Restat-Caterpillar Drug Formulary Database
Caterpillar Drug Formulary Generated April 22, 2016 Caterpillar Drug Formulary As Applied to Active Employees and Certain Retirees Effective May 1, 2016 to July 31, 2016 DESCRIPTION Prescription medications in this formulary are listed by common categories and classes. They are placed into cost levels known as tiers. Both brand and generic prescription medications are included. The following list represents commonly prescribed medications. This is not a complete list of medications, and not all medications listed may be covered under the plan. Not all dosage forms and strengths are covered under the prescription drug benefit provision (i.e. infusions, injections, etc). Where differences are noted between this drug formulary and your summary plan document (SPD), the plan document will rule. Please look at your SPD provided at www.catatwork.cat.com > Compensation & Benefits > Summary Plan Descriptions to learn more about your prescription drug benefit plan. ELIGIBILITY This list contains medications and/or products covered by the prescription drug benefit provisions of the Caterpillar Inc. Employee Health, Life and Disability Benefit Program, the Caterpillar Inc. Retiree Benefit Program, the Caterpillar Inc. Group Insurance Plan A, and the Caterpillar Inc. Group Insurance Plan B: for those participants who are eligible for and who elect to participate in the preferred provider organization (“PPO”) product administered by UnitedHealthcare (UHC). for those participants who are eligible for and who elect to participate in the EPO or EPO-like product administered by Blue Cross Blue Shield (BCBS). for the Solar Turbines Inc. participants who are eligible for and who elect to participate in the plan. Please refer to your summary plan description (SPD) provided at www.catatwork.cat.com > Compensation & Benefits > Summary Plan Descriptions for additional information. FOR ADDITIONAL INFORMATION Visit https://benefits.cat.com/en.html > RX Prescription Drug Lists & Updates Obtain the Network Pharmacy Directory View Rx Videos and Education materials Visit www.myCatamaranRx.com Locate Network Pharmacies View your Explanation of Benefits (EOB) Obtain specific drug pricing and out of pocket costs View drug information and interactions Download the OptumRx/CatamaranRx Mobile App Call the OptumRx Member Services (formerly Catamaran) number on the back of your ID card FORMULARY DESIGN Caterpillar utilizes a clinical team of Physicians and Pharmacists to help ensure that our formulary is medically sound and supports patients’ health. This team of professionals reviews and evaluates medications that are placed on the formulary based on safety and efficacy to help maintain clinical integrity. The formulary is reviewed quarterly for possible additions and deletions. Please note that brand name medications new to the market will be considered for addition to the formulary at that time. New generics for a 1 / 61 Caterpillar Drug Formulary Generated April 22, 2016 covered brand name medication may be a covered benefit between quarterly updates upon availability. If a medication or product that has been prescribed for you or your covered dependents is not on the formulary (and thus, not covered), you may consult with your physician regarding treatment alternatives. You also have the option to purchase the medication at full retail cost. Note: Brand name medications may move to non-preferred status if a generic version becomes available on the next drug formulary update. This will result in a higher cost share for the member. PLAN DESIGN The co-pay for Tier 1 products will be $0 when prescriptions are filled at a Walmart pharmacy (and its affiliates) or a Kroger pharmacy (and its affiliates). Plan Design Structure effective January 1, 2016 Co-pay or Co-insurance amounts are based on a 30-day supply unless otherwise noted. LIMITATIONS The plan requires as a condition for reimbursement, that if there is a generic medication alternative for a Brand name medication, the generic medication alternative be obtained first. There may not be a generic alternative for all dosage strengths of a brand medication. If a prescription medication is re-classified from a generic to a brand, the brand co-insurance will apply. OUT OF NETWORK Some pharmacies may not be able to submit an electronic claim. The member will be required to pay 100% of the prescription medication cost at the point of service. 2 / 61 Caterpillar Drug Formulary Generated April 22, 2016 The pharmacy may not be aware of step therapies, prior authorizations, quantity limits or if the medication is covered under the plan. If one of these is applied to the prescription medication you purchase, it could possibly reduce or eliminate the amount of your reimbursement. Submit a Caterpillar Prescription Drug Expense Claim Form to OptumRx for processing. You will receive an explanation of benefits (EOB) and any applicable reimbursement. The Caterpillar Prescription Drug Expense Claim Form is available on www.benefits.cat.com > RX > Forms > Caterpillar Prescription Drug Expense Claim Form. INDICATORS MEDICAL BENEFIT CONTACTS Please note that some items that may be purchased at a pharmacy but are not listed below may be covered under the medical benefit provisions of the above-referenced plans. If you have questions about coverage under the medical benefit provisions of the PPO offering, please contact UnitedHealthcare (UHC) at 866-228-4215. If you have questions about coverage under the medical benefit provisions of the EPO product, please contact Blue Cross Blue Shield (BCBS) at 844-228-2227. PATIENT PROTECTION AND AFFORDABLE CARE ACT The list also includes preventive care medications covered in accordance with the Patient Protection and Affordable Care Act, as modified by the Healthcare and Education Reconciliation Act of 2010. Certain preventive care medications are covered at 100% by the Program if you use a Network Provider, and the primary purpose of your visit is the delivery of such preventive care service. If you use a non-Network Provider, you will be subject to the applicable Co-pay or Co-insurance. For additional information on preventive care medications covered by the Program, please visit: www.healthcare.gov/center/regulations/prevention.html, or www.uspreventiveservicestaskforce.org. The information regarding alternatives is not intended and should not be construed, in any way, as medical advice, opinion, diagnosis or as advice about the treatment of any specific medical condition. You should consult with your physician regarding your particular health needs and whether any of the alternative treatments is right for you. In the event that the content of this document or any representations made by any person regarding the plan conflict with or are inconsistent with the provisions of the plan document, the provisions of the plan document are controlling. To the fullest extent permitted by law, Caterpillar reserves the right to amend, modify, suspend, replace or terminate any of its plans, policies or programs, in whole or in part, at any time and for any reason, by appropriate company action. 3 / 61 Caterpillar Drug Formulary Generated April 22, 2016 ADHD/ANTI-NARCOLEPSY ...................................................................... 6 ANALGESICS - ANTI-INFLAMMATORY ............................................................. 6 ANALGESICS - NONNARCOTIC ................................................................... 7 ANALGESICS - OPIOID ......................................................................... 7 ANDROGENS-ANABOLIC ....................................................................... 8 ANORECTAL AGENTS .......................................................................... 9 ANTHELMINTICS .............................................................................. 9 ANTIANGINAL AGENTS ......................................................................... 9 ANTIANXIETY AGENTS ........................................................................ 10 ANTIARRHYTHMICS .......................................................................... 10 ANTIBIOTICS ................................................................................ 10 ANTICOAGULANTS ........................................................................... 12 ANTICONVULSANTS .......................................................................... 12 ANTIDEPRESSANTS .......................................................................... 13 ANTIDIABETICS .............................................................................. 14 ANTIDIARRHEALS ............................................................................ 15 ANTIDOTES ................................................................................. 16 ANTIEMETICS ............................................................................... 16 ANTIFUNGALS ............................................................................... 16 ANTIHISTAMINES ............................................................................ 17 ANTIHYPERLIPIDEMICS ....................................................................... 17 ANTIHYPERTENSIVES ......................................................................... 18 ANTIMALARIALS ............................................................................. 19 ANTIMYASTHENIC AGENTS .................................................................... 19 ANTIMYCOBACTERIAL AGENTS ................................................................. 19 ANTINEOPLASTICS .......................................................................... 19 ANTIPARKINSON AGENTS ..................................................................... 20 ANTIPROTOZOAL AGENTS ..................................................................... 21 ANTIPSYCHOTICS/ANTIMANIC AGENTS ........................................................... 21 ANTISEPTICS & DISINFECTANTS ................................................................ 22 ANTIVIRALS ................................................................................. 22 BETA BLOCKERS ............................................................................ 23 CALCIUM CHANNEL BLOCKERS ................................................................ 24 CARDIOTONICS .............................................................................. 24 CARDIOVASCULAR AGENTS - MISC. ............................................................. 24 CHEMICALS ................................................................................. 25 CONTRACEPTIVES ........................................................................... 25 CORTICOSTEROIDS .......................................................................... 26 COUGH/COLD/ALLERGY ....................................................................... 26 DERMATOLOGICALS ......................................................................... 27 DIABETIC SUPPLIES .......................................................................... 31 DIGESTIVE AIDS ............................................................................. 31 DIURETICS .................................................................................. 31 ENDOCRINE AND METABOLIC AGENTS - MISC. ..................................................... 32 ESTROGENS ................................................................................ 33 GASTROINTESTINAL AGENTS - MISC. ............................................................ 33 GENITOURINARY AGENTS ..................................................................... 34 GOUT AGENTS .............................................................................. 35 HEMATOLOGICAL AGENTS - MISC. .............................................................. 35 HEMATOPOIETIC AGENTS ..................................................................... 35 HEMOSTATICS .............................................................................. 36 HYPNOTICS ................................................................................. 36 IMMUNE MEDIATORS ......................................................................... 37 LAXATIVES ................................................................................. 37 MEDICAL DEVICES ........................................................................... 37 MIGRAINE PRODUCTS ........................................................................ 37 MINERALS & ELECTROLYTES .................................................................. 38 MOUTH/THROAT/DENTAL AGENTS .............................................................. 39 MUSCULOSKELETAL THERAPY AGENTS ......................................................... 39 NASAL AGENTS - SYSTEMIC AND TOPICAL ........................................................ 40 NEUROMUSCULAR AGENTS .................................................................... 40 OPHTHALMIC AGENTS ........................................................................ 40 OTIC AGENTS ............................................................................... 42 4 / 61 Caterpillar Drug Formulary Generated April 22, 2016 OXYTOCICS ................................................................................. PHARMACEUTICAL ADJUVANTS ................................................................ PROGESTINS ................................................................................ PSYCHOTHERAPEUTIC AND NEUROLOGICAL AGENTS - MISC. ........................................ RESPIRATORY AGENTS ....................................................................... THYROID AGENTS ............................................................................ ULCER DRUGS .............................................................................. URINARY ANTI-INFECTIVES .................................................................... URINARY ANTISPASMODICS ................................................................... URINE TEST STRIPS .......................................................................... VAGINAL PRODUCTS ......................................................................... VASOPRESSORS ............................................................................. VITAMINS ................................................................................... 