSIUM CITRATE, POTASSIUM CITRATE

POTASSIUM IODIDE, POTASSIUM IODIDE (OTC)

POTASSIUM PHOSPHATES, POTASSIUM PHOSPHATE, DIBASIC

POVIDONE IODINE, POVIDONE-IODINE (OTC)

PRADAXA, DABIGATRAN ETEXILATE MESYLATE

PRAMIPEXOLE DIHYDROCHLORIDE, PRAMIPEXOLE DIHYDROCHLORIDE

PRAMOSONE, HYDROCORTISONE ACETATE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 46

APPENDIX A - PRODUCT NAME INDEX

** P **

PRASUGREL, PRASUGREL HYDROCHLORIDE

PRASUGREL HYDROCHLORIDE, PRASUGREL HYDROCHLORIDE

PRAVASTATIN SODIUM, PRAVASTATIN SODIUM

PRAZIQUANTEL, PRAZIQUANTEL

PRAZOSIN HYDROCHLORIDE, PRAZOSIN HYDROCHLORIDE

PRE-OP, HEXACHLOROPHENE

PRE-OP II, HEXACHLOROPHENE

PRECEDEX, DEXMEDETOMIDINE HYDROCHLORIDE

PRED FORTE, PREDNISOLONE ACETATE

PRED MILD, PREDNISOLONE ACETATE

PREDNICARBATE, PREDNICARBATE

PREDNISOLONE, PREDNISOLONE

PREDNISOLONE SODIUM PHOSPHATE, PREDNISOLONE SODIUM PHOSPHATE

PREDNISONE, PREDNISONE

PREDNISONE INTENSOL, PREDNISONE

PREGABALIN, PREGABALIN

PRELONE, PREDNISOLONE

PREMARIN, ESTROGENS, CONJUGATED

PREMASOL 10% IN PLASTIC CONTAINER, AMINO ACIDS

PREMASOL 6% IN PLASTIC CONTAINER, AMINO ACIDS

PREMPHASE 14/14, ESTROGENS, CONJUGATED

PREMPRO, ESTROGENS, CONJUGATED

PREPIDIL, DINOPROSTONE

PRESTALIA, AMLODIPINE BESYLATE

PRETOMANID, PRETOMANID

PREVACID, LANSOPRAZOLE

PREVACID 24 HR, LANSOPRAZOLE (OTC)

PREVALITE, CHOLESTYRAMINE

PREVANTICS MAXI SWABSTICK, CHLORHEXIDINE GLUCONATE (OTC)

PREVANTICS SWAB, CHLORHEXIDINE GLUCONATE (OTC)

PREVANTICS SWABSTICK, CHLORHEXIDINE GLUCONATE (OTC)

PREVDUO, GLYCOPYRROLATE

PREVIFEM, ETHINYL ESTRADIOL

PREVYMIS, LETERMOVIR

PREZCOBIX, COBICISTAT

PREZISTA, DARUNAVIR

PRIALT, ZICONOTIDE ACETATE

PRIFTIN, RIFAPENTINE

PRILOCAINE HYDROCHLORIDE, PRILOCAINE HYDROCHLORIDE

PRILOCAINE HYDROCHLORIDE AND EPINEPHRINE BITARTRATE, EPINEPHRINE BITARTRATE

PRILOSEC, OMEPRAZOLE MAGNESIUM

PRILOSEC OTC, OMEPRAZOLE MAGNESIUM (OTC)

PRIMAQUINE, PRIMAQUINE PHOSPHATE

PRIMAQUINE PHOSPHATE, PRIMAQUINE PHOSPHATE

PRIMATENE MIST, EPINEPHRINE (OTC)

PRIMAXIN, CILASTATIN SODIUM

PRIMIDONE, PRIMIDONE

PRISMASOL B22GK 4/0 IN PLASTIC CONTAINER, CALCIUM CHLORIDE

PRISMASOL BGK 0/2.5 IN PLASTIC CONTAINER, CALCIUM CHLORIDE

PRISMASOL BGK 2/0 IN PLASTIC CONTAINER, CALCIUM CHLORIDE

PRISMASOL BGK 2/3.5 IN PLASTIC CONTAINER, CALCIUM CHLORIDE

PRISMASOL BGK 4/0/1.2 IN PLASTIC CONTAINER, CALCIUM CHLORIDE

PRISMASOL BGK 4/2.5 IN PLASTIC CONTAINER, CALCIUM CHLORIDE

PRISMASOL BK 0/0/1.2 IN PLASTIC CONTAINER, CALCIUM CHLORIDE

PRISTIQ, DESVENLAFAXINE SUCCINATE

PROAIR DIGIHALER, ALBUTEROL SULFATE

PROAIR HFA, ALBUTEROL SULFATE

PROAIR RESPICLICK, ALBUTEROL SULFATE

PROBALAN, PROBENECID

PROBENECID, PROBENECID

PROBENECID AND COLCHICINE, COLCHICINE

PROCAINAMIDE HYDROCHLORIDE, PROCAINAMIDE HYDROCHLORIDE

PROCARDIA, NIFEDIPINE

PROCARDIA XL, NIFEDIPINE

PROCHLORPERAZINE, PROCHLORPERAZINE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 47

APPENDIX A - PRODUCT NAME INDEX

** P **

PROCHLORPERAZINE EDISYLATE, PROCHLORPERAZINE EDISYLATE

PROCHLORPERAZINE MALEATE, PROCHLORPERAZINE MALEATE

PROCOMP, PROCHLORPERAZINE MALEATE

PROCTOFOAM HC, HYDROCORTISONE ACETATE

PROCYSBI, CYSTEAMINE BITARTRATE

PROGESTERONE, PROGESTERONE

PROGLYCEM, DIAZOXIDE

PROGRAF, TACROLIMUS

PROHANCE, GADOTERIDOL

PROHANCE MULTIPACK, GADOTERIDOL

PROLENSA, BROMFENAC SODIUM

PROMACTA, ELTROMBOPAG OLAMINE

PROMACTA KIT, ELTROMBOPAG OLAMINE

PROMETH HYDROCHLORIDE,PHENYLEPHRINE HYDROCHLORIDE W/CODEINE PHOSPHATE, CODEINE PHOSPHATE

PROMETHAZINE DM, DEXTROMETHORPHAN HYDROBROMIDE

PROMETHAZINE HYDROCHLORIDE, PROMETHAZINE HYDROCHLORIDE

PROMETHAZINE HYDROCHLORIDE AND CODEINE PHOSPHATE, CODEINE PHOSPHATE

PROMETHAZINE HYDROCHLORIDE AND DEXTROMETHORPHAN HYDROBROMIDE, DEXTROMETHORPHAN

PROMETHAZINE HYDROCHLORIDE AND PHENYLEPHRINE HYDROCHLORIDE, PHENYLEPHRINE HYDROCHLORIDE

PROMETHAZINE HYDROCHLORIDE, PHENYLEPHRINE HYDROCHLORIDE W/CODEINE PHOSPHATE, CODEINE

PROMETHAZINE HYDROCHLORIDE,PHENYLEPHRINE HYDROCHLORIDE W/CODEINE PHOSPHATE, CODEINE

PROMETHAZINE PLAIN, PROMETHAZINE HYDROCHLORIDE

PROMETHAZINE W/ DEXTROMETHORPHAN, DEXTROMETHORPHAN HYDROBROMIDE

PROMETHAZINE WITH CODEINE, CODEINE PHOSPHATE

PROMETHEGAN, PROMETHAZINE HYDROCHLORIDE

PROMETRIUM, PROGESTERONE

PROPAFENONE HYDROCHLORIDE, PROPAFENONE HYDROCHLORIDE

PROPARACAINE HYDROCHLORIDE, PROPARACAINE HYDROCHLORIDE

PROPECIA, FINASTERIDE

PROPOFOL, PROPOFOL

PROPRANOLOL HYDROCHLORIDE, PROPRANOLOL HYDROCHLORIDE

PROPYLTHIOURACIL, PROPYLTHIOURACIL

PROSCAR, FINASTERIDE

PROSOL 20% SULFITE FREE IN PLASTIC CONTAINER, AMINO ACIDS

PROSTIN VR PEDIATRIC, ALPROSTADIL

PROTAMINE SULFATE, PROTAMINE SULFATE

PROTONIX, PANTOPRAZOLE SODIUM

PROTONIX IV, PANTOPRAZOLE SODIUM

PROTOPAM CHLORIDE, PRALIDOXIME CHLORIDE

PROTOPIC, TACROLIMUS

PROTRIPTYLINE HYDROCHLORIDE, PROTRIPTYLINE HYDROCHLORIDE

PROVAYBLUE, METHYLENE BLUE

PROVENTIL-HFA, ALBUTEROL SULFATE

PROVERA, MEDROXYPROGESTERONE ACETATE

PROVIGIL, MODAFINIL

PROVOCHOLINE, METHACHOLINE CHLORIDE

PROZAC, FLUOXETINE HYDROCHLORIDE

PSEUDOEPHEDRINE HYDROCHLORIDE, PSEUDOEPHEDRINE HYDROCHLORIDE (OTC)

