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FORMULARY

DECEMBER 2012

July 2011 was the last printed publication of the Nova Scotia Formulary Monthly updates of the Nova Scotia Formulary are published online and can be accessed at: www.nspharmacare.ca

Copyright ©1996 Nova Scotia Department of Health and Wellness. All rights reserved. No part of this publication may be reproduced, photocopied, stored on a retrieval system, or transmitted without the express written consent of the publisher.

TABLE OF CONTENTS

INTRODUCTION ...................................................................................................................................................I

How to Use the Formulary ................................................................................................................................................... i Legend ............................................................................................................................................................................... iv

ATC CLASSIFICATION OF DRUGS ...................................................................................................................1

A - Alimentary Tract & Metabolism ..................................................................................................................................... 1 B - Blood and Blood Forming Organs ............................................................................................................................... 19 C - Cardiovascular System ............................................................................................................................................... 25 D - Dermatologicals .......................................................................................................................................................... 61 G - Genito-Urinary System & Sex Hormones ................................................................................................................... 71 H - Systemic Hormonal Preparations, Excluding Sex Hormones ..................................................................................... 81 J - General Antiinfectives, Systemic ................................................................................................................................. 87 L - Antineoplastics and Immunomodulating Agents ....................................................................................................... 103 M - Musculo-Skeletal System ......................................................................................................................................... 113 N - Nervous System ........................................................................................................................................................ 123 P - Antiparasitic Products, Insecticides and Repellents ................................................................................................. 167 R - Respiratory System ................................................................................................................................................... 169 S - Sensory Organs ........................................................................................................................................................ 177 V - Various ...................................................................................................................................................................... 185

MISCELLANEOUS

Diabetic Supplies Benefit List................................................................................................................................... MISC-1 Ostomy Supplies Benefit List ................................................................................................................................... MISC-4

APPENDICES

Appendix I - Abbreviations Appendix II - Abbreviations of Manufacturers' Names Appendix III - Criteria for Coverage of Exception Status Drugs

PRODUCT INDEX

INTRODUCTION

The Nova Scotia Formulary details which drugs and supplies are benefits under the Nova Scotia Seniors' Pharmacare Program, Family Pharmacare Program, Diabetes Assistance Program, Community Services Pharmacare Programs and Drug Assistance for Cancer Patients. The Formulary is provided on our website at www.nspharmacare.ca in PDF. The ATC Classification System All medications are classified according to the Anatomical Therapeutic Chemical (ATC) Classification System which is used by the World Health Organization for pharmacoepidemiological purposes and by the Patented Medicine Prices Review Board for pricing purposes. The ATC Classification System groups chemically similar products according to their site of action and facilitates the comparison of new medicines with previously available medicines. There are fourteen main groups in the ATC system: A B C D G H J L M N P R S V Alimentary tract and metabolism Blood and blood forming organs Cardiovascular system Dermatologicals Genito-urinary system and sex hormones Systemic hormonal preparations, excluding sex hormones General antiinfectives, systemic Antineoplastic and immunomodulating agents Musculo-skeletal system Nervous system Antiparasitic products, insecticides and repellents Respiratory system Sensory organs Various

Each group is subdivided into anatomical, therapeutic and chemical subgroups as shown in the Legend. A drug may be given more than one ATC code. If it is available in two or more strengths or formulations with clearly different therapeutic uses, the drug would appear in various categories depending on its different forms. If a drug has more than one clinical indication, the main indication is chosen for the listing of the various brands and strengths of this drug.

December 2012

Page i

Interchangeability, Maximum Reimbursable Price (MRP) and Pharmacare Reimbursement Price (PRP) The Formulary indicates those products which have been deemed interchangeable by the Drugs and Therapeutics Committee of the Nova Scotia Department of Health and Wellness (see the Legend). For generic products that meet the criteria for interchangeability a Maximum Reimbursable Price (MRP) may be applied. MRP is the maximum price established by the Pharmacare Programs for an interchangeable generic drug. MRP is applied to those drugs which are Pharmacare benefits, and have been deemed interchangeable (e.g., brand name drugs and their generic equivalents) The MRP is the maximum amount that the Pharmacare Programs will reimburse providers for one unit (tablet, capsule, millilitre, etc.) of a drug. For each interchangeable, generic drug category, a maximum reimbursable price per unit (e.g., tablet, capsule, millilitre) is determined by calculating a percentage of the cost of the equivalent brand name drug. The percentage the MRP is based on will be 35%, but is phased in as follows: July 1, 2011: 45% of the cost of the price of the equivalent brand drug January 1, 2012: 40% of the cost of the price of the equivalent brand drug July 1, 2012: 35% of the cost of the price of the equivalent brand drug Some generic drugs may have exceptions to the MRP formula, and their MRP will also be included in the Reimbursement List. Exemptions to the MRP are available for beneficiaries who have experienced side effects with lower cost alternatives. A request must be received from the prescriber detailing the reaction. Providers shall not charge any cost difference between the MRP of the drug and amount reimbursed by the Pharmacare Programs unless the beneficiary requests the higher priced drug. If the beneficiary requests the higher priced drug the extra cost is not counted toward their annual maximum copayment or annual maximum deductible. In addition, a Pharmacare Reimbursement Price (PRP) is the maximum cost assigned to: certain groups of drugs that are similar in effect; specific services for which coverage is established; certain unit dose and special delivery formats that are also available in less expensive bulk formats; and certain supplies that are used for the same function.

The PRP is the maximum amount the Pharmacare Program reimburses providers for one unit of a drug (tablet, capsule, millilitre, etc.) supply or service. Providers may charge the beneficiary the portion of their AAC that exceeds the PRP. The extra cost is not counted toward the beneficiary's annual maximum copayment or annual maximum deductible. In all pricing categories, except AAC, the Pharmacare Programs will reimburse pharmacies the lesser of the amount submitted, or as applicable, MRP, or PRP. Prescriber The Formulary provides prescriber codes (see Legend) associated with each benefit under the Pharmacare Programs. These codes indicate which benefits will be reimbursed when prescribed by a specific prescriber.

December 2012

Page ii

The Nova Scotia Government Pharmacare Programs 1. Seniors' Pharmacare Program - available to all Nova Scotia seniors 65 years or older who have a valid Nova Scotia Health Card, and do not have private drug coverage. 2. Community Services Pharmacare Programs - The Department of Community Services provides drug benefits as part of the Income Assistance Programs (including Special Needs Pharmacare and Transitional Pharmacare), the Low Income Pharmacare Program for Children, Services for Persons with Disabilities and the Children in Care Programs. Eligibility is determined by the Department of Community Services. 3. Drug Assistance for Cancer Patients, an income based assistance program covering medication for the treatment of cancer. 4. Diabetes Assistance Program, an income based assistance program covering medication and supplies needed for diabetes treatment. 5. Under 65-Long Term Care (LTC) Pharmacare, provides drug coverage for long term care residents under 65 years of age who have no drug insurance. 6. Family Pharmacare Program, an income based program available to all Nova Scotians with a valid Nova Scotia Health Card who are not currently receiving drug benefits through Seniors', Community Services, Diabetes Assistance or the Under 65-Long Term Care Pharmacare Programs. The benefit status of medications reimbursed under these programs are indicated, in the fourth column of the ATC classification, by the letters S (Seniors' Pharmacare), F (Community Services Pharmacare / Under 65-Long Term Care Pharmacare / Family Pharmacare), C (Drug Assistance for Cancer Patients), D (Diabetes Assistance) or E (Exception Status Drug - see Appendix III). If this column is blank, the product is not a benefit under any of these programs.

December 2012

Page iii

Miscellaneous Section Diabetes and ostomy supplies are listed in this section. These products are benefits under the Seniors' and Community Services Pharmacare Programs and are cross-referenced in the appropriate ATC classification. Diabetes supplies are also benefits under the Diabetes Assistance Program.

Legend

1. 2. 3. 4. 5. 6.

Therapeutic Main Group Therapeutic Subgroup Chemical/Therapeutic Subgroup Subgroup for Chemical Substance Brand or Manufacturer's Name of the Drug, including dosage form and/or route and strength Prescriber Codes: D - Physician / Dentist N - Nurse Practitioner P - Pharmacist M - Midwife O - Prescribing Optometrist 7. Benefit Status (plans for which the product is a benefit): S - Seniors' Pharmacare F - Community Services Pharmacare - Under 65-Long Term Care Pharmacare - Family Pharmacare C - Drug Assistance for Cancer Patients D - Diabetes Assistance Program E - Exception status applies (see Appendix III) 8. Drug Identification Number (DIN) 9. Abbreviation of Manufacturer (see Appendix II) 10. Interchangeable Product Group Box 11. Interchangeable Product Heading 12. MRP = Maximum Reimbursable Price PRP = Pharmacare Reimbursement Price

December 2012

Page iv

A01

STOMATOLOGICAL PREPARATIONS

A01A STOMATOLOGICAL PREPARATIONS A01AB ANTIINFECTIVES AND ANTISEPTICS FOR LOCAL ORAL TREATMENT A01AB03 CHLORHEXIDINE chlorhexidine 0.12% oral rinse Perichlor 0.12% Oral Rinse Peridex 0.12% Oral Rinse DOXYCYCLINE Periostat 20mg Cap

02240433 02237452 02247104

PMS ZIA PDP

A01AB22

A01AC CORTICOSTEROIDS FOR LOCAL ORAL TREATMENT A01AC01 TRIAMCINOLONE triamcinolone acetonide 0.1% oral paste Oracort 0.1% Oral Paste Kenalog 0.1% in Orabase (discontinued)

DNP

MRP

SF

01964054

TAR

A01AD OTHER AGENTS FOR LOCAL ORAL TREATMENT A01AD02 BENZYDAMINE benzydamine 0.15% oral rinse Novo-Benzydamine 0.15% Oral Rinse pms-Benzydamine 0.15% Oral Rinse Apo-Benzydamine 0.15% Oral Rinse (discontinued) Novo-Benzydamine 0.15% Oral Rinse (discontinued) Tantum Oral Rinse (discontinued)

DNP DNP

MRP MRP

E E

02310422 02229777 02229799

TEV PMS TEV

A02

DRUGS FOR ACID RELATED DISORDERS

A02A ANTACIDS A02AB ALUMINIUM COMPOUNDS A02AB01 ALUMINIUM HYDROXIDE Basaljel 500mg Cap SF 02135620 AUR

DNP

A02AD COMBINATIONS AND COMPLEXES OF ALUMINIUM, CALCIUM AND MAGNESIUM COMPOUNDS A02AD01 ANTACIDS, ORDINARY SALT COMBINATIONS Diovol Regular O/L 01966529 CHU

A02AF ANTACIDS WITH ANTIFLATULENTS A02AF02 ANTACIDS, ORDINARY SALT COMBINATIONS AND ANTIFLATULENTS Diovol Plus O/L Diovol Plus Tab Mylanta Double St Tab 00116815 00116882 02019787 CHU CHU JNJ

A02B DRUGS FOR PEPTIC ULCER AND GASTRO-ESOPHAGEAL REFLUX DISEASE (GERD) A02BA H2-RECEPTOR ANTAGONISTS A02BA01 CIMETIDINE cimetidine 200mg tab Apo-Cimetidine 200mg Tab Tagamet 200mg Tab (discontinued) cimetidine 300mg tab Apo-Cimetidine 300mg Tab MYLAN-Cimetidine 300mg Tab Tagamet 300mg Tab (discontinued) cimetidine 400mg tab Apo-Cimetidine 400mg Tab MYLAN-Cimetidine 400mg Tab Tagamet 400mg Tab (discontinued)

December 2012

DNP

MRP

SF

00584215

APX

DNP DNP

MRP MRP

SF SF

00487872 02227444

APX MYL

DNP DNP

MRP MRP

SF SF

00600059 02227452

APX MYL

Alimentary Tract and Metabolism ­ 1

cimetidine 600mg tab Apo-Cimetidine 600mg Tab MYLAN-Cimetidine 600mg Tab Tagamet 600mg Tab (discontinued) cimetidine 800mg tab Apo-Cimetidine 800mg Tab Tagamet 800mg Tab (discontinued) A02BA02 RANITIDINE ranitidine 25mg/mL inj Ranitidine 25mg/mL Inj Zantac 25mg/mL Inj ranitidine 15mg/mL o/l Apo-Ranitidine 15mg/mL O/L Novo-Ranitidine 15mg/mL O/L Zantac 15mg/mL O/L (discontinued) ranitidine 75mg tab Apo-Ranitidine 75mg Tab Zantac 75mg Tab ranitidine 150mg tab Apo-Ranitidine 150mg Tab CO Ranitidine 150mg Tab MYLAN-Ranitidine 150mg Tab Myl-Ranitidine 150mg Tab Novo-Ranidine 150mg Tab pms-Ranitidine 150mg Tab RAN-Ranitidine 150mg Tab Ranitidine 150mg Tab ratio-Ranitidine 150mg Tab Sandoz Ranitidine 150mg Tab Zantac 150mg Tab ranitidine 300mg tab Apo-Ranitidine 300mg Tab CO Ranitidine 300mg Tab MYLAN-Ranitidine 300mg Tab Myl-Ranitidine 300mg Tab Novo-Ranidine 300mg Tab pms-Ranitidine 300mg Tab RAN-Ranitidine 300mg Tab Ranitidine 300mg Tab Sandoz Ranitidine 300mg Tab Zantac 300mg Tab ratio-Ranitidine 300mg Tab (discontinued) A02BA03 FAMOTIDINE famotidine 10mg/mL inj Famotidine Omega 10mg/mL Inj Pepcid 10mg/mL Inj (discontinued) famotidine 10mg/mL inj (pf) Famotidine Omega (PF) 10mg/mL Inj Pepcid (PF)10mg/mL Inj (discontinued) famotidine 20mg tab Apo-Famotidine 20mg Tab Famotidine 20mg Tab MYLAN-Famotidine 20mg Tab Novo-Famotidine 20mg Tab Pepcid 20mg Tab

DNP DNP

MRP MRP

SF SF

00600067 02227460

APX MYL

DNP

MRP

SF

00749494

APX

DNP DNP

MRP MRP

SFC SFC

02256711 02212366

SDZ GSK

DNP DNP

MRP MRP

SFC SFC

02280833 02242940

APX TEV

02230507 02230287

APX JNJ

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

00733059 02248570 02207761 02367378 00828564 02242453 02336480 02353016 00828823 02243229 02212331

APX COB MYL MYL TEV PMS RAN SAS TEV SDZ GSK

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

00733067 02248571 02207788 02367386 00828556 02242454 02336502 02353024 02243230 02212358

APX COB MYL MYL TEV PMS RAN SAS SDZ GSK

DNP

MRP

SF

02247745

OMG

DNP

MRP

SF

02247735

OMG

DNP DNP DNP DNP DNP

PRP PRP PRP PRP PRP

SF SF SF SF SF

01953842 02351102 02196018 02022133 00710121

APX SAS MYL TEV FRS

December 2012

Alimentary Tract and Metabolism ­ 2

famotidine 40mg tab Apo-Famotidine 40mg Tab Famotidine 40mg Tab MYLAN-Famotidine 40mg Tab Novo-Famotidine 40mg Tab Pepcid 40mg Tab (discontinued) A02BA04 NIZATIDINE nizatidine 150mg cap Apo-Nizatidine 150mg Cap Novo-Nizatidine 150mg Cap pms-Nizatidine 150mg Cap Axid 150mg Cap nizatidine 300mg cap Apo-Nizatidine 300mg Cap Novo-Nizatidine 300mg Cap pms-Nizatidine 300mg Cap Axid 300mg Cap A02BB PROSTAGLANDINS A02BB01 MISOPROSTOL misoprostol 100mcg tab Misoprostol 100mcg Tab Cytotec 100mcg Tab (discontinued) misoprostol 200mcg tab Misoprostol 200mcg Tab Cytotec 200mcg Tab (discontinued) A02BC PROTON PUMP INHIBITORS A02BC01 OMEPRAZOLE omeprazole 10mg cap MYLAN-Omeprazole 10mg Cap Sandoz Omeprazole 10mg Cap Losec 10mg Cap omeprazole 20mg cap Apo-Omeprazole 20mg Cap MYLAN-Omeprazole 20mg Cap Omeprazole 20mg Cap pms-Omeprazole 20mg Cap Sandoz Omeprazole 20mg Cap Losec 20mg Cap omeprazole 10mg cap/tab MYLAN-Omeprazole 10mg Cap Losec 10mg Tab omeprazole 20mg cap/tab Apo-Omeprazole 20mg Cap MYLAN-Omeprazole 20mg Cap Novo-Omeprazole Delayed-Release 20mg Tab Omeprazole 20mg Cap pms-Omeprazole DR 20mg Tab RAN-Omeprazole 20mg Tab ratio-Omeprazole 20mg Tab Losec 20mg Tab

DNP DNP DNP DNP

PRP PRP PRP PRP

SF SF SF SF

01953834 02351110 02196026 02022141

APX SAS MYL TEV

DNP DNP DNP DNP

PRP PRP PRP PRP

SF SF SF SF

02220156 02240457 02177714 00778338

APX TEV PMS MMT

DNP DNP DNP DNP

PRP PRP PRP PRP

SF SF SF SF

02220164 02240458 02177722 00778346

APX TEV PMS MMT

DNPM

MRP

SF

02244022

AAP

DNPM

MRP

SF

02244023

AAP

DNP DNP DNP

PRP PRP PRP

SFC1 SFC1 SFC1 SFC1 SFC1 SFC1 1 SFC SFC1 SFC1 SFC1 SFC1 SFC1 SFC1 SFC1 SFC1 SFC1 SFC1 SFC1 SFC1

02329425 02296438 02119579

MYL SDZ AZE

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

02245058 02329433 02348691 02320851 02296446 00846503

APX MYL SAS PMS SDZ AZE

DNP DNP

PRP PRP

02329425 02230737

MYL AZE

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

02245058 02329433 02295415 02348691 02310260 02374870 02260867 02190915

APX MYL TEV SAS PMS RAN TEV AZE

1

Omeprazole and rabeprazole are exception status when a daily dose exceeds 20mg. Please refer to Appendix III for criteria.

Alimentary Tract and Metabolism ­ 3

December 2012

A02BC02

PANTOPRAZOLE pantoprazole 20mg EC tab Apo-Pantoprazole 20mg DR Tab pms-Pantoprazole 20mg DR Tab RAN-Pantoprazole 20mg Tab Sandoz Pantoprazole 20mg DR Tab Teva Pantoprazole 20mg DR Tab Pantoloc 20mg Tab pantoprazole 40mg EC tab Apo-Pantoprazole 40mg Tab CO Pantoprazole 40mg DR Tab MYLAN-Pantoprazole 40mg DR Tab Novo-Pantoprazole 40mg Tab pms-Pantoprazole 40mg DR Tab RAN-Pantoprazole 40mg Tab Sandoz Pantoprazole 40mg DR Tab Pantoprazole 40mg Tab Pantoloc 40mg Tab Tecta 40mg Tab

DNP DNP DNP DNP DNP

PRP PRP PRP PRP PRP

E E E E E

02292912 02307863 02305038 02301075 02285479 02241804

APX PMS RAN SDZ TEV NYC

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E E SFC2

02292920 02300486 02299585 02285487 02307871 02305046 02301083 02370808 02229453 02267233

APX COB MYL TEV PMS RAN SDZ SAS NYC NYC

A02BC03

LANSOPRAZOLE lansoprazole 15mg cap Apo-Lansoprazole 15mg DR Cap Lansoprazole 15mg DR Cap MYLAN-Lansoprazole 15mg DR Cap Novo-Lansoprazole 15mg DR Cap Sandoz Lansoprazole 15mg DR Cap Prevacid 15mg Cap lansoprazole 30mg cap Apo-Lansoprazole 30mg DR Cap Lansoprazole 30mg DR Cap MYLAN-Lansoprazole 30mg DR Cap Novo-Lansoprazole 30mg DR Cap Sandoz Lansoprazole 30mg DR Cap Prevacid 30mg Cap Prevacid FasTab 15mg Tab Prevacid FasTab 30mg Tab

DNP DNP DNP DNP DNP DNP

PRP PRP PRP PRP PRP PRP

E E E E E E

02293811 02357682 02353830 02280515 02385643 02165503

APX SAS MYL TEV SDZ ABB

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

E E E E E E E E

02293838 02357690 02353849 02280523 02385651 02165511 02249464 02249472

APX SAS MYL TEV SDZ ABB ABB ABB

A02BC04

RABEPRAZOLE rabeprazole 10mg EC tab Apo-Rabeprazole 10mg EC Tab PAT-Rabeprazole 10mg Tab pms-Rabeprazole 10mg EC Tab Rabeprazole EC 10mg Tab RAN-Rabeprazole 10mg Tab Sandoz Rabeprazole 10mg EC Tab Teva-Rabeprazole-EC 10mg Tab Pariet 10mg Tab

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

SFC1 SFC1 SFC1 SFC1 SFC1 SFC1 SFC1 SFC1

02345579 02381737 02310805 02356511 02298074 02314177 02296632 02243796

APX PPH PMS SAS RAN SDZ TEV JAN

1 2

Omeprazole and rabeprazole are exception status when a daily dose exceeds 20mg. Please refer to Appendix III for criteria. Tecta is exception status when the daily dose exceeds 40mg. Please refer to Appendix III for criteria.

December 2012

Alimentary Tract and Metabolism ­ 4

rabeprazole 20mg EC tab Apo-Rabeprazole 20mg EC Tab PAT-Rabeprazole 20mg EC Tab pms-Rabeprazole 20mg EC Tab Rabeprazole EC 20mg Tab RAN-Rabeprazole 20mg Tab Sandoz Rabeprazole 20mg EC Tab Teva-Rabeprazole-EC 20mg Tab Pariet 20mg Tab A02BC05 ESOMEPRAZOLE esomeprazole 20mg tab Apo-Esomeprazole 20mg DR Tab Nexium 20mg Tab esomeprazole 40mg tab Apo-Esomeprazole 40mg DR Tab MYLAN-Esomeprazole 40mg DR Tab Nexium 40mg Tab A02BD COMBINATIONS FOR ERADICATION OF HELICOBACTER PYLORI A02BD99

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

SFC1 SFC1 SFC1 SFC1 SFC1 SFC1 SFC1 SFC1

02345587 02381745 02310813 02356538 02298082 02314185 02296640 02243797

APX PPH PMS SAS RAN SDZ TEV JAN

02339099 02244521

APX AZE

02339102 02383047 02244522

APX MYL AZE

LANSOPRAZOLE, CLARITHROMYCIN AND AMOXICILLIN DNP Hp-PAC

SF3

02238525

ABB

A02BX OTHER DRUGS FOR PEPTIC ULCER AND GASTRO-ESOPHAGEAL REFLUX DISEASE (GERD) A02BX02 SUCRALFATE Sulcrate 1g/5mL Plus Susp sucralfate 1g tab Apo-Sucralfate 1g Tab Novo-Sucralate 1g Tab Sulcrate 1g Tab SF SF SF SF 02103567 02125250 02045702 02100622 AXC APX TEV AXC

DNP

DNP DNP DNP

MRP MRP MRP

A03

DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS

A03A DRUGS FOR FUNCTIONAL BOWEL DISORDERS A03AA SYNTHETIC ANTICHOLINERGICS, ESTERS WITH TERTIARY AMINO GROUP A03AA05 TRIMEBUTINE Trimebutine 100mg Tab trimebutine 200mg tab Trimebutine 200mg Tab Modulon 200mg Tab A03AA07 DICYCLOVERINE (DICYCLOMINE) Dicyclomine 10mg/mL Inj Bentylol 10mg/5mL Syr Bentylol 10mg Tab Bentylol 20mg Tab SFC SFC SFC 02245663 02245664 00803499 00392812 02102978 02103087 02103095 AAP AAP AXC SDZ AXC AXC AXC

DNP

DNP DNP

MRP MRP

DNP DNP DNP

SFC SFC SFC

A03AB SYNTHETIC ANTICHOLINERGICS, QUATERNARY AMMONIUM COMPOUNDS A03AB02 GLYCOPYRROLATE (GLYCOPYRRONIUM) Glycopyrrolate 0.2mg/mL Inj SFC 02039508 SDZ

DNP

A03AD PAPAVERINE AND DERIVATIVES A03AD01 PAPAVERINE Papaverine HCl 32.5mg/mL Inj 00009881 SDZ

1

3

Omeprazole and rabeprazole are exception status when a daily dose exceeds 20mg. Please refer to Appendix III for criteria. Hp-PAC has a quantity limit of one pack per year

Alimentary Tract and Metabolism ­ 5

December 2012

A03AE DRUGS ACTING ON SEROTONIN RECEPTORS A03AE04 PRUCALOPRIDE Resotran 1mg Tab Resotran 2mg Tab 02377012 02377020 JAN JAN

A03AX OTHER DRUGS FOR FUNCTIONAL BOWEL DISORDERS A03AX04 PINAVERIUM Dicetel 50mg Tab Dicetel 100mg Tab SILICONES Ovol 80 (80mg) Tab SFC SFC 01950592 02230684 00292990 ABB ABB CHU

DNP DNP

A03AX13

A03B BELLADONNA AND DERIVATIVES, PLAIN A03BA BELLADONNA ALKALOIDS, TERTIARY AMINES A03BA01 ATROPINE Atropine Sulfate 0.4mg/mL Inj Atropine Sulfate 0.6mg/mL Inj HYOSCYAMINE Levsin 0.125mg SL Tab SFC SFC SFC 00392782 00392693 00125857 SDZ SDZ AXS

DNP DNP

A03BA03

DNP

A03C ANTISPASMODICS IN COMBINATION WITH PSYCHOLEPTICS A03CA SYNTHETIC ANTICHOLINERGIC AGENTS IN COMBINATION WITH PSYCHOLEPTICS A03CA02 CLIDINIUM AND PSYCHOLEPTICS chlordiazepoxide HCl 5mg & clidinium Br 2.5mg cap Apo-Chlorax 5/2.5mg Cap D Librax Cap D

MRP MRP

SFC SFC

00618454 00115630

APX VLN

A03E ANTISPASMODICS AND ANTICHOLINERGICS IN COMBINATION WITH OTHER DRUGS A03ED ANTISPASMODICS IN COMBINATION WITH OTHER DRUGS A03ED99 ANTISPASMODICS, COMBINATIONS Bellergal Spacetabs SFC 00176141 TRI

D

A03F PROPULSIVES A03FA PROPULSIVES A03FA01 METOCLOPRAMIDE Metoclopramide 5mg/mL Inj metoclopramide HCl 1mg o/l pms-Metoclopramide 1mg/mL Liq Maxeran 1mg/mL O/L (discontinued) metoclopramide HCl 5mg tab pms-Metoclopramide 5mg Tab Apo-Metoclop 5mg Tab (discontinued) Maxeran 5mg Tab (discontinued) metoclopramide HCl 10mg tab pms-Metoclopramide 10mg Tab Apo-Metoclop 10mg Tab (discontinued) Maxeran 10mg Tab (discontinued) SFC SFC 02185431 02230433 SDZ PMS

DNP

DNP

MRP

DNP

MRP

SFC

02230431

PMS

DNP

MRP

SFC

02230432

PMS

December 2012

Alimentary Tract and Metabolism ­ 6

A03FA03

DOMPERIDONE domperidone maleate 10mg tab Apo-Domperidone 10mg Tab Domperidone 10mg Tab Jamp-Domperidone 10mg Tab MYLAN-Domperidone 10mg Tab pms-Domperidone 10mg Tab RAN-Domperidone 10mg Tab ratio-Domperidone 10mg Tab Teva-Domperidone 10mg Tab Motilium 10mg Tab (discontinued)

DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM

MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC

02103613 02350440 02369206 02278669 02236466 02268078 01912070 02157195

APX SAS JPC MYL PMS RAN TEV TEV

A04

ANTIEMETICS AND ANTINAUSEANTS

A04A ANTIEMETICS AND ANTINAUSEANTS A04AA SEROTONIN (5-HT3) ANTAGONISTS A04AA01 ONDANSETRON ondansetron 4mg/5mL o/l Ondansetron 4mg/5mL O/L Zofran 4mg/5mL O/L ondansetron 4mg tab Apo-Ondansetron 4mg Tab CO Ondansetron 4mg Tab Jamp-Ondansetron 4mg Tab Mar-Ondansetron 4mg Tab MINT-Ondansetron 4mg Tab MYLAN-Ondansetron 4mg Tab Novo-Ondansetron 4mg Tab Ondansetron-Odan 4mg Tab phl-Ondansetron 4mg Tab pms-Ondansetron 4mg Tab RAN-Ondansetron 4mg Tab ratio-Ondansetron 4mg Tab Sandoz Ondansetron 4mg Tab Zofran 4mg Tab ondansetron 8mg tab Apo-Ondansetron 8mg Tab CO Ondansetron 8mg Tab Jamp-Ondansetron 8mg Tab Mar-Ondansetron 8mg Tab MINT-Ondansetron 8mg Tab MYLAN-Ondansetron 8mg Tab Ondansetron-Odan 8mg Tab phl-Ondansetron 8mg Tab pms-Ondansetron 8mg Tab RAN-Ondansetron 8mg Tab ratio-Ondansetron 8mg Tab Sandoz Ondansetron 8mg Tab Teva-Ondansetron 8mg Tab Zofran 8mg Tab Zofran 4mg ODT Tab Zofran 8mg ODT Tab

DNP DNP

MRP MRP

E E

02291967 02229639

AAP GSK

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

PRP PRP PRP PRP PRP PRP PRP PRP PRP PRP PRP PRP PRP PRP

E E E E E E E E E E E E E E

02288184 02296349 02313685 02371731 02305259 02297868 02264056 02306212 02278618 02258188 02312247 02278529 02274310 02213567

APX COB JPC MAR MNT MYL TEV ODN PHL PMS RAN TEV SDZ GSK

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP PRP PRP

E E E E E E E E E E E E E E E E

02288192 02296357 02313693 02371758 02305267 02297876 02306220 02278626 02258196 02312255 02278537 02274329 02264064 02213575 02239372 02239373

APX COB JPC MAR MNT MYL ODN PHL PMS RAN TEV SDZ TEV GSK GSK GSK

December 2012

Alimentary Tract and Metabolism ­ 7

A04AA02

GRANISETRON granisetron 1 mg tab Granisetron 1mg Tab Kytril 1mg Tab (discontinued) DOLASETRON Anzemet 100mg Tab

DNP

MRP

E

02308894

AAP

A04AA04

DNP

E

02231379

SAV

A04AD OTHER ANTIEMETICS A04AD01 SCOPOLAMINE Scopolamine 0.4mg/mL Inj Scopolamine 0.6mg/mL Inj scopolamine 20mg/mL inj Hyoscine Butylbromide 20mg/mL Inj Buscopan 20mg/mL Inj (discontinued) Buscopan 10mg Tab Transderm-V 1.5mg Patch Transderm-V 1.5mg Patch A04AD10 SFC SFC SF SF 00541869 00541877 02229868 00363812 00550094 80024336 HOS HOS SDZ BOE NVR NVR

DNP DNP

DNP

MRP

DNP

DRONABINOL (DELTA-9-TETRAHYDROCANNABINOL) Marinol 2.5mg Cap (discontinued) Marinol 5mg Cap (discontinued) NABILONE (CANNABINOID (THC) DERIVATIVES) Cesamet 0.25mg Cap nabilone 0.5mg cap pms-Nabilone 0.5mg Cap RAN-Nabilone 0.5mg Cap Teva-Nabilone 0.5mg Cap Cesamet 0.5mg Cap nabilone 1mg cap pms-Nabilone 1mg Cap RAN-Nabilone 1mg Cap Teva-Nabilone 1mg Cap Cesamet 1mg Cap E E E E E 02312263 02380900 02358085 02384884 02256193 VLN PMS RAN TEV VLN

A04AD11

D

D D D D

MRP MRP MRP MRP

D D D D

MRP MRP MRP MRP

E E E E E E E

02380919 02358093 02384892 00548375 02298791 02298805 02298813

PMS RAN TEV VLN FRS FRS FRS

A04AD12

APREPITANT Emend 80mg Cap Emend 125mg Cap Emend Tri-Pack Cap DIMENHYDRINATE dimenhydrinate 10mg/mL IV inj Dimenhydrinate 10mg/mL IV Amp Gravol 10mg/mL IV Amp (discontinued) dimenhydrinate 50mg/mL IM inj Dimenhydrinate 50mg/mL IM Inj Gravol l 50mg/mL IM Inj Gravol 15mg/5mL O/L Gravol 50mg Tab Gravol 25mg Supp Gravol 100mg Supp Dimenhydrinate 50mg Supp Dimenhydrinate 100mg (Adult) Supp

DNP DNP DNP

A04AD99

DNP

MRP

SFC

00392731

SDZ

DNP DNP

MRP MRP

SFC SFC

00392537 00013579 00230197 00013803 00783595 00013609 00392553 00392545

SDZ CHU CHU CHU CHU CHU SDZ SDZ

December 2012

Alimentary Tract and Metabolism ­ 8

A05

BILE AND LIVER THERAPY

A05A BILE THERAPY A05AA BILE ACID PREPARATIONS A05AA02 URSODIOL (URSODEOXYCHOLIC ACID) ursodiol 250mg tab pms-Ursodiol C 250mg Tab Urso 250mg Tab ursodiol 500mg tab pms-Ursodiol C 500mg Tab Urso DS 500mg Tab A05AA99 DEHYDROCHOLIC ACID Dycholium 300mg Tab

D D

MRP MRP

E E

02273497 02238984

PMS AXC

D D

MRP MRP

E E SF

02273500 02245894 02162148

PMS AXC NNC

D

A06

LAXATIVES

A06A LAXATIVES A06AA SOFTENERS, EMOLLIENTS A06AA02 DOCUSATE SODIUM Colace 100mg Cap Colace 10mg/mL Drp Colace 20mg/5mL Syrup Docusate Sodium 100mg Cap Jamp-Docusate Sodium 100mg Cap Novo-Docusate 100mg Cap pms-Docusate Sodium 100mg Cap pms-Docusate Sodium 10mg Drp pms-Docusate Sodium 4mg/mL Syr ratio-Docusate Sodium 100mg Cap ratio-Docusate Sodium 20mg/5mL Syr Selax 100mg Cap Selax 20mg/5mL USP C C C C C C C C C C C C C 02106256 02090163 02086018 00716731 02245946 02020084 00703494 00880140 00703508 00870196 00870226 00514888 00695033 WLS WLS WLS TAR JPC TEV PMS PMS PMS TEV TEV ODN ODN

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

A06AB CONTACT LAXATIVES A06AB02 BISACODYL Apo-Bisacodyl 5mg Tab Bisacodyl-ODAN 5mg Tab Dulcolax 5mg Supp Dulcolax 10mg Supp Dulcolax ECT 5mg Tab Jamp-Bisacodyl 5mg Tab pms-Bisacodyl 10mg Supp pms-Bisacodyl 5mg Tab (discontinued) SENNA GLYCOSIDES Jamp-Sennosides 8.6mg Tab Sandoz Sennosides 8.6mg Tab Sandoz Sennosides 12mg Tab Senokot 1.7mg/mL Syr Senokot 8.6mg Tab SENNA GLYCOSIDES, COMBINATIONS Senokot S 8.6mg/50mg Tab C C C C C C C 00545023 02273411 00003867 00003875 00254142 02246039 00582883 APX ODN BOE BOE BOE JPC PMS

DNP DNP DNP DNP DNP DNP DNP

A06AB06

DNP DNP DNP DNP DNP

C C C C C C

80009595 02089653 02089645 00367729 00026158 00026123

JPC SDZ SDZ PFR PFR PFR

A06AB56

DNP

A06AD OSMOTICALLY ACTING LAXATIVES A06AD10 MINERAL SALTS IN COMBINATION CoLyte Powder for Solution Peglyte Powder for Solution C C 00677442 00777838 ZYM PDP

DNP DNP

December 2012

Alimentary Tract and Metabolism ­ 9

A06AD11

LACTULOSE pms-Lactulose 667mg/mL O/L lactulose 667mg/mL o/l Apo-Lactulose 667mg/mL O/L Jamp-Lactulose 667mg/mL O/L ratio-Lactulose 667mg/mL O/L Teva-Lactulose 667mg/mL O/L Chronulac 667mg/mL O/L (discontinued)

DNP

E E E E E

00703486 02242814 02295881 00854409 02331551

PMS APX JPC TEV TEV

DNP DNP DNP DNP

MRP MRP MRP MRP

A06AD15 A06AD19

MACROGOL PEG 3350 MAGNESIUM CITRATE Citro Mag 50mg/mL O/L Citrodan 50mg/mL O/L C C

02358034 00262609 80001809

MSC ROG ODN

DNP DNP

A06AH MISCELLANEOUS GI DRUGS A06AH01 METHYLNALTREXONE BROMIDE Relistor 20mg/mL Inj 02308215 PFI

A07

ANTIDIARRHEALS, INTESTINAL ANTIINFLAMMATORY/ANTIINFECTIVE AGENTS

A07A INTESTINAL ANTIINFECTIVES A07AA ANTIBIOTICS A07AA02 NYSTATIN pms-Nystatin 100,000iu/mL Oral Susp nystatin 100,000iu o/l ratio-Nystatin 100,000iu/mL Oral Drops Mycostatin 100,000iu/mL Oral Susp (discontinued) ratio-Nystatin 500,000iu Oral Tab A07AA06 PAROMOMYCIN Humatin 250mg Cap SFC SFC SFC 00792667 02194201 02194198 02078759 PMS TEV TEV ERF

DNP

DNP

MRP

DNP

A07BB BISMUTH PREPARATIONS A07BB99 BISMUTH SUBSALICYLATE PeptoBismol 17.6mg/mL O/L 02097079 WNC

A07D ANTIPROPULSIVES A07DA ANTIPROPULSIVES A07DA01 A07DA02 A07DA03 DIPHENOXYLATE Lomotil 2.5mg Tab OPIUM Sandoz Opium & Belladonna 65mg/15mg Supp LOPERAMIDE loperamide 2mg caplet Apo-Loperamide 2mg Caplet Novo-Loperamide 2mg Caplet pms-Loperamide 2mg Caplet Sandoz Loperamide 2mg Caplet Imodium 2mg Caplet Diarr-eze 2mg Caplet (discontinued) Jamp-Loperamide 2mg Tab loperamide HCl 0.2mg/mL o/l pms-Loperamide 0.2mg/mL O/L Imodium 0.2mg/mL O/L (discontinued)

December 2012

D

SFC SFC

00036323 01901869

PFI SDZ

D

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC

02212005 02132591 02228351 02257564 02183862 02256452 02016095

APX TEV PMS SDZ JNJ JPC PMS

DNP

DNP

MRP

Alimentary Tract and Metabolism ­ 10

A07E INTESTINAL ANTIINFLAMMATORY AGENTS A07EA CORTICOSTEROIDS ACTING LOCALLY A07EA02 HYDROCORTISONE Cortenema 100mg/60mL Susp Cortifoam BETAMETHASONE Betnesol 5mg/100mL Retention Enema BUDESONIDE Entocort 3mg Cap Entocort 0.02mg/mL Enema SF SF SF SF SF 02112736 00579335 02060884 02229293 02052431 AXC PAL PAL AZE AZE

DNP DNP

A07EA04 A07EA06

DNP

DNP DNP

A07EB ANTIALLERGIC AGENTS, EXCLUDING CORTICOSTEROIDS A07EB01 CROMOGLYCATE SODIUM Nalcrom 100mg Cap SF 00500895 SAV

DNP

A07EC AMINOSALICYLIC ACID AND SIMILAR AGENTS A07EC01 SULFASALAZINE pms-Sulfasalazine 500mg Tab Salazopyrin 500mg Tab pms-Sulfasalazine EC 500mg Tab Salazopyrin 500mg Entabs 5-AMINOSALICYLIC ACID (MESALAMINE) 5-aminosalicylic acid 400mg tab Novo-5-ASA 400mg EC Tab Asacol 400mg Tab Pentasa 1g/100mL Rectal Susp Pentasa 4g/100mL Rectal Susp Salofalk 2g/60g Rectal Susp Salofalk 4g/60g Rectal Susp Salofalk 500mg Supp Pentasa 1g Supp Salofalk 1g Supp Mezavant 1.2g Tab Mesasal 500mg Tab Pentasa 500mg Tab Salofalk 500mg Tab Asacol 800 (800mg) Tab A07EC03 OLSALAZINE (5-ASA) Dipentum 250mg Cap SF SF SF SF 00598461 02064480 00598488 02064472 PMS PFI PMS PFI

DNP DNP DNP DNP

A07EC02

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF

02171929 01997580 02153521 02153556 02112795 02112809 02112760 02153564 02242146 02297558 01914030 02099683 02112787 02267217 02063808

TEV WNC FEI FEI AXC AXC AXC FEI AXC SHI GSK FEI AXC WNC UCB

DNP

A07F ANTIDIARRHEAL MICROORGANISMS A07FA ANTIDIARRHEAL MICROORGANISMS A07FA01 LACTIC ACID PRODUCING ORGANISMS Bacid Cap Bacid Cap SF SF 01927906 80017987 ERF ERF

DNP DNP

A08

ANTIOBESITY PREPARATIONS, EXCLUDING DIET PRODUCTS

A08A ANTIOBESITY PREPARATIONS, EXCLUDING DIET PRODUCTS A08AB PERIPHERALLY ACTING ANTIOBESITY PRODUCTS A08AB01 ORLISTAT Xenical 120mg Cap 02240325 HLR

December 2012

Alimentary Tract and Metabolism ­ 11

A09

DIGESTIVES, INCLUDING ENZYMES

A09A DIGESTIVES, INCLUDING ENZYMES A09AA ENZYME PREPARATIONS A09AA02 MULTIENZYMES (LIPASE, PROTEASE, ETC) Cotazym Cap Cotazym ECS 4 Cap (discontinued) Cotazym ECS 8 Cap Cotazym ECS 20 Cap Cotazym-65B Cap (discontinued) Pancrease MT 4 Cap Pancrease MT 10 Cap Pancrease MT 16 Cap Creon 5 Minimicrospheres Creon 10 Minimicrospheres Creon 20 Minimicrospheres Creon 25 Minimicrospheres Ultrase MS4 Cap Ultrase MT12 Cap Ultrase MT20 Cap Viokase Tab Viokase 16 Tab PEPSIN Fermentol 100mg/30mL Liq SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF 00263818 00502790 00821373 00789445 00789437 00789429 02239007 02200104 02239008 01985205 02203324 02045834 02045869 02230019 02241933 00378739 SCH SCH SCH JAN JAN JAN ABB ABB ABB ABB AXC AXC AXC AXC AXC CHU

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

A09AA03

DNP

A10

DRUGS USED IN DIABETES

A10A INSULINS AND ANALOGUES A10AB INSULINS AND ANALOGUES FOR INJECTION, FAST-ACTING A10AB01 INSULIN (HUMAN) Humulin R Cartridges Humulin R Insulin Novolin GE Toronto Insulin Novolin GE Toronto Penfill INSULIN LISPRO Humalog Cartridges Humalog Insulin Humalog KwikPen INSULIN ASPART NovoRapid 100iu/mL Penfill Ins NovoRapid 100iu/mL Vial Ins NovoMix 30 Penfill INSULIN GLULISINE Apidra 3mL Cartridges Apidra 3mL Pre-filled Pen Apidra 10mL Vial SFD SFD SFD SFD E4 E4 E4 E4 E4 01959220 00586714 02024233 02024284 02229705 02229704 02229705 02244353 02245397 02265435 02279479 02294346 02279460 LIL LIL NNO NNO LIL LIL LIL NNO NNO NNO SAV SAV SAV

DNP DNP DNP DNP

A10AB04

DNP DNP DNP

A10AB05

DNP DNP

A10AB06

DNP DNP DNP

E4 E4 E4

A10AC INSULINS AND ANALOGUES FOR INJECTION, INTERMEDIATE-ACTING A10AC01 INSULIN (HUMAN) Humulin N Cartridges Humulin N Insulin Novolin GE NPH Insulin Novolin GE NPH Penfill SFD SFD SFD SFD 01959239 00587737 02024225 02024268 LIL LIL NNO NNO

DNP DNP DNP DNP

4

Insulin Lispro, Insulin Aspart and Insulin Glulisine are full benefits for children 18 years and younger. For coverage in adults refer to criteria in Appendix III.

