National Formulary
Preferred Drug List
- J a n u a r y
CARDIOVASCULAR
(BLOOD PRESSURE/ HEART/ CHOLESTEROL)
ACE-INHIBITORS
fosinopril, lisinopril, quinapril, ramipril
2 0 1 3 -
ANGIOTENSIN II RECEPTOR BLOCKERS/RENIN
INHIBITORS/RELATED DRUGS
irbesartan, losartan, losartan-hct, valsartan,
valsartan-hct
AMTURNIDE, ATACAND, ATACAND HCT,
BENICAR, BENICAR HCT, MICARDIS, MICARDIS
HCT, TEKAMLO, TEKTURNA, TEKTURNA HCT,
VALTURNA
The Catamaran™ Preferred Drug List is a
guide identifying preferred brand-name
medicines within select therapeutic
categories. The Preferred Drug List may not
include all drugs covered by your prescription
drug benefit. Generic medicines are available
within many of the therapeutic categories
listed, in addition to categories not listed, and
should be considered as the first line of
prescribing. Generics listed are for
representational purposes only. Branded
products are listed in CAPS and generic
products in lowercase italics.
BETA BLOCKERS
atenolol, carvedilol, metoprolol, metoprolol ER
COREG CR, BYSTOLIC
CALCIUM BLOCKERS
amlodipine, diltiazem ER, nifedipine ER,
verapamil ER
For benefit coverage or restrictions please
check your benefit plan document(s). This
listing is revised periodically as new drugs and
new prescribing information becomes
available. It is recommended that you bring
this list of medications when you or a covered
family member sees a physician or other
healthcare provider.
NITRATES & NITRITES
isosorbide dinitrate, nitroglycerin
DILATRATE SR, NITRO-DUR, NITROLINGUAL
PUMPSPRAY, NITROSTAT
ORAL ANTI-INFECTIVES
(ANTIFUNGALS/ ANTIBIOTICS)
ANTIFUNGALS
fluconazole, itraconazole, ketoconazole,
terbinafine
LAMISIL GRANULES, NOXAFIL, SPORANOX
SOLUTION
CEPHALOSPORINS
cefaclor, cefdinir, cephalexin
CEFTIN SUSPENSION
FIBRATES
fenofibrate
ANTARA, FENOGLIDE, LIPOFEN, TRICOR,
TRIGLIDE, TRILIPIX
INSULIN
APIDRA, HUMALOG, HUMULIN R U-500,
LANTUS, LEVEMIR, NOVOLOG
DERMATOLOGICALS
ACNE
adapalene, clindamycin, tretinoin
ACANYA, ACZONE, ATRALIN, AZELEX,
BENZACLIN, BENZACLIN CARE KIT,
BENZACLIN W/PUMP, DIFFERIN, DUAC,
EPIDUO, FINACEA, METROGEL, ORACEA,
TAZORAC, VELTIN
NSAIDS
ibuprofen, meloxicam, naproxen
VIMOVO
COX-2 INHIBITORS
CELEBREX
AUTO-IMMUNE
ENBREL, HUMIRA
CONTRACEPTIVE AGENTS
ethinyl estradiol-norgestimate, levonorgestrel,
medroxyprogesterone acetate
BEYAZ, CRINONE, DEPO-PROVERA, ELLA,
ENDOMETRIN, LOESTRIN 24 FE, LO
LOESTRIN FE, YAZ, NATAZIA, NUVARING,
SAFYRAL
TESTOSTERONE AGENTS
testosterone cypionate, testosterone
enanthate
ANDRODERM, ANDROGEL, ANDROXY, AXIRON,
FORTESTA, METHITEST
OMEGA-3 FATTY ACIDS
LOVAZA
ANTI-INFLAMMATORY
ENDOCRINE
(CONTRACEPTIVES/ HORMONES/ DIABETES)
ANTILIPEMICS
HMG-COA REDUCTASE INHIBITORS
atorvastatin, lovastatin, pravastatin,
