Drugs: Contract Drugs List Part 4 – drugs cdl p4
Therapeutic Classifications1
This section provides a quick reference to common drug classifications. The referenced pages include a staggered list that organizes drugs with respect to their use or form. Refer to the Contract Drugs List sections in this manual for a full list of drugs and their specific utilization controls.
2 – Drugs: Contract Drugs List Part 4 Pharmacy 878
Therapeutic ClassificationsAugust 2016
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ADRENERGIC AGENTS
(SYMPATHOMIMETICS)...... 10
ADRENERGIC BLOCKING AGENTS (SYMPATHOLYTICS)...... 10
AMEBACIDE...... 5
AMYOTROPHIC LATERAL
SCLEROSIS AGENT...... 19
ANALGESICS...... 10
ANDROGENS...... 14
ANTACIDS AND ADSORBENTS...... 14
ANTHELMINTICS...... 5
ANTI-ALCOHOLISM...... 19
ANTIANXIETY...... 11
ANTIASTHMATICS...... 9
ANTIBIOTICS...... 5
ANTICHOLINERGIC AGENTS...... 10
(PARASYMPATHOLYTICS)
ANTICOAGULANT ANTAGONIST...... 10
ANTICOAGULANTS...... 10
ANTICONVULSANTS...... 11
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ANTIDEPRESSANTS...... 11
ANTI-DIARRHEA AGENTS...... 14
ANTI-EMETICS...... 9
ANTI-FUNGALS...... 5
ANTI-GLAUCOMA AGENTS...... 16
ANTI-GOUT...... 19
ANTIHISTAMINE AND
DECONGESTANT COMBINATIONS....19
ANTIHISTAMINE CONTAINING
COMBINATIONS...... 9
ANTIHISTAMINES...... 9
ANTI-HYPERKINETICS...... 11
ANTIHYPERTENSIVES...... 12
ANTI-INFECTIVES...... 5
ANTI-INFLAMMATORY ...... 10
ANTI-LIPIDEMIC AGENTS...... 20
ANTI-MALARIALS...... 5
ANTI-NEOPLASTICS...... 7
2 – Drugs: Contract Drugs List Part 4 Pharmacy 870
Therapeutic ClassificationsApril 2016
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ANTI-PARKINSONISM...... 9
ANTI-PLATELET…………………………..10
ANTI-PLATELET AGENTS…………………20
ANTI-PROTOZOAL...... 6
ANTIPRURITICS...... 9
ANTI-TUBERCULARS...... 6
ANTI-VIRALS...... 6
APPETITE STIMULANT...... 12
AUTONOMIC DRUGS...... 9
BILE ACID MODIFIER...... 14
BISPHOSPHONATES...... 20
BLOOD MODIFIERS...... 10
BRONCHO-PULMONARY
SECRETION MODIFIERS...... 20
CALCIMIMETIC AGENT...... 20
CALCIUM SUPPLEMENTS
AND VITAMIN D ANALOGS...... 16
CARDIAC DRUGS...... 13
CENTRAL NERVOUS SYSTEM
DRUGS...... 11
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CHELATING AGENT...... 20
CHOLINERGIC AGENTS
(PARASYMPATHOMIMETICS)...... 10
CONTRACEPTIVES...... 15
DECONGESTANTS...... 20
DERMATOLOGICAL PREPARATIONS...18
DIGESTANT PREPARATIONS...... 14
DIURETICS...... 13
DIURETICS AND
CARDIO-VASCULARS...... 12
ELECTROLYTE SOLUTIONS...... 20
ESTROGENS AND COMBINATIONS....15
EXPECTORANTS AND COUGH
PREPARATIONS ...... 20
FLUORIDE...... 16
GALLSTONE DISSOLVING AGENT.....20
GASTRO-INTESTINAL DRUGS...... 14
G.I. STIMULANT...... 14
GLUCOCORTICOIDS...... 15
GOLD COMPOUNDS...... 21
2 – Drugs: Contract Drugs List Part 4 Pharmacy 878
Therapeutic ClassificationsAugust 2016
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H + /K + ATPase ENZYME
SYSTEM INHIBITORS...... 14
HEMATINICS...... 10
HEMATOPOIETIC...... 10
HEMORHEOLOGIC AGENTS...... 21
HISTAMINE H2-RECEPTOR
ANTAGONISTS...... 14
HORMONES...... 14
HYPOGLYCEMICS...... 15
HYPOGLYCEMIC SHOCK...... 16
HYPOPROLACTINEMIC AGENT...... 21
IMMUNOMODULATORS...... 21
IMMUNOSUPPRESSIVE AGENT...... 21
INTERSTITIAL CYSTITIS AGENT...... 21