Alimentary Tract and Metabolism ­ 12

December 2012

A10AD INSULINS AND ANALOGUES FOR INJECTION, INTERMEDIATE-ACTING COMBINED WITH FAST-ACTING A10AD01 INSULIN (HUMAN) Humulin 30/70 Cartridges Humulin 30/70 Insulin Novolin GE 30/70 Insulin Novolin GE 30/70 Penfill Novolin GE 40/60 Penfill Novolin GE 50/50 Penfill INSULIN LISPRO Humalog Mix25 Cartridges Humalog Mix50 Cartridges Humalog Mix25 Vial SFD SFD SFD SFD SFD SFD 01959212 00795879 02024217 02025248 02024314 02024322 02240294 02240297 02240296 LIL LIL NNO NNO NNO NNO LIL LIL LIL

DNP DNP DNP DNP DNP DNP

A10AD04

A10AE INSULINS AND ANALOGUES FOR INJECTION, LONG-ACTING A10AE04 INSULIN GLARGINE Lantus 100u/mL Vial Lantus 100u/mL Cartridge Lantus 100u/mL Solostar Pre-filled Pen INSULIN DETEMIR Levemir 100u/mL Penfill E E E E 02245689 02251930 02294338 02271842 SAV SAV SAV NNO

DNP DNP DNP

A10AE05

DNP

A10B BLOOD GLUCOSE LOWERING DRUGS, EXCLUDING INSULINS A10BA BIGUANIDES A10BA02 METFORMIN metformin HCl 500mg tab Apo-Metformin 500mg Tab CO Metformin 500mg Tab Jamp-Metformin 500mg Tab Jamp-Metformin Blackberry 500mg Tab Mar-Metformin 500mg Tab Metformin 500mg Tab (MAR) Metformin 500mg Tab (MEL) Metformin 500mg Tab (SAS) MYLAN-Metformin 500mg Tab Novo-Metformin 500mg Tab pms-Metformin 500mg Tab RAN-Metformin 500mg Tab ratio-Metformin 500mg Tab Sandoz Metformin FC 500mg Tab Septa-Metformin 500mg Tab Glucophage 500mg Tab metformin HCl 850mg tab Apo-Metformin 850mg Tab CO Metformin 850mg Tab Jamp-Metformin 850mg Tab Jamp-Metformin Blackberry 850mg Tab Mar-Metformin 850mg Tab Metformin 850mg Tab (MAR) Metformin 850mg Tab (SAS) MYLAN-Metformin 850mg Tab Novo-Metformin 850mg Tab pms-Metformin 850mg Tab RAN-Metformin 850mg Tab ratio-Metformin 850mg Tab Sandoz Metformin FC 850mg Tab Septa Metformin 850mg Tab Glucophage 850mg Tab Zym-Metformin 850mg Tab (discontinued)

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFD SFD SFD SFD SFD SFD SFD SFD SFD SFD SFD SFD SFD SFD SFD SFD

02167786 02257726 02380196 02380722 02378620 02378841 02242794 02353377 02148765 02045710 02223562 02269031 02242974 02246820 02379767 02099233

APX COB JPC JPC MAR MAR MEL SAS MYL TEV PMS RAN TEV SDZ SPT SAV

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFD SFD SFD SFD SFD SFD SFD SFD SFD SFD SFD SFD SFD SFD SFD

02229785 02257734 02380218 02380730 02378639 02378868 02353385 02229656 02230475 02242589 02269058 02242931 02246821 02379775 02162849

APX COB JPC JPC MAR MAR SAS MYL TEV PMS RAN TEV SDZ SPT SAV

December 2012

Alimentary Tract and Metabolism ­ 13

A10BB SULFONAMIDES, UREA DERIVATIVES A10BB01 GLYBURIDE (GLIBENCLAMIDE) glyburide 2.5mg tab Apo-Glyburide 2.5mg Tab Glyburide 2.5mg Tab MYLAN-Glybe 2.5mg Tab ratio-Glyburide 2.5mg Tab Sandoz Glyburide 2.5mg Tab Teva-Glyburide 2.5mg Tab Diabeta 2.5mg Tab Euglucon 2.5mg Tab (discontinued) glyburide 5mg tab Apo-Glyburide 5mg Tab Glyburide 5mg Tab MYLAN-Glybe 5mg Tab pms-Glyburide 5mg Tab ratio-Glyburide 5mg Tab Sandoz Glyburide 5mg Tab Teva-Glyburide 5mg Tab Diabeta 5mg Tab Euglucon 5mg Tab (discontinued) A10BB02 CHLORPROPAMIDE Apo-Chlorpropamide 100mg Tab chlorpropamide 250mg tab Apo-Chlorpropamide 250mg Tab Diabinese 250mg Tab (discontinued) A10BB03 TOLBUTAMIDE tolbutamide 500mg tab Tolbutamide 500mg Tab Mobenol 500mg Tab (discontinued) GLICLAZIDE gliclazide MR 30mg tab Gliclazide MR 30mg Tab Diamicron MR 30mg Tab Diamicron MR 60mg Tab gliclazide 80mg tab Apo-Gliclazide 80mg Tab Gliclazide 80mg Tab MYLAN-Gliclazide 80mg Tab Novo-Gliclazide 80mg Tab Diamicron 80mg Tab A10BB12 GLIMEPIRIDE glimepiride 1mg tab Apo-Glimepiride 1mg Tab Novo-Glimepiride 1mg Tab ratio-Glimepiride 1mg Tab Sandoz Glimepiride 1mg Tab Amaryl 1mg Tab glimepiride 2mg tab Apo-Glimepiride 2mg Tab Novo-Glimepiride 2mg Tab ratio-Glimepiride 2mg Tab Sandoz Glimepiride 2mg Tab Amaryl 2mg Tab

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

SFD SFD SFD SFD SFD SFD SFD

01913654 02350459 00808733 01900927 02248008 01913670 02224550

APX SAS MYL TEV SDZ TEV SAV

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

SFD SFD SFD SFD SFD SFD SFD SFD

01913662 02350467 00808741 02236734 01900935 02248009 01913689 02224569

APX SAS MYL PMS TEV SDZ TEV SAV

00399302 00312711

APX APX

DNP

MRP

SFD

00312762

AAP

A10BB09

DNP DNP DNP

MRP MRP

SFD SFD SFD SFD SFD SFD SFD SFD

02297795 02242987 02356422 02245247 02287072 02229519 02238103 00765996

AAP SEV SEV APX SAS MYL TEV SEV

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

02295377 02273756 02273101 02269589 02245272

APX TEV TEV SDZ SAV

02295385 02273764 02273128 02269597 02245273

APX TEV TEV SDZ SAV

December 2012

Alimentary Tract and Metabolism ­ 14

glimepiride 4mg tab Apo-Glimepiride 4mg Tab Novo-Glimepiride 4mg Tab ratio-Glimepiride 4mg Tab Sandoz Glimepiride 4mg Tab Amaryl 4mg Tab A10BD COMBINATIONS OF ORAL BLOOD GLUCOSE LOWERING DRUGS A10BD03 METFORMIN AND ROSIGLITAZONE Avandamet 1/500mg Tab Avandamet 2/500mg Tab Avandamet 4/500mg Tab Avandamet 2/1000mg Tab Avandamet 4/1000mg Tab METFORMIN AND SITAGLIPTIN Janumet 50/500mg Tab Janumet 50/850mg Tab Janumet 50/1000mg Tab E E E

02295393 02273772 02273136 02269619 02245274

APX TEV TEV SDZ SAV

02247085 02247086 02247087 02248440 02248441 02333856 02333864 02333872

GSK GSK GSK GSK GSK FRS FRS FRS

A10BD07

DNP DNP DNP

A10BF ALPHA GLUCOSIDASE INHIBITORS A10BF01 ACARBOSE Glucobay 50mg Tab Glucobay 100mg Tab SFD SFD 02190885 02190893 BAY BAY

DNP DNP

A10BG THIAZOLINEDIONES A10BG02 ROSIGLITAZONE Avandia 2mg Tab Avandia 4mg Tab Avandia 8mg Tab PIOGLITAZONE pioglitazone 15mg tab Accel Pioglitazone 15mg Tab Apo-Pioglitazone 15mg Tab CO Pioglitazone 15mg Tab MINT-Pioglitazone 15mg Tab MYLAN-Pioglitazone 15mg Tab Novo-Pioglitazone 15mg Tab phl-Pioglitazone 15mg Tab pms-Pioglitazone 15mg Tab RAN-Pioglitazone 15mg Tab ratio-Pioglitazone 15mg Tab Sandoz Pioglitazone 15mg Tab Zym-Pioglitazone 15mg Tab Actos 15mg Tab pioglitazone 30mg tab Accel Pioglitazone 30mg Tab Apo-Pioglitazone 30mg Tab CO Pioglitazone 30mg Tab Jamp-Pioglitazone 30mg Tab MINT-Pioglitazone 30mg Tab MYLAN-Pioglitazone 30mg Tab Novo-Pioglitazone 30mg Tab phl-Pioglitazone 30mg Tab Pioglitazone 30mg Tab pms-Pioglitazone 30mg Tab RAN-Pioglitazone 30mg Tab Sandoz Pioglitazone 30mg Tab Zym-Pioglitazone 30mg Tab Actos 30mg Tab ratio-Pioglitazone 30mg Tab (discontinued) 02241112 02241113 02241114 GSK GSK GSK

A10BG03

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E E E E E

02303442 02302942 02302861 02326477 02298279 02274914 02307669 02303124 02375850 02301423 02297906 02320754 02242572

ACC APX COB MNT MYL TEV PHL PMS RAN TEV SDZ ZYM TAK

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E E E E E E

02303450 02302950 02302888 02365529 02326485 02298287 02274922 02307677 02339587 02303132 02375869 02297914 02320762 02242573

ACC APX COB JPC MNT MYL TEV PHL AHI PMS RAN SDZ ZYM TAK

December 2012

Alimentary Tract and Metabolism ­ 15

pioglitazone 45mg tab Accel Pioglitazone 45mg Tab Apo-Pioglitazone 45mg Tab CO Pioglitazone 45mg Tab Jamp-Pioglitazone 45mg Tab MINT-Pioglitazone 45mg Tab MYLAN-Pioglitazone 45mg Tab Novo-Pioglitazone 45mg Tab phl-Pioglitazone 45mg Tab Pioglitazone 45mg Tab pms-Pioglitazone 45mg Tab RAN-Pioglitazone 45mg Tab ratio-Pioglitazone 45mg Tab Sandoz Pioglitazone 45mg Tab Zym-Pioglitazone 45mg Tab Actos 45mg Tab A10BH DIPEPTIDYL PEPTIDASE-4 (DDP-4) INHIBITORS A10BH01 A10BH03 SITAGLIPTIN Januvia 100mg Tab SAXAGLIPTIN Onglyza 5mg Tab

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E E E E E E E

02303469 02302977 02302896 02365537 02326493 02298295 02274930 02307723 02339595 02303140 02375877 02301458 02297922 02320770 02242574

ACC APX COB JPC MNT MYL TEV PHL AHI PMS RAN TEV SDZ ZYM TAK

DNP

E

02303922 02333554

FRS BRI

A10BX OTHER BLOOD GLUCOSE LOWERING DRUGS, EXCLUDING INSULINS A10BX02 REPAGLINIDE repaglinide 0.5mg tab Apo-Repaglinide 0.5mg Tab CO Repaglinide 0.5mg Tab pms-Repaglinide 0.5mg Tab Sandoz Repaglinide 0.5mg Tab GlucoNorm 0.5mg Tab repaglinide 1mg tab Apo-Repaglinide 1mg Tab CO Repaglinide 1mg Tab pms-Repaglinide 1mg Tab Sandoz Repaglinide 1mg Tab GlucoNorm 1mg Tab repaglinide 2mg tab Apo-Repaglinide 2mg Tab CO Repaglinide 2mg Tab pms-Repaglinide 2mg Tab Sandoz Repaglinide 2mg Tab GlucoNorm 2mg Tab A10BX03 NATEGLINIDE Starlix 60mg Tab Starlix 120mg Tab LIRAGLUTIDE Victoza 6mg/mL Sol

02355663 02321475 02354926 02357453 02239924

APX COB PMS SDZ NNO

02355671 02321483 02354934 02357461 02239925

APX COB PMS SDZ NNO

02355698 02321491 02354942 02357488 02239926 02245438 02245439 02351064

APX COB PMS SDZ NNO NVR NVR NNO

A10BX07

A11

VITAMINS AND MINERALS

A11C VITAMIN A AND D, INCLUDING COMBINATIONS OF THE TWO A11CC VITAMIN D AND ANALOGUES A11CC01 ERGOCALCIFEROL Erdol 8,288iu/mL Sol SF 80003615 ODN

DNP

December 2012

Alimentary Tract and Metabolism ­ 16

A11CC03

ALFACALCIDOL One-Alpha 0.25mcg Cap One-Alpha 1mcg Cap One-Alpha 2mcg O/L CALCITRIOL Rocaltrol 0.25mcg Cap Rocaltrol 0.5mcg Cap Rocaltrol 1mcg/mL O/L

DNP DNP DNP

SF SF SF SF SF SF

00474517 00474525 02240329 00481823 00481815 00824291

LEO LEO LEO HLR HLR HLR

A11CC04

DNP DNP DNP

A11D VITAMIN B1, PLAIN AND IN COMBINATION WITH VITAMIN B6 AND B12 A11DA VITAMIN B1, PLAIN A11DA01 THIAMINE (VIT B1) thiamine (vit B1) 100mg/mL inj Thiamiject 100mg/mL Inj (Omega) Thiamine 100mg/mL Inj Vitamin B1 100mg/mL Inj Betaxin 100mg/mL Inj (discontinued)

DNP DNP

MRP MRP

SF SF

02193221 02243525 00816078

OMG CYI SDZ

A12

REPLACEMENT PREPARATIONS

A12B POTASSIUM A12BA POTASSIUM A12BA01 POTASSIUM CHLORIDE Micro-K 8mEq Extencap potassium chloride 1.33mEq/mL o/l pms-Potassium Chloride 20mEq/15mL K-10 Sol 20mEq/15mL JAMP-K8 600mg Tab Apo-K 8mEq Tab Slow-K 8mEq Tab JAMP-K20 1500mg Tab ODAN K-20 1500mg Tab K-Dur 20mEq Tab A12BA02 POTASSIUM CITRATE K-Lyte 25mEq Eff Tab SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC 02042304 02238604 80024360 80013005 00602884 00074225 80013007 80004415 00713376 02085992 PAL PMS GSK JPC APX NVR JPC ODN SCH WLS

DNP

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP

DNP

A12C OTHER MINERAL SUPPLEMENTS A12CC MAGNESIUM A12CC99 MAGNESIUM GLUCOHEPTONATE Jamp-Magnesium 5mg/mL O/L Magnesium-Odan 5mg/mL O/L Rougier-Magnesium 5mg/mL O/L E E E 80009357 80004109 00026697 JPC ODN ROG

DNP DNP DNP

A12CX OTHER MINERAL PRODUCTS A12CX99 SODIUM PHOSPHATE Phosphate-Novartis 500mg Eff Tab Phosphate Novartis 500mg Eff Tab SF SF 00225819 80027202 NVR NVR

DNP DNP

December 2012

Alimentary Tract and Metabolism ­ 17

A16

OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS

A16A OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS A16AA AMINO ACIDS AND DERIVATIVES A16AA01 LEVOCARNITINE Carnitor 1g/5mL Inj Carnitor 100mg/mL O/L Carnitor 330mg Tab BETAINE Cystadane 1g Powder for Oral Sol E E E 02144344 02144336 02144328 02238526 PPC PPC PPC ORP

DNP DNP DNP

A16AA06

A16AB ENZYMES A16AB05 A16AB07 A16AB09 LARONIDASE Aldurazyme 0.58mg/mL Inj ALGLUCOSIDASE ALFA Myozyme 50mg Pdr for Inj IDURSULFASE Elaprase 2mg/mL Inj E 02254506 02284863 02296314 GZM GZM PAL

DNP

A16AX VARIOUS ALIMENTARY TRACT AND METABOLISM PRODUCTS A16AX02 A16AX06 ANETHOLE TRITHONE Sialor 25mg Tab MIGLUSTAT Zavesca 100mg Cap 02240344 02250519 PMS ACT

December 2012

Alimentary Tract and Metabolism ­ 18

B01

ANTITHROMBOTIC AGENTS

B01A ANTITHROMBOTIC AGENTS B01AA VITAMIN K ANTAGONISTS B01AA03 WARFARIN warfarin 1mg tab Apo-Warfarin 1mg Tab MYLAN-Warfarin 1mg Tab Novo-Warfarin 1mg Tab Taro-Warfarin 1mg Tab Warfarin 1mg Tab Coumadin 1mg Tab warfarin 2mg tab Apo-Warfarin 2mg Tab MYLAN-Warfarin 2mg Tab Novo-Warfarin 2mg Tab Taro-Warfarin 2mg Tab Warfarin 2mg Tab Coumadin 2mg Tab warfarin 2.5mg tab Apo-Warfarin 2.5mg Tab MYLAN-Warfarin 2.5mg Tab Novo-Warfarin 2.5mg Tab Taro-Warfarin 2.5mg Tab Warfarin 2.5mg Tab Coumadin 2.5mg Tab warfarin 3mg tab Apo-Warfarin 3mg Tab MYLAN-Warfarin 3mg Tab Novo-Warfarin 3mg Tab Taro-Warfarin 3mg Tab Warfarin 3mg Tab Coumadin 3mg Tab warfarin 4mg tab Apo-Warfarin 4mg Tab MYLAN-Warfarin 4mg Tab Novo-Warfarin 4mg Tab Taro-Warfarin 4mg Tab Warfarin 4mg Tab Coumadin 4mg Tab warfarin 5mg tab Apo-Warfarin 5mg Tab MYLAN-Warfarin 5mg Tab Novo-Warfarin 5mg Tab Taro-Warfarin 5mg Tab Warfarin 5mg Tab Coumadin 5mg Tab warfarin 6mg tab MYLAN-Warfarin 6mg Tab Taro-Warfarin 6mg Tab Warfarin 6mg Tab Coumadin 6mg Tab warfarin 7.5mg tab MYLAN-Warfarin 7.5mg Tab Taro-Warfarin 7.5mg Tab Warfarin 7.5mg Tab

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC

02242924 02244462 02265273 02242680 02344025 01918311

APX MYL TEV TAR SAS BRI

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC

02242925 02244463 02265281 02242681 02344033 01918338

APX MYL TEV TAR SAS BRI

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC

02242926 02244464 02265303 02242682 02344041 01918346

APX MYL TEV TAR SAS BRI

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC

02245618 02287498 02265311 02242683 02344068 02240205

APX MYL TEV TAR SAS BRI

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC

02242927 02244465 02265338 02242684 02344076 02007959

APX MYL TEV TAR SAS BRI

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC

02242928 02244466 02265346 02242685 02344084 01918354

APX MYL TEV TAR SAS BRI

DNP

MRP

SFC SFC SFC SFC

DNP

MRP

02287501 02242686 02344092 02240206 02287528 02242697 02344106

MYL TAR SAS BRI MYL TAR SAS

DNP DNP

MRP MRP

December 2012

Blood and Blood Forming Organs ­ 19

warfarin 10mg tab Apo-Warfarin 10mg Tab MYLAN-Warfarin 10mg Tab Taro-Warfarin 10mg Tab Warfarin 10mg Tab Coumadin 10mg Tab B01AA07 ACENOCOUMAROL Sintrom 1mg Tab Sintrom 4mg Tab

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC

02242929 02244467 02242687 02344114 01918362 00010383 00010391

APX MYL TAR SAS BRI PAL PAL

DNP DNP

B01AB HEPARIN GROUP B01AB01 HEPARIN Heparin 100iu/mL USP Inj Heparin 100iu/mL Inj Heparin 1,000iu/mL Inj Heparin 10,000iu/mL Inj Heparin 25,000iu/mL Inj DALTEPARIN Fragmin 2,500iu [anti-Xa] 0.2/mL Syringe Inj Fragmin 5,000iu [anti-Xa] 0.2/mL Syringe Inj Fragmin 7,500iu [anti-Xa] 0.3/mL Syringe Inj Fragmin 10,000iu [anti-Xa] 0.4/mL Syringe Inj Fragmin 12,500iu [anti-Xa] 0.5/mL Syringe Inj Fragmin 15,000iu [anti-Xa] 0.6/mL Syringe Inj Fragmin 18,000iu [anti-Xa] 0.72/mL Syringe Inj Fragmin 10,000iu [anti-Xa]/mL Amp Inj Fragmin 25,000iu [anti-Xa]/mL Vial Inj ENOXAPARIN Lovenox 30mg/0.3mL Syringe Inj Lovenox 40mg/0.4mL Syringe Inj Lovenox 100mg/mL Vial Inj Lovenox 120mg/0.8mL Syringe Inj Lovenox HP 150mg/1.0mL Syringe Inj TINZAPARIN Innohep 2,500iu, 0.25mL Innohep 3,500iu, 0.35mL Innohep 4,500iu, 0.45mL Innohep 10,000iu, 0.5mL Innohep 14,000iu, 0.7mL Innohep 18,000iu, 0.9mL SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC 00725315 00727520 00453811 00579718 00453781 02132621 02132648 02352648 02352656 02352664 02352672 02352680 02132664 02231171 02012472 02236883 02236564 02242692 02378469 02229755 02358158 02358166 02231478 02358174 02358182 HOS LEO LEO LEO LEO PFI PFI PFI PFI PFI PFI PFI PFI PFI SAV SAV SAV SAV SAV LEO LEO LEO LEO LEO LEO

DNP DNP DNP DNP DNP

B01AB04

DNP DNP DNP DNP DNP DNP DNP DNP DNP

B01AB05

DNP DNP DNP DNP DNP

B01AB10

DNP DNP DNP DNP DNP DNP

B01AC PLATELET AGGREGATION INHIBITORS EXCLUDING HEPARIN B01AC04 CLOPIDOGREL clopidogrel 75mg tab Apo-Clopidogrel 75mg Tab CO Clopidogrel 75mg Tab MYLAN-Clopidogrel 75mg Tab pms-Clopidogrel 75mg Tab RAN-Clopidogrel 75mg Tab Sandoz Clopidogrel 75mg Tab Teva-Clopidogrel 75mg Tab Plavix 75mg Tab TICLOPIDINE ticlopidine 250mg tab Apo-Ticlopidine 250mg Tab MYLAN-Ticlopidine 250mg Tab Novo-Ticlopidine 250mg Tab Ticlopidine 250mg Tab Ticlid 250mg Tab (discontinued)

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E

02252767 02303027 02351536 02348004 02379813 02359316 02293161 02238682

APX COB MYL PMS RAN SDZ TEV BRI

B01AC05

DNP DNP DNP DNP

MRP MRP MRP MRP

E E E E

02237701 02239744 02236848 02343045

APX MYL TEV SAS

December 2012

Blood and Blood Forming Organs ­ 20

B01AC07

DIPYRIDAMOLE dipyridamole 25mg tab Apo-Dipyridamole-FC 25mg Tab Persantine 25mg Tab (discontinued) dipyridamole 50mg tab Apo-Dipyridamole-FC 50mg Tab Persantine 50mg Tab (discontinued) dipyridamole 50mg tab Apo-Dipyridamole-FC 75mg Tab Persantine 75mg Tab (discontinued)

DNP

MRP

SF

00895644

APX

DNP

MRP

SF

00895652

APX

DNP

MRP

SF

00895660

APX

B01AC21

TREPROSTINIL Remodulin 1mg/mL Inj Remodulin 2.5mg/mL Inj Remodulin 5mg/mL Inj Remodulin 10mg/mL Inj PRASUGREL Effient 10mg Tab TICAGRELOR Brilinta 90mg Tab E E

02246552 02246553 02246554 02246555 02349124 02368544 02242119

UTC UTC UTC UTC NVR AZE BOE

B01AC22 B01AC24 B01AC30

DNP

PLATELET AGGREGATION INHIBITORS, COMBINATIONS Aggrenox 200/25mg Cap DNP

B01AE DIRECT THROMBIN INHIBITORS B01AE07 DABIGATRAN ETEXILATE Pradax 75mg Cap Pradax 110mg Cap Pradax 150mg Cap 02312433 02312441 02358808 BOE BOE BOE

DNP DNP

E E

B01AX OTHER ANTITHROMBOTIC AGENTS B01AX05 B01AX06 FONDAPARINUX Arixtra 2.5mg/0.5mL Inj RIVAROXABAN Xarelto 10mg Tab Xarelto 15mg Tab Xarelto 20mg Tab E E E 02245531 02316986 02378604 02378612 GSK BAY BAY BAY

DNP DNP DNP

B02

ANTIHEMORRHAGICS

B02A ANTIFIBRINOLYTICS B02AA AMINO ACIDS B02AA02 TRANEXAMIC ACID tranexamic acid 100mg/mL inj Tranexamic Acid 100mg/mL Inj Cyklokapron 100mg/mL Inj Cyklokapron 500mg Tab B02B VITAMIN K AND OTHER HEMOSTATICS B02BA VITAMIN K B02BA01 PHYTONADIONE Vitamin K1 2mg/mL Inj Vitamin K1 10mg/mL Inj SF SF 00781878 00804312 SDZ SDZ

DNP

02246365 02064413 SF 02064405

SDZ PFI PFI

DNPM DNPM

B02BX04

ROMIPLOSTIM Nplate 250ug/0.5mL Inj Nplate 500ug/mL Inj

02322854 02322862

AGA AGA

December 2012

Blood and Blood Forming Organs ­ 21

B02BX05

ELTROMBOPAG Revolade 25mg Tab Revolade 50mg Tab

02361825 02361833

GSK GSK

B03

ANTIANEMIC PREPARATIONS

B03A IRON PREPARATIONS B03AA IRON BIVALENT, ORAL PREPARATIONS B03AA02 FERROUS FUMARATE Palafer 300mg Cap Palafer 300mg/5mL Susp FERROUS GLUCONATE ferrous gluconate 300mg tab APC-Ferrous Gluconate 300mg Tab Apo-Ferrous Gluconate 300mg Tab Novo-Ferrogluc 300mg Tab Novo-Ferrogluc 300mg Tab (discontinued) FERROUS SULFATE Ferodan Infant Drops 75mg/mL pms-Ferrous Sulfate 75mg/0.6mL Drops Ferodan 150mg/5mL Syrup Slow Fe 160mg Tab 01923420 01923439 GCH GCH

B03AA03

00545031 00545031 80000435 00021458 02237385 02222574 00758469 00623520

APX APX TEV TEV ODN PMS ODN NNC

B03AA07

B03AC IRON TRIVALENT, PARENTERAL PREPARATIONS B03AC01 DEXTRIFERRON (IRON DEXTRAN) DexIron 50mg/mL Inj Infufer 50mg/mL Inj SACCHARATED IRON OXIDE Venofer 20mg/mL Inj SFC SFC E 02205963 02221780 02243716 BHC SDZ BHC

DNP DNP

B03AC02

DNP

B03AD IRON IN COMBINATION WITH FOLIC ACID B03AD03 FERROUS SULFATE Slow-Fe Folic Tab 00795208 NNC

B03AE IRON IN OTHER COMBINATIONS B03AE02 B03AE04 IRON, MULTIVITAMINS AND FOLIC ACID Palafer CF Cap IRON, MULTIVITAMINS AND MINERALS PregVit Tab 01923455 02246067 GCH DUI

B03B VITAMIN B12 AND FOLIC ACID B03BA VITAMIN B12 (CYANOCOBALAMIN AND DERIVATIVES) B03BA01 CYANOCOBALAMIN cyanocobalamin 100mcg/mL inj Vitamin B12 100mcg/mL Inj Vitamin B12 100mcg/mL Inj (discontinued) Cyanocobalamin 1,000mcg/mL Inj Vitamin B12 1,000mcg/mL Inj Vitamin B12 250mcg Tab Vitamin B12 500mcg Tab Vitamin B12 1,000mcg Tab B03BA51 CYANOCOBALAMIN, COMBINATIONS Vitamin B12 1,000mcg Tab w Folic Acid

DNP

MRP

E E E SE SE SE

02241500 01987003 00521515 00502758 00689726 02237736 02243119

SDZ HOS CYI SDZ SWS SWS SWS SWS

DNP DNP DNP DNP

DNP

December 2012

Blood and Blood Forming Organs ­ 22

B03BB FOLIC ACID AND DERIVATIVES B03BB01 FOLIC ACID Folic Acid 5mg/mL Inj Folic Acid 1mg Tab Apo-Folic Acid 5mg Tab SFC SFC 00816086 02236747 00426849 SDZ WAM APX

DNPM DNPM

B03X OTHER ANTIANEMIC PREPARATIONS B03XA OTHER ANTIANEMIC PREPARATIONS B03XA01 ERYTHROPOIETIN Eprex 1,000iu/0.5mL Syringe Inj Eprex 2,000iu/0.5mL Syringe Inj Eprex 3,000iu/0.3mL Syringe Inj Eprex 4,000iu/0.4mL Syringe Inj Eprex 5,000iu/0.5mL Syringe Inj Eprex 6,000iu/0.6mL Syringe Inj Eprex 8,000iu/0.8mL Syringe Inj Eprex 10,000iu/mL Syringe Inj Eprex 20,000iu/0.5mL Syringe Inj Eprex 30,000iu/0.75mL Syringe Inj Eprex 40,000iu/mL Syringe Inj Eprex 20,000iu/mL Multidose vial (discontinued) DARBEPOETIN Aranesp 25mcg/mL Syringe Inj Aranesp 40mcg/mL Syringe Inj Aranesp 100mcg/mL Syringe Inj Aranesp 200mcg/mL Syringe Inj Aranesp 500mcg/mL Syringe Inj E E E E E E E E E E E 02231583 02231584 02231585 02231586 02243400 02243401 02243403 02231587 02243239 02288680 02240722 JAN JAN JAN JAN JAN JAN JAN JAN JAN JAN JAN

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

PRP PRP PRP PRP PRP PRP PRP PRP PRP PRP PRP

B03XA02

DNP DNP DNP DNP DNP

E E E E E

02246354 02246355 02246357 02246358 02246360

AGA AGA AGA AGA AGA

B05

BLOOD SUBSTITUTES AND PERFUSION SOLUTIONS

B05B I.V. SOLUTIONS B05BA SOLUTIONS FOR PARENTERAL NUTRITION B05BA03 CARBOHYDRATES Dextrose 50% Inj SF 00037974 HOS

DNPM

B05C IRRIGATING SOLUTIONS B05CA ANTIINFECTIVES B05CA10 ANTIINFECTIVES, COMBINATIONS Neosporin Irrigating Sol SF 00666157 GSK

DNP

B05CB SALT SOLUTIONS B05CB01 SODIUM CHLORIDE Sodium Chloride Irr Sol SF 00786160 BAX

DNP

B05X I.V. SOLUTION ADDITIVES B05XA ELECTROLYTE SOLUTIONS B05XA03 SODIUM CHLORIDE Sodium Chloride 9mg/mL Inj Sodium Chloride 146mg/mL Inj SFC SFC 00037796 00262005 HOS HOS

DNPM DNPM

December 2012

Blood and Blood Forming Organs ­ 23

December 2012

Blood and Blood Forming Organs ­ 24

C01

CARDIAC THERAPY

C01A CARDIAC GLYCOSIDES C01AA DIGITALIS GLYCOSIDES C01AA05 DIGOXIN digoxin 0.05mg/mL inj Digoxin 0.05mg/mL Inj Lanoxin 0.05mg/mL Inj (discontinued) digoxin 0.25mg/mL inj Digoxin 0.25mg/mL Inj Lanoxin 0.25mg/mL Inj (discontinued) Toloxin 0.05mg/mL Sol digoxin 0.0625mg tab Toloxin 0.0625mg Tab Lanoxin 0.0625mg Tab (discontinued) digoxin 0.125mg tab Toloxin 0.125mg Tab Lanoxin 0.125mg Tab (discontinued) digoxin 0.25mg tab Toloxin 0.25mg Tab Lanoxin 0.25mg Tab (discontinued) C01B ANTIARRHYTHMICS, CLASS I AND III C01BA ANTIARRHYTHMICS, CLASS IA C01BA02 PROCAINAMIDE procainamide 100mg/mL inj Procainamide 100mg/mL Inj Pronestyl 100mg/mL Inj (discontinued) Procan SR 250mg Tab Procan SR 500mg Tab Procan SR 750mg Tab C01BA03 DISOPYRAMIDE Rythmodan 100mg Cap (discontinued) Rythmodan 150mg Cap (discontinued) Rythmodan-LA 250mg Tab (discontinued)

DNP DNP DNP DNP

02048272

SDZ

02048264 SF SF 02242320 02335700

SDZ PDP PDP

DNP

DNP

SF

02335719

PDP

DNP

SF

02335727

PDP

02184486 SF SF SF 00638692 00638676 00638684

SDZ ERF ERF ERF

C01BB ANTIARRHYTHMICS, CLASS IB C01BB02 MEXILETINE mexiletine 100mg cap Novo-Mexiletine 100mg Cap Mexitil 100mg Cap (discontinued) mexiletine 200mg cap Novo-Mexiletine 200mg Cap Mexitil 200mg Cap (discontinued)

DNP

MRP

SF

02230359

TEV

DNP

MRP

SF

02230360

TEV

December 2012

Cardiovascular System ­ 25

C01BC ANTIARRHYTHMICS, CLASSIC C01BC03 PROPAFENONE propafenone 150mg tab Apo-Propafenone 150mg Tab MYLAN-Propafenone 150mg Tab pms-Propafenone 150mg Tab

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

Propafenone 150mg Tab

Rythmol 150mg Tab propafenone 300mg tab Apo-Propafenone 300mg Tab MYLAN-Propafenone 300mg Tab pms-Propafenone 300mg Tab Propafenone 300mg Tab Rythmol 300mg Tab C01BC04 FLECAINIDE flecainide 50mg tab Flecainide 50mg Tab Tambocor 50mg Tab flecainide 100mg tab Flecainide 100mg Tab Tambocor 100mg Tab C01BD ANTIARRHYTHMICS, CLASS III C01BD01 AMIODARONE amiodarone HCl 50mg/mL inj Amiodarone 50mg/mL Inj Cordarone 50mg/mL Inj (discontinued) pms-Amiodarone 100mg Tab amiodarone 200mg tab Amiodarone 200mg Tab Apo-Amiodarone 200mg Tab MYLAN-Amiodarone 200mg Tab phl-Amiodarone 200mg Tab pms-Amiodarone 200mg Tab Sandoz Amiodarone 200mg Tab Teva-Amiodarone 200mg Tab Cordarone 200mg Tab ratio-Amiodarone 200mg Tab (discontinued) C01BD02 BRETYLIUM TOSYLATE bretylium tosylate 50mg/mL inj Bretylium Tosylate 50mg/mL Inj Bretylate 50mg/mL Inj (discontinued) DRONEDARONE Multaq 400mg Tab

SF SF SF SF SF

02243324 02245372 02294559 02343053 00603708

APX MYL PMS SAS ABB

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

02243325 02245373 02294575 02343061 00603716

APX MYL PMS SAS ABB

DNP DNP

MRP MRP

SF SF

02275538 01966197

AAP GWP

DNP DNP

MRP MRP

SF SF

02275546 01966200

AAP GWP

02242325 SF SF SF SF SF SF SF SF SF 02292173 02364336 02246194 02240604 02245781 02242472 02243836 02239835 02036282

SDZ PMS SAS APX MYL PHL PMS SDZ TEV PFI

DNP

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

02185377

SDZ

C01BD07

02330989

SAV

December 2012

Cardiovascular System ­ 26

C01C CARDIAC STIMULANTS EXCLUDING CARDIAC GLYCOSIDES C01CA ADRENERGIC AND DOPAMINERGIC AGENTS C01CA03 NOREPINEPHRINE norepinephrine 1mg/mL inj Norepinephrine Bitartrate 1mg/mL Inj Levophed 1mg/mL Inj PHENYLEPHRINE phenylephrine 10mg/mL inj Phenylephrine 10mg/mL Inj Neo-Synephrine 10mg/mL Inj DOBUTAMINE dobutamine 12.5mg/mL inj Dobutamine 12.5mg/mL Inj Dobutrex 12.5mg/mL Inj (discontinued) MIDODRINE midodrine 2.5mg tab Midodrine 2.5mg Tab Amatine 2.5mg Tab (discontinued) midodrine 5mg tab Midodrine 5mg Tab Amatine 5mg Tab (discontinued) C01CA24 EPINEPHRINE Epinephrine 1:1000 Inj Epipen Jr. 1:2000 (0.15mg/dose) Inj Epipen 1:1000 (0.3mg/dose) Inj Twinject 0.15mg Auto-Injector Twinject 0.3mg Auto-Injector

00893285 02241981

SDZ HOS

C01CA06

DNP DNP

MRP MRP

SF SF

01953583 02241980

SDZ HOS

C01CA07

DNP

MRP

SF

02242010

SDZ

C01CA17

DNP

MRP

SF

02278677

AAP

DNP

MRP

SF

02278685

AAP

DNPM DNPM DNPM DNPM DNPM

SF SF5 SF5 SF5 SF5

00721891 00578657 00509558 02268205 02247310

HOS KNG KNG PAL PAL

C01D VASODILATORS USED IN CARDIAC DISEASES C01DA ORGANIC NITRATES C01DA02 NITROGLYCERIN (GLYCERYL TRINITRATE) Nitroglycerin 5mg/mL Inj Nitrol 2% Oint Minitran 0.2mg/hr Patch Nitro-Dur 0.2mg/hr Patch Transderm-Nitro 0.2mg/hr Patch Trinipatch 0.2mg/hr Patch Minitran 0.4mg/hr Patch Nitro-Dur 0.4mg/hr Patch Transderm-Nitro 0.4mg/hr Patch Trinipatch 0.4mg/hr Patch Minitran 0.6mg/hr Patch Nitro-Dur 0.6mg/hr Patch Transderm-Nitro 0.6mg/hr Patch Trinipatch 0.6mg/hr Patch Nitro-Dur 0.8mg/hr Patch nitroglycerin 0.4mg/dose pumpspray Rho-Nitro Pumpspray 0.4mg/dose Nitrolingual Pumpspray 0.4mg/dose MYLAN-Nitro 0.4mg/dose SL Spray Nitrostat 0.3mg Tab Nitrostat 0.6mg Tab SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF 00860778 01926454 02162806 01911910 00584223 02230732 02163527 01911902 00852384 02230733 02163535 01911929 02046156 02230734 02011271 02238998 02231441 02243588 00037613 00037621 SDZ PAL GWP SCH NVR PAL GWP SCH NVR PAL GWP SCH NVR PAL SCH SDZ SAV MYL PFI PFI

DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM

DNPM DNPM DNPM DNPM DNPM

MRP MRP

5

Epipen and Twinject have a quantity limit of two injections per fiscal year. The prescriber may submit a request to the Pharmacare office for consideration should beneficiaries require more than two injections per fiscal year.

Cardiovascular System ­ 27

December 2012

C01DA08

ISOSORBIDE DINITRATE isosorbide dinitrate 5mg SL tab ISDN 5mg Tab Isordil Sublingual 5mg Tab (discontinued) isosorbide dinitrate 10mg tab ISDN 10mg Tab Isordil 10mg Tab (discontinued) isosorbide dinitrate 30mg tab ISDN 30mg Tab Isordil 30mg Tab (discontinued)

DNP

MRP

SF

00670944

AAP

DNP

MRP

SF

00441686

AAP

DNP

MRP

SF

00441694

AAP

C01DA14

ISOSORBIDE MONONITRATE isosorbide mononitrate 60mg SR tab Apo-ISMN 60mg Tab pms-ISMN 60mg SR Tab Imdur 60mg ER Tab

DNP DNP DNP

MRP MRP MRP

SF SF SF

02272830 02301288 02126559

APX PMS AZE

C02

ANTIHYPERTENSIVES

C02A ANTIADRENERGIC AGENTS, CENTRALLY ACTING C02AB METHYLDOPA C02AB02 METHYLDOPA (RACEMIC) methyldopa 125mg tab Methyldopa 125mg Tab Aldomet 125mg Tab (discontinued) methyldopa 250mg tab Methyldopa 250mg Tab Aldomet 250mg Tab (discontinued) methyldopa 500mg tab Methyldopa 500mg Tab Aldomet 500mg Tab (discontinued) C02AC IMIDAZOLINE RECEPTOR AGONISTS C02AC01 CLONIDINE clonidine HCl 0.025mg tab Novo-Clonidine 0.025mg Tab Dixarit 0.025mg Tab Clonidine 0.025mg Tab (discontinued) clonidine HCl 0.1mg tab Novo-Clonidine 0.1mg Tab Catapres 0.1mg Tab Clonidine 0.1mg Tab (discontinued) clonidine HCl 0.2mg tab Novo-Clonidine 0.2mg Tab Catapres 0.2mg Tab Apo-Clonidine 0.2mg Tab (discontinued) Clonidine 0.2mg Tab (discontinued)

DNP

MRP

SF

00360252

AAP

DNP

MRP

SF

00360260

AAP

DNP

MRP

SF

00426830

AAP

DNP DNP

MRP MRP

SF SF

02304163 00519251

TEV BOE

DNP DNP

MRP MRP

SF SF

02046121 00259527

TEV BOE

DNP DNP

MRP MRP

SF SF

02046148 00291889

TEV BOE

December 2012

Cardiovascular System ­ 28

C02C ANTIADRENERGIC AGENTS, PERIPHERALLY ACTING C02CA ALPHA-ADRENOCEPTOR ANTAGONISTS C02CA01 PRAZOSIN prazosin HCl 1mg tab Apo-Prazo 1mg Tab Novo-Prazin 1mg Tab Minipres 1mg Tab (discontinued) prazosin HCl 2mg tab Apo-Prazo 2mg Tab Novo-Prazin 2mg Tab Minipres 2mg Tab (discontinued) prazosin HCl 5mg tab Apo-Prazo 5mg Tab Novo-Prazin 5mg Tab Minipres 5mg Tab (discontinued) C02CA04 DOXAZOSIN doxazosin 1mg tab Apo-Doxazosin 1mg Tab MYLAN-Doxazosin 1mg Tab Novo-Doxazosin 1mg Tab pms-Doxazosin 1mg Tab Cardura-1 1mg Tab doxazosin 2mg tab Apo-Doxazosin 2mg Tab MYLAN-Doxazosin 2mg Tab Novo-Doxazosin 2mg Tab pms-Doxazosin 2mg Tab Cardura-2 2mg Tab doxazosin 4mg tab Apo-Doxazosin 4mg Tab MYLAN-Doxazosin 4mg Tab Novo-Doxazosin 4mg Tab pms-Doxazosin 4mg Tab Cardura-4 4mg Tab C02D ARTERIOLAR SMOOTH MUSCLE, AGENTS ACTING ON C02DB HYDRAZINOPHTHALAZINE DERIVATIVES C02DB02 HYDRALAZINE Apresoline 20mg/mL Inj hydralazine HCl 10mg tab Apo-Hydralazine 10mg Tab Apresoline 10mg Tab (discontinued) hydralazine HCl 25mg tab Apo-Hydralazine 25mg Tab Apresoline 25mg Tab (discontinued) hydralazine HCl 50mg tab Apo-Hydralazine 50mg Tab Apresoline 50mg Tab (discontinued) SF SF 00723754 00441619 STR APX

DNP DNP

MRP MRP

SF SF

00882801 01934198

APX TEV

DNP DNP

MRP MRP

SF SF

00882828 01934201

APX TEV

DNP DNP

MRP MRP

SF SF

00882836 01934228

APX TEV

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

02240588 02240498 02242728 02244527 01958100

APX MYL TEV PMS PFI

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

02240589 02240499 02242729 02244528 01958097

APX MYL TEV PMS PFI

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

02240590 02240500 02242730 02244529 01958119

APX MYL TEV PMS PFI

DNP

DNP

MRP

DNP

MRP

SF

00441627

APX

DNP

MRP

SF

00441635

APX

December 2012

Cardiovascular System ­ 29

C02DC PYRIMIDINE DERIVATIVES C02DC01 MINOXIDIL Loniten 2.5mg Tab Loniten 10mg Tab SF SF 00514497 00514500 PFI PFI

DNP DNP

C02K OTHER ANTIHYPERTENSIVES C02KX OTHER ANTIHYPERTENSIVES C02KX01 BOSENTAN bosentan 62.5mg tab CO Bosentan 62.5mg Tab MYLAN-Bosentan 62.5mg Tab pms-Bosentan 62.5mg Tab Sandoz Bosentan 62.5mg Tab Tracleer 62.5mg Tab bosentan 125mg tab CO Bosentan 125mg Tab MYLAN-Bosentan 125mg Tab pms-Bosentan 125mg Tab Sandoz Bosentan 125mg Tab Tracleer 125mg Tab C02KX02 AMBRISENTAN Volibris 5mg Tab Volibris 10mg Tab

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

E E E E E

02386194 02383497 02383012 02386275 02244981

COB MYL PMS SDZ ACT

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

E E E E E E E

02386208 02383500 02383020 02386283 02244982 02307065 02307073

COB MYL PMS SDZ ACT GSK GSK

DNP DNP

C03

DIURETICS

C03A LOW-CEILING DIURETICS, THIAZIDES C03AA THIAZIDES, PLAIN C03AA03 HYDROCHLOROTHIAZIDE hydrochlorothiazide 12.5mg tab Apo-Hydro 12.5mg Tab pms-Hydrochlorothiazide 12.5mg Tab hydrochlorothiazide 25mg tab Apo-Hydro 25mg Tab Hydrochlorothiazide 25mg Tab pms-Hydrochlorothiazide 25mg Tab Teva-Hydrochlorothiazide 25mg Tab Hydrodiuril 25mg Tab (discontinued) hydrochlorothiazide 50mg tab Apo-Hydro 50mg Tab Hydrochlorothiazide 50mg Tab Novo-Hydrazide 50mg Tab pms-Hydrochlorothiazide 50mg Tab Hydrodiuril 50mg Tab (discontinued) hydrochlorothiazide 100mg tab Apo-Hydro 100mg Tab Hydrodiuril 100mg Tab (discontinued) C03B LOW-CEILING DIURETICS, EXCLUDING THIAZIDES C03BA SULFONAMIDES, PLAIN C03BA04 CHLORTHALIDONE Chlorthalidone 50mg Tab SF 00360279 AAP

DNP DNP

MRP MRP

SF SF

02327856 02274086

APX PMS

DNP DNP DNP DNP

MRP MRP MRP MRP

SF SF SF SF

00326844 02360594 02247386 00021474

APX SAS PMS TEV

DNP DNP DNP DNP

MRP MRP MRP MRP

SF SF SF SF

00312800 02360608 00021482 02247387

APX SAS TEV PMS

DNP

MRP

SF

00644552

APX

DNP

December 2012

Cardiovascular System ­ 30

C03BA08 C03BA11

METOLAZONE Zaroxolyn 2.5mg Tab INDAPAMIDE indapamide 1.25mg tab Apo-Indapamide 1.25mg Tab Jamp-Indapamide 1.25mg Tab MYLAN-Indapamide 1.25mg Tab pms-Indapamide 1.25mg Tab Lozide 1.25mg Tab indapamide 2.5mg tab Apo-Indapamide 2.5mg Tab Jamp-Indapamide 2.5mg Tab MYLAN-Indapamide 2.5mg Tab Novo-Indapamide 2.5mg Tab pms-Indapamide 2.5mg Tab Lozide 2.5mg Tab

DNP

SF

00888400

SAV

02245246 02373904 02240067 02239619 02179709

APX JPC MYL PMS SEV

02223678 02373912 02153483 02231184 02239620 00564966

APX JPC MYL TEV PMS SEV

C03C HIGH-CELING DIURETICS C03CA SULFONAMIDES, PLAIN C03CA01 FUROSEMIDE Furosemide 10mg/mL Inj Lasix 10mg/mL Sol furosemide 20mg tab Apo-Furosemide 20mg Tab Furosemide 20mg Tab Novo-Semide 20mg Tab Lasix 20mg Tab (discontinued) furosemide 40mg tab Apo-Furosemide 40mg Tab Furosemide 40mg Tab Novo-Semide 40mg Tab Lasix 40mg Tab (discontinued) furosemide 80mg tab Apo-Furosemide 80mg Tab Furosemide 80mg Tab Novo-Semide 80mg Tab Lasix 80mg Tab (discontinued) Lasix Special 500mg Tab C03CA02 BUMETANIDE Burinex 1mg Tab Burinex 5mg Tab SF SF SF SF SF 00527033 02224720 00396788 02351420 00337730 SDZ SAV APX SAS TEV

DNP DNP

DNP DNP DNP

MRP MRP MRP

DNP DNP DNP

MRP MRP MRP

SF SF SF

00362166 02351439 00337749

APX SAS TEV

DNP DNP DNP

MRP MRP MRP

SF SF SF SF SF SF

00707570 02351447 00765953 02224755 00728284 00728276

APX SAS TEV SAV LEO LEO

DNP

DNP DNP

C03CC ARYLOXYACETIC ACID DERIVATIVES C03CC01 ETACRYNIC ACID Edecrin 25mg Tab C03D POTASSIUM-SPARING AGENTS C03DA ALDOSTERONE ANTAGONISTS C03DA01 SPIRONOLACTONE spironolactone 25mg tab Novo-Spiroton 25mg Tab Aldactone 25mg Tab spironolactone 100mg tab Novo-Spiroton 100mg Tab Aldactone 100mg Tab

DNP

SF

02258528

VAL

DNP DNP

MRP MRP

SF SF

00613215 00028606

TEV PFI

DNP DNP

MRP MRP

SF SF

00613223 00285455

TEV PFI

December 2012

Cardiovascular System ­ 31

C03DA04

EPLERENONE Inspra 25mg Tab Inspra 50mg Tab

02323052 02323060

PFI PFI

C03DB OTHER POTASSIUM-SPARING AGENTS C03DB01 AMILORIDE amiloride 5mg tab Midamor 5mg Tab Midamor 5mg Tab (discontinued)

DNP

MRP

SF

02249510 00487805

AAP ORB

C03E DIURETICS AND POTASSIUM-SPARING AGENTS IN COMBINATION C03EA LOW-CEILING DIURETICS AND POTASSIUM-SPARING AGENTS C03EA01 HYDROCHLOROTHIAZIDE AND POTASSIUM-SPARING AGENTS hydrochlorothiazide 50mg & amiloride HCl 5mg tab DNP MRP Apo-Amilzide 5-50 Tab DNP MRP Novamilor 5/50 Tab Moduret 5/50 Tab (discontinued) MYLAN-Amilazide 5/50 Tab (discontinued) hydrochlorothiazide 25mg & spironolactone 25mg tab Novo-Spirozine 25mg Tab DNP DNP Aldactazide 25mg Tab hydrochlorothiazide 50mg & spironolactone 50mg tab Novo-Spirozine 50mg Tab DNP Aldactazide 50mg Tab DNP hydrochlorothiazide 25mg & triamterene 50mg tab Apo-Triazide 50-25 Tab DNP Novo-Triamzide 50/25 Tab DNP Dyazide 50/25 Tab (discontinued)

SF SF

00784400 01937219

APX TEV

MRP MRP

SF SF

00613231 00180408

TEV PFI

MRP MRP

SF SF

00657182 00594377

TEV PFI

MRP MRP

SF SF

00441775 00532657

APX TEV

C04

PERIPHERAL VASODILATORS

C04A PERIPHERAL VASODILATORS C04AB IMIDAZOLINE DERIVATIVES C04AB01 PHENTOLAMINE Phentolamine Mesylate 5mg/mL Inj 02243737 SDZ

C04AD PURINE DERIVATIVES C04AD03 PENTOXIFYLLINE pentoxifylline 400mg tab Apo-Pentoxifylline SR 400mg Tab Trental 400mg Tab

DNP DNP

MRP MRP

E E

02230090 02221977

APX SAV

C04AE ERGOT ALKALOIDS C04AE01 ERGOLOID MESYLATES Hydergine 1mg Tab 00176176 STR

December 2012

Cardiovascular System ­ 32

C05

VASOPROTECTIVES

C05A AGENTS FOR TREATMENT OF HEMORRHOIDS AND ANAL FISSURES FOR TOPICAL USE C05AA CORTICOSTEROIDS C05AA01 HYDROCORTISONE hydrocortisone 0.5% oint Anodan-HC Oint Sandoz Anuzinc HC Oint Anusol-HC Oint hydrocortisone 10mg supp Anodan-HC Supp Sandoz Anuzinc HC Supp Anusol-HC Supp ratio-Hemcort HC Oint ratio-Hemcort HC Supp Proctofoam HC Aer

DNPM DNPM DNPM

MRP MRP MRP

SF SF SF

02128446 02247691 00505773

ODN SDZ JNJ

DNPM DNPM DNPM DNPM DNPM DNPM

MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF

02236399 02242798 00476285 00607789 00607797 00363014 02247322 02226383 02242527 02223252

ODN SDZ JNJ TEV TEV DUI ODN TEV SDZ AXC

hydrocortisone, framycetin sulfate & cinchocaine HCl oint DNPM Proctol Oint ratio-Proctosone Oint DNPM DNPM Sandoz Proctomyxin HC Oint Proctosedyl Oint DNPM

MRP MRP MRP MRP

hydrocortisone, framycetin sulfate & cinchocaine HCl supp Proctol Supp DNPM MRP DNPM MRP ratio-Proctosone Supp Sandoz Proctomyxin HC Supp DNPM MRP DNPM MRP Proctosedyl Supp hydrocortisone, pramoxine oint Proctodan-HC Oint Anugesic-HC Oint Sandoz Anuzinc HC Plus Oint (discontinued) hydrocortisone, pramoxine supp Proctodan-HC Supp Sandoz Anuzinc HC Plus Supp Anugesic-HC Supp C05B ANTIVARICOSE THERAPY C05BA HEPARINS OR HEPARINOIDS FOR TOPICAL USE C05BA04 PENTOSAN POLYSULFATE SODIUM Elmiron 100mg Cap

SF SF SF SF

02247882 02226391 02242528 02223260

ODN TEV SDZ AXC

DNPM DNPM

MRP MRP

SF SF

02234466 00505781

ODN JNJ

DNPM DNPM DNPM

MRP MRP MRP

SF SF SF

02240851 02242797 00476242

ODN SDZ JNJ

DNP

SF

02029448

JAN

C07

BETA BLOCKING AGENTS

C07A BETA BLOCKING AGENTS C07AA BETA BLOCKING AGENTS, NON-SELECTIVE C07AA03 PINDOLOL pindolol 5mg tab Apo-Pindol 5mg Tab Novo-Pindol 5mg Tab pms-Pindolol 5mg Tab Sandoz Pindolol 5mg Tab Visken 5mg Tab pindolol 10mg tab Apo-Pindol 10mg Tab Novo-Pindol 10mg Tab pms-Pindolol 10mg Tab Sandoz Pindolol 10mg Tab Visken 10mg Tab

December 2012

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

00755877 00869007 02231536 02261782 00417270

APX TEV PMS SDZ NVR

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

00755885 00869015 02231537 02261790 00443174

APX TEV PMS SDZ NVR

Cardiovascular System ­ 33

pindolol 15mg tab Apo-Pindol 15mg Tab Novo-Pindol 15mg Tab pms-Pindolol 15mg Tab Sandoz Pindolol 15mg Tab Visken 15mg Tab C07AA05 PROPRANOLOL Inderal-LA 60mg Cap Inderal-LA 80mg Cap Inderal-LA 120mg Cap Inderal-LA 160mg Cap Propranolol HCL 1mg/mL Inj propranolol 10mg tab Apo-Propranolol 10mg Tab Novo-Pranol 10mg Tab Inderal 10mg Tab (discontinued) propranolol 20mg tab Apo-Propranolol 20mg Tab Novo-Pranol 20mg Tab Inderal 20mg Tab (discontinued) propranolol 40mg tab Apo-Propranolol 40mg Tab Novo-Pranol 40mg Tab Inderal 40mg Tab (discontinued) propranolol 80mg tab Apo-Propranolol 80mg Tab Novo-Pranol 80mg Tab Inderal 80mg Tab (discontinued) propranolol 120mg tab Apo-Propranolol 120mg Tab Inderal 120mg Tab (discontinued) C07AA06 TIMOLOL timolol maleate 5mg tab Apo-Timol 5mg Tab Novo-Timol 5mg Tab Blocadren 5mg Tab (discontinued) timolol maleate 10mg tab Apo-Timol 10mg Tab Novo-Timol 10mg Tab Blocadren 10mg Tab (discontinued) timolol maleate 20mg tab Apo-Timol 20mg Tab Novo-Timol 20mg Tab Blocadren 20mg Tab (discontinued)