simvastatin
ALTOPREV, CRESTOR
NIACIN/NIACIN COMBINATIONS
NIASPAN, SIMCOR
TETRACYCLINES
doxycycline, minocycline
VIBRAMYCIN SUSPENSION
ACCU-CHECK, FASTTAKE, ONETOUCH,
SURESTEP, INSULIN SYRINGES, LANCETS,
PEN NEEDLES
ANTIHYPERTENSIVE COMBINATIONS
lisinopril-hct, trandolapril-verapamil,
BIDIL, TARKA, AZOR, EXFORGE, EXFORGE HCT,
TRIBENZOR, TWYNSTA
CHOLESTEROL ABSORPTION
INHIBITOR/RELATED DRUGS
ZETIA, VYTORIN
QUINOLONES
ciprofloxacin, ciprofloxacin ER, levofloxacin
AVELOX, AVELOX ABC, CIPRO SUSPENSION
DIABETIC SUPPLIES
ESTROGENS/ESTROGEN COMBINATIONS
estradiol, estradiol-norethindrone acetate
CENESTIN, CLIMARA, COMBIPATCH, ENJUVIA,
ESTRACE CREAM, ESTRING, EVAMIST,
PREMARIN TABLETS, PREMPHASE, PREMPRO,
VAGIFEM, VIVELLE-DOT
BILE ACID SEQUESTRANTS
cholestyramine
WELCHOL
PENICILLINS
amoxicillin, amoxicillin/clavulanate,
penicillin vk
AUGMENTIN SUSPENSION
TOPICAL ANTI-INFLAMMATORY AGENTS
clobetasol, halobetasol, hydrocortisone
acetate, triamcinolone
ANUSOL-HC CREAM, CAPEX, CLOBEX,
CORDRAN TAPE, CORTIFOAM, HALOG,
KENALOG SPRAY, LOCOID LIPOCREAM,
LOCOID LOTION, PRAMOSONE
NON-INSULIN HYPOGLYCEMIC AGENTS
BIGUANIDE/THIAZOLIDINEDIONE (TZDs)
pioglitazone, pioglitazone-metformin
SULFONYLUREA/TZDs COMBINATIONS
DUETACT
DIPEPTIDYL PEPTIDASE-4 INHIBITORS (DPP-4)
JANUVIA, ONGLYZA, TRADJENTA
DPP-4/HMG-COA REDUCTASE INHIBITOR
COMBINATIONS
JUVISYNC
BIGUANIDES
metformin, metformin ER
RIOMET
BIGUANIDE/DPP-4 COMBINATIONS
JANUMET, JANUMET XR, JENTADUETO,
KOMBIGLYZE XR
BIGUANIDE/SULFONYLUREA COMBINATIONS
glipizide-metformin
BIGUANIDE/ INSULIN SECRETAGOGUE
COMBINATIONS
PRANDIMET
INCRETIN MIMETICS
BYDUREON, BYETTA, VICTOZA
Catamaran Preferred Drug List – Effective January 1, 2013
214-091112-3
© 2012 Catamaran Inc. All rights reserved. Catamaran is a registered trademark of Catamaran Inc.
AMYLIN ANALOGS
SYMLIN
ANTI-INFECTIVES
ciprofloxacin, ofloxacin, tobramycin
BESIVANCE, CILOXAN, MOXEZA, NATACYN,
TOBREX, VIGAMOX, ZYMAXID
ANTIHYPOGLYCEMIC AGENTS
GLUCAGON
ANTI-INFLAMMATORY AGENTS
cromolyn sodium, diclofenac sodium,
ketorolac
ACUVAIL, BROMDAY, NEVANAC
SULFONYLUREAS
glimiperide, glipizide, glipizide ER
GASTROINTESTINAL
CORTICOSTEROIDS/RELATED AGENTS
prednisolone acetate,
tobramycin/dexmethasone
ALREX, BLEPHAMIDE S.O.P., DUREZOL, FML,
LOTEMAX, OZURDEX, PRED MILD, RETISERT,
TOBRADEX, TOBRADEX ST, ZYLET
PROTON PUMP INHIBITORS
lansoprazole, omeprazole, pantoprazole
NEXIUM
ULCER DRUGS
nizatidine, sucralfate
AXID SOLUTION, CARAFATE SUSPENSION,
PYLERA
MIOTICS
pilocarpine
ISOPTO CARBACHOL, PHOSPHOLINE IODINE,
PILOPINE HS
GROWTH HORMONE
NORDITROPIN, NUTROPIN
MISCELLANEOUS
LACRISERT, RESTASIS
HEPATITIS C
ANTIVIRALS
ribavirin
RIBAPAK
OSTEOPOROSIS THERAPY
LEUKOTRIENE RECEPTOR ANTAGONISTS