43 43 43 43 44 45 46 46 47 47 47 48 48 5 / 61 Caterpillar Drug Formulary Generated April 22, 2016 ADHD/ANTI-NARCOLEPSY Amphetamines Tier 1 amphetamine/dextroamphet er PA QL amphetamine/dextroampheta PA QL dextroamphetamine sulfate PA methamphetamine hcl PA ADDERALL PA QL Tier 3 ADDERALL XR PA QL DESOXYN PA DEXEDRINE PA PROCENTRA PA Attention-Deficit/Hyperactivity Disorder (ADHD) Agents Misc. Tier 1 guanfacine hcl Tier 2 STRATTERA Tier 3 INTUNIV Miscellaneous Tier 1 caffeine citrate Tier 3 CAFCIT Stimulants - Misc. Tier 1 Tier 2 Tier 3 dexmethylphenidate hcl dexmethylphenidate sr QL methylin methylphenidate hcl methylphenidate hcl er methylphenidate hcl sr metadate er 20mg methylphenidate hcl cd methylphenidate hcl cr modafinil PA QL CONCERTA DAYTRANA QL FOCALIN FOCALIN XR QL METADATE CD METHYLIN CHEW & SOLN RITALIN RITALIN LA RITALIN SR Tier 4 PROVIGIL PA QL ANALGESICS - ANTI-INFLAMMATORY Miscellaneous Tier 1 leflunomide Tier 2 RIDAURA Tier 3 ARAVA RHEUMATREX ACTEMRA INJ PA SP ARCALYST PA ENBREL PA SP HUMIRA PA SP KINERET PA ORENCIA SQ PA SP SIMPONI SQ PA SP STELARA SQ PA SP XELJANZ PA SP XELJANZ XR PA SP Tier 4 + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 6 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Nonsteroidal Anti-inflammatory Agents (NSAIDs) Tier 1 celecoxib QL diclofenac potassium diclofenac sodium dr diclofenac sodium er diclofenac sodium sr diclofenac sodium xr diclofenac-misoprostil etodolac etodolac er flurbiprofen ibuprofen 400mg ibuprofen 600mg ibuprofen 800mg indomethacin indomethacin cr indomethacin er indomethacin sa indomethacin sr ketoprofen ketorolac tromethamine Tier 3 mefenamic acid meloxicam QL nabumetone naproxen naproxen dr naproxen ec oxaprozin piroxicam sulindac tolmetin sodium ANAPROX ANAPROX DS ARTHROTEC 50 ARTHROTEC 75 CATAFLAM CELEBREX QL CLINORIL DAYPRO EC-NAPROSYN FELDENE FENOPROFEN CALCIUM INDOCIN KETOPROFEN ER KETOPROFEN ULTRA MICRONIZ MECLOFENAMATE SODIUM MOBIC QL NALFON NAPRELAN NAPROSYN PONSTEL VOLTAREN GEL PA QL VOLTAREN XR ANALGESICS - NONNARCOTIC Analgesic Combinations ali-flex anolor 300 butalbital/acetaminophen Tier 1 Tier 3 biogesic butalbital compound capacet cephadyn dologesic dolorex duraxin ed-flex margesic marten-tab promacet repan rhinoflex zebutal zflex BIOREGESIC DOLGIC PLUS EQUAGESIC ESGIC ESGIC-PLUS FIORICET FIORINAL PHRENILIN FORTE RELAGESIC RHINOFLEX-650 STAFLEX TENCON diflunisal salsalate Salicylates Tier 0 aspirin + QL Tier 1 choline magnesium trisali ANALGESICS - OPIOID Opioid Agonists Tier 1 codeine sulfate fentanyl QL fentanyl citrate oral tra QL meperidine hcl meperitab methadone hcl morphine sulfate er tabs oxycodone solution 5mg/5ml Tier 2 morphine sulfate cr oxycodone hcl oxymorphone hcl QL oxymorphone inj PA tramadol hcl QL hydromorphone hcl morphine sulfate er caps oxymorphone hcl sr QL tramadol hcl er QL OPANA ER QL OXYCONTIN + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 7 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Opioid Agonists Tier 3 ACTIQ QL DEMEROL DILAUDID DOLOPHINE DURAGESIC EXALGO FENTORA KADIAN LEVORPHANOL TARTRATE METHADOSE MORPHINE SULFATE MS CONTIN OPANA INJ PA QL OPANA IR PA QL OXYCODONE SOL 5MG/5ML ULTRAM QL ULTRAM ER Opioid Combinations acetaminophen/codeine #3, #4 QL asa compound/codeine Tier 1 apap/caff/dihydrocodeine butalbital compound/codeinei butalbital/apap/caff butalbital/aspirn/caffeine co-gesic QL codeine/acetaminophen QL endocet endodan hydrocodone/acetaminophen QL hydrocodone/ibuprofen hydrogesic QL ibudone oxycodone/acetaminophen pentazocine/acetaminophen oxycodone/aspirin roxicet stagesic QL tramadol /apap QL Tier 3 ANEXSIA QL CAPITAL/CODEINE FIORICET/CODEINE HYCET HYDROCODONE/APAP LORCET QL LORCET PLUS QL LORTAB MAXIDONE NORCO QL PERCOCET PERCODAN PRIMLEV REPREXAIN SYNALGOS-DC TYLENOL/CODEINE #3, #4 QL VICOPROFEN XODOL ZOLVIT ZYDONE TYLOX ULTRACET QL XOLOX ZAMICET Opioid Partial Agonists buprenorphine hcl sl Tier 1 Tier 3 buprenorphine-naloxone sl butorphanol tartrate pentazocine/naloxone hcl BUTRANS SUBOXONE TALWIN ANDROGENS-ANABOLIC Anabolic Steroids Tier 2 oxandrolone Tier 3 OXANDRIN Androgens danazol Tier 1 methyltestosterone testosterone enanthate ANDROGEL Tier 2 testosterone cypionate testosterone gel 12.5mg testosterone gel 25mg testosterone gel 50mg + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 8 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Androgens Tier 3 ANDRODERM ANDROID ANDROXY DELATESTRYL DEPO-TESTOSTERONE METHITEST METHYLTESTOSTERONE PWD STRIANT TESTIM TESTRED VOGELXO ANORECTAL AGENTS Intrarectal Steroids Tier 1 colocort Tier 2 CORTIFOAM Tier 3 CORTENEMA hydrocortisone rectal Rectal Combinations Tier 1 lidazone hc Tier 2 lidocaine hcl/hydrocortis crm Tier 3 ANALPRAM-HC PROCTOFOAM HC LIDOCAINE HCL-HYDROCORTIS GEL Rectal Steroids anucort-hc Tier 1 anusol-hc hydrocortisone acetate proctocream hc Tier 3 proctosol hc hemorrhoidal-hc hemril-30 procto-pak proctocare-hc proctozone-hc rectacort-hc PROCTOCORT ANTHELMINTICS Antimalarials Tier 1 ivermectin Tier 3 ALBENZA BILTRICIDE STROMECTOL ANTIANGINAL AGENTS Antianginals-Other Tier 3 RANEXA Nitrates Tier 1 Tier 3 isoditrate er isosorbide dinitrate isosorbide dinitrate er isosorbide dinitrate sa isosorbide dinitrate sl isosorbide mononitrate isosorbide mononitrate er minitran nitro-time nitroglycerin nitroglycerin spray nitroglycerin sr nitroglycerin transdermal DILATRATE SR IMDUR ISORDIL TITRADOSE NITRO-BID NITRO-DUR NITROGLYCERIN LINGUAL NITROLINGUAL PUMPSPRAY NITROMIST nitroglycerin er NITROSTAT + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 9 / 61 Caterpillar Drug Formulary Generated April 22, 2016 ANTIANXIETY AGENTS Antianxiety Agents - Misc. buspirone hcl Tier 1 Tier 3 droperidol hydroxyzine hcl hydroxyzine pamoate meprobamate VISTARIL Benzodiazepines Tier 1 Tier 3 alprazolam alprazolam er alprazolam odt alprazolam xr chlordiazepoxide hcl clorazepate dipotassium diazepam tab lorazepam oxazepam ALPRAZOLAM INTENSOL ATIVAN DIAZEPAM INTENSOL NIRAVAM TRANXENE T VALIUM XANAX XANAX XR diazepam rectal gel ANTIARRHYTHMICS Antiarrhythmics Tier 1 Tier 3 amiodarone hcl disopyramide phosphate flecainide acetate mexiletine hcl pacerone procainamide hcl er propafenone hcl propafenone hcl er quinidine gluconate cr quinidine gluconate er quinidine sulfate quinidine sulfate er CORDARONE MULTAQ NORPACE NORPACE CR RYTHMOL RYTHMOL SR TAMBOCOR TIKOSYN ANTIBIOTICS Aminoglycosides Tier 1 gentamicin inj PA Tier 2 tobramycin neb PA QL SP Tier 3 AMIKACIN SULFATE PA Tier 4 TOBI PA QL neomycin sulfate tobramycin inj PA Azithromycin Tier 1 azithromycin Tier 3 ZITHROMAX Cephalosporins - 1st Generation Tier 1 cefadroxil Tier 3 KEFLEX cephalexin Cephalosporins - 2nd Generation Tier 1 cefaclor + Preventive Care cefprozil PA Prior Authorization cefuroxime axetil QL Quantity Limitations ST Step Therapy SP Specialty 10 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Cephalosporins - 2nd Generation Tier 3 CEFACLOR ER CEFTIN Cephalosporins - 3rd Generation Tier 1 cefixime susp cefpodoxime proxetil Tier 2 cefdinir ceftibuten Tier 3 CEDAX CEFDITOREN PIVOXIL SPECTRACEF SUPRAX Clarithromycin Tier 1 clarithromycin clarithromycin er Tier 3 BIAXIN BIAXIN XL BIAXIN XL PAC Erythromycins Tier 1 Tier 3 erythromycin cap ec erythromycin gel E.E.S. 400 E.E.S. GRANULES ERY-TAB ERYPED 200 ERYPED 400 ERYTHROCIN STEARATE ERYTHROMYCIN ERYTHROMYCIN BASE ERYTHROMYCIN STEARATE PCE ERYTHROMYCIN ETHYLSUCCINA Fidaxomicin Tier 3 DIFICID PA QL Fluoroquinolones ciprofloxacin er Tier 1 Tier 3 levofloxacin levofloxacin inj PA moxifloxacin AVELOX CIPRO CIPRO XR FACTIVE LEVAQUIN TABS NOROXIN ofloxacin Misc.- Combinations e.s.p. Tier 1 Tier 3 erythromycin/sulfisoxazol smz-tmp ds sulfamethoxazole/trimetho BACTRIM BACTRIM DS Miscellaneous Tier 1 Tier 2 clindamycin hcl clindamycin palmitate hcl clindamycin phos inj PA colistimethate sodium dapsone linezolid susp linezolid tbs metronidazole tinidazole trimethoprim vancomycin hcl inj PA vancomycin caps + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 11 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Miscellaneous BACITRACIN OINT CHLORAMPHENICOL CLEOCIN PEDIATRIC GRANULE Tier 3 Tier 4 CLEOCIN CAPS CLEOCIN PHOSPHATE COLY-MYCIN M PA FLAGYL FLAGYL ER KETEK PRIMSOL SIVEXTRO TINDAMAX VANCOCIN HCL VANCOMYCIN ORAL SOLN XIFAXAN PA QL ZYVOX amoxicillin/clavulanate ampicillin dicloxacillin sodium AUGMENTIN ES-600 AUGMENTIN XR CAYSTON PA Penicillins amoxicillin Tier 1 Tier 3 penicillin vk AUGMENTIN Tetracyclines demeclocycline hcl Tier 1 Tier 3 doxycycline hyclate 20mg tb doxycycline hyclate caps doxycycline monohydrate caps minocycline hcl morgidox DORYX DYNACIN TETRACYCLINE HCL VIBRAMYCIN MINOCIN MONODOX ANTICOAGULANTS Coumarin Anticoagulants Tier 1 jantoven Tier 3 COUMADIN warfarin sodium Direct Factor Xa Inhibitors Tier 3 ELIQUIS SAVAYSA XARELTO Heparins And Heparinoid-Like Agents Tier 1 heparin sodium Tier 2 enoxaparin sodium fondaparinux sodium Tier 3 ARIXTRA FRAGMIN LOVENOX Thrombin Inhibitors Tier 3 PRADAXA ANTICONVULSANTS Benzodiazepines Tier 1 clonazepam Tier 3 DIASTAT + Preventive Care KLONOPIN PA Prior Authorization ONFI PA QL Quantity Limitations ONFI SUSP PA ST Step Therapy SP Specialty 12 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Carbamates Tier 1 felbamate Tier 3 FELBATOL GABA Modulators Tier 1 tiagabine hydrochloride Tier 3 GABITRIL SABRIL Hydantoins Tier 1 phenytoin phenytoin sodium extended Tier 3 DILANTIN PHENYTEK Miscellaneous Tier 1 Tier 3 carbamazepine carbamazepine er epitol gabapentin lamotrigine levetiracetam levetiracetam er oxcarbazepine primidone topiragen topiramate zonisamide BANZEL CARBATROL FYCOMPA PA KEPPRA LAMICTAL LAMICTAL XR LYRICA LYRICA SOL MYSOLINE NEURONTIN POTIGA PA QL QUDEXY XR ST TEGRETOL TEGRETOL-XR TOPAMAX TRILEPTAL TROKENDI XR ST VIMPAT PA ZONEGRAN Succinimides Tier 1 ethosuximide Tier 3 ZARONTIN Valproic Acid Tier 1 divalproex sodium divalproex sodium dr divalproex sodium er valproic acid Tier 3 DEPAKENE DEPAKOTE DEPAKOTE ER DEPAKOTE SPRINKLES ANTIDEPRESSANTS Alpha-2 Receptor Antagonists (Tetracyclics) Tier 1 mirtazapine Tier 3 REMERON mirtazapine odt Miscellaneous Tier 1 Tier 3 budeprion sr bupropion hcl bupropion hcl er bupropion hcl xl nefazodone hcl trazodone hcl MAPROTILINE HCL WELLBUTRIN WELLBUTRIN SR + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy bupropion hcl sr WELLBUTRIN XL SP Specialty 13 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Monoamine Oxidase Inhibitors (MAOIs) Tier 1 phenelzine sulfate tranylcypromine sulfate Tier 3 EMSAM PA QL NARDIL PARNATE Selective Serotonin Reuptake Inhibitors (SSRIs) citalopram hydrobromide Tier 1 escitalopram oxalate fluoxetine dr QL ST fluvoxamine maleate paroxetine hcl paroxetine hcl er PA ST CELEXA LEXAPRO PAXIL PAXIL CR PA ST PEXEVA PA ST PROZAC PROZAC WEEKLY PA QL ST SELFEMRA PA ZOLOFT fluoxetine hcl sertraline hcl Tier 3 Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) Tier 1 duloxetine venlafaxine hcl cap Tier 3 CYMBALTA EFFEXOR XR PA ST venlafaxine hcl er cap Tricyclic Agents Tier 1 Tier 2 Tier 3 amitriptyline hcl desipramine hcl doxepin hcl imipramine hcl imipramine pamoate nortriptyline hcl protriptyline hcl trimipramine maleate AMOXAPINE ANAFRANIL NORPRAMIN PAMELOR SURMONTIL TOFRANIL TOFRANIL-PM VIVACTIL clomipramine hcl ANTIDIABETICS Alpha-Glucosidase Inhibitors Tier 1 acarbose Tier 3 GLYSET PRECOSE Antidiabetic - Amylin Analogs Tier 3 SYMLIN PA Antidiabetic Combinations Tier 0 glyburide/metformin hcl Tier 1 glipizide/metformin hcl pioglitazone hcl/metformi ACTOPLUS MET AVANDAMET GLUCOVANCE METAGLIP Tier 3 pioglitazone-glimepiride AVANDARYL DUETACT Biguanides Tier 0 metformin hcl + Preventive Care metformin hcl er PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 14 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Biguanides Tier 3 GLUCOPHAGE GLUCOPHAGE XR RIOMET Diabetic Other Tier 2 GLUCAGEN Tier 4 KORLYM PA GLUCAGEN HYPOKIT GLUCAGON EMERGENCY KIT Incretin Mimetic Agents (GLP-1 Receptor Agonists) Tier 3 BYETTA PA VICTOZA PA Insulin Tier 0 Tier 1 Tier 2 Tier 3 HUMULIN N VIAL HUMULIN R VIAL NOVOLIN 70/30 RELION NOVOLIN N VIAL NOVOLIN R RELION NOVOLIN R VIAL NOVOLOG MIX 70/30 VIAL NOVOLOG VIAL LANTUS VIAL NOVOLIN PENS NOVOLOG MIX 70/30 PREFILL NOVOLIN N RELION NOVOLOG FLEXPEN NOVOLOG PENFILL APIDRA VIAL HUMALOG MIX 50/50 VIAL LANTUS SOLOSTAR PA LEVEMIR VIAL HUMALOG MIX 75/25 VIAL HUMALOG VIAL Insulin Sensitizing Agents Tier 1 pioglitazone hcl Tier 3 ACTOS AVANDIA Meglitinide Analogues Tier 1 nateglinide repaglinide Tier 3 PRANDIN STARLIX Sulfonylureas Tier 0 Tier 1 Tier 3 glimepiride glipizide glipizide er glyburide glyburide micronized chlorpropamide tolazamide tolbutamide AMARYL DIABETA GLUCOTROL glipizide xl GLUCOTROL XL GLYNASE ANTIDIARRHEALS Antiperistaltic Agents Tier 1 Tier 3 diphenatol diphenoxylate/atropine loperamide hcl opium tincture LOMOTIL MOTOFEN + Preventive Care PA Prior Authorization lofene lonox PAREGORIC QL Quantity Limitations ST Step Therapy SP Specialty 15 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Miscellaneous Tier 3 FULYZAQ PA ANTIDOTES Chelating Agents-Misc. Tier 2 CUPRIMINE Tier 3 CHEMET DEPEN TITRATABS Tier 4 EXJADE PA FERRIPROX PA JADENU PA Opioid Antagonists Tier 1 depade Tier 3 REVIA naltrexone hcl ANTIEMETICS 5-HT3 Receptor Antagonists Tier 1 granisetron hcl QL Tier 2 ANZEMET QL Tier 3 GRANISOL QL ondansetron hcl ondansetron odt SANCUSO PA QL ZOFRAN ZOFRAN ODT Antiemetics - Anticholinergic Tier 1 trimethobenzamide hcl Tier 3 TIGAN TRANSDERM-SCOP Antiemetics - Miscellaneous Tier 1 dronabinol Tier 3 DICLEGIS QL EMEND PA QL MARINOL ANTIFUNGALS Antifungals Tier 1 bio-statin Tier 2 flucytosine Tier 3 griseofulvin microsize terbinafine hcl AMPHOTERICIN B PA ANCOBON CRESEMBA PA GRIS-PEG LAMISIL GRIFULVIN V Imidazole-Related Antifungals Tier 1 fluconazole Tier 2 voriconazole PA + Preventive Care fluconazole 150mg QL PA Prior Authorization itraconazole QL Quantity Limitations ketoconazole ST Step Therapy SP Specialty 16 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Imidazole-Related Antifungals DIFLUCAN Tier 3 DIFLUCAN 150MG QL NOXAFIL PA SPORANOX VFEND PA ANTIHISTAMINES Antihistamines - Alkylamines AHIST Tier 3 BROMPHENIRAMINE TANNATE DEXCHLORPHENIRAMINE MALEA ED CHLORPED