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF

00755893 00869023 02231539 02261804 00417289 02042231 02042258 02042266 02042274 02225883 00402788 00496480

APX TEV PMS SDZ NVR PFI PFI PFI PFI SDZ APX TEV

DNP DNP DNP DNP

DNP DNP

MRP MRP

SF SF

DNP DNP

MRP MRP

SF SF

00663719 00740675

APX TEV

DNP DNP

MRP MRP

SF SF

00402753 00496499

APX TEV

DNP DNP

MRP MRP

SF SF

00402761 00496502

APX TEV

DNP

MRP

SF

00504335

APX

DNP DNP

MRP MRP

SF SF

00755842 01947796

APX TEV

DNP DNP

MRP MRP

SF SF

00755850 01947818

APX TEV

DNP DNP

MRP MRP

SF SF

00755869 01947826

APX TEV

December 2012

Cardiovascular System ­ 34

C07AA07

SOTALOL sotalol 80mg tab Apo-Sotalol 80mg Tab CO Sotalol 80mg Tab Jamp-Sotalol 80mg Tab MYLAN-Sotalol 80mg Tab Novo-Sotalol 80mg Tab pms-Sotalol 80mg Tab ratio-Sotalol 80mg Tab Sandoz Sotalol 80mg Tab Sotacor 80mg Tab (discontinued) sotalol 160mg tab Apo-Sotalol 160mg Tab CO Sotalol 160mg Tab Jamp-Sotalol 160mg Tab MYLAN-Sotalol 160mg Tab Novo-Sotalol 160mg Tab pms-Sotalol 160mg Tab ratio-Sotalol 160mg Tab Sandoz Sotalol 160mg Tab Sotacor 160mg Tab (discontinued)

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF

02210428 02270625 02368617 02229778 02231181 02238326 02084228 02257831

APX COB JPC MYL TEV PMS TEV SDZ

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF

02167794 02270633 02368625 02229779 02231182 02238327 02084236 02257858

APX COB JPC MYL TEV PMS TEV SDZ

C07AA12

NADOLOL nadolol 40mg tab Apo-Nadol 40mg Tab Novo-Nadolol 40mg Tab Corgard 40mg Tab (discontinued) nadolol 80mg tab Apo-Nadol 80mg Tab Novo-Nadolol 80mg Tab Corgard 80mg Tab (discontinued) nadolol 160mg tab Apo-Nadol 160mg Tab Corgard 160mg Tab (discontinued)

DNP DNP

MRP MRP

SF SF

00782505 02126753

APX TEV

DNP DNP

MRP MRP

SF SF

00782467 02126761

APX TEV

DNP

MRP

SF

00782475

APX

C07AB BETA BLOCKING AGENTS, SELECTIVE C07AB02 METOPROLOL Apo-Metoprolol 25mg Tab MYLAN-Metoprolol (Type L) 25mg Tab pms-Metoprolol-L 25mg Tab metoprolol tartrate 50mg tab Apo-Metoprolol 50mg Tab Apo-Metoprolol-L 50mg Tab Jamp-Metoprolol-L 50mg Tab Metoprolol Film-Coated 50mg Tab MYLAN-Metoprolol (Type L) 50mg Tab pms-Metoprolol-L 50mg Tab Sandoz Metoprolol (Type L) 50mg Tab Teva-Metoprol 50mg Tab (pink) Lopresor 50mg Tab Betaloc 50mg Tab (discontinued) Sandoz Metoprolol (Type L) 50mg Tab (discontinued) Teva-Metoprol 50mg Tab (white) SF SF SF SF SF SF SF SF SF SF SF SF 02246010 02302055 02248855 00618632 00749354 0235682 1 02350394 02174545 02230803 02354187 00648035 00397423 APX MYL PMS APX APX JPC SAS MYL PMS SDZ TEV NVR

DNP DNP DNP

DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP

DNP

SF

00842648

TEV

December 2012

Cardiovascular System ­ 35

metoprolol tartrate 100mg tab Apo-Metoprolol 100mg Tab DNP DNP Apo-Metoprolol-L 100mg Tab Jamp-Metoprolol-L 100mg Tab DNP DNP Metoprolol Film-Coated 100mg Tab MYLAN-Metoprolol (Type L) 100mg Tab DNP DNP pms-Metoprolol-L 100mg Tab Sandoz Metoprolol (Type L) 100mg Tab DNP DNP Teva-Metoprol 100mg Tab (blue) Lopresor 100mg Tab DNP Betaloc 100mg Tab (discontinued) Sandoz Metoprolol (Type L) 100mg Tab (discontinued) metoprolol tartrate 100mg SR tab Apo-Metoprolol SR 100mg Tab Sandoz Metoprolol SR 100mg Tab Lopresor SR 100mg Tab metoprolol tartrate 200mg SR tab Apo-Metoprolol SR 200mg Tab Sandoz Metoprolol SR 200mg Tab Lopresor SR 200mg Tab Novo-Metoprol 100mg Tab (white) Betaloc Durules 200mg Tab (discontinued) C07AB03 ATENOLOL atenolol 25mg tab phl-Atenolol 25mg Tab pms-Atenolol 25mg Tab MINT-Atenolol 25mg Tab MYLAN-Atenolol 25mg Tab Teva-Atenolol 25mg Tab atenolol 50mg tab Apo-Atenol 50mg Tab CO Atenolol 50mg Tab Jamp-Atenolol 50mg Tab Mar-Antenolol 50mg Tab MINT-Atenol 50mg Tab MYLAN-Atenolol 50mg Tab phl-Atenolol 50mg Tab pms-Atenolol 50mg Tab RAN-Atenolol 50mg Tab ratio-Atenolol 50mg Tab Sandoz Atenolol 50mg Tab Septa-Atenolol 50mg Tab Tenormin 50mg Tab Teva-Atenolol 50mg Tab (discontinued) atenolol 100mg tab Apo-Atenol 100mg Tab CO Atenolol 100mg Tab Jamp-Atenolol 100mg Tab Mar-Atenolol 100mg Tab MINT-Atenol 100mg Tab MYLAN-Atenolol 100mg Tab phl-Atenolol 100mg Tab pms-Atenolol 100mg Tab RAN-Atenolol 100mg Tab ratio-Atenolol 100mg Tab Sandoz Atenolol 100mg Tab Septa-Atenolol 100mg Tab Teva-Atenolol 100mg Tab Tenormin 100mg Tab

MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF

00618640 00751170 02356848 02350408 02174553 02230804 02354195 00648043 00397431

APX APX JPC SAS MYL PMS SDZ TEV NVR

DNP DNP DNP

MRP MRP MRP

SF SF SF

02285169 02303396 00658855

APX SDZ NVR

DNP DNP DNP DNP

MRP MRP MRP

SF SF SF SF

02285177 02303418 00534560 00842656

APX SDZ NVR TEV

DNP DNP DNP DNP DNP

MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF

02247182 02246581 02368013 02303647 02266660 00773689 02255545 02367564 02371987 02368021 02146894 02238316 02237600 02267985 02171791 02231731 02368641 02039532

PHL PMS MNT MYL TEV APX COB JPC MAR MNT MYL PHL PMS RAN TEV SDZ SPT AZE

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF SF

00773697 02255553 02367572 02371995 02368048 02147432 02238318 02237601 02267993 02171805 02231733 02368668 01912054 02039540

APX COB JPC MAR MNT MYL PHL PMS RAN TEV SDZ SPT TEV AZE

December 2012

Cardiovascular System ­ 36

C07AB04

ACEBUTOLOL acebutolol HCl 100mg tab Acebutolol 100mg Tab Apo-Acebutolol 100mg Tab MYLAN-Acebutolol 100mg Tab MYLAN-Acebutolol (Type S) 100mg Tab Novo-Acebutolol 100mg Tab Sectral 100mg Tab Monitan 100mg Tab (discontinued) acebutolol HCl 200mg tab Acebutolol 200mg Tab Apo-Acebutolol 200mg Tab MYLAN-Acebutolol 200mg Tab MYLAN-Acebutolol (Type S) 200mg Tab Novo-Acebutolol 200mg Tab Sectral 200mg Tab Monitan 200mg Tab (discontinued) acebutolol HCl 400mg tab Acebutolol 400mg Tab Apo-Acebutolol 400mg Tab MYLAN-Acebutolol 400mg Tab MYLAN-Acebutolol (Type S) 400mg Tab Novo-Acebutolol 400mg Tab Sectral 400mg Tab Monitan 400mg Tab (discontinued) Rhotral 400mg Tab (discontinued)

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02286246 02147602 02237721 02237885 02204517 01926543

SAS APX MYL MYL TEV SAV

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02286254 02147610 02237722 02237886 02204525 01926551

SAS APX MYL MYL TEV SAV

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02286262 02147629 02237723 02237887 02204533 01926578

SAS APX MYL MYL TEV SAV

C07AB07

BISOPROLOL bisoprolol 5mg tab Apo-Bisoprolol 5mg Tab MYLAN-Bisoprolol 5mg Tab Novo-Bisoprolol 5mg Tab pms-Bisoprolol 5mg Tab Sandoz Bisoprolol 5mg Tab Monocor 5mg Tab (discontinued) bisoprolol 10mg tab Apo-Bisoprolol 10mg Tab MYLAN-Bisoprolol 10mg Tab Novo-Bisoprolol 10mg Tab pms-Bisoprolol 10mg Tab Sandoz Bisoprolol 10mg Tab Monocor 10mg Tab (discontinued)

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

02256134 02384418 02267470 02302632 02247439

APX MYL TEV PMS SDZ

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

02256177 02384426 02267489 02302640 02247440

APX MYL TEV PMS SDZ

C07AG ALPHA AND BETA BLOCKING AGENTS C07AG01 LABETALOL labetalol 5mg/mL inj Labetalol 5mg/mL Inj Trandate 5mg/mL Inj (discontinued) Trandate 100mg Tab Trandate 200mg Tab

DNP DNP

02231689 SF SF 02106272 02106280

SDZ PAL PAL

December 2012

Cardiovascular System ­ 37

C07AG02

CARVEDILOL carvedilol 3.125mg tab Apo-Carvedilol 3.125mg Tab Carvedilol 3.125mg Tab Jamp-Carvedilol 3.125mg Tab MYLAN-Carvedilol 3.125mg Tab phl-Carvedilol 3.125mg Tab pms-Carvedilol 3.125mg Tab RAN-Carvedilol 3.125mg Tab ratio-Carvedilol 3.125mg Tab Zym-Carvedilol 3.125mg Tab Coreg 3.125mg Tab (discontinued) carvedilol 6.25mg tab Apo-Carvedilol 6.25mg Tab Carvedilol 6.25mg Tab Jamp-Carvedilol 6.25mg Tab MYLAN-Carvedilol 6.25mg Tab phl-Carvedilol 6.25mg Tab pms-Carvedilol 6.25mg Tab RAN-Carvedilol 6.25mg Tab ratio-Carvedilol 6.25mg Tab Zym-Carvedilol 6.25mg Tab Coreg 6.25mg Tab (discontinued) carvedilol 12.5mg tab Apo-Carvedilol 12.5mg Tab Carvedilol 12.5mg Tab Jamp-Carvedilol 12.5mg Tab MYLAN-Carvedilol 12.5mg Tab phl-Carvedilol 12.5mg Tab pms-Carvedilol 12.5mg Tab RAN-Carvedilol 12.5mg Tab ratio-Carvedilol 12.5mg Tab Zym-Carvedilol 12.5mg Tab Coreg 12.5mg Tab (discontinued) carvedilol 25mg tab Apo-Carvedilol 25mg Tab Carvedilol 25mg Tab Jamp-Carvedilol 25mg Tab MYLAN-Carvedilol 25mg Tab phl-Carvedilol 25mg Tab pms-Carvedilol 25mg Tab RAN-Carvedilol 25mg Tab ratio-Carvedilol 25mg Tab Zym-Carvedilol 25mg Tab Coreg 25mg Tab (discontinued)

DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E E

02247933 02364913 02368897 02347512 02248752 02245914 02268027 02252309 02338068

APX SAS JPC MYL PHL PMS RAN TEV ZYM

DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E E

02247934 02364921 02368900 02347520 02248753 02245915 02268035 02252317 02338092

APX SAS JPC MYL PHL PMS RAN TEV ZYM

DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E E

02247935 02364948 02368919 02347555 02248754 02245916 02268043 02252325 02338106

APX SAS JPC MYL PHL PMS RAN TEV ZYM

DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E E

02247936 02364956 02368927 02347571 02248755 02245917 02268051 02252333 02338114

APX SAS JPC MYL PHL PMS RAN TEV ZYM

C07C BETA BLOCKING AGENTS AND OTHER DIURETICS C07CA BETA BLOCKING AGENTS, NON-SELECTIVE, AND OTHER DIURETICS C07CA03 PINDOLOL AND OTHER DIURETICS Viskazide 10/25 Tab Viskazide 10/50 Tab SF SF 00568627 00568635 NVR NVR

DNP DNP

C07CB BETA BLOCKING AGENTS, SELECTIVE, AND OTHER DIURETICS C07CB03 ATENOLOL AND OTHER DIURETICS atenolol 50mg & chlorthalidone 25mg tab Apo-Atenidone 50/25 Tab Teva-Atenolol/Chlorthalidone 50/25 Tab Tenoretic 50/25 Tab

DNP DNP DNP

MRP MRP MRP

SF SF SF

02248763 02302918 02049961

APX TEV AZE

December 2012

Cardiovascular System ­ 38

atenolol 100mg & chlorthalidone 25mg tab Apo-Atenidone 100/25 Tab Teva-Atenolol/Chlorthalidone 100/25 Tab Tenoretic 100/25 Tab

DNP DNP DNP

MRP MRP MRP

SF SF SF

02248764 02302926 02049988

APX TEV AZE

C08

CALCIUM CHANNEL BLOCKERS

C08C SELECTIVE CALCIUM CHANNEL BLOCKERS WITH MAINLY VASCULAR EFFECTS C08CA DIHYDROPYRIDINE DERIVATIVES C08CA01 AMLODIPINE pms-Amlodipine 2.5mg Tab amlodipine 5mg tab Amlodipine 5mg Tab Amlodipine-ODAN 5mg Tab Apo-Amlodipine 5mg Tab CO Amlodipine 5mg Tab GD-Amlodipine 5mg Tab Jamp-Amlodipine 5mg Tab Jamp-Amlodipine 5mg Tab Mar-Amlodipine 5mg Tab MINT-Amlodipine 5mg Tab MYLAN-Amlodipine 5mg Tab phl-Amlodipine 5mg Tab pms-Amlodipine 5mg Tab RAN-Amlodipine 5mg Tab ratio-Amlodipine 5mg Tab Sandoz Amlodipine 5mg Tab Septa-Amlodipine 5mg Tab Teva-Amlodipine 5mg Tab Norvasc 5mg Tab amlodipine 10mg tab Amlodipine 10mg Tab Amlodipine-ODAN 10mg Tab Apo-Amlodipine 10mg Tab CO Amlodipine 10mg Tab GD-Amlodipine 10mg Tab Jamp-Amlodipine 10mg Tab Jamp-Amlodipine 10mg Tab Mar-Amlodipine 10mg Tab MINT-Amlodipine 10mg Tab MYLAN-Amlodipine 10mg Tab phl-Amlodipine 10mg Tab pms-Amlodipine 10mg Tab RAN-Amlodipine 10mg Tab ratio-Amlodipine 10mg Tab Sandoz Amlodipine 10mg Tab Septa-Amlodipine 10mg Tab Teva-Amlodipine 10mg Tab Norvasc 10mg Tab C08CA02 FELODIPINE felodipine 5mg tab Sandoz Felodipine 5mg Tab Plendil 5mg Tab felodipine 5mg tab Sandoz Felodipine 5mg Tab Renedil 5mg Tab felodipine 10mg tab Sandoz Felodipine 10mg Tab Plendil 10mg Tab SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF 02295148 02331284 02378760 02273373 02297485 02280132 02331071 02357194 02371715 02362651 02272113 02326779 02284065 02321858 02259605 02284383 02357712 02250497 00878928 PMS SAS ODN APX COB GMD JPC JPC MAR MNT MYL PHL PMS RAN TEV SDZ SPT TEV PFI

DNP

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF

02331292 02378779 02273381 02297493 02280140 02331098 02357208 02371723 02362678 02272121 02326787 02284073 02321866 02259613 02284391 02357720 02250500 00878936

SAS ODN APX COB GMD JPC JPC MAR MNT MYL PHL PMS RAN TEV SDZ SPT TEV PFI

DNP DNP

MRP MRP

SF SF

02280264 00851779

SDZ AZE

DNP DNP

MRP MRP

SF SF

02280264 02221993

SDZ SAV

DNP DNP

MRP MRP

SF SF

02280272 00851787

SDZ AZE

December 2012

Cardiovascular System ­ 39

felodipine 10mg tab Sandoz Felodipine 10mg Tab Renedil 10mg Tab Plendil 2.5mg ER Tab Renedil 2.5mg ER Tab C08CA05 NIFEDIPINE nifedipine 5mg cap Nifedipine 5mg Cap Adalat 5mg Cap (discontinued) nifedipine 10mg cap Nifedipine 10mg Cap Adalat 10mg Cap (discontinued) Adalat XL 20mg Tab nifedipine 30mg ER tab MYLAN-Nifedipine ER 30mg Tab Adalat XL 30mg Tab nifedipine 60mg ER tab MYLAN-Nifedipine ER 60mg Tab Adalat XL 60mg Tab C08CA06 C08CA55 NIMODIPINE Nimotop 30mg Tab NIFEDIPINE, COMBINATIONS Adalat XL Plus 81mg & 20mg Tab Kit Adalat XL Plus 81mg & 30mg Tab Kit Adalat XL Plus 81mg & 60mg Tab Kit

DNP DNP DNP DNP

MRP MRP

SF SF SF SF

02280272 02222000 02057778 02221985

SDZ SAV AZE SAV

DNP

MRP

SF

00725110

AAP

DNP

MRP

SF SF SF SF

00755907 02237618 02349167 02155907

AAP BAY MYL BAY

DNP

DNP DNP

MRP MRP

DNP DNP

MRP MRP

SF SF SF

02321149 02155990 02325926 02313766 02313774 02313782

MYL BAY BAY BAY BAY BAY

DNP

C08D SELECTIVE CALCIUM CHANNEL BLOCKERS WITH DIRECT CARDIAC EFFECTS C08DA PHENYLALKYLAMINE DERIVATIVES C08DA01 VERAPAMIL verapamil 2.5mg/mL inj Verapamil 2.5mg/mL Inj Isoptin IV 2.5mg/mL Inj (discontinued) verapamil HCl 80mg tab Apo-Verap 80mg Tab MYLAN-Verapamil 80mg Tab Isoptin 80mg Tab (discontinued) verapamil HCl 120mg tab Apo-Verap 120mg Tab MYLAN-Verapamil 120mg Tab Isoptin 120mg Tab (discontinued) verapamil 120mg SR tab Apo-Verap SR 120mg Tab MYLAN-Verapamil SR 120mg Tab Isoptin SR 120mg Tab verapamil 180mg SR tab Apo-Verap SR 180mg Tab MYLAN-Verapamil SR 180mg Tab Isoptin SR 180mg Tab

02166739

SDZ

DNP DNP

MRP MRP

SF SF

00782483 02237921

APX MYL

DNP DNP

MRP MRP

SF SF

00782491 02237922

APX MYL

02246893 02210347 01907123

APX MYL ABB

DNP DNP DNP

MRP MRP MRP

SF SF SF

02246894 02210355 01934317

APX MYL ABB

December 2012

Cardiovascular System ­ 40

verapamil 240mg SR tab Apo-Verap SR 240mg Tab MYLAN-Verapamil SR 240mg Tab Novo-Veramil SR 240mg Tab pms-Verapamil SR 240mg Tab Isoptin SR 240mg Tab C08DB BENZOTHIAZEPINE DERIVATIVES C08DB01 DILTIAZEM diltiazem 120mg CD cap Apo-Diltiaz CD 120mg Cap CO Diltiazem CD 120mg Cap Novo-Diltazem CD 120mg Cap pms-Diltiazem CD 120mg Cap Sandoz Diltiazem CD 120mg Cap Cardizem CD 120mg Cap ratio-Diltiazem CD 120mg Cap (discontinued) diltiazem 180mg CD cap Apo-Diltiaz CD 180mg Cap CO Diltiazem CD 180mg Cap Novo-Diltazem CD 180mg Cap pms-Diltiazem CD 180mg Cap Sandoz Diltiazem CD 180mg Cap Cardizem CD 180mg Cap ratio-Diltiazem CD 180mg Cap (discontinued) diltiazem 240mg CD cap Apo-Diltiaz CD 240mg Cap CO Diltiazem CD 240mg Cap Novo-Diltazem CD 240mg Cap pms-Diltiazem CD 240mg Cap Sandoz Diltiazem CD 240mg Cap Cardizem CD 240mg Cap ratio-Diltiazem CD 240mg Cap (discontinued) diltiazem 300mg CD cap Apo-Diltiaz CD 300mg Cap CO Diltiazem CD 300mg Cap Novo-Diltazem CD 300mg Cap pms-Diltiazem CD 300mg Cap Sandoz Diltiazem CD 300mg Cap Cardizem CD 300mg Cap ratio-Diltiazem CD 300mg Cap (discontinued) diltiazem 120mg ER cap Apo-Diltiaz TZ 120mg Cap CO Diltiazem T 120mg Cap Novo-Diltazem ER 120mg Cap Sandoz Diltiazem T 120mg Cap Tiazac ER 120mg Cap diltiazem 180mg ER cap Apo-Diltiaz TZ 180mg Cap CO Diltiazem T 180mg Cap Novo-Diltazem ER 180mg Cap Sandoz Diltiazem T 180mg Cap Tiazac ER 180mg Cap diltiazem 240mg ER cap Apo-Diltiaz TZ 240mg Cap CO Diltiazem T 240mg Cap Novo-Diltazem ER 240mg Cap Sandoz Diltiazem T 240mg Cap Tiazac ER 240mg Cap

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

02246895 02210363 02211920 02237791 00742554

APX MYL TEV PMS ABB

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02230997 02370611 02242538 02355752 02243338 02097249

APX COB TEV PMS SDZ BVL

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02230998 02370638 02242539 02355760 02243339 02097257

APX COB TEV PMS SDZ BVL

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02230999 02370646 02242540 02355779 02243340 02097265

APX COB TEV PMS SDZ BVL

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02229526 02370654 02242541 02355787 02243341 02097273

APX COB TEV PMS SDZ BVL

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

02291037 02370441 02271605 02245918 02231150

APX COB TEV SDZ BVL

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

02291045 02370492 02271613 02245919 02231151

APX COB TEV SDZ BVL

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

02291053 02370506 02271621 02245920 02231152

APX COB TEV SDZ BVL

December 2012

Cardiovascular System ­ 41

diltiazem 300mg ER cap Apo-Diltiaz TZ 300mg Cap CO Diltiazem T 300mg Cap Novo-Diltazem ER 300mg Cap Sandoz Diltiazem T 300mg Cap Tiazac ER 300mg Cap diltiazem 360mg ER cap Apo-Diltiaz TZ 360mg Cap CO Diltiazem T 360mg Cap Novo-Diltazem ER 360mg Cap Sandoz Diltiazem T 360mg Cap Tiazac ER 360mg Cap diltiazem 5mg/mL inj Diltiazem Hydrochloride 5mg/mL Inj Cardizem 5mg/mL Inj (discontinued) diltiazem HCl 30mg tab Apo-Diltiaz 30mg Tab Novo-Diltazem 30mg Tab Cardizem 30mg Tab (discontinued) diltiazem HCl 60mg tab Apo-Diltiaz 60mg Tab Novo-Diltazem 60mg Tab Cardizem 60mg Tab (discontinued) Tiazac XC 120mg Tab Tiazac XC 180mg Tab Tiazac XC 240mg Tab Tiazac XC 300mg Tab Tiazac XC 360mg Tab

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

02291061 02370514 02271648 02245921 02231154

APX COB TEV SDZ BVL

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

02291088 02370522 02271656 02245922 02231155

APX COB TEV SDZ BVL

02244728

SDZ

DNP DNP

MRP MRP

SF SF

00771376 00862924

APX TEV

DNP DNP

MRP MRP

SF SF SF SF SF SF SF

00771384 00862932 02256738 02256746 02256754 02256762 02256770

APX TEV BVL BVL BVL BVL BVL

DNP DNP DNP DNP DNP

C09

AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM

C09A ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS, PLAIN C09AA ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS, PLAIN C09AA01 CAPTOPRIL Apo-Capto 6.25mg Tab captopril 12.5mg tab Apo-Capto 12.5mg Tab MYLAN-Captopril 12.5mg Tab Novo-Captoril 12.5mg Tab pms-Captopril 12.5mg Tab Capoten 12.5mg Tab (discontinued) captopril 25mg tab Apo-Capto 25mg Tab MYLAN-Captopril 25mg Tab Novo-Captoril 25mg Tab pms-Captopril 25mg Tab Capoten 25mg Tab (discontinued) captopril 50mg tab Apo-Capto 50mg Tab MYLAN-Captopril 50mg Tab Novo-Captoril 50mg Tab pms-Captopril 50mg Tab Capoten 50mg Tab (discontinued) SF SF SF SF 01999559 00893595 02163551 01942964 02230203 APX APX MYL TEV PMS

DNP

DNP DNP DNP

MRP MRP MRP

DNP DNP DNP

MRP MRP MRP

SF SF SF

00893609 02163578 01942972 02230204

APX MYL TEV PMS

DNP DNP DNP

MRP MRP MRP

SF SF SF

00893617 02163586 01942980 02230205

APX MYL TEV PMS

December 2012

Cardiovascular System ­ 42

captopril 100mg tab Apo-Capto 100mg Tab MYLAN-Captopril 100mg Tab Novo-Captoril 100mg Tab Capoten 100mg Tab (discontinued) C09AA02 ENALAPRIL enalapril 2.5mg tab Apo-Enalapril 2.5mg Tab CO Enalapril 2.5mg Tab MYLAN-Enalapril 2.5mg Tab Novo-Enalapril 2.5mg Tab pms-Enalapril 2.5mg Tab RAN-Enalapril 2.5mg Tab Sandoz Enalapril 2.5mg Tab Vasotec 2.5mg Tab enalapril 5mg tab Apo-Enalapril 5mg Tab CO Enalapril 5mg Tab MYLAN-Enalapril 5mg Tab Novo-Enalapril 5mg Tab pms-Enalapril 5mg Tab RAN-Enalapril 5mg Tab Sandoz Enalapril 5mg Tab Vasotec 5mg Tab enalapril 10mg tab Apo-Enalapril 10mg Tab CO Enalapril 10mg Tab MYLAN-Enalapril 10mg Tab Novo-Enalapril 10mg Tab RAN-Enalapril 10mg Tab pms-Enalapril 10mg Tab Sandoz Enalapril 10mg Tab Vasotec 10mg Tab enalapril 20mg tab Apo-Enalapril 20mg Tab CO Enalapril 20mg Tab MYLAN-Enalapril 20mg Tab Novo-Enalapril 20mg Tab RAN-Enalapril 20mg Tab pms-Enalapril 20mg Tab Sandoz Enalapril 20mg Tab Vasotec 20mg Tab C09AA03 LISINOPRIL lisinopril 5mg tab Apo-Lisinopril 5mg Tab CO Lisinopril 5mg Tab Jamp-Lisinopril 5mg Tab MYLAN-Lisinopril 5mg Tab Novo-Lisinopril P 5mg Tab Novo-Lisinopril Z 5mg Tab pms-Lisinopril 5mg Tab RAN-Lisinopril 5mg Tab ratio-Lisinopril P 5mg Tab ratio-Lisinopril Z 5mg Tab Sandoz Lisinopril 5mg Tab Prinivil 5mg Tab Zestril 5mg Tab

DNP DNP DNP

MRP MRP MRP

SF SF SF

00893625 02163594 01942999

APX MYL TEV

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF

02020025 02291878 02300036 02300680 02300079 02352230 02299933 00851795

APX COB MYL TEV PMS RAN SDZ FRS

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF

02019884 02291886 02300044 02233005 02300087 02352249 02299941 00708879

APX COB MYL TEV PMS RAN SDZ FRS

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF

02019892 02291894 02300052 02233006 02352257 02300095 02299968 00670901

APX COB MYL TEV RAN PMS SDZ FRS

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF

02019906 02291908 02300060 02233007 02352265 02300109 02299976 00670928

APX COB MYL TEV RAN PMS SDZ FRS

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF

02217481 02271443 02361531 02274833 02285061 02285118 02292203 02294230 02256797 02299879 02289199 00839388 02049333

APX COB JPC MYL TEV TEV PMS RAN TEV TEV SDZ FRS AZE

December 2012

Cardiovascular System ­ 43

lisinopril 10mg tab Apo-Lisinopril 10mg Tab CO Lisinopril 10mg Tab Jamp-Lisinopril 10mg Tab MYLAN-Lisinopril 10mg Tab Novo-Lisinopril Z 10mg Tab pms-Lisinopril 10mg Tab RAN-Lisinopril 10mg Tab ratio-Lisinopril P 10mg Tab ratio-Lisinopril Z 10mg Tab Sandoz Lisinopril 10mg Tab Teva-Lisinopril (Type P) 10mg Tab Prinivil 10mg Tab Zestril 10mg Tab lisinopril 20mg tab Apo-Lisinopril 20mg Tab CO Lisinopril 20mg Tab Jamp-Lisinopril 20mg Tab MYLAN-Lisinopril 20mg Tab Novo-Lisinopril Z 20mg Tab pms-Lisinopril 20mg Tab RAN-Lisinopril 20mg Tab ratio-Lisinopril Z 20mg Tab Sandoz Lisinopril 20mg Tab Teva-Lisinopril (Type P) 20mg Tab Prinivil 20mg Tab Zestril 20mg Tab ratio-Lisinopril P 20mg Tab (discontinued) C09AA04 PERINDOPRIL Coversyl 2mg Tab Coversyl 4mg Tab Coversyl 8mg Tab RAMIPRIL ramipril 1.25mg cap/tab Apo-Ramipril 1.25mg Cap CO Ramipril 1.25mg Cap Jamp-Ramipril 1.25mg Cap MYLAN-Ramipril 1.25mg Cap pms-Ramipril 1.25mg Cap RAN-Ramipril 1.25mg Cap ratio-Ramipril 1.25mg Cap Sandoz Ramipril 1.25mg Tab Altace 1.25mg Cap Ramipril 1.25mg Cap (discontinued) ramipril 2.5mg cap/tab Apo-Ramipril 2.5mg Cap CO Ramipril 2.5mg Cap Jamp-Ramipril 2.5mg Cap MYLAN-Ramipril 2.5mg Cap pms-Ramipril 2.5mg Cap Ramipril 2.5mg Cap RAN-Ramipril 2.5mg Cap ratio-Ramipril 2.5mg Cap Sandoz Ramipril 2.5mg Tab Teva-Ramipril 2.5mg Cap Altace 2.5mg Cap

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF

02217503 02271451 02361558 02274841 02285126 02292211 02294249 02256800 02299887 02289202 02285088 00839396 02049376

APX COB JPC MYL TEV PMS RAN TEV TEV SDZ TEV FRS AZE

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF

02217511 02271478 02361566 02274868 02285134 02292238 02294257 02299895 02289229 02285096 00839418 02049384

APX COB JPC MYL TEV PMS RAN TEV SDZ TEV FRS AZE

DNP DNP

SF SF

02123274 02123282 02246624

SEV SEV SEV

C09AA05

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF

02251515 02295482 02331101 02301148 02295369 02310503 02287692 02291398 02221829

APX COB JPC MYL PMS RAN TEV SDZ SAV

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF

02251531 02295490 02331128 02301156 02247917 02374846 02310511 02287706 02291401 02247945 02221837

APX COB JPC MYL PMS SAS RAN TEV SDZ TEV SAV

December 2012

Cardiovascular System ­ 44

ramipril 5mg cap/tab Apo-Ramipril 5mg Cap CO Ramipril 5mg Cap Jamp-Ramipril 5mg Cap MYLAN-Ramipril 5mg Cap pms-Ramipril 5mg Cap Ramipril 5mg Cap RAN-Ramipril 5mg Cap Sandoz Ramipril 5mg Tab Teva-Ramipril 5mg Cap Altace 5mg Cap ramipril 10mg cap/tab Apo-Ramipril 10mg Cap CO Ramipril 10mg Cap Jamp-Ramipril 10mg Cap MYLAN-Ramipril 10mg Cap pms-Ramipril 10mg Cap Ramipril 10mg Cap RAN-Ramipril 10mg Cap Sandoz Ramipril 10mg Tab Teva-Ramipril 10mg Cap Altace 10mg Cap ramipril 15mg cap Apo-Ramipril 15mg Cap Altace 15mg Cap C09AA06 QUINAPRIL Accupril 5mg Tab Accupril 10mg Tab Accupril 20mg Tab Accupril 40mg Tab BENAZEPRIL benazepril 5mg tab Benazepril 5mg Tab Lotensin 5mg Tab benazepril 10mg tab Benazepril 10mg Tab Lotensin 10mg Tab (discontinued) benazepril 20mg tab Benazepril 20mg Tab Lotensin 20mg Tab C09AA08 CILAZAPRIL cilazapril 1mg tab Apo-Cilazapril 1mg Tab Cilazapril 1mg Tab MYLAN-Cilazapril 1mg Tab Novo-Cilazapril 1mg Tab pms-Cilazapril 1mg Tab Inhibace 1mg Tab (discontinued) cilazapril 2.5mg tab Apo-Cilazapril 2.5mg Tab Cilazapril 2.5mg Tab MYLAN-Cilazapril 2.5mg Tab Novo-Cilazapril 2.5mg Tab pms-Cilazapril 2.5mg Tab Inhibace 2.5mg Tab

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF

02251574 02295504 02331136 02301164 02247918 02374854 02310538 02291428 02247946 02221845

APX COB JPC MYL PMS SAS RAN SDZ TEV SAV

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF

02251582 02295512 02331144 02301172 02247919 02374862 02310546 02291436 02247947 02221853

APX COB JPC MYL PMS SAS RAN SDZ TEV SAV

DNP DNP

MRP MRP

SF SF SF SF SF SF

02325381 02281112 01947664 01947672 01947680 01947699

APX SAV PFI PFI PFI PFI

DNP DNP DNP DNP

C09AA07

DNP DNP

MRP MRP

SF SF

02290332 00885835

AAP NVR

DNP

MRP

SF

02290340

AAP

DNP DNP

MRP MRP

SF SF

02273918 00885851

AAP NVR

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

02291134 02350963 02283778 02266350 02280442

APX SAS MYL TEV PMS

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02291142 02350971 02283786 02266369 02280450 01911473

APX SAS MYL TEV PMS HLR

December 2012

Cardiovascular System ­ 45

cilazapril 5mg tab Apo-Cilazapril 5mg Tab Cilazapril 5mg Tab MYLAN-Cilazapril 5mg Tab Novo-Cilazapril 5mg Tab pms-Cilazapril 5mg Tab Inhibace 5mg Tab C09AA09 FOSINOPRIL fosinopril 10mg tab Apo-Fosinopril 10mg Tab Jamp-Fosinopril 10mg Tab MYLAN-Fosinopril 10mg Tab RAN-Fosinopril 10mg Tab Teva-Fosinopril 10mg Tab Monopril 10mg Tab fosinopril 20mg tab Apo-Fosinopril 20mg Tab Jamp-Fosinopril 20mg Tab MYLAN-Fosinopril 20mg Tab RAN-Fosinopril 20mg Tab Teva-Fosinopril 20mg Tab Monopril 20mg Tab C09AA10 TRANDOLAPRIL Mavik 0.5mg Cap Mavik 1mg Cap Mavik 2mg Cap Mavik 4mg Cap

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02291150 02350998 02283794 02266377 02280469 01911481

APX SAS MYL TEV PMS HLR

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02266008 02331004 02262401 02294524 02247802 01907107

APX JPC MYL RAN TEV BRI

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02266016 02331012 02262428 02294532 02247803 01907115 02231457 02231459 02231460 02239267

APX JPC MYL RAN TEV BRI ABB ABB ABB ABB

DNP DNP DNP

SF SF SF

C09B ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS, COMBINATIONS C09BA ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS AND DIURETICS C09BA02 ENALAPRIL AND DIURETICS enalapril 5mg & hydrochlorothiazide 12.5mg tab Apo-Enalapril Maleate/HCTZ 5/12.5mg Tab Novo-Enalapril/HCTZ 5/12.5mg Tab Vaseretic 5/12.5mg Tab (discontinued) enalapril 10mg & hydrochlorothiazide 25mg tab Apo-Enalapril Maleate/HCTZ 10/25mg Tab Novo-Enalapril/HCTZ 10/25mg Tab Vaseretic 10/25mg Tab C09BA03 LISINOPRIL AND DIURETICS lisinopril 10mg & hydrochlorothiazide 12.5mg tab Apo-Lisinopril/HCTZ 10/12.5mg Tab Lisinopril/HCTZ 10mg/12.5mg Tab (Type Z) MYLAN-Lisinopril/HCTZ 10/12.5mg Tab Novo-Lisinopril/HCTZ 10/12.5mg Tab (Type P) Novo-Lisinopril/HCTZ 10/12.5mg Tab (Type Z) Sandoz Lisinopril HCT 10/12.5mg Tab Zestoretic 10/12.5mg Tab Prinzide 10/12.5mg Tab (discontinued) lisinopril 20mg & hydrochlorothiazide 12.5mg tab Apo-Lisinopril/HCTZ 20/12.5mg Tab Lisinopril/HCTZ 20mg/12.5mg Tab (Type Z) MYLAN-Lisinopril/HCTZ 20/12.5mg Tab Novo-Lisinopril/HCTZ 20/12.5mg Tab (Type P) Sandoz Lisinopril HCT 20/12.5mg Tab Teva-Lisinopril/HCTZ (Type Z) 20/12.5mg Tab Prinzide 20/12.5mg Tab Zestoretic 20/12.5mg Tab

DNP DNP

MRP MRP

SF SF

02352923 02300222

APX TEV

DNP DNP DNP

MRP MRP MRP

SF SF SF

02352931 02300230 00657298

APX TEV FRS

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF

02261979 02362945 02297736 02302136 02301768 02302365 02103729

APX SAS MYL TEV TEV SDZ AZE

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF

02261987 02362953 02297744 02302144 02302373 02301776 00884413 02045737

APX SAS MYL TEV SDZ TEV FRS AZE

December 2012

Cardiovascular System ­ 46

lisinopril 20mg & hydrochlorothiazide 25mg tab Apo-Lisinopril/HCTZ 20/25mg Tab Lisinopril/HCTZ 20mg/25mg Tab (Type Z) MYLAN-Lisinopril/HCTZ 20/25mg Tab Novo-Lisinopril/HCTZ 20/25mg Tab (Type P) Novo-Lisinopril/HCTZ 20/25mg Tab (Type Z) Sandoz Lisinopril HCT 20/25mg Tab Zestoretic 20/25mg Tab Prinzide 20/25mg Tab (discontinued) C09BA04 PERINDOPRIL AND DIURETICS Coversyl Plus 4/1.25mg Tab Coversyl Plus HD 8/2.5mg Tab Coversyl Plus LD 2/0.625mg Tab RAMIPRIL AND DIURETICS ramipril 2.5mg & hydrochlorothiazide 12.5mg tab pms-Ramipril-HCTZ 2.5/12.5mg Tab Altace HCT 2.5/12.5mg Tab ramipril 5mg & hydrochlorothiazide 12.5mg tab pms-Ramipril-HCTZ 5/12.5mg Tab Altace HCT 5/12.5mg Tab ramipril 10mg & hydrochlorothiazide 12.5mg tab pms-Ramipril-HCTZ 10/12.5mg Tab Altace HCT 10/12.5mg Tab ramipril 5mg & hydrochlorothiazide 25mg tab pms-Ramipril-HCTZ 5/25mg Tab Altace HCT 5/25mg Tab ramipril 10mg & hydrochlorothiazide 25mg tab pms-Ramipril-HCTZ 10/25mg Tab Altace HCT 10/25mg Tab C09BA06 QUINAPRIL AND DIURETICS Accuretic 10/12.5mg Tab Accuretic 20/12.5mg Tab Accuretic 20/25mg Tab CILAZAPRIL AND DIURETICS cilazapril 5mg & hydrochlorothiazide 12.5mg tab Apo-Cilazapril/HCTZ 5/12.5mg Tab Novo-Cilazapril/HCTZ 5mg/12.5mg Tab Inhibace Plus 5/12.5mg Tab

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF

02261995 02362961 02297752 02302152 02301784 02302381 02045729

APX SAS MYL TEV TEV SDZ AZE

DNP DNP

SF SF

02246569 02321653 02246568

SEV SEV SEV

C09BA05

DNP DNP

MRP MRP

SF SF

02342138 02283131

PMS SAV

DNP DNP

MRP MRP

SF SF

02342146 02283158

PMS SAV

DNP DNP

MRP MRP

SF SF

02342154 02283166

PMS SAV

DNP DNP

MRP MRP

SF SF

02342162 02283174

PMS SAV

DNP DNP

MRP MRP

SF SF SF SF SF

02342170 02283182 02237367 02237368 02237369

PMS SAV PFI PFI PFI

DNP DNP DNP

C09BA08

DNP DNP DNP

MRP MRP MRP

SF SF SF

02284987 02313731 02181479

APX TEV HLR

C09BB ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS AND CALCIUM CHANNEL BLOCKERS C09BB10 TRANDOLAPRIL AND VERAPAMIL Tarka 2/240mg Tab Tarka 4/240mg Tab 02240946 02238097 ABB ABB

C09C ANGIOTENSIN II ANTAGONISTS, PLAIN C09CA ANGIOTENSIN II ANTAGONISTS, PLAIN C09CA01 LOSARTAN losartan 25mg tab Apo-Losartan 25mg Tab CO Losartan 25mg Tab Losartan 25mg Tab MYLAN-Losartan 25mg Tab pms-Losartan 25mg Tab Sandoz Losartan 25mg Tab Teva-Losartan 25mg Tab Cozaar 25mg Tab

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF

02379058 02354829 02388863 02368277 02309750 02313332 02380838 02182815

APX COB SAS MYL PMS SDZ TEV FRS

December 2012

Cardiovascular System ­ 47

losartan 50mg tab Apo-Losartan 50mg Tab CO Losartan 50mg Tab Losartan 50mg Tab MYLAN-Losartan 50mg Tab pms-Losartan 50mg Tab Sandoz Losartan 50mg Tab Teva-Losartan 50mg Tab Cozaar 50mg Tab losartan 100mg tab Apo-Losartan 100mg Tab CO Losartan 100mg Tab Losartan 100mg Tab MYLAN-Losartan 100mg Tab pms-Losartan 100mg Tab Sandoz Losartan 100mg Tab Teva-Losartan 100mg Tab Cozaar 100mg Tab C09CA02 EPROSARTAN Teveten 400mg Tab Teveten 600mg Tab VALSARTAN valsartan 40mg tab Apo-Valsartan 40mg Tab CO-Valsartan 40mg Tab MYLAN-Valsartan 40mg Tab pms-Valsartan 40mg Tab RAN-Valsartan 40mg Tab Sandoz Valsartan 40mg Tab Teva-Valsartan 40mg Tab Valsartan 40mg Tab Diovan 40mg Tab valsartan 80mg tab Apo-Valsartan 80mg Tab CO Valsartan 80mg Tab MYLAN-Valsartan 80mg Tab pms-Valsartan 80mg Tab RAN-Valsartan 80mg Tab Sandoz Valsartan 80mg Tab Teva-Valsartan 80mg Tab Valsartan 80mg Tab Diovan 80mg Tab valsartan 160mg tab Apo-Valsartan 160mg Tab CO Valsartan 160mg Tab MYLAN-Valsartan 160mg Tab pms-Valsartan 160mg Tab RAN-Valsartan 160mg Tab Sandoz Valsartan 160mg Tab Teva-Valsartan 160mg Tab Valsartan 160mg Tab Diovan 160mg Tab

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF

02353504 02354837 02388871 02368285 02309769 02313340 02357968 02182874

APX COB SAS MYL PMS SDZ TEV FRS

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF

02353512 02354845 02388898 02368293 02309777 02313359 02357976 02182882 02240432 02243942

APX COB SAS MYL PMS SDZ TEV FRS ABB ABB

DNP DNP

C09CA03

DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF

02371510 02337487 02383527 02312999 02363062 02356740 02356643 02366040 02270528

APX COB MYL PMS RAN SDZ TEV SAS NVR

DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF

02371529 02337495 02383535 02313006 02363100 02356759 02356651 02366959 02244781

APX COB MYL PMS RAN SDZ TEV SAS NVR

DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF

02371537 02337509 02383543 02313014 02363119 02356767 02356678 02366967 02244782

APX COB MYL PMS RAN SDZ TEV SAS NVR

December 2012

Cardiovascular System ­ 48

valsartan 320mg tab Apo-Valsartan 320mg Tab CO Valsartan 320mg Tab MYLAN-Valsartan 320mg Tab pms-Valsartan 320mg Tab Sandoz Valsartan 320mg Tab Teva-Valsartan 320mg Tab Valsartan 320mg Tab Diovan 320mg Tab C09CA04 IRBESARTAN irbesartan 75mg tab Apo-Irbesartan 75mg Tab CO-Irbesartan 75mg Tab Irbesartan 75mg Tab MYLAN-Irbesartan 75mg Tab pms-Irbesartan 75mg Tab ratio-Irbesartan 75mg Tab Sandoz Irbesartan 75mg Tab Teva-Irbesartan 75mg Tab Avapro 75mg Tab irbesartan 150mg tab Apo-Irbesartan 150mg Tab CO Irbesartan 150mg Tab Irbesartan 150mg Tab MYLAN-Irbesartan 150mg Tab pms-Irbesartan 150mg Tab ratio-Irbesartan 150mg Tab Sandoz Irbesartan 150mg Tab Teva-Irbesartan 150mg Tab Avapro 150mg Tab irbesartan 300mg tab Apo-Irbesartan 300mg Tab CO Irbesartan 300mg Tab Irbesartan 300mg Tab MYLAN-Irbesartan 300mg Tab pms-Irbesartan 300mg Tab ratio-Irbesartan 300mg Tab Sandoz Irbesartan 300mg Tab Teva-Irbesartan 300mg Tab Avapro 300mg Tab C09CA06 CANDESARTAN candesartan 4mg tab Apo-Candesartan 4mg Tab Candesartan 4mg Tab Candesartan Cilexetil 4mg Tab CO Candesartan 4mg Tab Jamp-Candesartan 4mg Tab MYLAN-Candesartan 4mg Tab pms-Candesartan 4mg Tab Sandoz Candesartan 4mg Tab Atacand 4mg Tab candesartan 8mg tab Apo-Candesartan 8mg Tab Candesartan 8mg Tab Candesartan Cilexetil 8mg Tab CO Candesartan 8mg Tab Jamp-Candesartan 8mg Tab MYLAN-Candesartan 8mg Tab pms-Candesartan 8mg Tab Sandoz Candesartan 8mg Tab Teva-Candesartan 8mg Tab Atacand 8mg Tab

December 2012

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF

02371545 02337517 02383551 02344564 02356775 02356686 02366975 02289504

APX COB MYL PMS SDZ TEV SAS NVR

DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF

02386968 02328070 02372347 02347296 02317060 02316390 02328461 02315971 02237923

APX COB SAS MYL PMS TEV SDZ TEV BRI

DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF

02386976 02328089 02372371 02347318 02317079 02316404 02328488 02315998 02237924

APX COB SAS MYL PMS TEV SDZ TEV BRI

DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF

02386984 02328100 02372398 02347326 02317087 02316412 02328496 02316005 02237925

APX COB SAS MYL PMS TEV SDZ TEV BRI

02365340 02388901 02379260 02376520 02386496 02379120 02391171 02326957 02239090

APX SAS AHI COB JPC MYL PMS SDZ AZE

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF

02365359 02388928 02379279 02376539 02386518 02379139 02391198 02326965 02366312 02239091

APX SAS AHI COB JPC MYL PMS SDZ TEV AZE

Cardiovascular System ­ 49

candesartan 16mg tab Apo-Candesartan 16mg Tab Candesartan 16mg Tab Candesartan Cilexetil 16mg Tab CO Candesartan 16mg Tab Jamp-Candesartan 16mg Tab MYLAN-Candesartan 16mg Tab pms-Candesartan 16mg Tab Sandoz Candesartan 16mg Tab Teva-Candesartan 16mg Tab Atacand 16mg Tab candesartan 32mg tab Candesartan Cilexetil 32mg Tab CO Candesartan 32mg Tab Jamp-Candesartan 32mg Tab MYLAN-Candesartan 32mg Tab pms-Candesartan 32mg Tab Teva-Candesartan 32mg Tab Atacand 32mg Tab C09CA07 TELMISARTAN telmisartan 40mg tab MYLAN-Telmisartan 40mg Tab pms-Telmisartan 40mg Tab Sandoz Telmisartan 40mg Tab Telmisartan 40mg Tab Teva-Telmisartan 40mg Micardis 40mg Tab telmisartan 80mg tab MYLAN-Telmisartan 80mg Tab pms-Telmisartan 80mg Tab Sandoz Telmisartan 80mg Tab Telmisartan 80mg Tab Teva-Telmisartan 80mg Micardis 80mg Tab C09CA08 OLMESARTAN MEDOXOMIL Olmetec 20mg Tab Olmetec 40mg Tab

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF

02365367 02388936 02379287 02376547 02386526 02379147 02391201 02326973 02366320 02239092

APX SAS AHI COB JPC MYL PMS SDZ TEV AZE

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF

02379295 02376555 02386534 02379155 02391228 02366339 02311658

AHI COB JPC MYL PMS TEV AZE

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02376717 02391236 02375958 02388944 02320177 02240769