INTRAVENOUS SOLUTIONS...... 21
IRRIGATING SOLUTIONS...... 7
LAXATIVES...... 14
LOCAL ANESTHETICINJECTION...... 21
METABOLIC SUPPLEMENTS...... 16
MIGRAINE...... 9
MISCELLANEOUS...... 19
MISCELLANEOUS (CENTRAL NERVOUS SYSTEM DRUGS)...... 12
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NARCOTIC ANTAGONISTS...... 11
NARCOTICS...... 11
NASAL ANTI-INFLAMMATORIES...... 21
NON-NARCOTICS...... 11
OPHTHALMIC ANESTHETIC...... 17
OPHTHALMIC ANTIBIOTICS...... 17
OPHTHALMIC ANTIHISTAMINES...... 17
OPHTHALMIC
ANTI-INFLAMMATORIES...... 17
OPHTHALMIC ANTI-VIRALS...... 17
OPHTHALMIC MAST CELL
STABILIZERS...... 17
OPHTHALMIC MIOTICS...... 17
OPHTHALMIC MISCELLANEOUS...... 17
OPHTHALMIC MYDRIATICS...... 17
OPHTHALMIC PREPARATIONS...... 16
OPHTHALMIC SULFONAMIDE...... 17
OPHTHALMIC VASOCONSTRICTORS
AND COMBINATIONS...... 17
OTIC PREPARATIONS...... 18
OXYTOCICS...... 21
2 – Drugs: Contract Drugs List Part 4 Pharmacy 892
Therapeutic ClassificationsMarch 2017
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PARASYMPATHOLYTIC AGENTS
(ANTICHOLINERGIC)...... 10
PARASYMPATHOMIMETIC AGENTS
(CHOLINERGIC)...... 10
PARATHYROID...... 16
PHOSPHATE BINDERS...... 21
PITUITARY...... 16
POTASSIUM SUPPLEMENT...... 16
PROGESTINS AND COMBINATIONS...16
PROSTAGLANDIN ANALOG...... 14
PROSTATE AGENTS...... 21
PSYCHOTROPICS...... 12
RECTAL PREPARATIONS...... 18
SEDATIVES AND HYPNOTICS...... 12
SKELETAL MUSCLE RELAXANTS.....21
SMOKING DETERRENTS...... 21
SULFONAMIDES...... 7
SYMPATHOLYTIC AGENTS
(ADRENERGIC BLOCKING)...... 10
SYMPATHOMIMETIC AGENTS
(ADRENERGIC)...... 10
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THROMBOCYTOPENIC...... 10
THYROID AND ANTITHYROID...... 16
TOPICAL AND LOCAL
PREPARATIONS...... 18
TRICHOMONACIDE...... 7
ULCER ADHERENT...... 14
URINARY TRACT ANTI-INFECTIVES....7
URINARY TRACT ANTISPASMODICS...21
VACCINES...... 18
VAGINAL PREPARATIONS...... 19
VASODILATING AGENTS...... 13
VITAMINS...... 16
2 – Drugs: Contract Drugs List Part 4 Pharmacy 892
Therapeutic ClassificationsMarch 2017
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ANTI-INFECTIVES
AMEBACIDE
PAROMOMYCIN
ANTHELMINTICS
MEBENDAZOLE
PYRANTEL PAMOATE
ANTIBIOTICS
AMIKACIN SULFATE
AMOXICILLIN
AMOXICILLIN/CLAVULANATE
POTASSIUM
AMOXICILLIN TRIHYDRATE
AMPICILLIN
AZITHROMYCIN
BENZATHINE PENCILLIN G
CEFACLOR
CEFAZOLIN
CEFDINIR
CEFIXIME
CEFPODOXIME PROXETIL
CEFTAZIDIME
CEFTRIAXONE SODIUM
CEPHALEXIN
CHLORAMPHENICOL
CIPROFLOXACIN
CIPROFLOXACIN HCL
CLARITHROMYCIN
CLINDAMYCIN
DICLOXACILLIN
DOXYCYCLINE
DOXYCYCLINE HYCLATE
ERYTHROMYCIN BASE
ERYTHROMYCIN ETHYLSUCCINATE
ERYTHROMYCIN STEARATE
GENTAMICIN
ANTI-INFECTIVES (continued)
ANTIBIOTICS (continued)
GRISEOFULVIN
LEVOFLOXACIN
METRONIDAZOLE
MOXIFLOXACIN
NAFCILLIN
NEOMYCIN
NYSTATIN
OFLOXACIN
PENICILLIN G
PENICILLIN G PROCAINE
PENICILLIN V (K)
PIPERACILLIN SODIUM
STREPTOMYCIN
TETRACYCLINE
TOBRAMYCIN
VANCOMYCIN
ANTI-FUNGALS
AMPHOTERICIN B
BUTOCONAZOLE NITRATE
CLOTRIMAZOLE
ECONAZOLE NITRATE
FLUCONAZOLE
ITRACONAZOLE
KETOCONAZOLE
MICONAZOLE NITRATE
NYSTATIN
TERBINAFINE HCL
TERCONAZOLE
ANTI-MALARIALS
CHLOROQUINE
HYDROXYCHLOROQUINE
PRIMAQUINE
PYRIMETHAMINE
2 – Drugs: Contract Drugs List Part 4 Pharmacy 892
Therapeutic ClassificationsMarch 2017