PULMICORT FLEXHALER, BUDESONIDE

PULMICORT RESPULES, BUDESONIDE

PUR-WASH, PURIFIED WATER (OTC)

PURIFIED CORTROPHIN GEL, CORTICOTROPIN

PURINETHOL, MERCAPTOPURINE

PURIXAN, MERCAPTOPURINE

PYLARIFY, PIFLUFOLASTAT F-18

PYLERA, BISMUTH SUBCITRATE POTASSIUM

PYRAZINAMIDE, PYRAZINAMIDE

PYRIDOSTIGMINE BROMIDE, PYRIDOSTIGMINE BROMIDE

PYRIDOXINE HYDROCHLORIDE, PYRIDOXINE HYDROCHLORIDE

PYRIMETHAMINE, PYRIMETHAMINE

PYRUKYND, MITAPIVAT SULFATE

PYTEST, UREA, C-14

** Q **

QALSODY, TOFERSEN
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 48

APPENDIX A - PRODUCT NAME INDEX

** Q **

QBRELIS, LISINOPRIL

QBREXZA, GLYCOPYRRONIUM TOSYLATE

QDOLO, TRAMADOL HYDROCHLORIDE

QELBREE, VILOXAZINE HYDROCHLORIDE

QINLOCK, RIPRETINIB

QLOSI, PILOCARPINE HYDROCHLORIDE

QNASL, BECLOMETHASONE DIPROPIONATE

QOLIANA, BRIMONIDINE TARTRATE

QSYMIA, PHENTERMINE HYDROCHLORIDE

QTERN, DAPAGLIFLOZIN

QUALAQUIN, QUININE SULFATE

QUARTETTE, ETHINYL ESTRADIOL

QUASENSE, ETHINYL ESTRADIOL

QUDEXY XR, TOPIRAMATE

QUELICIN, SUCCINYLCHOLINE CHLORIDE

QUETIAPINE FUMARATE, QUETIAPINE FUMARATE

QUILLICHEW ER, METHYLPHENIDATE HYDROCHLORIDE

QUILLIVANT XR, METHYLPHENIDATE HYDROCHLORIDE

QUINAPRIL HYDROCHLORIDE, QUINAPRIL HYDROCHLORIDE

QUINAPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE

QUINIDINE GLUCONATE, QUINIDINE GLUCONATE

QUINIDINE SULFATE, QUINIDINE SULFATE

QUININE SULFATE, QUININE SULFATE

QULIPTA, ATOGEPANT

QUTENZA, CAPSAICIN

QUVIVIQ, DARIDOREXANT HYDROCHLORIDE

QUZYTTIR, CETIRIZINE HYDROCHLORIDE

QVAR REDIHALER, BECLOMETHASONE DIPROPIONATE

** R **

R-GENE 10, ARGININE HYDROCHLORIDE

RABEPRAZOLE SODIUM, RABEPRAZOLE SODIUM

RADICAVA, EDARAVONE

RADICAVA ORS, EDARAVONE

RADIOGARDASE (PRUSSIAN BLUE), FERRIC HEXACYANOFERRATE(II)

RALOXIFENE HYDROCHLORIDE, RALOXIFENE HYDROCHLORIDE

RAMELTEON, RAMELTEON

RAMIPRIL, RAMIPRIL

RANITIDINE HYDROCHLORIDE, RANITIDINE HYDROCHLORIDE (OTC)

RANITIDINE HYDROCHLORIDE, RANITIDINE HYDROCHLORIDE

RANOLAZINE, RANOLAZINE

RAPAFLO, SILODOSIN

RAPAMUNE, SIROLIMUS

RAPIVAB, PERAMIVIR

RASAGILINE MESYLATE, RASAGILINE MESYLATE

RASUVO, METHOTREXATE

RAVICTI, GLYCEROL PHENYLBUTYRATE

RAYALDEE, CALCIFEDIOL

RAYOS, PREDNISONE

READI-CAT 2, BARIUM SULFATE

READI-CAT 2 SMOOTHIE, BARIUM SULFATE

READYPREP CHG, CHLORHEXIDINE GLUCONATE (OTC)

RECARBRIO, CILASTATIN SODIUM

RECLAST, ZOLEDRONIC ACID

RECORLEV, LEVOKETOCONAZOLE

RECTIV, NITROGLYCERIN

REGADENOSON, REGADENOSON

REGLAN, METOCLOPRAMIDE HYDROCHLORIDE

REGONOL, PYRIDOSTIGMINE BROMIDE

RELENZA, ZANAMIVIR

RELEXXII, METHYLPHENIDATE HYDROCHLORIDE

RELISTOR, METHYLNALTREXONE BROMIDE

RELPAX, ELETRIPTAN HYDROBROMIDE

RELYVRIO, SODIUM PHENYLBUTYRATE

REMERON, MIRTAZAPINE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 49

APPENDIX A - PRODUCT NAME INDEX

** R **

REMERON SOLTAB, MIRTAZAPINE

REMIFENTANIL HYDROCHLORIDE, REMIFENTANIL HYDROCHLORIDE

REMODULIN, TREPROSTINIL

RENACIDIN, CITRIC ACID

RENAGEL, SEVELAMER HYDROCHLORIDE

RENOVA, TRETINOIN

RENVELA, SEVELAMER CARBONATE

REPAGLINIDE, REPAGLINIDE

RESTASIS, CYCLOSPORINE

RESTASIS MULTIDOSE, CYCLOSPORINE

RESTORIL, TEMAZEPAM

RETEVMO, SELPERCATINIB

RETIN-A, TRETINOIN

RETIN-A MICRO, TRETINOIN

RETIN-A-MICRO, TRETINOIN

RETISERT, FLUOCINOLONE ACETONIDE

RETROVIR, ZIDOVUDINE

REVATIO, SILDENAFIL CITRATE

REVLIMID, LENALIDOMIDE

REVONTO, DANTROLENE SODIUM

REXULTI, BREXPIPRAZOLE

REYATAZ, ATAZANAVIR SULFATE

REYVOW, LASMIDITAN SUCCINATE

REZIPRES, EPHEDRINE HYDROCHLORIDE

REZLIDHIA, OLUTASIDENIB

REZUROCK, BELUMOSUDIL MESYLATE

REZZAYO, REZAFUNGIN ACETATE

RHINOCORT ALLERGY, BUDESONIDE (OTC)

RHOFADE, OXYMETAZOLINE HYDROCHLORIDE

RHOPRESSA, NETARSUDIL MESYLATE

RIBAVIRIN, RIBAVIRIN

RIDAURA, AURANOFIN

RIFABUTIN, RIFABUTIN

RIFADIN, RIFAMPIN

RIFAMPIN, RIFAMPIN

RILUTEK, RILUZOLE

RILUZOLE, RILUZOLE

RIMACTANE, RIFAMPIN

RIMANTADINE HYDROCHLORIDE, RIMANTADINE HYDROCHLORIDE

RIMSO-50, DIMETHYL SULFOXIDE

RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE

RINVOQ, UPADACITINIB

RIOCIGUAT, RIOCIGUAT

RISEDRONATE SODIUM, RISEDRONATE SODIUM

RISPERDAL, RISPERIDONE

RISPERDAL CONSTA, RISPERIDONE

RISPERIDONE, RISPERIDONE

RITALIN, METHYLPHENIDATE HYDROCHLORIDE

RITALIN LA, METHYLPHENIDATE HYDROCHLORIDE

RITONAVIR, RITONAVIR

RIVASTIGMINE, RIVASTIGMINE

RIVASTIGMINE TARTRATE, RIVASTIGMINE TARTRATE

RIVFLOZA, NEDOSIRAN SODIUM

RIVIVE, NALOXONE HYDROCHLORIDE (OTC)

RIZAFILM, RIZATRIPTAN BENZOATE

RIZATRIPTAN BENZOATE, RIZATRIPTAN BENZOATE

ROBAXIN, METHOCARBAMOL

ROBINUL, GLYCOPYRROLATE

ROBINUL FORTE, GLYCOPYRROLATE

ROCALTROL, CALCITRIOL

ROCKLATAN, LATANOPROST

ROCURONIUM BROMIDE, ROCURONIUM BROMIDE

ROFLUMILAST, ROFLUMILAST

ROGAINE (FOR MEN), MINOXIDIL (OTC)