MYL PMS SDZ SAS TEV BOE

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF

02376725 02391244 02375966 02388952 02320185 02240770 02318660 02318679

MYL PMS SDZ SAS TEV BOE SCO SCO

DNP DNP

C09D ANGIOTENSIN II ANTAGONISTS, COMBINATIONS C09DA ANGIOTENSIN II ANTAGONISTS AND DIURETICS C09DA01 LOSARTAN AND DIURETICS losartan 50mg & hydrochlorothiazide 12.5mg tab Apo-Losartan/HCTZ 50/12.5mg Tab MYLAN-Losartan HCTZ 50/12.5mg Tab pms-Losartan-HCTZ 50/12.5mg Tab Sandoz Losartan HCT 50/12.5mg Tab Teva-Losartan/HCTZ 50/12.5mg Tab Hyzaar 50/12.5mg Tab losartan 100mg & hydrochlorothiazide 12.5mg tab Apo-Losartan/HCTZ 100/12.5mg Tab MYLAN-Losartan HCTZ 100/12.5mg Tab pms-Losartan-HCTZ 100/12.5mg Tab Sandoz Losartan HCT 100/12.5mg Tab Teva-Losartan/HCTZ 100/12.5mg Tab Hyzaar 100/12.5mg Tab

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02371235 02378078 02392224 02313375 02358263 02230047

APX MYL PMS SDZ TEV FRS

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02371243 02378086 02392232 02362449 02377144 02297841

APX MYL PMS SDZ TEV FRS

December 2012

Cardiovascular System ­ 50

losartan 100mg & hydrochlorothiazide 25mg tab Apo-Losartan/HCTZ 100/25mg Tab MYLAN-Losartan HCTZ 100/25mg Tab pms-Losartan-HCTZ 100/25mg Tab Sandoz Losartan HCT DS 100/25mg Tab Teva-Losartan/HCTZ 100/25mg Tab Hyzaar DS 100/25mg Tab C09DA02 C09DA03 EPROSARTAN AND DIURETICS Teveten Plus 600mg/12.5mg Tab VALSARTAN AND DIURETICS valsartan 80mg & hydrochlorothiazide 12.5mg tab Apo-Valsartan/HCTZ 80/12.5mg Tab MYLAN-Valsartan HCTZ 80/12.5mg Tab Sandoz Valsartan/HCT 80/12.5mg Tab Teva-Valsartan/HCTZ 80/12.5mg Tab Valsartan HCT 80/12.5mg Tab Diovan-HCT 80/12.5mg Tab

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF

02371251 02378094 02392240 02313383 02377152 02241007 02253631

APX MYL PMS SDZ TEV FRS ABB

DNP

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02382547 02373734 02356694 02356996 02367009 02241900

APX MYL SDZ TEV SAS NVR

valsartan 160mg & hydrochlorothiazide 12.5mg tab Apo-Valsartan/HCTZ 160/12.5mg Tab DNP DNP MYLAN-Valsartan HCTZ 160/12.5mg Tab DNP Sandoz Valsartan/HCT 160/12.5mg Tab Teva-Valsartan/HCTZ 160/12.5mg Tab DNP DNP Valsartan HCT 160/12.5mg Tab Diovan-HCT 160/12.5mg Tab DNP valsartan 160mg & hydrochlorothiazide 25mg tab Apo-Valsartan/HCTZ 160/25mg Tab MYLAN-Valsartan HCTZ 160/25mg Tab Sandoz Valsartan/HCT 160/25mg Tab Teva-Valsartan/HCTZ 160/25mg Tab Valsartan HCT 160/25mg Tab Diovan-HCT 160/25mg Tab

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02382555 02373742 02356708 02357003 02367017 02241901

APX MYL SDZ TEV SAS NVR

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02382563 02373750 02356716 02357011 02367025 02246955

APX MYL SDZ TEV SAS NVR

valsartan 320mg & hydrochlorothiazide 12.5mg tab Apo-Valsartan/HCTZ 320/12.5mg Tab DNP DNP MYLAN-Valsartan HCTZ 320/12.5mg Tab Sandoz Valsartan/HCT 320/12.5mg Tab DNP DNP Teva-Valsartan/HCT 320/12.5mg Tab Valsartan HCT 320/12.5mg Tab DNP DNP Dilovan-HCT 320/12.5mg Tab valsartan 320mg & hydrochlorothiazide 25mg tab Apo-Valsartan/HCTZ 320/25mg Tab MYLAN-Valsartan HCTZ 320/25mg Tab Sandoz Valsartan/HCT 320/25mg Tab Teva-Valsartan/HCT 320/25mg Tab Valsartan HCT 320/25mg Tab Diovan-HCT 320/25mg Tab C09DA04

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02382571 02373769 02356724 02357038 02367033 02308908

APX MYL SDZ TEV SAS NVR

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02382598 02373777 02356732 02357046 02367041 02308916

APX MYL SDZ TEV SAS NVR

IRBESARTAN AND DIURETICS irbesartan 150mg & hydrochlorothiazide 12.5mg tab CO Irbesartan/HCT 150/12.5mg Tab DNP DNP Irbesartan/HCTZ 150/12.5mg Tab pms-Irbesartran-HCTZ 150/12.5mg Tab DNP DNP RAN-Irbesartan HCTZ 150/12.5mg Tab ratio-Irbesartan HCTZ 150/12.5mg Tab DNP DNP Sandoz Irbesartan HCT 150/12.5mg Tab Teva-Irbesartan/HCTZ 150/12.5mg Tab DNP DNP Avalide 150/12.5mg Tab

MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF

02357399 02372886 02328518 02363208 02330512 02337428 02316013 02241818

COB SAS PMS RAN TEV SDZ TEV BRI

December 2012

Cardiovascular System ­ 51

irbesartan 300mg & hydrochlorothiazide 12.5mg tab CO Irbesartan/HCT 300/12.5mg Tab DNP Irbesartan/HCTZ 300/12.5mg Tab DNP DNP pms-Irbesartran-HCTZ 300/12.5mg Tab RAN-Irbesartan HCTZ 300/12.5mg Tab DNP DNP ratio-Irbesartan HCTZ 300/12.5mg Tab Sandoz Irbesartan HCT 300/12.5mg Tab DNP DNP Teva-Irbesartan/HCTZ 300/12.5mg Tab Avalide 300/12.5mg Tab DNP irbesartan 300mg & hydrochlorothiazide 25mg tab CO Irbesartan/HCT 300/25mg Tab DNP Irbesartan/HCTZ 300/25mg Tab DNP DNP pms-Irbesartran-HCTZ 300/25mg Tab RAN-Irbesartan HCTZ 300/25mg Tab DNP DNP ratio-Irbesartan HCTZ 300/25mg Tab Sandoz Irbesartan HCT 300/25mg Tab DNP DNP Teva-Irbesartan/HCTZ 300/25mg Tab Avalide 300/25mg Tab (discontinued) C09DA06 CANDESARTAN AND DIURETICS candesartan 16mg & hydrochlorothiazide 12.5mg tab Apo-Candesartan/HCTZ 16/12.5mg Tab DNP DNP CO Candesartan/HCT 16/12.5mg Tab MYLAN-Candesartan HCTZ 16/12.5mg Tab DNP DNP pms-Candesartan HCTZ 16/12.5mg Tab Sandoz Candesartan Plus 16/12.5mg Tab DNP DNP Atacand Plus 16/12.5mg Tab Atacand Plus 32/12.5mg Tab Atacand Plus 32/25mg Tab C09DA07

DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF

02357402 02372894 02328526 02363216 02330520 02337436 02316021 02241819

COB SAS PMS RAN TEV SDZ TEV BRI

MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF

02357410 02372908 02328534 02363224 02330539 02337444 02316048

COB SAS PMS RAN TEV SDZ TEV

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF

02367866 02388650 02374897 02391295 02327902 02244021 02332922 02332957

APX COB MYL SDZ SDZ AZE AZE AZE

TELMISARTAN AND DIURETICS telmisartan 80mg & hydrochlorothiazide 12.5mg tab MYLAN-Telmisartan HCTZ 80/12.5mg Tab DNP Sandoz Telmisartan HCT 80/12.5mg Tab DNP DNP Teva-Telmisartan HCTZ 80/12.5mg Tab Micardis Plus 80/12.5mg Tab DNP telmisartan 80mg & hydrochlorothiazide 25mg tab MYLAN-Telmisartan HCTZ 80/25mg Tab DNP Sandoz Telmisartan HCT 80/25mg Tab DNP DNP Teva-Telmisartan HCTZ 80/25mg Tab Micardis Plus 80/25mg Tab DNP

MRP MRP MRP MRP

SF SF SF SF

02373564 02393557 02330288 02244344

MYL SDZ TEV BOE

MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF

02373572 02393565 02379252 02318709 02319616 02319624 02319632 02371022 02371030 02371049 02371057

MYL SDZ TEV BOE SCO SCO SCO BOE BOE BOE BOE

C09DA08

OLMESARTAN MEDOXOMIL AND DIURETICS Olmetec Plus 20mg/12.5mg Tab Olmetec Plus 40mg/12.5mg Tab Olmetec Plus 40mg/25mg Tab TELMISARTAN AND AMLODIPINE Twynsta 40/5mg Tab Twynsta 40/10mg Tab Twynsta 80/5mg Tab Twynsta 80/10mg Tab

DNP DNP DNP

C09DB04

DNP DNP DNP DNP

C09X RENIN-ANGIOTENSIN-ALDOSTERON SYSTEM INHIBITORS C09XA RENIN INHIBITORS C09XA02 ALISKIREN Rasilez 150mg Tab Rasilez 300mg Tab 02302063 02302071 NVR NVR

December 2012

Cardiovascular System ­ 52

C10

LIPID MODIFYING AGENTS

C10A LIPID MODIFYING AGENTS, PLAIN C10AA HMG-CoA REDUCTASE INHIBITORS C10AA01 SIMVASTATIN simvastatin 5mg tab Apo-Simvastatin 5mg Tab CO Simvastatin 5mg Tab Jamp-Simvastatin 5mg Tab Mar-Simvastatin 5mg Tab MINT-Simvastatin 5mg Tab MYLAN-Simvastatin 5mg Tab phl-Simvastatin 5mg Tab pms-Simvastatin 5mg Tab RAN-Simvastatin 5mg Tab Simvastatin 5mg Tab Teva-Simvastatin 5mg Tab Zocor 5mg Tab simvastatin 10mg tab Apo-Simvastatin 10mg Tab CO Simvastatin 10mg Tab Jamp-Simvastatin 10mg Tab Mar-Simvastatin 10mg Tab MINT-Simvastatin 10mg Tab MYLAN-Simvastatin 10mg Tab Novo-Simvastatin 10mg Tab phl-Simvastatin 10mg Tab pms-Simvastatin 10mg Tab RAN-Simvastatin 10mg Tab Sandoz Simvastatin 10mg Tab Simvastatin 10mg Tab Zocor 10mg Tab ratio-Simvastatin 10mg Tab (discontinued) simvastatin 20mg tab Apo-Simvastatin 20mg Tab CO Simvastatin 20mg Tab Jamp-Simvastatin 20mg Tab Jamp-Simvastatin 20mg Tab Mar-Simvastatin 20mg Tab MINT-Simvastatin 20mg Tab MYLAN-Simvastatin 20mg Tab Novo-Simvastatin 20mg Tab phl-Simvastatin 20mg Tab pms-Simvastatin 20mg Tab RAN-Simvastatin 20mg Tab Sandoz Simvastatin 20mg Tab Simvastatin 20mg Tab Zocor 20mg Tab simvastatin 40mg tab Apo-Simvastatin 40mg Tab CO Simvastatin 40mg Tab Jamp-Simvastatin 40mg Tab Jamp-Simvastatin 40mg Tab Mar-Simvastatin 40mg Tab MINT-Simvastatin 40mg Tab MYLAN-Simvastatin 40mg Tab phl-Simvastatin 40mg Tab pms-Simvastatin 40mg Tab RAN-Simvastatin 40mg Tab Sandoz Simvastatin 40mg Tab Simvastatin 40mg Tab Teva-Simvastatin 40mg Tab Zocor 40mg Tab

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF

02247011 02248103 02331020 02375036 02372932 02246582 02281546 02269252 02329131 02284723 02250144 00884324

APX COB JPC MAR MNT MYL PHL PMS RAN SAS TEV FRS

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF

02247012 02248104 02331039 02375044 02372940 02246583 02250152 02281554 02269260 02329158 02247828 02284731 00884332

APX COB JPC MAR MNT MYL TEV PHL PMS RAN SDZ SAS FRS

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF SF

02247013 02248105 02331047 02375613 02375052 02372959 02246737 02250160 02281562 02269279 02329166 02247830 02284758 00884340

APX COB JPC JPC MAR MNT MYL TEV PHL PMS RAN SDZ SAS FRS

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF SF

02247014 02248106 02331055 02375621 02375060 02372967 02246584 02281570 02269287 02329174 02247831 02284766 02250179 00884359

APX COB JPC JPC MAR MNT MYL PHL PMS RAN SDZ SAS TEV FRS

December 2012

Cardiovascular System ­ 53

simvastatin 80mg tab Apo-Simvastatin 80mg Tab CO Simvastatin 80mg Tab Jamp-Simvastatin 80mg Tab Jamp-Simvastatin 80mg Tab Mar-Simvastatin 80mg Tab MYLAN-Simvastatin 80mg Tab phl-Simvastatin 80mg Tab pms-Simvastatin 80mg Tab RAN-Simvastatin 80mg Tab Sandoz Simvastatin 80mg Tab Simvastatin 80mg Tab Teva-Simvastatin 80mg Tab Zocor 80mg Tab ratio-Simvastatin 80mg Tab (discontinued) MINT-Simvastatin 80mg Tab C10AA02 LOVASTATIN lovastatin 20mg tab Apo-Lovastatin 20mg Tab CO Lovastatin 20mg Tab Lovastatin 20mg Tab MYLAN-Lovastatin 20mg Tab Novo-Lovastatin 20mg Tab pms-Lovastatin 20mg Tab ratio-Lovastatin 20mg Tab Sandoz Lovastatin 20mg Tab Mevacor 20mg Tab RAN-Lovastatin 20mg Tab (discontinued) lovastatin 40mg tab Apo-Lovastatin 40mg Tab CO Lovastatin 40mg Tab Lovastatin 40mg Tab MYLAN-Lovastatin 40mg Tab Novo-Lovastatin 40mg Tab pms-Lovastatin 40mg Tab ratio-Lovastatin 40mg Tab Sandoz Lovastatin 40mg Tab Mevacor 40mg Tab RAN-Lovastatin 40mg Tab (discontinued) C10AA03 PRAVASTATIN pravastatin 10mg tab Apo-Pravastatin 10mg Tab CO Pravastatin 10mg Tab Jamp-Pravastatin 10mg Tab MINT-Pravastatin 10mg Tab MYLAN-Pravastatin 10mg Tab Novo-Pravastatin 10mg Tab pms-Pravastatin 10mg Tab Pravastatin 10mg Tab (MEL) Pravastatin 10mg Tab (SAS) RAN-Pravastatin 10mg Tab Sandoz Pravastatin 10mg Tab Pravachol 10mg Tab

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF

02247015 02248107 02331063 02375648 02375079 02246585 02281589 02269295 02329182 02247833 02284774 02250187 02240332 02372975

APX COB JPC JPC MAR MYL PHL PMS RAN SDZ SAS TEV FRS MNT

DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF

02220172 02248572 02353229 02243127 02246542 02246013 02245822 02247056 00795860

APX COB SAS MYL TEV PMS TEV SDZ FRS

DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF

02220180 02248573 02353237 02243129 02246543 02246014 02245823 02247057 00795852

APX COB SAS MYL TEV PMS TEV SDZ FRS

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF

02243506 02248182 02330954 02317451 02257092 02247008 02247655 02249766 02356546 02284421 02247856 00893749

APX COB JPC MNT MYL TEV PMS MEL SAS RAN SDZ BRI

December 2012

Cardiovascular System ­ 54

pravastatin 20mg tab Apo-Pravastatin 20mg Tab CO Pravastatin 20mg Tab Jamp-Pravastatin 20mg Tab MINT-Pravastatin 20mg Tab MYLAN-Pravastatin 20mg Tab Novo-Pravastatin 20mg Tab pms-Pravastatin 20mg Tab Pravastatin 20mg Tab (MEL) Pravastatin 20mg Tab (SAS) RAN-Pravastatin 20mg Tab Sandoz Pravastatin 20mg Tab Pravachol 20mg Tab pravastatin 40mg tab Apo-Pravastatin 40mg Tab CO Pravastatin 40mg Tab Jamp-Pravastatin 40mg Tab MINT-Pravastatin 40mg Tab MYLAN-Pravastatin 40mg Tab Novo-Pravastatin 40mg Tab pms-Pravastatin 40mg Tab Pravastatin 40mg Tab (MEL) Pravastatin 40mg Tab (SAS) RAN-Pravastatin 40mg Tab Sandoz Pravastatin 40mg Tab Pravachol 40mg Tab C10AA04 FLUVASTATIN Lescol 20mg Cap Lescol 40mg Cap Lescol XL 80mg Cap ATORVASTATIN atorvastatin 10mg tab Apo-Atorvastatin 10mg Tab Atorvastatin 10mg Tab (RPH) Atorvastatin 10mg Tab (SAS) CO Atorvastatin 10mg Tab GD-Atorvastatin 10mg Tab MYLAN-Atorvastatin 10mg Tab Novo-Atorvastatin 10mg Tab pms-Atorvastatin 10mg Tab RAN-Atorvastatin 10mg Tab ratio-Atorvastatin 10mg Tab Sandoz Atorvastatin 10mg Tab Lipitor 10mg Tab atorvastatin 20mg tab Apo-Atorvastatin 20mg Tab Atorvastatin 20mg Tab (RPH) Atorvastatin 20mg Tab (SAS) CO Atorvastatin 20mg Tab GD-Atorvastatin 20mg Tab MYLAN-Atorvastatin 20mg Tab Novo-Atorvastatin 20mg Tab pms-Atorvastatin 20mg Tab RAN-Atorvastatin 20mg Tab ratio-Atorvastatin 20mg Tab Sandoz Atorvastatin 20mg Tab Lipitor 20mg Tab

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF

02243507 02248183 02330962 02317478 02257106 02247009 02247656 02249774 02356554 02284448 02247857 00893757

APX COB JPC MNT MYL TEV PMS MEL SAS RAN SDZ BRI

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF

02243508 02248184 02330970 02317486 02257114 02247010 02247657 02249782 02356562 02284456 02247858 02222051 02061562 02061570 02250527

APX COB JPC MNT MYL TEV PMS MEL SAS RAN SDZ BRI NVR NVR NVR

DNP DNP DNP

C10AA05

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF

02295261 02348624 02348705 02310899 02288346 02373203 02302675 02313448 02313707 02350297 02324946 02230711

APX TEV SAS COB GMD MYL TEV PMS RAN TEV SDZ PFI

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF

02295288 02348632 02348713 02310902 02288354 02373211 02302683 02313456 02313715 02350319 02324954 02230713

APX TEV SAS COB GMD MYL TEV PMS RAN TEV SDZ PFI

December 2012

Cardiovascular System ­ 55

atorvastatin 40mg tab Apo-Atorvastatin 40mg Tab Atorvastatin 40mg Tab (RPH) Atorvastatin 40mg Tab (SAS) CO Atorvastatin 40mg Tab GD-Atorvastatin 40mg Tab MYLAN-Atorvastatin 40mg Tab Novo-Atorvastatin 40mg Tab pms-Atorvastatin 40mg Tab RAN-Atorvastatin 40mg Tab ratio-Atorvastatin 40mg Tab Sandoz Atorvastatin 40mg Tab Lipitor 40mg Tab atorvastatin 80mg tab Apo-Atorvastatin 80mg Tab Atorvastatin 80mg Tab (RPH) Atorvastatin 80mg Tab (SAS) CO Atorvastatin 80mg Tab GD-Atorvastatin 80mg Tab MYLAN-Atorvastatin 80mg Tab Novo-Atorvastatin 80mg Tab pms-Atorvastatin 80mg Tab RAN-Atorvastatin 80mg Tab ratio-Atorvastatin 80mg Tab Sandoz Atorvastatin 80mg Tab Lipitor 80mg Tab C10AA07 ROSUVASTATIN rosuvastatin 5mg tab Apo-Rosuvastatin 5mg Tab CO Rosuvastatin 5mg Tab MYLAN-Rosuvastatin 5mg Tab pms-Rosuvastatin 5mg Tab RAN-Rosuvastatin 5mg Tab Sandoz Rosuvastatin 5mg Tab Teva-Rosuvastatin 5mg Tab Crestor 5mg Tab rosuvastatin 10mg tab Apo-Rosuvastatin 10mg Tab CO Rosuvastatin 10mg Tab MYLAN-Rosuvastatin 10mg Tab pms-Rosuvastatin 10mg Tab RAN-Rosuvastatin 10mg Tab Sandoz Rosuvastatin 10mg Tab Teva-Rosuvastatin 10mg Tab Crestor 10mg Tab rosuvastatin 20mg tab Apo-Rosuvastatin 20mg Tab CO Rosuvastatin 20mg Tab MYLAN-Rosuvastatin 20mg Tab pms-Rosuvastatin 20mg Tab RAN-Rosuvastatin 20mg Tab Sandoz Rosuvastatin 20mg Tab Teva-Rosuvastatin 20mg Tab Crestor 20mg Tab

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF

02295296 02348640 02348721 02310910 02288362 02373238 02302691 02313464 02313723 02350327 02324962 02230714

APX TEV SAS COB GMD MYL TEV PMS RAN TEV SDZ PFI

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF

02295318 02348659 02348748 02310929 02288370 02373246 02302713 02313472 02313758 02350335 02324970 02243097

APX TEV SAS COB GMD MYL TEV PMS RAN TEV SDZ PFI

02337975 02339765 02381265 02378523 02382644 02338726 02354608 02265540

APX COB MYL PMS RAN SDZ TEV AZE

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF

02337983 02339773 02381273 02378531 02382652 02338734 02354616 02247162

APX COB MYL PMS RAN SDZ TEV AZE

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF

02337991 02339781 02381281 02378558 02382660 02338742 02354624 02247163

APX COB MYL PMS RAN SDZ TEV AZE

December 2012

Cardiovascular System ­ 56

rosuvastatin 40mg tab Apo-Rosuvastatin 40mg Tab CO Rosuvastatin 40mg Tab MYLAN-Rosuvastatin 40mg Tab pms-Rosuvastatin 40mg Tab RAN-Rosuvastatin 40mg Tab Sandoz Rosuvastatin 40mg Tab Teva-Rosuvastatin 40mg Tab Crestor 40mg Tab C10AB FIBRATES C10AB02 C10AB04 BEZAFIBRATE Bezalip 400mg SR Tab GEMFIBROZIL gemfibrozil 300mg cap Apo-Gemfibrozil 300mg Cap MYLAN-Gemfibrozil 300mg Cap Novo-Gemfibrozil 300mg Cap pms-Gemfibrozil 300mg Cap Lopid 300mg Cap (discontinued) gemfibrozil 600mg tab Apo-Gemfibrozil 600mg Tab MYLAN-Gemfibrozil 600mg Tab Novo-Gemfibrozil 600mg Tab pms-Gemfibrozil 600mg Tab Lopid 600mg Tab (discontinued) C10AB05 FENOFIBRATE fenofibrate 67mg cap Apo-Feno-Micro 67mg Cap Novo-Fenofibrate Micronized 67mg Cap Lipidil Micro 67mg Cap (discontinued) Apo-Fenofibrate 100mg Cap fenofibrate 200mg cap Apo-Feno-Micro 200mg Cap Fenofibrate Micro 200mg Cap MYLAN-Fenofibrate Micro 200mg Cap Novo-Fenofibrate Micronized 200mg Cap pms-Fenofibrate Micro 200mg Cap ratio-Fenofibrate MC 200mg Cap Lipidil Micro 200mg Cap fenofibrate 100mg tab Apo-Feno-Super 100mg Tab Fenofibrate-S 100mg Tab Novo-Fenofibrate-S 100mg Tab Sandoz Fenofibrate S 100mg Tab Lipidil Supra 100mg Tab fenofibrate 160mg tab Apo-Feno-Super 160mg Tab Fenofibrate-S 160mg Tab Novo-Fenofibrate-S 160mg Tab Sandoz Fenofibrate S 160mg Tab Lipidil Supra 160mg Tab Lipidil EZ 48mg Tab Lipidil EZ 145mg Tab

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF

02338009 02339803 02381303 02378566 02382679 02338750 02354632 02247164

APX COB MYL PMS RAN SDZ TEV AZE

DNP

SF

02083523

TRB

DNP DNP DNP DNP

MRP MRP MRP MRP

SF SF SF SF

01979574 02185407 02241704 02239951

APX MYL TEV PMS

DNP DNP DNP DNP

MRP MRP MRP MRP

SF SF SF SF

01979582 02230476 02142074 02230183

APX MYL TEV PMS

DNP DNP

MRP MRP

SF SF SF SF SF SF SF SF SF SF

02243180 02243551 02225980 02239864 02286092 02240210 02243552 02273551 02250039 02146959

APX TEV APX APX SAS MYL TEV PMS TEV ABB

DNP

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

02246859 02356570 02289083 02288044 02241601

APX SAS TEV SDZ ABB

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

02246860 02356589 02289091 02288052 02241602 02269074 02269082

APX SAS TEV SDZ ABB ABB ABB

December 2012

Cardiovascular System ­ 57

C10AC BILE ACID SEQUESTRANTS C10AC01 CHOLESTYRAMINE cholestyramine powder pouches Olestyr Regular 4g/9g Pdr Olestyr Light 4g/5g Pdr* Questran Pdr and Light Pdr 4g/dose (discontinued)

*This formulation is Sugar Reduced

DNP DNP

SF SF

02210320 00890960

PDP PDP

C10AC02

COLESTIPOL Colestid Granules 5g/pack Colestid Orange Gran 5g/pack Colestid 1g Tab

DNP DNP DNP

SF SF SF

00642975 02132699 02132680

PFI PFI PFI

C10AD NICOTINIC ACID AND DERIVATIVES C10AD02 NICOTINIC ACID Niaspan 500mg Tab Niaspan FCT 500mg ER Tab Ni-ODAN 500mg ER Tab Niaspan FCT 750mg ER Tab Niaspan 1,000mg Tab Niaspan FCT 1000mg ER Tab 02262347 02309254 00779806 02309262 02262339 02309289 SEP SNV ODN SNV SEP SNV

C10AX OTHER LIPID MODIFYING AGENTS C10AX09 EZETIMIBE Ezetrol 10mg Tab E 02247521 FRS

DNP

C10B LIPID MODIFYING AGENTS, COMBINATIONS C10BA HMG-CoA REDUCTASE INHIBITORS IN COMBINATION WITH OTHER LIPID MODIFYING AGENTS C10BA01 LOVASTATIN AND NICOTINIC ACID Advicor 20/500mg Tab (discontinued) Advicor 20/1000mg Tab (discontinued)

C10BX HMG-CoA REDUCTASE INHIBITORS, OTHER COMBINATIONS C10BX03 ATORVASTATIN AND AMLODIPINE atorvastatin and amlodipine 5/10mg tab GD-Amlodipine/Atorvastatin 5/10mg Tab Caduet 5/10mg Tab atorvastatin and amlodipine 5/20mg tab GD-Amlodipine/Atorvastatin 5/20mg Caduet 5/20mg Tab atorvastatin and amlodipine 5/40mg tab GD-Amlodipine/Atorvastatin 5/40mg Caduet 5/40mg Tab atorvastatin and amlodipine 5/80mg tab GD-Amlodipine/Atorvastatin 5/40mg Tab Caduet 5/80mg Tab atorvastatin and amlodipine 10/10mg tab GD-Amlodipine/Atorvastatin 10/10mg Tab Caduet 10/10mg Tab atorvastatin and amlodipine 10/20mg tab GD-Amlodipine/Atorvastatin 10/20mg Tab Caduet 10/20mg Tab atorvastatin and amlodipine 10/40mg tab GD-Amlodipine/Atorvastatin 10/40mg Tab Caduet 10/40mg Tab

December 2012

DNP DNP

MRP MRP

SF SF

02362759 02273233

GMD PFI

DNP DNP

MRP MRP

SF SF

02362767 02273241

GMD PFI

DNP DNP

MRP MRP

SF SF

02362775 02273268

GMD PFI

DNP DNP

MRP MRP

SF SF

02362783 02273276

GMD PFI

DNP DNP

MRP MRP

SF SF

02362791 02273284

GMD PFI

DNP DNP

MRP MRP

SF SF

02362805 02273292

GMD PFI

DNP DNP

MRP MRP

SF SF

02362813 02273306

GMD PFI

Cardiovascular System ­ 58

atorvastatin and amlodipine 10/80mg tab GD-Amlodipine/Atorvastatin 10/80mg Tab Caduet 10/80mg Tab

DNP DNP

MRP MRP

SF SF

02362821 02273314

GMD PFI

December 2012

Cardiovascular System ­ 59

December 2012

Cardiovascular System ­ 60

D01

ANTIFUNGALS FOR DERMATOLOGICAL USE

D01A ANTIFUNGALS FOR TOPICAL USE D01AA ANTIBIOTICS D01AA01 NYSTATIN Nyaderm 100,000 iu/g Cr ratio-Nystatin 100,000 iu/g Cr ratio-Nystatin 100,000 iu/g Oint Mycostatin 100,000 iu/g Pdr (discontinued) SFC SFC SFC 00716871 02194236 02194228 TAR TEV TEV

DNPM DNPM DNPM

D01AC IMIDAZOLE AND TRIAZOLE DERIVATIVES D01AC01 CLOTRIMAZOLE clotrimazole 1% cr Clotrimaderm 1% Cr Canesten 1% Cr MICONAZOLE Micatin 2% Cr Monistat 2% Derm Cr KETOCONAZOLE ketoconazole 2% cr Ketoderm 2% Cr Nizoral 2% Cr (discontinued) IMIDAZOLE DERIVATIVES, COMBINATIONS Hydrocortisone Pdr 1-2.5% in Clotrimazole Cr Lotriderm Cr

DNPM DNPM

MRP MRP

SFC SFC SFC SFC

00812382 02150867 02085852 02126567

TAR YNO WLS JNJ

D01AC02

DNPM DNPM

D01AC08

DNP

MRP

SFC

02245662

TPH

D01AC20

DNP DNP

SF SFC

00999474 00611174

CPD SCH

D01AE OTHER ANTIFUNGALS FOR TOPICAL USE D01AE12 D01AE13 D01AE14 SALICYLIC ACID Salicylic Acid Oint SELENIUM SULFIDE Versel 2.5% Lot CICLOPIROX Loprox 1% Cr Loprox 1% Lot Stieprox 1.5% Shampoo ciclopirox 8% w/w top sol Apo-Ciclopirox 8% w/w Top Sol Taro-Ciclopirox 8% w/w Top Sol Penlac 8% w/w Top Sol D01AE15 TERBINAFINE Lamisil 1% Cr Lamisil 1% Top Spray TOLNAFTATE Tinactin 10mg/g Cr SFC SFC SFC SFC SF 00900788 00594601 02221802 02221810 02247228 02298953 02353288 02250535 02031094 02238703 00576034 CPD VAL VLN VLN STI APX TAR VLN NVR NVR SCH

DNP

DNP DNP

DNP DNP

D01AE18

December 2012

Dermatologicals ­ 61

D01B ANTIFUNGALS FOR SYSTEMIC USE D01BA ANTIFUNGALS FOR SYSTEMIC USE D01BA02 TERBINAFINE terbinafine 250mg tab Apo-Terbinafine 250mg Tab Auro-Terbinafine 250mg Tab CO Terbinafine 250mg Tab GD-Terbinafine 250mg Tab Jamp-Terbinafine 250mg Tab MYLAN-Terbinafine 250mg Tab Novo-Terbinafine 250mg Tab pms-Terbinafine 250mg Tab Sandoz Terbinafine 250mg Tab Terbinafine 250mg Tab Lamisil 250mg Tab

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E E E E

02239893 02320134 02254727 02352818 02357070 02242503 02240346 02294273 02262177 02353121 02031116

APX ARO COB GMD JPC MYL TEV PMS SDZ SAS NVR

D03B ENZYMES D03BA PROTEOLYTIC ENZYMES D03BA02 COLLAGENASE (CLOSTRIDIOPEPITIDASE) Santyl 250u/g Oint 02063670 HPT

D04

ANTIPRURITICS, INCLUDING ANTIHISTAMINES, ANESTHETICS, ETC.

D04A ANTIPRURITICS, INCLUDING ANTIHISTAMINES, ANESTHETICS, ETC. D04AB ANESTHETICS FOR TOPICAL USE D04AB01 LIDOCAINE lidocaine 5% oint Lidodan 5% Oint Xylocaine 5% Oint Xylocaine 2% Jelly Xylocaine 4% Topical Liq Lidodan 2% Viscous Liq pms-Lidocaine 2% Viscous Liq Xylocaine 2% Viscous Liq Magic Mouthwash O/L Xylocaine 12mg/dose Endotracheal Spray

DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM

MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC

02083795 00001961 00001694 00049816 01968823 00811874 00001686 00999022 02003767

ODN AZE AZE AZE ODN PMS AZE CPD AZE

D05

ANTIPSORIATICS

D05A ANTIPSORIATICS FOR TOPICAL USE D05AA TARS D05AA99 COAL TAR LCD (coal tar) Preparations LCD 20% USP Tar Pomade SF SF SF 00358494 00358495 00901121 CPD ODN CPD

DNP DNP DNP

D05AC ANTRACEN DERIVATIVES D05AC01 ANTHRALIN (DITHRANOL) Anthranol 0.1% Cr Anthranol 0.2% Cr Anthrascalp 0.4% Lot Anthraforte 1% Oint Anthraforte 2% Oint Anthralin 0.4% Oint Anthralin Weak 0.2% Oint Anthralin Soft 0.05% Paste Anthralin Soft 0.1% Paste Anthralin Soft 0.2% Paste SF SF SF SF SF SF SF SF SF SF 00537594 00537608 00695351 00566756 00566748 00901113 00901105 00902063 00900907 00900915 MED MED MED MED MED CPD CPD CPD CPD CPD

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

December 2012

Dermatologicals ­ 62

D05AD PSORALENS FOR TOPICAL USE D05AD02 METHOXSALEN Oxsoralen 1% Lot SF 01907476 VLN

DNP

D05AX OTHER ANTIPSORIATICS FOR TOPICAL USE D05AX02 CALCIPOTRIOL Dovonex 50mcg/g Oint Dovonex 50mcg/g Cr Dovonex 50mcg/mL Scalp Sol CALCITRIOL Silkis 3ug/G Oint TAZAROTENE Tazorac 0.05% Gel Tazorac 0.1% Gel CALCIPOTRIOL, COMBINATIONS Dovobet 50mcg/0.5mg/g Oint E E E E E 01976133 02150956 02194341 02338572 02230784 02230785 02244126 LEO LEO LEO GAC ALL ALL LEO

DNP DNP DNP

D05AX03 D05AX05

DNP DNP

D05AX52

D05B ANTIPSORIATICS FOR SYSTEMIC USE D05BA PSORALENS FOR SYSTEMIC USE D05BA02 METHOXSALEN Oxsoralen 10mg Cap Oxsoralen Ultra 10mg Cap SF SF 01946374 00252654 VLN VLN

DNP DNP

D05BB RETINOIDS FOR TREATMENT OF PSORIASIS D05BB02 ACITRETIN Soriatane 10mg Cap Soriatane 25mg Cap SF SF 02070847 02070863 TRB TRB

DNP DNP

D06

ANTIBIOTICS AND CHEMOTHERAPEUTICS FOR DERMATOLOGICAL USE

D06A ANTIBIOTICS FOR TOPICAL USE D06AX OTHER ANTIBIOTICS FOR TOPICAL USE D06AX01 FUSIDIC ACID Fucidin 2% Cr Fucidin 2% Oint NEOMYCIN Neosporin Oint BACITRACIN Bacitracin 50,000iu Pdr/Vial GENTAMICIN ratio-Gentamicin 0.1% Cr ratio-Gentamicin 0.1% Oint MUPIROCIN Bactroban 2% Cr mupirocin 2% oint Taro-Mupirocin 2% Oint Bactroban 2% Oint D06AX30 ANTIBIOTICS, COMBINATIONS Soframycin Oint SF SF SF SF SF SF SF SF SF SF 00586668 00586676 00666122 00030708 00805386 00805025 02239757 02279983 01916947 02224879 LEO LEO GSK PFI TEV TEV GCH TAR GCH ERF

DNP DNP

D06AX04 D06AX05 D06AX07

DNP

DNP

DNP DNP

D06AX09

DNPM

DNPM DNPM

MRP MRP

DNP

December 2012

Dermatologicals ­ 63

D06B CHEMOTHERAPEUTICS FOR TOPICAL USE D06BA SULFONAMIDES D06BA01 SILVER SULFADIAZINE Flamazine 1% Cr SFC 00323098 SNE

DNP

D06BB ANTIVIRALS D06BB01 IDOXURIDINE idoxuridine 0.1% sol Sandoz Idoxuridine 0.1% Sol (discontinued) Herplex-D 0.1% Sol (discontinued) ACYCLOVIR Zovirax 5% Oint PODOPHYLLOTOXIN Podofilm 250mg/mL Liq Condyline 0.5% Top Sol Wartec 0.5% Top Sol IMIQUIMOD Aldara 5% Cr SF SF SF E 00569771 00598208 01945149 02074788 02239505 GSK PAL CDX PAL GWP

D06BB03 D06BB04

DNP DNP DNP

D06BB10

DNP

D06BX OTHER CHEMOTHERAPEUTICS D06BX01 METRONIDAZOLE MetroCream 0.75% Cr Noritate 1% Cr Rosasol 1% Cr MetroGel 1% Gel MetroLotion 0.75% Lot SFC SFC SFC SFC SFC 02226839 02156091 02242919 02297809 02248206 GAC SAV STI GAC GAC

DNP DNP DNP DNP DNP

D07

CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS

D07A CORTICOSTEROIDS, PLAIN D07AA CORTICOSTEROIDS, WEAK (GROUP I) D07AA02 HYDROCORTISONE Hydrocortisone 0.5% in Dermabase Cr Hydrocortisone 0.5% in Glaxal Base Cr Emo-Cort 1% Cr Hyderm 1% Cr Hydrocortisone 1% in Dermabase Cr Hydrocortisone 1% in Glaxal Base Cr Prevex HC 1% Cr Emo-Cort 2.5% Cr Emo-Cort 1% Lot Sarna HC 1% Lot Emo-Cort 2.5% Lot Sarna HC 2.5% Lot Cortoderm 1% Oint Hydrocorisone 0.5% in Soft Petrolatum Oint Hydrocorisone 1% in Soft Petrolatum Oint hydrocortisone valerate 0.2% cr Hydroval 0.2% Cr Westcort 0.2% Cr (discontinued) Hydroval 0.2% Oint D07AB CORTICOSTEROIDS, MODERATELY POTENT (GROUP II) D07AB01 CLOBETASONE Spectro Eczemacare Medicated Cream SF 02214415 GCH SF SF 00903124 00903159 00192597 00716839 00903132 00903167 00804533 00595799 00192600 00578541 00595802 00856711 00716693 00903175 00903183 02242984 02242985 CPD CPD STI TAR CPD CPD STI STI STI STI STI STI TAR CPD CPD TPH TPH

DNP DNP

SF SF SF SF SF SF SF SF SF

DNP DNP DNP DNP DNP DNP DNP

DNP

MRP

DNP

DNP

December 2012

Dermatologicals ­ 64

D07AB08

DESONIDE desonide 0.05% cr pms-Desonide 0.05% Cr Tridesilon 0.05% Cr (discontinued) desonide 0.05% oint pms-Desonide 0.05% Oint Tridesilon 0.05% Oint (discontinued)

DNP

MRP

SF

02229315

PMS

DNP

MRP

SF

02229323

PMS

D07AB09

TRIAMCINOLONE Aristocort C 0.5% Cr Aristocort R 0.1% Cr Triaderm 0.1% Cr Aristocort R 0.1% Oint

DNP DNP DNP

SF SF SF

02194066 02194058 00716960 02194031

VAL VAL TAR VAL

D07AC CORTICOSTEROIDS, POTENT (GROUP III) D07AC01 BETAMETHASONE betamethasone dipropionate 0.05% cr Taro-Sone 0.05% Cr Diprosone 0.05% Cr ratio-Topisone 0.05% Cr betamethasone dipropionate 0.05% glycol cr ratio-Topilene 0.05% Glycol Cr Diprolene 0.05% Glycol Cr betamethasone dipropionate 0.05% glycol lot ratio-Topilene 0.05% Glycol Lot Diprolene 0.05% Glycol Lot betamethasone dipropionate 0.05% glycol oint ratio-Topilene 0.05% Glycol Oint Diprolene 0.05% Glycol Oint betamethasone dipropionate 0.05% lot ratio-Topisone 0.05% Lot Diprosone 0.05% Lot betamethasone dipropionate 0.05% oint ratio-Topisone 0.05% Oint Diprosone 0.05% Oint betamethasone 17 valerate 0.05% cr Betaderm 0.05% Cr Celestoderm-V/2 0.05% Cr Celestoderm-V/2 0.05% Cr (discontinued) ratio-Ectosone 0.05% Cr ratio-Ectosone 0.05% Lot Betaderm 0.05% Oint Celestoderm V/2 0.05% Oint betamethasone 17 valerate 0.1% cr Betaderm 0.1% Cr Celestoderm V 0.1% Cr Celestoderm-V 0.1% Cr (discontinued) ratio-Ectosone 0.1% Cr Prevex B 0.1% Cr ratio-Ectosone 1% Lot Betaderm 0.1% Oint Celestoderm V 0.1% Oint Betaderm 0.1% Scalp Lot

December 2012

DNPM DNPM DNPM

MRP MRP

SF SF SF SF SF

01925350 00323071 00804991 00849650 00688622

TAR SCH TEV TEV SCH

DNPM DNPM

MRP MRP

DNPM DNPM

MRP MRP

SF SF

01927914 00862975

TEV SCH

DNPM DNPM

MRP MRP

SF SF

00849669 00629367

TEV SCH

DNPM DNPM

MRP MRP

SF SF

00809187 00417246

TEV SCH

DNPM DNPM

MRP MRP

SF SF

00805009 00344923

TEV SCH

DNPM DNPM

MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF SF

00716618 02357860 00027898 00535427 00653209 00716642 02357879 00716626 02357844 00027901 00535435 00804541 00750050 00716650 02357852 00716634

TAR VAL SCH TEV TEV TAR VAL TAR VAL SCH TEV STI TEV TAR VAL TAR

DNPM DNPM DNPM DNPM

DNPM DNPM

MRP MRP

DNPM DNPM DNPM DNPM DNPM DNPM

Dermatologicals ­ 65

ratio-Ectosone 0.1% Scalp Lot Valisone 0.1% Scalp Lot D07AC03 DESOXIMETASONE Topicort Mild 0.05% Cr Topicort 0.25% Cr Topicort 0.05% Gel Topicort 0.25% Oint FLUOCINOLONE ACETONIDE Derma-Smoothe FS 0.01% Top Oil DIFLUCORTOLONE Nerisone 0.1% Cr Nerisone 0.1% Oily Cr Nerisone 0.1% Oint (discontinued) FLUOCINONIDE Lidemol 0.05% Cr Tiamol 0.05% Cr fluocinonide 0.05% cr Lyderm 0.05% Cr Lidex 0.05% Cr fluocinonide 0.05% gel Lyderm 0.05% Gel Lidex 0.05% Gel fluocinonide 0.05% oint Lyderm 0.05% Oint Lidex 0.05% Oint D07AC11 AMCINONIDE amcinonide 0.1% cr ratio-Amcinonide 0.1% Cr Taro-Amcinonide 0.1% Cr Cyclocort 0.1% Cr amcinonide 0.1% lot ratio-Amcinonide 0.1% Lot Cyclocort 0.1% Lot amcinonide 0.1% oint ratio-Amcinonide 0.1% Oint Cyclocort 0.1% Oint D07AC13 MOMETASONE mometasone 0.1% cr Taro-Mometasone 0.1% Cr Elocom 0.1% Cr mometasone 0.1% lot Taro-Mometasone 0.1% Lot Elocom 0.1% Lot mometasone 0.1% oint ratio-Mometasone 0.1% Oint Taro-Mometasone 0.1% Oint Elocom 0.1% Oint

DNPM DNPM

SF SF SF SF SF SF SF SF SF

00653217 00027944 02221918 02221896 02221926 02221934 00873292 00587826 00587818

TEV VAL VLN VLN VLN VLN HLZ STI STI

DNP DNP DNP DNP

D07AC04 D07AC06

DNP

DNP DNP

D07AC08

DNP DNP

SF SF SF SF

02163152 00598933 00716863 02161923

VAL TPH TPH VAL

DNP DNP

MRP MRP

DNP DNP

MRP MRP

SF SF

02236997 02161974

TPH VAL

DNP DNP

MRP MRP

SF SF

02236996 02161966

TPH VAL

DNP DNP DNP

MRP MRP MRP

SF SF SF

02247098 02246714 02192284

TEV TAR STI

DNP DNP

MRP MRP

SF SF

02247097 02192276

TEV STI

DNP DNP

MRP MRP

SF SF

02247096 02192268

TEV STI

DNP DNP

MRP MRP

SF SF

02367157 00851744

SCH SCH

DNP DNP

MRP MRP

SF SF

02266385 00871095

TAR SCH

DNP DNP DNP

MRP MRP MRP

SF SF SF

02248130 02264749 00851736

TEV TAR SCH

December 2012

Dermatologicals ­ 66

D07AD CORTICOSTEROIDS, VERY POTENT (GROUP IV) D07AD01 CLOBETASOL clobetasol 17-propionate 0.05% cr MYLAN-Clobetasol 0.05% Cr Novo-Clobetasol 0.05% Cr pms-Clobetasol 0.05% Cr ratio-Clobetasol 0.05% Cr Taro-Clobetasol 0.05% Cr Dermovate 0.05% Cr pms-Clobetasol 0.05% Cr (discontinued) clobetasol 17-propionate 0.05% oint MYLAN-Clobetasol 0.05% Oint Novo-Clobetasol 0.05% Oint pms-Clobetasol 0.05% Oint ratio-Clobetasol 0.05% Oint Taro-Clobetasol 0.05% Oint Dermovate 0.05% Oint clobetasol 17-propionate 0.05% scalp lot MYLAN-Clobetasol 0.05% Scalp Lot pms-Clobetasol 0.05% Scalp Lot ratio-Clobetasol 0.05% Scalp Lot Taro-Clobetasol 0.05% Scalp Lot Dermovate 0.05% Scalp Lot D07C CORTICOSTEROIDS, COMBINATIONS WITH ANTIBIOTICS D07CA CORTICOSTEROIDS, WEAK, COMBINATIONS WITH ANTIBIOTICS D07CA01 HYDROCORTISONE AND ANTIBIOTICS Fucidin H 1% Cr Cortisporin Oint Vioform HC Cr 02238578 00666246 00074500 LEO GSK PAL

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02024187 02093162 02309521 01910272 02245523 02213265 02232191

MYL TEV PMS TEV TAR TPH PMS

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02026767 02126192 02309548 01910280 02245524 02213273

MYL TEV PMS TEV TAR TPH

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

02216213 02232195 01910299 02245522 02213281

MYL PMS TEV TAR TPH

D07CB CORTICOSTEROIDS, MODERATELY POTENT, COMBINATIONS WITH ANTIBIOTICS D07CB01 TRIAMCINOLONE AND ANTIBIOTICS triamcinolone 0.1%, nystatin, neomycin & gramicidin cr Viaderm KC Cr Kenacomb Cr (discontinued) triamcinolone 0.1%, nystatin, neomycin & gramicidin oint Viaderm KC Oint Kenacomb Oint (discontinued) D07CB05 FLUMETASONE AND ANTIBIOTICS Locacorten Vioform Cr

00717002

TAR

00717029

TAR

00074462

PAL

D07CC CORTICOSTEROIDS, POTENT, COMBINATIONS WITH ANTIBIOTICS D07CC01 BETAMETHASONE AND ANTIBIOTICS Valisone G Oint Valisone G Cream 00232351 00177016 VAL VAL

D07X CORTICOSTEROIDS, OTHER COMBINATIONS D07XA CORTICOSTEROIDS, WEAK, OTHER COMBINATIONS D07XA01 HYDROCORTISONE Pramox HC 1% Cr Uremol HC 1% Cr Pramox HC 1% Lot Uremol HC 1% Lot SF SF SF SF 00770957 00503134 01954210 00560022 DPT STI DPT STI

DNP DNP DNP DNP

December 2012

Dermatologicals ­ 67

D07XC CORTICOSTEROIDS, POTENT, OTHER COMBINATIONS D07XC01 BETAMETHASONE Diprosalic Oint Dovobet 0.5mg/g/50mcg/g Gel SF E SF SF 00578436 02319012 02245688 00578428 SCH LEO TEV SCH

DNP DNP

bethamethasone dipropionate 0.05% & salicylic acid 2% lot ratio-Topisalic Lot DNP MRP DNP MRP Diprosalic Lot D07XC04 DIFLUCORTOLONE Nerisalic Oily Cr (discontinued)

D08

ANTISEPTICS AND DISINFECTANTS

D08A ANTISEPTICS AND DISINFECTANTS D08AE PHENOL AND DERIVATIVES D08AE01 HEXACHLOROPHENE pHisoHex 3% Liq SF 02017733 SAV

DNP

D08AG IODINE PRODUCTS D08AG02 POVIDONE-IODINE Betadine 10% Oint Betadine 10% Sol 00254339 00158348 PFR PFR

D08AJ BENZETHONIUM CHLORIDE, COMBINATIONS D08AJ58 BENZETHONIUM CHLORIDE, COMBINATIONS Buro-Sol 2.36g/Pack Pdr SF 00579947 STI

DNP

D09

MEDICATED DRESSINGS

D09A MEDICATED DRESSINGS D09AA OINTMENT DRESSINGS WITH ANTIINFECTIVES D09AA01 FRAMYCETIN Sofra-Tulle 1% 10cm x 10cm Sofra-Tulle 1% 10cm x 30cm SF SF 01988840 01987682 ERF ERF

DNP DNP

D10

ANTI-ACNE PREPARATIONS

D10A ANTI-ACNE PREPARATIONS FOR TOPICAL USE D10AA CORTICOSTEROIDS, COMBINATIONS FOR TREATMENT OF ACNE D10AA02 METHYLPREDNISOLONE Neo-Medrol Acne Lot

DNP

F

00195057

PFI

D10AB PREPARATIONS CONTAINING SULFUR D10AB02 SULPHUR Sulfacet-R Lot F 02220407 VLN

DNP

D10AD RETINOIDS FOR TOPICAL USE IN ACNE D10AD01 TRETINOIN Stieva-A 0.01% Cr Stieva-A 0.025% Cr Retin-A 0.05% Cr Stieva-A 0.05% Cr Retin-A 0.1% Cr Stieva-A 0.1% Forte Cr Retin-A 0.01% Gel Retin-A 0.025% Gel Stieva-A 0.025% Gel (discontinued) FE6 FE6 6 FE FE6 FE6 FE6 FE6 FE6 00657204 00578576 00443794 00518182 00870021 00662348 00870013 00443816 STI STI JNJ STI JNJ STI JNJ JNJ

DNP DNP DNP DNP DNP DNP DNP DNP

6

Full benefit for beneficiaries 30 years and under. For coverage in beneficiaries over the age of 30, please refer to criteria in Appendix III.

