MaineCare Brands Preferred Over Generic Version List

Category Name / Preferred Brand / Non-Preferred Generic

Ace Inhibitors

/ Monopril / Fosinopril Sodium

Antiarrhythmics

/ Norpace / Disopyramide Phosphate
Norpace CR / Disopyramide PhosphateER
Tambocor / Flecainide Acetate
Rythmol / Propafenone HCL
Antiasthmatic-Nasal Steroids / Nasalide / Flunisolide
Antibiotics – Misc / Coly-Mycin-M / Colistimethate Sodium
Anticonvulsants / Mysoline / Primidone
Antiretrovirals / Videx-EC / Didanosine
Beta-Lactams/Clavulanate Combo’s / Augmentin ES-600 Susp. / Amoxicillin/Clavulanate
Cephalosporins / Vantin / Cefpodoxime Proxetil
Claforan / Cefotaxime Sodium
Fortaz / Tazicef, Tazidime
Contraceptives – Bi-Phasic Combo’s / Ortho-Novum 10/11 –28 / Necon 10/11-28
Contraceptives – Injectable / Depo-Provera / Medroxyprogesterone Acetate IM
Contraceptives – Progestin Only / Nor-QD, Ortho Micronor / Norethindrone tab 0.35mg
Contraceptives – Tri-Phasic Combo’s / Tri-Levlen, Triphasil / Levonorgestrel-Eth Estra Tab 0.05-30/0.075-40/0.125-30mg-mcg
Ortho-Novum 7/7/7 / Norethindrone-Eth Estradiol Tab 0.5-35/0.75-35/1-35mg-mcg
Ortho Tri-Cyclen / Norgestimate-Eth Estrad Tab 0.18-35/0.215-35/0.25-35 mg-mcg
Contraceptives-Monophasic Combination O/C’s / Desogen, Ortho-Cept / Desogestrel & Ethinyl Estradiol tab 0.15mg-30mcg
Demulen / Zovia
Alesse, Levlite / Aviane, Lessina, Lutera
Norinyl,Ortho-Novum / Norethindrone & Ethinyl Estradiol Tab 1mg-35mcg
Lo/Ovral / Norgestrel & Ethinyl Estradiol Tab 0.3mg-30mcg
Ortho-Cyclen / Norgestimate & Ethinyl Estradiol Tab 0.25mg-35mcg
Hepatitis Agents / Rebetol / Ribavirin
Immunosuppressants / Sandimmune / Cyclosporine
Miscellaneous / Purinethol / Mercaptopurine
Vepesid / Etoposide
Migraine – Misc. / Cafergot / Ergotamine w/Caffeine Supp. 2-100mg
Narcotics – Long Acting / RMS / Morphine Sulfate Supp.
Neurologics –Misc. / Mestinon / Pyridostigmine bromide
Op.Quinolones / Ocuflox / Ofloxacin Ophth Sol 0.3%
Somatostatic Agents / Sandostatin / Octreotide Acetate
Stimulants / Dexedrine / Dextroamphetamine Sulf. Cap SR 24HR 15mg
Topical – Antifungals / Loprox / Ciclopirox Olamine Cream 0.77%
Spectazole / Econazole Nitrate Cream 1%
Nizoral / Ketoconazole Shampoo 2%
Topical – Corticosteroids / Diprolene / Augmented Betamethasone Dipropionate
Cutivate / Fluticasone Propionate
Ultravate / Halobetasol Propionate
Locoid / Hydrocortisone Butyrate
Topical – Acne Preparations / Accutane / Isotretinoin Cap
Retin-A / Tretinoin
Cleocin-T / Clindamycin Phosphate
Topical – Emollients / Lac-Hydrin / Lactic Acid (Ammonium Lactate)
Urological – Misc. / Macrodantin / Nitrofurantoin Macrocrystals