ROGAINE (FOR WOMEN), MINOXIDIL (OTC)
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 50

APPENDIX A - PRODUCT NAME INDEX

** R **

ROGAINE EXTRA STRENGTH (FOR MEN), MINOXIDIL (OTC)

ROMIDEPSIN, ROMIDEPSIN

ROPINIROLE HYDROCHLORIDE, ROPINIROLE HYDROCHLORIDE

ROPIVACAINE HYDROCHLORIDE, ROPIVACAINE HYDROCHLORIDE

ROSUVASTATIN CALCIUM, ROSUVASTATIN CALCIUM

ROWASA, MESALAMINE

ROXICODONE, OXYCODONE HYDROCHLORIDE

ROXYBOND, OXYCODONE HYDROCHLORIDE

ROZEREM, RAMELTEON

ROZLYTREK, ENTRECTINIB

RUBRACA, RUCAPARIB CAMSYLATE

RUBY-FILL, RUBIDIUM CHLORIDE RB-82

RUFINAMIDE, RUFINAMIDE

RUKOBIA, FOSTEMSAVIR TROMETHAMINE

RYALTRIS, MOMETASONE FUROATE

RYANODEX, DANTROLENE SODIUM

RYBELSUS, SEMAGLUTIDE

RYDAPT, MIDOSTAURIN

RYKINDO, RISPERIDONE

RYTARY, CARBIDOPA

RYZUMVI, PHENTOLAMINE MESYLATE

** S **

SABRIL, VIGABATRIN

SAFYRAL, DROSPIRENONE

SALAGEN, PILOCARPINE HYDROCHLORIDE

SALONPAS, MENTHOL (OTC)

SAMSCA, TOLVAPTAN

SANCUSO, GRANISETRON

SANDIMMUNE, CYCLOSPORINE

SANDOSTATIN, OCTREOTIDE ACETATE

SANDOSTATIN LAR, OCTREOTIDE ACETATE

SAPHRIS, ASENAPINE MALEATE

SAPROPTERIN DIHYDROCHLORIDE, SAPROPTERIN DIHYDROCHLORIDE

SAVAYSA, EDOXABAN TOSYLATE

SAVELLA, MILNACIPRAN HYDROCHLORIDE

SAXAGLIPTIN, SAXAGLIPTIN HYDROCHLORIDE

SAXAGLIPTIN AND METFORMIN HYDROCHLORIDE, METFORMIN HYDROCHLORIDE

SAXENDA, LIRAGLUTIDE RECOMBINANT

SCANDONEST PLAIN, MEPIVACAINE HYDROCHLORIDE

SCEMBLIX, ASCIMINIB HYDROCHLORIDE

SCENESSE, AFAMELANOTIDE

SCLEROSOL, TALC

SCOPOLAMINE, SCOPOLAMINE

SEASONALE, ETHINYL ESTRADIOL

SEASONIQUE, ETHINYL ESTRADIOL

SECUADO, ASENAPINE

SEGLENTIS, CELECOXIB

SEGLUROMET, ERTUGLIFLOZIN

SEIZALAM, MIDAZOLAM HYDROCHLORIDE

SELEGILINE HYDROCHLORIDE, SELEGILINE HYDROCHLORIDE

SELENIOUS ACID, SELENIOUS ACID

SELENIUM SULFIDE, SELENIUM SULFIDE

SELEXIPAG, SELEXIPAG

SELZENTRY, MARAVIROC

SENSIPAR, CINACALCET HYDROCHLORIDE

SENSORCAINE, BUPIVACAINE HYDROCHLORIDE

SEPTOCAINE, ARTICAINE HYDROCHLORIDE

SEPTRA, SULFAMETHOXAZOLE

SEPTRA DS, SULFAMETHOXAZOLE

SEREVENT, SALMETEROL XINAFOATE

SERNIVO, BETAMETHASONE DIPROPIONATE

SEROMYCIN, CYCLOSERINE

SEROQUEL, QUETIAPINE FUMARATE

SEROQUEL XR, QUETIAPINE FUMARATE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 51

APPENDIX A - PRODUCT NAME INDEX

** S **

SERTRALINE HYDROCHLORIDE, SERTRALINE HYDROCHLORIDE

SETLAKIN, ETHINYL ESTRADIOL

SEVELAMER CARBONATE, SEVELAMER CARBONATE

SEVELAMER HYDROCHLORIDE, SEVELAMER HYDROCHLORIDE

SEVOFLURANE, SEVOFLURANE

SEYSARA, SARECYCLINE HYDROCHLORIDE

SEZABY, PHENOBARBITAL SODIUM

SFROWASA, MESALAMINE

SIGNIFOR, PASIREOTIDE DIASPARTATE

SIGNIFOR LAR KIT, PASIREOTIDE PAMOATE

SIKLOS, HYDROXYUREA

SILDENAFIL CITRATE, SILDENAFIL CITRATE

SILENOR, DOXEPIN HYDROCHLORIDE

SILODOSIN, SILODOSIN

SILVADENE, SILVER SULFADIAZINE

SIMBRINZA, BRIMONIDINE TARTRATE

SIMLIYA, DESOGESTREL

SIMPESSE, ETHINYL ESTRADIOL

SIMVASTATIN, SIMVASTATIN

SINCALIDE, SINCALIDE

SINE-AID IB, IBUPROFEN (OTC)

SINEMET, CARBIDOPA

SINGULAIR, MONTELUKAST SODIUM

SINUVA, MOMETASONE FUROATE

SIROLIMUS, SIROLIMUS

SIRTURO, BEDAQUILINE FUMARATE

SITAVIG, ACYCLOVIR

SIVEXTRO, TEDIZOLID PHOSPHATE

SKLICE, IVERMECTIN (OTC)

SKYCLARYS, OMAVELOXOLONE

SKYLA, LEVONORGESTREL

SLYND, DROSPIRENONE

SMOFLIPID 20%, FISH OIL

SOAANZ, TORSEMIDE

SODIUM ACETATE, SODIUM ACETATE

SODIUM BICARBONATE, SODIUM BICARBONATE

SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, SODIUM CHLORIDE

SODIUM CHLORIDE 0.9%, SODIUM CHLORIDE

SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, SODIUM CHLORIDE

SODIUM CHLORIDE 0.9% IN STERILE PLASTIC CONTAINER, SODIUM CHLORIDE

SODIUM CHLORIDE 14.6%, SODIUM CHLORIDE

SODIUM CHLORIDE 23.4%, SODIUM CHLORIDE

SODIUM CHLORIDE 3% IN PLASTIC CONTAINER, SODIUM CHLORIDE

SODIUM CHLORIDE 5% IN PLASTIC CONTAINER, SODIUM CHLORIDE

SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE, FERRIC OXYHYDROXIDE

SODIUM FLUORIDE F-18, SODIUM FLUORIDE F-18

SODIUM IODIDE I 123, SODIUM IODIDE I-123

SODIUM IODIDE I 131, SODIUM IODIDE I-131

SODIUM NITRITE, SODIUM NITRITE

SODIUM NITROPRUSSIDE, SODIUM NITROPRUSSIDE

SODIUM PHENYLACETATE AND SODIUM BENZOATE, SODIUM BENZOATE

SODIUM PHENYLBUTYRATE, SODIUM PHENYLBUTYRATE

SODIUM PHOSPHATES, SODIUM PHOSPHATE, DIBASIC, HEPTAHYDRATE

SODIUM PHOSPHATES IN PLASTIC CONTAINER, SODIUM PHOSPHATE, DIBASIC, HEPTAHYDRATE

SODIUM PICOSULFATE, MAGNESIUM OXIDE AND ANHYDROUS CITRIC ACID, CITRIC ACID

SODIUM POLYSTYRENE SULFONATE, SODIUM POLYSTYRENE SULFONATE

SODIUM SULFATE, POTASSIUM SULFATE AND MAGNESIUM SULFATE, MAGNESIUM SULFATE

SODIUM TETRADECYL SULFATE, SODIUM TETRADECYL SULFATE

SODIUM THIOSULFATE, SODIUM THIOSULFATE

SOHONOS, PALOVAROTENE

SOJOURN, SEVOFLURANE

SOLIFENACIN SUCCINATE, SOLIFENACIN SUCCINATE

SOLODYN, MINOCYCLINE HYDROCHLORIDE

SOLOSEC, SECNIDAZOLE

SOLTAMOX, TAMOXIFEN CITRATE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 52