ED-CHLOR-TAN RESPA-BR Antihistamines - Ethanolamines Tier 1 arbinoxa Tier 3 PALGIC carbinoxamine maleate clemastine fumarate diphenhydramine hcl Antihistamines - Phenothiazines Tier 1 Tier 3 phenadoz promethazine hcl promethegan 25mg supp promethegan tabs PHENERGAN promethegan 50mg supp promethegan 12.5mg supp Antihistamines - Piperidines Tier 1 cyproheptadine hcl ANTIHYPERLIPIDEMICS Bile Acid Sequestrants Tier 1 cholestyramine Tier 2 WELCHOL Tier 3 COLESTID cholestyramine light colestipol hcl prevalite QUESTRAN QUESTRAN LIGHT Fibric Acid Derivatives Tier 1 Tier 3 fenofibrate fenofibrate 130mg ST fenofibric acid ST gemfibrozil fenofibrate 43mg ST fenofibrate micronized LOPID ST HMG CoA Reductase Inhibitors Tier 0 atorvastatin calcium lovastatin QL Tier 1 fluvastatin QL fluvastatin xl PA ST ADVICOR PA ST LESCOL XL PA ST Tier 3 pravastatin sodium QL simvastatin QL ALTOPREV PA QL ST CRESTOR PA QL ST LESCOL QL LIPITOR QL MEVACOR QL PRAVACHOL QL ZOCOR QL + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 17 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Intestinal Cholesterol Absorption Inhibitors Tier 2 ZETIA PA QL ST Nicotinic Acid Derivatives Tier 1 niacin er tab Tier 3 NIASPAN ANTIHYPERTENSIVES ACE Inhibitors Tier 0 Tier 1 Tier 3 benazepril hcl captopril enalapril maleate lisinopril fosinopril sodium moexipril hcl perindopril erbumine quinapril hcl ramipril trandolapril ACCUPRIL ACEON ALTACE EPANED ORAL SOL PA LOTENSIN MAVIK PRINIVIL UNIVASC VASOTEC ZESTRIL Angiotensin II Receptor Antagonists Tier 1 Tier 3 candesartan eprosartan mesylate telmisartan valsartan ATACAND AVAPRO PA ST DIOVAN MICARDIS irbesartan losartan potassium BENICAR PA ST COZAAR Antiadrenergic Antihypertensives Tier 1 Tier 3 clonidine hcl doxazosin mesylate prazosin hcl terazosin hcl CARDURA CATAPRES RESERPINE TENEX guanfacine hcl methyldopa CATAPRES-TTS MINIPRESS Antihypertensive Combinations Tier 0 Tier 1 benazepril hcl/hctz captopril/hctz amlodipine/benazapril atenolol/chlorthalidone bisoprolol/hctz candesartan/hctz eprosartan mesylate/hctz fosinopril/hctz irbesartan/hctz losartan potassium/hctz methyldopa/hctz metoprolol/hctz moexipril/hctz nadolol/bendroflumethiazi propranolol/hctz quinapril/hctz quinaretic trandolapril/verapamil ST + Preventive Care PA Prior Authorization enalapril/hctz lisinopril/hctz telmisartan/hctz valsartan/hctz QL Quantity Limitations ST Step Therapy SP Specialty 18 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Antihypertensive Combinations Tier 3 ACCURETIC ATACAND HCTZ AVALIDE PA ST BENICAR HCTZ PA ST CLORPRES CORZIDE DIOVAN HCTZ ENTRESTO PA HYZAAR LOPRESSOR HCTZ LOTENSIN HCTZ LOTREL MICARDIS HCTZ PRINZIDE TARKA ST TENORETIC UNIRETIC VASERETIC ZESTORETIC ZIAC phenoxybenzamine Miscellaneous Tier 1 eplerenone hydralazine hcl minoxidil Tier 3 DIBENZYLINE INSPRA PHENTOLAMINE MESYLATE ANTIMALARIALS Antimalarials Tier 1 Tier 3 atovaquone/proguanil hcl chloroquine phosphate hydroxychloroquine sulfat mefloquine hcl quinine sulf 324mg PA MALARONE PLAQUENIL ARALEN COARTEM PRIMAQUINE PHOSPHATE QUALAQUIN PA ANTIMYASTHENIC AGENTS Antimyasthenic Agents Tier 1 pyridostigmine bromide Tier 3 MESTINON MESTINON TIMESPAN PROSTIGMIN ANTIMYCOBACTERIAL AGENTS Antibacterial Agents Tier 1 rifabutin Tier 3 MYCOBUTIN Antimycobacterial Agents Tier 1 ethambutol hcl isoniazid tb rifampin Tier 3 ISONIAZID SYRP MYAMBUTOL RIFADIN Tier 4 SIRTURO ANTINEOPLASTICS Alkylating Agents Tier 2 CYCLOPHOSPHAMIDE CAPS temozolomide PA SP Tier 3 ALKERAN LEUKERAN Tier 4 HEXALEN PA SP TEMODAR PA SP + Preventive Care PA Prior Authorization LOMUSTINE QL Quantity Limitations MYLERAN ST Step Therapy SP Specialty 19 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Antineoplastic Enzyme Inhibitors Tier 2 Tier 4 imatinib PA SP AFINITOR PA SP ALECENSA PA BOSULIF PA CAPRELSA PA GILOTRIF PA GLEEVEC PA SP IMBRUVICA PA INLYTA PA JAKAFI PA NEXAVAR PA SPRYCEL PA SP STIVARGA PA SUTENT PA TARCEVA PA SP TASIGNA PA SP TYKERB PA SP VOTRIENT PA SP XALKORI PA ZELBORAF PA SP ZOLINZA PA QL SP ZORTRESS Antineoplastics Misc. Tier 1 Tier 2 Tier 3 anastrozole bexarotene oral PA SP bicalutamide exemestane flutamide hydroxyurea letrozole leuprolide acetate megestrol acetate mercaptopurine methotrexate tamoxifen citrate capecitabine PA SP FARESTON TABLOID ACTIMMUNE ARIMIDEX AROMASIN CASODEX ELIGARD EMCYT ETOPOSIDE FEMARA HYDREA LUPRON DEPOT SP MATULANE MEGACE ORAL OFORTA PA PURINETHOL PURIXAN SUS PA SOLTAMOX ERIVEDGE PA HYCAMTIN PA SP INTRON-A PA SP LONSURF PA LYSODREN PA SP NILANDRON PA SP SYLATRON PA SP TARGRETIN ORAL PA SP XELODA PA SP XTANDI PA ZYTIGA PA SP TREXALL Tier 4 Chemotherapy Rescue/Antidote Agents Tier 1 leucovorin calcium Tier 3 MESNEX Immunomodulators Tier 4 POMALYST PA SP REVLIMID PA SP THALOMID PA SP ANTIPARKINSON AGENTS Antiparkinson Anticholinergics Tier 1 benztropine mesylate trihexyphenidyl hcl Antiparkinson COMT Inhibitors Tier 1 ENTACAPONE tolcapone Tier 3 COMTAN TASMAR + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 20 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Antiparkinson Dopaminergics Tier 1 amantadine hcl bromocriptine mesylate carbidopa/levodopa carbidopa/levodopa er carbidopa/levodopa odt carbidopa/levodopa sr carbidopa/levodopa/entaca carbidopa/levodopa cr pramipexole ropinirole er PA ropinirole hcl Tier 3 MIRAPEX NEUPRO PATCH PA PARCOPA PARLODEL REQUIP REQUIP XL PA SINEMET SINEMET CR STALEVO Tier 4 DUOPA Antiparkinson Monoamine Oxidase Inhibitors Tier 1 selegiline hcl cap Tier 3 AZILECT QL ELDEPRYL Miscellaneous Tier 2 carbidopa ANTIPROTOZOAL AGENTS Antiprotozoal Agents Tier 2 atovaquone Tier 3 ALINIA MEPRON ANTIPSYCHOTICS/ANTIMANIC AGENTS Antimanic Agents Tier 1 lithium carbonate lithium carbonate er Tier 3 LITHIUM CARBONATE LITHIUM CITRATE LITHOBID Butyrophenones Tier 1 haloperidol haloperidol decanoate Tier 3 HALDOL HALDOL DECANOATE haloperidol lactate Dibenzapines Tier 1 clozapine Tier 2 SEROQUEL XR QL ST Tier 3 loxapine olanzapine quetiapine fumarate CLOZARIL LOXITANE SAPHRIS PA QL SEROQUEL IR ZYPREXA ZYPREXA SOLN ZYPREXA ZYDIS Miscellaneous Tier 1 aripiprazole + Preventive Care risperidone PA Prior Authorization thiothixene QL Quantity Limitations ziprasidone hcl ST Step Therapy SP Specialty 21 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Miscellaneous ABILIFY Tier 3 EQUETRO GEODON LATUDA PA fluphenazine hcl perphenazine RISPERDAL Phenothiazines chlorpromazine hcl Tier 1 prochlorperazine edisylat thioridazine hcl Tier 3 compro prochlorperazine maleate trifluoperazine hcl FLUPHENAZINE DECANOATE ANTISEPTICS & DISINFECTANTS Antiseptics & Disinfectants Tier 1 formadon Tier 3 FORMA-RAY FORMALDEHYDE POTASSIUM PERMANGANATE Chlorine Antiseptics Tier 3 CHLORHEXIDINE GLUCONATE PHISOHEX ANTIVIRALS Antiretrovirals abacav/lamiv/zido SP Tier 1 Tier 2 Tier 3 abacavir SP lamivudine/zidovudine SP didanosine lamivudine SP nevirapine SP nevirapine er SP stavudine zidovudine APTIVUS CAPS ATRIPLA SP COMPLERA SP CRIXIVAN EDURANT EMTRIVA SP EPZICOM SP INTELENCE SP INVIRASE CAPS ISENTRESS POW PACK PA SP KALETRA SP LEXIVA NORVIR SP PREZISTA SP RESCRIPTOR REYATAZ SP SELZENTRY SP STRIBILD SP SUSTIVA SP TIVICAY SP TRUVADA PA SP VIRACEPT 250 VIREAD 300MG SP VITEKTA SP ZIAGEN SOLN SP APTIVUS SOLN COMBIVIR SP EPIVIR SP GENVOYA SP INVIRASE TB RETROVIR TRIUMEQ SP TRIZIVIR SP VIDEX VIDEX EC VIRACEPT 625 VIRAMUNE SUS SP VIRAMUNE TAB SP VIRAMUNE XR SP VIREAD SP ZERIT FUZEON PA SP ODEFSEY SP PREZCOBIX SP ISENTRESS TAB SP ZIAGEN TB SP EVOTAZ SP Tier 4 TYBOST SP CMV Agents Tier 2 valganciclovir + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 22 / 61 Caterpillar Drug Formulary Generated April 22, 2016 CMV Agents Tier 3 VALCYTE SOLN VALCYTE TB Hepatitis Agents Tier 1 entecavir PA SP Tier 2 adefovir dipivoxil PA SP Tier 3 Tier 4 ribasphere SP ribavirin SP BARACLUDE PA SP COPEGUS SP MODERIBA SP REBETOL SP RIBAPAK SP RIBATAB SP DAKLINZA PA SP HARVONI PA SP HEPSERA PA SP INCIVEK PA SP OLYSIO PA SP PEG-INTRON PA QL SP PEGASYS PA SP SOVALDI PA SP TECHNIVIE PA SP TYZEKA PA SP VIEKIRA PA SP Herpes Agents Tier 1 acyclovir famciclovir valacyclovir hcl Tier 3 FAMVIR VALTREX ZOVIRAX ORAL Influenza Agents Tier 1 rimantadine hcl Tier 3 FLUMADINE BETA BLOCKERS Alpha-Beta Blockers Tier 1 carvedilol labetalol hcl Tier 3 COREG TRANDATE Beta Blockers Cardio-Selective acebutolol hcl Tier 1 Tier 3 atenolol betaxolol hcl metoprolol succinate er bisoprolol fumarate metoprolol tartrate KERLONE LOPRESSOR TOPROL XL ZEBETA SECTRAL TENORMIN Beta Blockers Non-Selective Tier 1 Tier 3 nadolol pindolol propranolol hcl sorine sotalol hcl timolol maleate BETAPACE CORGARD INDERAL LA INNOPRAN XL LEVATOL SOTYLIZE PA + Preventive Care PA Prior Authorization QL Quantity Limitations propranolol hcl er INDERAL XL ST Step Therapy SP Specialty 23 / 61 Caterpillar Drug Formulary Generated April 22, 2016 CALCIUM CHANNEL BLOCKERS Calcium Channel Blockers Tier 1 Tier 3 afeditab cr amlodipine besylate cartia xt dilt-cd dilt-xr diltiazem diltiazem cd diltiazem er diltiazem sr diltzac felodipine er isradipine matzim la nicardipine hcl nifediac cc nifedical xl nifedipine nifedipine er nimodipine QL nisoldipine nisoldipine er taztia xt verapamil hcl verapamil hcl cr verapamil hcl er verapamil hcl sa verapamil hcl sr ADALAT CC CALAN CALAN SR CARDENE SR CARDIZEM CARDIZEM CD CARDIZEM LA DILACOR XR ISOPTIN SR NIMOTOP QL NORVASC PROCARDIA PROCARDIA XL SULAR TIAZAC VERELAN VERELAN PM CARDIOTONICS Cardiac Glycosides Tier 1 digoxin Tier 3 LANOXIN digoxin solution CARDIOVASCULAR AGENTS - MISC. Impotence Agents Tier 3 CAVERJECT CAVERJECT IMPULSE CIALIS QL EDEX LEVITRA QL MUSE STAXYN QL VIAGRA QL Misc. - Combinations Tier 1 isosorb dinitrate/hyral QL Tier 3 BIDIL QL Miscellaneous Tier 1 papaverine hcl Tier 3 ISOXSUPRINE HCL Tier 4 CORLANOR Pulmonary Hypertension Tier 2 Tier 4 sildenafil PA QL SP ADCIRCA PA QL SP ADEMPAS PA LETAIRIS PA QL ORENITRAM PA REVATIO PA QL SP TRACLEER PA QL + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy OPSUMIT PA QL SP Specialty 24 / 61 Caterpillar Drug Formulary Generated April 22, 2016 CHEMICALS Solids Tier 3 BORIC ACID CONTRACEPTIVES Combination Contraceptives - Oral Tier 0 altavera + alyacen 1/35 + alyacen 7/7/7 + amethia + amethia lo + apri + aranelle + aviane + azurette + balziva + briellyn + camrese + camrese lo + caziant + cesia + cryselle + cryselle-28 + cyclafem 1/35 + cyclafem 7/7/7 + dasetta 1/35 + dasetta 7/7/7 + daysee + elinest + emoquette + enpresse-28 + estarylla + falmina + gianvi + gildess fe 1.5/30 + gildess fe 1/20 + INTROVALE + jolessa + junel 1.5/30 + junel 1/20 + junel fe 1.5/30 + junel fe 1/20 + kariva + kelnor 1/35 + kurvelo + leena + lessina-28 + levo/ethi/estradio + levonest + levora 0.15/30-28 + loryna + low-ogestrel + lutera + marlissa + microgestin 1.5/30 + microgestin 1/20 + microgestin fe + microgestin fe 1.5/30 + mono-linyah + mononessa + myzilra + necon 0.5/35-28 + necon 1/35-28 + necon 7/7/7 + noreth/ethinyl/ferr fum + norgestimate/ethinyl estr + Tier 3 nortrel 0.5/35 (28) + nortrel 1/35 (21) + nortrel 1/35 (28) + nortrel 7/7/7 + ocella + orsythia + philith + portia-28 + previfem + quanese + QUARTETTE + reclipsen + solia + sprintec 28 + sronyx + syeda + tilia fe + tri-estarylla + tri-legest fe + tri-linyah + tri-lo-estarylla + tri-lo-marzia + tri-lo-sprintec + tri-previfem + tri-sprintec + trinessa + trinessa lo + trivora-28 + velivet + VESTURA + viorele + wera + wymzya fe + zarah + zenchent + zenchent fe + zeosa + zovia 1/35e + AMETHYST BREVICON-28 CYCLESSA DESOGEN ESTROSTEP FE FEMCON FE LO LOESTRIN FE LOESTRIN 1.5/30-21 LOESTRIN 1/20-21 LOESTRIN 24 FE LOESTRIN FE 1.5/30 LOESTRIN FE 1/20 MIRCETTE MODICON MODICON-28 NECON 1/50-28 NORDETTE-28 NORINYL 1+35 NORINYL 1+50 OGESTREL ORTHO TRI-CYCLEN ORTHO TRI-CYCLEN LO ORTHO-CEPT ORTHO-CYCLEN ORTHO-CYCLEN-28 ORTHO-NOVUM 1/35-28 ORTHO-NOVUM 7/7/7 ORTHO-NOVUM 7/7/7-28 OVCON-35 TRI-NORINYL 28 YASMIN 28 YAZ ZOVIA 1/50E + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 25 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Combination Contraceptives - Transdermal Tier 0 XULANE + Combination Contraceptives - Vaginal Tier 0 NUVARING + Device-Diaphragm Tier 0 OMNIFLEX ALL + ORTHOFLEX ALL + Miscellaneous Tier 0 Tier 3 cervical caps + condoms (female) + spermicides gel + sponges (contraceptives) + spermicides (foam, film, supp) + CONCEPTROL GEL + Progestin Contraceptives - Injectable Tier 0 DEPO-SUBQ PROVERA 104 + Tier 3 DEPO-PROVERA CONTRACEPTIV medroxyprogesterone im + Progestin Contraceptives - Oral Tier 0 Tier 3 camila + errin + heather + nora-be + norethindrone + NOR-QD ORTHO MICRONOR jolivette + CORTICOSTEROIDS Glucocorticosteroids Tier 1 Tier 2 a-hydrocort a-methapred asmalpred baycadron cortisone acetate dexamethasone fludrocortisone acetate hydrocortisone methylprednisolone methylprednisolone dose pak prednisolone prednisone budesonide cap CELESTONE CORTEF DEPO-MEDROL DEXAMETHASONE INTENSOL Tier 3 asmalpred plus DEXPAK 10 DAY DEXPAK 13 DAY DEXPAK 6 DAY ENTOCORT EC KENALOG-10 KENALOG-40 MEDROL MEDROL DOSEPAK MILLIPRED ORAPRED PREDNISONE INTENSOL PRELONE SOLU-CORTEF SOLU-MEDROL COUGH/COLD/ALLERGY Antitussives benzonatate Tier 1 hydrocodone/homatropine hydromet tussigon + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 26 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Antitussives Tier 3 TESSALON TESSALON PERLES ZONATUSS Miscellaneous Tier 1 acetylcysteine sodium chloride neb Tier 3 HYPER-SAL NEBUSAL DERMATOLOGICALS Acne Products Tier 1 adapalene amnesteem avar cleanser avar-e emollient avita crm PA avita gel PA cerisa wash clindacin-p clindamax clindamycin phosphate topical myorisan prascion prascion ra with sunscree tretinoin crm/gel PA ery prascion fc tretinoin gel 0.1% PA rosanil cleanser sodium sulfacetamide tretinoin micro gel PA virti-sulf zenatane Tier 2 Tier 3 claravis tretinoin caps ABSORICA CAP AKNE-MYCIN ATRALIN GEL PA AZELEX CLEOCIN-T CLINDAGEL DIFFERIN ERYTHROMYCIN TOP EVOCLIN KLARON METRONIDAZOLE BENZOATE NUOX RETIN-A PA RETIN-A MICRO PA SODIUM SULFACETAMIDE/SULF TRETIN-X PA VANOXIDE-HC ZIANA VELTIN TRETINOIN GEL 0.04% PA Antibiotics - Topical Tier 2 mupirocin ALTABAX Tier 3 BACTROBAN CENTANY CORTISPORIN GENTAMICIN SULFATE Antifungals - Topical Tier 1 ciclodan ciclopirox clotrimazole/betamethason dermazene econazole nitrate exoderm hydrocortisone/iodoquinol ketoconazole top nyamyc nystatin/triamcinolone nystop oxiconazole cre