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ANTI-INFECTIVES (continued)
ANTI-PROTOZOAL
ATOVAQUONE
PENTAMIDINE
PYRIMETHAMINE
ANTI-TUBERCULARS
AZITHROMYCIN
CLARITHROMYCIN
CYCLOSERINE
ETHAMBUTOL
ETHIONAMIDE
ISONIAZID
PYRAZINAMIDE
RIFABUTIN
RIFAMPIN
RIFAMPIN AND ISONIAZID
RIFAMPIN, ISONIAZID AND
PYRAZINAMIDE
RIFAPENTINE
STREPTOMYCIN
ANTI-VIRALS
ABACAVIR SULFATE
ABACAVIR SULFATE AND LAMIVUDINE
ABACAVIR SULFATE/DOLUTEGRAVIR/ LAMIVUDINE
ABACAVIR SULFATE, LAMIVUDINE
AND ZIDOVUDINE
ACYCLOVIR
AMANTADINE
ATAZANAVIR/COBICISTAT
ATAZANAVIR SULFATE
BICTEGRAVIR/EMTRICITABINE/
TENOFOVIR ALAFENAMIDE
CIDOFOVIR
COBICISTAT
COBICISTAT/DARUNAVIR
DARUNAVIR
DELAVIRIDINE MESYLATE
DIDANOSINE
DOLUTEGRAVIR
DOLUTEGRAVIR/RILPIVIRINE
EFAVIRENZ
EFAVIRENZ, EMTRICITABINE AND
TENOFOVIR DISOPROXIL FUMARATE
EFAVIRENZ/LAMIVUDINE/TENOFOVIR DISOPROXIL FUMARATE
ELBASVIR/GRAZOPREVIR
ELVITEGRAVIR
ANTI-INFECTIVES (continued)
ANTI-VIRALS (continued)
ELVITEGRAVIR/COBICISTAT/
EMTRICITABINE/TENOFOVIR ALAFENAMIDE
ELVITEGRAVIR/COBICISTAT/
EMTRICITABINE/TENOFOVIR DISOPROXIL FUMARATE
EMTRICITABINE
EMTRICITABINE/RILPIVIRINE/
TENOFOVIR ALAFENAMIDE
EMTRICITABINE/RILPIVIRINE/
TENOFOVIR DISOPROXIL FUMARATE
EMTRICITABINE/TENOFOVIR
ALAFENAMIDE
ENTECAVIR
ETRAVIRINE
FOSAMPRENAVIR CALCIUM
FOSCARNET SODIUM
GANCICLOVIR
GANCICLOVIR SODIUM
GLECAPREVIR/PIBRENTASVIR
IBALIZUMAB-UIYK
INDINAVIR SULFATE
LAMIVUDINE
LAMIVUDINE AND ZIDOVUDINE
LEDIPASVIR/SOFOSBUVIR
LOPINAVIR AND RITONAVIR
MARAVIROC
NELFINAVIR MESYLATE
NEVIRAPINE
OMBITASVIR/PARITAPREVIR/
RITONAVIR AND DASABUVIR
OSELTAMIVIR PHOSPHATE
PEGINTERFERON ALFA-2A
PEGINTERFERON ALFA-2B
RALTEGRAVIR
RIBAVIRIN
RILPIVIRINE
RITONAVIR
SAQUINAVIR
SAQUINAVIR MESYLATE
SOFOSBUVIR
SOFOSBUVIR/VELPATASVIR
STAVUDINE
TENOFOVIR ALAFENAMIDE
TENOFOVIR DISOPROXIL FUMARATE
TIPRANAVIR
VALACYCLOVIR HCL
2 – Drugs: Contract Drugs List Part 4 Pharmacy 926
Therapeutic ClassificationsAugust 2018
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ANTI-INFECTIVES (continued)
ANTI-VIRALS (continued)
VALGANCICLOVIR HCL
ZANAMIVIR
ZIDOVUDINE
IRRIGATING SOLUTIONS
ACETIC ACID
NEOMYCIN AND POLYMYXIN
SODIUM CHLORIDE
SULFONAMIDES
DAPSONE
SULFADIAZINE
SULFASALAZINE
TRIMETHOPRIM AND
SULFAMETHOXAZOLE
TRICHOMONACIDE
METRONIDAZOLE
URINARY TRACT ANTI-INFECTIVES
METHENAMINE HIPPURATE
METHENAMINE MANDELATE
NITROFURANTOIN
TRIMETHOPRIM
TRIMETHOPRIM AND
SULFAMETHOXAZOLE
ANTI-NEOPLASTICS
ABEMACICLIB
ABIRATERONE ACETATE
ACALABRUTINIB
ADO-TRASTUZUMAB EMTANSINE
AFATINIB
ALDESLEUKIN
ALECTINIB
ALITRETINOIN
ALTRETAMINE
ANASTROZOLE
APALUTAMIDE
ARSENIC TRIOXIDE
ATEZOLIZUMAB
AVELUMAB
AXITINIB
BENDAMUSTINE HCL
BEVACIZUMAB
ANTI-NEOPLASTICS (continued)
BEXAROTENE
bicalutamide
BLEOMYCIN SULFATE
BORTEZOMIB
BOSUTINIB
BRIGATINIB
BUSULFAN
CABAZITAXEL
CABOZANTINIB S-MALATE
CAPECITABINE
CARBOPLATIN
CARMUSTINE
CERITINIB
CETUXIMAB
CHLORAMBUCIL
CISPLATIN
CLADRIBINE
COBIMETINIB
COPANLISIB
CRIZOTINIB
CYCLOPHOSPHAMIDE
CYTARABINE
DABRAFENIB
DACARBAZINE
DARATUMUMAB
DASATINIB
DAUNORUBICIN citrate liposome
DAUNORUBICIN HCL
DECITABINE
DEGARELIX
DOCETAXEL
DOXORUBICIN HCL
DOXORUBICIN HCL LIPOSOME
DURVALUMAB
ELOTUZUMAB
ENZALUTAMIDE
EPIRUBICIN HCL
ERIBULIN MESYLATE
ERLOTINIB
ESTRADIOL
ESTRAMUSTINE PHOSPHATE
ETOPOSIDE
ETOPOSIDE PHOSPHATE
EVEROLIMUS
EXEMESTANE
FLOXURIDINE
FLUDARABINE PHOSPHATE