Dermatologicals ­ 68

December 2012

Stieva-A 0.05% Gel (discontinued) Vitamin A Acid 0.05% Gel D10AE PEROXIDES D10AE01 BENZOYL PEROXIDE PanOxyl 10% Bar (discontinued) PanOxyl 10% Gel PanOxyl 20% Gel Solugel 4% Gel Solugel 8% Gel

DNP

FE6

01926489

VLN

DNP DNP

F F

00263699 00373036 01975382 02019825

STI STI STI STI

D10AF ANTINFECTIVES FOR TREATMENT OF ACNE D10AF01 CLINDAMYCIN clindamycin 1% top sol Taro-Clindamycin 1% Sol Dalacin T 1% Sol CLINDAMYCIN, COMBINATIONS BenzaClin Gel Clindoxyl Gel ERYTHROMYCIN, COMBINATIONS Stievamycin Regular Gel Stievamycin Forte Gel Stievamycin Mild Gel F F F

DNP DNP

MRP MRP

F F

02266938 00582301 02248472 02243158 01905112 01945262 02015994

TAR PFI VLN STI STI STI STI

D10AF51

D10AF52

DNP DNP DNP

D10AX OTHER ANTI-ACNE PREPARATIONS FOR TOPICAL USE D10AX03 AZELAIC ACID Finacea 15% Gel SFC 02270811 BAY

DNP

D10B ANTI-ACNE PREPARATIONS FOR SYSTEMIC USE D10BA RETINOIDS FOR TREATMENT OF ACNE D10BA01 ISOTRETINOIN isotretinoin 10mg cap Clarus 10mg Cap Accutane 10mg Cap isotretinoin 40mg cap Clarus 40mg Cap Accutane 40mg Cap

DNP DNP

MRP MRP

F F

02257955 00582344

MYL HLR

DNP DNP

MRP MRP

F F

02257963 00582352

MYL HLR

D11

OTHER DERMATOLOGICAL PREPARATIONS

D11A OTHER DERMATOLOGICAL PREPARATIONS D11AH AGENTS FOR DERMATITIS, EXCLUDING CORTICOSTEROIDS D11AH01 TACROLIMUS Protopic 0.03% Oint Protopic 0.1% Oint PIMECROLIMUS Elidel 1% Cr ALITRETINOIN Toctino 10mg Cap Toctino 30mg Cap E E 02244149 02244148 ASL ASL

DNP DNP

D11AH02 D11AH04

02247238 02337630 02337649

NVR ACT ACT

6

Full benefit for beneficiaries 30 years and under. For coverage in beneficiaries over the age of 30, please refer to criteria in Appendix III.

Dermatologicals ­ 69

December 2012

D11AX OTHER DERMATOLOGICALS D11AX01 MINOXIDIL minoxidil 20mg/mL top sol Apo-Gain 20mg/mL Top Sol Rogaine 20mg/mL Top Sol (discontinued) FINASTERIDE finasteride 1mg tab pms-Finasteride 1mg Tab Propecia 1mg Tab AMINOBENZOATE POTASSIUM, SYSTEMIC Potaba 500mg Cap Potaba 500mg Tab SF SF

00885754

APX

D11AX10

02320169 02238213 00611271 00550175

PMS FRS GLE GLE

D11AX99

DNP DNP

December 2012

Dermatologicals ­ 70

G01

GYNECOLOGICAL ANTI-INFECTIVES AND ANTISEPTICS

G01A ANTI-INFECTIVES/ANTISEPTICS, EXCLUDING COMBINATIONS WITH CORTICOSTEROIDS G01AA ANTIBIOTICS G01AA01 NYSTATIN Nyaderm 100,000 iu/dose Vag Cr ratio-Nystatin 500,000 iu/dose Vag Cr CLINDAMYCIN Dalacin 100mg/dose Vag Cr NYSTATIN, COMBINATIONS Flagystatin Vag Cr Flagystatin Vag Ovules SFC SFC FC SFC SFC 00716901 02194163 02060604 01926845 01926829 TAR TEV PAL SAV SAV

DNP DNP

G01AA10 G01AA51

DNP

DNP DNP

G01AF IMIDAZOLE DERIVATIVES G01AF01 METRONIDAZOLE Flagyl 10% Vag Cr NidaGel 0.75% Vag Gel CLOTRIMAZOLE clotrimazole 1% vag cr Clotrimaderm 1% Vag Cr Canesten 6 Vag Cr (6 day) clotrimazole 2% vag cr Clotrimaderm 2% Vag Cr Canesten 3 Vag Cr (3 day) Canesten 1 Vag Cr Canesten 1 Vag Cr Combi-Pak Canesten 1 Comfortab Combi-Pak (1 day) Canesten 3 Comfortab Combi-Pak (3 day) G01AF04 MICONAZOLE miconazole 2% vag cr Micozole 2% Vag Cr Monistat 7 (2%) Vag Cr Monistat 3 Dual-Pak Monistat 7 Dual-Pak Monistat 3 (400mg) Vag Ovules G01AF15 BUTOCONAZOLE Gynazole.1 Vag Cr SFC SFC 01926861 02125226 SAV GWP

DNP DNP

G01AF02

DNP DNP

MRP MRP

SFC SFC

00812366 02150891

TAR YNO

DNP DNP DNP DNP DNP DNP

MRP MRP

SFC SFC SFC SFC SFC SFC

00812374 02150905 02150883 02230509 02264102 02264099

TAR YNO YNO YNO YNO YNO

DNP DNP DNP DNP DNP

MRP MRP

SFC SFC SFC SFC SFC

02231106 02084309 02126249 02126257 02126605 02248417

TAR JNJ JNJ JNJ JNJ FEI

G01AG TRIAZOLE DERIVATIVES G01AG02 TERCONAZOLE Terazol-3 Dual Pak 02130874 JAN

G02

OTHER GYNECOLOGICALS

G02A OXYTOCICS G02AD PROSTAGLANDINS G02AD02 DINOPROSTONE Prostin E2 0.5mg Tab SF 00400688 PAL

DNPM

December 2012

Genito-Urinary System & Sex Hormones ­ 71

G02B CONTRACEPTIVES G02BA INTRAUTERINE CONTRACEPTIVES G02BA03 PLASTIC IUD WITH PROGESTOGEN Mirena IUD 52mg/insert F 02243005 BAY

DNP

G02BB VAGINAL RING WITH PROGESTOGEN AND ESTROGEN G02BB01 ETHINYL ESTRADIOL AND ETONOGESTREL NuvaRing 02253186 SCH

G02C OTHER GYNECOLOGICALS G02CB PROLACTINE INHIBITORS G02CB01 BROMOCRIPTINE bromocriptine mesylate 2.5mg tab Apo-Bromocriptine 2.5mg Tab Parlodel 2.5mg Tab (discontinued) pms-Bromocriptine 2.5mg Tab (discontinued) bromocriptine mesylate 5mg cap Apo-Bromocriptine 5mg Cap Parlodel 5mg Cap (discontinued) pms-Bromocriptine 5mg Cap (discontinued) G02CB03 CABERGOLINE cabergoline 0.5mg tab CO Cabergoline 0.5mg Tab Dostinex 0.5mg Tab QUINAGOLIDE Norprolac 0.025mg Tab Norprolac 0.05mg Tab Norprolac 0.075mg Tab Norprolac 0.15mg Tab

DNP

MRP

SFC

02087324

APX

DNP

MRP

SFC

02230454

APX

DNP DNP

MRP MRP

E E E E E E

02301407 02242471 02223740 02223759 02223767 02223775

COB PAL FEI FEI FEI FEI

G02CB04

DNP DNP DNP DNP

G03

SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM

G03A HORMONAL CONTRACEPTIVES FOR SYSTEMIC USE G03AA PROGESTOGENS AND ESTROGENS, FIXED COMBINATIONS G03AA01 ETHYNODIOL AND ESTROGEN Demulen 30 Tab 21 Day Demulen 30 Tab 28 Day NORETHINDRONE AND ESTROGEN Brevicon 0.5/35 Tab 21 Day Brevicon 0.5/35 Tab 28 Day Brevicon 1/35 Tab 21 Day Brevicon 1/35 Tab 28 Day LoEstrin 1.5/30 Tab 21 Day LoEstrin 1.5/30 Tab 28 Day MinEstrin 1/20 Tab 21 Day MinEstrin 1/20 Tab 28 Day Ortho 0.5/35 Tab 21 Day Ortho 0.5/35 Tab 28 Day Ortho 1/35 Tab 28 Day Ortho 1/35 Tab 21 Day Select 1/35 Tab 21 Day Select 1/35 Tab 28 Day F F F F F F F F F F F F F F F F 00469327 00471526 02187086 02187094 02189054 02189062 00297143 00353027 00315966 00343838 00317047 00340731 00372838 00372846 02197502 02199297 PFI PFI PFI PFI PFI PFI PAL PAL PAL PAL JAN JAN JAN JAN PFI PFI

DNP DNP

G03AA05

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

December 2012

Genito-Urinary System & Sex Hormones ­ 72

G03AA07

LEVONORGESTREL AND ESTROGEN levonorgestrel 0.10mg & ethinyl estradiol 0.02mg tab (21) ESME Tab 21 Day DNP Alysena Tab 21 Day DNP DNP Alesse Tab 21 Day Aviane Tab 21 Day (discontinued) levonorgestrel 0.10mg & ethinyl estradiol 0.02mg tab (28) ESME Tab 28 Day DNP Alysena Tab 28 Day DNP DNP Alesse Tab 28 Day Aviane Tab 28 Day (discontinued) levonorgestrel 0.15mg & ethinyl estradiol 0.03mg tab (21) DNP Portia Tab 21 Day DNP Min-Ovral Tab 21 Day levonorgestrel 0.15mg & ethinyl estradiol 0.03mg tab (28) Portia Tab 28 Day DNP DNP Min-Ovral Tab 28 Day Seasonale Tab (91 Day)

MRP MRP MRP

F F F

02388138 02387875 02236974

MYL APX PFI

MRP MRP MRP

F F F

02388146 02387883 02236975

MYL APX PFI

MRP MRP

F F

02295946 02042320

APX PFI

MRP MRP

F F

02295954 02042339 02296659

APX PFI WNC SCH SCH JAN APX SCH

G03AA09

DESOGESTREL AND ESTROGEN Linessa Tab 21 Day Linessa Tab 28 Day Orthocept Tab 28 Day

DNP DNP DNP

F F F F F

02272903 02257238 02042533 02317192 02042487

desogestrel 150mcg and ethiny estradiol 30mcg tab (21) DNP Apri 21 Tab 21 Day DNP Marvelon Tab 21 Day desogestrel 150mcg and ethiny estradiol 30mcg tab (28) Apri 28 Tab 28 Day DNP DNP Marvelon Tab 28 Day G03AA11 NORGESTIMATE AND ESTROGEN Cyclen Tab 21 Day Cyclen Tab 28 Day DROSPIRENONE AND ESTROGEN Yasmin Tab 21 Day Yasmin Tab 28 Day Yaz 3mg/0.02mg Tab NORELGESTROMIN AND ESTROGEN Evra 0.6/6mg Patch

MRP MRP

MRP MRP

F F F F F F

02317206 02042479 01968440 01992872 02261723 02261731 02321157 02248297

APX SCH JAN JAN BAY BAY BAY JAN

DNP DNP

G03AA12

DNP DNP

G03AA13

G03AB PROGESTOGENS AND ESTROGENS, SEQUENTIAL PREPARATIONS G03AB03 LEVONORGESTREL AND ESTROGEN Triquilar Tab 21 Day Triquilar Tab 28 Day NORETHINDRONE AND ESTROGEN Ortho 7/7/7 Tab 21 Day Ortho 7/7/7 Tab 28 Day Synphasic Tab 21 Day Synphasic Tab 28 Day NORGESTIMATE AND ESTROGEN Tri-Cyclen Tab 21 Day Tri-Cyclen Tab 28 Day Tri-Cyclen Lo Tab 21 Day Tri-Cyclen Lo Tab 28 Day F F F F F F F F F F 00707600 00707503 00602957 00602965 02187108 02187116 02028700 02029421 02258560 02258587 BAY BAY JAN JAN PFI PFI JAN JAN JAN JAN

DNP DNP

G03AB04

DNP DNP DNP DNP

G03AB11

DNP DNP DNP DNP

December 2012

Genito-Urinary System & Sex Hormones ­ 73

G03AC PROGESTOGENS G03AC01 G03AC03 G03AC06 NORETHINDRONE Micronor Tab 28 Day LEVONORGESTREL Plan B 0.75mg Tab MEDROXYPROGESTERONE Depo-Provera 50mg/mL Inj Medroxyprogesterone acetate 150mg/mL inj Medroxyprogesterone Acetate 150mg/mL Inj Depo-Provera 150mg/mL Inj G03B ANDROGENS G03BA 3-OXOANDROSTEN (4) DERIVATIVES G03BA03 TESTOSTERONE testosterone undercanoate 40mg cap pms-Testosterone 40mg Cap Andriol 40mg Cap testosterone cypionate 100mg/mL Inj Testosterone Cypionate 100mg/mL Inj Depo-Testosterone 100mg/mL Inj Delatestryl 200mg/mL Inj Androderm 2.5mg (12.2mg)/24 hr Patch Androderm 5mg (24.3mg)/24 hr Patch Androgel 2.5g/pkt Top Gel Androgel 5g/pkt Top Gel Testim 1% Top Gel G03C ESTROGENS G03CA NATURAL AND SEMISYNTHETIC ESTROGENS, PLAIN G03CA03 ESTRADIOL estradiol 50mcg/day patch Sandoz Estradiol Derm 50 (50mcg/day patch) Estradot Patch (50mcg/day) estradiol 50mcg/day patch Sandoz Estradiol Derm 50 (50mcg/day patch) Vivelle Patch (50mcg/day) (discontinued) estradiol 75mcg/day patch Sandoz Estradiol Derm 75 (75mcg/day patch) Estradot Patch (75mcg/day) estradiol 75mcg/day patch Sandoz Estradiol Derm 75 (75mcg/day patch) Vivelle Patch (75mcg/day) (discontinued) estradiol 100mcg/day patch Sandoz Estradiol Derm 100 (100mcg/day patch) Estradot Patch (100mcg/day) estradiol 100mcg/day patch Sandoz Estradiol Derm 100 (100mcg/day patch) Vivelle Patch (100mcg/day) (discontinued) Climara 25 (25mcg/day, 2mg/patch) Climara 50 (50mcg/day, 3.9mg/patch) Climara 75 (75mcg/day, 5.7mg/patch)

December 2012

DNP

SF F SFC SFC SFC

00037605 02241674 00030848 02322250 00585092

JAN PAL PFI SDZ PFI

DNP

DNP

DNP DNP

MRP MRP

D D

MRP MRP

SFC SFC

02322498 00782327

PMS SCH

D D D D D D D D

MRP MRP

SFC SFC SFC E E E E E

02246063 00030783 00029246 02239653 02245972 02245345 02245346 02280248

SDZ PFI VAL WTS WTS ABB ABB PAL

DNP DNP

MRP MRP

E E

02246967 02244000

SDZ NVR

DNP

MRP

E

02246967

SDZ

DNP DNP

MRP MRP

E E

02246968 02244001

SDZ NVR

DNP

MRP

E

02246968

SDZ

DNP DNP

MRP MRP

E E

02246969 02244002

SDZ NVR

DNP

MRP

E E E E

02246969 02247499 02231509 02247500

SDZ BAY BAY BAY

DNP DNP DNP

Genito-Urinary System & Sex Hormones ­ 74

Climara 100 (100mcg/day, 7.8mg/patch) Estraderm-25 (25mcg/day, 2mg/patch) Estraderm-100 (100mcg/day, 8mg/patch) Estradot Patch (25mcg/day) Estradot Patch (37.5mcg/day) Oesclim (25mcg/day, 5mg/patch) Oesclim (50mcg/day, 10mg/patch) Estrace 0.5mg Tab Estrace 1mg Tab Estrace 2mg Tab Estring 7.5mcg/24 hr Vag Ring Estrogel 0.06% Top Gel Vagifem 10mcg Vag Tab Vagifem 25mcg Vag Tab G03CA07 G03CA57 ESTRONE Estragyn Vag Cr CONJUGATED ESTROGENS Premarin 25mg/vial Inj Premarin 0.625mg/g Vag Cr Premarin 0.3mg Tab C.E.S. 0.625mg Tab Premarin 0.625mg Tab Premarin 1.25mg Tab

DNP DNP DNP DNP DNP

E E E E E SFC SFC SFC SFC E SFC SFC SFC SFC SFC SFC SFC SFC SFC

DNP DNP DNP DNP DNP DNP DNP

02231510 00756849 00756792 02245676 02243999 02243722 02243724 02225190 02148587 02148595 02168898 02238704 02325462 02241332 00727369 02043386 02043440 02043394 00265470 02043408 02043424

BAY NVR NVR NVR NVR TRI TRI SHI SHI SHI PAL SCH NNO NNO TRI PFI PFI PFI VLN PFI PFI

DNP

DNP DNP DNP DNP DNP DNP

G03D PROGESTOGENS G03DA PREGNEN (4) DERIVATIVES G03DA02 MEDROXYPROGESTERONE medroxyprogesterone acetate 2.5mg tab Apo-Medroxy 2.5mg Tab Novo-Medrone 2.5mg Tab Provera 2.5mg Tab medroxyprogesterone acetate 5mg tab Apo-Medroxy 5mg Tab Novo-Medrone 5mg Tab Provera 5mg Tab medroxyprogesterone acetate 10mg tab Apo-Medroxy 10mg Tab Novo-Medrone 10mg Tab Provera 10mg Tab medroxyprogesterone acetate 100mg tab Apo-Medroxy 100mg Tab Provera 100mg Tab (discontinued) G03DA04 PROGESTERONE Prometrium 100mg Cap

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC

02244726 02221284 00708917

APX TEV PFI

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC

02244727 02221292 00030937

APX TEV PFI

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC

02277298 02221306 00729973

APX TEV PFI

DNP

MRP

SFC

02267640

APX

02166704

SCH

G03DB PRAGNADIENDERIVATIVES G03DB08 DIENOGEST Visanne 2mg Tab E 02374900 BAY

DNP

G03F PROGESTOGENS AND ESTROGENS IN COMBINATION G03FA PROGESTOGENS AND ESTROGENS, COMBINATIONS G03FA01 NORETHINDRONE AND ESTROGEN Estalis 140/50mcg Transdermal Patch Estalis 250/50mcg Transdermal Patch Fem HRT 1mg/4mcg Tab (discontinued)

DNP DNP

E E

02241835 02241837

NVR NVR

December 2012

Genito-Urinary System & Sex Hormones ­ 75

G03FB PROGESTOGENS AND ESTROGENS, SEQUENTIAL PREPARATIONS G03FB05 NORETHISTERONE AND ESTROGEN Estalis-Sequi Patch 250/50 (discontinued) Estracomb Patch (discontinued)

G03G GONADOTROPHINS AND OTHER OVULATION STIMULANTS G03GB OVULATION STIMULANTS, SYNTHETICS G03GB02 CLOMIFENE Clomid 50mg Tab Serophene 50mg Tab 02091879 00893722 SAV EMD

G03H ANTIANDROGENS G03HA ANTIANDROGENS, PLAIN G03HA01 CYPROTERONE cyproterone 50mg tab Cyproterone 50mg Tab Androcur 50mg Tab

DNP DNP

MRP MRP

SFC SFC

02245898 00704431

AAP PMS

G03HB ANTIANDROGENS AND ESTROGENS G03HB01 CYPROTERONE AND ESTROGEN cyproterone acetate 2mg & ethinyl estradiol 0.035mg tab Cyestra-35 Tab Novo-Cyproterone/Ethinyl Estradiol 2mg/0.035mg Tab Diane-35 Tab

02290308 02309556 02233542

PMS TEV BAY

G03X OTHER SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM G03XA ANTIGONADOTROPHINS AND SIMILAR AGENTS G03XA01 DANAZOL Cyclomen 50mg Cap Cyclomen 100mg Cap Cyclomen 200mg Cap SF SF SF 02018144 02018152 02018160 SAV SAV SAV

DNP DNP DNP

G03XC SELECTIVE ESTROGEN RECEPTOR MODULATORS G03XC01 RALOXIFENE raloxifene 60mg tab Apo-Raloxifene 60mg Tab CO Raloxifene 60mg Tab Novo-Raloxifene 60mg Tab pms-Raloxifene 60mg Tab Evista 60mg Tab

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

E E E E E

02279215 02358840 02312298 02358921 02239028

APX COB TEV PMS LIL

G04

UROLOGICALS

G04B OTHER UROLOGICALS, INCLUDING ANTISPASMODICS G04BD URINARY ANTISPASMODICS G04BD02 G04BD04 FLAVOXATE Urispas 200mg Tab (discontinued) OXYBUTYNIN oxybutynin 1mg/mL o/l pms-Oxybutynin 1mg/mL O/L Ditropan 1mg/mL O/L (discontinued)

DNP

MRP

SF

02223376

PMS

December 2012

Genito-Urinary System & Sex Hormones ­ 76

oxybutynin 5mg tab Apo-Oxybutynin 5mg Tab MYLAN-Oxybutynin 5mg Tab Novo-Oxybutynin 5mg Tab Oxybutynin 5mg Tab pms-Oxybutynin 5mg Tab Ditropan 5mg Tab (discontinued) Ditropan XL 5mg Tab Ditropan XL 10mg Tab Uromax 10mg Tab Uromax 15mg Tab Oxytrol Patch (3.9mg/day 36mg/patch) Gelnique 100mg/g Gel G04BD07 TOLTERODINE Detrol 1mg Tab Detrol 2mg Tab Detrol LA 2mg Cap Detrol LA 4mg Cap SOLIFENACIN Vesicare 5mg Tab Vesicare 10mg Tab TROSPIUM Trosec 20mg Tab DARIFENACIN Enablex 7.5mg Tab Enablex 15mg Tab

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF E E E E

02163543 02230800 02230394 02350238 02240550 02243960 02243961 02273578 02273586 02254735 02366150 02239064 02239065 02244612 02244613 02277263 02277271 02275066 02273217 02273225

APX MYL TEV SAS PMS JAN JAN PFR PFR PAL WTS PFI PFI PFI PFI ASL ASL SEP NVR NVR

DNP DNP DNP DNP

DNP DNP DNP DNP

E E E E E E E E E

G04BD08

DNP DNP

G04BD09 G04BD10

DNP

DNP DNP

G04BE DRUGS USED IN ERECTILE DYSFUNCTION G04BE03 SILDENAFIL sildenafil 20mg tab ratio-Sildenafil-R 20mg Tab Revatio 20mg Tab sildenafil 25mg tab Apo-Sildenafil 25mg Tab CO Sildenafil 25mg Tab Novo-Sildenafil 25mg Tab pms-Sildenafil 25mg Tab Viagra 25mg Tab sildenafil 50mg tab Apo-Sildenafil 50mg Tab CO Sildenafil 50mg Tab Novo-Sildenafil 50mg Tab pms-Sildenafil 50mg Tab Viagra 50mg Tab sildenafil 100mg tab Apo-Sildenafil 100mg Tab CO Sildenafil 100mg Tab Novo-Sildenafil 100mg Tab pms-Sildenafil 100mg Tab Viagra 100mg Tab G04BE08 TADALAFIL Adcirca 20mg Tab

DNP DNP

MRP MRP

E E

02319500 02279401

TEV PFI

02248201 02372053 02308738 02371626 02239766

APX COB TEV PMS PFI

02248202 02372061 02308746 02371634 02239767

APX COB TEV PMS PFI

02248203 02372088 02308754 02371642 02239768

APX COB TEV PMS PFI

02338327

LIL

December 2012

Genito-Urinary System & Sex Hormones ­ 77

G04BX OTHER UROLOGICALS G04BX01 G04BX13 MAGNESIUM HYDROXIDE Urologic G Irr Sol DIMETHYL SULFOXIDE dimethyl sulfoxide 500mg/g (50%) irr sol Dimethyl Sulfoxide 500mg/g (50%) Irr Sol Rimso-50 (50%) Irr Sol SF 00039373 HOS

DNP

DNP DNP

MRP MRP

SF SF

02243231 00493392

SDZ BCH

G04C DRUGS USED IN BENIGN PROSTATIC HYPERTROPHY G04CA ALPHA-ADRENORECEPTOR ANTAGONISTS G04CA01 ALFUZOSIN alfuzosin 10mg extended release tab Apo-Alfuzosin 10mg Tab Novo-Alfuzosin PR 10mg Tab Sandoz Alfuzosin 10mg Tab Xatral 10mg Tab TAMSULOSIN tamsulosin 0.4mg sustained release cap MYLAN-Tamsulosin 0.4mg Cap Novo-Tamsulosin 0.4mg Cap RAN-Tamsulosin 0.4mg Cap ratio-Tamsulosin 0.4mg Cap Sandoz Tamsulosin 0.4mg CR Cap Flomax 0.4mg Cap (discontinued) tamsulosin 0.4mg sustained release cap/tab Apo-Tamsulosin 0.4mg CR Tab Sandoz Tamsulosin 0.4mg CR Cap Sandoz Tamsulosin 0.4mg CR Tab Flomax 0.4mg CR Tab Jamp-Tamsulosin 0.4mg Cap (discontinued) G04CA03 TERAZOSIN terazosin 1mg tab Apo-Terazosin 1mg Tab pms-Terazosin 1mg Tab ratio-Terazosin 1mg Tab Terazosin 1mg Tab Teva-Terazosin 1mg Tab Hytrin 1mg Tab terazosin 2mg tab Apo-Terazosin 2mg Tab pms-Terazosin 2mg Tab ratio-Terazosin 2mg Tab Terazosin 2mg Tab Teva-Terazosin 2mg Tab Hytrin 2mg Tab terazosin 5mg tab Apo-Terazosin 5mg Tab pms-Terazosin 5mg Tab ratio-Terazosin 5mg Tab Terazosin 5mg Tab Teva-Terazosin 5mg Tab Hytrin 5mg Tab

02315866 02314282 02304678 02245565

APX TEV SDZ SAV

G04CA02

02298570 02281392 02294885 02294265 02295121

MYL TEV RAN TEV SDZ

02362406 02295121 02340208 02270102

APX SDZ SDZ BOE

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02234502 02243518 02218941 02350475 02230805 00818658

APX PMS TEV SAS TEV ABB

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02234503 02243519 02218968 02350483 02230806 00818682

APX PMS TEV SAS TEV ABB

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02234504 02243520 02218976 02350491 02230807 00818666

APX PMS TEV SAS TEV ABB

December 2012

Genito-Urinary System & Sex Hormones ­ 78

terazosin 10mg tab Apo-Terazosin 10mg Tab pms-Terazosin 10mg Tab ratio-Terazosin 10mg Tab Terazosin 10mg Tab Teva-Terazosin 10mg Tab Hytrin 10mg Tab G04CB TESTOSTERONE-5-ALPHA REDUCTASE INHIBITORS G04CB01 FINASTERIDE finasteride 5mg Apo-Finasteride 5mg Tab CO Finasteride 5mg Tab Finasteride 5mg Tab Jamp-Finasteride 5mg Tab MINT-Finasteride 5mg Tab MYLAN-Finasteride 5mg Tab Novo-Finasteride 5mg Tab pms-Finasteride 5mg Tab RAN-Finasteride 5mg Tab ratio-Finasteride 5mg Tab Sandoz Finasteride 5mg Tab Proscar 5mg Tab DUTASTERIDE Avodart 0.5mg Cap

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF

02234505 02243521 02218984 02350505 02230808 00818674

APX PMS TEV SAS TEV ABB

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E E E E E

02365383 02354462 02355043 02357224 02389878 02356058 02348500 02310112 02371820 02306905 02322579 02010909 02247813

APX COB AHI JPC MNT MYL TEV PMS RAN TEV SDZ FRS GSK

G04CB02

December 2012

Genito-Urinary System & Sex Hormones ­ 79

December 2012

Genito-Urinary System & Sex Hormones ­ 80

H01

PITUITARY, HYPOTHALAMIC HORMONES, AND ANALOGUES

H01A ANTERIOR PITUITARY LOBE HORMONES AND ANALOGUES H01AC SOMATROPHIN AND SOMATROPHIN AGONISTS H01AC01 SOMATROPIN Humatrope 1mg/mL Inj Humatrope 6mg/vial Inj Humatrope 12mg/vial Inj Humatrope 24mg/vial Inj Nutropin 10mg/vial Inj Nutropin AQ 10mg/vial Inj Nutropin AQ Pen Cartridge Omnitrope 5mg/1.5mL Omnitrope 10mg/1.5mL Omnitrope 5.8mg/vial Saizen 3.33mg/vial Inj Saizen 5mg/vial Inj Saizen 8.8mg/vial Inj Saizen 6mg/cartridge Saizen 12mg/cartridge Saizen 20mg/cartridge E E E E E E E 00745626 02243077 02243078 02243079 02216191 02229722 02249002 02325063 02325071 02325055 02215136 02237971 02272083 02350122 02350130 02350149 LIL LIL LIL LIL HLR HLR HLR SDZ SDZ SDZ EMD EMD EMD EMD EMD EMD

DNP DNP DNP DNP DNP DNP DNP

DNP DNP DNP DNP DNP DNP

E E E E E E

H01AX OTHER ANTERIOR PITUITARY LOBE HORMONES AND ANALOGUES H01AX01 PEGVISOMANT Somavert 10mg/vial Inj Somavert 15mg/vial Inj Somavert 20mg/vial Inj 02272199 02272202 02272210 PFI PFI PFI

H01B POSTERIOR PITUITARY LOBE HORMONES H01BA VASOPRESSIN AND ANALOGUES H01BA01 VASOPRESSIN vasopressin 20units/mL usp inj Vasopressin 20units/mL USP Inj Pressyn 20units/mL USP Inj Pressyn AR 20units/mL USP Inj DESMOPRESSIN DDAVP 100mcg/mL Rhinyle Drops DDAVP 4mcg/mL Inj Octostim 15mcg/mL Inj desmopressin 10mcg/dose nasal sp Desmopressin 10mcg/dose Nasal Sp DDAVP 10mcg/dose Nasal Sp Octostim 1.5mg/mL Nasal Spray desmopressin 0.1mg tab Apo-Desmopressin 0.1mg Tab Novo-Desmopressin 0.1mg Tab pms-Desmopressin 0.1mg Tab DDAVP 0.1mg Tab desmopressin 0.2mg tab Apo-Desmopressin 0.2mg Tab pms-Desmopressin 0.2mg Tab Novo-Desmopressin 0.2mg Tab DDAVP 0.2mg Tab F7 F7 F7 F7

7

02247938 00693820 02246133 00402516 00873993 02024179 02242465 00836362 02237860 02284030 02287730 02304368 00824305

SDZ FEI FEI FEI FEI FEI AAP FEI FEI APX TEV PMS FEI

H01BA02

DNP DNP DNP DNP

MRP MRP MRP MRP

DNP DNP DNP DNP

MRP MRP MRP MRP

F F7 F7 F7

02284049 02304376 02287749 00824143

APX PMS TEV FEI

7

Full benefit for children 16 years and under.

Systemic Hormonal Preparations, Excluding Sex Hormones ­ 81

December 2012

Minirin 0.1mg Tab DDAVP MELT 60mcg Tab DDAVP MELT 120mcg Tab DDAVP MELT 240mcg Tab H01C HYPOTHALAMIC HORMONES H01CA GONADOTROPIN-RELEASING HORMONES H01CA02 NAFARELIN Synarel 2mg/mL Sol HISTRELIN Vantas 50mg/vial Inj

DNP DNP DNP

PRP PRP

F7 F7 F7

02246500 02284995 02285002 02285010

FEI FEI FEI FEI

DNP

SFC

02188783

PFI

H01CA03

02278383

PAL

H01CB SOMATOSTATIN AND ANALOGUES H01CB02 OCTREOTIDE octreotide 50mcg/mL inj Octreotide Acetate Omega 50mcg/mL Inj Sandostatin 50mcg/mL Inj octreotide 100mcg/mL inj Octreotide Acetate Omega 100mcg/mL Inj Sandostatin 100mcg/mL Inj octreotide 200mcg/mL inj Octreotide Acetate Omega 200mcg/mL Inj Sandostatin 200mcg/mL Inj octreotide 500mcg/mL inj Octreotide Acetate Omega 500mcg/mL Inj Sandostatin 500mcg/mL Inj Sandostatin LAR 10mg/vial Inj Sandostatin LAR 20mg/vial Inj Sandostatin LAR 30mg/vial Inj H01CB03 LANREOTIDE Somatuline Autogel 60mg/0.3 mL Syringe Inj Somatuline Autogel 90mg/0.3 mL Syringe Inj Somatuline Autogel 120mg/0.5 mL Syringe Inj

DNP DNP

MRP MRP

SFC SFC

02248639 00839191

HOS NVR

DNP DNP

MRP MRP

SFC SFC

02248640 00839205

HOS NVR

DNP DNP

MRP MRP

SFC SFC

02248642 02049392

HOS NVR

DNP DNP DNP DNP DNP

MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC

02248641 00839213 02239323 02239324 02239325 02283395 02283409 02283417

HOS NVR NVR NVR NVR TER TER TER

DNP DNP DNP

H02

CORTICOSTEROIDS FOR SYSTEMIC USE

H02A CORTICOSTEROIDS FOR SYSTEMIC USE, PLAIN H02AA MINERALOCORTICOIDS H02AA02 FLUDROCORTISONE Florinef 0.1mg Tab SFC 02086026 PAL

DNP

H02AB GLUCOCORTICOIDS H02AB01 BETAMETHASONE betamethasone 6mg/mL inj Betaject 6mg/mL Inj Celestone 6mg/mL Soluspan Inj

DNP DNP

MRP MRP

SFC SFC

02237835 00028096

SDZ SCH

7

Full benefit for children 16 years and under.

Systemic Hormonal Preparations, Excluding Sex Hormones ­ 82

December 2012

H02AB02

DEXAMETHASONE dexamethasone 4mg/mL inj Dexamethasone 4mg/mL Inj Dexamethasone 4mg/mL Inj Decadron 4mg/mL Inj (discontinued) Dexamethasone 10mg/mL Inj Dexamethasone 10mg/mL Inj pms-Dexamethasone 10mg/mL Inj dexamethasone 0.5mg tab Apo-Dexamethasone 0.5mg Tab pms-Dexamethasone 0.5mg Tab Decadron 0.5mg Tab (discontinued) dexamethasone 0.75mg tab pms-Dexamethasone 0.75mg Tab Decadron 0.75mg Tab (discontinued) pms-Dexamethasone 2mg Tab dexamethasone 4mg tab Apo-Dexamethasone 4mg Tab pms-Dexamethasone 4mg Tab Dexasone 4mg Tab Decadron 4mg Tab (discontinued)

DNP DNP

MRP MRP

SFC SFC SFC SFC SFC SFC SFC

01977547 00664227 02204274 00874582 00783900 02261081 01964976

CYI SDZ OMG SDZ PMS APX PMS

DNP DNP DNP

DNP DNP

MRP MRP

DNP

MRP

SFC SFC SFC SFC SFC

01964968 02279363 02250055 01964070 00489158

PMS PMS APX PMS VLN

DNP

DNP DNP DNP

MRP MRP MRP

H02AB04

METHYLPREDNISOLONE methylprednisolone acetate 40mg/vial inj Methylprednisolone Acetate 40mg/vial Inj Depo-Medrol 40mg/mL Aq Multidose Inj methylprednisolone acetate 80mg/vial inj Methylprednisolone Acetate 80mg/vial Inj Depo-Medrol 80mg/mL Aq Multidose Inj methylprednisolone acetate 40mg/vial inj (pf) Methylprednisolone Acetate 40mg/vial Inj (PF) Depo-Medrol 40mg/mL Aq Multidose Inj (PF) methylprednisolone acetate 80mg/vial inj (pf) Methylprednisolone Acetate 80mg/vial Inj (PF) Depo-Medrol 80mg/mL Aq Multidose Inj (PF)

DNP DNP

MRP MRP

SFC SFC

02245407 01934333

SDZ PFI

DNP DNP

MRP MRP

SFC SFC

02245408 01934341

SDZ PFI

DNP DNP

MRP MRP

SFC SFC

02245400 00030759

SDZ PFI

DNP DNP

MRP MRP

SFC SFC

02245406 00030767

SDZ PFI

methylprednisolone sodium succinate 40mg/vial inj Methylprednisolone Sod. Succ. 40mg/vial Inj DNP Solu-Medrol 40mg/vial Inj (discontinued) methylprednisolone sodium succinate 125mg/vial inj Methylprednisolone Sod. Succ. 125mg/vial Inj DNP Solu-Medrol 125mg/vial Inj (discontinued) methylprednisolone sodium succinate 500mg/vial inj Methylprednisolone Sod. Succ. 500mg/vial Inj DNP Solu-Medrol 500mg/vial Inj DNP methylprednisolone sodium succinate 1g/vial inj Methylprednisolone Sod. Succ. 1g/vial Inj Solu-Medrol 1g/vial Inj Solu-Medrol Act-O-Vial 1g Inj (discontinued) Solu-Medrol Act-O-Vial 40mg Inj (discontinued) Solu-Medrol Act-O-Vial 125mg Inj (discontinued) Solu-Medrol Act-O-Vial 500mg Inj (discontinued)

MRP

SFC

02231893

TEV

MRP

SFC

02231894

TEV

MRP MRP

SFC SFC

02231895 00030678

TEV PFI

DNP DNP

MRP MRP

SFC SFC

02241229 00036137

TEV PFI

December 2012

Systemic Hormonal Preparations, Excluding Sex Hormones ­ 83

Depo-Medrol 20mg/mL Aq Multidose Inj Medrol 4mg Tab Medrol 16mg Tab H02AB06 PREDNISOLONE prednisolone sodium phosphare 1mg/mL o/l pms-Prednisolone 1mg/mL O/L Pediapred 1mg/mL O/L PREDNISONE prednisone 1mg tab Apo-Prednisone 1mg Tab Winpred 1mg Tab prednisone 5mg tab Apo-Prednisone 5mg Tab Novo-Prednisone 5mg Tab Deltasone 5mg Tab (discontinued) prednisone 50mg tab Apo-Prednisone 50mg Tab Novo-Prednisone 50mg Tab Deltasone 50mg Tab (discontinued) H02AB08 TRIAMCINOLONE triamcinolone 10mg/mL inj Triamcinolone 10mg/mL Inj Kenalog-10 (10mg/mL) Inj triamcinolone 40mg/mL inj Triamcinolone 40mg/mL Inj Triamcinolone 40mg/mL Inj Kenalog-40 (40mg/mL) Inj H02AB09 HYDROCORTISONE Solu-Cortef 1g/vial Inj Solu-Cortef 100mg/vial Inj Solu-Cortef 250mg/vial Inj Solu-Cortef 500mg/vial Inj Cortef 10mg Tab Cortef 20mg Tab CORTISONE Cortisone Acetate 25mg Tab

DNP DNP DNP

SFC SFC SFC

01934325 00030988 00036129

PFI PFI PFI

DNP DNP

MRP MRP

SFC SFC

02245532 02230619

PMS SAV

H02AB07

DNP DNP

MRP MRP

SFC SFC

00598194 00271373

APX VLN

DNP DNP

MRP MRP

SFC SFC

00312770 00021695

APX TEV

DNP DNP

MRP MRP

SFC SFC

00550957 00232378

APX TEV

DNP DNP

MRP MRP

SFC SFC

02229540 01999761

SDZ WSQ

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

01977563 02229550 01999869 00030635 00030600 00030619 00030627 00030910 00030929 00280437

CYI SDZ WSQ PFI PFI PFI PFI PFI PFI VLN

DNP DNP DNP DNP DNP DNP

H02AB10

DNP

H02B CORTICOSTEROIDS FOR SYSTEMIC USE, COMBINATIONS H02BX CORTICOSTEROIDS FOR SYSTEMIC USE, COMBINATIONS H02BX01 METHYLPREDNISOLONE, COMBINATIONS Depo-Medrol 40mg/mL w Lidocaine Inj SFC 00260428 PFI

DNP

H03

THYROID THERAPY

H03A THYROID PREPARATIONS H03AA THYROID HORMONES H03AA01 LEVOTHYROXINE SODIUM Synthroid 0.025mg Tab Synthroid 0.05mg Tab Synthroid 0.075mg Tab Synthroid 0.088mg Tab Synthroid 0.1mg Tab Synthroid 0.112mg Tab Synthroid 0.125mg Tab Synthroid 0.137mg Tab Synthroid 0.15mg Tab Synthroid 0.175mg Tab Synthroid 0.2mg Tab SF SF SF SF SF SF SF SF SF SF SF 02172062 02172070 02172089 02172097 02172100 02171228 02172119 02233852 02172127 02172135 02172143 ABB ABB ABB ABB ABB ABB ABB ABB ABB ABB ABB

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

December 2012

Systemic Hormonal Preparations, Excluding Sex Hormones ­ 84

Synthroid 0.3mg Tab Eltroxin 50mcg Tab Eltroxin 100mcg Tab Eltroxin 150mcg Tab Eltroxin 200mcg Tab Eltroxin 300mcg Tab H03AA02 LIOTHYRONINE SODIUM Cytomel 5mcg Tab Cytomel 25mcg Tab THYROID GLAND PREPARATIONS Thyroid 30mg Tab Thyroid 60mg Tab Thyroid 125mg Tab

DNP DNP DNP DNP DNP DNP

SF SF SF SF SF SF SF SF SF SF SF

02172151 02213192 02213206 02213214 02213222 02213230 01919458 01919466 00023949 00023957 00023965

ABB TRI TRI TRI TRI TRI KNG KNG ERF ERF ERF

DNP DNP

H03AA05

DNP DNP DNP

H03B ANTITHYROID PREPARATIONS H03BA THIOURACILS H03BA02 PROPYLTHIOURACIL Propyl-Thyracil 50mg Tab Propyl-Thyracil 100mg Tab SF SF 00010200 00010219 PAL PAL

DNP DNP

H03BB SULPHUR-CONTAINING IMIDAZOLE DERIVATIVES H03BB02 METHIMAZOLE (THIAMAZOLE) Tapazole 5mg Tab Tapazole 10mg Tab SF SF 00015741 02296039 PAL PAL

DNP DNP

H04

PANCREATIC HORMONES

H04A GLYCOGENOLYTIC HORMONES H04AA GLYCOGENOLYTIC HORMONES H04AA01 GLUCAGON Glucagon 1mg/vial Inj GlucaGen 1mg/vial GlucaGen Hypokit 1mg/vial SFD SFD SFD 02243297 02333619 02333627 LIL NNO NNO

DNP DNP DNP

H05

CALCIUM HOMEOSTASIS

H05A PARATHYROID HORMONES AND ANALOGUES H05AA PARATHYROID HORMONES AND ANALOGUES H05AA02 TERIPARATIDE Forteo 250mcg/mL Inj 02254689 LIL

H05B ANTI-PARATHYROID AGENTS H05BA CALCITONIN PREPARATIONS H05BA01 CALCITONIN (SALMON SYNTHETIC) Calcimar 200iu/mL Inj calcitonin 200iu/dose nasal spray Apo-Calcitonin 200iu/dose Nasal Sp Sandoz Calcitonin NS 200iu/dose Nasal Sp Miacalcin 200iu/dose Nasal Sp HO5BX OTHER ANTI-PARATHYROID AGENTS H05BX01 CINACALET Sensipar 30mg Tab Sensipar 60mg Tab Sensipar 90mg Tab 02257130 02257149 02257157 AGA AGA AGA SFC E E E 01926691 02247585 02261766 02240775 SAV APX SDZ NVR

DNP

DNP DNP DNP

MRP MRP MRP

December 2012

Systemic Hormonal Preparations, Excluding Sex Hormones ­ 85

December 2012

Systemic Hormonal Preparations, Excluding Sex Hormones ­ 86

J01

ANTIBACTERIALS FOR SYSTEMIC USE

J01A TETRACYCLINES J01AA TETRACYCLINES J01AA02 DOXYCYCLINE doxycycline 100mg cap Apo-Doxy 100mg Cap Doxycycline 100mg Cap Novo-Doxylin 100mg Cap Vibramycin 100mg Cap doxycycline 100mg tab Apo-Doxy 100mg Tab Doxycycline 100mg Tab Novo-Doxylin 100mg Tab Vibra-Tabs C-Pak (discontinued) Doxycin 100mg Cap Doxycin 100mg Tab J01AA07 TETRACYCLINE tetracycline 250mg cap Tetra 250mg Cap Tetracyn 250mg Cap (discontinued) MINOCYCLINE minocycline HCl 50mg cap Apo-Minocycline 50mg Cap Minocycline 50mg Cap MYLAN-Minocycline 50mg Cap Novo-Minocycline 50mg Cap pms-Minocycline 50mg Cap Sandoz Minocycline 50mg Cap Minocin 50mg Cap (discontinued) minocycline HCl 100mg cap Apo-Minocycline 100mg Cap MYLAN-Minocycline 100mg Cap Minocycline 100mg Cap Novo-Minocycline 100mg Cap pms-Minocycline 100mg Cap Sandoz Minocycline 100mg Cap Minocin 100mg Cap (discontinued) J01B AMPHENICOLS J01BA AMPHENICOLS J01BA01 CHLORAMPHENICOL Chloromycetin Succinate 1g/vial Inj SFC 00312363 ERF

DNPM DNPM DNPM DNPM

MRP MRP MRP MRP

SFC SFC SFC SFC

00740713 02351234 00725250 00024368

APX SAS TEV PFI

DNPM DNPM DNPM

MRP MRP MRP

SFC SFC SFC

00874256 02351242 02158574 00817120 00860751

APX SAS TEV RIV RIV

DNPM

SFC

DNP

MRP

SFC

00580929

AAP

J01AA08

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC

02084090 02287226 02230735 02108143 02294419 02237313

APX SAS MYL TEV PMS SDZ

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC

02084104 02230736 02287234 02108151 02294427 02237314

APX MYL SAS TEV PMS SDZ

DNP

J01C BETA-LACTAM ANTIBACTERIALS, PENICILLINS J01CA PENICILLINS WITH EXTENDED SPECTRUM J01CA01 AMPICILLIN ampicillin 250mg cap Novo-Ampicillin 250mg Cap Penbritin 250mg Cap (discontinued) ampicillin 500mg cap Novo-Ampicillin 500mg Cap Penbritin 500mg Cap (discontinued)

DNPM

MRP

SFC

00020877

TEV

DNPM

MRP

SFC

00020885

TEV

December 2012

General Antiinfectives, Systemic ­ 87

J01CA04

AMOXICILLIN amoxicillin 250mg cap Amoxicillin 250mg Cap Apo-Amoxi 250mg Cap MYLAN-Amoxicillin 250mg Cap Novamoxin 250mg Cap pms-Amoxicillin 250mg Cap Amoxil 250mg Cap (discontinued) amoxicillin 500mg cap Amoxicillin 500mg Cap Apo-Amoxi 500mg Cap MYLAN-Amoxicillin 500mg Cap Novamoxin 500mg Cap pms-Amoxicillin 500mg Cap Amoxil 500mg Cap (discontinued) amoxicillin 25mg/mL o/l Amoxicillin 125mg Susp Amoxicillin Sugar Reduced 25mg/mL O/L Apo-Amoxi 125mg Susp Apo-Amoxi Sugar Free 125mg Susp Novamoxin 125mg Susp Novamoxin Sugar Reduced 25mg/mL O/L pms-Amoxicillin 25mg/mL Susp Amoxil 25mg/mL Susp (discontinued) amoxicillin 50mg/mL o/l Amoxicillin 250mg Susp Amoxicillin Sugar Reduced 50mg/mL O/L Apo-Amoxi 250mg Susp Apo-Amoxi Sugar Free 250mg Susp Novamoxin 250mg Susp Novamoxin Sugar Reduced 50mg/mL O/L pms-Amoxicillin 50mg/mL Susp Amoxil 50mg/mL Susp (discontinued) amoxicillin 250mg chewable tab Novamoxin 250mg Chew Tab Amoxil 250mg Chew Tab (discontinued) Amoxicillin 250mg Chew Tab (discontinued)

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

02352710 00628115 02238171 00406724 02230243

SAS APX MYL TEV PMS

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

02352729 00628123 02238172 00406716 02230244

SAS APX MYL TEV PMS

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC

02352745 02352761 00628131 00628131 00452149 01934171 02230245

SAS SAS APX APX TEV TEV PMS

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC

02352753 02352788 00628158 00628158 00452130 01934163 02230246

SAS SAS APX APX TEV TEV PMS

DNP

MRP

SFC

02036355

TEV

J01CE BETA-LACTAMASE SENSITIVE PENCILLINS J01CE02 PHENOXYMETHYLPENICILLIN (PENICILLIN V) Apo-Pen VK 125mg/5mL Susp Pen-Vee 180mg/5mL Susp (discontinued) Pen-Vee 300mg/5mL Susp (discontinued) penicillin V potassium 60mg/mL o/l Apo-Pen VK 300mg/5mL Susp Novo-Pen-VK 300mg/5mL Susp PVF 500 (300mg/5mL) Susp (discontinued) penicillin V potassium 300mg tab Apo-Pen VK 300mg Tab Novo-Pen-VK 300mg Tab PVF K 300mg Tab (discontinued) J01CF BETA-LACTAMASE RESISTANT PENICILLINS J01CF02 CLOXACILLIN cloxacillin 250mg cap Novo-Cloxin 250mg Cap Orbenin 250mg Cap (discontinued) SFC 00642223 APX