ALA QUIN ALCORTIN A CLIOQUINOL ERTACZO EXELDERM LOPROX LOPROX SHAMPOO LOTRISONE MICONAZOLE NITRATE NIZORAL OXISTAT nystatin top pedi-dri Tier 3 Antineoplastic or Premalignant Lesion Agents - Topical Tier 1 fluorouracil + Preventive Care tretinoin crm/gel PA PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 27 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Antineoplastic or Premalignant Lesion Agents - Topical Tier 2 CARAC diclofenac gel 3% FLUOROPLEX Tier 3 EFUDEX SOLARAZE TOLAK CRE Tier 4 TARGRETIN TOP PA SP VALCHLOR GEL 0.16% PA Antipruritics - Topical Tier 1 doxepin hcl cre Tier 3 PRUDOXIN ZONALON Antipsoriatics Tier 1 acitretin Tier 2 TAZORAC PA Tier 3 Tier 4 calcipotriene sol methoxalen 8-MOP CALCIPOTRIENE OINT CALCITRENE OXSORALEN ULTRA SORIATANE DRITHO-CREME HP COSENTYX PA SP Antiseborrheic Products mexar wash Tier 1 OVACE PLUS Tier 3 re 10 wash seb-prev wash selenium sulfide OVACE PLUS WASH OVACE WASH SEB-PREV sodium sulfacetamide wash SELSUN SHAMPOO Antivirals - Topical Tier 3 DENAVIR ZOVIRAX TOP Burn Products Tier 1 silver sulfadiazine ssd Tier 3 SILVADENE SULFAMYLON thermazene Cauterizing Agents Tier 1 grafco silver nitrate app Tier 3 ARZOL SILVER NITRATE APP + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 28 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Corticosteroids - Topical Tier 1 ala cort alclometasone dipropionat amcinonide apexicon oint augmented betamethasone betamethasone dipropionat betamethasone val foam betamethasone valerate betamethasone valerate oint clobetasol propionate cormax scalp application desonide desoximetasone diflorasone diacetate fluocinolone acetonide fluticasone propionate halobetasol propionate hydrocortisone butyrate Tier 3 cortalo diflorasone oint hydrocortisone in absorba hydrocortisone topical hydrocortisone valerate mometasone furoate pramcort triamcinolone acetonide Tier 2 alphatrex lokara prednicarbate scalacort triderm u-cort calcip/betameth oint fluocinonide fluocinonide-e HALOG ACLOVATE ALA SCALP APEXICON E CAPEX CARMOL-HC CLOBEX CLODERM CORDRAN CORDRAN SP CORDRAN TAPE CORTANE-B CUTIVATE DERMA-SMOOTHE/FS BODY OIL DERMA-SMOOTHE/FS SCALP OI DERMATOP DESOWEN DIFLORASONE CRM DIPROLENE DIPROLENE AF ELOCON EPIFOAM KENALOG LOCOID LOCOID LIPOCREAM LUXIQ NOVACORT NUZON OLUX OLUX-E PANDEL PRAMOSONE SYNALAR TACLONEX OINT TACLONEX SCALP TEMOVATE TEMOVATE E TOPICORT TRIANEX ULTRAVATE VANOS VERDESO WESTCORT Emollient/Keratolytic Agents Tier 1 cerovel remeven u-kera e urea urea 40% nail film urea nail urea topical urea-c40 CEM-UREA GORDONS UREA UMECTA UMECTA NAIL FILM URAMAXIN URAMAXIN GT x-viate Tier 3 Emollients Tier 1 Tier 3 ammonium lactate laclotion lactic acid ATOPICLAIR ELETONE HYLATOPIC PLUS LAC-HYDRIN MIMYX Enzymes - Topical Tier 1 revina tbc aer Tier 3 SANTYL XENADERM + Preventive Care PA Prior Authorization vasolex QL Quantity Limitations ST Step Therapy SP Specialty 29 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Immunomodulating Agents - Topical Tier 1 imiquimod Tier 3 ALDARA ZYCLARA CRM 3.75% Immunosuppressive Agents - Topical Tier 3 ELIDEL PROTOPIC Keratolytic/Antimitotic Agents podocon 25 in benzoin tin Tier 1 Tier 3 podofilox salacyn salicylic acid CANTHARIDIN CONDYLOX Local Anesthetics - Topical Tier 2 lidocaine pad Tier 3 LIDODERM XYLOCAINE Miscellaneous Tier 1 aluminum chloride hypercare Tier 3 DRYSOL VEREGEN XCLAIR Nonsteroidal Anti-inflammatory Agts(NSAIDs) Tier 1 diclofenac soln 1.5% PA QL FLECTOR PATCH PA QL Tier 3 PENNSAID SOLN 1.5% PA QL PENNSAID SOLN 2.0% PA QL VOLTAREN GEL PA QL Pigmenting-Depigmenting Agents Tier 3 OXSORALEN Rosacea Agents Tier 1 metronidazole top Tier 2 FINACEA Tier 3 METROCREAM rosadan vitazol METROGEL METROLOTION NORITATE Scabicides & Pediculicides Tier 1 acticin lindane malathion permethrin Tier 3 ELIMITE EURAX OVIDE ULESFIA Tar Products Tier 3 COAL TAR + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 30 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Wound Care Products ATRAPRO ANTIPRURITIC HYDR CARRASYN HYDROGEL WOUND D CURAFIL GEL WOUND DRESSIN Tier 3 RADIAPLEXRX RADIGEL DIAB DIAB F.D.G. FREEZE-DRIED REGRANEX SILVASORB SPECTRAGEL DIABETIC SUPPLIES Blood Glucose Monitors Tier 2 ACCU-CHEK MONITORS QL Tier 3 BLOOD GLUCOSE MONITOR-OTHER QL ONETOUCH MONITORS QL Lancets Tier 1 lancets QL Syringes Tier 1 needles (insulin) syringes insulin Test Strips Tier 1 ACCU-CHEK STRIPS QL Tier 2 COAGUCHEK QL Tier 3 BLOOD GLUCOSE STRIPS-OTHER QL ONETOUCH STRIPS QL DIGESTIVE AIDS Digestive Aids - Misc Tier 3 COTAZYM Digestive Enzymes Tier 2 Tier 3 CREON PANCREAZE PANCRELIPASE PEPSIN SUCRAID ULTRESA ZENPEP PERTZYE DIURETICS Carbonic Anhydrase Inhibitors Tier 0 hydrochlorothiazide 12.5mg Tier 1 acetazolamide acetazolamide er Tier 3 DIAMOX NEPTAZANE methazolamide Diuretic Combinations Tier 0 amiloride/hctz Tier 1 spironolactone/hctz + Preventive Care triamterene/hctz PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 31 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Diuretic Combinations Tier 3 ALDACTAZIDE DYAZIDE MAXZIDE MAXZIDE-25 Loop Diuretics Tier 1 bumetanide furosemide tabs 7 & liq torsemide Tier 3 DEMADEX EDECRIN LASIX Potassium Sparing Diuretics Tier 1 amiloride hcl spironolactone Tier 3 ALDACTONE DYRENIUM Thiazides and Thiazide-Like Diuretics chlorothiazide Tier 0 chlorthalidone hydrochlorothiazide 25mg hydrochlorothiazide 50mg indapamide Tier 1 methyclothiazide metolazone Tier 3 DIURIL MICROZIDE ZAROXOLYN ENDOCRINE AND METABOLIC AGENTS - MISC. Antidotes-Potassium Removing Agents Tier 1 kionex Tier 3 SPS Tier 4 VISTOGARD QL sodium polystyrene sulfon Bone Density Regulators alendronate sodium PA QL Tier 1 Tier 3 calcitonin-salmon QL etidronate disodium FORTEO PA FORTICAL QL risedronate PA QL ST ACTONEL PA QL ST DIDRONEL FOSAMAX QL MIACALCIN QL Enzymes Tier 4 STRENSIQ INJ PA XURIDEN PA Growth Hormones GENOTROPIN PA SP Tier 4 HUMATROPE PA SP NORDITROPIN FLEXPRO PA SP NORDITROPIN NORDIFLEX PEN PA SP NUTROPIN PA SAIZEN PA SP SEROSTIM PA SP ZOMACTON PA SP ZORBTIVE PA SP TEV-TROPIN PA SP Lipodystrophy Agents Tier 4 MYALEPT INJ PA QL + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 32 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Miscellaneous Tier 1 Tier 2 Tier 3 Tier 4 cabergoline calcitriol desmopressin acetate doxercalciferol levocarnitine minirin paricalcitol raloxifene BUPHENYL CARNITOR CARNITOR SF DDAVP EVISTA HECTOROL OSPHENA ROCALTROL SENSIPAR STIMATE ZEMPLAR ACTHAR PA CERDELGA PA SP CYSTAGON INCRELEX PA KUVAN PA PROSCYBI ST RAVICTI PA SAMSCA PA SP SANDOSTATIN PA SP SANDOSTATIN LAR DEPOT PA SP SOMAVERT SYNAREL PA SP octreotide acetate PA SP SIGNIFOR PA ESTROGENS Estrogen Combinations Tier 1 covaryx covaryx hs eemt essian essian h.s. esterified estrogens/meth estradiol/norethindrone jinteli methyltestosterone/esteri mimvey eemt hs norethindrone/thinyl estradiol Tier 2 Tier 3 CLIMARA PRO PREMPHASE PREMPRO ACTIVELLA ANGELIQ COMBIPATCH FEMHRT LOW DOSE estradiol td patch estradiol valerate estropipate ALORA CENESTIN CLIMARA DELESTROGEN DEPO-ESTRADIOL DIVIGEL ENJUVIA ESTRACE TABS ESTROGEL ESTRONE EVAMIST MENEST MENOSTAR VIVELLE-DOT PREFEST Estrogens estradiol tabs Tier 1 Tier 2 Tier 3 ortho-est PREMARIN TABS GASTROINTESTINAL AGENTS - MISC. Gallstone Solubilizing Agents Tier 1 ursodiol Tier 3 ACTIGALL CHENODAL URSO 250 URSO FORTE Gastrointestinal Stimulants Tier 1 metoclopramide hcl + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 33 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Gastrointestinal Stimulants Tier 3 REGLAN Inflammatory Bowel Agents Tier 1 Tier 2 Tier 3 Tier 4 azathioprine balsalazide disodium colocort hydrocortisone rectal mercaptopurine mesalamine prednisone sulfasalazine sulfazine sulfazine ec ASACOL HD CANASA CORTIFOAM DELZICOL APRISO AZULFIDINE AZULFIDINE EN-TABS COLAZAL CORTENEMA LIALDA PENTASA ROWASA CIMZIA PA SP HUMIRA PA SP DIPENTUM Intestinal Acidifiers Tier 1 enulose generlac Irritable Bowel Syndrome (IBS) Agents Tier 3 AMITIZA QL LINZESS QL LOTRONEX QL Miscellaneous Tier 3 MOVANTIK PA Tier 4 CHOLBAM PA RELISTOR PA Phosphate Binder Agents Tier 1 calcium acetate sevelamer carbonate tab PA Tier 2 RENAGEL PA RENVELA POW PACK PA AURYXIA PA ELIPHOS PHOSLYRA PA RENVELA TAB PA Tier 3 FOSRENOL PA PHOSLO GENITOURINARY AGENTS Alkalinizers Tier 1 citric acid/sodium citrat cytra k crystals cytra-2 cytra-3 cytra-k potassium citrate potassium citrate/citric taron-crystals POLYCITRA-K CRYSTALS SHOHLS SOLUTION MODIFIED tricitrates ORACIT Tier 3 UROCIT-K Miscellaneous Tier 2 ELMIRON Tier 3 K-PHOS NO 2 + Preventive Care LITHOSTAT PA Prior Authorization RENACIDIN QL Quantity Limitations THIOLA ST Step Therapy SP Specialty 34 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Prostatic Hypertrophy Agents Tier 1 alfuzosin hcl er duasteride finasteride 5mg tamsulosin hcl Tier 3 AVODART FLOMAX PROSCAR UROXATRAL Urinary Analgesics Tier 1 phenazopyridine hcl Tier 3 PYRIDIUM GOUT AGENTS Gout Agents Tier 1 allopurinol probenecid probenecid/colchicine Tier 3 COLCRYS ULORIC PA QL ZYLOPRIM HEMATOLOGICAL AGENTS - MISC. Bradykinin B2 Receptor Antagonists Tier 4 FIRAZYR PA QL SP Hematorheologic Agents Tier 1 pentoxifylline cr Tier 3 TRENTAL pentoxifylline er Platelet Aggregation Inhibitors anagrelide hydrochloride Tier 1 Tier 3 aspirin/dipyridamole cilostazol EFFIENT clopidogrel QL dipyridamole AGGRENOX AGRYLIN BRILINTA PERSANTINE PLAVIX QL PLETAL HEMATOPOIETIC AGENTS Agents for Gaucher Disease Tier 4 ZAVESCA Cobalamins Tier 1 cyanocobalamin Folic Acid/Folates Tier 0 folic acid 400mcg + Tier 1 folic acid 1mg folic acid 800mcg + Hematopoietic Growth Factors Tier 3 ARANESP ALBUMIN FREE PA SP + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 35 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Hematopoietic Growth Factors Tier 4 ARANESP PA SP EPOGEN PA SP GRANIX PA SP LEUKINE PA SP NEULASTA PA SP NEUMEGA PA SP NEUPOGEN PA SP PROCRIT PA SP Hematopoietic Mixtures Tier 1 airavite fabb fe c plus ferocon ferotrinsic ferrex 150 forte ferrogels forte folbee folcaps folic acid/cyanocobalamin folplex 2.2 foltrin hematinic/folic acid hematogen hematogen forte hemocyte-f iferex 150 forte martinic myferon 150 forte nufol poly-iron 150 forte polysaccharide iron forte Tier 3 folic acid/vitamin b-6/vi purevit dualfe plus se-tan plus tl icon tl-fol 500 MULTIGEN senilezol tl gard rx tricon trigels-f forte FOLGARD RX HEMATOGEN FA ICAR-C PLUS NEPHRON FA PROFERRIN-FORTE TANDEM PLUS Miscellaneous Tier 4 PROMACTA PA QL SP HEMOSTATICS Hemostatics - Systemic Tier 1 tranexamic acid Tier 2 aminocaproic acid Tier 3 AMICAR LYSTEDA HYPNOTICS Barbiturate Hypnotics Tier 1 phenobarbital Tier 3 BUTISOL SODIUM SECONAL Miscellaneous Tier 3 ROZEREM QL Non-Barbiturate Hypnotics Tier 1 estazolam QL eszopiclone QL flurazepam hcl QL triazolam QL zaleplon QL zolpidem tartrate QL AMBIEN QL AMBIEN CR QL HALCION QL RESTORIL QL SONATA QL temazepam QL zolpidem tartrate er QL Tier 3 + Preventive Care PA Prior Authorization QL Quantity Limitations LUNESTA QL ST Step Therapy SP Specialty 36 / 61 Caterpillar Drug Formulary Generated April 22, 2016 IMMUNE MEDIATORS Immunomodulators Tier 4 POMALYST PA SP REVLIMID PA SP THALOMID PA SP Immunosuppressive Agents Tier 1 Tier 3 azathioprine cyclosporine gengraf hecoria mycophenolate mofetil sirolimus tacrolimus caps SP AZASAN CELLCEPT CYCLOSPORINE MODIFIED IMURAN MYFORTIC NEORAL PROGRAF CAPS SP RAPAMUNE SANDIMMUNE LAXATIVES Laxative Combinations gavilyte-c Tier 1 Tier 3 gavilyte-g gavilyte-n/flavor pack peg 3350/electrolytes GOLYTELY NULYTELY/FLAVOR PACKS SUPREP BOWEL PREP trilyte COLYTE-FLAVOR PACKS Laxatives - Miscellaneous Tier 1 constulose Tier 2 KRISTALOSE lactulose Saline Laxatives Tier 2 VISICOL Tier 3 OSMOPREP MEDICAL DEVICES Contraceptives FEMCAP + Tier 0 ORTHO DIAPHRAGM ALL-FLEX/ + PRENTIF CAVITY-RIM CERVIC + PRENTIF FITTING SET + Parenteral Therapy Supplies Tier 1 SYRINGES INSULIN SYRINGES VARIOUS MIGRAINE PRODUCTS Migraine Combinations epidrin Tier 1 Tier 3 isometheptene/caff/apap isometheptene/dichloral/apap CAFERGOT MIGERGOT migragesic ida nodolor MIGRALAM PRODRIN Migraine Products Tier 1 dihydroergotamine mesylat + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 37 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Migraine Products Tier 3 D.H.E. 45 ERGOMAR MIGRANAL Serotonin Agonists Tier 1 Tier 3 almotriptan PA QL ST naratriptan hcl QL rizatriptan QL rizatriptan mlt QL sumatriptan inj QL sumatriptan tabs QL AMERGE QL ST AXERT PA QL ST FROVA PA QL ST IMITREX QL IMITREX NASL PA QL MAXALT PA QL ST MAXALT-MLT PA QL ST RELPAX PA QL ST ZECUITY ST ZOMIG QL ST SUMATRIPTAN NASAL PA QL ZOMIG NASL PA QL MINERALS & ELECTROLYTES Bicarbonates Tier 3 NEUT Fluoride Tier 0 Tier 1 Tier 3 sodium fluoride + epiflur fluor-a-day fluoride fluoritab flura-drops 0.125 karidium ludent nafrinse drops FLURA-DROPS 0.25 LURIDE k-effervescent k-prime Iodine Products Tier 3 SSKI Iron-Misc. Tier 0 ferrous sulfate + Tier 3 VITAFOL Magnesium Tier 3 MAGNEBIND 400 Phosphate Tier 1 phospha 250 neutral Tier 3 K-PHOS K-PHOS NEUTRAL Potassium effervescent pot chloride Tier 1 k-vescent klor-con klor-con 10 klor-con 8 klor-con m10 klor-con m20 klor-con/ef potassium chloride cr potassium chloride er potassium chloride sa potassium chloride sr + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 38 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Potassium EFFER-K Tier 3 K-TABS KLOR-CON 25 KLOR-CON M15 MICRO-K Sodium Tier 1 sodium chloride tab Tier 3 SODIUM CHLORIDE MOUTH/THROAT/DENTAL AGENTS Anesthetics Topical Oral Tier 1 lidocaine viscous Tier 2 BXN MOUTHWASH SUSP Tier 3 LTA 360 KIT Anti-infectives - Throat Tier 1 clotrimazole troches nystatin Antiallergy Agents - Mouth/Throat Tier 3 APHTHASOL Antiseptics - Mouth/Throat Tier 1 periogard Tier 3 DEBACTEROL PERIDEX Steroids - Mouth/Throat Tier 1 oralone triamcinolone in orabase Throat Products - Misc. Tier 1 Tier 3 cevimeline hcl pilocarpine hydrochloride CAPHOSOL EVOXAC GELCLAIR NUMOISYN SALAGEN MUSCULOSKELETAL THERAPY AGENTS Central Muscle Relaxants Tier 1 baclofen carisoprodol 250mg carisoprodol 350mg chlorzoxazone cyclobenzaprine hcl ed baclofen metaxalone methocarbamol orphenadrine citrate orphenadrine citrate cr orphenadrine citrate er Tier 3 tizanidine hcl FLEXERIL NORFLEX PARAFON FORTE DSC SKELAXIN SOMA ZANAFLEX + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy ROBAXIN SP Specialty 