FLUOROURACIL
2 – Drugs: Contract Drugs List Part 4 Pharmacy 924
Therapeutic ClassificationsJuly 2018
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ANTI-NEOPLASTICS (continued)
FLUOXYMESTERONE
FLUTAMIDE
FULVESTRANT
GEFITINIB
GEMCITABINE HCL
GEMTUZUMAB OZOGAMICIN
GOSERELIN ACETATE
HYDROXYUREA
IBRUTINIB
IDELALISIB
IFOSFAMIDE
IFOSFAMIDE WITH MESNA
IMATINIB MESYLATE
INOTUZUMAB OZOGAMCIN
INTERFERON ALFA-2A
INTERFERON ALFA-2B
IPILIMUMAB
IRINOTECAN HCL
IXABEPILONE
IXAZOMIB
LAPATINIB
LENVATINIB
LETROZOLE
LEUPROLIDE ACETATE
LOMUSTINE
MECHLORETHAMINE HCL
MEDROXYPROGESTERONE
ACETATE
MEGESTROL ACETATE
MELPHALAN
MERCAPTOPURINE
METHOTREXATE
METHYL TESTOSTERONE
MIDOSTAURIN
MITOMYCIN
MITOTANE
MITOXANTRONE
NECITUMUMAB
NELARABINE
NILOTINIB
NILUTAMIDE
NIRAPARIB
NIVOLUMAB
OBINUTUZUMAB
OFATUMUMAB
OLAPARIB
OLARATUMAB
OMACETAXINE MEPESUCCINATE
OSIMERTINIB
OXALIPLATIN
ANTI-NEOPLASTICS (continued)
PACLITAXEL
PALBOCICLIB
PANOBINOSTAT
PAZOPANIB HCL
PEGASPARGASE
PEGINTERFERON ALFA-2B
PEMBROLIZUMAB
PEMETREXED
PENTOSTATIN
PERTUZUMAB
PONATINIB
PORFIMER SODIUM
PROCARBAZINE
RAMUCIRUMAB
REGORAFENIB
RIBOCICLIB
RIBOCICLIB AND LETROZOLE
RITUXIMAB
RITUXIMAB AND HYALURONIDASE HUMAN
SONIDEGIB
SORAFENIB
STREPTOZOCIN
SUNITINIB MALATE
TAMOXIFEN CITRATE
TEMOZOLOMIDE
TEMSIROLIMUS
TENIPOSIDE
TESTOSTERONE
THIOGUANINE
THIOTEPA
TOPOTECAN HCL
TRABECTEDIN
TRAMETINIB
TRASTUZUMAB
TRETINOIN
TRIPTORELIN PAMOATE
VANDETANIB
Vemurafenib
VENETOCLAX
VINBLASTINE SULFATE
VINCRISTINE SULFATE
VINORELBINE TARTRATE
VISMODEGIB
VORINOSTAT
ZIV-AFLIBERCEPT
2 – Drugs: Contract Drugs List Part 4 Pharmacy 922
Therapeutic ClassificationsJune2018
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AUTONOMIC DRUGS
ANTIASTHMATICS
ALBUTEROL SULFATE
AMINOPHYLLINE
BECLOMETHASONE DIPROPIONATE
BUDESONIDE
BUDESONIDE/FORMOTEROL
FUMARATE DIHYDRATE
CROMOLYN SODIUM
EPINEPHRINE
FLUNISOLIDE
FLUTICASONE FUROATE
FLUTICASONE PROPIONATE
FLUTICASONE PROPIONATE
AND SALMETEROL
GLYCOPYRROLATE AND FORMOTEROL FUMARATE
IPRATROPIUM BROMIDE AND
ALBUTEROL SULFATE
METAPROTERENOL
MOMETASONE FUROATE
MONOHYDRATE
MOMETASONE FUROATE AND
FORMOTEROL FUMARATE DIHYDRATE
MONTELUKAST SODIUM
SALMETEROL XINAFOATE
TERBUTALINE
THEOPHYLLINE
TIOTROPIUM BROMIDE
TRIAMCINOLONE
ANTI-EMETICS
APREPITANT
CHLORPROMAZINE
DIPHENHYDRAMINE
DOLASETRON MESYLATE
DOXYLAMINE/PYRIDOXINE HCL
GRANISETRON HCL
MECLIZINE HCL
ONDANSETRON
PALONOSETRON HCL
PERPHENAZINE
PROCHLORPERAZINE
PROMETHAZINE
ANTIHISTAMINE CONTAINING COMBINATIONS
see Expectorants and Cough Preparations
AUTONOMIC DRUGS (continued)
ANTIHISTAMINES
AZELASTINE HCL
BROMPHENIRAMINE MALEATE
CHLORPHENIRAMINE MALEATE
DEXBROMPHENIRAMINE MALEATE
DIPHENHYDRAMINE HCL
LORATADINE
OLOPATADINE HCL
PROMETHAZINE
TRIPROLIDINE
ANTI-PARKINSONISM
AMANTADINE
BENZTROPINE MESYLATE
CARBIDOPA AND LEVODOPA
CARBIDOPA AND LEVODOPA AND
ENTACAPONE
DIPHENHYDRAMINE HCL
ENTACAPONE
PRAMIPEXOLE DIHYDROCHLORIDE
ROPINIROLE HCL
SELEGILINE HCL
TRIHEXYPHENIDYL HCL
ANTIPRURITICS – also see Antihistamines
DIPHENHYDRAMINE
HYDROCHLORIDE
HYDROXYZINE
PROMETHAZINE
MIGRAINE
ERGOTAMINE TARTRATE AND
CAFFEINE
ISOMETHEPTENE MUCATE,
DICHLORALPHENAZONE AND APAP
SUMATRIPTAN
SUMATRIPTAN SUCCINATE
2 – Drugs: Contract Drugs List Part 4 Pharmacy 908
Therapeutic ClassificationsNovember 2017
