The following is a list of the most commonly prescribed drugs. It representsan abbreviated version of the drug list (formulary) that is at the core of yourprescription-drug benefit plan. The list is not all-inclusive and does notguarantee coverage. In addition to using this list, you are encouraged to askyour doctor to prescribe generic drugs whenever appropriate. 2012 Express Scripts Medicare PLEASE NOTE: Not all the drugs listed are covered by all prescription-drug benefit programs; check your benefit materials for the specific drugs National Preferred covered and the copayments for your prescription-drug benefit program. Formulary For specific questions about your coverage, please call the phone number printed on your ID card. ANESTHETICS ANTINEOPLASTIC/ IMMUNOSUPPRESSANT DRUGS SEROQUEL, XR [Q] Topical Anesthetics Other Macrolides Antivertigo & Antiemetic Drugs ANTIINFECTIVES Other Topical Antifungals Antiretrovirals & Protease Inhibitors Penicillins Anxiolytics AUTONOMIC & CNS Carbamazepines Quinolones MEDICATIONS Cephalosporins Class II Narcotics Analgesics Sulfonamides Clindamycins Antidementia Drugs Erythromycins Tetracyclines Oral Antifungal Drugs Class III Narcotics Antimania Drugs Topical Antibacterial Drugs Antiparkinson Topical Antifungal- Anticholinergic Drugs Other Antiinfective Drugs Corticosteroid Comb. Drugs To Prevent & Other Antiviral Drugs Antipsychotic Drugs Treat Headaches Urinary Antiinfectives KEY The symbol [INJ] next to a drug name indicates that the drug is available in injectable form only. The symbol [P] indicates that prior authorization may apply. The symbol [Q] indicates that quantities dispensed may be limited. The symbol [S] indicates that step therapy may apply. For the member: Generic medications contain the same active ingredients as their corresponding brand-name medications, although they may look different in color or shape. They have been FDA-approved under strict standards. For the physician: Please prescribe preferred products and allow generic substitutions when medically appropriate. Thank you. Brand-name drugs are listed in CAPITAL letters. Generic drugs are listed in lower case, italicized letters. THIS DOCUMENT LIST IS EFFECTIVE JANUARY 1, 2012 THROUGH DECEMBER 31, 2012. THIS LIST IS SUBJECT TO CHANGE. Express Scripts Prescription Drug Plan is a stand-alone prescription drug plan with a Medicare Contract. All beneficiaries must use their plan sponsor's network pharmacies to access their prescription drug benefit, except under non-routine circumstances. This document is available in alternate formats or languages. 2012 Express Scripts, Inc. NP 4T- S7950_2012_DOC7NP All Rights Reserved PRMTMDCNP-12 (07/15/11) Other Antihypertensives Topical Dermatological Drugs Hydantoins Other Anticonvulsants Angiotensin II Receptor Antagonists EAR-NOSE-THROAT Beta-Adrenergic MEDICATIONS Antagonist Drugs Other Antidepressants Drugs Affecting The Ear Drugs Affecting The Nose Calcium Antagonists Other Cardiovascular Drugs Other Antiparkinson Drugs Other Vasodilating Drugs Cardiac Glycosides Potassium Sparing Diuretics Drugs Affecting The Throat & Mouth Centrally Acting Antihypertensives Thiazide & Related Drugs Other CNS/Autonomic Drugs Endothelin Receptor Vasodilator Antihypertensives ENDOCRINE MEDICATIONS Antagonists Glucocorticoid Drugs Secondary Amines Hmg-CoA Reductase Inhibitors DERMATOLOGICAL Sedative/Hypnotic Drugs MEDICATIONS Glucose Elevating Drugs Antiacne Drugs Hypoglycemic Drugs Selective Serotonin Reuptake Inhibitors Hypolipoproteinemics Antipruritic Drugs Insulin Antipsoriasis & Antieczema Drugs Tertiary Amines Oral Dermatological Drugs Oral Hypoglycemics & Scabicides Combos CARDIOVASCULAR Loop Diuretics Topical Antiinflammatory MEDICATIONS Drugs Amiodarones Nitrates Topical Corticosteroid Drugs Angiotensin Converting Enzyme Inhibitors THIS DOCUMENT LIST IS EFFECTIVE JANUARY 1, 2012 THROUGH DECEMBER 31, 2012. THIS LIST IS SUBJECT TO CHANGE. Express Scripts Prescription Drug Plan is a stand-alone prescription drug plan with a Medicare Contract. All beneficiaries must use their plan sponsor's network pharmacies to access their prescription drug benefit, except under non-routine circumstances. This document is available in alternate formats or languages. 