39 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Direct Muscle Relaxants Tier 1 dantrolene sodium Tier 3 DANTRIUM Muscle Relaxant Combinations Tier 1 carisoprodol/asa/codeine carisoprodol/aspirin orphenadrine compound ds orphenadrine/asa/caffeine Phosphodiesterase Inhibitor Tier 4 OTEZLA PA NASAL AGENTS - SYSTEMIC AND TOPICAL Nasal Anti-infectives Tier 3 BACTROBAN NASAL Nasal Antiallergy Tier 1 azelastine nasal Tier 3 ASTELIN Nasal Anticholinergics Tier 1 ipratropium bromide nasal Tier 3 ATROVENT Nasal Steroids Tier 1 budesonide nsl(pregnancy only) PA Tier 3 RHINOCORT NASAL (PREGNANCY ONLY) PA Sympathomimetic Decongestants Tier 3 LUSONAL TYZINE NEUROMUSCULAR AGENTS ALS Agents Tier 3 RILUTEK OPHTHALMIC AGENTS Artificial Tears and Lubricants Tier 3 LACRISERT Beta-blockers - Ophthalmic Tier 1 betaxolol ophth carteolol hcl metipranolol timolol ophth + Preventive Care PA Prior Authorization dorzolamide/timolol QL Quantity Limitations ST Step Therapy levobunolol hcl SP Specialty 40 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Beta-blockers - Ophthalmic Tier 2 Tier 3 BETIMOL BETOPTIC-S BETAGAN BETAGAN C CAP QD COMBIGAN COSOPT ISTALOL OPTIPRANOLOL TIMOPTIC TIMOPTIC-XE Cycloplegic Mydriatics Tier 1 Tier 3 atropine sulfate cyclopentolate hcl mydral tropicamide CYCLOGYL CYCLOMYDRIL ISOPTO HYOSCINE MYDRIACYL homatropaire homatropine hbr ISOPTO ATROPINE ISOPTO HOMATROPINE Cystine-Depleting Agents Tier 3 CYSTARAN Miotics Tier 1 pilocarpine ophth ISOPTO CARBACHOL Tier 3 ISOPTO CARPINE MIOSTAT PHOSPHOLINE IODIDE PILOPINE HS Ophthalmic Adrenergic Agents Tier 1 apraclonidine brimonidine tartrate Tier 3 ALPHAGAN P IOPIDINE SIMBRINZA Ophthalmic Anti-infectives Tier 1 Tier 2 Tier 3 ak-poly-bac bacitracin/polymyxin b ciprofloxacin hcl erythromycin ophth gatifloxacin gentak gentamicin ophth ilotycin levofloxacin ophth neo-polycin neomycin/polymyxin/bacitr/hc neomycin/polymyxin/gramic ofloxacin ophth polycin b romycin sodium sulfacetamide ophth tobramycin sulfate trifluridine trimethoprim/polymyxin b triple antibiotic MOXEZA VIGAMOX AZASITE BACITRACIN OPHTH BLEPH-10 CILOXAN GARAMYCIN NATACYN NEOSPORIN OCUFLOX POLYTRIM TOBREX VIROPTIC ZIRGAN ZYMAXID Ophthalmic Decongestants Tier 1 ak-con Tier 3 MYDFRIN + Preventive Care altafrin PA Prior Authorization neofrin QL Quantity Limitations phenylephrine hcl ST Step Therapy SP Specialty 41 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Ophthalmic Immunomodulators Tier 3 RESTASIS Ophthalmic Local Anesthetics Tier 1 Tier 3 altacaine parcaine proparacaine hcl tetracaine hcl tetravisc tetravisc forte tetcaine ALCAINE Ophthalmic Steroids Tier 1 Tier 2 Tier 3 dexamethasone ophth diclofenac ophth 0.1% ketorolac ophth neomycin/polymyxin/dexame fluor-op fluorometholone neomycin/polymyxin/hc ophth poly-dex prednisolone ophth sulfacetamide/prednisolon tobramycin/dexamethasone LOTEMAX PRED MILD ALREX BLEPHAMIDE FLAREX FML FML FORTE FML LIQUIFILM ILEVRO MAXIDEX MAXITROL OMNIPRED PRED FORTE PRED-G PRED-G S.O.P. TOBRADEX VEXOL ZYLET Ophthalmics - Misc. Tier 1 Tier 3 azelastine ophth bromfenac cromolyn sodium ophth dorzolamide hcl epinastine hcl flurbiprofen ophth diclofenac sodium ACULAR ACULAR LS ALOCRIL ALOMIDE AZOPT ELESTAT NEVANAC OCUFEN OPTIVAR TRUSOPT Prostaglandins - Ophthalmic Tier 1 latanoprost QL Tier 3 LUMIGAN QL ST TRAVATAN Z QL ST XALATAN QL ST ZIOPTAN QL ST OTIC AGENTS Otic Agents - Miscellaneous Tier 1 acetic acid acetic acid/aluminum acet Tier 3 CRESYLATE VOSOL Otic Analgesics Tier 3 PINNACAINE OTIC Otic Anti-infectives Tier 1 ofloxacin otic + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 42 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Otic Combinations Tier 1 aero otic hc antibiotic ear antipyrine/benzocaine aurodex auroguard cortic-nd cyotic exotic-hc oticin oto-end 10 neomycin/polymyxin/hc otic otomar Tier 2 Tier 3 otomax-hc pramoxine-hc CIPRO HC COLY-MYCIN S PA CORTANE-B AQUEOUS CORTISPORIN OTIC CORTISPORIN-TC PRAMOTIC CIPRODEX CORTANE-B-OTIC Otic Steroids Tier 1 acetasol hc fluocinolone otic Tier 3 DERMOTIC VOSOL HC hydrocortisone/acetic aci OXYTOCICS Oxytocics Tier 1 methylergonovine maleate Tier 3 METHERGINE PHARMACEUTICAL ADJUVANTS Irrigation Solutions Tier 1 sterile water irrigation tis-u-sol Liquid Vehicles Tier 1 sodium chloride bacterios sterile water for injecti Tier 3 BACTERIOSTATIC WATER INJ COLLODION Placebos Tier 3 PLACEBO #00 PROGESTINS Progestins medroxyprogesterone Tier 1 progesterone micronized MAKENA SP MEGACE ES progesterone oral AYGESTIN Tier 3 norethindrone acetate PROMETRIUM PROVERA PSYCHOTHERAPEUTIC AND NEUROLOGICAL AGENTS - MISC. Agents for Chemical Dependency bupropion hcl er 150mg + QL Tier 0 CHANTIX + QL nicotine replacement + QL + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 43 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Agents for Chemical Dependency Tier 1 acampro disulfiram Tier 3 ANTABUSE CAMPRAL Antidementia Agents Tier 1 Tier 3 donepezil 10mg donepezil 5mg donepezil odt galantamine memantine hcl memantine sol rivastigmine patch QL rivastigmine tartrate ARICEPT 10MG ARICEPT 5MG ARICEPT ODT EXELON EXELON PATCH QL NAMENDA NAMENDA SOL NAMENDA XR RAZADYNE ER RAZADYNE SOLN RAZADYNE TBS Combination Psychotherapeutics chlordiazepoxide/amitript Tier 1 Tier 3 olanzapine/fluoxetine QL perphenazine/amitriptylin SYMBYAX QL Miscellaneous Tier 1 pimozide Tier 2 tetrabenazine PA QL Tier 3 NUEDEXTA PA QL ORAP Tier 4 XENAZINE PA QL XYREM PA QL Multiple Sclerosis Agents Tier 4 AMPYRA PA QL AUBAGIO PA AVONEX PA SP BETASERON PA SP COPAXONE 20MG PA SP COPAXONE 40MG PA SP EXTAVIA PA SP GILENYA PA SP PLEGRIDY INJ PA SP REBIF PA SP TECFIDERA PA QL SP RESPIRATORY AGENTS Bronchodilator Combinations Tier 3 ANORO ELLIPTA Bronchodilators Tier 1 ipratropium bromide Tier 2 ATROVENT HFA SPIRIVA QL Tier 3 INCRUSE ELLIPTA PA TUDORZA PRESSAIR PA Combinations Tier 1 difil-g forte dyflex-g Tier 3 BRONDIL ED-BRON G + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 44 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Devices Tier 3 AEROCHAMBER Leukotriene Modulators Tier 1 montelukast sodium zafirlukast ST Tier 3 ACCOLATE PA ST SINGULAIR Miscellaneous Tier 1 cromolyn sodium Tier 3 DALIRESP PA Tier 4 KALYDECO PA PULMOZYME PA SP Steroid Inhalants Tier 1 budesonide inh Tier 2 FLOVENT QVAR Tier 3 ALVESCO ASMANEX PULMICORT PULMICORT FLEXHALER Sympathomimetics Tier 1 albuterol sulfate albuterol sulfate er levalbuterol neb metaproterenol sulfate albuterol sulfate neb ipratropium/albuterol terbutaline sulfate VENTOLIN HFA Tier 2 Tier 3 ADVAIR COMBIVENT SEREVENT DISKUS SYMBICORT FORADIL AEROLIZER PROVENTIL HFA ACCUNEB ADRENALIN ARCAPTA NEOHALER BREO ELLIPTA DULERA DUONEB MAXAIR AUTOHALER PERFOROMIST PA PROAIR STRIVERDI AER RESPIMAT VOSPIRE ER XOPENEX theophylline sr Xanthines Tier 1 Tier 3 theochron theophylline cr theophylline er ELIXOPHYLLIN LUFYLLIN THEO-24 THEOPHYLLINE 400,600 CR,ER THYROID AGENTS Antithyroid Agents Tier 1 methimazole Tier 3 TAPAZOLE propylthiouracil Thyroid Hormones Tier 1 levothroid levothyroxine sodium levoxyl liothyronine tab np thyroid 30 np thyroid 60 np thyroid 90 unithroid + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 45 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Thyroid Hormones Tier 3 ARMOUR THYROID CYTOMEL NATURE-THROID NATURE-THROID NT-2.5 SYNTHROID THYROLAR TRIIODO-L-THYRONINE WESTHROID ULCER DRUGS Antispasmodics belladonna & opium supp Tier 1 chlordiazepoxide/clidnium bro dicyclomine hcl ed-spaz glycopyrrolate hyomax -dt hyomax-sl hyomax-sr hyoscyamine sulfate hyoscyamine sulfate er hyoscyamine sulfate sr hyosyne hyoscyamine sulfate odt me-pb-hyos methscopolamine bromide oscimin oscimin sr symax fastabs nulev symax-sl ANASPAZ BENTYL CANTIL CUVPOSA DONNATAL LEVBID LEVSIN LEVSIN/SL LIBRAX PAMINE PAMINE FORTE PROPANTHELINE BROMIDE ROBINUL ROBINUL FORTE SCOPOLAMINE HBR SYMAX DUOTAB symax-sr Tier 3 H-2 Antagonists Tier 1 nizatidine solu PA ranitidine syrup Misc. Anti-Ulcer Tier 1 sucralfate Tier 3 CARAFATE Proton Pump Inhibitors Tier 3 NEXIUM GRANULES PA PREVACID SOLUTAB PA Ulcer Drugs - Prostaglandins Tier 1 misoprostol Tier 3 CYTOTEC Ulcer Therapy Combinations Tier 3 PYLERA URINARY ANTI-INFECTIVES Urinary Anti-infective Combinations Tier 1 Tier 3 hyophen phosphasal ur n-c urelle uretron d/s urin d/s ustell uta uticap utira-c utrona-c PROSED/DS UROQID #2 + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 46 / 61 Caterpillar Drug Formulary Generated April 22, 2016 Urinary Anti-infectives methenamine hippurate Tier 1 Tier 3 methenamine mandelate nitrofurantoin macrocryst nitrofurantoin nitrofurantoin monohydrat FURADANTIN HIPREX MONUROL UREX MACROBID MACRODANTIN URINARY ANTISPASMODICS Beta-3 Adrenergic Agonists Tier 3 MYRBETRIQ PA ST Urinary Antispasmodic Combinations Tier 1 phenazopyridine plus phenazopyridine/butabarb urelief plus Urinary Antispasmodics Tier 1 bethanechol chloride darifenacin hbr er PA ST flavoxate hcl oxybutynin chloride oxybutynin chloride er tolterodine er tolterodine tartrate DETROL PA ST DETROL LA PA ST DITROPAN XL ST ENABLEX PA ST OXYTROL PA ST URECHOLINE VESICARE PA ST trospium chloride Tier 3 URINE TEST STRIPS Miscellaneous Tier 2 CHEMSTRIP K QL CLINITEST TABS - STRIPS QL ST KETO-DIASTIX QL KETOCARE QL COMBISTIX QL URISTIX QL VAGINAL PRODUCTS Miscellaneous Vaginal Products Tier 3 ACID JELLY FEM PH RELAGARD Vaginal Anti-infectives Tier 1 Tier 3 clindamycin phosphate metronidazole vaginal miconazole 3 combo pack terconazole vandazole zazole AVC CLEOCIN METROGEL-VAGINAL NYSTATIN VAGINAL TERAZOL 3 TERAZOL 7 MICONAZOLE 3 Vaginal Estrogens Tier 2 FEMRING PREMARIN CRM Tier 3 ESTRACE ESTRING VAGIFEM Vaginal Progestins Tier 3 CRINONE PA + Preventive Care PA Prior Authorization QL Quantity Limitations ST Step Therapy SP Specialty 47 / 61 Caterpillar Drug Formulary Generated April 22, 2016 VASOPRESSORS Anaphylaxis Therapy Agents Tier 2 epinephrine injector EPIPEN Tier 3 ADRENACLICK AUVI-Q EPIPEN 2-PAK EPIPEN-JR 2-PAK Vasopressors Tier 1 midodrine hcl VITAMINS B-Complex w/ Folic Acid Tier 1 Tier 3 b-plex dialyvite ferrocite plus folbee plus cz hematinic plus complex hematinic plus vitamins/m nephronex rena-vite rx renal reno caps triphrocaps vol-care rx DIATX ZN FOLBEE PLUS HEMOCYTE-PLUS mynephrocaps renalpren NEPHRO-VITE RX NEPHROCAPS Multiple Vitamins w/ Minerals v-c forte Tier 1 Tier 3 vic-forte vicap forte vita-min PROTECT PLUS PROTECT PLUS NR vitamin forte FORTAVIT Oil Soluable Vitamins Tier 1 ergocalciferol + QL phytonadione Tier 3 DRISDOL + QL MEPHYTON + Preventive Care PA Prior Authorization vitamin d + QL QL Quantity Limitations ST Step Therapy vitamin k SP Specialty 48 / 61 Caterpillar Drug Formulary Generated April 22, 2016 8-MOP - 28 A-HYDROCORT - 26 A-METHAPRED - 26 ABACAV/LAMIV/ZIDO - 22 ABACAVIR - 22 ABILIFY - 22 ABSORICA CAP - 27 ACAMPRO - 44 ACARBOSE - 14 ACCOLATE - 45 ACCU-CHEK MONITORS - 31 ACCU-CHEK STRIPS - 31 ACCUNEB - 45 ACCUPRIL - 18 ACCURETIC - 19 ACEBUTOLOL HCL - 23 ACEON - 18 ACETAMINOPHEN/CODEINE #3, #4 - 8 ACETASOL HC - 43 ACETAZOLAMIDE - 31 ACETAZOLAMIDE ER - 31 ACETIC ACID - 42 ACETIC ACID/ALUMINUM ACET - 42 ACETYLCYSTEINE - 27 ACID JELLY - 47 ACITRETIN - 28 ACLOVATE - 29 ACTEMRA INJ - 6 ACTHAR - 33 ACTICIN - 30 ACTIGALL - 33 ACTIMMUNE - 20 ACTIQ - 8 ACTIVELLA - 33 ACTONEL - 32 ACTOPLUS MET - 14 ACTOS - 15 ACULAR - 42 ACULAR LS - 42 ACYCLOVIR - 23 ADALAT CC - 24 ADAPALENE - 27 ADCIRCA - 24 ADDERALL - 6 ADDERALL XR - 6 ADEFOVIR DIPIVOXIL - 23 ADEMPAS - 24 ADRENACLICK - 48 ADRENALIN - 45 ADVAIR - 45 ADVICOR - 17 AERO OTIC HC - 43 AEROCHAMBER - 45 AFEDITAB CR - 24 AFINITOR - 20 AGGRENOX - 35 AGRYLIN - 35 AHIST - 17 AIRAVITE - 36 AK-CON - 41 AK-POLY-BAC - 41 AKNE-MYCIN - 27 ALA CORT - 29 ALA QUIN - 27 ALA SCALP - 29 ALBENZA - 9 ALBUTEROL SULFATE - 45 ALBUTEROL SULFATE ER - 45 ALBUTEROL SULFATE NEB - 45 ALCAINE - 42 ALCLOMETASONE DIPROPIONAT - 29 ALCORTIN A - 27 ALDACTAZIDE - 32 ALDACTONE - 32 ALDARA - 30 ALECENSA - 20 ALENDRONATE SODIUM - 32 ALFUZOSIN HCL ER - 35 ALI-FLEX - 7 ALINIA - 21 ALKERAN - 19 ALLOPURINOL - 35 ALMOTRIPTAN - 38 ALOCRIL - 42 ALOMIDE - 42 ALORA - 33 ALPHAGAN P - 41 ALPHATREX - 29 ALPRAZOLAM - 10 ALPRAZOLAM ER - 10 ALPRAZOLAM INTENSOL - 10 ALPRAZOLAM ODT - 10 ALPRAZOLAM XR - 10 ALREX - 42 ALTABAX - 27 ALTACAINE - 42 ALTACE - 18 ALTAFRIN - 41 ALTAVERA - 25 ALTOPREV - 17 ALUMINUM CHLORIDE - 30 ALVESCO - 45 ALYACEN 1/35 - 25 ALYACEN 7/7/7 - 25 AMANTADINE HCL - 21 AMARYL - 15 AMBIEN - 36 AMBIEN CR - 36 AMCINONIDE - 29 AMERGE - 38 AMETHIA - 25 AMETHIA LO - 25 AMETHYST - 25 AMICAR - 36 AMIKACIN SULFATE - 10 AMILORIDE HCL - 32 AMILORIDE/HCTZ - 31 AMINOCAPROIC ACID - 36 AMIODARONE HCL - 10 AMITIZA - 34 AMITRIPTYLINE HCL - 14 AMLODIPINE BESYLATE - 24 AMLODIPINE/BENAZAPRIL - 18 AMMONIUM LACTATE - 29 AMNESTEEM - 27 AMOXAPINE - 14 AMOXICILLIN - 12 AMOXICILLIN/CLAVULANATE - 12 AMPHETAMINE/DEXTROAMPHET ER - 6 AMPHETAMINE/DEXTROAMPHETA - 6 AMPHOTERICIN B - 16 AMPICILLIN - 12 AMPYRA - 44 ANAFRANIL - 14 ANAGRELIDE HYDROCHLORIDE - 35 ANALPRAM-HC - 9 ANAPROX - 7 ANAPROX DS - 7 ANASPAZ - 46 ANASTROZOLE - 20 ANCOBON - 16 ANDRODERM - 9 ANDROGEL - 8 ANDROID - 9 ANDROXY - 9 ANEXSIA - 8 ANGELIQ - 33 ANOLOR 300 - 7 ANORO ELLIPTA - 44 ANTABUSE - 44 ANTIBIOTIC EAR - 43 ANTIPYRINE/BENZOCAINE - 43 ANUCORT-HC - 9 ANUSOL-HC - 9 ANZEMET - 16 APAP/CAFF/DIHYDROCODEINE - 8 APEXICON E - 29 APEXICON OINT - 29 APHTHASOL - 39 APIDRA VIAL - 15 APRACLONIDINE - 41 APRI - 25 APRISO - 34 APTIVUS CAPS - 22 APTIVUS SOLN - 22 ARALEN - 19 ARANELLE - 25 ARANESP - 36 ARANESP ALBUMIN FREE - 35 ARAVA - 6 ARBINOXA - 17 ARCALYST - 6 ARCAPTA NEOHALER - 45 ARICEPT 10MG - 44 ARICEPT 5MG - 44 ARICEPT ODT - 44 ARIMIDEX - 20 ARIPIPRAZOLE - 21 ARIXTRA - 12 ARMOUR THYROID - 46 AROMASIN - 20 ARTHROTEC 50 - 7 ARTHROTEC 75 - 7 ARZOL SILVER NITRATE APP - 28 ASA COMPOUND/CODEINE - 8 ASACOL HD - 34 ASMALPRED - 26 ASMALPRED PLUS - 26 ASMANEX - 45 ASPIRIN - 7 ASPIRIN/DIPYRIDAMOLE - 35 ASTELIN - 40 ATACAND - 18 ATACAND HCTZ - 19 ATENOLOL - 23 ATENOLOL/CHLORTHALIDONE - 18 ATIVAN - 10 ATOPICLAIR - 29 ATORVASTATIN CALCIUM - 17 ATOVAQUONE - 21 ATOVAQUONE/PROGUANIL HCL - 19 ATRALIN GEL - 27 ATRAPRO ANTIPRURITIC HYDR - 31 ATRIPLA - 22 ATROPINE SULFATE - 41 ATROVENT - 40 ATROVENT HFA - 44 Caterpillar Drug Formulary Generated April 22, 2016 AUBAGIO - 44 AUGMENTED BETAMETHASONE - 29 AUGMENTIN - 12 AUGMENTIN ES-600 - 12 AUGMENTIN XR - 12 AURODEX - 43 AUROGUARD - 43 AURYXIA - 34 AUVI-Q - 48 AVALIDE - 19 AVANDAMET - 14 AVANDARYL - 14 AVANDIA - 15 AVAPRO - 18 AVAR CLEANSER - 27 AVAR-E EMOLLIENT - 27 AVC - 47 AVELOX - 11 AVIANE - 25 AVITA CRM - 27 AVITA GEL - 27 AVODART - 35 AVONEX - 44 AXERT - 38 AYGESTIN - 43 AZASAN - 37 AZASITE - 41 AZATHIOPRINE - 34, 37 AZELASTINE NASAL - 40 AZELASTINE OPHTH - 42 AZELEX - 27 AZILECT - 21 AZITHROMYCIN - 10 AZOPT - 42 AZULFIDINE - 34 AZULFIDINE EN-TABS - 34 AZURETTE - 25 B-PLEX - 48 BACITRACIN OINT - 12 BACITRACIN OPHTH - 41 BACITRACIN/POLYMYXIN B - 41 BACLOFEN - 39 BACTERIOSTATIC WATER INJ - 43 BACTRIM - 11 BACTRIM DS - 11 BACTROBAN - 27 BACTROBAN NASAL - 40 BALSALAZIDE DISODIUM - 34 BALZIVA - 25 BANZEL - 13 BARACLUDE - 23 BAYCADRON - 26 BELLADONNA & OPIUM SUPP - 46 BENAZEPRIL HCL - 18 BENAZEPRIL HCL/HCTZ - 18 BENICAR - 18 BENICAR HCTZ - 19 BENTYL - 46 BENZONATATE - 26 BENZTROPINE MESYLATE - 20 BETAGAN - 41 BETAGAN C CAP QD - 41 BETAMETHASONE DIPROPIONAT - 29 BETAMETHASONE VAL FOAM - 29 BETAMETHASONE VALERATE - 29 BETAMETHASONE VALERATE OINT - 29 BETAPACE - 23 BETASERON - 44 BETAXOLOL HCL - 23 BETAXOLOL OPHTH - 40 BETHANECHOL CHLORIDE - 47 BETIMOL - 41 BETOPTIC-S - 41 BEXAROTENE ORAL - 20 BIAXIN - 11 BIAXIN XL - 11 BIAXIN XL PAC - 11 BICALUTAMIDE - 20 BIDIL - 24 BILTRICIDE - 9 BIO-STATIN - 16 BIOGESIC - 7 BIOREGESIC - 7 BISOPROLOL FUMARATE - 23 BISOPROLOL/HCTZ - 18 BLEPH-10 - 41 BLEPHAMIDE - 42 BLOOD GLUCOSE MONITOR-OTHER - 31 BLOOD GLUCOSE STRIPS-OTHER - 31 BORIC ACID - 25 BOSULIF - 20 BREO ELLIPTA - 45 BREVICON-28 - 25 BRIELLYN - 25 BRILINTA - 35 BRIMONIDINE TARTRATE - 41 BROMFENAC - 42 BROMOCRIPTINE MESYLATE - 21 BROMPHENIRAMINE TANNATE - 17 BRONDIL - 44 BUDEPRION SR - 13 BUDESONIDE CAP - 26 BUDESONIDE INH - 45 BUDESONIDE NSL(PREGNANCY ONLY) - 40 BUMETANIDE - 32 BUPHENYL - 33 BUPRENORPHINE HCL SL - 8 BUPRENORPHINE-NALOXONE SL - 8 BUPROPION HCL - 13 BUPROPION HCL ER - 13 BUPROPION HCL ER 150MG - 43 BUPROPION HCL SR - 13 BUPROPION HCL XL - 13 BUSPIRONE HCL - 10 BUTALBITAL COMPOUND - 7 BUTALBITAL COMPOUND/CODEINEI - 8 BUTALBITAL/ACETAMINOPHEN - 7 BUTALBITAL/APAP/CAFF - 8 BUTALBITAL/ASPIRN/CAFFEINE - 8 BUTISOL SODIUM - 36 BUTORPHANOL TARTRATE - 8 BUTRANS - 8 BXN MOUTHWASH SUSP - 39 BYETTA - 15 CABERGOLINE - 33 CAFCIT - 6 CAFERGOT - 37 CAFFEINE CITRATE - 6 CALAN - 24 CALAN SR - 24 CALCIP/BETAMETH OINT - 29 CALCIPOTRIENE OINT - 28 CALCIPOTRIENE SOL - 28 CALCITONIN-SALMON - 32 CALCITRENE - 28 CALCITRIOL - 33 CALCIUM ACETATE - 34 CAMILA - 26 CAMPRAL - 44 CAMRESE - 25 CAMRESE LO - 25 CANASA - 34 CANDESARTAN - 18 CANDESARTAN/HCTZ - 18 CANTHARIDIN - 30 CANTIL - 46 CAPACET - 7 CAPECITABINE - 20 CAPEX - 29 CAPHOSOL - 39 CAPITAL/CODEINE - 8 CAPRELSA - 20 CAPTOPRIL - 18 CAPTOPRIL/HCTZ - 18 CARAC - 28 CARAFATE - 46 CARBAMAZEPINE - 13 CARBAMAZEPINE ER - 13 CARBATROL - 13 CARBIDOPA - 21 CARBIDOPA/LEVODOPA - 21 CARBIDOPA/LEVODOPA CR - 21 CARBIDOPA/LEVODOPA ER - 21 CARBIDOPA/LEVODOPA ODT - 21 CARBIDOPA/LEVODOPA SR - 21 CARBIDOPA/LEVODOPA/ENTACA - 21 CARBINOXAMINE MALEATE - 17 CARDENE SR - 24 CARDIZEM - 24 CARDIZEM CD - 24 CARDIZEM LA - 24 CARDURA - 18 CARISOPRODOL 250MG - 39 CARISOPRODOL 350MG - 39 CARISOPRODOL/ASA/CODEINE - 40 CARISOPRODOL/ASPIRIN - 40 CARMOL-HC - 29 CARNITOR - 33 CARNITOR SF - 33 CARRASYN HYDROGEL WOUND D - 31 CARTEOLOL HCL - 40 CARTIA XT - 24 CARVEDILOL - 23 CASODEX - 20 CATAFLAM - 7 CATAPRES - 18 CATAPRES-TTS - 18 CAVERJECT - 24 CAVERJECT IMPULSE - 24 CAYSTON - 12 CAZIANT - 25 CEDAX - 11 CEFACLOR - 10 CEFACLOR ER - 11 CEFADROXIL - 10 CEFDINIR - 11 CEFDITOREN PIVOXIL - 11 CEFIXIME SUSP - 11 CEFPODOXIME PROXETIL - 11 CEFPROZIL - 10 CEFTIBUTEN - 11 CEFTIN - 11 CEFUROXIME AXETIL - 10 CELEBREX - 7 CELECOXIB - 7 CELESTONE - 26 CELEXA - 14 Caterpillar Drug Formulary Generated April 22, 2016 CELLCEPT - 37 CEM-UREA - 29 CENESTIN - 33 CENTANY - 27 CEPHADYN - 7 CEPHALEXIN - 10 CERDELGA - 33 CERISA WASH - 27 CEROVEL - 29 CERVICAL CAPS - 26 CESIA - 25 CEVIMELINE HCL - 39 CHANTIX - 43 CHEMET - 16 CHEMSTRIP K - 47 CHENODAL - 33 CHLORAMPHENICOL - 12 CHLORDIAZEPOXIDE HCL - 10 CHLORDIAZEPOXIDE/AMITRIPT - 44 CHLORDIAZEPOXIDE/CLIDNIUM BRO - 46 CHLORHEXIDINE GLUCONATE - 22 CHLOROQUINE PHOSPHATE - 19 CHLOROTHIAZIDE - 32 CHLORPROMAZINE HCL - 22 CHLORPROPAMIDE - 15 CHLORTHALIDONE - 32 CHLORZOXAZONE - 39 CHOLBAM - 34 CHOLESTYRAMINE - 17 CHOLESTYRAMINE LIGHT - 17 CHOLINE MAGNESIUM TRISALI - 7 CIALIS - 24 CICLODAN - 27 CICLOPIROX - 27 CILOSTAZOL - 35 CILOXAN - 41 CIMZIA - 34 CIPRO - 11 CIPRO HC - 43 CIPRO XR - 11 CIPRODEX - 43 CIPROFLOXACIN ER - 11 CIPROFLOXACIN HCL - 41 CITALOPRAM HYDROBROMIDE - 14 CITRIC ACID/SODIUM CITRAT - 34 CLARAVIS - 27 CLARITHROMYCIN - 11 CLARITHROMYCIN ER - 11 CLEMASTINE FUMARATE - 17 CLEOCIN - 47 CLEOCIN CAPS - 12 CLEOCIN PEDIATRIC GRANULE - 12 CLEOCIN PHOSPHATE - 12 CLEOCIN-T - 27 CLIMARA - 33 CLIMARA PRO - 33 CLINDACIN-P - 27 CLINDAGEL - 27 CLINDAMAX - 27 CLINDAMYCIN HCL - 11 CLINDAMYCIN PALMITATE HCL - 11 CLINDAMYCIN PHOS INJ - 11 CLINDAMYCIN PHOSPHATE - 47 CLINDAMYCIN PHOSPHATE TOPICAL - 27 CLINITEST TABS - STRIPS - 47 CLINORIL - 7 CLIOQUINOL - 27 CLOBETASOL PROPIONATE - 29 CLOBEX - 29 CLODERM - 29 CLOMIPRAMINE HCL - 14 CLONAZEPAM - 12 CLONIDINE HCL - 18 CLOPIDOGREL - 35 CLORAZEPATE DIPOTASSIUM - 10 CLORPRES - 19 CLOTRIMAZOLE TROCHES - 39 CLOTRIMAZOLE/BETAMETHASON - 27 CLOZAPINE - 21 CLOZARIL - 21 CO-GESIC - 8 COAGUCHEK - 31 COAL TAR - 30 COARTEM - 19 CODEINE SULFATE - 7 CODEINE/ACETAMINOPHEN - 8 COLAZAL - 34 COLCRYS - 35 COLESTID - 17 COLESTIPOL HCL - 17 COLISTIMETHATE SODIUM - 11 COLLODION - 43 COLOCORT - 9, 34 COLY-MYCIN M - 12 COLY-MYCIN S - 43 COLYTE-FLAVOR PACKS - 37 COMBIGAN - 41 COMBIPATCH - 33 COMBISTIX - 47 COMBIVENT - 45 COMBIVIR - 22 COMPLERA - 22 COMPRO - 22 COMTAN - 20 CONCEPTROL GEL - 26 CONCERTA - 6 CONDOMS (FEMALE) - 26 CONDYLOX - 30 CONSTULOSE - 37 COPAXONE 20MG - 44 COPAXONE 40MG - 44 COPEGUS - 23 CORDARONE - 10 CORDRAN - 29 CORDRAN SP - 29 CORDRAN TAPE - 29 COREG - 23 CORGARD - 23 CORLANOR - 24 CORMAX SCALP APPLICATION - 29 CORTALO - 29 CORTANE-B - 29 CORTANE-B AQUEOUS - 43 CORTANE-B-OTIC - 43 CORTEF - 26 CORTENEMA - 9, 34 CORTIC-ND - 43 CORTIFOAM - 9, 34 CORTISONE ACETATE - 26 CORTISPORIN - 27 CORTISPORIN OTIC - 43 CORTISPORIN-TC - 43 CORZIDE - 19 COSENTYX - 28 COSOPT - 41 COTAZYM - 31 COUMADIN - 12 COVARYX - 33 COVARYX HS - 33 COZAAR - 18 CREON - 31 CRESEMBA - 16 CRESTOR - 17 CRESYLATE - 42 CRINONE - 47 CRIXIVAN - 22 CROMOLYN SODIUM - 45 CROMOLYN SODIUM OPHTH - 42 CRYSELLE - 25 CRYSELLE-28 - 25 CUPRIMINE - 16 CURAFIL GEL WOUND DRESSIN - 31 CUTIVATE - 29 CUVPOSA - 46 CYANOCOBALAMIN - 35 CYCLAFEM 1/35 - 25 CYCLAFEM 7/7/7 - 25 CYCLESSA - 25 CYCLOBENZAPRINE HCL - 39 CYCLOGYL - 41 CYCLOMYDRIL - 41 CYCLOPENTOLATE HCL - 41 CYCLOPHOSPHAMIDE CAPS - 19 CYCLOSPORINE - 37 CYCLOSPORINE MODIFIED - 37 CYMBALTA - 14 CYOTIC - 43 CYPROHEPTADINE HCL - 17 CYSTAGON - 33 CYSTARAN - 41 CYTOMEL - 46 CYTOTEC - 46 CYTRA K CRYSTALS - 34 CYTRA-2 - 34 CYTRA-3 - 34 CYTRA-K - 34 D.H.E. 45 - 38 DAKLINZA - 23 DALIRESP - 45 DANAZOL - 8 DANTRIUM - 40 DANTROLENE SODIUM - 40 DAPSONE - 11 DARIFENACIN HBR ER - 47 DASETTA 1/35 - 25 DASETTA 7/7/7 - 25 DAYPRO - 7 DAYSEE - 25 DAYTRANA - 6 DDAVP - 33 DEBACTEROL - 39 DELATESTRYL - 9 DELESTROGEN - 33 DELZICOL - 34 DEMADEX - 32 DEMECLOCYCLINE HCL - 12 DEMEROL - 8 DENAVIR - 28 DEPADE - 16 DEPAKENE - 13 DEPAKOTE - 13 DEPAKOTE ER - 13 DEPAKOTE SPRINKLES - 13 DEPEN TITRATABS - 16 DEPO-ESTRADIOL - 33 DEPO-MEDROL - 26 DEPO-PROVERA CONTRACEPTIV - 26 Caterpillar Drug Formulary Generated April 22, 2016 DEPO-SUBQ PROVERA 104 - 26 DEPO-TESTOSTERONE - 9 DERMA-SMOOTHE/FS BODY OIL - 29 DERMA-SMOOTHE/FS SCALP OI - 29 DERMATOP - 29 DERMAZENE - 27 DERMOTIC - 43 DESIPRAMINE HCL - 14 DESMOPRESSIN ACETATE - 33 DESOGEN - 25 DESONIDE - 29 DESOWEN - 29 DESOXIMETASONE - 29 DESOXYN - 6 DETROL - 47 DETROL LA - 47 DEXAMETHASONE - 26 DEXAMETHASONE INTENSOL - 26 DEXAMETHASONE OPHTH - 42 DEXCHLORPHENIRAMINE MALEA - 17 DEXEDRINE - 6 DEXMETHYLPHENIDATE HCL - 6 DEXMETHYLPHENIDATE SR - 6 DEXPAK 10 DAY - 26 DEXPAK 13 DAY - 26 DEXPAK 6 DAY - 26 DEXTROAMPHETAMINE SULFATE - 6 DIAB - 31 DIAB F.D.G. FREEZE-DRIED - 31 DIABETA - 15 DIALYVITE - 48 DIAMOX - 31 DIASTAT - 12 DIATX ZN - 48 DIAZEPAM INTENSOL - 10 DIAZEPAM RECTAL GEL - 10 DIAZEPAM TAB - 10 DIBENZYLINE - 19 DICLEGIS - 16 DICLOFENAC GEL 3% - 28 DICLOFENAC OPHTH 0.1% - 42 DICLOFENAC POTASSIUM - 7 DICLOFENAC SODIUM - 42 DICLOFENAC SODIUM DR - 7 DICLOFENAC SODIUM ER - 7 DICLOFENAC SODIUM SR - 7 DICLOFENAC SODIUM XR - 7 DICLOFENAC SOLN 1.5% - 30 DICLOFENAC-MISOPROSTIL - 7 DICLOXACILLIN SODIUM - 12 DICYCLOMINE HCL - 46 DIDANOSINE - 22 DIDRONEL - 32 DIFFERIN - 27 DIFICID - 11 DIFIL-G FORTE - 44 DIFLORASONE CRM - 29 DIFLORASONE DIACETATE - 29 DIFLORASONE OINT - 29 DIFLUCAN - 17 DIFLUCAN 150MG - 17 DIFLUNISAL - 7 DIGOXIN - 24 DIGOXIN SOLUTION - 24 DIHYDROERGOTAMINE MESYLAT - 37 DILACOR XR - 24 DILANTIN - 13 DILATRATE SR - 9 DILAUDID - 8 DILT-CD - 24 DILT-XR - 24 DILTIAZEM - 24 DILTIAZEM CD - 24 DILTIAZEM ER - 24 DILTIAZEM SR - 24 DILTZAC - 24 DIOVAN - 18 DIOVAN HCTZ - 19 DIPENTUM - 34 DIPHENATOL - 15 DIPHENHYDRAMINE HCL - 17 DIPHENOXYLATE/ATROPINE - 15 DIPROLENE - 29 DIPROLENE AF - 29 DIPYRIDAMOLE - 35 DISOPYRAMIDE PHOSPHATE - 10 DISULFIRAM - 44 DITROPAN XL - 47 DIURIL - 32 DIVALPROEX SODIUM - 13 DIVALPROEX SODIUM DR - 13 DIVALPROEX SODIUM ER - 13 DIVIGEL - 33 DOLGIC PLUS - 7 DOLOGESIC - 7 DOLOPHINE - 8 DOLOREX - 7 DONEPEZIL 10MG - 44 DONEPEZIL 5MG - 44 DONEPEZIL ODT - 44 DONNATAL - 46 DORYX - 12 DORZOLAMIDE HCL - 42 DORZOLAMIDE/TIMOLOL - 40 DOXAZOSIN MESYLATE - 18 DOXEPIN HCL - 14 DOXEPIN HCL CRE - 28 DOXERCALCIFEROL - 33 DOXYCYCLINE HYCLATE 20MG TB - 12 DOXYCYCLINE HYCLATE CAPS - 12 DOXYCYCLINE MONOHYDRATE CAPS - 12 DRISDOL - 48 DRITHO-CREME HP - 28 DRONABINOL - 16 DROPERIDOL - 10 DRYSOL - 30 DUASTERIDE - 35 DUETACT - 14 DULERA - 45 DULOXETINE - 14 DUONEB - 45 DUOPA - 21 DURAGESIC - 8 DURAXIN - 7 DYAZIDE - 32 DYFLEX-G - 44 DYNACIN - 12 DYRENIUM - 32 E.E.S. 400 - 11 E.E.S. GRANULES - 11 E.S.P. - 11 EC-NAPROSYN - 7 ECONAZOLE NITRATE - 27 ED BACLOFEN - 39 ED CHLORPED - 17 ED-BRON G - 44 ED-CHLOR-TAN - 17 ED-FLEX - 7 ED-SPAZ - 46 EDECRIN - 32 EDEX - 24 EDURANT - 22 EEMT - 33 EEMT HS - 33 EFFER-K - 39 EFFERVESCENT POT CHLORIDE - 38 EFFEXOR XR - 14 EFFIENT - 35 EFUDEX - 28 ELDEPRYL - 21 ELESTAT - 42 ELETONE - 29 ELIDEL - 30 ELIGARD - 20 ELIMITE - 30 ELINEST - 25 ELIPHOS - 34 ELIQUIS - 12 ELIXOPHYLLIN - 45 ELMIRON - 34 ELOCON - 29 EMCYT - 20 EMEND - 16 EMOQUETTE - 25 EMSAM - 14 EMTRIVA - 22 ENABLEX - 47 ENALAPRIL MALEATE - 18 ENALAPRIL/HCTZ - 18 ENBREL - 6 ENDOCET - 8 ENDODAN - 8 ENJUVIA - 33 ENOXAPARIN SODIUM - 12 ENPRESSE-28 - 25 ENTACAPONE - 20 ENTECAVIR - 23 ENTOCORT EC - 26 ENTRESTO - 19 ENULOSE - 34 EPANED ORAL SOL - 18 EPIDRIN - 37 EPIFLUR - 38 EPIFOAM - 29 EPINASTINE HCL - 42 EPINEPHRINE INJECTOR - 48 EPIPEN - 48 EPIPEN 2-PAK - 48 EPIPEN-JR 2-PAK - 48 EPITOL - 13 EPIVIR - 22 EPLERENONE - 19 EPOGEN - 36 EPROSARTAN MESYLATE - 18 EPROSARTAN MESYLATE/HCTZ - 18 EPZICOM - 22 EQUAGESIC - 7 EQUETRO - 22 ERGOCALCIFEROL - 48 ERGOMAR - 38 ERIVEDGE - 20 ERRIN - 26 ERTACZO - 27 ERY - 27 ERY-TAB - 11 ERYPED 200 - 11 ERYPED 400 - 11 Caterpillar Drug Formulary Generated April 22, 2016 ERYTHROCIN STEARATE - 11 ERYTHROMYCIN - 11 ERYTHROMYCIN BASE - 11 ERYTHROMYCIN CAP EC - 11 ERYTHROMYCIN ETHYLSUCCINA - 11 ERYTHROMYCIN GEL - 11 ERYTHROMYCIN OPHTH - 41 ERYTHROMYCIN STEARATE - 11 ERYTHROMYCIN TOP - 27 ERYTHROMYCIN/SULFISOXAZOL - 11 ESCITALOPRAM OXALATE - 14 ESGIC - 7 ESGIC-PLUS - 7 ESSIAN - 33 ESSIAN H.S. - 33 ESTARYLLA - 25 ESTAZOLAM - 36 ESTERIFIED ESTROGENS/METH - 33 ESTRACE - 47 ESTRACE TABS - 33 ESTRADIOL TABS - 33 ESTRADIOL TD PATCH - 33 ESTRADIOL VALERATE - 33 ESTRADIOL/NORETHINDRONE - 33 ESTRING - 47 ESTROGEL - 33 ESTRONE - 33 ESTROPIPATE - 33 ESTROSTEP FE - 25 ESZOPICLONE - 36 ETHAMBUTOL HCL - 19 ETHOSUXIMIDE - 13 ETIDRONATE DISODIUM - 32 ETODOLAC - 7 ETODOLAC ER - 7 ETOPOSIDE - 20 EURAX - 30 EVAMIST - 33 EVISTA - 33 EVOCLIN - 27 EVOTAZ - 22 EVOXAC - 39 EXALGO - 8 EXELDERM - 27 EXELON - 44 EXELON PATCH - 44 EXEMESTANE - 20 EXJADE - 16 EXODERM - 27 EXOTIC-HC - 43 EXTAVIA - 44 FABB - 36 FACTIVE - 11 FALMINA - 25 FAMCICLOVIR - 23 FAMVIR - 23 FARESTON - 20 FE C PLUS - 36 FELBAMATE - 13 FELBATOL - 13 FELDENE - 7 FELODIPINE ER - 24 FEM PH - 47 FEMARA - 20 FEMCAP - 37 FEMCON FE - 25 FEMHRT LOW DOSE - 33 FEMRING - 47 FENOFIBRATE - 17 FENOFIBRATE 130MG - 17 FENOFIBRATE 43MG - 17 FENOFIBRATE MICRONIZED - 17 FENOFIBRIC ACID - 17 FENOPROFEN CALCIUM - 7 FENTANYL - 7 FENTANYL CITRATE ORAL TRA - 7 FENTORA - 8 FEROCON - 36 FEROTRINSIC - 36 FERREX 150 FORTE - 36 FERRIPROX - 16 FERROCITE PLUS - 48 FERROGELS FORTE - 36 FERROUS SULFATE - 38 FINACEA - 30 FINASTERIDE 5mg - 35 FIORICET - 7 FIORICET/CODEINE - 8 FIORINAL - 7 FIRAZYR - 35 FLAGYL - 12 FLAGYL ER - 12 FLAREX - 42 FLAVOXATE HCL - 47 FLECAINIDE ACETATE - 10 FLECTOR PATCH - 30 FLEXERIL - 39 FLOMAX - 35 FLOVENT - 45 FLUCONAZOLE - 16 FLUCONAZOLE 150MG - 16 FLUCYTOSINE - 16 FLUDROCORTISONE ACETATE - 26 FLUMADINE - 23 FLUOCINOLONE ACETONIDE - 29 FLUOCINOLONE OTIC - 43 FLUOCINONIDE - 29 FLUOCINONIDE-E - 29 FLUOR-A-DAY - 38 FLUOR-OP - 42 FLUORIDE - 38 FLUORITAB - 38 FLUOROMETHOLONE - 42 FLUOROPLEX - 28 FLUOROURACIL - 27 FLUOXETINE DR - 14 FLUOXETINE HCL - 14 FLUPHENAZINE DECANOATE - 22 FLUPHENAZINE HCL - 22 FLURA-DROPS 0.125 - 38 FLURA-DROPS 0.25 - 38 FLURAZEPAM HCL - 36 FLURBIPROFEN - 7 FLURBIPROFEN OPHTH - 42 FLUTAMIDE - 20 FLUTICASONE PROPIONATE - 29 FLUVASTATIN - 17 FLUVASTATIN XL - 17 FLUVOXAMINE MALEATE - 14 FML - 42 FML FORTE - 42 FML LIQUIFILM - 42 FOCALIN - 6 FOCALIN XR - 6 FOLBEE - 36 FOLBEE PLUS - 48 FOLBEE PLUS CZ - 48 FOLCAPS - 36 FOLGARD RX - 36 FOLIC ACID 1mg - 35 FOLIC ACID 400mcg - 35 FOLIC ACID 800mcg - 35 FOLIC ACID/CYANOCOBALAMIN - 36 FOLIC ACID/VITAMIN B-6/VI - 36 FOLPLEX 2.2 - 36 FOLTRIN - 36 FONDAPARINUX SODIUM - 12 FORADIL AEROLIZER - 45 FORMA-RAY - 22 FORMADON - 22 FORMALDEHYDE - 22 FORTAVIT - 48 FORTEO - 32 FORTICAL - 32 FOSAMAX - 32 FOSINOPRIL SODIUM - 18 FOSINOPRIL/HCTZ - 18 FOSRENOL - 34 FRAGMIN - 12 FROVA - 38 FULYZAQ - 16 FURADANTIN - 47 FUROSEMIDE TABS 7 & LIQ - 32 FUZEON - 22 FYCOMPA - 13 GABAPENTIN - 13 GABITRIL - 13 GALANTAMINE - 44 GARAMYCIN - 41 GATIFLOXACIN - 41 GAVILYTE-C - 37 GAVILYTE-G - 37 GAVILYTE-N/FLAVOR PACK - 37 GELCLAIR - 39 GEMFIBROZIL - 17 GENERLAC - 34 GENGRAF - 37 GENOTROPIN - 32 GENTAK - 41 GENTAMICIN INJ - 10 GENTAMICIN OPHTH - 41 GENTAMICIN SULFATE - 27 GENVOYA - 22 GEODON - 22 GIANVI - 25 