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AUTONOMIC DRUGS (continued)
PARASYMPATHOLYTIC (ANTICHOLINERGIC) AGENTS
ATROPINE
DICYCLOMINE
GLYCOPYRROLATE
PROPANTHELINE BROMIDE
PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS – also see Ophthalmic Miotics
BETHANECHOL CHLORIDE
DONEPEZIL HCL
GALANTAMINE HYDROBROMIDE
PILOCARPINE
PYRIDOSTIGMINE
RIVASTIGMINE
RIVASTIGMINE TARTRATE
SYMPATHOLYTIC (ADRENERGIC BLOCKING)
AGENTS
ERGOTAMINE TARTRATE AND CAFFEINE
PROPRANOLOL
SYMPATHOMIMETIC (ADRENERGIC) AGENTS –
also see Ophthalmic Vasoconstrictors
EPINEPHRINE
BLOOD MODIFIERS
ANTICOAGULANT ANTAGONIST
PHYTONADIONE
ANTICOAGULANTS
ENOXAPARIN SODIUM
HEPARIN
HEPARIN LOCK FLUSH SOLUTION
RIVAROXABAN
WARFARIN SODIUM
BLOOD MODIFIERS (continued)
ANTI-PLATELET
CLOPIDOGREL
PRASUGREL
TICAGRELOR
HEMATINICS
FERROUS SULFATE
IRON DEXTRAN INJECTION
HEMATOPOIETIC
EPOETIN ALFA
THROMBOCYTOPENIC
ANAGRELIDE HYDROCHLORIDE
ANALGESICS
ANTI-INFLAMMATORY – also see Glucocorticoids
ASPIRIN
CELECOXIB
COLCHICINE
DICLOFENAC SODIUM
DIFLUNISAL
FENOPROFEN
FLURBIPROFEN
IBUPROFEN
INDOMETHACIN
MELOXICAM
NABUMETONE
NAPROXEN
PIROXICAM
SALSALATE
SULINDAC
TOLMETIN
2 – Drugs: Contract Drugs List Part 4 Pharmacy 892
Therapeutic ClassificationsMarch 2017
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ANALGESICS (continued)
NARCOTIC ANTAGONISTS
BUPRENORPHINE
BUPRENORPHINE/NALOXONE
NALOXONE HCL
NALTREXONE HCL
NARCOTICS
CODEINE AND ACETAMINOPHEN
FENTANYL
HYDROCODONE AND ACETAMINOPHEN
HYDROMORPHONE
LEVORPHANOL TARTRATE
MEPERIDINE HCL
MORPHINE SULFATE
OXYCODONE AND ACETAMINOPHEN
OXYCODONE HCL
OXYCODONE HCL AND ASPIRIN
OXYMORPHONE
NON-NARCOTICS
ACETAMINOPHEN
ASPIRIN
PHENAZOPYRIDINE HCL
TRAMADOL HCL
CENTRAL NERVOUS SYSTEM DRUGS
ANTIANXIETY
BUSPIRONE
HYDROXYZINE HCL
HYDROXYZINE PAMOATE
LORAZEPAM
ANTICONVULSANTS
CARBAMAZEPINE
CLONAZEPAM
DIAZEPAM
DIVALPROEX SODIUM
ESLICARBAZEPINE ACETATE
ETHOSUXIMIDE
GABAPENTIN
LAMOTRIGINE
CENTRAL NERVOUS SYSTEM DRUGS
(continued)
ANTICONVULSANTS (continued)
OXCARBAZEPINE
PHENOBARBITAL
PHENYTOIN
PRIMIDONE
TIAGABINE HCL
TOPIRAMATE
VALPROIC ACID
ZONISAMIDE
ANTIDEPRESSANTS
AMITRIPTYLINE
AMITRIPTYLINE HCL,
PERPHENAZINE
BUPROPION HCL
CLOMIPRAMINE HCL
DESIPRAMINE HCL
DOXEPIN
DULOXETINE HCL
ESCITALOPRAM OXALATE
FLUOXETINE HCL
FLUVOXAMINE MALEATE
IMIPRAMINE
MIRTAZAPINE
NORTRIPTYLINE HCL
PAROXETINE HCL
PROTRIPTYLINE
SERTRALINE HCL
TRAZODONE
VENLAFAXINE HCL
VORTIOXETINE
ANTI-HYPERKINETICS
DEXMETHYLPHENIDATE HCL
DEXTROAMPHETAMINE SULFATE
LISDEXAMFETAMINE DIMESYLATE
2 – Drugs: Contract Drugs List Part 4 Pharmacy 914
Therapeutic ClassificationsFebruary 2018
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CENTRAL NERVOUS SYSTEM DRUGS(continued)
APPETITE STIMULANT
DRONABINOL
MISCELLANEOUS
MILNACIPRAN HCL
PSYCHOTROPICS
ARIPIPRAZOLE
ASENAPINE
CHLORPROMAZINE
CLOZAPINE
FLUPHENAZINE
HALOPERIDOL
ILOPERIDONE
LITHIUM CARBONATE
LITHIUM CITRATE
LOXAPINE
LURASIDONE HYDROCHLORIDE
MOLINDONE HYDROCHLORIDE
OLANZAPINE
PERPHENAZINE
QUETIAPINE FUMARATE
RISPERIDONE
THIORIDAZINE
THIOTHIXENE
TRIFLUOPERAZINE
ZIPRASIDONE HCL
SEDATIVES AND HYPNOTICS
The Department of Health Care Services (DHCS)recommends that a patient’s use of a hypnotic in insomnia therapy be occasional rather than continuous.