montelukast, zafirlukast
PULMONARY CORTICOSTEROIDS
budesonide
ALVESCO, ASMANEX, PULMICORT, QVAR
NASAL ANTIHISTAMINES
azelastine
ASTEPRO, ASTELIN
NASAL CORTICOSTEROIDS
fluticasone, triamcinolone
NASONEX, QNASL, RHINOCORT, VERAMYST
STEROID/BETA AGONIST COMBINATIONS
ADVAIR, DULERA, SYMBICORT
UROLOGICALS
BENIGN PROSTATIC HYPERPLASIA (BPH)
finasteride, tamsulosin
RAPAFLO
URINARY ANTISPASMODICS
oxybutynin, oxybutynin ER, tolterodine
DETROL LA, ENABLEX, GELNIQUE, OXYTROL,
SANCTURA XR, TOVIAZ, VESICARE
BISPHOSPHONATES
alendronate, ibandronate, ACTONEL, ATELVIA
INTERFERONS
PEGASYS, PEG-INTRON
SELECTIVE ESTROGEN RECEPTOR
MODULATOR
EVISTA
PROTEASE INHIBITORS
INCIVEK, VICTRELIS
PSYCHOTHERAPEUTICS
MULTIPLE SCLEROSIS
ATYPICAL ANTIPSYCHOTICS
clozapine, olanzapine, quetiapine,
risperidone, ziprasidone
ABILIFY, CLOZARIL, LATUDA, SEROQUEL XR
AMPYRA, AVONEX, COPAXONE, REBIF
NEUROLOGICALS
ALZHEIMER’S DISEASE
donepezil, rivastigmine
EXELON PATCH, NAMENDA
Formulary Disclaimer: Coverage for some drugs may
be limited to specific dosage forms and/or
strengths. The benefit design determines what is
covered and the applicable co-payment. The
medications listed on this formulary are subject to
change pursuant to the formulary management
activities of Catamaran. The presence of a
medication on this formulary list does not guarantee
coverage.
CNS STIMULANTS
amphetamine-dextroamphetamine,
methylphenidate, methylphenidate ER
DAYTRANA, INTUNIV, METADATE CD, VYVANSE
ANTICONVULSANTS/ANTI-SEIZURE
carbamazepine, carbamazepine ER,
divalproex, gabapentin, lamotrigine,
levetiracetam, levetiracetam ER,
oxcarbazepine
BANZEL, CELONTIN, DIASTAT PEDIATRIC,
DILANTIN INFATABS, GABITRIL, LAMICTAL
ODT, LAMICTAL STARTER KIT, LAMICTAL XR,
LYRICA, PEGANONE, TEGRETOL XR, TRILEPTAL
SUSPENSION, VIMPAT
SNRI ANTIDEPRESSANTS
venlafaxine, venlafaxine ER
CYMBALTA, PRISTIQ
SSRI ANTIDEPRESSANTS
citalopram, escitalopram, fluoxetine,
paroxetine, paroxetine ER, sertraline
PAXIL SUSPENSION, VIIBRYD
RESPIRATORY
MIGRAINE/HEADACHE
naratriptan, sumatriptan
CAFERGOT, ERGOMAR, MAXALT,
RELPAX, TREXIMET, ZOMIG
ANAPHYLAXIS TREATMENT AGENTS
EPIPEN, TWINJECT
ANTICHOLINERGICS
ipratropium
ATROVENT HFA, SPIRIVA
OPHTHALMICS
ANTI-ALLERGIC AGENTS
azelastine, ketotifen
PATADAY, PATANOL
ANTICHOLINERGIC/BETA AGONIST
COMBINATIONS
ipratropium-albuterol
COMBIVENT
ANTI-GLAUCOMA AGENTS
betaxolol, brimonidine, latanoprost
ALPHAGAN P, AZOPT, BETOPTIC-S, COMBIGAN,
LUMIGAN, TRAVATAN Z
BETA AGONIST BRONCHODILATORS
albuterol, levalbuterol solution
FORADIL, PERFOROMIST, PROAIR, SEREVENT,
VENTOLIN HFA
Catamaran Preferred Drug List - Effective January 1, 2013
214-091112-3
© 2012 Catamaran Inc. All rights reserved. Catamaran is a registered trademark of Catamaran Inc.