DNP

DNP DNP

MRP MRP

SFC SFC

00642231 00391603

APX TEV

DNP DNP

MRP MRP

SFC SFC

00642215 00021202

APX TEV

DNPM

MRP

SFC

00337765

TEV

December 2012

General Antiinfectives, Systemic ­ 88

cloxacillin 500mg cap Novo-Cloxin 500mg Cap Orbenin 500mg Cap (discontinued) cloxacillin 25mg/mL o/l Novo-Cloxin 125mg/5mL Susp Orbenin 125mg/5mL Susp (discontinued)

DNPM

MRP

SFC

00337773

TEV

DNPM

MRP

SFC

00337757

TEV

J01CR COMBINATIONS OF PENICILLINS, INCLUDING BETA-LACTAMASE INHIBITOR J01CR02 AMOXICILLIN AND ENZYME INHIBITOR Clavulin-200 (200mg/5mL) Susp amoxicillin & enzyme inhibitor 125mg/5mL susp Apo-Amoxi Clav 125mg/5mL Susp ratio-Aclavulanate 125mg/5mL Susp Clavulin-125F (125mg/5mL) Susp amoxicillin & enzyme inhibitor 250mg/5mL susp Apo-Amoxi Clav 250mg/5mL Susp ratio-Aclavulanate 250mg/5mL Susp Clavulin-250F (250mg/5mL) Susp amoxicillin & enzyme inhibitor 400mg/5mL susp Apo-Amoxi Clav 400mg/5mL Susp Clavulin-400 (400mg/5mL) Susp amoxicillin & enzyme inhibitor 250mg tab Apo-Amoxi Clav 250mg Tab Clavulin-250 (250mg) Tab (discontinued) amoxicillin & enzyme inhibitor 500mg tab Apo-Amoxi Clav 500mg Tab ratio-Aclavulanate 500mg Tab Clavulin-500F (500mg) Tab amoxicillin & enzyme inhibitor 875mg tab Apo-Amoxi Clav 875mg Tab Novo-Clavamoxin 875 (875mg) Tab ratio-Aclavulanate 875mg Tab Clavulin-875 (875mg) Tab J01CR05 PIPERACILLIN AND ENZYME INHIBITOR piperacillin sodium & enzyme inhibitor 2g/vial inj Piperacillin & Tazobactam 2g/vial Inj (Apotex) Tazocin 2g/vial Inj piperacillin sodium & enzyme inhibitor 3g/vial inj Piperacillin & Tazobactam 3g/vial Inj (Apotex) Tazocin 3g/vial Inj piperacillin sodium & enzyme inhibitor 4g/vial inj Piperacillin & Tazobactam 4g/vial Inj (Apotex) Tazocin 4g/vial Inj J01D OTHER BETA-LACTAM ANTIBACTERIALS J01DB FIRST-GENERATION CEPHALOSPORINS J01DB01 CEPHALEXIN Novo-Lexin 250mg Cap Novo-Lexin 500mg Cap cephalexin monohydrate 25mg o/l Novo-Lexin 125mg/5mL Susp Keflex 125mg/5mL Susp (discontinued) SFC SFC SFC 00342084 00342114 00342106 TEV TEV TEV SFC SFC SFC SFC SFC SFC SFC SFC SFC 02238831 02243986 02244646 01916882 02243987 02244647 01916874 02288559 02238830 GSK APX TEV GSK APX TEV GSK APX GSK

DNPM

DNPM DNPM DNPM

MRP MRP MRP

DNPM DNPM DNPM

MRP MRP MRP

DNPM DNPM

MRP MRP

DNPM

MRP

SFC

02243350

APX

DNPM DNPM DNPM

MRP MRP MRP

SFC SFC SFC

02243351 02243771 01916858

APX TEV GSK

DNPM DNPM DNPM DNPM

MRP MRP MRP MRP

SFC SFC SFC SFC

02245623 02248138 02247021 02238829

APX TEV TEV GSK

02308444 02170817

APX PFI

02308452 02170795

APX PFI

02308460 02170809

APX PFI

DNPM DNPM

DNPM

MRP

December 2012

General Antiinfectives, Systemic ­ 89

cephalexin monohydrate 50mg o/l Novo-Lexin 250mg/5mL Susp Keflex 250mg/5mL Susp (discontinued) cephalexin monohydrate 250mg tab Apo-Cephalex 250mg Tab Novo-Lexin 250mg Tab Keflex 250mg Tab (discontinued) cephalexin monohydrate 500mg tab Apo-Cephalex 500mg Tab Novo-Lexin 500mg Tab Keflex 500mg Tab (discontinued) J01DB04 CEFAZOLIN cefazolin sodium 500mg/vial inj Cefazolin Sodium 500mg/vial Inj Cefazolin Sodium 500mg/vial Inj cefazolin sodium 1g/vial inj Cefazolin Sodium 1g/vial Inj Cefazolin Sodium 1g/vial Inj Cefazolin Sodium 1g/vial Inj cefazolin sodium 10g/vial inj Cefazolin Sodium 10g/vial Inj Cefazolin Sodium 10g/vial Inj J01DB05 CEFADROXIL cefadroxil 500mg cap Apo-Cefadroxil 500mg Cap Novo-Cefadroxil 500mg Cap Duricef 500mg Cap (discontinued)

DNPM

MRP

SFC

00342092

TEV

DNPM DNPM

MRP MRP

SFC SFC

00768723 00583413

APX TEV

DNPM DNPM

MRP MRP

SFC SFC

00768715 00583421

APX TEV

DNPM DNPM

MRP MRP

SFC SFC

02108119 02308932

TEV SDZ

DNPM DNPM DNPM

MRP MRP MRP

SFC SFC SFC

02297205 02108127 02308959

APX TEV SDZ

02297213 02108135

APX TEV

DNP DNP

MRP MRP

SFC SFC

02240774 02235134

APX TEV

J01DC SECOND-GENERATION CEPHALOSPORINS J01DC02 CEFUROXIME Ceftin 125mg/5mL O/L cefuroxime axetil 250mg tab Apo-Cefuroxime 250mg Tab Auro-Cefuroxime 250mg Tab ratio-Cefuroxime 250mg Tab Ceftin 250mg Tab cefuroxime axetil 500mg tab Apo-Cefuroxime 500mg Tab Auro-Cefuroxime 500mg Tab ratio-Cefuroxime 500mg Tab Ceftin 500mg Tab J01DC04 CEFACLOR Ceclor 250mg Cap Ceclor 500mg Cap Ceclor 125mg/5mL Susp Ceclor 250mg/5mL Susp CEFPROZIL cefprozil 125mg/5mL o/l Apo-Cefprozil 125mg/5mL O/L Auro-Cefprozil 125mg/5mL O/L RAN-Cefprozil 125mg/5mL O/L Sandoz Cefprozil 125mg/5mL O/L Cefzil 125mg/5mL O/L SFC SFC SFC SFC SFC 02212307 02244393 02344823 02242656 02212277 GSK APX ARO TEV GSK

DNP

DNP DNP DNP DNP

MRP MRP MRP MRP

DNP DNP DNP DNP

MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC

02244394 02348853 02242657 02212285 00465186 00465194 00465208 00465216

APX ARO TEV GSK PDP PDP PDP PDP

DNP DNP DNP DNP

J01DC10

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

02293943 02347261 02329204 02303426 02163675

APX ARO RAN SDZ BRI

December 2012

General Antiinfectives, Systemic ­ 90

cefprozil 250mg/5mL o/l Apo-Cefprozil 250mg/5mL O/L Auro-Cefprozil 250mg/5mL O/L RAN-Cefprozil 250mg/5mL O/L Sandoz Cefprozil 250mg/5mL O/L Cefzil 250mg/5mL O/L cefprozil 250mg tab Apo-Cefprozil 250mg Tab Auro-Cefprozil 250mg Tab RAN-Cefprozil 250mg Tab Sandoz Cefprozil 250mg Tab Cefzil 250mg Tab cefprozil 500mg tab Apo-Cefprozil 500mg Tab Auro-Cefprozil 500mg Tab RAN-Cefprozil 500mg Tab Sandoz Cefprozil 500mg Tab Cefzil 500mg Tab J01DD THIRD-GENERATION CEPHALOSPORINS J01DD01 CEFOTAXIME Claforan 0.5g/vial Inj (discontinued) Claforan 1g/vial Inj CEFTAZIDIME Fortaz 1g/vial Inj Fortaz 2g/vial Inj Fortaz 6g/vial Inj CEFTRIAXONE ceftriaxone 0.25g/vial inj Ceftriaxone 0.25g/vial Inj Rocephin 0.25g/vial Inj (discontinued) ceftriaxone 1g/vial inj Ceftriaxone 1g/vial Inj Ceftriaxone 1g/vial Inj Rocephin 1g/vial Inj (discontinued) ceftriaxone 2g/vial inj Ceftriaxone 2g/vial Inj Ceftriaxone 2g/vial Inj Rocephin 2g/vial Inj (discontinued) ceftriaxone 10g/vial inj Ceftriaxone 10g/vial Inj Rocephin 10g/vial Inj (discontinued) J01DD08 CEFIXIME Suprax 100mg/5mL Susp Suprax 400mg Tab CEFEPIME (HYDROCHLORIDE) cefepime 2g/vial inj Cefepime for injection 2g/vial Inj Maxipime 2g/vial Inj

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

02293951 02347288 02293579 02303434 02163683

APX ARO RAN SDZ BRI

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

02292998 02347245 02293528 02302179 02163659

APX ARO RAN SDZ BRI

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

02293005 02347253 02293536 02302187 02163667

APX APO RAN SDZ BRI

DNP

SFC SFC SFC SFC

02225093 02212218 02212226 02212234

SAV GSK GSK GSK

J01DD02

DNP DNP DNP

J01DD04

DNP

MRP

SFC

02292866

APX

DNP DNP

MRP MRP

SFC SFC

02292874 02292270

APX SDZ

DNP DNP

MRP MRP

SFC SFC

02292882 02292289

APX SDZ

02292904

APX

DNP DNP

SFC SFC

00868965 00868981

SAV SAV

J01DE01

02319039 02163640

APX BRI

J01DF MONOBACTAMS J01DF01 AZTREONAM Cayston 75mg/vial Pdr for Sol 02329840 GIL

December 2012

General Antiinfectives, Systemic ­ 91

J01DH CARBAPENEMS J01DH51 IMIPENEM AND ENZYME INHIBITOR Primaxin 250mg/vial Inj Primaxin 500mg/vial Inj SFC SFC 00717274 00717282 FRS FRS

DNP DNP

J01E SULFONAMIDES AND TRIMETHOPRIM J01EA TRIMETHOPRIM AND DERIVATIVES J01EA01 TRIMETHOPRIM trimethoprim 100mg tab Trimethoprim 100mg Tab Proloprim 100mg Tab (discontinued) trimethoprim 200mg tab Trimethoprim 200mg Tab Proloprim 200mg Tab (discontinued) J01EE

DNPM

MRP

SFC

02243116

AAP

DNPM

MRP

SFC

02243117

AAP

COMBINATIONS OF SULFONAMIDES AND TRIMETHOPRIM, INCLUDING DERIVATIVES J01EE01 SULFAMETHOXAZOLE AND TRIMETHOPRIM sulfamethoxazole 40mg & trimethoprim 8mg/mL o/l Novo-Trimel 40/8mg Susp DNPM Septra 40/8mg Susp (discontinued) sulfamethoxazole 400mg & trimethoprim 80mg tab Apo-Sulfatrim 400/80mg Tab DNPM Novo-Trimel 400/80mg Tab DNPM Septra 400/80mg Tab (discontinued) sulfamethoxazole 800mg & trimethoprim 160mg tab Apo-Sulfatrim DS 800/160mg Tab DNPM DNPM Novo-Trimel 800/160mg Tab Septra 800/160mg Tab (discontinued) Apo-Sulfatrim 100/20mg Tab

DNPM

MRP

SFC

00726540

TEV

MRP MRP

SFC SFC

00445274 00510637

APX TEV

MRP MRP

SFC SFC SFC

00445282 00510645 00445266

APX TEV APX

J01F MACROLIDES, LINCOSAMIDES AND STREPTOGRAMINS J01FA MACROLIDES J01FA01 ERYTHROMYCIN erythromycin base 250mg cap Apo-Erythro-EC 250mg Cap ERYC 250mg Cap

DNPM DNPM

MRP MRP

SFC SFC

00726672 00607142

AAP PFI

*Interchangeability does not apply if the capsule must be opened to administer the contents (e.g. sprinkle on food or administer via a tube).

erythromycin base 333mg cap Apo-Erythro-EC 333mg Cap ERYC 333mg Cap

DNPM DNPM

MRP MRP

SFC SFC

01925938 00873454

AAP PFI

*Interchangeability does not apply if the capsule must be opened to administer the contents (e.g. sprinkle on food or administer via a tube).

Apo-Erythro Base 250mg Tab Novo-Rythro EST 250mg/5mL Susp erythromycin ethylsuccinate 40mg/mL o/l Novo-Rythro EES 200mg/5mL Susp EES-200 (200mg/5mL) Granules (discontinued) erythromycin ethylsuccinate 80mg/mL o/l Novo-Rythro EES 400mg/5mL Susp EES-400 (400mg/5mL) Granules (discontinued)

DNPM DNPM

SFC SFC SFC

00682020 00262595 00605859

AAP TEV TEV

DNPM

MRP

DNPM

MRP

SFC

00652318

TEV

December 2012

General Antiinfectives, Systemic ­ 92

erythromycin ethylsuccinate 600mg tab Erythro-ES 600mg Tab EES-600 (600mg) Tab (discontinued) Erythro-S 250mg Tab Erythro-S 500mg Tab J01FA02 SPIRAMYCIN Rovamycine 250mg Cap Rovamycine 500mg Cap CLARITHROMYCIN Biaxin 125mg/5mL O/L Biaxin 250mg/5mL O/L clarithromycin 250mg tab Apo-Clarithromycin 250mg Tab MYLAN-Clarithromycin 250mg Tab pms-Clarithromycin 250mg Tab RAN-Clarithromycin 250mg Tab ratio-Clarithromycin 250mg Tab Sandoz Clarithromycin 250mg Tab Biaxin BID 250mg Tab Biaxin XL 500mg Tab clarithromycin 500mg tab Apo-Clarithromycin 500mg Tab MYLAN-Clarithromycin 500mg Tab pms-Clarithromycin 500mg Tab RAN-Clarithromycin 500mg Tab ratio-Clarithromycin 500mg Tab Sandoz Clarithromycin 500mg Tab Biaxin BID 500mg Tab J01FA10 AZITHROMYCIN Zithromax 500mg/vial Inj azithromycin pos 100mg/5mL susp Azithromycin POS 100mg/5mL Susp Novo-Azithromycin POS 100mg/5mL Susp pms-Azithromycin POS 100mg/5mL Susp Zithromax POS 100mg/5mL Susp azithromycin pos 200mg/5mL susp Azithromycin POS 200mg/5mL Susp Novo-Azithromycin POS 200mg/5mL Susp pms-Azithromycin POS 200mg/5mL Susp Zithromax POS 200mg/5mL Susp azithromycin 250mg tab Apo-Azithromycin 250mg Tab Azithromycin 250mg Tab CO Azithromycin 250mg Tab GD-Azithromycin 250mg Tab MYLAN-Azithromycin 250mg Tab Novo-Azithromycin 250mg Tab phl-Azithromycin 250mg Tab pms-Azithromycin 250mg Tab ratio-Azithromycin 250mg Tab Sandoz Azithromycin 250mg Tab Zithromax 250mg Tab

DNPM

MRP

SFC SFC SFC SFC SFC E E E E E E E E E E E E E E E E E

00637416 00545678 00688568 01927825 01927817 02146908 02244641 02274744 02248856 02247573 02361426 02247818 02266539 01984853 02244756 02274752 02248857 02247574 02361434 02247819 02266547 02126710 02239952

AAP AAP AAP ODN ODN ABB ABB APX MYL PMS RAN TEV SDZ ABB ABB APX MYL PMS RAN TEV SDZ ABB PFI SDZ TEV PMS PFI

DNPM DNPM

DNP DNP

J01FA09

DNP DNP

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

DNPM DNPM DNPM DNPM

MRP MRP MRP MRP

E E E E

02332388 02315157 02274388 02223716

DNPM DNPM DNPM DNPM

MRP MRP MRP MRP

E E E E

02332396 02315165 02274396 02223724

SDZ TEV PMS PFI

DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E E E E

02247423 02330881 02255340 02274531 02278359 02267845 02278588 02261634 02275287 02265826 02212021

APX SAS COB GMD MYL TEV PHL PMS TEV SDZ PFI

December 2012

General Antiinfectives, Systemic ­ 93

azithromycin 600mg tab Azithromycin 600mg Tab CO Azithromycin 600mg Tab pms-Azithromycin 600mg Tab Zithromax 600mg Tab J01FF LINCOSAMIDES J01FF01 CLINDAMYCIN Dalacin C 75mg/5mL Granules clindamycin 150mg cap Apo-Clindamycin 150mg Cap MYLAN-Clindamycin 150mg Cap Teva-Clindamycin 150mg Cap Dalacin C 150mg Cap clindamycin 300mg cap Apo-Clindamycin 300mg Cap MYLAN-Clindamycin 300mg Cap Novo-Clindamycin 300mg Cap Dalacin C 300mg Cap clindamycin 150mg/mL inj Clindamycin 150mg/mL Inj Dalacin C Phos 150mg/mL Inj clindamycin 150mg/mL (bulk) inj Clindamycin 150mg/mL Inj Dalacin C Phos 150mg/mL Inj J01FF02 LINCOMYCIN Lincocin 300mg/mL Inj

DNPM DNPM DNPM DNPM

MRP MRP MRP MRP

E E E E

02330911 02256088 02261642 02231143

SAS COB PMS PFI

DNPM

SFC SFC SFC SFC SFC

00225851 02245232 02258331 02241709 00030570

PFI APX MYL TEV PFI

DNPM DNPM DNPM DNPM

MRP MRP MRP MRP

DNPM DNPM DNPM DNPM

MRP MRP MRP MRP

SFC SFC SFC SFC

02245233 02258358 02241710 02182866

APX MYL TEV PFI

DNPM DNPM

MRP MRP

SFC SFC

02230540 00260436

SDZ PFI

DNPM DNPM

MRP MRP

SFC SFC

02230535 00260436 00030732

SDZ PFI PFI

J01G AMINOGLYCOSIDE ANTIBACTERIALS J01GB OTHER AMINOGLYCOSIDES J01GB01 TOBRAMYCIN tobramycin 10mg/mL inj Tobramycin 10mg/mL Inj Nebcin 10mg/mL Inj (discontinued) tobramycin 40mg/mL inj Tobramycin 40mg/mL Inj (AJP) Tobramycin 40mg/mL Inj (SDZ) Nebcin 40mg/mL Inj (discontinued) TOBI 300mg/5mL Sol TOBI Podhaler 28mg Cap J01GB03 GENTAMICIN gentamicin 40mg/mL inj Gentamicin 40mg/mL Inj Garamycin 40mg/mL Inj (discontinued) AMIKACIN amikacin 250mg/mL inj Amikacin 250mg/mL Inj Amikin 250mg/mL Inj (discontinued)

DNP

MRP

SFC

02241209

SDZ

DNP DNP

MRP MRP

SFC SFC

02382814 02241210 02239630 02365154

AJP SDZ NVR NVR

DNP

MRP

SFC

02242652

SDZ

J01GB06

02242971

SDZ

December 2012

General Antiinfectives, Systemic ­ 94

J01M QUINOLONE ANTIBACTERIALS J01MA FLUOROQUINOLONES J01MA01 OFLOXACIN Ofloxacin 200mg Tab Novo-Ofloxacin 200mg Tab (discontinued) ofloxacin 300mg tab Ofloxacin 300mg Tab Floxin 300mg Tab (discontinued) ofloxacin 400mg tab Ofloxacin 400mg Tab Floxin 400mg Tab (discontinued) J01MA02 CIPROFLOXACIN Cipro 100mg/mL O/L ciprofloxacin 250mg tab Apo-Ciproflox 250mg Tab Ciprofloxacin 250mg Tab CO Ciprofloxacin 250mg Tab Jamp-Ciprofloxacin 250mg Tab Mar-Ciprofloxacin 250mg Tab MINT-Ciprofloxacin 250mg Tab MYLAN-Ciprofloxacin 250mg Tab Novo-Ciprofloxacin 250mg Tab pms-Ciprofloxacin 250mg Tab RAN-Ciproflox 250mg Tab ratio-Ciprofloxacin 250mg Tab Sandoz Ciprofloxacin 250mg Tab Septa-Ciprofloxacin 250mg Tab Cipro 250mg Tab RAN-Ciprofloxacin 250mg Tab (discontinued) ciprofloxacin 500mg tab Apo-Ciproflox 500mg Tab Ciprofloxacin 500mg Tab CO Ciprofloxacin 500mg Tab Jamp-Ciprofloxacin 500mg Tab Mar-Ciprofloxacin 500mg Tab MINT-Ciprofloxacin 500mg Tab MYLAN-Ciprofloxacin 500mg Tab Novo-Ciprofloxacin 500mg Tab pms-Ciprofloxacin 500mg Tab RAN-Ciproflox 500mg Tab ratio-Ciprofloxacin 500mg Tab Sandoz Ciprofloxacin 500mg Tab Septa-Ciprofloxacin 500mg Tab Cipro 500mg Tab RAN-Ciprofloxacin 500mg Tab (discontinued) E 02231529 AAP

DNP

DNP

MRP

E

02231531

AAP

DNP

MRP

E

02231532

AAP

DNPM

E E E E E E E E E E E E E E E

02237514 02229521 02353318 02247339 02380358 02379686 02317427 02245647 02161737 02248437 02303728 02246825 02248756 02379627 02155958

BAY APX SAS COB JPC MAR MNT MYL TEV PMS RAN TEV SDZ SPT BAY

DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E E E E E E E

02229522 02353326 02247340 02380366 02379694 02317435 02245648 02161745 02248438 02303736 02246826 02248757 02379635 02155966

APX SAS COB JPC MAR MNT MYL TEV PMS RAN TEV SDZ SPT BAY

December 2012

General Antiinfectives, Systemic ­ 95

ciprofloxacin 750mg tab Apo-Ciproflox 750mg Tab Ciprofloxacin 750mg Tab CO Ciprofloxacin 750mg Tab Jamp-Ciprofloxacin 750mg Tab Mar-Ciprofloxacin 750mg Tab MINT-Ciprofloxacin 750mg Tab MYLAN-Ciprofloxacin 750mg Tab Novo-Ciprofloxacin 750mg Tab pms-Ciprofloxacin 750mg Tab RAN-Ciproflox 750mg Tab ratio-Ciprofloxacin 750mg Tab Sandoz Ciprofloxacin 750mg Tab Septa-Ciprofloxacin 750mg Tab Cipro 750mg Tab RAN-Ciprofloxacin 750mg Tab (discontinued) Cipro XL 500mg Tab Cipro XL 1,000mg Tab J01MA06 NORFLOXACIN norfloxacin 400mg tab Apo-Norflox 400mg Tab CO Norfloxacin 400mg Tab Novo-Norfloxacin 400mg Tab pms-Norfloxacin 400mg Tab Noroxin 400mg Tab (discontinued) LEVOFLOXACIN levofloxacin 250mg tab Apo-Levofloxacin 250mg Tab CO Levofloxacin 250mg Tab MYLAN-Levofloxacin 250mg Tab Novo-Levofloxacin 250mg Tab pms-Levofloxacin 250mg Tab Sandoz Levofloxacin 250mg Tab Levaquin 250mg Tab levofloxacin 500mg tab Apo-Levofloxacin 500mg Tab CO Levofloxacin 500mg Tab MYLAN-Levofloxacin 500mg Tab Novo-Levofloxacin 500mg Tab pms-Levofloxacin 500mg Tab Sandoz Levofloxacin 500mg Tab Levaquin 500mg Tab levofloxacin 750mg tab Apo-Levofloxacin 750mg Tab CO Levofloxacin 750mg Tab Novo-Levofloxacin 750mg Tab pms-Levofloxacin 750mg Tab Sandoz Levofloxacin 750mg Tab Levaquin 750mg Tab Levaquin 5mg/mL Inj (premix) J01MA14 MOXIFLOXACIN Avelox 400mg Tab

DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E E E E E E E

02229523 02353334 02247341 02380374 02379708 02317443 02245649 02161753 02248439 02303744 02246827 02248758 02379643 02155974 02247916 02251787

APX SAS COB JPC MAR MNT MYL TEV PMS RAN TEV SDZ SPT BAY BAY BAY

DNPM

E

DNP DNP DNP DNP

MRP MRP MRP MRP

E E E E

02229524 02269627 02237682 02246596

APX COB TEV PMS

J01MA12

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

E E E E E E E

02284707 02315424 02313979 02248262 02284677 02298635 02236841

APX COB MYL TEV PMS SDZ JAN

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

E E E E E E E

02284715 02315432 02313987 02248263 02284685 02298643 02236842

APX COB MYL TEV PMS SDZ JAN

02325942 02315440 02285649 02305585 02298651 02246804 02236839 E 02242965

APX COB TEV PMS SDZ JAN JAN BAY

DNP

December 2012

General Antiinfectives, Systemic ­ 96

J01X OTHER ANTIBACTERIALS J01XA GLYCOPEPTIDE ANTIBACTERIALS J01XA01 VANCOMYCIN vancomycin 125mg cap Vancomycin HCI 125mg Cap Vancocin 125mg Cap vancomycin 250mg cap Vancomycin HCI 250mg Cap Vancocin 250mg Cap vancomycin 500mg/vial inj pms-Vancomycin 500mg/vial Inj Vancocin CP 500mg/vial Inj (discontinued) vancomycin HCI 500mg/vial inj Val-Vanco 500mg/vial Inj Sterile Vancomycin HCI 500mg/vial Inj vancomycin 1g/vial inj pms-Vancomycin 1g/vial Inj Vancocin CP 1g/vial Inj (discontinued) vancomycin HCI 1g/vial inj Val-Vanco 1000mg/vial Inj Sterile Vancomycin HCI 1g/vial Inj J01XD IMIDAZOLE DERIVATIVES J01XD01 METRONIDAZOLE metronidazole 250mg tab Metronidazole 250mg Tab Flagyl 250mg Tab (discontinued) metronidazole 500mg cap Metronidazole 500mg Cap pms-Metronidazole 500mg Cap Flagyl 500mg Cap J01XE NITROFURAN DERIVATIVES J01XE01 NITROFURANTOIN nitrofurantoin 50mg cap Novo-Furantoin 50mg Cap Macrodantin 50mg Cap (discontinued) nitrofurantoin 100mg cap Novo-Furantoin 100mg Cap Macrodantin 100mg Cap (discontinued) Nitrofurantoin 50mg Tab Nitrofurantoin 100mg Tab Macrobid 100mg Cap J01XX OTHER ANTIBACTERIALS J01XX05 J01XX08 J01XX09 METHENAMINE Mandelamine 500mg Tab LINEZOLID Zyvoxam 600mg Tab DAPTOMYCIN Cubicin 500mg Vial SFC E 00499013 02243684 02299909 ERF PFI SEP

DNPM DNPM

DNPM DNPM

MRP MRP

E E

02377470 00800430

PPC MRS

DNPM DNPM

MRP MRP

E E

02377489 00788716

PPC MRS

DNPM

MRP

SFC

02241820

PMS

DNPM DNPM

MRP MRP

SFC SFC

02342855 02230191

VAL HOS

DNPM

MRP

SFC

02241821

PMS

DNPM DNPM

MRP MRP

SFC SFC

02342863 02230192

VAL HOS

DNPM

MRP

SFC

00545066

AAP

02248562 00783137 01926853

AAP PMS SAV

DNPM

MRP

SFC

02231015

TEV

02231016 SFC SFC 00319511 00312738 02063662

TEV AAP AAP WNC

DNP

DNP

PRP

December 2012

General Antiinfectives, Systemic ­ 97

J02

ANTIMYCOTICS FOR SYSTEMIC USE

J02A ANTIMYCOTICS FOR SYSTEMIC USE J02AA ANTIBIOTICS J02AA01 AMPHOTERICIN Fungizone 50mg/vial Inj SFC 00029149 BRI

DNP

J02AB IMIDAZOLE DERIVATIVES J02AB02 KETOCONAZOLE ketoconazole 200mg tab Apo-Ketoconazole 200mg Tab Novo-Ketoconazole 200mg Tab Nizoral 200mg Tab (discontinued)

DNP DNP

MRP MRP

SFC SFC

02237235 02231061

APX TEV

J02AC TRIAZOLE DERIVATIVES J02AC01 FLUCONAZOLE fluconazole 2mg/mL inj Diflucan 2mg/mL Inj Fluconazole 2mg/mL Inj Diflucan POS 10mg/mL fluconazole 50mg tab Apo-Fluconazole 50mg Tab CO Fluconazole 50mg Tab MYLAN-Fluconazole 50mg Tab Novo-Fluconazole 50mg Tab pms-Fluconazole 50mg Tab Diflucan 50mg Tab (discontinued) fluconazole 100mg tab Apo-Fluconazole 100mg Tab CO Fluconazole 100mg Tab MYLAN-Fluconazole 100mg Tab Novo-Fluconazole 100mg Tab pms-Fluconazole 100mg Tab Diflucan 100mg Tab (discontinued) fluconazole 150mg cap Apo-Fluconazole 150mg Cap pms-Fluconazole 150mg Cap Diflucan 150mg Cap (discontinued) J02AC02 J02AC03 ITRACONAZOLE Sporanox 100mg Cap VORICONAZOLE Vfend 50mg Tab Vfend 200mg Tab POSACONAZOLE Posanol 40mg/mL Susp

DNP

00891835 02248443 E SFC SFC SFC SFC SFC 02024152 02237370 02281260 02245292 02236978 02245643

PFI SDZ PFI APX COB MYL TEV PMS

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

02237371 02281279 02245293 02236979 02245644

APX COB MYL TEV PMS

DNP DNP

MRP MRP

SFC SFC

02241895 02282348

APX PMS

DNP

E E E

02047454 02256460 02256479 02293404

JAN PFI PFI SCH

DNP DNP

J02AC04

J04

ANTIMYCOBACTERIALS

J04A DRUGS FOR TREATMENT OF TUBERCULOSIS J04AB ANTIBIOTICS J04AB02 RIFAMPIN (RIFAMPICIN) rifampin 150mg cap Rifadin 150mg Cap Rofact 150mg Cap

DNP DNP

MRP MRP

SFC SFC

02091887 00393444

SAV VLN

December 2012

General Antiinfectives, Systemic ­ 98

rifampin 300mg cap Rifadin 300mg Cap Rofact 300mg Cap J04AB04 RIFABUTIN Mycobutin 150mg Cap

DNP DNP

MRP MRP

SFC SFC SFC

02092808 00343617 02063786

SAV VLN PFI

DNP

J04AC HYDRAZIDES J04AC01 ISONIAZID pms-Isoniazid 300mg Tab Isotamine 300mg Tab SFC SFC 00577804 00272655 PMS VLN

DNP DNP

J04AK OTHER DRUGS FOR TREATMENT OF TUBERCULOSIS J04AK01 J04AK02 PYRAZINAMIDE Tebrazid 500mg Tab ETHAMBUTOL Etibi 100mg Tab ethambutol 400mg tab Etibi 400mg Tab Myambutol 400mg Tab (discontinued) SFC SFC SFC 00283991 00247960 00247979 VLN VLN VLN

DNP

DNP

DNP

J04AM COMBINATIONS OF DRUGS FOR TREATMENT OF TUBERCULOSIS J04AM02 RIFAMPIN AND ISONIAZID Rifater Tab 02148625 SAV

J04B DRUGS FOR TREATMENT OF LEPRA J04BA DRUGS FOR TREATMENT OF LEPRA J04BA02 DAPSONE Dapsone 100mg Tab SFC 02041510 JCB

DNP

J05

ANTIVIRALS FOR SYSTEMIC USE

J05A DIRECT ACTING ANTIVIRALS J05AB NUCLEOSIDES AND NUCLEOTIDES EXCLUDING REVERSE TRANSCRIPTASE INHIBITORS J05AB01 ACYCLOVIR Zovirax 200mg/5mL O/L acyclovir 200mg tab Acyclovir 200mg Tab Apo-Acyclovir 200mg Tab MYLAN-Acyclovir 200mg Tab Novo-Acyclovir 200mg Tab ratio-Acyclovir 200mg Tab Zovirax 200mg Tab acyclovir 400mg tab Acyclovir 400mg Tab Apo-Acyclovir 400mg Tab MYLAN-Acyclovir 400mg Tab Novo-Acyclovir 400mg Tab ratio-Acyclovir 400mg Tab Zovirax 400mg Tab SFC SFC SFC SFC SFC SFC SFC 00886157 02286556 02207621 02242784 02285959 02078627 00634506 GSK SAS APX MYL TEV TEV GSK

DNPM

DNPM DNPM DNPM DNPM DNPM DNPM

MRP MRP MRP MRP MRP MRP

DNPM DNPM DNPM DNPM DNPM DNPM

MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC

02286564 02207648 02242463 02285967 02078635 01911627

SAS APX MYL TEV TEV GSK

December 2012

General Antiinfectives, Systemic ­ 99

acyclovir 800mg tab Acyclovir 800mg Tab Apo-Acyclovir 800mg Tab MYLAN-Acyclovir 800mg Tab Novo-Acyclovir 800mg Tab ratio-Acyclovir 800mg Tab Zovirax Zostab 800mg Tab (discontinued) J05AB06 J05AB09 GANCICLOVIR Cytovene 500mg/vial Inj FAMCICLOVIR famciclovir 125mg tab Apo-Famciclovir 125mg Tab CO Famciclovir 125mg Tab pms-Famciclovir 125mg Tab Sandoz Famciclovir 125mg Tab Famvir 125mg Tab famciclovir 250mg tab Apo-Famciclovir 250mg Tab CO Famciclovir 250mg Tab pms-Famciclovir 250mg Tab Sandoz Famciclovir 250mg Tab Famvir 250mg Tab famciclovir 500mg tab Apo-Famciclovir 500mg Tab CO Famciclovir 500mg Tab pms-Famciclovir 500mg Tab Sandoz Famciclovir 500mg Tab Famvir 500mg Tab J05AB11 VALACYCLOVIR valacyclovir 500mg tab Apo-Valacyclovir 500mg Tab CO Valacyclovir 500mg Tab MYLAN-Valacyclovir 500mg Tab pms-Valacyclovir 500mg Tab Valtrex 500mg Tab valacyclovir 1000mg tab Apo-Valacyclovir 1000mg Tab pms-Valacyclovir 1000mg Tab Valtrex 1000mg Tab J05AB14 VALGANCICLOVIR Valcyte 450mg Tab

DNPM DNPM DNPM DNPM DNPM

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

02286572 02207656 02242464 02285975 02078651

SAS APX MYL TEV TEV

02162695

HLR

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

02292025 02305682 02278081 02278634 02229110

APX COB PMS SDZ NVR

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

02292041 02305690 02278103 02278642 02229129

APX COB PMS SDZ NVR

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

02292068 02305704 02278111 02278650 02177102

APX COB PMS SDZ NVR

DNPM DNPM DNPM DNPM DNPM

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

02295822 02331748 02351579 02298457 02219492

APX COB MYL PMS GSK

02354705 02381230 02246559 E 02245777

APX PMS GSK HLR

DNP

J05AE PROTEASE INHIBITORS J05AE01 SAQUINAVIR Invirase 200mg Cap Invirase 500mg Tab INDINAVIR Crixivan 200mg Cap Crixivan 400mg Cap RITONAVIR Norvir 80mg/mL O/L Norvir 100mg Tab NELFINAVIR Viracept 625mg Tab 02216965 02279320 02229161 02229196 02229145 02357593 02248761 HLR HLR FRS FRS ABB ABB PFI

J05AE02

J05AE03

J05AE04

December 2012

General Antiinfectives, Systemic ­ 100

J05AE07

FOSAMPRENAVIR Telzir 50mg/mL Susp Telzir 700mg Tab ATAZANAVIR Reyataz 150mg Cap Reyataz 200mg Cap Reyataz 300mg Cap TIPRANAVIR Aptivus 250mg Cap DARUNAVIR Prezista 75mg Tab Prezista 400mg Tab TELAPREVIR Incivek 375mg Tab Incivek 375mg Tab BOCEPREVIR Victrelis 200mg Cap PROTEASE INHIBITORS, COMBINATIONS Kaletra 100/25mg Pediatric Tab Kaletra 200/50mg Tab

DNP DNP PRP PRP

02261553 02261545 02248610 02248611 02294176 02273322 02338432 02324016 E E E 02371553 00999627 02370816 02312301 02285533

GSK GSK BRI BRI BRI BOE JAN JAN VTX VTX FRS ABB ABB

J05AE08

J05AE09 J05AE10

J05AE11

J05AE12 J05AE30

DNP

J05AF

NUCLEOSIDE AND NUCLEOTIDE REVERSE TRANSCRIPTASE INHIBITORS J05AF01 ZIDOVUDINE zidovudine 100mg cap Apo-Zidovudine 100mg Cap Retrovir 100mg Cap STAVUDINE Zerit 15mg Cap Zerit 20mg Cap Zerit 30mg Cap Zerit 40mg Cap LAMIVUDINE lamivudine 100mg tab Apo-Lamivudine HBV 100mg Tab Heptovir 100mg Tab lamivudine 150mg tab Apo-Lamivudine 150mg Tab 3TC 150mg Tab lamivudine 300mg tab Apo-Lamivudine 300mg Tab 3TC 300mg Tab 3TC 10mg/mL O/L J05AF07 J05AF08 J05AF10 J05AF11 TENOFOVIR DISOPROXIL Viread 300mg Tab ADEFOVIR DIPIVOXIL Hepsera 10mg Tab ENTECAVIR Baraclude 0.5mg Tab TELBIVUDINE Sebivo 600mg Tab E E E

01946323 01902660 02216086 02216094 02216108 02216116

APX GSK BRI BRI BRI BRI

J05AF04

J05AF05

DNP DNP

MRP MRP

E E

02393239 02239193

APX VIV

02369052 02192683

APX GSK

02369060 02247825 02192691 02247128 02247823 02282224 02288389

APX GSK GSK GIL GIL BRI NVR

DNP

DNP

DNP

December 2012

General Antiinfectives, Systemic ­ 101

J05AG NONNUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS J05AG01 NEVIRAPINE nevirapine 200mg tab Auro-Nevirapine 200mg Tab MYLAN-Nevirapine 200mg Tab Teva-Nevirapine 200mg Tab Viramune 200mg Tab ETRAVIRINE Intelence 100mg Tab RILPIVIRINE Edurant 25mg Tab

02318601 02387727 02352893 02238748 02306778 02370603

ARO MYL TEV BOE JAN JAN

J05AG04 J05AG05

J05AH NEURAMINIDASE INHIBITORS J05AH01 J05AH02 ZANAMIVIR Relenza 5mg Pdr for Inhalation OSELTAMIVIR Tamiflu 30mg Cap Tamiflu 45mg Cap Tamiflu 75mg Cap Tamiflu 12mg/mL Susp Tamiflu 15mg/mL Oral Susp E E E E E E 02240863 02304848 02304856 02241472 02245549 00903521 GSK HLR HLR HLR HLR CPD

DNP

DNP DNP DNP DNP DNP

J05AR ANTIVIRALS FOR TREATMENT OF HIV INFECTIONS, COMBINATION J05AR01 ZIDOVUDINE AND LAMIVUDINE lamivudine 150mg & zidovudine 300mg tab Apo-Lamuvudine-Zidovudine 150/300mg Tab Teva-Lamivudine/Zidovudine 150/300mg Tab Combivir 150/300mg Tab LAMIVUDINE AND ABACAVIR Kivexa Tab TENOFOVIR DISOPROXIL AND EMTRICITABINE Truvada Tab EMTRICITABINE, TENOFOVIR DISOPROXIL AND EFAVIRENZ Atripla Tab EMTRICITABINE, TENOFOVIR DISOPROXIL AND RILPIVIRINE Complera 200/25/300mg Tab

02375540 02387247 02239213 02269341 02274906 02300699 02374129

APX VEV VIV GSB GIL GIL GIL

J05AR02 J05AR03 J05AR06 J05AR08

J05AX OTHER ANTIVIRALS J05AX07 J05AX08 J05AX09 ENFUVIRTIDE Fuzeon 108mg/vial Inj RALTEGRAVIR Isentress 400mg Tab MARAVIROC Celsentri 150mg Tab Celsentri 300mg Tab 02247725 02301881 02299844 02299852 HLR FRS VIV VIV

December 2012

General Antiinfectives, Systemic ­ 102

L01

ANTINEOPLASTIC AGENTS

L01A ALKYLATING AGENTS L01AA NITROGEN MUSTARD ANALOGUES L01AA01 CYCLOPHOSPHAMIDE Procytox 25mg Tab Procytox 50mg Tab CHLORAMBUCIL Leukeran 2mg Tab MELPHALAN Alkeran 2mg Tab

DNP DNP

SFC SFC SFC SFC

02241795 02241796 00004626 00004715

BAX BAX GSK GSK

L01AA02 L01AA03

DNP

DNP

L01AB ALKYL SULPHONATES L01AB01 BUSULFAN Myleran 2mg Tab

DNP

SFC

00004618

GSK

L01AD NITROSOUREAS L01AD02 LOMUSTINE CeeNU 10mg Cap CeeNU 40mg Cap CeeNU 100mg Cap

DNP DNP DNP

SFC SFC SFC

00360430 00360422 00360414

BRI BRI BRI

L01AX OTHER ALKYLATING AGENTS L01AX03 TEMOZOLOMIDE Temodal 5mg Cap Temodal 20mg Cap Temodal 100mg Cap Temodal 140mg Cap Temodal 180mg Cap (discontinued) Temodal 250mg Cap

DNP DNP DNP DNP DNP

PRP PRP PRP

E E E E E

02241093 02241094 02241095 02312794 02241096

SCH SCH SCH SCH SCH

L01B ANTIMETABOLITES L01BA FOLIC ACID ANALOGUES L01BA01 METHOTREXATE Methotrexate 10mg/mL Inj Methotrexate 25mg/mL Inj Methotrexate 25mg/mL Inj (PF) Methotrexate 25mg/mL Inj (PF) Methotrexate 25mg/mL Inj methotrexate 2.5mg tab Apo-Methotrexate 2.5mg Tab ratio-Methotrexate Sodium 2.5mg Tab Methotrexate 2.5mg Tab Methotrexate 10mg Tab L01BB PURINE ANALOGUES L01BB02 L01BB03 L01BB05 MERCAPTOPURINE Purinethol 50mg Tab THIOGUANINE Lanvis 40mg Tab FLUDARABINE Fludara 10mg Tab SFC SFC E 00004723 00282081 02246226 TEV GSK GZM SFC SFC SFC SFC SFC SFC SFC SFC SFC 02182947 02182777 02182971 02182955 02099705 02182963 02244798 02170698 02182750 HOS HOS HOS HOS TEV APX TEV PFI HOS

DNP DNP DNP DNP DNP

DNP DNP DNP DNP

MRP MRP MRP

DNP

DNP

DNP

December 2012

Antineoplastics and Immunomodulating Agents ­ 103

L01BC02

FLUOROURACIL Efudex 5% Cr Fluorouracil 50mg/vial Inj GEMCITABINE gemcitabine hydrochloride 1g/vial inj Gemcitabine 1g/vial Inj Gemzar 1g/vial Inj CAPECITABINE Xeloda 150mg Tab Xeloda 500mg Tab

DNP DNP

SFC SFC

00330582 00012882

VLN SDZ

L01BC05

02324210 02230309 E E 02238453 02238454

AHI LIL HLR HLR

L01BC06

DNP DNP

L01C PLANT ALKALOIDS AND OTHER NATURAL PRODUCTS L01CA VINCA ALKALOIDS AND ANALOGUES L01CA04 VINORELBINE Navelbine 10mg/mL Inj 02091283 GSK

L01CB PODOPHYLLOTOXIN DERIVATIVES L01CB01 ETOPOSIDE Vepesid 50mg Cap SFC 00616192 BRI

DNP

L01CD TAXANES L01CD02 DOCETAXEL docetaxel 10mg/mL inj (2mL) Docetaxel 10mg/mL Inj (2mL) Taxotere 20mg Inj docetaxel 10mg/mL inj (8mL) Docetaxel 10mg.mL Inj (8mL) Taxotere 80mg Inj L01D ANTINEOPLASTIC AGENTS L01DB ANTHRACYCLINES AND RELATED SUBSTANCES L01DB03 EPIRUBICIN epirubicin HCI 2mg/mL inj Pharmorubicin PFS 2mg/mL Inj Epiriubicin HCI 2mg/mL Inj (discontinued)

02361957 02177099 02361957 02177080

HOS SAV HOS SAV

02065703

PFI

L01X OTHER ANTINEOPLASTIC AGENTS L01XB METHYLHYDRAZINES LO1XB01 PROCARBAZINE Matulane 50mg Cap SFC 00012750 QGT

DNP

L01XC MONOCLONAL ANTIBODIES L01XC02 RITUXIMAB Rituxan 10mg/mL Inj E 02241927 HLR

DNP

PRP

L01XE PROTEIN KINASE INHIBITORS L01XE01 IMATINIB Gleevec 100mg Tab Gleevec 400mg Tab E E 02253275 02253283 NVR NVR

DNP DNP

PRP PRP

December 2012

Antineoplastics and Immunomodulating Agents ­ 104

L01XE02 L01XE03

GEFITINIB Iressa 250mg Tab ERLOTINIB Tarceva 100mg Tab Tarceva 150mg Tab SUNITINIB Sutent 12.5mg Cap Sutent 25mg Cap Sutent 50mg Cap SORAFENIB Nexavar 200mg Tab DASATINIB Sprycel 20mg Cap Sprycel 50mg Cap Sprycel 70mg Cap Sprycel 100mg Cap LAPATINIB Tykerb 250mg Tab NILOTINIB Tasigna 150mg Cap Tasigna 200mg Cap PAZOPANIB Votrient 200mg Tab E E E E E E E E E E E E E E

02248676 02269015 02269023 02280795 02280809 02280817 02284227 02293129 02293137 02293145 02320193 02326442 02368250 02315874 02352303

AZE HLR HLR PFI PFI PFI BAY BRI BRI BRI BRI GSK NVR NVR GSK

DNP DNP

L01XE04

DNP DNP DNP

PRP PRP

L01XE05 L01XE06

DNP

PRP

DNP DNP DNP DNP

PRP PRP

L01XE07 L01XE08

DNP

DNP DNP

PRP PRP

L01XE11

DNP

PRP

L01XX OTHER ANTINEOPLASTIC AGENTS L01XX03 L01XX05 ALTRETAMINE Hexalen 50mg Cap HYDROXYUREA (HYDROXYCARBAMIDE) hydroxyurea 500mg cap Hydroxyurea 500mg Cap MYLAN-Hydroxyurea 500mg Cap Hydrea 500mg Cap ESTRAMUSTINE Emcyt 140mg Tab TOPOTECAN topotecan 1mg/mL inj Topotecan HCI 1mg/mL Inj (4mL Vial) Hycamtin 4mg/vial Inj ANAGRELIDE anagrelide 0.5mg cap MYLAN-Anagrelide 0.5mg Cap Sandoz Anagrelide 0.5mg Cap Agrylin 0.5mg Cap E 02126230 MGI

DNP

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC SFC

02343096 02242920 00465283 02063794

SAS MYL BRI PFI

L01XX11 L01XX17

DNP

02379422 02231116

HOS GSK

L01XX35

DNP DNP DNP

MRP MRP MRP

E E E

02253054 02260107 02236859

MYL SDZ SHI

L02

ENDOCRINE THERAPY

L02A HORMONES AND RELATED AGENTS L02AB PROGESTOGENS L02AB01 MEGESTROL Megace OS 40mg/mL O/L megestrol acetate 40mg tab Megestrol 40mg Tab Megace 40mg Tab (discontinued) SFC SFC 02168979 02195917 BRI AAP

DNP

DNP

MRP

December 2012

Antineoplastics and Immunomodulating Agents ­ 105

megestrol acetate 160mg tab Megestrol 160mg Tab Megace 160mg Tab (discontinued) L02AE GONADOTROPHIN RELEASING HORMONE ANALOGUES L02AE01 BUSERELIN Suprefact 1mg/mL Nasal Sol Suprefact Depot 6.3mg (2 month) Implant Suprefact Depot 9.45mg (3 month) Implant LEUPROLIDE (LEUPRORELIN) Lupron 5mg/mL Inj Lupron Depot 7.5mg (monthly) Inj Kit Lupron Depot 3.75mg (monthly) Inj Kit Lupron Depot 11.25mg (3 month) SR Inj Kit Eligard 22.5mg (3 month) Inj Kit Lupron Depot 22.5mg (3 month) SR Inj Kit Lupron Depot 30mg (4 month) SR Inj Kit Eligard 45mg (6 month) Inj Kit GOSERELIN Zoladex Depot 3.6mg/syringe Inj Zoladex LA 10.8mg/syringe (3 month) Inj TRIPTORELIN Trelstar Depot 3.75mg/vial Inj Trelstar LA 11.25mg/vial Inj

DNP

MRP

SFC

02195925

AAP

DNP DNP DNP

SFC SFC SFC SFC SFC SF SF SFC SFC SFC SFC SFC SFC SFC SFC

02225158 02228955 02240749 00727695 00836273 00884502 02239834 02248240 02230248 02239833 02268892 02049325 02225905 02240000 02243856