FLURAZEPAM
PENTOBARBITAL
PHENOBARBITAL
TEMAZEPAM
TRIAZOLAM
ZOLPIDEM TARTRATE
DIURETICS AND CARDIOVASCULARS
ANTIHYPERTENSIVES – also see Diuretics
ACEBUTOLOL
AMLODIPINE/BENAZEPRIL HCL
AMLODIPINE BESYLATE
AMLODIPINE/VALSARTAN
AMLODIPINE/VALSARTAN
HYDROCHLOROTHIAZIDE
ATENOLOL
BENAZEPRIL HCL
BENAZEPRIL HCL AND
HYDROCHLOROTHIAZIDE
BISOPROLOL FUMARATE
CAPTOPRIL
CLONIDINE HYDROCHLORIDE
DILTIAZEM HCL
DOXAZOSIN MESYLATE
ENALAPRIL MALEATE
GUANFACINE HCL
HYDRALAZINE
ISRADIPINE
LABETALOL HCL
LISINOPRIL
LOSARTAN
LOSARTAN AND
HYDROCHLOROTHIAZIDE
METHYLDOPA
METHYLDOPA WITH
HYDROCHLOROTHIAZIDE
METOPROLOL SUCCINATE
METOPROLOL TARTRATE
2 – Drugs: Contract Drugs List Part 4 Pharmacy 892
Therapeutic ClassificationsMarch 2017
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DIURETICS AND CARDIOVASCULARS(continued)
ANTIHYPERTENSIVES – also see Diuretics (continued)
NICARDIPINE
NISOLDIPINE
PENBUTOLOL SULFATE
PINDOLOL
PRAZOSIN HCL
PROPRANOLOL
RAMIPRIL
TELMISARTAN
TELMISARTAN AND
HYDROCHLOROTHIAZIDE
TERAZOSIN HYDROCHLORIDE
TIMOLOL MALEATE
VALSARTAN
VALSARTAN/HYDROCHLOROTHIAZIDE
VERAPAMIL HCL
CARDIAC DRUGS
AMIODARONE
BETAXOLOL
CAPTOPRIL
CARVEDILOL
CARVEDILOL PHOSPHATE
DIGOXIN
ENALAPRIL MALEATE
METOPROLOL SUCCINATE
METOPROLOL TARTRATE
MEXILETINE HYDROCHLORIDE
PROCAINAMIDE
PROPRANOLOL
QUINIDINE GLUCONATE
QUINIDINE SULFATE
SOTALOL HCL
TIMOLOL MALEATE
DIURETICS AND CARDIOVASCULARS
(continued)
DIURETICS
ACETAZOLAMIDE
CHLORTHALIDONE
ETHACRYNIC ACID
FUROSEMIDE
HYDROCHLOROTHIAZIDE
INDAPAMIDE
METHAZOLAMIDE
METOLAZONE
SPIRONOLACTONE
SPIRONOLACTONE WITH
HYDROCHLOROTHIAZIDE
TRIAMTERENE
TRIAMTERENE WITH
HYDROCHLOROTHIAZIDE
VASODILATING AGENTS
AMLODIPINE BESYLATE AND ATORVASTATIN CALCIUM
DILTIAZEM HCL
ISOSORBIDE DINITRATE
ISOSORBIDE DINITRATE AND HYDRALAZINE HYDROCHLORIDE
ISOSORBIDE MONONITRATE
NIACIN
NICARDIPINE
NIFEDIPINE
NITROGLYCERIN
VERAPAMIL HCL
2 – Drugs: Contract Drugs List Part 4 Pharmacy 878
Therapeutic ClassificationsAugust 2016
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GASTRO-INTESTINAL DRUGS
ANTACIDS AND ADSORBENTS
ALUMINUM AND MAGNESIUM
HYDROXIDE GEL
ALUMINUM HYDROXIDE AND
MAGNESIUM TRISILICATE GEL
ALUMINUM HYDROXIDE GEL
ALUMINUM HYDROXIDE, MAGNESIUM
HYDROXIDE, AND SIMETHICONE
CALCIUM CARBONATE AND
MAGNESIUMCARBONATE
ANTI-DIARRHEA AGENTS
BISMUTH SUBSALICYLATE
DIPHENOXYLATE HCL WITH
ATROPINE SULFATE
PAREGORIC
PAREGORIC AND PROTECTIVE
ANTI-INFLAMMATORY AGENTS
BALSALAZIDE DISODIUM
SULFASALAZINE
BILE ACID MODIFIER
URSODIOL
DIGESTANT PREPARATIONS
PANCRELIPASE (AMYLASE/ LIPASE/
PROTEASE)
G.I. STIMULANT
METOCLOPRAMIDE HCL
GASTRO-INTESTINAL DRUGS(continued)
H + /K + ATPase ENZYME SYSTEM
INHIBITORS
DEXLANSOPRAZOLE
ESOMEPRAZOLE MAGNESIUM
HISTAMINE H2-RECEPTOR ANTAGONISTS
CIMETIDINE
FAMOTIDINE
RANITIDINE HCL
LAXATIVES
BISACODYL