APPENDIX A - PRODUCT NAME INDEX

** S **

SOLU-CORTEF, HYDROCORTISONE SODIUM SUCCINATE

SOLU-MEDROL, METHYLPREDNISOLONE SODIUM SUCCINATE

SOLUPREP S, CHLORHEXIDINE GLUCONATE (OTC)

SOMA, CARISOPRODOL

SOMATULINE DEPOT, LANREOTIDE ACETATE

SONATA, ZALEPLON

SOOLANTRA, IVERMECTIN

SORAFENIB TOSYLATE, SORAFENIB TOSYLATE

SORBITOL 3% IN PLASTIC CONTAINER, SORBITOL

SORBITOL 3.3% IN PLASTIC CONTAINER, SORBITOL

SORBITOL-MANNITOL IN PLASTIC CONTAINER, MANNITOL

SORILUX, CALCIPOTRIENE

SORINE, SOTALOL HYDROCHLORIDE

SOTALOL HYDROCHLORIDE, SOTALOL HYDROCHLORIDE

SOTRADECOL, SODIUM TETRADECYL SULFATE

SOTYKTU, DEUCRAVACITINIB

SOTYLIZE, SOTALOL HYDROCHLORIDE

SOVALDI, SOFOSBUVIR

SOVUNA, HYDROXYCHLOROQUINE SULFATE

SPINRAZA, NUSINERSEN SODIUM

SPIRIVA, TIOTROPIUM BROMIDE

SPIRIVA RESPIMAT, TIOTROPIUM BROMIDE

SPIRONOLACTONE, SPIRONOLACTONE

SPIRONOLACTONE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE

SPORANOX, ITRACONAZOLE

SPRAVATO, ESKETAMINE HYDROCHLORIDE

SPRINTEC, ETHINYL ESTRADIOL

SPRITAM, LEVETIRACETAM

SPRIX, KETOROLAC TROMETHAMINE

SPRYCEL, DASATINIB

SPS, SODIUM POLYSTYRENE SULFONATE

SPY AGENT GREEN KIT, INDOCYANINE GREEN

SSD, SILVER SULFADIAZINE

STALEVO 100, CARBIDOPA

STALEVO 125, CARBIDOPA

STALEVO 150, CARBIDOPA

STALEVO 200, CARBIDOPA

STALEVO 50, CARBIDOPA

STALEVO 75, CARBIDOPA

STEGLATRO, ERTUGLIFLOZIN

STEGLUJAN, ERTUGLIFLOZIN

STENDRA, AVANAFIL

STERILE WATER, STERILE WATER FOR IRRIGATION

STERILE WATER FOR INJECTION, STERILE WATER FOR INJECTION

STERILE WATER FOR INJECTION IN PLASTIC CONTAINER, STERILE WATER FOR INJECTION

STERILE WATER IN PLASTIC CONTAINER, STERILE WATER FOR IRRIGATION

STERITALC, TALC

STIE-CORT, HYDROCORTISONE

STIOLTO RESPIMAT, OLODATEROL HYDROCHLORIDE

STIVARGA, REGORAFENIB

STRATTERA, ATOMOXETINE HYDROCHLORIDE

STREPTOMYCIN SULFATE, STREPTOMYCIN SULFATE

STRIBILD, COBICISTAT

STRIVERDI RESPIMAT, OLODATEROL HYDROCHLORIDE

STROMECTOL, IVERMECTIN

STRONTIUM CHLORIDE SR-89, STRONTIUM CHLORIDE SR-89

SUBLIMAZE PRESERVATIVE FREE, FENTANYL CITRATE

SUBLOCADE, BUPRENORPHINE

SUBOXONE, BUPRENORPHINE HYDROCHLORIDE

SUCCINYLCHOLINE CHLORIDE, SUCCINYLCHOLINE CHLORIDE

SUCRALFATE, SUCRALFATE

SUDAFED 24 HOUR, PSEUDOEPHEDRINE HYDROCHLORIDE (OTC)

SUFENTA PRESERVATIVE FREE, SUFENTANIL CITRATE

SUFENTANIL CITRATE, SUFENTANIL CITRATE

SUFLAVE, MAGNESIUM SULFATE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 53

APPENDIX A - PRODUCT NAME INDEX

** S **

SUGAMMADEX SODIUM, SUGAMMADEX SODIUM

SULAR, NISOLDIPINE

SULFACETAMIDE SODIUM, SULFACETAMIDE SODIUM

SULFACETAMIDE SODIUM AND PREDNISOLONE SODIUM PHOSPHATE, PREDNISOLONE SODIUM PHOSPHATE

SULFADIAZINE, SULFADIAZINE

SULFAMETHOXAZOLE AND TRIMETHOPRIM, SULFAMETHOXAZOLE

SULFAMYLON, MAFENIDE ACETATE

SULFASALAZINE, SULFASALAZINE

SULFATRIM PEDIATRIC, SULFAMETHOXAZOLE

SULINDAC, SULINDAC

SUMATRIPTAN, SUMATRIPTAN

SUMATRIPTAN AND NAPROXEN SODIUM, NAPROXEN SODIUM

SUMATRIPTAN SUCCINATE, SUMATRIPTAN SUCCINATE

SUNITINIB MALATE, SUNITINIB MALATE

SUNLENCA, LENACAPAVIR SODIUM

SUNOSI, SOLRIAMFETOL HYDROCHLORIDE

SUPPRELIN LA, HISTRELIN ACETATE

SUPRANE, DESFLURANE

SUPRAX, CEFIXIME

SUPREP BOWEL PREP KIT, MAGNESIUM SULFATE

SUSTOL, GRANISETRON

SUTAB, MAGNESIUM SULFATE

SUTENT, SUNITINIB MALATE

SYEDA, DROSPIRENONE

SYFOVRE, PEGCETACOPLAN

SYMBICORT, BUDESONIDE

SYMBICORT AEROSPHERE, BUDESONIDE

SYMBYAX, FLUOXETINE HYDROCHLORIDE

SYMDEKO (COPACKAGED), IVACAFTOR

SYMFI, EFAVIRENZ

SYMFI LO, EFAVIRENZ

SYMJEPI, EPINEPHRINE

SYMLIN, PRAMLINTIDE ACETATE

SYMPAZAN, CLOBAZAM

SYMPROIC, NALDEMEDINE TOSYLATE

SYMTUZA, COBICISTAT

SYNALAR, FLUOCINOLONE ACETONIDE

SYNAREL, NAFARELIN ACETATE

SYNDROS, DRONABINOL

SYNERCID, DALFOPRISTIN

SYNJARDY, EMPAGLIFLOZIN

SYNJARDY XR, EMPAGLIFLOZIN

SYNRIBO, OMACETAXINE MEPESUCCINATE

SYNTHROID, LEVOTHYROXINE SODIUM **

SYPRINE, TRIENTINE HYDROCHLORIDE

** T **

TABRECTA, CAPMATINIB HYDROCHLORIDE

TACLONEX, BETAMETHASONE DIPROPIONATE

TACROLIMUS, TACROLIMUS

TADALAFIL, TADALAFIL

TADLIQ, TADALAFIL

TAFINLAR, DABRAFENIB MESYLATE

TAFLUPROST, TAFLUPROST

TAGAMET HB, CIMETIDINE (OTC)