GILDESS FE 1.5/30 - 25 GILDESS FE 1/20 - 25 GILENYA - 44 GILOTRIF - 20 GLEEVEC - 20 GLIMEPIRIDE - 15 GLIPIZIDE - 15 GLIPIZIDE ER - 15 GLIPIZIDE XL - 15 GLIPIZIDE/METFORMIN HCL - 14 GLUCAGEN - 15 GLUCAGEN HYPOKIT - 15 GLUCAGON EMERGENCY KIT - 15 GLUCOPHAGE - 15 GLUCOPHAGE XR - 15 GLUCOTROL - 15 GLUCOTROL XL - 15 GLUCOVANCE - 14 GLYBURIDE - 15 GLYBURIDE MICRONIZED - 15 GLYBURIDE/METFORMIN HCL - 14 GLYCOPYRROLATE - 46 Caterpillar Drug Formulary Generated April 22, 2016 GLYNASE - 15 GLYSET - 14 GOLYTELY - 37 GORDONS UREA - 29 GRAFCO SILVER NITRATE APP - 28 GRANISETRON HCL - 16 GRANISOL - 16 GRANIX - 36 GRIFULVIN V - 16 GRIS-PEG - 16 GRISEOFULVIN MICROSIZE - 16 GUANFACINE HCL - 6, 18 HALCION - 36 HALDOL - 21 HALDOL DECANOATE - 21 HALOBETASOL PROPIONATE - 29 HALOG - 29 HALOPERIDOL - 21 HALOPERIDOL DECANOATE - 21 HALOPERIDOL LACTATE - 21 HARVONI - 23 HEATHER - 26 HECORIA - 37 HECTOROL - 33 HEMATINIC PLUS COMPLEX - 48 HEMATINIC PLUS VITAMINS/M - 48 HEMATINIC/FOLIC ACID - 36 HEMATOGEN - 36 HEMATOGEN FA - 36 HEMATOGEN FORTE - 36 HEMOCYTE-F - 36 HEMOCYTE-PLUS - 48 HEMORRHOIDAL-HC - 9 HEMRIL-30 - 9 HEPARIN SODIUM - 12 HEPSERA - 23 HEXALEN - 19 HIPREX - 47 HOMATROPAIRE - 41 HOMATROPINE HBR - 41 HUMALOG MIX 50/50 VIAL - 15 HUMALOG MIX 75/25 VIAL - 15 HUMALOG VIAL - 15 HUMATROPE - 32 HUMIRA - 6, 34 HUMULIN N VIAL - 15 HUMULIN R VIAL - 15 HYCAMTIN - 20 HYCET - 8 HYDRALAZINE HCL - 19 HYDREA - 20 HYDROCHLOROTHIAZIDE 12.5MG - 31 HYDROCHLOROTHIAZIDE 25MG - 32 HYDROCHLOROTHIAZIDE 50MG - 32 HYDROCODONE/ACETAMINOPHEN - 8 HYDROCODONE/APAP - 8 HYDROCODONE/HOMATROPINE - 26 HYDROCODONE/IBUPROFEN - 8 HYDROCORTISONE - 26 HYDROCORTISONE ACETATE - 9 HYDROCORTISONE BUTYRATE - 29 HYDROCORTISONE IN ABSORBA - 29 HYDROCORTISONE RECTAL - 9, 34 HYDROCORTISONE TOPICAL - 29 HYDROCORTISONE VALERATE - 29 HYDROCORTISONE/ACETIC ACI - 43 HYDROCORTISONE/IODOQUINOL - 27 HYDROGESIC - 8 HYDROMET - 26 HYDROMORPHONE HCL - 7 HYDROXYCHLOROQUINE SULFAT - 19 HYDROXYUREA - 20 HYDROXYZINE HCL - 10 HYDROXYZINE PAMOATE - 10 HYLATOPIC PLUS - 29 HYOMAX -DT - 46 HYOMAX-SL - 46 HYOMAX-SR - 46 HYOPHEN - 46 HYOSCYAMINE SULFATE - 46 HYOSCYAMINE SULFATE ER - 46 HYOSCYAMINE SULFATE ODT - 46 HYOSCYAMINE SULFATE SR - 46 HYOSYNE - 46 HYPER-SAL - 27 HYPERCARE - 30 HYZAAR - 19 IBUDONE - 8 IBUPROFEN 400mg - 7 IBUPROFEN 600MG - 7 IBUPROFEN 800MG - 7 ICAR-C PLUS - 36 IFEREX 150 FORTE - 36 ILEVRO - 42 ILOTYCIN - 41 IMATINIB - 20 IMBRUVICA - 20 IMDUR - 9 IMIPRAMINE HCL - 14 IMIPRAMINE PAMOATE - 14 IMIQUIMOD - 30 IMITREX - 38 IMITREX NASL - 38 IMURAN - 37 INCIVEK - 23 INCRELEX - 33 INCRUSE ELLIPTA - 44 INDAPAMIDE - 32 INDERAL LA - 23 INDERAL XL - 23 INDOCIN - 7 INDOMETHACIN - 7 INDOMETHACIN CR - 7 INDOMETHACIN ER - 7 INDOMETHACIN SA - 7 INDOMETHACIN SR - 7 INLYTA - 20 INNOPRAN XL - 23 INSPRA - 19 INTELENCE - 22 INTRON-A - 20 INTROVALE - 25 INTUNIV - 6 INVIRASE CAPS - 22 INVIRASE TB - 22 IOPIDINE - 41 IPRATROPIUM BROMIDE - 44 IPRATROPIUM BROMIDE NASAL - 40 IPRATROPIUM/ALBUTEROL - 45 IRBESARTAN - 18 IRBESARTAN/HCTZ - 18 ISENTRESS POW PACK - 22 ISENTRESS TAB - 22 ISODITRATE ER - 9 ISOMETHEPTENE/CAFF/APAP - 37 ISOMETHEPTENE/DICHLORAL/APAP - 37 ISONIAZID SYRP - 19 ISONIAZID TB - 19 ISOPTIN SR - 24 ISOPTO ATROPINE - 41 ISOPTO CARBACHOL - 41 ISOPTO CARPINE - 41 ISOPTO HOMATROPINE - 41 ISOPTO HYOSCINE - 41 ISORDIL TITRADOSE - 9 ISOSORB DINITRATE/HYRAL - 24 ISOSORBIDE DINITRATE - 9 ISOSORBIDE DINITRATE ER - 9 ISOSORBIDE DINITRATE SA - 9 ISOSORBIDE DINITRATE SL - 9 ISOSORBIDE MONONITRATE - 9 ISOSORBIDE MONONITRATE ER - 9 ISOXSUPRINE HCL - 24 ISRADIPINE - 24 ISTALOL - 41 ITRACONAZOLE - 16 IVERMECTIN - 9 JADENU - 16 JAKAFI - 20 JANTOVEN - 12 JINTELI - 33 JOLESSA - 25 JOLIVETTE - 26 JUNEL 1.5/30 - 25 JUNEL 1/20 - 25 JUNEL FE 1.5/30 - 25 JUNEL FE 1/20 - 25 K-EFFERVESCENT - 38 K-PHOS - 38 K-PHOS NEUTRAL - 38 K-PHOS NO 2 - 34 K-PRIME - 38 K-TABS - 39 K-VESCENT - 38 KADIAN - 8 KALETRA - 22 KALYDECO - 45 KARIDIUM - 38 KARIVA - 25 KEFLEX - 10 KELNOR 1/35 - 25 KENALOG - 29 KENALOG-10 - 26 KENALOG-40 - 26 KEPPRA - 13 KERLONE - 23 KETEK - 12 KETO-DIASTIX - 47 KETOCARE - 47 KETOCONAZOLE - 16 KETOCONAZOLE TOP - 27 KETOPROFEN - 7 KETOPROFEN ER - 7 KETOPROFEN ULTRA MICRONIZ - 7 KETOROLAC OPHTH - 42 KETOROLAC TROMETHAMINE - 7 KINERET - 6 KIONEX - 32 KLARON - 27 KLONOPIN - 12 KLOR-CON - 38 KLOR-CON 10 - 38 KLOR-CON 25 - 39 KLOR-CON 8 - 38 KLOR-CON M10 - 38 KLOR-CON M15 - 39 KLOR-CON M20 - 38 Caterpillar Drug Formulary Generated April 22, 2016 KLOR-CON/EF - 38 KORLYM - 15 KRISTALOSE - 37 KURVELO - 25 KUVAN - 33 LABETALOL HCL - 23 LAC-HYDRIN - 29 LACLOTION - 29 LACRISERT - 40 LACTIC ACID - 29 LACTULOSE - 37 LAMICTAL - 13 LAMICTAL XR - 13 LAMISIL - 16 LAMIVUDINE - 22 LAMIVUDINE/ZIDOVUDINE - 22 LAMOTRIGINE - 13 LANCETS - 31 LANOXIN - 24 LANTUS SOLOSTAR - 15 LANTUS VIAL - 15 LASIX - 32 LATANOPROST - 42 LATUDA - 22 LEENA - 25 LEFLUNOMIDE - 6 LESCOL - 17 LESCOL XL - 17 LESSINA-28 - 25 LETAIRIS - 24 LETROZOLE - 20 LEUCOVORIN CALCIUM - 20 LEUKERAN - 19 LEUKINE - 36 LEUPROLIDE ACETATE - 20 LEVALBUTEROL NEB - 45 LEVAQUIN TABS - 11 LEVATOL - 23 LEVBID - 46 LEVEMIR VIAL - 15 LEVETIRACETAM - 13 LEVETIRACETAM ER - 13 LEVITRA - 24 LEVO/ETHI/ESTRADIO - 25 LEVOBUNOLOL HCL - 40 LEVOCARNITINE - 33 LEVOFLOXACIN - 11 LEVOFLOXACIN INJ - 11 LEVOFLOXACIN OPHTH - 41 LEVONEST - 25 LEVORA 0.15/30-28 - 25 LEVORPHANOL TARTRATE - 8 LEVOTHROID - 45 LEVOTHYROXINE SODIUM - 45 LEVOXYL - 45 LEVSIN - 46 LEVSIN/SL - 46 LEXAPRO - 14 LEXIVA - 22 LIALDA - 34 LIBRAX - 46 LIDAZONE HC - 9 LIDOCAINE HCL-HYDROCORTIS GEL - 9 LIDOCAINE HCL/HYDROCORTIS CRM - 9 LIDOCAINE PAD - 30 LIDOCAINE VISCOUS - 39 LIDODERM - 30 LINDANE - 30 LINEZOLID SUSP - 11 LINEZOLID TBS - 11 LINZESS - 34 LIOTHYRONINE TAB - 45 LIPITOR - 17 LISINOPRIL - 18 LISINOPRIL/HCTZ - 18 LITHIUM CARBONATE - 21 LITHIUM CARBONATE ER - 21 LITHIUM CITRATE - 21 LITHOBID - 21 LITHOSTAT - 34 LO LOESTRIN FE - 25 LOCOID - 29 LOCOID LIPOCREAM - 29 LOESTRIN 1.5/30-21 - 25 LOESTRIN 1/20-21 - 25 LOESTRIN 24 FE - 25 LOESTRIN FE 1.5/30 - 25 LOESTRIN FE 1/20 - 25 LOFENE - 15 LOKARA - 29 LOMOTIL - 15 LOMUSTINE - 19 LONOX - 15 LONSURF - 20 LOPERAMIDE HCL - 15 LOPID - 17 LOPRESSOR - 23 LOPRESSOR HCTZ - 19 LOPROX - 27 LOPROX SHAMPOO - 27 LORAZEPAM - 10 LORCET - 8 LORCET PLUS - 8 LORTAB - 8 LORYNA - 25 LOSARTAN POTASSIUM - 18 LOSARTAN POTASSIUM/HCTZ - 18 LOTEMAX - 42 LOTENSIN - 18 LOTENSIN HCTZ - 19 LOTREL - 19 LOTRISONE - 27 LOTRONEX - 34 LOVASTATIN - 17 LOVENOX - 12 LOW-OGESTREL - 25 LOXAPINE - 21 LOXITANE - 21 LTA 360 KIT - 39 LUDENT - 38 LUFYLLIN - 45 LUMIGAN - 42 LUNESTA - 36 LUPRON DEPOT - 20 LURIDE - 38 LUSONAL - 40 LUTERA - 25 LUXIQ - 29 LYRICA - 13 LYRICA SOL - 13 LYSODREN - 20 LYSTEDA - 36 MACROBID - 47 MACRODANTIN - 47 MAGNEBIND 400 - 38 MAKENA - 43 MALARONE - 19 MALATHION - 30 MAPROTILINE HCL - 13 MARGESIC - 7 MARINOL - 16 MARLISSA - 25 MARTEN-TAB - 7 MARTINIC - 36 MATULANE - 20 MATZIM LA - 24 MAVIK - 18 MAXAIR AUTOHALER - 45 MAXALT - 38 MAXALT-MLT - 38 MAXIDEX - 42 MAXIDONE - 8 MAXITROL - 42 MAXZIDE - 32 MAXZIDE-25 - 32 ME-PB-HYOS - 46 MECLOFENAMATE SODIUM - 7 MEDROL - 26 MEDROL DOSEPAK - 26 MEDROXYPROGESTERONE - 43 MEDROXYPROGESTERONE IM - 26 MEFENAMIC ACID - 7 MEFLOQUINE HCL - 19 MEGACE ES - 43 MEGACE ORAL - 20 MEGESTROL ACETATE - 20 MELOXICAM - 7 MEMANTINE HCL - 44 MEMANTINE SOL - 44 MENEST - 33 MENOSTAR - 33 MEPERIDINE HCL - 7 MEPERITAB - 7 MEPHYTON - 48 MEPROBAMATE - 10 MEPRON - 21 MERCAPTOPURINE - 20, 34 MESALAMINE - 34 MESNEX - 20 MESTINON - 19 MESTINON TIMESPAN - 19 METADATE CD - 6 METADATE ER 20MG - 6 METAGLIP - 14 METAPROTERENOL SULFATE - 45 METAXALONE - 39 METFORMIN HCL - 14 METFORMIN HCL ER - 14 METHADONE HCL - 7 METHADOSE - 8 METHAMPHETAMINE HCL - 6 METHAZOLAMIDE - 31 METHENAMINE HIPPURATE - 47 METHENAMINE MANDELATE - 47 METHERGINE - 43 METHIMAZOLE - 45 METHITEST - 9 METHOCARBAMOL - 39 METHOTREXATE - 20 METHOXALEN - 28 METHSCOPOLAMINE BROMIDE - 46 METHYCLOTHIAZIDE - 32 METHYLDOPA - 18 METHYLDOPA/HCTZ - 18 METHYLERGONOVINE MALEATE - 43 METHYLIN - 6 METHYLIN CHEW & SOLN - 6 Caterpillar Drug Formulary Generated April 22, 2016 METHYLPHENIDATE HCL - 6 METHYLPHENIDATE HCL CD - 6 METHYLPHENIDATE HCL CR - 6 METHYLPHENIDATE HCL ER - 6 METHYLPHENIDATE HCL SR - 6 METHYLPREDNISOLONE - 26 METHYLPREDNISOLONE DOSE PAK - 26 METHYLTESTOSTERONE - 8 METHYLTESTOSTERONE PWD - 9 METHYLTESTOSTERONE/ESTERI - 33 METIPRANOLOL - 40 METOCLOPRAMIDE HCL - 33 METOLAZONE - 32 METOPROLOL SUCCINATE ER - 23 METOPROLOL TARTRATE - 23 METOPROLOL/HCTZ - 18 METROCREAM - 30 METROGEL - 30 METROGEL-VAGINAL - 47 METROLOTION - 30 METRONIDAZOLE - 11 METRONIDAZOLE BENZOATE - 27 METRONIDAZOLE TOP - 30 METRONIDAZOLE VAGINAL - 47 MEVACOR - 17 MEXAR WASH - 28 MEXILETINE HCL - 10 MIACALCIN - 32 MICARDIS - 18 MICARDIS HCTZ - 19 MICONAZOLE 3 - 47 MICONAZOLE 3 COMBO PACK - 47 MICONAZOLE NITRATE - 27 MICRO-K - 39 MICROGESTIN 1.5/30 - 25 MICROGESTIN 1/20 - 25 MICROGESTIN FE - 25 MICROGESTIN FE 1.5/30 - 25 MICROZIDE - 32 MIDODRINE HCL - 48 MIGERGOT - 37 MIGRAGESIC IDA - 37 MIGRALAM - 37 MIGRANAL - 38 MILLIPRED - 26 MIMVEY - 33 MIMYX - 29 MINIPRESS - 18 MINIRIN - 33 MINITRAN - 9 MINOCIN - 12 MINOCYCLINE HCL - 12 MINOXIDIL - 19 MIOSTAT - 41 MIRAPEX - 21 MIRCETTE - 25 MIRTAZAPINE - 13 MIRTAZAPINE ODT - 13 MISOPROSTOL - 46 MOBIC - 7 MODAFINIL - 6 MODERIBA - 23 MODICON - 25 MODICON-28 - 25 MOEXIPRIL HCL - 18 MOEXIPRIL/HCTZ - 18 MOMETASONE FUROATE - 29 MONO-LINYAH - 25 MONODOX - 12 MONONESSA - 25 MONTELUKAST SODIUM - 45 MONUROL - 47 MORGIDOX - 12 MORPHINE SULFATE - 8 MORPHINE SULFATE CR - 7 MORPHINE SULFATE ER CAPS - 7 MORPHINE SULFATE ER TABS - 7 MOTOFEN - 15 MOVANTIK - 34 MOXEZA - 41 MOXIFLOXACIN - 11 MS CONTIN - 8 MULTAQ - 10 MULTIGEN - 36 MUPIROCIN - 27 MUSE - 24 MYALEPT INJ - 32 MYAMBUTOL - 19 MYCOBUTIN - 19 MYCOPHENOLATE MOFETIL - 37 MYDFRIN - 41 MYDRAL - 41 MYDRIACYL - 41 MYFERON 150 FORTE - 36 MYFORTIC - 37 MYLERAN - 19 MYNEPHROCAPS - 48 MYORISAN - 27 MYRBETRIQ - 47 MYSOLINE - 13 MYZILRA - 25 NABUMETONE - 7 NADOLOL - 23 NADOLOL/BENDROFLUMETHIAZI - 18 NAFRINSE DROPS - 38 NALFON - 7 NALTREXONE HCL - 16 NAMENDA - 44 NAMENDA SOL - 44 NAMENDA XR - 44 NAPRELAN - 7 NAPROSYN - 7 NAPROXEN - 7 NAPROXEN DR - 7 NAPROXEN EC - 7 NARATRIPTAN HCL - 38 NARDIL - 14 NATACYN - 41 NATEGLINIDE - 15 NATURE-THROID - 46 NATURE-THROID NT-2.5 - 46 NEBUSAL - 27 NECON 0.5/35-28 - 25 NECON 1/35-28 - 25 NECON 1/50-28 - 25 NECON 7/7/7 - 25 NEEDLES (INSULIN) - 31 NEFAZODONE HCL - 13 NEO-POLYCIN - 41 NEOFRIN - 41 NEOMYCIN SULFATE - 10 NEOMYCIN/POLYMYXIN/BACITR/HC - 41 NEOMYCIN/POLYMYXIN/DEXAME - 42 NEOMYCIN/POLYMYXIN/GRAMIC - 41 NEOMYCIN/POLYMYXIN/HC OPHTH - 42 NEOMYCIN/POLYMYXIN/HC OTIC - 43 NEORAL - 37 NEOSPORIN - 41 NEPHRO-VITE RX - 48 NEPHROCAPS - 48 NEPHRON FA - 36 NEPHRONEX - 48 NEPTAZANE - 31 NEULASTA - 36 NEUMEGA - 36 NEUPOGEN - 36 NEUPRO PATCH - 21 NEURONTIN - 13 NEUT - 38 NEVANAC - 42 NEVIRAPINE - 22 NEVIRAPINE ER - 22 NEXAVAR - 20 NEXIUM GRANULES - 46 NIACIN ER TAB - 18 NIASPAN - 18 NICARDIPINE HCL - 24 NICOTINE REPLACEMENT - 43 NIFEDIAC CC - 24 NIFEDICAL XL - 24 NIFEDIPINE - 24 NIFEDIPINE ER - 24 NILANDRON - 20 NIMODIPINE - 24 NIMOTOP - 24 NIRAVAM - 10 NISOLDIPINE - 24 NISOLDIPINE ER - 24 NITRO-BID - 9 NITRO-DUR - 9 NITRO-TIME - 9 NITROFURANTOIN - 47 NITROFURANTOIN MACROCRYST - 47 NITROFURANTOIN MONOHYDRAT - 47 NITROGLYCERIN - 9 NITROGLYCERIN ER - 9 NITROGLYCERIN LINGUAL - 9 NITROGLYCERIN SPRAY - 9 NITROGLYCERIN SR - 9 NITROGLYCERIN TRANSDERMAL - 9 NITROLINGUAL PUMPSPRAY - 9 NITROMIST - 9 NITROSTAT - 9 NIZATIDINE SOLU - 46 NIZORAL - 27 NODOLOR - 37 NOR-QD - 26 NORA-BE - 26 NORCO - 8 NORDETTE-28 - 25 NORDITROPIN FLEXPRO - 32 NORDITROPIN NORDIFLEX PEN - 32 NORETH/ETHINYL/FERR FUM - 25 NORETHINDRONE - 26 NORETHINDRONE ACETATE - 43 NORETHINDRONE/THINYL ESTRADIOL - 33 NORFLEX - 39 NORGESTIMATE/ETHINYL ESTR - 25 NORINYL 1+35 - 25 NORINYL 1+50 - 25 NORITATE - 30 NOROXIN - 11 NORPACE - 10 NORPACE CR - 10 NORPRAMIN - 14 NORTREL 0.5/35 (28) - 25 NORTREL 1/35 (21) - 25 Caterpillar Drug Formulary Generated April 22, 2016 NORTREL 1/35 (28) - 25 NORTREL 7/7/7 - 25 NORTRIPTYLINE HCL - 14 NORVASC - 24 NORVIR - 22 NOVACORT - 29 NOVOLIN 70/30 RELION - 15 NOVOLIN N RELION - 15 NOVOLIN N VIAL - 15 NOVOLIN PENS - 15 NOVOLIN R RELION - 15 NOVOLIN R VIAL - 15 NOVOLOG FLEXPEN - 15 NOVOLOG MIX 70/30 PREFILL - 15 NOVOLOG MIX 70/30 VIAL - 15 NOVOLOG PENFILL - 15 NOVOLOG VIAL - 15 NOXAFIL - 17 NP THYROID 30 - 45 NP THYROID 60 - 45 NP THYROID 90 - 45 NUEDEXTA - 44 NUFOL - 36 NULEV - 46 NULYTELY/FLAVOR PACKS - 37 NUMOISYN - 39 NUOX - 27 NUTROPIN - 32 NUVARING - 26 NUZON - 29 NYAMYC - 27 NYSTATIN - 39 NYSTATIN TOP - 27 NYSTATIN VAGINAL - 47 NYSTATIN/TRIAMCINOLONE - 27 NYSTOP - 27 OCELLA - 25 OCTREOTIDE ACETATE - 33 OCUFEN - 42 OCUFLOX - 41 ODEFSEY - 22 OFLOXACIN - 11 OFLOXACIN OPHTH - 41 OFLOXACIN OTIC - 42 OFORTA - 20 OGESTREL - 25 OLANZAPINE - 21 OLANZAPINE/FLUOXETINE - 44 OLUX - 29 OLUX-E - 29 OLYSIO - 23 OMNIFLEX ALL - 26 OMNIPRED - 42 ONDANSETRON HCL - 16 ONDANSETRON ODT - 16 ONETOUCH MONITORS - 31 ONETOUCH STRIPS - 31 ONFI - 12 ONFI SUSP - 12 OPANA ER - 7 OPANA INJ - 8 OPANA IR - 8 OPIUM TINCTURE - 15 OPSUMIT - 24 OPTIPRANOLOL - 41 OPTIVAR - 42 ORACIT - 34 ORALONE - 39 ORAP - 44 ORAPRED - 26 ORENCIA SQ - 6 ORENITRAM - 24 ORPHENADRINE CITRATE - 39 ORPHENADRINE CITRATE CR - 39 ORPHENADRINE CITRATE ER - 39 ORPHENADRINE COMPOUND DS - 40 ORPHENADRINE/ASA/CAFFEINE - 40 ORSYTHIA - 25 ORTHO DIAPHRAGM ALL-FLEX/ - 37 ORTHO MICRONOR - 26 ORTHO TRI-CYCLEN - 25 ORTHO TRI-CYCLEN LO - 25 ORTHO-CEPT - 25 ORTHO-CYCLEN - 25 ORTHO-CYCLEN-28 - 25 ORTHO-EST - 33 ORTHO-NOVUM 1/35-28 - 25 ORTHO-NOVUM 7/7/7 - 25 ORTHO-NOVUM 7/7/7-28 - 25 ORTHOFLEX ALL - 26 OSCIMIN - 46 OSCIMIN SR - 46 OSMOPREP - 37 OSPHENA - 33 OTEZLA - 40 OTICIN - 43 OTO-END 10 - 43 OTOMAR - 43 OTOMAX-HC - 43 OVACE PLUS - 28 OVACE PLUS WASH - 28 OVACE WASH - 28 OVCON-35 - 25 OVIDE - 30 OXANDRIN - 8 OXANDROLONE - 8 OXAPROZIN - 7 OXAZEPAM - 10 OXCARBAZEPINE - 13 OXICONAZOLE CRE - 27 OXISTAT - 27 OXSORALEN - 30 OXSORALEN ULTRA - 28 OXYBUTYNIN CHLORIDE - 47 OXYBUTYNIN CHLORIDE ER - 47 OXYCODONE HCL - 7 OXYCODONE SOL 5MG/5ML - 8 OXYCODONE SOLUTION 5MG/5ML - 7 OXYCODONE/ACETAMINOPHEN - 8 OXYCODONE/ASPIRIN - 8 OXYCONTIN - 7 OXYMORPHONE HCL - 7 OXYMORPHONE HCL SR - 7 OXYMORPHONE INJ - 7 OXYTROL - 47 PACERONE - 10 PALGIC - 17 PAMELOR - 14 PAMINE - 46 PAMINE FORTE - 46 PANCREAZE - 31 PANCRELIPASE - 31 PANDEL - 29 PAPAVERINE HCL - 24 PARAFON FORTE DSC - 39 PARCAINE - 42 PARCOPA - 21 PAREGORIC - 15 PARICALCITOL - 33 PARLODEL - 