DOCUSATE SODIUM
PROSTAGLANDIN ANALOG
MISOPROSTOL
ULCER ADHERENT
SUCRALFATE
HORMONES
ANDROGENS
FLUOXYMESTERONE
METHYL TESTOSTERONE
TESTOSTERONE
2 – Drugs: Contract Drugs List Part 4 Pharmacy 892
Therapeutic ClassificationsMarch 2017
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HORMONES (continued)
CONTRACEPTIVES
DESOGESTREL AND ETHINYL
ESTRADIOL
DROSPIRENONE AND ETHINYL
ESTRADIOL
ESTRADIOL VALERATE AND
DIENOGEST
ETHYNODIOL DIACETATE AND ETHINYL
ESTRADIOL
ETONOGESTREL AND ETHINYL ESTRADIOL
LEVONORGESTREL
LEVONORGESTREL AND ETHINYL
ESTRADIOL
NONOXYNOL 9
NORELGESTROMIN AND ETHINYL
ESTRADIOL
NORETHINDRONE
NORETHINDRONE AND ETHINYL
ESTRADIOL
NORETHINDRONE AND MESTRANOL
NORGESTIMATE AND ETHINYL
ESTRADIOL
NORGESTREL AND ETHINYL ESTRADIOL
ULIPRISTAL ACETATE
ESTROGENS AND COMBINATIONS
ESTRADIOL
ESTROGENS, CONJUGATED
ESTROGENS, CONJUGATED
AND MEDROXYPROGESTERONE
ACETATE
ESTROGENS, ESTERIFIED
GLUCOCORTICOIDS
CORTISONE
DEXAMETHASONE
HORMONES (continued)
GLUCOCORTICOIDS (continued)
FLUDROCORTISONE ACETATE
HYDROCORTISONE
PREDNISOLONE
PREDNISOLONE SODIUM
PHOSPHATE
PREDNISONE
TRIAMCINOLONE
HYPOGLYCEMICS
ACARBOSE
ALOGLIPTIN
ALOGLIPTIN/METFORMIN HCL
ALOGLIPTIN/PIOGLITAZONE
CHLORPROPAMIDE
DAPAGLIFLOZIN
DAPAGLIFLOZIN/METFORMIN HCL
EXTENDED-RELEASE
EMPAGLIFLOZIN
EXENATIDE
GLIMEPIRIDE
GLIPIZIDE
GLYBURIDE
GLYBURIDE AND METFORMIN HCL
INSULIN
INSULIN ASPART PROTAMINE/ INSULIN ASPART, (rDNA ORIGIN)
INSULIN GLARGINE (rDNA origin)
INSULIN LISPRO PROTAMINE/INSULIN LISPRO (rDNA ORIGIN)
LINAGLIPTIN
LINAGLIPTIN/METFORMIN HCL
METFORMIN HCI
MIGLITOL
NATEGLINIDE
PIOGLITAZONE HCL
PIOGLITAZONE HCL/GLIMEPIRIDE
PIOGLITAZONE HCL/METFORMIN HCL
PRAMLINTIDE ACETATE
ROSIGLITAZONE MALEATE
2 – Drugs: Contract Drugs List Part 4 Pharmacy 892
Therapeutic ClassificationsMarch 2017
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HORMONES (continued)
HYPOGLYCEMICS (continued)
SAXAGLIPTIN
SAXAGLIPTIN/METFORMIN HCL EXTENDED-RELEASE
SITAGLIPTIN
SITAGLIPTIN/METFORMIN HCL
TOLAZAMIDE
TOLBUTAMIDE
HYPOGLYCEMIC SHOCK
GLUCAGON (r-DNA ORIGIN)
PARATHYROID
CALCITONIN-SALMON
PITUITARY
DESMOPRESSIN ACETATE
PROGESTINS AND COMBINATIONS
MEDROXYPROGESTERONE ACETATE
NORETHINDRONE ACETATE AND ETHINYL ESTRADIOL
PROGESTERONE
THYROID AND ANTITHYROID
LEVOTHYROXINE SODIUM
METHIMAZOLE
PROPYLTHIOURACIL
THYROID
METABOLIC SUPPLEMENTS
CALCIUM SUPPLEMENTS AND
VITAMIN D ANALOGS
CALCITRIOL
CALCIUM ACETATE
CALCIUM CARBONATE
CALCIUM GLUCONATE
CALCIUM LACTATE
DOXERCALCIFEROL
METABOLIC SUPPLEMENTS (continued)
FLUORIDE
SODIUM FLUORIDE
POTASSIUM SUPPLEMENT
POTASSIUM CHLORIDE
VITAMINS
CYANOCOBALAMIN
FOLIC ACID
LEUCOVORIN CALCIUM
LEVOCARNITINE
NIACIN
PYRIDOXINE
THIAMINE HYDROCHLORIDE
VITAMINS A, D, C
VITAMINS A, D, C, WITH IRON
VITAMINS A, D, C, WITH SODIUM
FLUORIDE
VITAMINS – MINERALS,
COMBINATION PRODUCTS,