TAGITOL V, BARIUM SULFATE

TAGRISSO, OSIMERTINIB MESYLATE

TALC, TALC

TALICIA, AMOXICILLIN

TALZENNA, TALAZOPARIB TOSYLATE

TAMIFLU, OSELTAMIVIR PHOSPHATE

TAMOXIFEN CITRATE, TAMOXIFEN CITRATE

TAMSULOSIN HYDROCHLORIDE, TAMSULOSIN HYDROCHLORIDE

TARGRETIN, BEXAROTENE

TARPEYO, BUDESONIDE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 54

APPENDIX A - PRODUCT NAME INDEX

** T **

TASCENSO ODT, FINGOLIMOD LAURYL SULFATE

TASIGNA, NILOTINIB HYDROCHLORIDE

TASIMELTEON, TASIMELTEON

TASMAR, TOLCAPONE

TAUVID, FLORTAUCIPIR F-18

TAVABOROLE, TAVABOROLE

TAVALISSE, FOSTAMATINIB DISODIUM

TAVNEOS, AVACOPAN

TAXOTERE, DOCETAXEL

TAYTULLA, ETHINYL ESTRADIOL

TAZAROTENE, TAZAROTENE

TAZICEF, CEFTAZIDIME

TAZORAC, TAZAROTENE

TAZTIA XT, DILTIAZEM HYDROCHLORIDE

TAZVERIK, TAZEMETOSTAT HYDROBROMIDE

TECFIDERA, DIMETHYL FUMARATE

TECHNEGAS KIT, TECHNETIUM TC-99M LABELED CARBON

TECHNELITE, TECHNETIUM TC-99M SODIUM PERTECHNETATE GENERATOR

TECHNESCAN, TECHNETIUM TC-99M OXIDRONATE KIT

TECHNESCAN MAG3, TECHNETIUM TC-99M MERTIATIDE KIT

TECHNESCAN PYP KIT, TECHNETIUM TC-99M PYROPHOSPHATE KIT

TECHNETIUM TC 99M MERTIATIDE KIT, TECHNETIUM TC-99M MERTIATIDE KIT

TECHNETIUM TC 99M SESTAMIBI, TECHNETIUM TC-99M SESTAMIBI KIT

TECHNETIUM TC-99M MEBROFENIN, TECHNETIUM TC-99M MEBROFENIN KIT

TECHNETIUM TC-99M MEDRONATE KIT, TECHNETIUM TC-99M MEDRONATE KIT

TECHNETIUM TC-99M SULFUR COLLOID KIT, TECHNETIUM TC-99M SULFUR COLLOID KIT

TECHNETIUM TC99M MERTIATIDE KIT, TECHNETIUM TC-99M MERTIATIDE KIT

TEFLARO, CEFTAROLINE FOSAMIL

TEGRETOL, CARBAMAZEPINE

TEGRETOL-XR, CARBAMAZEPINE

TEGSEDI, INOTERSEN SODIUM

TEKTURNA, ALISKIREN HEMIFUMARATE

TELMISARTAN, TELMISARTAN

TELMISARTAN AND AMLODIPINE, AMLODIPINE BESYLATE

TELMISARTAN AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE

TEMAZEPAM, TEMAZEPAM

TEMBEXA, BRINCIDOFOVIR

TEMODAR, TEMOZOLOMIDE

TEMOZOLOMIDE, TEMOZOLOMIDE

TEMSIROLIMUS, TEMSIROLIMUS

TENOFOVIR ALAFENAMIDE, TENOFOVIR ALAFENAMIDE FUMARATE

TENOFOVIR DISOPROXIL FUMARATE, TENOFOVIR DISOPROXIL FUMARATE

TENORETIC 100, ATENOLOL

TENORETIC 50, ATENOLOL

TENORMIN, ATENOLOL

TEPADINA, THIOTEPA

TEPMETKO, TEPOTINIB HYDROCHLORIDE

TERAZOSIN HYDROCHLORIDE, TERAZOSIN HYDROCHLORIDE

TERBINAFINE HYDROCHLORIDE, TERBINAFINE HYDROCHLORIDE (OTC)

TERBINAFINE HYDROCHLORIDE, TERBINAFINE HYDROCHLORIDE

TERBUTALINE SULFATE, TERBUTALINE SULFATE

TERCONAZOLE, TERCONAZOLE

TERIFLUNOMIDE, TERIFLUNOMIDE

TERIL, CARBAMAZEPINE

TERIPARATIDE, TERIPARATIDE

TERLIVAZ, TERLIPRESSIN ACETATE

TESSALON, BENZONATATE

TESTIM, TESTOSTERONE

TESTOPEL, TESTOSTERONE

TESTOSTERONE, TESTOSTERONE

TESTOSTERONE CYPIONATE, TESTOSTERONE CYPIONATE

TESTOSTERONE ENANTHATE, TESTOSTERONE ENANTHATE

TETRABENAZINE, TETRABENAZINE

TETRACAINE HYDROCHLORIDE, TETRACAINE HYDROCHLORIDE

TETRACYCLINE HYDROCHLORIDE, TETRACYCLINE HYDROCHLORIDE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 55

APPENDIX A - PRODUCT NAME INDEX

** T **

TEXACORT, HYDROCORTISONE

THALITONE, CHLORTHALIDONE

THALLOUS CHLORIDE TL 201, THALLOUS CHLORIDE TL-201

THALOMID, THALIDOMIDE

THAM, TROMETHAMINE

THEO-24, THEOPHYLLINE

THEOCHRON, THEOPHYLLINE

THEOPHYLLINE, THEOPHYLLINE

THERMAZENE, SILVER SULFADIAZINE

THEROXIDIL, MINOXIDIL (OTC)

THIAMINE HYDROCHLORIDE, THIAMINE HYDROCHLORIDE

THIOGUANINE, THIOGUANINE

THIOLA, TIOPRONIN

THIOLA EC, TIOPRONIN

THIORIDAZINE HYDROCHLORIDE, THIORIDAZINE HYDROCHLORIDE

THIOTEPA, THIOTEPA

THIOTHIXENE, THIOTHIXENE

THYQUIDITY, LEVOTHYROXINE SODIUM

THYRO-TABS, LEVOTHYROXINE SODIUM **

THYROSAFE, POTASSIUM IODIDE (OTC)

TIAGABINE HYDROCHLORIDE, TIAGABINE HYDROCHLORIDE

TIAZAC, DILTIAZEM HYDROCHLORIDE

TIBSOVO, IVOSIDENIB

TICAGRELOR, TICAGRELOR

TICLOPIDINE HYDROCHLORIDE, TICLOPIDINE HYDROCHLORIDE

TIGAN, TRIMETHOBENZAMIDE HYDROCHLORIDE

TIGECYCLINE, TIGECYCLINE

TIGLUTIK KIT, RILUZOLE

TIKOSYN, DOFETILIDE

TIMOLOL MALEATE, TIMOLOL MALEATE

TIMOPTIC, TIMOLOL MALEATE

TIMOPTIC IN OCUDOSE, TIMOLOL MALEATE

TIMOPTIC-XE, TIMOLOL MALEATE

TINDAMAX, TINIDAZOLE

TINIDAZOLE, TINIDAZOLE

TIOCONAZOLE, TIOCONAZOLE (OTC)