21 PARNATE - 14 PAROXETINE HCL - 14 PAROXETINE HCL ER - 14 PAXIL - 14 PAXIL CR - 14 PCE - 11 PEDI-DRI - 27 PEG 3350/ELECTROLYTES - 37 PEG-INTRON - 23 PEGASYS - 23 PENICILLIN VK - 12 PENNSAID SOLN 1.5% - 30 PENNSAID SOLN 2.0% - 30 PENTASA - 34 PENTAZOCINE/ACETAMINOPHEN - 8 PENTAZOCINE/NALOXONE HCL - 8 PENTOXIFYLLINE CR - 35 PENTOXIFYLLINE ER - 35 PEPSIN - 31 PERCOCET - 8 PERCODAN - 8 PERFOROMIST - 45 PERIDEX - 39 PERINDOPRIL ERBUMINE - 18 PERIOGARD - 39 PERMETHRIN - 30 PERPHENAZINE - 22 PERPHENAZINE/AMITRIPTYLIN - 44 PERSANTINE - 35 PERTZYE - 31 PEXEVA - 14 PHENADOZ - 17 PHENAZOPYRIDINE HCL - 35 PHENAZOPYRIDINE PLUS - 47 PHENAZOPYRIDINE/BUTABARB - 47 PHENELZINE SULFATE - 14 PHENERGAN - 17 PHENOBARBITAL - 36 PHENOXYBENZAMINE - 19 PHENTOLAMINE MESYLATE - 19 PHENYLEPHRINE HCL - 41 PHENYTEK - 13 PHENYTOIN - 13 PHENYTOIN SODIUM EXTENDED - 13 PHILITH - 25 PHISOHEX - 22 PHOSLO - 34 PHOSLYRA - 34 PHOSPHA 250 NEUTRAL - 38 PHOSPHASAL - 46 PHOSPHOLINE IODIDE - 41 PHRENILIN FORTE - 7 PHYTONADIONE - 48 PILOCARPINE HYDROCHLORIDE - 39 PILOCARPINE OPHTH - 41 PILOPINE HS - 41 PIMOZIDE - 44 PINDOLOL - 23 PINNACAINE OTIC - 42 PIOGLITAZONE HCL - 15 PIOGLITAZONE HCL/METFORMI - 14 PIOGLITAZONE-GLIMEPIRIDE - 14 PIROXICAM - 7 PLACEBO #00 - 43 PLAQUENIL - 19 PLAVIX - 35 PLEGRIDY INJ - 44 Caterpillar Drug Formulary Generated April 22, 2016 PLETAL - 35 PODOCON 25 IN BENZOIN TIN - 30 PODOFILOX - 30 POLY-DEX - 42 POLY-IRON 150 FORTE - 36 POLYCIN B - 41 POLYCITRA-K CRYSTALS - 34 POLYSACCHARIDE IRON FORTE - 36 POLYTRIM - 41 POMALYST - 20, 37 PONSTEL - 7 PORTIA-28 - 25 POTASSIUM CHLORIDE CR - 38 POTASSIUM CHLORIDE ER - 38 POTASSIUM CHLORIDE SA - 38 POTASSIUM CHLORIDE SR - 38 POTASSIUM CITRATE - 34 POTASSIUM CITRATE/CITRIC - 34 POTASSIUM PERMANGANATE - 22 POTIGA - 13 PRADAXA - 12 PRAMCORT - 29 PRAMIPEXOLE - 21 PRAMOSONE - 29 PRAMOTIC - 43 PRAMOXINE-HC - 43 PRANDIN - 15 PRASCION - 27 PRASCION FC - 27 PRASCION RA WITH SUNSCREE - 27 PRAVACHOL - 17 PRAVASTATIN SODIUM - 17 PRAZOSIN HCL - 18 PRECOSE - 14 PRED FORTE - 42 PRED MILD - 42 PRED-G - 42 PRED-G S.O.P. - 42 PREDNICARBATE - 29 PREDNISOLONE - 26 PREDNISOLONE OPHTH - 42 PREDNISONE - 26, 34 PREDNISONE INTENSOL - 26 PREFEST - 33 PRELONE - 26 PREMARIN CRM - 47 PREMARIN TABS - 33 PREMPHASE - 33 PREMPRO - 33 PRENTIF CAVITY-RIM CERVIC - 37 PRENTIF FITTING SET - 37 PREVACID SOLUTAB - 46 PREVALITE - 17 PREVIFEM - 25 PREZCOBIX - 22 PREZISTA - 22 PRIMAQUINE PHOSPHATE - 19 PRIMIDONE - 13 PRIMLEV - 8 PRIMSOL - 12 PRINIVIL - 18 PRINZIDE - 19 PROAIR - 45 PROBENECID - 35 PROBENECID/COLCHICINE - 35 PROCAINAMIDE HCL ER - 10 PROCARDIA - 24 PROCARDIA XL - 24 PROCENTRA - 6 PROCHLORPERAZINE EDISYLAT - 22 PROCHLORPERAZINE MALEATE - 22 PROCRIT - 36 PROCTO-PAK - 9 PROCTOCARE-HC - 9 PROCTOCORT - 9 PROCTOCREAM HC - 9 PROCTOFOAM HC - 9 PROCTOSOL HC - 9 PROCTOZONE-HC - 9 PRODRIN - 37 PROFERRIN-FORTE - 36 PROGESTERONE MICRONIZED - 43 PROGESTERONE ORAL - 43 PROGRAF CAPS - 37 PROMACET - 7 PROMACTA - 36 PROMETHAZINE HCL - 17 PROMETHEGAN 12.5MG SUPP - 17 PROMETHEGAN 25MG SUPP - 17 PROMETHEGAN 50MG SUPP - 17 PROMETHEGAN TABS - 17 PROMETRIUM - 43 PROPAFENONE HCL - 10 PROPAFENONE HCL ER - 10 PROPANTHELINE BROMIDE - 46 PROPARACAINE HCL - 42 PROPRANOLOL HCL - 23 PROPRANOLOL HCL ER - 23 PROPRANOLOL/HCTZ - 18 PROPYLTHIOURACIL - 45 PROSCAR - 35 PROSCYBI - 33 PROSED/DS - 46 PROSTIGMIN - 19 PROTECT PLUS - 48 PROTECT PLUS NR - 48 PROTOPIC - 30 PROTRIPTYLINE HCL - 14 PROVENTIL HFA - 45 PROVERA - 43 PROVIGIL - 6 PROZAC - 14 PROZAC WEEKLY - 14 PRUDOXIN - 28 PULMICORT - 45 PULMICORT FLEXHALER - 45 PULMOZYME - 45 PUREVIT DUALFE PLUS - 36 PURINETHOL - 20 PURIXAN SUS - 20 PYLERA - 46 PYRIDIUM - 35 PYRIDOSTIGMINE BROMIDE - 19 QUALAQUIN - 19 QUANESE - 25 QUARTETTE - 25 QUDEXY XR - 13 QUESTRAN - 17 QUESTRAN LIGHT - 17 QUETIAPINE FUMARATE - 21 QUINAPRIL HCL - 18 QUINAPRIL/HCTZ - 18 QUINARETIC - 18 QUINIDINE GLUCONATE CR - 10 QUINIDINE GLUCONATE ER - 10 QUINIDINE SULFATE - 10 QUINIDINE SULFATE ER - 10 QUININE SULF 324mg - 19 QVAR - 45 RADIAPLEXRX - 31 RADIGEL - 31 RALOXIFENE - 33 RAMIPRIL - 18 RANEXA - 9 RANITIDINE SYRUP - 46 RAPAMUNE - 37 RAVICTI - 33 RAZADYNE ER - 44 RAZADYNE SOLN - 44 RAZADYNE TBS - 44 RE 10 WASH - 28 REBETOL - 23 REBIF - 44 RECLIPSEN - 25 RECTACORT-HC - 9 REGLAN - 34 REGRANEX - 31 RELAGARD - 47 RELAGESIC - 7 RELISTOR - 34 RELPAX - 38 REMERON - 13 REMEVEN - 29 RENA-VITE RX - 48 RENACIDIN - 34 RENAGEL - 34 RENAL - 48 RENALPREN - 48 RENO CAPS - 48 RENVELA POW PACK - 34 RENVELA TAB - 34 REPAGLINIDE - 15 REPAN - 7 REPREXAIN - 8 REQUIP - 21 REQUIP XL - 21 RESCRIPTOR - 22 RESERPINE - 18 RESPA-BR - 17 RESTASIS - 42 RESTORIL - 36 RETIN-A - 27 RETIN-A MICRO - 27 RETROVIR - 22 REVATIO - 24 REVIA - 16 REVINA - 29 REVLIMID - 20, 37 REYATAZ - 22 RHEUMATREX - 6 RHINOCORT NASAL (PREGNANCY ONLY) - 40 RHINOFLEX - 7 RHINOFLEX-650 - 7 RIBAPAK - 23 RIBASPHERE - 23 RIBATAB - 23 RIBAVIRIN - 23 RIDAURA - 6 RIFABUTIN - 19 RIFADIN - 19 RIFAMPIN - 19 RILUTEK - 40 RIMANTADINE HCL - 23 RIOMET - 15 RISEDRONATE - 32 RISPERDAL - 22 RISPERIDONE - 21 Caterpillar Drug Formulary Generated April 22, 2016 RITALIN - 6 RITALIN LA - 6 RITALIN SR - 6 RIVASTIGMINE PATCH - 44 RIVASTIGMINE TARTRATE - 44 RIZATRIPTAN - 38 RIZATRIPTAN MLT - 38 ROBAXIN - 39 ROBINUL - 46 ROBINUL FORTE - 46 ROCALTROL - 33 ROMYCIN - 41 ROPINIROLE ER - 21 ROPINIROLE HCL - 21 ROSADAN - 30 ROSANIL CLEANSER - 27 ROWASA - 34 ROXICET - 8 ROZEREM - 36 RYTHMOL - 10 RYTHMOL SR - 10 SABRIL - 13 SAIZEN - 32 SALACYN - 30 SALAGEN - 39 SALICYLIC ACID - 30 SALSALATE - 7 SAMSCA - 33 SANCUSO - 16 SANDIMMUNE - 37 SANDOSTATIN - 33 SANDOSTATIN LAR DEPOT - 33 SANTYL - 29 SAPHRIS - 21 SAVAYSA - 12 SCALACORT - 29 SCOPOLAMINE HBR - 46 SE-TAN PLUS - 36 SEB-PREV - 28 SEB-PREV WASH - 28 SECONAL - 36 SECTRAL - 23 SELEGILINE HCL CAP - 21 SELENIUM SULFIDE - 28 SELFEMRA - 14 SELSUN SHAMPOO - 28 SELZENTRY - 22 SENILEZOL - 36 SENSIPAR - 33 SEREVENT DISKUS - 45 SEROQUEL IR - 21 SEROQUEL XR - 21 SEROSTIM - 32 SERTRALINE HCL - 14 SEVELAMER CARBONATE TAB - 34 SHOHLS SOLUTION MODIFIED - 34 SIGNIFOR - 33 SILDENAFIL - 24 SILVADENE - 28 SILVASORB - 31 SILVER SULFADIAZINE - 28 SIMBRINZA - 41 SIMPONI SQ - 6 SIMVASTATIN - 17 SINEMET - 21 SINEMET CR - 21 SINGULAIR - 45 SIROLIMUS - 37 SIRTURO - 19 SIVEXTRO - 12 SKELAXIN - 39 SMZ-TMP DS - 11 SODIUM CHLORIDE - 39 SODIUM CHLORIDE BACTERIOS - 43 SODIUM CHLORIDE NEB - 27 SODIUM CHLORIDE TAB - 39 SODIUM FLUORIDE - 38 SODIUM POLYSTYRENE SULFON - 32 SODIUM SULFACETAMIDE - 27 SODIUM SULFACETAMIDE OPHTH - 41 SODIUM SULFACETAMIDE WASH - 28 SODIUM SULFACETAMIDE/SULF - 27 SOLARAZE - 28 SOLIA - 25 SOLTAMOX - 20 SOLU-CORTEF - 26 SOLU-MEDROL - 26 SOMA - 39 SOMAVERT - 33 SONATA - 36 SORIATANE - 28 SORINE - 23 SOTALOL HCL - 23 SOTYLIZE - 23 SOVALDI - 23 SPECTRACEF - 11 SPECTRAGEL - 31 SPERMICIDES (FOAM, FILM, SUPP) - 26 SPERMICIDES GEL - 26 SPIRIVA - 44 SPIRONOLACTONE - 32 SPIRONOLACTONE/HCTZ - 31 SPONGES (CONTRACEPTIVES) - 26 SPORANOX - 17 SPRINTEC 28 - 25 SPRYCEL - 20 SPS - 32 SRONYX - 25 SSD - 28 SSKI - 38 STAFLEX - 7 STAGESIC - 8 STALEVO - 21 STARLIX - 15 STAVUDINE - 22 STAXYN - 24 STELARA SQ - 6 STERILE WATER FOR INJECTI - 43 STERILE WATER IRRIGATION - 43 STIMATE - 33 STIVARGA - 20 STRATTERA - 6 STRENSIQ INJ - 32 STRIANT - 9 STRIBILD - 22 STRIVERDI AER RESPIMAT - 45 STROMECTOL - 9 SUBOXONE - 8 SUCRAID - 31 SUCRALFATE - 46 SULAR - 24 SULFACETAMIDE/PREDNISOLON - 42 SULFAMETHOXAZOLE/TRIMETHO - 11 SULFAMYLON - 28 SULFASALAZINE - 34 SULFAZINE - 34 SULFAZINE EC - 34 SULINDAC - 7 SUMATRIPTAN INJ - 38 SUMATRIPTAN NASAL - 38 SUMATRIPTAN TABS - 38 SUPRAX - 11 SUPREP BOWEL PREP - 37 SURMONTIL - 14 SUSTIVA - 22 SUTENT - 20 SYEDA - 25 SYLATRON - 20 SYMAX DUOTAB - 46 SYMAX FASTABS - 46 SYMAX-SL - 46 SYMAX-SR - 46 SYMBICORT - 45 SYMBYAX - 44 SYMLIN - 14 SYNALAR - 29 SYNALGOS-DC - 8 SYNAREL - 33 SYNTHROID - 46 SYRINGES INSULIN - 31, 37 SYRINGES VARIOUS - 37 TABLOID - 20 TACLONEX OINT - 29 TACLONEX SCALP - 29 TACROLIMUS CAPS - 37 TALWIN - 8 TAMBOCOR - 10 TAMOXIFEN CITRATE - 20 TAMSULOSIN HCL - 35 TANDEM PLUS - 36 TAPAZOLE - 45 TARCEVA - 20 TARGRETIN ORAL - 20 TARGRETIN TOP - 28 TARKA - 19 TARON-CRYSTALS - 34 TASIGNA - 20 TASMAR - 20 TAZORAC - 28 TAZTIA XT - 24 TBC AER - 29 TECFIDERA - 44 TECHNIVIE - 23 TEGRETOL - 13 TEGRETOL-XR - 13 TELMISARTAN - 18 TELMISARTAN/HCTZ - 18 TEMAZEPAM - 36 TEMODAR - 19 TEMOVATE - 29 TEMOVATE E - 29 TEMOZOLOMIDE - 19 TENCON - 7 TENEX - 18 TENORETIC - 19 TENORMIN - 23 TERAZOL 3 - 47 TERAZOL 7 - 47 TERAZOSIN HCL - 18 TERBINAFINE HCL - 16 TERBUTALINE SULFATE - 45 TERCONAZOLE - 47 TESSALON - 27 TESSALON PERLES - 27 TESTIM - 9 TESTOSTERONE CYPIONATE - 8 TESTOSTERONE ENANTHATE - 8 Caterpillar Drug Formulary Generated April 22, 2016 TESTOSTERONE GEL 12.5MG - 8 TESTOSTERONE GEL 25MG - 8 TESTOSTERONE GEL 50MG - 8 TESTRED - 9 TETCAINE - 42 TETRABENAZINE - 44 TETRACAINE HCL - 42 TETRACYCLINE HCL - 12 TETRAVISC - 42 TETRAVISC FORTE - 42 TEV-TROPIN - 32 THALOMID - 20, 37 THEO-24 - 45 THEOCHRON - 45 THEOPHYLLINE 400,600 CR,ER - 45 THEOPHYLLINE CR - 45 THEOPHYLLINE ER - 45 THEOPHYLLINE SR - 45 THERMAZENE - 28 THIOLA - 34 THIORIDAZINE HCL - 22 THIOTHIXENE - 21 THYROLAR - 46 TIAGABINE HYDROCHLORIDE - 13 TIAZAC - 24 TIGAN - 16 TIKOSYN - 10 TILIA FE - 25 TIMOLOL OPHTH - 40 TIMOLOL MALEATE - 23 TIMOPTIC - 41 TIMOPTIC-XE - 41 TINDAMAX - 12 TINIDAZOLE - 11 TIS-U-SOL - 43 TIVICAY - 22 TIZANIDINE HCL - 39 TL GARD RX - 36 TL ICON - 36 TL-FOL 500 - 36 TOBI - 10 TOBRADEX - 42 TOBRAMYCIN INJ - 10 TOBRAMYCIN NEB - 10 TOBRAMYCIN SULFATE - 41 TOBRAMYCIN/DEXAMETHASONE - 42 TOBREX - 41 TOFRANIL - 14 TOFRANIL-PM - 14 TOLAK CRE - 28 TOLAZAMIDE - 15 TOLBUTAMIDE - 15 TOLCAPONE - 20 TOLMETIN SODIUM - 7 TOLTERODINE ER - 47 TOLTERODINE TARTRATE - 47 TOPAMAX - 13 TOPICORT - 29 TOPIRAGEN - 13 TOPIRAMATE - 13 TOPROL XL - 23 TORSEMIDE - 32 TRACLEER - 24 TRAMADOL /APAP - 8 TRAMADOL HCL - 7 TRAMADOL HCL ER - 7 TRANDATE - 23 TRANDOLAPRIL - 18 TRANDOLAPRIL/VERAPAMIL - 18 TRANEXAMIC ACID - 36 TRANSDERM-SCOP - 16 TRANXENE T - 10 TRANYLCYPROMINE SULFATE - 14 TRAVATAN Z - 42 TRAZODONE HCL - 13 TRENTAL - 35 TRETIN-X - 27 TRETINOIN CAPS - 27 TRETINOIN CRM/GEL - 27 TRETINOIN GEL 0.04% - 27 TRETINOIN GEL 0.1% - 27 TRETINOIN MICRO GEL - 27 TREXALL - 20 TRI-ESTARYLLA - 25 TRI-LEGEST FE - 25 TRI-LINYAH - 25 TRI-LO-ESTARYLLA - 25 TRI-LO-MARZIA - 25 TRI-LO-SPRINTEC - 25 TRI-NORINYL 28 - 25 TRI-PREVIFEM - 25 TRI-SPRINTEC - 25 TRIAMCINOLONE ACETONIDE - 29 TRIAMCINOLONE IN ORABASE - 39 TRIAMTERENE/HCTZ - 31 TRIANEX - 29 TRIAZOLAM - 36 TRICITRATES - 34 TRICON - 36 TRIDERM - 29 TRIFLUOPERAZINE HCL - 22 TRIFLURIDINE - 41 TRIGELS-F FORTE - 36 TRIHEXYPHENIDYL HCL - 20 TRIIODO-L-THYRONINE - 46 TRILEPTAL - 13 TRILYTE - 37 TRIMETHOBENZAMIDE HCL - 16 TRIMETHOPRIM - 11 TRIMETHOPRIM/POLYMYXIN B - 41 TRIMIPRAMINE MALEATE - 14 TRINESSA - 25 TRINESSA LO - 25 TRIPHROCAPS - 48 TRIPLE ANTIBIOTIC - 41 TRIUMEQ - 22 TRIVORA-28 - 25 TRIZIVIR - 22 TROKENDI XR - 13 TROPICAMIDE - 41 TROSPIUM CHLORIDE - 47 TRUSOPT - 42 TRUVADA - 22 TUDORZA PRESSAIR - 44 TUSSIGON - 26 TYBOST - 22 TYKERB - 20 TYLENOL/CODEINE #3, #4 - 8 TYLOX - 8 TYZEKA - 23 TYZINE - 40 U-CORT - 29 U-KERA E - 29 ULESFIA - 30 ULORIC - 35 ULTRACET - 8 ULTRAM - 8 ULTRAM ER - 8 ULTRAVATE - 29 ULTRESA - 31 UMECTA - 29 UMECTA NAIL FILM - 29 UNIRETIC - 19 UNITHROID - 45 UNIVASC - 18 UR N-C - 46 URAMAXIN - 29 URAMAXIN GT - 29 UREA - 29 UREA 40% NAIL FILM - 29 UREA NAIL - 29 UREA TOPICAL - 29 UREA-C40 - 29 URECHOLINE - 47 URELIEF PLUS - 47 URELLE - 46 URETRON D/S - 46 UREX - 47 URIN D/S - 46 URISTIX - 47 UROCIT-K - 34 UROQID #2 - 46 UROXATRAL - 35 URSO 250 - 33 URSO FORTE - 33 URSODIOL - 33 USTELL - 46 UTA - 46 UTICAP - 46 UTIRA-C - 46 UTRONA-C - 46 V-C FORTE - 48 VAGIFEM - 47 VALACYCLOVIR HCL - 23 VALCHLOR GEL 0.16% - 28 VALCYTE SOLN - 23 VALCYTE TB - 23 VALGANCICLOVIR - 22 VALIUM - 10 VALPROIC ACID - 13 VALSARTAN - 18 VALSARTAN/HCTZ - 18 VALTREX - 23 VANCOCIN HCL - 12 VANCOMYCIN CAPS - 11 VANCOMYCIN HCL INJ - 11 VANCOMYCIN ORAL SOLN - 12 VANDAZOLE - 47 VANOS - 29 VANOXIDE-HC - 27 VASERETIC - 19 VASOLEX - 29 VASOTEC - 18 VELIVET - 25 VELTIN - 27 VENLAFAXINE HCL CAP - 14 VENLAFAXINE HCL ER CAP - 14 VENTOLIN HFA - 45 VERAPAMIL HCL - 24 VERAPAMIL HCL CR - 24 VERAPAMIL HCL ER - 24 VERAPAMIL HCL SA - 24 VERAPAMIL HCL SR - 24 VERDESO - 29 VEREGEN - 30 VERELAN - 24 VERELAN PM - 24 Powered by TCPDF (www.tcpdf.org) Caterpillar Drug Formulary Generated April 22, 2016 VESICARE - 47 VESTURA - 25 VEXOL - 42 VFEND - 17 VIAGRA - 24 VIBRAMYCIN - 12 VIC-FORTE - 48 VICAP FORTE - 48 VICOPROFEN - 8 VICTOZA - 15 VIDEX - 22 VIDEX EC - 22 VIEKIRA - 23 VIGAMOX - 41 VIMPAT - 13 VIORELE - 25 VIRACEPT 250 - 22 VIRACEPT 625 - 22 VIRAMUNE SUS - 22 VIRAMUNE TAB - 22 VIRAMUNE XR - 22 VIREAD - 22 VIREAD 300mg - 22 VIROPTIC - 41 VIRTI-SULF - 27 VISICOL - 37 VISTARIL - 10 VISTOGARD - 32 VITA-MIN - 48 VITAFOL - 38 VITAMIN D - 48 VITAMIN FORTE - 48 VITAMIN K - 48 VITAZOL - 30 VITEKTA - 22 VIVACTIL - 14 VIVELLE-DOT - 33 VOGELXO - 9 VOL-CARE RX - 48 VOLTAREN GEL - 7, 30 VOLTAREN XR - 7 VORICONAZOLE - 16 VOSOL - 42 VOSOL HC - 43 VOSPIRE ER - 45 VOTRIENT - 20 WARFARIN SODIUM - 12 WELCHOL - 17 WELLBUTRIN - 13 WELLBUTRIN SR - 13 WELLBUTRIN XL - 13 WERA - 25 WESTCORT - 29 WESTHROID - 46 WYMZYA FE - 25 X-VIATE - 29 XALATAN - 42 XALKORI - 20 XANAX - 10 XANAX XR - 10 XARELTO - 12 XCLAIR - 30 XELJANZ - 6 XELJANZ XR - 6 XELODA - 20 XENADERM - 29 XENAZINE - 44 XIFAXAN - 12 XODOL - 8 XOLOX - 8 XOPENEX - 45 XTANDI - 20 XULANE - 26 XURIDEN - 32 XYLOCAINE - 30 XYREM - 44 YASMIN 28 - 25 YAZ - 25 ZAFIRLUKAST - 45 ZALEPLON - 36 ZAMICET - 8 ZANAFLEX - 39 ZARAH - 25 ZARONTIN - 13 ZAROXOLYN - 32 ZAVESCA - 35 ZAZOLE - 47 ZEBETA - 23 ZEBUTAL - 7 ZECUITY - 38 ZELBORAF - 20 ZEMPLAR - 33 ZENATANE - 27 ZENCHENT - 25 ZENCHENT FE - 25 ZENPEP - 31 ZEOSA - 25 ZERIT - 22 ZESTORETIC - 19 ZESTRIL - 18 ZETIA - 18 ZFLEX - 7 ZIAC - 19 ZIAGEN SOLN - 22 ZIAGEN TB - 22 ZIANA - 27 ZIDOVUDINE - 22 ZIOPTAN - 42 ZIPRASIDONE HCL - 21 ZIRGAN - 41 ZITHROMAX - 10 ZOCOR - 17 ZOFRAN - 16 ZOFRAN ODT - 16 ZOLINZA - 20 ZOLOFT - 14 ZOLPIDEM TARTRATE - 36 ZOLPIDEM TARTRATE ER - 36 ZOLVIT - 8 ZOMACTON - 32 ZOMIG - 38 ZOMIG NASL - 38 ZONALON - 28 ZONATUSS - 27 ZONEGRAN - 13 ZONISAMIDE - 13 ZORBTIVE - 32 ZORTRESS - 20 ZOVIA 1/35E - 25 ZOVIA 1/50E - 25 ZOVIRAX ORAL - 23 ZOVIRAX TOP - 28 ZYCLARA CRM 3.75% - 30 ZYDONE - 8 ZYLET - 42 ZYLOPRIM - 35 ZYMAXID - 41 ZYPREXA - 21 ZYPREXA SOLN - 21 ZYPREXA ZYDIS - 21 ZYTIGA - 20 ZYVOX - 12
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