PRENATAL ONLY,
NONPRESCRIPTION ONLY
OPHTHALMIC PREPARATIONS
ANTI-GLAUCOMA AGENTS
ACETAZOLAMIDE
APRACLONIDINE HCL
BETAXOLOL HCL
BIMATOPROST
BRIMONIDINE TARTRATE
BRIMONIDINE TARTRATE/TIMOLOL
MALEATE
BRINZOLAMIDE
BRINZOLAMIDE/BRIMONIDINE
TARTRATE
CARTEOLOL HCL
dorzolamide hcl
DORZOLAMIDE HCL AND
TIMOLOL MALEATE
METHAZOLAMIDE
TIMOLOL MALEATE
TRAVOPROST
2 – Drugs: Contract Drugs List Part 4 Pharmacy 892
Therapeutic ClassificationsMarch 2017
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OPHTHALMIC PREPARATIONS (continued)
OPHTHALMIC ANESTHETIC
PROPARACAINE HCL
OPHTHALMIC ANTIBIOTICS
AZITHROMYCIN
BACITRACIN
CHLORAMPHENICOL
CIPROFLOXACIN HCL
ERYTHROMYCIN OPHTHALMICOINTMENT
GENTAMICIN
MOXIFLOXACIN HCL
NATAMYCIN
NEOMYCIN, BACITRACIN AND POLYMYXIN
NEOMYCIN, POLYMYXIN AND GRAMICIDIN
OFLOXACIN
POLYMYXIN, BACITRACIN
TOBRAMYCIN
TRIMETHOPRIM SULFATE AND POLYMYXIN B SULFATE
OPHTHALMIC ANTIHISTAMINES
ALCAFTADINE
AZELASTINE HCL
OLOPATADINE HCL
OPHTHALMIC ANTI-INFLAMMATORIES
BROMFENAC
DEXAMETHASONE
DEXAMETHASONE WITH NEOMYCIN AND POLYMYXIN
DEXAMETHASONE WITH TOBRAMYCIN
DICLOFENAC SODIUM
FLUOROMETHOLONE
KETOROLAC TROMETHAMINE
LOTEPREDNOL ETABONATE
LOTEPREDNOL ETABONATE/TOBRAMYCIN
PREDNISOLONE
PREDNISOLONE WITH
SULFACETAMIDE
RIMEXOLONE
OPHTHALMIC PREPARATIONS (continued)
OPHTHALMIC ANTI-VIRALS
GANCICLOVIR
TRIFLURIDINE
OPHTHALMIC MAST CELL STABILIZERS
CROMOLYN SODIUM
LODOXAMIDE
OPHTHALMIC MIOTICS
ECHOTHIOPHATE
PILOCARPINE
OPHTHALMIC MISCELLANEOUS
SODIUM CHLORIDE
TYLOXAPOL WITH
BENZALKONIUM CHLORIDE
OPHTHALMIC MYDRIATICS
ATROPINE
CYCLOPENTOLATE
PHENYLEPHRINE
TROPICAMIDE
OPHTHALMIC SULFONAMIDE
SULFACETAMIDE SODIUM
OPHTHALMIC VASOCONSTRICTORS AND COMBINATIONS
NAPHAZOLINE HCL
PHENYLEPHRINE
2 – Drugs: Contract Drugs List Part 4 Pharmacy 892
Therapeutic ClassificationsMarch 2017
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OTIC PREPARATIONS
ACETIC ACID WITH ALUMINUM ACETATE
ACETIC ACID WITH HYDROCORTISONE
CIPROFLOXACIN HCL/
DEXAMETHASONE
CIPROFLOXACIN HYDROCHLORIDE/
HYDROCORTISONE
HYDROCORTISONE WITH POLYMYXIN B
AND NEOMYCIN
OFLOXACIN
TOPICAL AND LOCAL PREPARATIONS
DERMATOLOGICAL PREPARATIONS
ALCLOMETASONE DIPROPIONATE
ALITRETINOIN
ALUMINUM ACETATE
BACITRACIN TOPICAL OINTMENT
BENZOYL PEROXIDE GEL
BUTENAFINE HCL
CALAMINE LOTION
CALCIPOTRIENE
CLINDAMYCIN PHOSPHATE
TOPICAL SOLUTION
CLOTRIMAZOLE
COLLAGENASE
CROTAMITON
ECONAZOLE NITRATE
ERYTHROMYCIN TOPICAL
SOLUTION
FLUOCINOLONE
FLUOCINONIDE
HYDROCORTISONE TOPICAL
IVERMECTIN
KETOCONAZOLE
MALATHION
MICONAZOLE NITRATE
NYSTATIN
TOPICAL AND LOCAL PREPARATIONS
(continued)
DERMATOLOGICAL PREPARATIONS
(continued)
PERMETHRIN
PODOFILOX
POLYMYXIN, BACITRACIN TOPICAL
OINTMENT
PREDNICARBATE
PYRETHRINS, PIPERONYL BUTOXIDE,
PETROLEUM DISTILLATE
SILVER SULFADIAZINE CREAM
SPINOSAD
TAZAROTENE