TIOPRONIN, TIOPRONIN

TIOTROPIUM BROMIDE, TIOTROPIUM BROMIDE

TIPIRACIL HYDROCHLORIDE AND TRIFLURIDINE, TIPIRACIL HYDROCHLORIDE

TIROFIBAN HYDROCHLORIDE, TIROFIBAN HYDROCHLORIDE

TIROSINT, LEVOTHYROXINE SODIUM

TIROSINT-SOL, LEVOTHYROXINE SODIUM

TIS-U-SOL, MAGNESIUM SULFATE

TIS-U-SOL IN PLASTIC CONTAINER, MAGNESIUM SULFATE

TISSUEBLUE, BRILLIANT BLUE G

TIVICAY, DOLUTEGRAVIR SODIUM

TIVICAY PD, DOLUTEGRAVIR SODIUM

TIZANIDINE HYDROCHLORIDE, TIZANIDINE HYDROCHLORIDE

TLANDO, TESTOSTERONE UNDECANOATE

TOBI, TOBRAMYCIN

TOBI PODHALER, TOBRAMYCIN

TOBRADEX, DEXAMETHASONE

TOBRADEX ST, DEXAMETHASONE

TOBRAMYCIN, TOBRAMYCIN

TOBRAMYCIN AND DEXAMETHASONE, DEXAMETHASONE

TOBRAMYCIN SULFATE, TOBRAMYCIN SULFATE

TOBRAMYCIN SULFATE (PHARMACY BULK), TOBRAMYCIN SULFATE

TOBREX, TOBRAMYCIN

TOFACITINIB CITRATE, TOFACITINIB CITRATE

TOFRANIL, IMIPRAMINE HYDROCHLORIDE

TOLAK, FLUOROURACIL

TOLCAPONE, TOLCAPONE

TOLMETIN SODIUM, TOLMETIN SODIUM

TOLSURA, ITRACONAZOLE

TOLTERODINE TARTRATE, TOLTERODINE TARTRATE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 56

APPENDIX A - PRODUCT NAME INDEX

** T **

TOLVAPTAN, TOLVAPTAN

TOPAMAX, TOPIRAMATE

TOPICORT, DESOXIMETASONE

TOPIRAMATE, TOPIRAMATE

TOPOTECAN HYDROCHLORIDE, TOPOTECAN HYDROCHLORIDE

TOPROL-XL, METOPROLOL SUCCINATE

TOREMIFENE CITRATE, TOREMIFENE CITRATE

TORISEL, TEMSIROLIMUS

TORSEMIDE, TORSEMIDE

TOSYMRA, SUMATRIPTAN

TOVIAZ, FESOTERODINE FUMARATE

TPN ELECTROLYTES IN PLASTIC CONTAINER, CALCIUM CHLORIDE

TPOXX, TECOVIRIMAT

TRACLEER, BOSENTAN

TRADJENTA, LINAGLIPTIN

TRALEMENT, CUPRIC SULFATE

TRAMADOL HYDROCHLORIDE, TRAMADOL HYDROCHLORIDE

TRAMADOL HYDROCHLORIDE AND ACETAMINOPHEN, ACETAMINOPHEN

TRANDOLAPRIL, TRANDOLAPRIL

TRANDOLAPRIL AND VERAPAMIL HYDROCHLORIDE, TRANDOLAPRIL

TRANEXAMIC ACID, TRANEXAMIC ACID

TRANSDERM SCOP, SCOPOLAMINE

TRANXENE, CLORAZEPATE DIPOTASSIUM

TRANYLCYPROMINE SULFATE, TRANYLCYPROMINE SULFATE

TRAVASOL 10% IN PLASTIC CONTAINER, AMINO ACIDS

TRAVASOL 5.5% IN PLASTIC CONTAINER, AMINO ACIDS

TRAVASOL 8.5% IN PLASTIC CONTAINER, AMINO ACIDS

TRAVATAN Z, TRAVOPROST

TRAVOPROST, TRAVOPROST

TRAZODONE HYDROCHLORIDE, TRAZODONE HYDROCHLORIDE

TREANDA, BENDAMUSTINE HYDROCHLORIDE

TRECATOR, ETHIONAMIDE

TRELEGY ELLIPTA, FLUTICASONE FUROATE

TRELSTAR, TRIPTORELIN PAMOATE

TREPROSTINIL, TREPROSTINIL

TRETINOIN, TRETINOIN

TRETINOIN MICROSPHERE, TRETINOIN

TREXALL, METHOTREXATE SODIUM

TREXIMET, NAPROXEN SODIUM

TREZIX, ACETAMINOPHEN

TRI LO SPRINTEC, ETHINYL ESTRADIOL

TRI-ESTARYLLA, ETHINYL ESTRADIOL

TRI-LEGEST FE, ETHINYL ESTRADIOL

TRI-LINYAH, ETHINYL ESTRADIOL

TRI-LO-ESTARYLLA, ETHINYL ESTRADIOL

TRI-LO-LINYAH, ETHINYL ESTRADIOL

TRI-LO-MILI, ETHINYL ESTRADIOL

TRI-LUMA, FLUOCINOLONE ACETONIDE

TRI-MILI, ETHINYL ESTRADIOL

TRI-NORINYL 28-DAY, ETHINYL ESTRADIOL

TRI-SPRINTEC, ETHINYL ESTRADIOL

TRIACIN-C, CODEINE PHOSPHATE

TRIAMCINOLONE ACETONIDE, TRIAMCINOLONE ACETONIDE (OTC)

TRIAMCINOLONE ACETONIDE, TRIAMCINOLONE ACETONIDE

TRIAMTERENE, TRIAMTERENE

TRIAMTERENE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE

TRIAZOLAM, TRIAZOLAM

TRIBENZOR, AMLODIPINE BESYLATE

TRICOR, FENOFIBRATE

TRIDERM, TRIAMCINOLONE ACETONIDE

TRIENTINE HYDROCHLORIDE, TRIENTINE HYDROCHLORIDE

TRIESENCE, TRIAMCINOLONE ACETONIDE

TRIFLUOPERAZINE HYDROCHLORIDE, TRIFLUOPERAZINE HYDROCHLORIDE

TRIFLURIDINE, TRIFLURIDINE

TRIGLIDE, FENOFIBRATE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 57

APPENDIX A - PRODUCT NAME INDEX

** T **

TRIHEXYPHENIDYL HYDROCHLORIDE, TRIHEXYPHENIDYL HYDROCHLORIDE

TRIJARDY XR, EMPAGLIFLOZIN

TRIKAFTA (COPACKAGED), ELEXACAFTOR, IVACAFTOR, TEZACAFTOR

TRILEPTAL, OXCARBAZEPINE

TRILIPIX, CHOLINE FENOFIBRATE

TRIMETHOBENZAMIDE HYDROCHLORIDE, TRIMETHOBENZAMIDE HYDROCHLORIDE

TRIMETHOPRIM, TRIMETHOPRIM

TRIMETHOPRIM SULFATE AND POLYMYXIN B SULFATE, POLYMYXIN B SULFATE

TRIMIPRAMINE MALEATE, TRIMIPRAMINE MALEATE

TRINTELLIX, VORTIOXETINE HYDROBROMIDE

TRIPTODUR KIT, TRIPTORELIN PAMOATE

TRISENOX, ARSENIC TRIOXIDE

TRIUMEQ, ABACAVIR SULFATE

TRIUMEQ PD, ABACAVIR SULFATE

TRIVAGIZOLE 3, CLOTRIMAZOLE (OTC)

TRIVORA-28, ETHINYL ESTRADIOL

TROKENDI XR, TOPIRAMATE

TROPHAMINE, AMINO ACIDS

TROPHAMINE 10%, AMINO ACIDS

TROPICACYL, TROPICAMIDE

TROPICAMIDE, TROPICAMIDE

TROSPIUM CHLORIDE, TROSPIUM CHLORIDE

TRUDHESA, DIHYDROERGOTAMINE MESYLATE

TRULANCE, PLECANATIDE

TRUQAP, CAPIVASERTIB

TRUVADA, EMTRICITABINE

TUDORZA PRESSAIR, ACLIDINIUM BROMIDE

TUKYSA, TUCATINIB

TURALIO, PEXIDARTINIB HYDROCHLORIDE

TURQOZ, ETHINYL ESTRADIOL

TUXARIN ER, CHLORPHENIRAMINE MALEATE

TWIRLA, ETHINYL ESTRADIOL

TWYNEO, BENZOYL PEROXIDE

TYBLUME, ETHINYL ESTRADIOL

TYBOST, COBICISTAT

TYDEMY, DROSPIRENONE

TYGACIL, TIGECYCLINE

TYKERB, LAPATINIB DITOSYLATE

TYLENOL, ACETAMINOPHEN (OTC)

TYMLOS, ABALOPARATIDE

TYRVAYA, VARENICLINE TARTRATE

TYVASO, TREPROSTINIL

TYVASO DPI, TREPROSTINIL

TYZINE, TETRAHYDROZOLINE HYDROCHLORIDE

** U **

UBRELVY, UBROGEPANT

UCERIS, BUDESONIDE

ULORIC, FEBUXOSTAT

ULSPIRA, NITRIC OXIDE

ULTANE, SEVOFLURANE

ULTIVA, REMIFENTANIL HYDROCHLORIDE

ULTRA-TECHNEKOW FM, TECHNETIUM TC-99M SODIUM PERTECHNETATE GENERATOR

ULTRATAG, TECHNETIUM TC-99M RED BLOOD CELL KIT

ULTRAVATE, HALOBETASOL PROPIONATE

ULTRAVIST (PHARMACY BULK), IOPROMIDE

ULTRAVIST 300, IOPROMIDE

ULTRAVIST 370, IOPROMIDE

UNASYN, AMPICILLIN SODIUM

UNISOM, DOXYLAMINE SUCCINATE (OTC)

UNITHROID, LEVOTHYROXINE SODIUM **

UPNEEQ, OXYMETAZOLINE HYDROCHLORIDE

UPTRAVI, SELEXIPAG

UREX, METHENAMINE HIPPURATE

UROCIT-K, POTASSIUM CITRATE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 58

APPENDIX A - PRODUCT NAME INDEX

** U **

UROXATRAL, ALFUZOSIN HYDROCHLORIDE

URSO 250, URSODIOL

URSO FORTE, URSODIOL

URSODIOL, URSODIOL

UVADEX, METHOXSALEN

UZEDY, RISPERIDONE

** V **

VABOMERE, MEROPENEM

VAGIFEM, ESTRADIOL

VAGISTAT-1, TIOCONAZOLE (OTC)