SAV SAV SAV ABB ABB ABB ABB SAV ABB ABB SAV AZE AZE PAL PAL

L02AE02

DNP DNP DNP DNP DNP DNP DNP DNP

L02AE03

DNP DNP

L02AE04

DNP DNP

L02B HORMONE ANTAGONISTS AND RELATED AGENTS L02BA ANTI-ESTROGENS L02BA01 TAMOXIFEN tamoxifen citrate 10mg tab Apo-Tamox 10mg Tab MYLAN-Tamoxifen 10mg Tab Novo-Tamoxifen 10mg Tab Nolvadex 10mg Tab (discontinued) Tamofen 10mg Tab (discontinued) tamoxifen citrate 20mg tab Apo-Tamox 20mg Tab MYLAN-Tamoxifen 20mg Tab Novo-Tamoxifen 20mg Tab Nolvadex-D 20mg Tab Tamofen 20mg Tab (discontinued) L02BB ANTI-ANDROGENS L02BB01 FLUTAMIDE flutamide 250mg tab Apo-Flutamide 250mg Tab Novo-Flutamide 250mg Tab pms-Flutamide 250mg Tab Euflex 250mg Tab NILUTAMIDE Anandron 50mg Tab

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC

00812404 02088428 00851965

APX MYL TEV

DNP DNP DNP DNP

MRP MRP MRP MRP

SFC SFC SFC SFC

00812390 02089858 00851973 02048485

APX MYL TEV AZE

DNP DNP DNP DNP

MRP MRP MRP MRP

SFC SFC SFC SFC SFC

02238560 02230089 02230104 00637726 02221861

APX TEV PMS SCH SAV

L02BB02

DNP

December 2012

Antineoplastics and Immunomodulating Agents ­ 106

L02BB03

BICALUTAMIDE bicalutamide 50mg tab Apo-Bicalutamide 50mg Tab Bicalutamide 50mg Tab CO Bicalutamide 50mg Tab Jamp-Bicalutamide 50mg Tab MYLAN-Bicalutamide 50mg Tab Novo-Bicalutamide 50mg Tab pms-Bicalutamide 50mg Tab RAN-Bicalutamide 50mg Tab ratio-Bicalutamide 50mg Tab Sandoz Bicalutamide 50mg Tab Casodex 50mg Tab

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02296063 02325985 02274337 02357216 02302403 02270226 02275589 02371324 02277700 02276089 02184478

APX AHI COB JPC MYL TEV PMS RAN TEV SDZ AZE

L02BG AROMATASE INHIBITORS L02BG03 ANASTROZOLE anastrozole 1mg tab Apo-Anastrozole 1mg Tab CO Anastrozole 1mg Tab Jamp-Anastrozole 1mg Tab Mar-Anastrozole 1mg Tab MED-Anastrozole 1mg Tab MYLAN-Anastrozole 1mg Tab pms-Anastrozole 1mg Tab RAN-Anastrozole 1mg Tab Sandoz Anastrozole 1mg Tab Taro-Anastrozole 1mg Tab Teva-Anastrozole 1mg Tab Arimidex 1mg Tab LETROZOLE letrozole 2.5 tab Apo-Letrozole 2.5mg Tab Jamp-Letrozole 2.5mg Tab Letrozole 2.5mg Tab (AHI) Letrozole 2.5mg Tab (COB) Letrozole 2.5mg Tab (TEV) Mar-Letrozole 2.5mg Tab MED-Letrozole 2.5mg Tab Myl-Letrozole 2.5mg Tab pms-Letrozole 2.5mg Tab RAN-Letrozole 2.5mg Tab Sandoz Letrozole 2.5mg Tab Femara 2.5mg Tab EXEMESTANE exemestane 25mg tab CO Exemestane 25mg Tab Aromasin 25mg Tab

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02374420 02394898 02339080 02379562 02379104 02361418 02320738 02328690 02338467 02365650 02313049 02224135

APX COB JPC MAR GMP MYL PMS RAN SDZ TAR TEV AZE

L02BG04

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02358514 02373009 02338459 02348969 02347997 02373424 02322315 02372169 02309114 02372282 02344815 02231384

APX JPC AHI COB TEV MAR GMP MYL PMS RAN SDZ NVR

L02BG06

DNP DNP

MRP MRP

SFC SFC

02390183 02242705

COB PFI

L02BX OTHER HORMONE ANTAGONISTS AND RELATED AGENTS L02BX02 DEGARELIX Firmagon 80mg/vial Firmagon 120mg/vial ABIRATERONE Zytiga 250mg Tab SFC SFC E 02337029 02337037 02371065 FEI FEI JAN

DNP DNP

L02BX03

DNP

L03

IMMUNOSTIMULANTS

L03A IMMUNOSTIMULANTS L03AA COLONY STIMULATING FACTORS L03AA02 FILGRASTIM Neupogen 300mcg/mL Inj 01968017 AGA

December 2012

Antineoplastics and Immunomodulating Agents ­ 107

L03AA13

PEGFILGRASTIM Neulasta 10mg/mL Inj

02249790

AGA

L03AB INTERFERONS L03AB05 INTERFERON ALPHA-2B Intron A 6,000,000iu/mL Inj (albumin free) Intron A 10,000,000iu/vial Inj Intron A 10,000,000iu/mL Inj (albumin free) Intron A 18,000,000iu/vial Inj Intron A 15,000,000iu Multidose Pen Intron A 25,000,000iu Multidose Pen Intron A 50,000,000iu Multidose Pen E E E E E E E 02238674 02223406 02238675 02231651 02240693 02240694 02240695 02269201 02237319 02237320 02318253 02318261 SCH SCH SCH SCH SCH SCH SCH BIG EMD EMD EMD EMD

DNP DNP DNP DNP DNP DNP DNP

L03AB07

INTERFERON BETA-1A Avonex PS 30mcg/0.5mL Inj Rebif 22mcg/0.5mL Inj Rebif 44mcg/0.5mL Inj Rebif Pack 8.8mcg/0.2mL / 22mcg/0.5mL Inj (discontinued) Rebif 22mcg Multidose Cartridges Rebif 44mcg Mulitdose Cartridges INTERFERON BETA-1B Betaseron 0.3mg/vial Inj Betaseron Initiation Pack Extavia 0.3mg/vial Inj PEGINTERFERON ALFA-2A Pegasys 180mcg/0.5mL Syr Inj PEGINTERFERON ALFA-2B, COMBINATIONS Pegetron Redipen 80mcg/0.5mL Inj / 200mg Cap Pegetron Redipen 100mcg/0.5mL Inj / 200mg Cap Pegetron Redipen 120mcg/0.5mL Inj / 200mg Cap Pegetron Redipen 150mcg/0.5mL Inj / 200mg Cap Pegetron 50mcg/mL Inj / 200mg Cap Pegetron 150mcg/mL Inj / 200mg Cap Victrelis Triple 80mcg Inj / 200mg / 200mg Cap Victrelis Triple 100mcg Inj / 200mg / 200mg Cap Victrelis Triple 120mcg Inj / 200mg / 200mg Cap Victrelis Triple 150mcg Inj / 200mg / 200mg Cap E E E E E E E E E E E

L03AB08

02169649 02169649 02337819 02248077 02254581 02254603 02254638 02254646 02246026 02246030 02371448 02371456 02371464 02371472

BAY BAY NVR HLR FRS FRS FRS FRS FRS FRS FRS FRS FRS FRS

L03AB11 L03AB60

DNP

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

L03AB61

PEGINTERFERON ALFA-2A, COMBINATIONS Pegasys RBV 180mcg/mL Inj / 200mg Tab (discontinued) Pegasys RBV 180mcg/0.5mL Inj / 200mg Tab (1 Kit) DNP Pegasys RBV 180mcg/0.5mL Inj / 200mg Tab (4 Kit) DNP

E E

02253429 00999450

HLR HLR

L03AX OTHER CYTOKINES AND IMMUNOMODULATORS/-STIMULANTS L03AX03 L03AX13 BCG VACCINE ImmuCyst BCG Therapeutic 3.5CFU/vial Inj GLATIRAMER ACETATE Copaxone 20mg/mL Syr Inj SFC 02194376 02245619 AVP TMP

DNP

December 2012

Antineoplastics and Immunomodulating Agents ­ 108

L04

IMMUNOSUPPRESSANTS

L04A IMMUNOSUPPRESSANTS L04AA SELECTIVE IMMUNOSUPPRESSANTS L04AA06 MYCOPHENOLIC ACID mycophenolic acid 250mg Cap Apo-Mycophenolate 250mg Cap Jamp-Mycophenolate 250mg Cap MYLAN-Mycophenolate 250mg Cap Novo-Mycopheolate 250mg Cap Sandoz Mycophenolate Mofetil 250mg Cap Cellcept 250mg Cab mycophenolic acid 500mg Tab Apo-Mycophenolate 500mg Tab CO Mycophenolate 500mg Tab Jamp-Mycophenolate Mofetil 500mg Tab MYLAN-Mycophenolate 500mg Tab Novo-Mycophenolate 500mg Tab Sandoz Mycophenolate Mofetil 500mg Tab Cellcept 500mg Tab Myfortic 180mg Tab Myfortic 360mg Tab L04AA13 LEFLUNOMIDE leflunomide 10mg tab Apo-Leflunomide 10mg Tab Leflunomide 10mg Tab MYLAN-Leflunomide 10mg Tab Novo-Leflunomide 10mg Tab pms-Leflunomide 10mg Tab Sandoz Leflunomide 10mg Tab Arava 10mg Tab leflunomide 20mg tab Apo-Leflunomide 20mg Tab Leflunomide 20mg Tab MYLAN-Leflunomide 20mg Tab Novo-Leflunomide 20mg Tab pms-Leflunomide 20mg Tab Sandoz Leflunomide 20mg Tab Arava 20mg Tab L04AA15 L04AA18 ALEFACEPT Amevive 15mg/0.5mL Pdr for Inj EVEROLIMUS Afinitor 2.5mg Tab Afinitor 5mg Tab Afinitor 10mg Tab ABATACEPT Orencia 250mg/vial Inj BELIMUMAB Benlysta 120mg/vial Benlysta 400mg/vial E E E E

02352559 02386399 02371154 02364883 02320630 02192748

APX JPC MYL TEV SDZ HLR

02352567 02379996 02380382 02370549 02348675 02313855 02237484 02264560 02264579

APX COB JPC MYL TEV SDZ HLR NVR NVR

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

E E E E E E E

02256495 02351668 02319225 02261251 02288265 02283964 02241888

APX SAS MYL TEV PMS SDZ SAV

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

E E E E E E E

02256509 02351676 02319233 02261278 02288273 02283972 02241889 02259052 02369257 02339501 02339528 02282097 02370050 02370069

APX SAS MYL TEV PMS SDZ SAV ASL NVR NVR NVR BRI GSK GSK

DNP DNP DNP

PRP PRP PRP

L04AA24 L04AA26

DNP

L04AB TUMOR NECROSIS FACTOR ALPHA (TNF­a) INHIBITORS L04AB01 ETANERCEPT Enbrel 25mg Pdr for Inj Enbrel 50mg/mL Inj INFLIXIMAB Remicade 100mg Pdr for Inj E E E 02242903 02274728 02244016 AGA AGA SCH

DNP DNP

PRP PRP

L04AB02

DNP

PRP

December 2012

Antineoplastics and Immunomodulating Agents ­ 109

L04AB04

ADALIMUMAB Humira 40mg/0.8mL Pen (PIN 97799757) Humira 40mg/0.8mL Syringe Inj (PIN 97799756) CERTOLIZUMAB PEGOL Cimzia 200mg/mL GOLIMUMAB Simponi 50mg/0.5mL Autoinjector Simponi 50mg/0.5mL Pre-filled Syringe

DNP DNP

PRP PRP

E E

02258595 02258595 02331675

ABB ABB UCB SCH SCH

L04AB05 L04AB06

DNP DNP

E E

02324784 02324776

L04AC INTERLEUKIN INHIBITORS L04AC03 L04AC05 L04AC07 ANAKINRA Kineret 100mg/Syringe Inj USTEKINUMAB Stelara 45mg/0.5mL Syringe Inj TOCILIZUMAB Actemra 80mg/4mL Inj Actemra 200mg/10mL Inj Actemra 400mg/20mL Inj CANAKINUMAB Ilaris 150mg/vial Inj E E E E 02245913 02320673 02350092 02350106 02350114 02344939 BVT JAN HLR HLR HLR NVR

DNP

PRP

DNP DNP DNP

L04AC08

L04AD CALCINEURIN INHIBITORS L04AD01 CYCLOSPORINE Neoral 10mg Cap cyclosporine 25mg cap Sandoz Cyclosporine 25mg Cap Neoral 25mg Cap cyclosporine 50mg cap Sandoz Cyclosporine 50mg Cap Neoral 50mg Cap cyclosporine 100mg cap Sandoz Cyclosporine 100mg Cap Neoral 100mg Cap cyclosporine 100mg/mL o/l Apo-Cyclosporine 100mg/mL O/L Neoral 100mg/mL O/L L04AD02 TACROLIMUS Advagraf 0.5mg ER Cap Advagraf 1mg ER Cap Advagraf 3mg Cap Advagraf 5mg ER Cap E E E 02237671 02247073 02150689 NVR SDZ NVR

DNP

DNP DNP

MRP MRP

DNP DNP

MRP MRP

E E

02247074 02150662

SDZ NVR

DNP DNP

MRP MRP

E E

02242821 02150670

SDZ NVR

DNP DNP

MRP MRP

E E

02244324 02150697 02296462 02296470 02331667 02296489

APX NVR ASL ASL ASL ASL

L04AX OTHER IMMUNOSUPPRESSANTS L04AX01 AZATHIOPRINE azathioprine 50mg tab Apo-Azathioprine 50mg Tab Azathioprine 50mg Tab MYLAN-Azathioprine 50mg Tab Teva-Azathioprine 50mg Tab Imuran 50mg Tab

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

02242907 02343002 02231491 02236819 00004596

APX SAS MYL TEV TRI

December 2012

Antineoplastics and Immunomodulating Agents ­ 110

L04AX04

LENALIDOMIDE Revlimid 5mg Cap Revlimid 10mg Cap Revlimid 15mg Cap Revlimid 25mg Cap

DNP DNP DNP DNP

E E E E

02304899 02304902 02317699 02317710

CEL CEL CEL CEL

December 2012

Antineoplastics and Immunomodulating Agents ­ 111

December 2012

Antineoplastics and Immunomodulating Agents ­ 112

M01

ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS

M01A ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS, NON-STEROIDS M01AB ACETIC ACID DERIVATIVES AND RELATED SUBSTANCES M01AB01 INDOMETHACIN indomethacin 25mg cap Novo-Methacin 25mg Cap Apo-Indomethacin 25mg Cap (discontinued) Indocid 25mg Cap (discontinued) indomethacin 50mg cap Novo-Methacin 50mg Cap Apo-Indomethacin 50mg Cap (discontinued) Indocid 50mg Cap (discontinued) indomethacin 50mg supp Sandoz Indomethacin 50mg Supp Indocid 50mg Supp (discontinued) indomethacin 100mg supp ratio-Indomethacin100mg Supp Sandoz Indomethacin 100mg Supp Indocid 100mg Supp (discontinued) M01AB02 SULINDAC sulindac 150mg tab Apo-Sulin 150mg Tab Novo-Sundac 150mg Tab Clinoril 150mg Tab (discontinued) sulindac 200mg tab Apo-Sulin 200mg Tab Novo-Sundac 200mg Tab Clinoril 200mg Tab (discontinued) M01AB05 DICLOFENAC diclofenac potassium 50mg tab Apo-Diclo Rapide 50mg Tab Diclofenac Potassium 50mg Tab pms-Diclofenac-K 50mg Tab Sandoz Diclofenac Rapide 50mg Tab Teva-Diclofenac-K 50mg Tab Voltaren Rapide 50mg Tab diclofenac sodium 50mg supp pms-Diclofenac 50mg Supp Sandoz Diclofenac 50mg Supp Voltaren 50mg Supp diclofenac sodium 100mg supp pms-Diclofenac 100mg Supp Sandoz Diclofenac 100mg Supp Voltaren 100mg Supp diclofenac sodium 25mg EC tab Apo-Diclo 25mg Tab Novo-Difenac 25mg Tab pms-Diclofenac 25mg Tab Sandoz Diclofenac 25mg Tab Voltaren 25mg Tab (discontinued)

DNPM

MRP

SFC

00337420

TEV

DNPM

MRP

SFC

00337439

TEV

DNPM

MRP

SFC

02231799

SDZ

DNPM DNPM

MRP MRP

SFC SFC

01934139 02231800

TEV SDZ

DNP DNP

PRP PRP

SF SF

00778354 00745588

APX TEV

DNP DNP

PRP PRP

SF SF

00778362 00745596

APX TEV

02243433 02351684 02239753 02261774 02239355 00881635

APX SAS PMS SDZ TEV NVR

DNPM DNPM DNPM

MRP MRP MRP

SF SF SF

02231506 02261928 00632724

PMS SDZ NVR

DNPM DNPM DNPM

MRP MRP MRP

SF SF SF

02231508 02261936 00632732

PMS SDZ NVR

DNPM DNPM DNPM DNPM

MRP MRP MRP MRP

SF SF SF SF

00839175 00808539 02302616 02261952

APX TEV PMS SDZ

December 2012

Musculo-Skeletal System ­ 113

diclofenac sodium 50mg EC tab Apo-Diclo 50mg Tab Diclofenac Sodium 50mg Tab Novo-Difenac 50mg Tab pms-Diclofenac 50mg Tab Sandoz Diclofenac 50mg Tab Voltaren 50mg Tab diclofenac sodium 75mg SR tab Apo-Diclo SR 75mg Tab Diclofenac Sodium SR 75mg Tab Novo-Difenac SR 75mg Tab pms-Diclofenac SR 75mg Tab Sandoz Diclofenac SR 75mg Tab Voltaren SR 75mg Tab diclofenac sodium 100mg SR tab Apo-Diclo SR 100mg Tab Novo-Difenac SR 100mg Tab pms-Diclofenac SR 100mg Tab Sandoz Diclofenac SR 100mg Tab Voltaren SR 100mg Tab M01AB08 ETODOLAC etodolac 200mg cap Etodolac 200mg Cap Ultradol 200mg Cap (discontinued) etodolac 300mg cap Etodolac 300mg Cap Ultradol 300mg Cap (discontinued) M01AB15 KETOROLAC Toradol 10mg/mL Inj ketorolac 30mg/mL inj Ketorolac 30mg/mL Inj Toradol 30mg/mL Inj (discontinued) ketorolac 10mg tab Apo-Ketorolac 10mg Tab Novo-Ketorolac 10mg Tab Toradol 10mg Tab M01AB55 DICLOFENAC, COMBINATIONS Arthrotec 50mg Tab Arthrotec 75mg Tab

DNPM DNPM DNPM DNPM DNPM DNPM

PRP PRP PRP PRP PRP PRP

SF SF SF SF SF SF

00839183 02352397 00808547 02302624 02261960 00514012

APX SAS TEV PMS SDZ NVR

DNPM DNPM DNPM DNPM DNPM DNPM

PRP PRP PRP PRP PRP PRP

SF SF SF SF SF SF

02162814 02352400 02158582 02231504 02261901 00782459

APX SAS TEV PMS SDZ NVR

DNPM DNPM DNPM DNPM DNPM

MRP MRP MRP MRP MRP

SF SF SF SF SF

02091194 02048698 02231505 02261944 00590827

APX TEV PMS SDZ NVR

DNP

PRP

SF

02232317

AAP

DNP

PRP

SF

02232318

AAP

DNP

SF SF

02162644 02239944

HLR SDZ

DNP

MRP

02229080 02230201 02162660 SF SF 01917056 02229837

APX TEV HLR PFI PFI

DNP DNP

M01AC OXICAMS M01AC01 PIROXICAM piroxicam 10mg cap Apo-Piroxicam 10mg Cap Novo-Pirocam 10mg Cap Feldene 10mg Cap (discontinued) piroxicam 20mg cap Apo-Piroxicam 20mg Cap Novo-Pirocam 20mg Cap Feldene 20mg Cap (discontinued)

DNP DNP

MRP MRP

SF SF

00642886 00695718

APX TEV

DNP DNP

MRP MRP

SF SF

00642894 00695696

APX TEV

December 2012

Musculo-Skeletal System ­ 114

piroxicam 20mg supp pms-Piroxicam 20mg Supp Feldene 20mg Supp (discontinued) M01AC02 TENOXICAM tenoxicam 20mg tab Tenoxicam 20mg Tab Mobiflex 20mg Tab (discontinued) MELOXICAM meloxicam 7.5mg tab Apo-Meloxicam 7.5mg Tab CO Meloxicam 7.5mg Tab Meloxicam 7.5mg Tab MYLAN-Meloxicam 7.5mg Tab Novo-Meloxicam 7.5mg Tab phl-Meloxicam 7.5mg Tab pms-Meloxicam 7.5mg Tab Mobicox 7.5mg Tab ratio-Meloxicam 7.5mg Tab (discontinued) meloxicam 15mg tab Apo-Meloxicam 15mg Tab CO Meloxicam 15mg Tab Meloxicam 15mg Tab MYLAN-Meloxicam 15mg Tab phl-Meloxicam 15mg Tab pms-Meloxicam 15mg Tab Teva-Meloxicam 15mg Tab Mobicox 15mg Tab ratio-Meloxicam 15mg Tab (discontinued) M01AE PROPIONIC ACID DERIVATIVES M01AE01 IBUPROFEN Apo-Ibuprofen 200mg Tab ibuprofen 300mg tab Apo-Ibuprofen 300mg Tab Motrin IB 300mg Tab Motrin 300mg Tab (discontinued) ibuprofen 400mg tab APC-Ibuprofen 400mg Tab Apo-Ibuprofen 400mg Tab Jamp-Ibuprofen 400mg Tab Motrin IB 400mg Tab Novo-Profen 400mg Tab Motrin 400mg Tab (discontinued) ibuprofen 600mg tab Apo-Ibuprofen 600mg Tab Novo-Profen 600mg Tab Motrin 600mg Tab (discontinued) M01AE02 NAPROXEN Naprosyn 25mg/mL Susp naproxen 500mg supp pms-Naproxen 500mg Supp Naprosyn 500mg Supp (discontinued) naproxen 125mg tab Apo-Naproxen 125mg Tab Naprosyn 125mg Tab (discontinued)

December 2012

DNP

MRP

SF

02154463

PMS

DNP

PRP

SF

02230661

AAP

M01AC06

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF

02248973 02250012 02353148 02255987 02258315 02248607 02248267 02242785

APX COB SAS MYL TEV PHL PMS BOE

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF

02248974 02250020 02353156 02255995 02248608 02248268 02258323 02242786

APX COB SAS MYL PHL PMS TEV BOE

00441643 SFC SFC 00441651 02242632

APX APX JNJ

DNP DNP

MRP MRP

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

00506052 00506052 02317338 02242658 00629340

APX APX JPC JNJ TEV

DNP DNP

MRP MRP

SFC SFC

00585114 00629359

APX TEV

DNPM

SF SFC

02162431 02017237

HLR PMS

DNPM

MRP

DNPM

MRP

SFC

00522678

APX

Musculo-Skeletal System ­ 115

naproxen 250mg tab Apo-Naproxen 250mg Tab Naproxen 250mg Tab Teva-Naproxen 250mg Tab Naprosyn 250mg Tab (discontinued) naproxen 375mg tab Apo-Naproxen 375mg Tab Naproxen 375mg Tab Teva-Naproxen 375mg Tab Naprosyn 375mg Tab (discontinued) naproxen 500mg tab Apo-Naproxen 500mg Tab Naproxen 500mg Tab Teva-Naproxen 500mg Tab Naprosyn 500mg Tab (discontinued) naproxen 250mg EC tab Apo-Naproxen 250mg EC Tab Naproxen 250mg EC Tab Novo-Naprox 250mg EC Tab Naprosyn-E 250mg EC Tab naproxen 375mg EC tab Apo-Naproxen 375mg EC Tab MYLAN-Naproxen 375mg EC Tab Naproxen 375mg EC Tab pms-Naproxen 375mg EC Tab Teva-Naproxen EC 375mg Tab Naprosyn-E 375mg EC Tab naproxen 500mg EC tab Apo-Naproxen 500mg EC Tab MYLAN-Naproxen 500mg EC Tab Naproxen 500mg EC Tab Novo-Naprox 500mg EC Tab pms-Naproxen 500mg EC Tab Naprosyn-E 500mg EC Tab Naprosyn SR 750mg Tab naproxen sodium 275mg tab Apo-Napro-Na 275mg Tab Naproxen Sodium 275mg Tab Teva-Naproxen Sodium 275mg Tab Anaprox 275mg Tab naproxen sodium 550mg tab Apo-Napro-Na DS 550mg Tab Naproxen Sodium DS 550mg Tab Teva-Naproxen Sodium DS 550mg Tab Anaprox DS 550mg Tab

DNPM DNPM DNPM

MRP MRP MRP

SFC SFC SFC

00522651 02350750 00565350

APX SAS TEV

DNPM DNPM DNPM

MRP MRP MRP

SFC SFC SFC

00600806 02350769 00627097

APX SAS TEV

DNPM DNPM DNPM

MRP MRP MRP

SFC SFC SFC

00592277 02350777 00589861

APX SAS TEV

DNPM DNPM DNPM DNPM

MRP MRP MRP MRP

SFC SFC SFC SFC

02246699 02350785 02243312 02162792

APX SAS TEV HLR

DNPM DNPM DNPM DNPM DNPM DNPM

MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC

02246700 02243432 02350793 02294702 02243313 02162415

APX MYL SAS PMS TEV HLR

DNPM DNPM DNPM DNPM DNPM DNPM DNPM

MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SF SF SF SF

02246701 02241024 02350807 02243314 02294710 02162423 02162466 00784354 02351013 00778389 02162725

APX MYL SAS TEV PMS HLR HLR APX SAS TEV HLR

DNPM DNPM DNPM DNPM

PRP PRP PRP PRP

DNPM DNPM DNPM DNPM

PRP PRP PRP PRP

SF SF SF SF

01940309 02351021 02026600 02162717

APX SAS TEV HLR

December 2012

Musculo-Skeletal System ­ 116

M01AE03

KETOPROFEN ketoprofen 50mg Cap Apo-Keto 50mg Cap Orudis 50mg Cap (discontinued) ketoprofen 50mg EC tab Apo-Keto-E 50mg Tab Orudis-E 50mg Tab (discontinued) pms-Ketoprofen 100mg supp ketoprofen 100mg EC tab Apo-Keto-E 100mg Tab Orudis-E 100mg Tab (discontinued) ketoprofen 200mg SR tab Ketoprofen SR 200mg Tab Orudis-SR 200mg Tab (discontinued)

DNP

PRP

SFC

00790427

AAP

DNP

PRP

SFC SFC SFC

00790435 02015951 00842664

AAP PMS AAP

DNP

DNP

PRP

DNP

PRP

SFC

02172577

AAP

M01AE09

FLURBIPROFEN flurbiprofen 50mg tab Apo-Flurbiprofen 50mg Tab Novo-Flurprofen 50mg Tab Ansaid 50mg Tab (discontinued) flurbiprofen 100mg tab Apo-Flurbiprofen 100mg Tab Novo-Flurprofen 100mg Tab Ansaid 100mg Tab (discontinued)

DNP DNP

PRP PRP

SF SF

01912046 02100509

APX TEV

DNP DNP

MRP MRP

SF SF

01912038 02100517

APX TEV

M01AE11

TIAPROFENIC ACID tiaprofenic acid 200mg tab Apo-Tiaprofenic 200mg Tab Novo-Tiaprofenic 200mg Tab Surgam 200mg Tab (discontinued) tiaprofenic acid 300mg tab Apo-Tiaprofenic 300mg Tab Novo-Tiaprofenic 300mg Tab Surgam 300mg Tab (discontinued)

DNP DNP

PRP PRP

SF SF

02136112 02179679

APX TEV

DNP DNP

MRP MRP

SF SF

02136120 02179687

APX TEV

M01AE12

OXAPROZIN oxaprozin 600mg tab Apo-Oxaprozin 600mg Tab Daypro 600mg Tab (discontinued)

02243661

APX

M01AG FENAMATES M01AG01 MEFENAMIC ACID mefenamic acid 250mg cap Apo-Mefenamic 250mg Cap Ponstan 250mg Cap (discontinued)

DNP

MRP

F

02229452

AAP

M01AH COXIBS M01AH01 CELECOXIB Celebrex 100mg Cap Celebrex 200mg Cap SF SF 02239941 02239942 PFI PFI

DNP DNP

PRP PRP

December 2012

Musculo-Skeletal System ­ 117

M01AX OTHER ANTIINFLAMMATORY AND ANTIRHEUMATIC AGENTS, NON-STEROIDS M01AX01 NABUMETONE nabumetone 500mg tab Apo-Nabumetone 500mg Tab MYLAN-Nabumetone 500mg Tab Nabumetone 500mg Tab Novo-Nabumetone 500mg Tab Relafen 500mg Tab (discontinued) nabumetone 750mg tab Novo-Nabumetone 750mg Tab Relafen 750mg Tab (discontinued) M01C SPECIFIC ANTIRHEUMATIC AGENTS M01CB GOLD PREPARATIONS M01CB01 SODIUM AUROTHIOMALATE sodium aurothiomalate 10mg/mL inj Sodium Aurothiomalate 10mg/mL Inj Myochrysine 10mg/mL Inj sodium aurothiomalate 25mg/mL inj Sodium Aurothiomalate 25mg/mL Inj Myochrysine 25mg/mL Inj (discontinued) sodium aurothiomalate 50mg/mL inj Sodium Aurothiomalate 50mg/mL Inj Myochrysine 50mg/mL Inj M01CB03 AURANOFIN Ridaura 3mg Cap

DNP DNP DNP

PRP PRP PRP

SF SF SF

02238639 02244563 02343282 02240867

APX MYL SAS TEV

DNP

PRP

SF

02240868

TEV

DNP DNP

MRP MRP

SF SF

02245456 01927620

SDZ SAV

DNP

MRP

SF

02245457

SDZ

DNP DNP

MRP MRP

SF SF SF

02245458 01927604 01916823

SDZ SAV XPI

DNP

M01CC PENICILLAMINE AND SIMILAR AGENTS M01CC01 PENICILLAMINE Cuprimine 250mg Cap SF 00016055 VAL

DNP

M02

TOPICAL PRODUCTS FOR JOINT AND MUSCULAR PAIN

M02A TOPICAL PRODUCTS FOR JOINT AND MUSCULAR PAIN M02AA ANTIINFLAMMATORY PREPARATIONS, NON-STEROIDS FOR TOPICAL USE M02AA15 DICLOFENAC Pennsaid 1.5% Top Sol 02247265 PAL

M03

MUSCLE RELAXANTS

M03A MUSCLE RELAXANTS, PERIPHERALLY ACTING AGENTS M03AX OTHER MUSCLE RELAXANTS, PERIPHERALLY ACTING AGENTS M03AX01 BOTULINUM TOXIN Botox 50unit/vial Inj Botox 100u/vial Inj Botox 200u/vial Inj Xeomin 100u/vial Inj E E E 00999443 01981501 00999505 02324032 ALL ALL ALL MRZ

DNP DNP DNP

M03B MUSCLE RELAXANTS, CENTRALLY ACTING AGENTS M03BA CARBAMIC ACID ESTERS M03BA03 METHOCARBAMOL Robaxin 500mg Tab Robaxin 750mg Tab METHOCARBAMOL, COMBINATIONS EXCLUDING PSYCHOLEPTICS Methoxacet Caplet Methoxacet-C1/8 Caplet 01930990 01932187 02230521 02236872 WCH WCH ROG ROG

M03BA53

December 2012

Musculo-Skeletal System ­ 118

Methoxisal-C1/4 Caplet Methoxisal-C1/8 Caplet Methoxisal-C1/2 Caplet Robaxacet Caplet Robaxacet-8 Tab Robaxisal C1/4 Tab Robaxisal C1/2 Tab M03BC ETHERS, CHEMICALLY CLOSE TO ANTIHISTAMINES M03BC01 ORPHENADRINE (CITRATE) orphenadrine 100mg tab Norflex 100mg Tab Sandoz Orphenadrine 100mg Tab Orfenace 100mg Tab M03BX OTHER CENTRALLY ACTING AGENTS M03BX01 BACLOFEN baclofen 10mg tab Apo-Baclofen 10mg Tab Baclofen 10mg Tab MYLAN-Baclofen 10mg Tab phl-Baclofen 10mg Tab pms-Baclofen 10mg Tab ratio-Baclofen 10mg Tab Lioresal 10mg Tab baclofen 20mg tab Apo-Baclofen 20mg Tab Baclofen 20mg Tab MYLAN-Baclofen 20mg Tab phl-Baclofen 20mg Tab pms-Baclofen 20mg Tab ratio-Baclofen 20mg Tab Lioresal DS 20mg Tab Lioresal Intrathecal 0.05mg/mL Lioresal Intrathecal 0.5mg/mL Lioresal Intrathecal 2mg/mL M03BX02 TIZANIDINE tizanidine 4mg tab Apo-Tizanidine 4mg Tab MYLAN-Tizanidine 4mg Tab Zanaflex 4mg Tab CYCLOBENZAPRINE cyclobenzaprine HCl 10mg tab Apo-Cyclobenzaprine 10mg Tab Auro-Cyclobenzaprine 10mg Tab Cyclobenzaprine 10mg Tab Jamp-Cyclobenzaprine 10mg Tab MYLAN-Cyclobenzaprine 10mg Tab Novo-Cycloprine 10mg Tab phl-Cyclobenzaprine 10mg Tab pms-Cyclobenzaprine 10mg Tab Flexeril 10mg Tab (discontinued)

01966367 01941895 01966375 02026805 01934767 01934783 01934791

ROG ROG ROG WCH WCH WCH WCH

01966154 02243559 02047535

MDS SDZ STR

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF

02139332 02287021 02088398 02236963 02063735 02236507 00455881

APX SAS MYL PHL PMS TEV NVR

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF

02139391 02287048 02088401 02236964 02063743 02236508 00636576 02131048 02131056 02131064

APX SAS MYL PHL PMS TEV NVR NVR NVR NVR

DNP DNP DNP

MRP MRP MRP

E E E

02259893 02272059 02239170

APX MYL PAL

M03BX08

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF

02177145 02348853 02287064 02357127 02231353 02080052 02249359 02212048

APX ARO SAS JPC MYL TEV PHL PMS

December 2012

Musculo-Skeletal System ­ 119

M03C MUSCLE RELAXANTS, DIRECTLY ACTING AGENTS M03CA DANTROLENE AND DERIVATIVES M03CA01 DANTROLENE Dantrium 25mg Cap Dantrium 100mg Cap SF SF 01997602 01997653 MTP MTP

DNP DNP

M04

ANTIGOUT PREPARATIONS

M04A ANTIGOUT PREPARATIONS M04AA PREPARATIONS INHIBITING URIC ACID PRODUCTION M04AA01 ALLOPURINOL allopurinol 100mg tab Zyloprim 100mg Tab Novo-Purol 100mg Tab (discontinued) Zyloprim 100mg Tab (discontinued) allopurinol 200mg tab Zyloprim 200mg Tab Novo-Purol 200mg Tab (discontinued) Zyloprim 200mg Tab (discontinued) allopurinol 300mg tab Zyloprim 300mg Tab Novo-Purol 300mg Tab (discontinued) Zyloprim 300mg Tab (discontinued) M04AA03 FEBUXOSTAT Uloric 80mg Tab

DNP

MRP

SFC

00402818 00004588

AAP GSK

DNP

MRP

SFC

00479799 00506370

AAP GSK

DNP

MRP

SFC

00402796 00294322

AAP GSK TAK

DNP

E

02357380

M04AB PREPARATIONS INCREASING URIC ACID EXCRETION M04AB01 PROBENECID Benuryl 500mg Tab (discontinued) Probenacid Compounded 250mg Cap Probenacid Compounded 500mg Cap SULFINPYRAZONE sulfinpyrazone 200mg tab Sulfinpyrazone 200mg Tab Anturan 200mg Tab (discontinued)

DNP DNP

SF SF

00903771 00903772

CPD CPD

M04AB02

DNP

MRP

SFC

00441767

AAP

M04AC PREPARATIONS WITH NO EFFECT ON URIC ACID METABOLISM M04AC01 COLCHICINE Colchicine 0.6mg Tab Colchicine 1mg Tab SF SF 00572349 00621374 ODN ODN

DNP DNP

M05

DRUGS FOR TREATMENT OF BONE DISEASES

M05B DRUGS AFFECTING BONE STRUCTURE AND MINERALIZATION M05BA BISPHOSPHONATES M05BA01 ETIDRONIC ACID (ETIDRONATE) etidronate 200mg tab CO Etidronate 200mg Tab MYLAN-Etidronate 200mg Tab Didronel 200mg Tab (discontinued) CLODRONIC ACID (CLODRONATE) Bonefos 400mg Cap Bonefos 60mg/mL Inj

DNP DNP

MRP MRP

E E

02248686 02245330

COB MYL

M05BA02

DNP

SFC

01984845 01984837

BAY BAY

December 2012

Musculo-Skeletal System ­ 120

M05BA03

PAMIDRONIC ACID (PAMIDRONATE) pamidronate acid (pamidronate) Pamidronate 30mg/vial Inj Aredia 30mg/vial Inj pamidronate disodium 90mg/vial inj Pamidronate Disodium Omega 90mg/mL Inj Aredia 90mg/vial Inj

02249669 02059762

OMG NVR

02249685 02059789

OMG NVR

M05BA04

ALENDRONIC ACID (ALENDRONATE) alendronate 5mg tab Apo-Alendronate 5mg Tab Sandoz Alendronate 5mg Tab Fosamax 5mg Tab (discontinued) alendronate 10mg tab Apo-Alendronate 10mg Tab MYLAN-Alendronate 10mg Tab Teva-Alendronate 10mg Tab Sandoz Alendronate 10mg Tab Fosamax 10mg Tab (discontinued) alendronate 40mg tab CO Alendronate 40mg Tab Fosamax 40mg Tab alendronate 70mg tab Alendronate 70mg Tab Alendronate-FC 70mg Tab Apo-Alendronate 70mg Tab CO Alendronate 70mg Tab Jamp-Alendronate 70mg Tab MYLAN-Alendronate 70mg Tab Teva-Alendronate 70mg Tab pms-Alendronate-FC 70mg Tab Sandoz Alendronate 70mg Tab Fosamax 70mg Tab

02248727 02288079

APX SDZ

DNP DNP DNP DNP

MRP MRP MRP MRP

E E E E

02248728 02270129 02247373 02288087

APX MYL TEV SDZ

DNP DNP

MRP MRP

E E

02258102 02201038

COB FRS

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E E E

02352966 02299712 02248730 02258110 02385031 02286335 02261715 02284006 02288109 02245329

SAS MEL APX COB JPC MYL TEV PMS SDZ FRS

M05BA07

RISEDRONIC ACID (RISEDRONATE) risedronate 5mg tab Teva-Risedronate 5mg Tab Actonel 5mg Tab risedronate 30mg tab Teva-Risedronate 30mg Tab Actonel 30mg Tab risedronate 35mg tab Apo-Risedronate 35mg Tab Jamp-Risedronate 35mg Tab MYLAN-Risedronate 35mg Tab pms-Risedronate 35mg Tab ratio-Risedronate 35mg Tab Risedronate 35mg Tab Sandoz Risedronate 35mg Tab Teva-Risedronate 35mg Tab Actonel 35mg Tab risedronate 150mg tab Apo-Risedronate 150mg Tab Actonel 150mg Tab

DNP DNP

MRP MRP

E E

02298376 02242518

TEV WNC

DNP DNP

MRP MRP

E E

02298384 02239146

TEV WNC

DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E E

02353687 02368552 02357984 02302209 02319861 02370255 02327295 02298392 02246896 02377721 02316838

APX JPC MYL PMS TEV SAS SDZ TEV WNC APX WNC

M05BA08

ZOLEDRONIC ACID Aclasta 5mg/100mL Inj Zometa 4mg/vial Inj (discontinued)

DNP

E

02269198

NVR

December 2012

Musculo-Skeletal System ­ 121

M05BB BISPHOSPHONATES, COMBINATIONS M05BB01 ETIDRONIC ACID AND CALCIUM, SEQUENTIAL etidronic disodium 400mg & calcium carbonate 500mg tab, sequential kit CO Etidrocal Kit DNP MRP E Etidrocal Kit DNP MRP E DNP MRP E MYLAN-Eti-Cal Carepac Novo-Etidronatecal Kit DNP MRP E DNP MRP E Didrocal Kit ALENDRONIC ACID AND COLECALCIFEROL Fosavance Tab 70mg/2800 IU Fosavance Tab 70mg/5600 IU

02263866 02353210 02247323 02324199 02176017 02276429 02314940

COB SAS MYL TEV WNC FRS FRS

M05BB03

DNP

E

M05BX OTHER DRUGS AFFECTING BONE STRUCTURE AND MINERALIZATION M05BX04 DENOSUMAB Prolia 60mg/mL Inj Xgeva 120mg/1.7mL Sol E E 02343541 02368153 AGA AGA

DNP DNP

December 2012

Musculo-Skeletal System ­ 122

N01

ANESTHETICS

N01A ANESTHETICS, GENERAL N01AH OPIOID ANESTHETICS N01AH01 FENTANYL fentanyl citrate 50mcg/mL inj Fentanyl Citrate 50mcg/mL Inj Fentanyl Citrate 50mcg/mL Inj ALFENTANIL alfentanil 500mcg/mL inj Alfentanil 500mcg/mL Inj Alfenta 500mcg/mL Inj (discontinued) SUFENTANIL sufentanil citrate 50mcg/mL inj Sufentanil Citrate 50mcg/mL Inj Sufenta 50mcg/mL Inj (discontinued)

02240434 00888346

SDZ HOS

N01AH02

02248181

SDZ

N01AH03

D

MRP

SFC

02244147

SDZ

N01AX OTHER GENERAL ANESTHETICS N01AX03 KETAMINE ketamine 10mg/mL inj Ketamine 10mg/mL Inj Ketalar 10mg/mL Inj ketamine 50mg/mL inj Ketamine 50mg/mL Inj Ketalar 50mg/mL Inj N01B ANESTHETICS, LOCAL N01BA ESTERS OF AMINOBENZOIC ACID N01BA03 N01BB AMIDES N01BB01 BUPIVACAINE Marcaine 0.25% Inj Sensorcaine 0.25% Inj Marcaine 0.5% Inj Sensorcaine 0.5% Inj LIDOCAINE Xylocaine 1% Inj Xylocaine 1% (with perservative) Xylocaine 2% Inj Xylocaine 2% (with perservative) Xylocaine 2% Jelly Inj Lidodan Endotracheal 10mg/ACT liquid LIDOCAINE, COMBINATIONS Xylocaine 2% W Epine Inj SFC SFC SFC SFC SFC SFC SFC SFC SFC 02241918 01976141 02241919 01976168 00001732 02302411 00036641 02302438 00385484 02231147 00284106 HOS AZE HOS AZE AZE AZE AZE AZE AZE ODN AZE TETRACAINE Pontocaine 20mg/vial Inj SFC 02241978 HOS

02246795 00224391

SDZ ERF

02246796 00224405

SDZ ERF

DNP

DNPM DNPM DNPM DNPM

N01BB02

DNPM DNPM DNPM DNPM DNPM

N01BB52

DNPM

SFC

N02

ANALGESICS

N02A OPIOIDS N02AA NATURAL OPIUM ALKALOIDS N02AA01 MORPHINE Kadian 10mg Cap Kadian 20mg Cap Kadian 50mg Cap Kadian 100mg Cap M-Eslon ER 10mg Cap M-Eslon ER 15mg Cap SFC SFC SFC SFC SFC SFC 02242163 02184435 02184443 02184451 02019930 02177749 ABB ABB ABB ABB SAV SAV

D D D D D D

December 2012

Nervous System ­ 123

M-Eslon ER 30mg Cap M-Eslon ER 60mg Cap M-Eslon ER 100mg Cap M-Eslon ER 200mg Cap Morphine HP 25mg/mL Inj Morphine HP 50mg/mL Inj Morphine LP Epidural 0.5mg/mL Inj Morphine LP Epidural 1mg/mL Inj Morphine Sulfate 2mg/mL Inj Morphine Sulfate 2mg/mL Inj morphine sulfate 10mg/mL inj Morphine Sulfate 10mg/mL Inj Morphine Sulfate 10mg/mL Inj (ABB - discontinued) morphine sulfate 15mg/mL inj Morphine Sulfate 15mg/mL Inj Morphine Sulfate 15mg/mL Inj (ABB - discontinued) MOS-SR 30mg Tab MOS-SR 60mg Tab MOS Sulphate 5mg Tab MOS Sulphate 10mg Tab MOS Sulphate 25mg Tab MOS Sulphate 50mg Tab morphine sulfate 15mg SR tab Morphine SR 15mg Tab Novo-Morphine SR 15mg Tab Sandoz Morphine SR 15mg Tab MS Contin 15mg Tab pms-Morphine Sulfate 15mg SR Tab (discontinued) morphine sulfate 30mg SR tab Morphine SR 30mg Tab Novo-Morphine SR 30mg Tab Sandoz Morphine SR 30mg Tab MS Contin 30mg Tab morphine sulfate 60mg SR tab Morphine SR 60mg Tab Novo-Morphine SR 60mg Tab Sandoz Morphine SR 60mg Tab MS Contin 60mg Tab morphine sulfate 100mg SR tab Morpine SR 100mg Tab Novo-Morphine SR 100mg Tab MS Contin 100mg Tab morphine sulfate 200mg SR tab Morphine SR 200mg Tab Novo-Morphine SR 200mg Tab MS Contin 200mg Tab pms-Morphine Sulfate SR 200mg Tab (discontinued) MS-IR 5mg Tab MS-IR 10mg Tab MS-IR 20mg Tab MS-IR 30mg Tab ratio-Morphine 1mg/mL Syr ratio-Morphine 5mg/mL Syr ratio-Morphine 10mg/mL Syr Statex 20mg/mL Drops Statex 50mg/mL Drops Statex 10mg Supp Statex 20mg Supp

December 2012

D D D D D D D D D D

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02019949 02019957 02019965 02177757 00676411 00617288 02021056 02021048 01964437 02242484 00392588

SAV SAV SAV SAV SDZ SDZ SDZ SDZ SDZ SDZ SDZ

D

MRP

D

MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

00392561 00776181 00776203 02009773 02009765 02009749 02009706 02350815 02302764 02244790 02015439

SDZ VLN VLN VLN VLN VLN VLN SAS TEV SDZ PFR

D D D D D D

D D D D

MRP MRP MRP MRP

D D D D

MRP MRP MRP MRP

SFC SFC SFC SFC

02350890 02302772 02244791 02014297

SAS TEV SDZ PFR

D D D D

MRP MRP MRP MRP

SFC SFC SFC SFC

02350912 02302780 02244792 02014300

SAS TEV SDZ PFR

D D D

MRP MRP MRP

SFC SFC SFC

02350920 02302799 02014319

SAS TEV PFR

D D D

MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02350947 02302802 02014327 02014203 02014211 02014238 02014254 00607762 00607770 00690783 00621935 00705799 00632201 00596965

SAS TEV PFR PFR PFR PFR PFR TEV TEV TEV PAL PAL PAL PAL

D D D D D D D D D D D

Nervous System ­ 124

Statex 30mg Supp Statex 1mg/mL Syr Statex 5mg/mL Syr Statex 5mg Tab Statex 10mg Tab Statex 25mg Tab Statex 50mg Tab N02AA03 HYDROMORPHONE Hydromorph Contin 3mg Cap Hydromorph Contin 4.5mg Cap Hydromorph Contin 6mg Cap Hydromoprh Contin 9mg Cap Hydromorph Contin 12mg Cap Hydromorph Contin 18mg Cap Hydromorph Contin 24mg Cap Hydromorph Contin 30mg Cap hydromorphone 2mg/mL inj Hydromorphone 2mg/mL Inj Dilaudid 2mg/mL Inj hydromorphone 10mg/mL inj Hydromorphone HP 10mg/mL Inj Dilaudid HP 10mg/mL Inj hydromorphone 20mg/mL inj Hydromorphone HP 20mg/mL Inj Dilaudid HP Plus 20mg/mL Inj (discontinued) hydromorphone 50mg/mL inj Hydromorphone HP 50mg/mL Inj Dilaudid XP 50mg/mL Inj (discontinued) hydromorphone 1mg/mL oral sol pms-Hydromorphone 1mg/mL Oral Sol Dilaudid 1mg/mL Oral Sol Dilaudid 250mg/vial Sterile Pdr (discontinued) hydromorphone HCl 1mg tab pms-Hydromorphone 1mg Tab Teva-Hydromorphone 1mg Tab Dilaudid 1mg Tab hydromorphone HCl 2mg tab pms-Hydromorphone 2mg Tab Teva-Hydromorphone 2mg Tab Dilaudid 2mg Tab hydromorphone HCl 4mg tab pms-Hydromorphone 4mg Tab Teva-Hydromorphone 4mg Tab Dilaudid 4mg Tab hydromorphone HCl 8mg tab pms-Hydromorphone 8mg Tab Teva-Hydromorphone 8mg Tab Dilaudid 8mg Tab Junista 4mg Tab Junista 8mg Tab Junista 16mg Tab Junista 32mg Tab

D D D D D D D

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

00639389 00591467 00591475 00594652 00594644 00594636 00675962 02125323 02359502 02125331 02359510 02125366 02243562 02125382 02125390 02145901 00627100

PAL PAL PAL PAL PAL PAL PAL PFR PFR PFR PFR PFR PFR PFR PFR SDZ PFR

D D D D D D D D

D D

MRP MRP

D D

MRP MRP

SFC SFC

02145928 00622133

SDZ PFR

D

MRP

SFC

02145936

SDZ

D

MRP

SFC

02146126

SDZ

D D

MRP MRP

SFC SFC

01916386 00786535

PMS PFR

D D D

MRP MRP MRP

SFC SFC SFC

00885444 02319403 00705438

PMS TEV PFR

D D D

MRP MRP MRP

SFC SFC SFC

00885436 02319411 00125083

PMS TEV PFR

D D D

MRP MRP MRP

SFC SFC SFC

00885401 02319438 00125121

PMS TEV PFR

D D D

MRP MRP MRP

SFC SFC SFC

00885428 02319446 00786543 02337266 02337274 02337282 02337290

PMS TEV PFR JAN JAN JAN JAN

December 2012

Nervous System ­ 125

N02AA05

OXYCODONE OxyContin 5mg CR Tab (discontinued) OxyContin 10mg CR Tab (discontinued) OxyContin 15mg CR Tab (discontinued) OxyContin 20mg CR Tab (discontinued) OxyContin 30mg CR Tab (discontinued) OxyContin 40mg CR Tab (discontinued) OxyContin 60mg CR Tab (discontinued) OxyContin 80mg CR Tab (discontinued) OxyNEO 10mg Tab OxyNEO 15mg Tab OxyNEO 20mg Tab OxyNEO 30mg Tab OxyNEO 40mg Tab OxyNEO 60mg Tab OxyNEO 80mg Tab Supeudol 10mg Supp Supeudol 20mg Supp oxycodone 5mg tab pms-Oxycodone 5mg Tab Oxy-IR 5mg Tab oxycodone 5mg tab pms-Oxycodone 5mg Tab Supeudol 5mg Tab oxycodone 10mg tab pms-Oxycodone 10mg Tab Oxy-IR 10mg Tab oxycodone 10mg tab pms-Oxycodone 10mg Tab Supeudol 10mg Tab oxycodone 20mg tab pms-Oxycodone 20mg Tab Oxy-IR 20mg Tab oxycodone 20mg tab pms-Oxycodone 20mg Tab Supeudol 20mg Tab