2012 Express Scripts, Inc. NP 4T- S7950_2012_DOC7NP All Rights Reserved PRMTMDCNP-12 (07/15/11) OBSTETRICAL & Ophthalmic Topical GYNECOLOGICAL Antibacterial Drugs MEDICAL (MISCELLANEOUS) MEDICATIONS SUPPLIES Androgen Drugs Other Endocrine Drugs Diabetic Supplies MISCELLANEOUS DRUGS Contraceptives Other Ophthalmic Drugs Thyroid Supplements MUSCULOSKELETAL Estrogen Drugs MEDICATIONS CNS Muscle Relaxants GASTROINTESTINAL MEDICATIONS Direct Muscle Relaxants RESPIRATORY MEDICATIONS Antispasmodics/ Antihistamines Drugs Affect GI Motility Drugs To Prevent & Estrogen/Progestin Treat Gout Combinations Antiulcer Drugs Beta-2 Adrenergic Drugs Irritable Bowel Drugs Non-Steroidal Antiinflammatory Agents Other Antiulcer Drugs Progestin Drugs Other GI Drugs Leukotriene Modifiers Selective Estrogen Receptor Modulator Other Drugs For Asthma NUTRITION, BLOOD MODIFIERS, ELECTROLYTES OPHTHALMIC MEDICATIONS Antiplatelet Drugs Antiglaucoma Drugs Blood Detoxicants Proton Pump Inhibitors UROLOGICAL MEDICATIONS Injectable Anticoagulants Anticholinergic Antispasmodics Oral Anticoagulants, Vitamin K IMMUNOLOGICALS & VACCINES Ophthalmic Antiinfective/ Corticosteroids Other Genitourinary Products Erythroid Stimulants Potassium Supplements neomycin-polymyxin-dexameth AVODART
Therapeutic Vitamins & Ophthalmic Corticosteroid Interferons Minerals Drugs THIS DOCUMENT LIST IS EFFECTIVE JANUARY 1, 2012 THROUGH DECEMBER 31, 2012. THIS LIST IS SUBJECT TO CHANGE. Express Scripts Prescription Drug Plan is a stand-alone prescription drug plan with a Medicare Contract. All beneficiaries must use their plan sponsor's network pharmacies to access their prescription drug benefit, except under non-routine circumstances. This document is available in alternate formats or languages. 2012 Express Scripts, Inc. NP 4T- S7950_2012_DOC7NP All Rights Reserved PRMTMDCNP-12 (07/15/11) Examples of Nonformulary Medications With Selected Formulary Alternatives
The following is a list of some nonformulary brand-name medications with examples of selected alternatives that are on theformulary.
Column 1 lists examples of nonformulary medications. Column 2 lists some alternatives that can be prescribed. Nonformulary Formulary Alternative Nonformulary Formulary Alternative lansoprazole/odt [Q] [S], omeprazole [Q],
citalopram [Q], fluoxetine [Q],
paroxetine/er [Q], sertraline [Q],
lovastatin [Q], pravastatin [Q],
lovastatin [Q], pravastatin [Q],
fenofibrate, TRICOR [S], TRILIPIX [S]
fenofibrate, TRICOR [S], TRILIPIX [S]
lovastatin [Q], pravastatin [Q],
fluoxetine [Q], fluvoxamine [Q],
paroxetine/er [Q], sertraline [Q]
MAXAIR AUTOHALER PROAIR HFA [Q], VENTOLIN HFA [Q]
dorzolamide, ALPHAGAN P 0.1% DROPS,
lansoprazole/odt [Q] [S], omeprazole [Q],
fenofibrate, TRICOR [S], TRILIPIX [S]
fenofibrate, TRICOR [S], TRILIPIX [S]
fenofibrate, TRICOR [S], TRILIPIX [S]
lovastatin [Q], pravastatin [Q],
lansoprazole/odt [Q] [S], omeprazole [Q],
KEY The symbol [INJ] next to a drug name indicates that the drug is available in injectable form only. The symbol [P] indicates that prior authorization may apply. The symbol [Q] indicates that quantities dispensed may be limited. The symbol [S] indicates that step therapy may apply. For the member: Generic medications contain the same active ingredients as their corresponding brand-name medications, although they may look different in color or shape. They have been FDA-approved under strict standards. For the physician: Please prescribe preferred products and allow generic substitutions when medically appropriate. Thank you. Brand-name drugs are listed in CAPITAL letters. Generic drugs are listed in lower case, italicized letters. THIS DOCUMENT LIST IS EFFECTIVE JANUARY 1, 2012 THROUGH DECEMBER 31, 2012. THIS LIST IS SUBJECT TO CHANGE. Express Scripts Prescription Drug Plan is a stand-alone prescription drug plan with a Medicare Contract. All beneficiaries must use their plan sponsor's network pharmacies to access their prescription drug benefit, except under non-routine circumstances. This document is available in alternate formats or languages. 2012 Express Scripts, Inc. NP 4T- S7950_2012_DOC7NP All Rights Reserved PRMTMDCNP-12 (07/15/11)
Therapie Therapieformen Behandlung mit GnRH-Agonisten Vorbemerkung In den vergangenen Jahren haben sich die Therapieansätze wesentlich weiterentwickelt. Da die Endometriose aber ein äusserst komplexes Leiden mit sehr unterschiedlichen Ausprägungen ist, muss für jede Patientin ein individuel es Therapiekonzept erstel t werden. Seien Sie vor Ärzten auf der Hut, welche Ihnen Patentl�
Studies on designing, syntheses, characterization, and biological screening of organic cocrystals Preamble: Organic cocrystals are at the forefront of the quest for novel crystal forms. There is a strong interest in their potential use in the pharmaceutical field and in all areas where the final products are commercialized and utilized in their solid state forms. Cocrystals are intens