VALACYCLOVIR HYDROCHLORIDE, VALACYCLOVIR HYDROCHLORIDE

VALCHLOR, MECHLORETHAMINE HYDROCHLORIDE

VALCYTE, VALGANCICLOVIR HYDROCHLORIDE

VALGANCICLOVIR HYDROCHLORIDE, VALGANCICLOVIR HYDROCHLORIDE

VALIUM, DIAZEPAM

VALNAC, BETAMETHASONE VALERATE

VALPROATE SODIUM, VALPROATE SODIUM

VALPROIC ACID, VALPROIC ACID

VALRUBICIN, VALRUBICIN

VALSARTAN, VALSARTAN

VALSARTAN AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE

VALSTAR PRESERVATIVE FREE, VALRUBICIN

VALTOCO, DIAZEPAM

VALTREX, VALACYCLOVIR HYDROCHLORIDE

VANCOCIN HYDROCHLORIDE, VANCOMYCIN HYDROCHLORIDE

VANCOCIN HYDROCHLORIDE IN PLASTIC CONTAINER, VANCOMYCIN HYDROCHLORIDE

VANCOMYCIN HYDROCHLORIDE, VANCOMYCIN HYDROCHLORIDE

VANCOMYCIN HYDROCHLORIDE IN PLASTIC CONTAINER, VANCOMYCIN HYDROCHLORIDE

VANDAZOLE, METRONIDAZOLE

VANFLYTA, QUIZARTINIB DIHYDROCHLORIDE

VANOS, FLUOCINONIDE

VAPRISOL IN 5% DEXTROSE IN PLASTIC CONTAINER, CONIVAPTAN HYDROCHLORIDE

VARDENAFIL HYDROCHLORIDE, VARDENAFIL HYDROCHLORIDE

VARENICLINE TARTRATE, VARENICLINE TARTRATE

VARIBAR HONEY, BARIUM SULFATE

VARIBAR NECTAR, BARIUM SULFATE

VARIBAR PUDDING, BARIUM SULFATE

VARIBAR THIN HONEY, BARIUM SULFATE

VARIBAR THIN LIQUID, BARIUM SULFATE

VARITHENA, POLIDOCANOL

VARUBI, ROLAPITANT HYDROCHLORIDE

VASCEPA, ICOSAPENT ETHYL

VASERETIC, ENALAPRIL MALEATE

VASOPRESSIN, VASOPRESSIN

VASOPRESSIN IN SODIUM CHLORIDE 0.9%, VASOPRESSIN

VASOSTRICT, VASOPRESSIN

VASOTEC, ENALAPRIL MALEATE

VAZALORE, ASPIRIN (OTC)

VAZCULEP, PHENYLEPHRINE HYDROCHLORIDE

VECTICAL, CALCITRIOL

VECURONIUM BROMIDE, VECURONIUM BROMIDE

VEKLURY, REMDESIVIR

VELCADE, BORTEZOMIB

VELETRI, EPOPROSTENOL SODIUM

VELIVET, DESOGESTREL

VELPHORO, FERRIC OXYHYDROXIDE

VELSIPITY, ETRASIMOD ARGININE

VELTASSA, PATIROMER SORBITEX CALCIUM

VELTIN, CLINDAMYCIN PHOSPHATE

VEMLIDY, TENOFOVIR ALAFENAMIDE FUMARATE

VENCLEXTA, VENETOCLAX

VENLAFAXINE BESYLATE, VENLAFAXINE BESYLATE

VENLAFAXINE HYDROCHLORIDE, VENLAFAXINE HYDROCHLORIDE

VENOFER, FERRIC OXYHYDROXIDE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 59

APPENDIX A - PRODUCT NAME INDEX

** V **

VENTAVIS, ILOPROST

VENTOLIN HFA, ALBUTEROL SULFATE

VEOZAH, FEZOLINETANT

VERAPAMIL HYDROCHLORIDE, VERAPAMIL HYDROCHLORIDE

VEREGEN, SINECATECHINS

VERELAN, VERAPAMIL HYDROCHLORIDE

VERELAN PM, VERAPAMIL HYDROCHLORIDE

VERKAZIA, CYCLOSPORINE

VERQUVO, VERICIGUAT

VERSACLOZ, CLOZAPINE

VERZENIO, ABEMACICLIB

VESICARE, SOLIFENACIN SUCCINATE

VESICARE LS, SOLIFENACIN SUCCINATE

VEVYE, CYCLOSPORINE

VFEND, VORICONAZOLE

VIAGRA, SILDENAFIL CITRATE

VIBATIV, TELAVANCIN HYDROCHLORIDE

VIBERZI, ELUXADOLINE

VIBISONE, CYANOCOBALAMIN

VIBRAMYCIN, DOXYCYCLINE

VIBRAMYCIN, DOXYCYCLINE CALCIUM

VIBRAMYCIN, DOXYCYCLINE HYCLATE

VICTOZA, LIRAGLUTIDE RECOMBINANT

VIDAZA, AZACITIDINE

VIENVA, ETHINYL ESTRADIOL

VIGABATRIN, VIGABATRIN

VIGADRONE, VIGABATRIN

VIGAMOX, MOXIFLOXACIN HYDROCHLORIDE

VIGPODER, VIGABATRIN

VIIBRYD, VILAZODONE HYDROCHLORIDE

VIJOICE, ALPELISIB

VILAZODONE HYDROCHLORIDE, VILAZODONE HYDROCHLORIDE

VILTEPSO, VILTOLARSEN

VIMPAT, LACOSAMIDE

VINBLASTINE SULFATE, VINBLASTINE SULFATE

VINCRISTINE SULFATE PFS, VINCRISTINE SULFATE

VINORELBINE TARTRATE, VINORELBINE TARTRATE

VIORELE, DESOGESTREL

VIRACEPT, NELFINAVIR MESYLATE

VIRAMUNE, NEVIRAPINE

VIRAMUNE XR, NEVIRAPINE

VIRAZOLE, RIBAVIRIN

VIREAD, TENOFOVIR DISOPROXIL FUMARATE

VIROPTIC, TRIFLURIDINE

VISINE, NAPHAZOLINE HYDROCHLORIDE (OTC)

VISINE L.R., OXYMETAZOLINE HYDROCHLORIDE (OTC)

VISIONBLUE, TRYPAN BLUE

VISIPAQUE 270, IODIXANOL

VISIPAQUE 320, IODIXANOL

VISTARIL, HYDROXYZINE PAMOATE

VISTOGARD, URIDINE TRIACETATE

VISUDYNE, VERTEPORFIN

VITAMIN D, ERGOCALCIFEROL

VITAMIN K1, PHYTONADIONE

VITRAKVI, LAROTRECTINIB SULFATE

VIVELLE-DOT, ESTRADIOL

VIVIMUSTA, BENDAMUSTINE HYDROCHLORIDE

VIVITROL, NALTREXONE

VIVJOA, OTESECONAZOLE

VIZAMYL, FLUTEMETAMOL F-18

VIZIMPRO, DACOMITINIB

VOCABRIA, CABOTEGRAVIR SODIUM

VOGELXO, TESTOSTERONE

VOLNEA, DESOGESTREL

VOLTAREN ARTHRITIS PAIN, DICLOFENAC SODIUM (OTC)
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 60

APPENDIX A - PRODUCT NAME INDEX

** V **

VONJO, PACRITINIB CITRATE

VOQUEZNA, VONOPRAZAN FUMARATE

VOQUEZNA DUAL PAK, AMOXICILLIN

VOQUEZNA TRIPLE PAK, AMOXICILLIN

VORICONAZOLE, VORICONAZOLE

VOSEVI, SOFOSBUVIR

VOSOL, ACETIC ACID, GLACIAL

VOSOL HC, ACETIC ACID, GLACIAL

VOTRIENT, PAZOPANIB HYDROCHLORIDE

VOXZOGO, VOSORITIDE

VRAYLAR, CARIPRAZINE HYDROCHLORIDE

VTAMA, TAPINAROF

VUITY, PILOCARPINE HYDROCHLORIDE

VUMERITY, DIROXIMEL FUMARATE

VUSION, MICONAZOLE NITRATE

VYDUO, NEBIVOLOL HYDROCHLORIDE

VYFEMLA, ETHINYL ESTRADIOL

VYLEESI (AUTOINJECTOR), BREMELANOTIDE ACETATE

VYNDAMAX, TAFAMIDIS

VYNDAQEL, TAFAMIDIS MEGLUMINE

VYONDYS 53, GOLODIRSEN

VYTORIN, EZETIMIBE

VYVANSE, LISDEXAMFETAMINE DIMESYLATE

VYXEOS, CYTARABINE

VYZULTA, LATANOPROSTENE BUNOD

** W **

WAINUA, EPLONTERSEN SODIUM

WAKIX, PITOLISANT HYDROCHLORIDE

WARFARIN SODIUM, WARFARIN SODIUM

WEGOVY, SEMAGLUTIDE

WELCHOL, COLESEVELAM HYDROCHLORIDE

WELIREG, BELZUTIFAN

WELLBUTRIN SR, BUPROPION HYDROCHLORIDE

WELLBUTRIN XL, BUPROPION HYDROCHLORIDE

WERA, ETHINYL ESTRADIOL

WINLEVI, CLASCOTERONE

WIXELA INHUB, FLUTICASONE PROPIONATE

WOMEN'S ROGAINE, MINOXIDIL (OTC)

WYNZORA, BETAMETHASONE DIPROPIONATE

** X **

XACDURO (COPACKAGED), DURLOBACTAM SODIUM

XACIATO, CLINDAMYCIN PHOSPHATE

XADAGO, SAFINAMIDE MESYLATE

XALATAN, LATANOPROST

XALKORI, CRIZOTINIB

XANAX, ALPRAZOLAM

XANAX XR, ALPRAZOLAM

XARACOLL, BUPIVACAINE HYDROCHLORIDE

XARELTO, RIVAROXABAN

XATMEP, METHOTREXATE SODIUM

XCOPRI, CENOBAMATE

XDEMVY, LOTILANER

XELJANZ, TOFACITINIB CITRATE

XELJANZ XR, TOFACITINIB CITRATE

XELODA, CAPECITABINE

XELPROS, LATANOPROST

XELSTRYM, DEXTROAMPHETAMINE

XENAZINE, TETRABENAZINE

XENICAL, ORLISTAT

XENLETA, LEFAMULIN ACETATE

XENON XE 133, XENON XE-133

XENOVIEW, XENON XE-129 HYPERPOLARIZED

XEPI, OZENOXACIN
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 61

APPENDIX A - PRODUCT NAME INDEX

** X **

XERAVA, ERAVACYCLINE DIHYDROCHLORIDE

XERESE, ACYCLOVIR

XERMELO, TELOTRISTAT ETIPRATE

XHANCE, FLUTICASONE PROPIONATE

XIFAXAN, RIFAXIMIN

XIGDUO XR, DAPAGLIFLOZIN

XIIDRA, LIFITEGRAST

XIPERE, TRIAMCINOLONE ACETONIDE

XOFIGO, RADIUM RA-223 DICHLORIDE

XOFLUZA, BALOXAVIR MARBOXIL

XOPENEX, LEVALBUTEROL HYDROCHLORIDE

XOPENEX HFA, LEVALBUTEROL TARTRATE

XOSPATA, GILTERITINIB FUMARATE

XPHOZAH, TENAPANOR HYDROCHLORIDE

XPOVIO, SELINEXOR

XTAMPZA ER, OXYCODONE

XTANDI, ENZALUTAMIDE

XULANE, ETHINYL ESTRADIOL

XURIDEN, URIDINE TRIACETATE

XYLOCAINE, LIDOCAINE HYDROCHLORIDE

XYLOCAINE W/ EPINEPHRINE, EPINEPHRINE

XYOSTED (AUTOINJECTOR), TESTOSTERONE ENANTHATE

XYREM, SODIUM OXYBATE

XYWAV, CALCIUM OXYBATE

XYZAL ALLERGY 24HR, LEVOCETIRIZINE DIHYDROCHLORIDE (OTC)

** Y **

YAELA, DROSPIRENONE

YARGESA, MIGLUSTAT

YASMIN, DROSPIRENONE

YAZ, DROSPIRENONE

YCANTH, CANTHARIDIN

YONDELIS, TRABECTEDIN

YONSA, ABIRATERONE ACETATE

YUPELRI, REVEFENACIN

YUTIQ, FLUOCINOLONE ACETONIDE

** Z **

ZADITOR, KETOTIFEN FUMARATE (OTC)

ZAFIRLUKAST, ZAFIRLUKAST

ZALEPLON, ZALEPLON

ZANAFLEX, TIZANIDINE HYDROCHLORIDE

ZANOSAR, STREPTOZOCIN

ZARONTIN, ETHOSUXIMIDE

ZAVESCA, MIGLUSTAT

ZAVZPRET, ZAVEGEPANT HYDROCHLORIDE

ZEGALOGUE, DASIGLUCAGON HYDROCHLORIDE

ZEGALOGUE (AUTOINJECTOR), DASIGLUCAGON HYDROCHLORIDE

ZEGERID, OMEPRAZOLE

ZEGERID OTC, OMEPRAZOLE (OTC)

ZEJULA, NIRAPARIB TOSYLATE

ZELAPAR, SELEGILINE HYDROCHLORIDE

ZELBORAF, VEMURAFENIB

ZEMBRACE SYMTOUCH, SUMATRIPTAN SUCCINATE

ZEMDRI, PLAZOMICIN SULFATE

ZEMPLAR, PARICALCITOL

ZENATANE, ISOTRETINOIN

ZEPATIER, ELBASVIR

ZEPBOUND, TIRZEPATIDE

ZEPOSIA, OZANIMOD HYDROCHLORIDE

ZEPZELCA, LURBINECTEDIN

ZERBAXA, CEFTOLOZANE SULFATE

ZERVIATE, CETIRIZINE HYDROCHLORIDE

ZESTORETIC, HYDROCHLOROTHIAZIDE

ZESTRIL, LISINOPRIL
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 62

APPENDIX A - PRODUCT NAME INDEX

** Z **

ZETIA, EZETIMIBE

ZETONNA, CICLESONIDE

ZIAC, BISOPROLOL FUMARATE

ZIAGEN, ABACAVIR SULFATE

ZIANA, CLINDAMYCIN PHOSPHATE

ZIDOVUDINE, ZIDOVUDINE

ZILBRYSQ, ZILUCOPLAN SODIUM

ZILEUTON, ZILEUTON

ZILRETTA, TRIAMCINOLONE ACETONIDE

ZILXI, MINOCYCLINE HYDROCHLORIDE

ZIMHI, NALOXONE HYDROCHLORIDE

ZINC CHLORIDE, ZINC CHLORIDE

ZINC CHLORIDE IN PLASTIC CONTAINER, ZINC CHLORIDE

ZINC SULFATE, ZINC SULFATE

ZINGO, LIDOCAINE HYDROCHLORIDE

ZIOPTAN, TAFLUPROST

ZIPRASIDONE HYDROCHLORIDE, ZIPRASIDONE HYDROCHLORIDE

ZIPRASIDONE MESYLATE, ZIPRASIDONE MESYLATE

ZIPSOR, DICLOFENAC POTASSIUM

ZIRGAN, GANCICLOVIR

ZITHROMAX, AZITHROMYCIN

ZITUVIMET, METFORMIN HYDROCHLORIDE

ZITUVIO, SITAGLIPTIN

ZOCOR, SIMVASTATIN

ZOKINVY, LONAFARNIB

ZOLADEX, GOSERELIN ACETATE

ZOLEDRONIC, ZOLEDRONIC ACID

ZOLEDRONIC ACID, ZOLEDRONIC ACID

ZOLINZA, VORINOSTAT

ZOLMITRIPTAN, ZOLMITRIPTAN

ZOLOFT, SERTRALINE HYDROCHLORIDE

ZOLPIDEM TARTRATE, ZOLPIDEM TARTRATE

ZOMIG, ZOLMITRIPTAN

ZONALON, DOXEPIN HYDROCHLORIDE

ZONEGRAN, ZONISAMIDE

ZONISADE, ZONISAMIDE

ZONISAMIDE, ZONISAMIDE

ZONTIVITY, VORAPAXAR SULFATE

ZORTRESS, EVEROLIMUS

ZORYVE, ROFLUMILAST

ZOSYN IN PLASTIC CONTAINER, PIPERACILLIN SODIUM

ZOVIA 1/50E-28, ETHINYL ESTRADIOL

ZOVIRAX, ACYCLOVIR

ZTALMY, GANAXOLONE

ZTLIDO, LIDOCAINE

ZUBSOLV, BUPRENORPHINE HYDROCHLORIDE

ZULRESSO, BREXANOLONE

ZUMANDIMINE, DROSPIRENONE

ZURAGARD, ISOPROPYL ALCOHOL (OTC)

ZURZUVAE, ZURANOLONE

ZYCLARA, IMIQUIMOD

ZYDELIG, IDELALISIB

ZYFLO, ZILEUTON

ZYKADIA, CERITINIB

ZYLET, LOTEPREDNOL ETABONATE

ZYLOPRIM, ALLOPURINOL

ZYMAXID, GATIFLOXACIN

ZYNRELEF KIT, BUPIVACAINE

ZYPITAMAG, PITAVASTATIN MAGNESIUM

ZYPREXA, OLANZAPINE

ZYPREXA RELPREVV, OLANZAPINE PAMOATE

ZYPREXA ZYDIS, OLANZAPINE

ZYRTEC ALLERGY, CETIRIZINE HYDROCHLORIDE (OTC)

ZYRTEC-D 12 HOUR, CETIRIZINE HYDROCHLORIDE (OTC)

ZYTIGA, ABIRATERONE ACETATE
DECEMBER 2023 - APPROVED DRUG PRODUCT LIST A - 63

APPENDIX A - PRODUCT NAME INDEX

** Z **

ZYVOX, LINEZOLID