D D

SFC SFC SFC SFC

02372525 02372533 02372797 02372541 02372568 02372576 02372584 00392480 00392472 02319977 02231934

PFR PFR PFR PFR PFR PFR PFR SDZ SDZ PMS PFR

D D

MRP MRP

D D

MRP MRP

SFC SFC

02319977 00789739

PMS SDZ

D D

MRP MRP

SFC SFC

02319985 02240131

PMS PFR

D D

MRP MRP

SFC SFC

02319985 00443948

PMS SDZ

D D

MRP MRP

SFC SFC

02319993 02240132

PMS PFR

D

MRP

SFC

02319993 02262983 00293512 00608882 00653276 00621463 02163926 02163918 02238645

PMS SDZ CHU TEV TEV TEV JAN JAN PDP

N02AA59

CODEINE, COMBINATIONS EXCL. PSYCHOLEPTICS Atasol 30 Tab D ratio-Emtec Tab D D ratio-Lenoltec #3 Tab ratio-Lenoltec #4 Tab D D Tylenol #3 Tab Tylenol #4 Tab D D 292 Tab

SFC SFC SFC SFC SFC SFC SFC

N02AB PHENYLPIPERIDINE DERIVATIVES N02AB02 PETHIDINE (MEPERIDINE) Meperidine 50mg/mL Inj pethidine 75mg/mL inj Meperidine 75mg/mL Inj Demerol 75mg/mL Inj (discontinued) SFC SFC 00725765 00725757 SDZ SDZ

D

MRP

D

MRP

December 2012

Nervous System ­ 126

pethidine 100mg/mL inj Meperidine 100mg/mL Inj Demerol 100mg/mL Inj (discontinued) Demerol 50mg Tab N02AB03 FENTANYL fentanyl 12mcg/hr patch pms-Fentanyl MTX 12mcg/hr Patch RAN-Fentanyl MTX 12mcg/hr Patch ratio-Fentanyl 12mcg/hr Patch Sandoz Fentanyl 12mcg/hr Patch Duragesic 12mcg/hr Patch (discontinued) fentanyl 25mcg/hr patch Novo-Fentanyl 25mcg/hr Patch pms-Fentanyl MTX 25mcg/hr Patch RAN-Fentanyl MTX 25mcg/hr Patch ratio-Fentanyl 25mcg/hr Patch Sandoz Fentanyl 25mcg/hr Patch Duragesic MAT 25mcg/hr Patch Duragesic 25mcg/hr Patch (discontinued) fentanyl 50mcg/hr patch Novo-Fentanyl 50mcg/hr Patch pms-Fentanyl MTX 50mcg/hr Patch RAN-Fentanyl MTX 50mcg/hr Patch ratio-Fentanyl 50mcg/hr Patch Sandoz Fentanyl 50mcg/hr Patch Duragesic MAT 50mcg/hr Patch Duragesic 50mcg/hr Patch (discontinued) fentanyl 75mcg/hr patch Novo-Fentanyl 75mcg/hr Patch pms-Fentanyl MTX 75mcg/hr Patch RAN-Fentanyl MTX 75mcg/hr Patch ratio-Fentanyl 75mcg/hr Patch Sandoz Fentanyl 75mcg/hr Patch Duragesic MAT 75mcg/hr Patch Duragesic 75mcg/hr Patch (discontinued) fentanyl 100mcg/hr patch Novo-Fentanyl 100mcg/hr Patch pms-Fentanyl MTX 100mcg/hr Patch RAN-Fentanyl MTX 100mcg/hr Patch ratio-Fentanyl 100mcg/hr Patch Sandoz Fentanyl 100mcg/hr Patch Duragesic MAT 100mcg/hr Patch Duragesic 100mcg/hr Patch (discontinued) Abstral 100mcg SL Tab Abstral 200mcg SL Tab Abstral 300mcg SL Tab Abstral 400mcg SL Tab Abstral 600mcg SL Tab Onsolis 200mcg Film Onsolis 400mcg Film Onsolis 600mcg Film Onsolis 800mcg Film Onsolis 1200mcg Film

D

MRP

SFC

00725749 02138018

SDZ SAV

D D D D

MRP MRP MRP MRP

E E E E

02341379 02330105 02311925 02327112

PMS RAN TEV SDZ

D D D D D D

MRP MRP MRP MRP MRP MRP

E E E E E E

02314630 02341387 02330113 02282941 02327120 02275813 01937383

TEV PMS RAN TEV SDZ JAN JAN

D D D D D D

MRP MRP MRP MRP MRP MRP

E E E E E E

02314649 02341395 02330121 02282968 02327147 02275821 01937391

TEV PMS RAN TEV SDZ JAN JAN

D D D D D D

MRP MRP MRP MRP MRP MRP

E E E E E E

02314657 02341409 02330148 02282976 02327155 02275848 01937405

TEV PMS RAN TEV SDZ JAN JAN

D D D D D D

MRP MRP MRP MRP MRP MRP

E E E E E E

02314665 02341417 02330156 02282984 02327163 02275856 01937413 02364174 02364182 02364190 02364204 02364212 02350661 02350688 02350696 02350718 02350726

TEV PMS RAN TEV SDZ JAN JAN PAL PAL PAL PAL PAL MVL MVL MVL MVL MVL

December 2012

Nervous System ­ 127

N02AD BENZOMORPHAN DERIVATIVES N02AD01 PENTAZOCINE Talwin 30mg/mL Inj Talwin 50mg Tab 02241976 02137984 HOS HOS

N02AE ORIPAVINE DERIVATIVES N02AE01 BUPRENORPHINE BuTrans 5 Patch BuTrans 10 Patch BuTrans 20 Patch 02341174 02341212 02341220 PFR PFR PFR

N02AF MORPHINAN DERIVATIVES N02AF01 BUTORPHANOL butorphanol 10mg/mL nasal sp Apo-Butorphanol Nasal Sp Stadol NS 10mg/mL Nasal Sp (discontinued)

D

MRP

E

02242504

APX

N02AX OTHER OPIOIDS N02AX02 TRAMADOL Ralivia 100mg Tab Ralivia 200mg Tab Ralivia 300mg Tab Zytram XL 150mg Tab Zytram XL 200mg Tab Zytram XL 300mg Tab Zytram XL 400mg Tab TAPENTADOL Nucynta CR 50mg Tab Nucynta CR 100mg Tab Nucynta CR 150mg Tab Nucynta CR 200mg Tab Nucynta CR 250mg Tab TRAMADOL, COMBINATIONS tramadol 37.5 mg & acetaminophen 325mg tab Apo-Tramadol/Acet 37.5mg/325mg Tab CO Tramadol/Acet 37.5/325mg Tab Jamp-Acet-Tramadol 325/37.5mg Tab Mar-Tramadol/Acet 37.5/325mg Tab PAT-Tramadol/Acet 37.5/325mg Tab RAN-Tramadol/Acet 37.5/325mg Tab Teva-Tramadol/Acetaminophen 37.5/325mg Tab Tramaphen-ODAN 37.5/325mg Tab Tramacet 37.5mg/325mg Tab 02299194 02299208 02299216 02286424 02286432 02286440 02286459 02360373 02360381 02360403 02360411 02360438 BVL BVL BVL PFR PFR PFR PFR JAN JAN JAN JAN JAN

N02AX06

N02AX52

02336790 02383209 02388308 02388324 02389274 02388197 02347180 02388294 02264846

APX COB JPC MAR PPH RAN TEV ODN JAN

N02B OTHER ANALGESICS AND ANTIPYRETICS N02BA SALICYLIC ACID AND DERIVATIVES N02BA01 ACETYLSALICYLIC ACID ASATAB 80mg Chewable Tab acetylsalicylic acid 325mg EC tab Novasen 325mg Tab pms-ASA EC 325mg Tab Entrophen 325mg Tab Enteric Coated ASA 325mg Tab ASATAB EC 325mg Tab acetylsalicylic acid 650mg EC tab Novasen 650mg Tab Entrophen 650mg Tab

December 2012

02280167 SFC SFC SFC SFC SFC SFC SFC 00216666 02284529 00010332 02010526 02352427 00229296 00010340

ODN TEV PMS PDP JPC ODN TEV PDP

DNP DNP DNP DNP DNP

MRP MRP MRP

DNP DNP

MRP MRP

Nervous System ­ 128

Enteric Coated ASA 650mg Tab N02BA11 DIFLUNISAL diflunisal 250mg tab Apo-Diflunisal 250mg Tab Novo-Diflunisal 250mg Tab Dolobid 250mg Tab (discontinued) diflunisal 500mg tab Apo-Diflunisal 500mg Tab Dolobid 500mg Tab (discontinued) N02BA51 N02BA71

DNP

SFC

00794244

JPC

DNP DNP

PRP PRP

SFC SFC

02039486 02048493

APX TEV

DNP

PRP

SFC

02039494

APX

ACETYLSALICYLIC ACID (ASA), COMBINATIONS EXCL. PSYCHOLEPTICS D SFC ratio-Oxycodan Tab ACETYLSALICYLIC ACID (ASA), COMBINATIONS WITH PSYCHOLEPTICS acetylsalicylic acid 330mg, butalbital 50mg & caffeine 40mg cap ratio-Tecnal Cap D MRP SFC D MRP SFC Fiorinal Cap

00608157

TEV

00608238 00226327

TEV NVR

acetylsalicylic acid 330mg, butalbital 50mg, caffeine 40mg & codeine phosphate 15mg cap ratio-Tecnal C1/4 Cap D MRP SFC 00608203 TEV D MRP SFC 00176192 NVR Fiorinal C1/4 Cap acetylsalicylic acid 330mg, butalbital 50mg, caffeine 40mg & codeine phosphate 30mg cap ratio-Tecnal C1/2 Cap D MRP SFC 00608181 TEV Fiorinal C1/2 Cap D MRP SFC 00176206 NVR ratio-Tecnal Tab Fiorinal Tab (discontinued) N02BE ANILIDES N02BE01 ACETAMINOPHEN (PARACETAMOL) Tylenol 325mg Caplets Tylenol 325mg Tab Tylenol 500mg Caplets Tylenol 500mg Tab Assorted Generic Brands ACETAMINOPHEN, COMB. EXCL. PSYCHOLEPTICS acetaminophen 325mg & oxycodone 5mg tab Apo-Oxycodone/Acet 5/325mg Tab D D Oxycodone/Acet 5/325mg Tab Sandoz Oxycodone/Acet 5/325mg Tab D D ratio-Oxycocet Tab Endocet Tab D D Percocet Tab Percocet Demi Tab Atasol 15 Tab ratio-Lenoltec #2 Tab Tylenol #2 Tab pms-Acetaminophen W Codeine Elx Tylenol W Codeine Elx

D D D D D D D

SFC

00608211

TEV

00723894 00559393 00723908 00559407

JNJ JNJ JNJ JNJ

N02BE51

MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02324628 02361361 02307898 00608165 01916548 01916475 01916491 00293504 00653241 02163934 00816027 02163942

APX SAS SDZ TEV BRI BRI BRI CHU TEV JAN PMS JAN

December 2012

Nervous System ­ 129

N02BG OTHER ANALGESICS AND ANTIPYRETICS N02BG04 FLOCTAFENINE floctafenine 200mg tab Floctafenine 200mg Tab Idarac 200mg Tab (discontinued) floctafenine 400mg tab Floctafenine 400mg Tab Idarac 400mg Tab (discontinued) N02BG99 CANNABINOID DERIVATIVES, COMBINATIONS Sativex Spray

DNP

PRP

SFC

02244680

AAP

DNP

PRP

SFC

02244681

AAP

02266121

BAY

N02C ANTIMIGRAINE PREPARATIONS N02CA ERGOT ALKALOIDS N02CA01 DIHYDROERGOTAMINE dihydroergotamine 1mg/mL inj Dihydroergotamine 1mg/mL Inj Dihydroergotamine 1mg/mL Inj Migranal 4mg/mL Nasal Spray N02CA52

DNP

MRP

SF SF

02241163 00027243 02228947

SDZ STR STR

DNP

ERGOTAMINE, COMBINATIONS EXCLUDING PSYCHOLEPTICS Ergodryl Cap DNP DNP Cafergot Tab

SF SF

00156086 00176095

ERF NVR

NO2CC SELECTIVE SEROTONIN (5HT) - RECEPTOR AGONISTS N02CC01 SUMATRIPTAN Imitrex 5mg Nasal Spray Imitrex 20mg Nasal Spray sumatriptan 12mg/mL inj Sumatriptan SUN 6mg/0.5mL Inj Imitrex 6mg/0.5mL Inj Refill Cartridge Imitrex 6mg/0.5mL Inj Stat Dose Kit Imitrex 6mg/0.5mL Inj Unit Dose sumatriptan 25mg tab CO Sumatriptan 25mg Tab MYLAN-Sumatriptan 25mg Tab Novo-Sumatriptan DF 25mg Tab pms-Sumatriptan 25mg Tab Sumatriptan 25mg Tab Imitrex DF 25mg Tab (discontinued) sumatriptan 50mg tab Apo-Sumatriptan 50mg Tab CO Sumatriptan 50mg Tab MYLAN-Sumatriptan 50mg Tab Novo-Sumatriptan DF 50mg Tab pms-Sumatriptan 50mg Tab Sandoz Sumatriptan 50mg Tab Sumatriptan 50mg Tab Imitrex DF 50mg Tab E E E E E E 02230418 02230420 02361698 02212188 00999446 00901886 GSK GSK TAR GSK GSK GSK

DNP DNP

DNP DNP DNP DNP

MRP MRP MRP MRP

02257882 02268906 02286815 02256428 02286513

COB MYL TEV PMS SAS

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E

02268388 02257890 02268914 02286823 02256436 02263025 02286521 02212153

APX COB MYL TEV PMS SDZ SAS GSK

December 2012

Nervous System ­ 130

sumatriptan 100mg tab Apo-Sumatriptan 100mg Tab CO Sumatriptan 100mg Tab MYLAN-Sumatriptan 100mg Tab Novo-Sumatriptan 100mg Tab Novo-Sumatriptan DF 100mg Tab pms-Sumatriptan 100mg Tab Sandoz Sumatriptan 100mg Tab Sumatriptan 100mg Tab Imitrex DF 100mg Tab N02CC02 NARATRIPTAN naratriptan 1mg tab Novo-Naratriptan 1mg Tab Amerge 1mg Tab naratriptan 2.5mg tab Novo-Naratriptan 2.5mg Tab Sandoz Naratriptan 2.5mg Tab Amerge 2.5mg Tab N02CC03 ZOLMITRIPTAN zolmitriptan 2.5mg tab MYLAN-Zolmitriptan 2.5mg Tab pms-Zolmitriptan 2.5mg Tab Sandoz Zolmitriptan 2.5mg Tab Teva Zolmitriptan 2.5mg Tab Zomig 2.5mg Tab zolmitriptan ODT 2.5mg tab MYLAN-Zolmitriptan ODT 2.5mg Tab pms-Zolmitriptan ODT 2.5mg Tab Sandoz Zolmitripran ODT 2.5mg Tab Teva-Zolmitriptan OD 2.5mg Tab Zomig Rapimelt 2.5mg Tab Zomig 2.5mg Nasal Spray Zomig 5mg Nasal Spray N02CC04 RIZATRIPTAN rizatriptan ODT 5mg tab CO Rizatriptan ODT 5mg Tab MYLAN-Rizatriptan ODT 5mg Tab pms-Rizatriptan RDT 5mg Tab Sandoz Rizatriptan ODT 5mg Tab Maxalt RPD 5mg Wafers rizatriptan 5mg tab Jamp-Rizatriptan 5mg Tab Mar-Rizatriptan 5mg Tab Maxalt 5mg Tab (discontinued) rizatriptan ODT 10mg tab CO Rizatriptan ODT 10mg Tab MYLAN-Rizatriptan ODT 10mg Tab pms-Rizatriptan RDT 10mg Tab Sandoz Rizatriptan ODT 10mg Tab Maxalt RPD 10mg Wafers rizatriptan 10mg tab CO Rizatriptan 10mg Tab Jamp-Rizatriptan 10mg Tab Mar-Rizatriptan 10mg Tab Maxalt 10mg Tab

DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E E

02268396 02257904 02268922 02239367 02286831 02256444 02263033 02286548 02212161

APX COB MYL TEV TEV PMS SDZ SAS GSK

DNP DNP

MRP MRP

E E

02314290 02237820

TEV GSK

DNP DNP DNP

MRP MRP MRP

E E E

02314304 02322323 02237821

TEV SDZ GSK

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

E E E E E

02369036 02324229 02362988 02313960 02238660

MYL PMS SDZ TEV AZE

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

E E E E E E E

02387158 02324768 02362996 02342545 02243045 02248992 02248993

MYL PMS SDZ TEV AZE AZE AZE

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

E E E E E E E

02374730 02379198 02393360 02351870 02240518 02380455 02379651

COB MYL PMS SDZ FRS JPC MAR

DNP DNP

MRP MRP

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

E E E E E E E E E

02374749 02379201 02393379 02351889 02240519 02381702 02380463 02379678 02240521

COB MYL PMS SDZ FRS COB JPC MAR FRS

DNP DNP DNP DNP

MRP MRP MRP MRP

December 2012

Nervous System ­ 131

N02CC05

ALMOTRIPTAN Axert 6.25mg Tab Axert 12.5mg Tab ELETRIPTAN eletriptan 20mg tab GD-Eletriptan 20mg Tab Relpax 20mg Tab eletriptan 40mg tab GD-Eletriptan 20mg Tab Relpax 40mg Tab

DNP DNP

E E

02248128 02248129

JNJ JNJ

N02CC06

02342235 02256290

GMD PFI

02342243 02256304

GMD PFI

N02CX OTHER ANTIMIGRAINE PREPARATIONS N02CX01 PIZOTIFEN Sandomigran DS 1mg Tab Sandomigran 0.5mg Tab SF SF 00511552 00329320 PAL PAL

DNP DNP

N03

ANTIEPILEPTICS

N03A ANTIEPILEPTICS N03AA BARBITURATES AND DERIVATIVES N03AA02 PHENOBARBITAL Phenobarb 5mg/mL Elixir Phenobarb 15mg Tab Phenobarb 30mg Tab Phenobarb 60mg Tab Phenobarb 100mg Tab PRIMIDONE primidone 125mg tab Primidone 125mg Tab Mysoline 125mg Tab (discontinued) primidone 250mg tab Primidone 250mg Tab Mysoline 250mg Tab (discontinued) N03AB HYDANTOIN DERIVATIVES N03AB02 PHENYTOIN Dilantin 30mg Cap Dilantin 100mg Cap Dilantin 50mg Infatabs Dilantin-30 (6mg/mL) Susp phenytoin 25mg/mL susp Taro-Phenytoin 25mg/mL Susp Dilantin-125 (25mg/mL) Susp N03AD SUCCINIMIDE DERIVATIVES N03AD01 ETHOSUXIMIDE Zarontin 250mg Cap Zarontin 250mg/5mL Syr METHSUXIMIDE (MESUXIMIDE) Celontin 300mg Cap SF SF SF 00022799 00023485 00022802 ERF ERF ERF SFC SFC SFC SFC SFC SFC 00022772 00022780 00023698 00023442 02250896 00023450 PFI PFI PFI PFI TAR PFI SFC SFC SFC SFC SFC 00645575 00178799 00178802 00178810 00178829 PDP PDP PDP PDP PDP

D D D D D

N03AA03

D

MRP

SF

00399310

AAP

D

MRP

SF

00396761

AAP

DNP DNP DNP DNP

DNP DNP

MRP MRP

DNP DNP

N03AD03

DNP

N03AE BENZODIAZEPINE DERIVATIVES N03AE01 CLONAZEPAM pms-Clonazepam 0.25mg Tab SF 02179660 PMS

D

December 2012

Nervous System ­ 132

clonazepam 0.5mg tab Apo-Clonazepam 0.5mg Tab CO Clonazepam 0.5mg Tab MYLAN-Clonazepam 0.5mg Tab Novo-Clonazepam 0.5mg Tab phl-Clonazepam-R 0.5mg Tab pms-Clonazepam 0.5mg Tab pms-Clonazepam-R 0.5mg Tab Sandoz Clonazepam 0.5mg Tab Zym-Clonazepam 0.5mg Tab Rivotril 0.5mg Tab clonazepam 1mg tab phl-Clonazepam 1mg Tab pms-Clonazepam 1mg Tab CO Clonazepam 1mg Tab Sandoz Clonazepam 1mg Tab clonazepam 2mg tab Apo-Clonazepam 2mg Tab CO Clonazepam 2mg Tab MYLAN-Clonazepam 2mg Tab Novo-Clonazepam 2mg Tab phl-Clonazepam 2mg Tab pms-Clonazepam 2mg Tab Sandoz Clonazepam 2mg Tab Zym-Clonazepam 2mg Tab Rivotril 2mg Tab N03AF CARBOXAMIDE DERIVATIVES N03AF01 CARBAMAZEPINE carbamazepine 100mg/5mL O/L Taro-Carbamazepine 100mg/5mL O/L Tegretol 100mg/5mL O/L carbamazepine 100mg chewable tab pms-Carbamazepine 100mg Chewtab Sandoz Carbamazepine 100mg Chewtab Taro-Carbamazepine 100mg Chewtab Tegretol 100mg Chewtab carbamazepine 200mg chewable tab pms-Carbamazepine 200mg Chewtab Sandoz Carbamazepine 200mg Chewtab Taro-Carbamazepine 200mg Chewtab Tegretol 200mg Chewtab carbamazepine 200mg tab Teva-Carbamazepine 200mg Tab Tegretol 200mg Tab Apo-Carbamazepine 200mg Tab (discontinued) carbamazepine 200mg CR tab MYLAN-Carbamazepine CR 200mg Tab pms-Carbamazepine CR 200mg Tab Sandoz Carbamazepine CR 200mg Tab Tegretol CR 200mg Tab carbamazepine 400mg CR tab MYLAN-Carbamazepine CR 400mg Tab pms-Carbamazepine CR 400mg Tab Sandoz Carbamazepine CR 400mg Tab Tegretol CR 400mg Tab

D D D D D D D D D D

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF

02177889 02270641 02230950 02239024 02236948 02048701 02207818 02233960 02345676 00382825

APX COB MYL TEV PHL PMS PMS SDZ ZYM HLR

D D D D

MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF

02145235 02048728 02270668 02233982 02177897 02270676 02230951 02239025 02145243 02048736 02233985 02303337 00382841

PHL PMS COB SDZ APX COB MYL TEV PHL PMS SDZ ZYM HLR

D D D D D D D D D

MRP MRP MRP MRP MRP MRP MRP MRP MRP

02367394 02194333

TAR NVR

DNP DNP DNP DNP

MRP MRP MRP MRP

SFC SFC SFC SFC

02231542 02261855 02244403 00369810

PMS SDZ TAR NVR

DNP DNP DNP DNP

MRP MRP MRP MRP

SFC SFC SFC SFC

02231540 02261863 02244404 00665088

PMS SDZ TAR NVR

DNP DNP

MRP MRP

SFC SFC

00782718 00010405

TEV NVR

DNP DNP DNP DNP

MRP MRP MRP MRP

SFC SFC SFC SFC

02241882 02231543 02261839 00773611

MYL PMS SDZ NVR

DNP DNP DNP DNP

MRP MRP MRP MRP

SFC SFC SFC SFC

02241883 02231544 02261847 00755583

MYL PMS SDZ NVR

December 2012

Nervous System ­ 133

N03AF02

OXCARBAZEPINE Trileptal 60mg/mL O/L oxcarbazepine 150mg tab Apo-Oxcarbazepine 150mg Tab Trileptal 150mg Tab oxcarbazepine 300mg tab Apo-Oxcarbazepine 300mg Tab Trileptal 300mg Tab oxcarbazepine 600mg tab Apo-Oxcarbazepine 600mg Tab Trileptal 600mg Tab

DNP

E E E

02244673 02284294 02242067

NVR APX NVR

DNP DNP

MRP MRP

DNP DNP

MRP MRP

E E

02284308 02242068

APX NVR

DNP DNP

MRP MRP

E E

02284316 02242069

APX NVR

N03AF03

RUFINAMIDE Banzel 100mg Tab Banzel 200mg Tab Banzel 400mg Tab

DNP DNP DNP

E E E

02369613 02369621 02369648

EIS EIS EIS

N03AG FATTY ACID DERIVATIVES N03AG01 VALPROIC ACID (DIVALPROEX SODIUM) valproic acid 250mg cap Apo-Valproic 250mg Cap MYLAN-Valproic 250mg Cap Novo-Valproic 250mg Cap pms-Valproic 250mg Cap Depakene 250mg Cap

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

02238048 02184648 02100630 02230768 00443840

APX MYL TEV PMS ABB

valproic acid 500mg EC cap pms-Valproic EC 500mg Cap Depakene 500mg Cap (discontinued) valproic acid 50mg/mL syr Apo-Valproic 50mg/mL Syr pms-Valproic 50mg/mL Syr ratio-Valproic 50mg/mL Syr Depakene 50mg/mL Syr divalproex sodium 125mg tab Apo-Divalproex 125mg Tab Novo-Divalproex 125mg Tab Epival 125mg Tab divalproex sodium 250mg tab Apo-Divalproex 250mg Tab Novo-Divalproex 250mg Tab Epival 250mg Tab divalproex sodium 500mg tab Apo-Divalproex 500mg Tab Novo-Divalproex 500mg Tab Epival 500mg Tab N03AG04 VIGABATRIN Sabril 500mg Tab Sabril 0.5g Sachets

DNP

MRP

SF

02229628

PMS

DNP DNP DNP DNP

MRP MRP MRP MRP

SF SF SF SF

02238370 02236807 02140063 00443832

APX PMS TEV ABB

DNP DNP DNP

MRP MRP MRP

SF SF SF

02239698 02239701 00596418

APX TEV ABB

DNP DNP DNP

MRP MRP MRP

SF SF SF

02239699 02239702 00596426

APX TEV ABB

DNP DNP DNP

MRP MRP MRP

SF SF SF

02239700 02239703 00596434

APX TEV ABB

DNP DNP

E E

02065819 02068036

VLH VLH

December 2012

Nervous System ­ 134

N03AX OTHER ANTIEPILEPTICS N03AX09 LAMOTRIGINE Lamictal 5mg Chewable Tab lamotrigine 25mg tab Apo-Lamotrigine 25mg Tab Lamotrigine 25mg Tab MYLAN-Lamotrigine 25mg Tab Novo-Lamotrigine 25mg Tab pms-Lamotrigine 25mg Tab ratio-Lamotrigine 25mg Tab Lamictal 25mg Tab lamotrigine 100mg tab Apo-Lamotrigine 100mg Tab Lamotrigine 100mg Tab MYLAN-Lamotrigine 100mg Tab Novo-Lamotrigine 100mg Tab pms-Lamotrigine 100mg Tab ratio-Lamotrigine 100mg Tab Lamictal 100mg Tab lamotrigine 150mg tab Apo-Lamotrigine 150mg Tab Lamotrigine 150mg Tab MYLAN-Lamotrigine 150mg Tab Novo-Lamotrigine 150mg Tab pms-Lamotrigine 150mg Tab ratio-Lamotrigine 150mg Tab Lamictal 150mg Tab N03AX11 TOPIRAMATE Topamax 15mg Sprinkle Cap Topamax 25mg Sprinkle Cap topiramate 25mg tab Apo-Topiramate 25mg Tab Auro-Topiramate 25mg Tab CO Topiramate 25mg Tab GD-Topiramate 25mg Tab MINT-Topiramate 25mg Tab MYLAN-Topiramate 25mg Tab Novo-Topiramate 25mg Tab phl-Topiramate 25mg Tab pms-Topiramate 25mg Tab Sandoz Topiramate 25mg Tab Topiramate 25mg Tab Zym-Topiramate 25mg Tab Topamax 25mg Tab pms-Topiramate 50mg Tab topiramate 100mg tab Apo-Topiramate 100mg Tab Auro-Topiramate 100mg Tab CO Topiramate 100mg Tab GD-Topiramate 100mg Tab MINT-Topiramate 100mg Tab MYLAN-Topiramate 100mg Tab Novo-Topiramate 100mg Tab phl-Topiramate 100mg Tab pms-Topiramate 100mg Tab Sandoz Topiramate 100mg Tab Topiramate 100mg Tab Zym-Topiramate 100mg Tab Topamax 100mg Tab

December 2012

DNP

SF SF SF SF SF SF SF SF

02240115 02245208 02343010 02265494 02248232 02246897 02243352 02142082

GSK APX SAS MYL TEV PMS TEV GSK

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF

02245209 02343029 02265508 02248233 02246898 02243353 02142104

APX SAS MYL TEV PMS TEV GSK

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF E E E E E E E E E E E E E E E E E E E E E E E E E E E E E

02245210 02343037 02265516 02248234 02246899 02246963 02142112 02239907 02239908 02279614 02345803 02287765 02352850 02315645 02263351 02248860 02271184 02262991 02260050 02356856 02325136 02230893 02312085 02279630 02345838 02287773 02352877 02315653 02263378 02248861 02271192 02263009 02260069 02356864 02325144 02230894

APX SAS MYL TEV PMS TEV GSK JAN JAN APX ARO COB GMD MNT MYL TEV PHL PMS SDZ SAS ZYM JAN PMS APX ARO COB GMD MNT MYL TEV PHL PMS SDZ SAS ZYM JAN

DNP DNP

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

Nervous System ­ 135

topiramate 200mg tab Apo-Topiramate 200mg Tab Auro-Topiramate 200mg Tab CO Topiramate 200mg Tab GD-Topiramate 200mg Tab MINT-Topiramate 200mg Tab MYLAN-Topiramate 200mg Tab Novo-Topiramate 200mg Tab phl-Topiramate 200mg Tab pms-Topiramate 200mg Tab Sandoz Topiramate 200mg Tab Topiramate 200mg Tab Zym-Topiramate 200mg Tab Topamax 200mg Tab N03AX12 GABAPENTIN gabapentin 100mg cap Apo-Gabapentin 100mg Cap Auro-Gabapentin 100mg Cap CO Gabapentin 100mg Cap Gabapentin 100mg Cap GD-Gabapentin 100mg Cap Jamp-Gabapentin 100mg Cap MYLAN-Gabapentin 100mg Cap Gabapentin 100mg Cap pms-Gabapentin 100mg Cap RAN-Gabapentin 100mg Cap Teva-Gabapentin 100mg Cap Neurontin 100mg Cap gabapentin 300mg cap Apo-Gabapentin 300mg Cap Auro-Gabapentin 300mg Cap CO Gabapentin 300mg Cap Gabapentin 300mg Cap GD-Gabapentin 300mg Cap Jamp-Gabapentin 300mg Cap MYLAN-Gabapentin 300mg Cap Gabapentin 300mg Cap pms-Gabapentin 300mg Cap RAN-Gabapentin 300mg Cap Teva-Gabapentin 300mg Cap Neurontin 300mg Cap gabapentin 400mg cap Apo-Gabapentin 400mg Cap Auro-Gabapentin 400mg Cap CO Gabapentin 400mg Cap Gabapentin 400mg Cap GD-Gabapentin 400mg Cap Jamp-Gabapentin 400mg Cap MYLAN-Gabapentin 400mg Cap Gabapentin 400mg Cap pms-Gabapentin 400mg Cap RAN-Gapapentin 400mg Cap ratio-Gabapentin 400mg Cap Teva-Gabapentin 400mg Cap Neurontin 400mg Cap gabapentin 600mg tab Apo-Gabapentin 600mg Tab GD-Gabapentin 600mg Tab Neurontin 600mg Tab pms-Gabapentin 600mg Tab Teva-Gabapentin 600mg Tab

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E E E E E E

02279649 02345846 02287781 02352885 02315661 02263386 02248862 02271206 02263017 02267837 02356872 02325152 02230896

APX ARO COB GMD MNT MYL TEV PHL PMS SDZ SAS ZYM JAN

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02244304 02321203 02256142 02353245 02285819 02361469 02248259 02246314 02243446 02319055 02244513 02084260

APX ARO COB SAS GMD JPC MYL MEL PMS RAN TEV PFI

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02244305 02321211 02256150 02353253 02285827 02361485 02248260 02246315 02243447 02319063 02244514 02084279

APX ARO COB SAS GMD JPC MYL MEL PMS RAN TEV PFI

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02244306 02321238 02256169 02353261 02285835 02361493 02248261 02246316 02243448 02319071 02260905 02244515 02084287

APX ARO COB SAS GMD JPC MYL MEL PMS RAN TEV TEV PFI

DNP DNP DNP DNP

MRP MRP MRP MRP

SFC SFC SFC SFC

02293358 02285843 02239717 02255898 02248457

APX GMD PFI PMS TEV

December 2012

Nervous System ­ 136

gabapentin 800mg tab Apo-Gabapentin 800mg Tab GD-Gabapentin 800mg Tab Neurontin 800mg Tab pms-Gabapentin 800mg Tab Teva-Gabapentin 800mg Tab N03AX14 LEVETIRACETAM levetiracetam 250mg tab Apo-Levetiracetam 250mg Tab Auro-Levetiracetam 250mg Tab CO Levetiracetam 250mg Tab pms-Levetiracetam 250mg Tab Levetiracetam 250mg Tab Keppra 250mg Tab levetiracetam 500mg tab Apo-Levetiracetam 500mg Tab Auro-Levetiracetam 500mg Tab CO Levetiracetam 500mg Tab Levetiracetam 500mg Tab pms-Levetiracetam 500mg Tab Keppra 500mg Tab levetiracetam 750mg tab Apo-Levetiracetam 750mg Tab Auro-Levetiracetam 750mg Tab CO Levetiracetam 750mg Tab Levetiracetam 750mg Tab pms-Levetiracetam 750mg Tab Keppra 750mg Tab N03AX16 PREGABALIN Lyrica 25mg Cap Lyrica 50mg Cap Lyrica 75mg Cap Lyrica 150mg Cap Lyrica 300mg Cap LACOSAMIDE Vimpat 50mg Tab Vimpat 100mg Tab Vimpat 150mg Tab Vimpat 200mg Tab

DNP DNP DNP DNP

MRP MRP MRP MRP

SFC SFC SFC SFC

02293366 02285851 02239718 02255901 02247346

APX GMD PFI PMS TEV

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

E E E E E E

02285924 02375249 02274183 02296101 02353342 02247027

APX AUR COB PMS SAS UCB

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

E E E E E E

02285932 02375257 02274191 02353350 02296128 02247028

APX AUR COB SAS PMS UCB

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

E E E E E E

02285940 02375265 02274205 02353369 02296136 02247029 02268418 02268426 02268434 02268450 02268485

APX ARO COB SAS PMS UCB PFI PFI PFI PFI PFI UCB UCB UCB UCB

N03AX18

DNP DNP DNP DNP

E E E E

02357615 02357623 02357631 02357658

N04

ANTI-PARKINSON DRUGS

N04A ANTICHOLINERGIC AGENTS N04AA TERTIARY AMINES N04AA01 TRIHEXYPHENIDYL Trihexyphenidyl 2mg Tab Trihexyphenidyl 5mg Tab PROCYCLIDINE procyclidine HCl 0.5mg/mL o/l pms-Procyclidine 0.5mg/mL Elx Kemadrin 0.5mg/mL O/L (discontinued) procyclidine HCl 5mg tab pms-Procyclidine 5mg Tab Kemadrin 5mg Tab (discontinued) N04AA05 ETHOPROPAZINE (PROFENAMINE) Parsitan 50mg Tab SF SF 00545058 00545074 AAP AAP

DNP DNP

N04AA04

DNP

MRP

SF

00587362

PMS

DNP

MRP

SF

00587354

PMS

DNP

SF

01927744

ERF

December 2012

Nervous System ­ 137

N04AC ETHERS OF TROPINE OR TROPINE DERIVATIVES N04AC01 BENZTROPINE pms-Benztropine 1mg Tab benztropine mesylate 2mg tab Apo-Benztropine 2mg Tab pms-Benztropine 2mg Tab Cogentin 2mg Tab (discontinued) N04B DOPAMINERGIC AGENTS N04BA DOPA AND DOPA DERIVATIVES N04BA02 LEVODOPA AND DECARBOXYLASE INHIBITOR Duodopa 5mg/20mg/mL Intratestional Gel Prolopa 50-12.5 Cap Prolopa 100-25 Cap Prolopa 200-50 Cap levodopa 100mg & carbidopa 10mg tab Apo-Levocarb 100/10 Tab Novo-Levocarbidopa 100/10 Tab Sinemet 100/10 Tab levodopa 100mg & carbidopa 25mg tab Apo-Levocarb 100/25 Tab Novo-Levocarbidopa 100/25 Tab Sinemet 100/25 Tab levodopa 200mg & carbidopa 50mg tab Levocarb CR 200/50 Tab Sinemet CR 200/50 Tab levodopa 250mg & carbidopa 25mg tab Apo-Levocarb 250/25 Tab Novo-Levocarbidopa 250/25 Tab Sinemet 250/25 Tab levodopa 100mg & carbidopa 25mg CR tab Levocarb CR 100/25mg Tab Sinemet CR 100/25mg Tab N04BA03 02292165 00522597 00386464 00386472 02195933 02244494 00355658 ABB HLR HLR HLR APX TEV FRS SF SF SF 00706531 00426857 00587265 PMS APX PMS

DNP

DNP DNP

MRP MRP

DNP DNP DNP

SF SF SF SF SF SF

DNP DNP DNP

MRP MRP MRP

DNP DNP DNP

MRP MRP MRP

SF SF SF

02195941 02244495 00513997

APX TEV FRS

DNP DNP

MRP MRP

SF SF

02245211 00870935

AAP FRS

DNP DNP DNP

MRP MRP MRP

SF SF SF

02195968 02244496 00328219

APX TEV FRS

DNP DNP

MRP MRP

SF SF E E E E E

02272873 02028786 02305933 02337827 02305941 02337835 02305968

AAP FRS NVR NVR NVR NVR NVR

LEVODOPA, DECARBOXYLASE INHIBITOR AND COMT INHIBITOR Stalevo 50mg Tab DNP Stalevo 75mg Tab DNP DNP Stalevo 100mg Tab Stalevo 125mg Tab DNP DNP Stalevo 150mg Tab

N04BB ADAMANTANE DERIVATIVES N04BB01 AMANTADINE amantadine HCl 100mg cap MYLAN-Amantadine 100mg Cap pms-Amantadine 100mg Cap Endantadine 100mg Cap (discontinued) Symmetrel 100mg Cap (discontinued) amantadine HCl 10mg/mL o/l pms-Amantadine 10mg/mL Syr Symmetrel 10mg/mL Syr (discontinued)

DNP DNP

MRP MRP

SF SF

02139200 01990403

MYL PMS

DNP

MRP

SF

02022826

PMS

December 2012

Nervous System ­ 138

N04BC DOPAMINE AGONISTS N04BC04 ROPINIROLE ropinirole 0.25mg tab CO Ropinirole 0.25mg Tab pms-Ropinirole 0.25mg Tab Ropinirole 0.25mg Tab ReQuip 0.25mg Tab RAN-Ropinirole 0.25mg Tab ropinirole 1mg tab CO Ropinirole 1mg Tab pms-Ropinirole 1mg Tab Ropinirole 1mg Tab ReQuip 1mg Tab RAN-Ropinirole 1mg Tab ropinirole 2mg tab CO Ropinirole 2mg Tab pms-Ropinirole 2mg Tab Ropinirole 2mg Tab ReQuip 2mg Tab RAN-Ropinirole 2mg Tab ropinirole 5mg tab CO Ropinirole 5mg Tab pms-Ropinirole 5mg Tab Ropinirole 5mg Tab ReQuip 5mg Tab RAN-Ropinirole 5mg Tab N04BC05 PRAMIPEXOLE pramipexole 0.25mg tab Apo-Pramipexole 0.25mg Tab CO Pramipexole 0.25mg Tab MYLAN-Pramipexole 0.25mg Tab Novo-Pramipexole 0.25mg Tab pms-Pramipexole 0.25mg Tab Sandoz Pramipexole 0.25mg Tab Mirapex 0.25mg Tab pramipexole 0.5mg tab Apo-Pramipexole 0.5mg Tab CO Pramipexole 0.5mg Tab MYLAN-Pramipexole 0.5mg Tab Novo-Pramipexole 0.5mg Tab pms-Pramipexole 0.5mg Tab Mirapex 0.5mg Tab pramipexole 1mg tab Apo-Pramipexole 1mg Tab CO Pramipexole 1mg Tab MYLAN-Pramipexole 1mg Tab Novo-Pramipexole 1mg Tab pms-Pramipexole 1mg Tab Sandoz Pramipexole 1mg Tab Mirapex 1mg Tab SF SF SF SF SF SF SF SF SF SF SF SF

DNP DNP DNP DNP

MRP MRP MRP MRP

SF SF SF SF

02316846 02326590 02353040 02232565 02314037 02316854 02326612 02353059 02232567 02314053 02316862 02326620 02353067 02232568 02314061 02316870 02326639 02353075 02232569 02314088

COB PMS SAS GSK RAN COB PMS SAS GSK RAN COB PMS SAS GSK RAN COB PMS SAS GSK RAN

DNP DNP DNP DNP

MRP MRP MRP MRP

DNP DNP DNP DNP

MRP MRP MRP MRP

DNP DNP DNP DNP

MRP MRP MRP MRP

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF

02292378 02297302 02376350 02269309 02290111 02315262 02237145

APX COB MYL TEV PMS SDZ BOE

02292386 02297310 02376369 02269317 02290138 02241594

APX COB MYL TEV PMS BOE

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF

02292394 02297329 02376377 02269325 02290146 02315289 02237146

APX COB MYL TEV PMS SDZ BOE

December 2012

Nervous System ­ 139

pramipexole 1.5mg tab Apo-Pramipexole 1.5mg Tab CO Pramipexole 1.5mg Tab MYLAN-Pramipexole 1.5mg Tab Novo-Pramipexole 1.5mg Tab pms-Pramipexole 1.5mg Tab Sandoz Pramipexole 1.5mg Tab Mirapex 1.5mg Tab N04BD MONOAMINE OXIDASE B INHIBITORS N04BD01 SELEGILINE selegiline 5mg tab Apo-Selegiline 5mg Tab MYLAN-Selegiline 5mg Tab Novo-Selegiline 5mg Tab Eldepryl 5mg Tab (discontinued) RASAGILINE Azilect 0.5mg Tab Azilect 1mg Tab

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF

02292408 02297337 02376385 02269333 02290154 02315297 02237147

APX COB MYL TEV PMS SDZ BOE

DNP DNP DNP

MRP MRP MRP

SF SF SF

02230641 02231036 02068087

APX MYL TEV

N04BD02

02284642 02284650

TMP TMP

N04BX OTHER DOPAMINERGIC AGENTS N04BX02 ENTACAPONE entacapone 200mg Tab Sandoz Entacapone 200mg Tab Teva-Entacapone 200mg Tab Comtan 200mg Tab

DNP DNP DNP

MRP MRP MRP

E E E

02380005 02375559 02243763

SDZ TEV NVR

N05

PSYCHOLEPTICS

N05A ANTIPSYCHOTICS N05AA PHENOTHIAZINE WITH ALIPHATIC SIDE-CHAIN N05AA01 CHLORPROMAZINE chlorpromazine 25mg/mL inj Chlorpromazine 25mg/mL Inj Largactil 25mg/mL Inj (discontinued) Teva-Chlorpromazine 25mg Tab Teva-Chlorpromazine 50mg Tab Teva-Chlorpromazine 100mg Tab N05AA02 METHOTRIMEPRAZINE (LEVOMEPROMAZINE) Nozinan 25mg/mL Inj methotrimeprazine 2mg tab Apo-Methoprazine 2mg Tab Nozinan 2mg Tab (discontinued) methotrimeprazine 5mg tab Apo-Methoprazine 5mg Tab Nozinan 5mg Tab (discontinued) methotrimeprazine 25mg tab Apo-Methoprazine 25mg Tab Nozinan 25mg Tab (discontinued) methotrimeprazine 50mg tab Apo-Methoprazine 50mg Tab Nozinan 50mg Tab (discontinued) N05AB PHENOTHIAZINES WITH PIPERAZINE STRUCTURE N05AB02 FLUPHENAZINE Fluphenazine Omega 25mg/mL Inj SFC 02239636 OMG

DNP

MRP

SFC SFC SFC SFC SFC SFC

00743518 00232823 00232807 00232831 01927698 02238403

SDZ TEV TEV TEV SAV APX

DNP DNP DNP

DNP

DNP

MRP

DNP

MRP

SFC

02238404

APX

DNP

MRP

SFC

02238405

APX

DNP

MRP

SFC

02238406

APX

DNP

December 2012

Nervous System ­ 140

fluphenazine decanoate 100mg/mL inj Modecate Concentrate 100mg/mL Inj pms-Fluphenazine 100mg/mL Inj (discontinued) Apo-Fluphenazine 1mg Tab Apo-Fluphenazine 2mg Tab Apo-Fluphenazine 5mg Tab pms-Fluphenazine 5mg Tab N05AB03 PERPHENAZINE Perphenazine 2mg Tab perphenazine 4mg tab Perphenazine 4mg Tab Trilafon 4mg Tab (discontinued) Perphenazine 8mg Tab Perphenazine 16mg Tab N05AB04 PROCHLORPERAZINE prochlorperazine 5mg/mL inj Prochlorperazine 5mg/mL Inj Stemetil 5mg/mL Inj (discontinued) pms-Prochlorperazine 5mg Tab (discontinued) pms-Prochloperazine 10mg Tab (discontinued) Prochlorperazine 10mg Supp prochlorperazine 5mg tab Apo-Prochlorazine 5mg Tab Stemetil 5mg Tab (discontinued) prochlorperazine 10mg tab Apo-Prochlorazine 10mg Tab Stemetil 10mg Tab (discontinued) N05AB06 TRIFLUOPERAZINE trifluoperazine 1mg tab Trifluoperazine 1mg Tab Stelazine 1mg Tab (discontinued) trifluoperazine 2mg tab Trifluoperazine 2mg Tab Stelazine 2mg Tab (discontinued) trifluoperazine 5mg tab Trifluoperazine 5mg Tab Stelazine 5mg Tab (discontinued) trifluoperazine 10mg tab Trifluoperazine 10mg Tab Stelazine 10mg Tab (discontinued) Trifluoperazine 20mg Tab N05AB08 THIOPROPERAZINE Majeptil 10mg Tab

DNP

SFC SFC SFC SFC SFC SFC SFC SFC SFC

00755575 00405345 00410632 00405361 00726354 00335134 00335126 00335118 00335096

BRI APX APX APX PMS AAP AAP AAP AAP

DNP DNP DNP DNP

DNP

DNP

MRP

DNP DNP

DNP

MRP

SFC

00789747

SDZ

DNP

SFC SFC

00789720 00886440

SDZ APX

DNP

MRP

DNP

MRP

SFC

00886432

APX

DNP

MRP

SFC

00345539

AAP

DNP

MRP

SFC

00312754

AAP

DNP

MRP

SFC

00312746

AAP

DNP

MRP

SFC SFC SFC

00326836 00595942 01927639

AAP AAP ERF

DNP

DNP

N05AC PHENOTHIAZINES WITH PIPERIDINE STRUCTURE N05AC01 PERICYAZINE (PROPERICYAZINE) Neuleptil 5mg Cap Neuleptil 10mg Cap Neuleptil 20mg Cap Neuleptil 10mg/mL Oral Drops 01926780 01926772 01926764 01926756 ERF ERF ERF ERF

December 2012

Nervous System ­ 141

N05AC04

PIPOTIAZINE Piportil L4 25mg/mL Inj Piportil L4 50mg/mL Inj

DNP DNP

SFC SFC

01926667 01926675

SAV SAV

N05AD BUTYROPHENONE DERIVATIVES N05AD01 HALOPERIDOL Haloperidol 5mg/mL Inj haloperidol LA 50mg/mL inj Haloperidol LA 50mg/mL Inj Haldol LA 50mg/mL Inj (discontinued) haloperidol LA 100mg/mL inj Haloperidol LA 100mg/mL Inj Haldol LA 100mg/mL Inj (discontinued) haloperidol 0.5mg tab Apo-Haloperidol 0.5mg Tab Novo-Peridol 0.5mg Tab Haldol 0.5mg Tab (discontinued) haloperidol 1mg tab Apo-Haloperidol 1mg Tab Novo-Peridol 1mg Tab Haldol 1mg Tab (discontinued) haloperidol 2mg tab Apo-Haloperidol 2mg Tab Novo-Peridol 2mg Tab Haldol 2mg Tab (discontinued) haloperidol 5mg tab Apo-Haloperidol 5mg Tab Novo-Peridol 5mg Tab Haldol 5mg Tab (discontinued) haloperidol 10mg tab Apo-Haloperidol 10mg Tab Novo-Peridol 10mg Tab Haldol 10mg Tab (discontinued) Haldol 2mg/mL O/L (discontinued) Novo-Peridol 20mg Tab N05AD08 DROPERIDOL Droperidol 2.5mg/mL Inj SFC SFC SFC 00808652 02130297 SDZ SDZ

DNP

DNP

MRP

DNP

MRP

SFC

02130300

SDZ

DNP DNP

MRP MRP

SFC SFC

00396796 00363685

APX TEV

DNP DNP

MRP MRP

SFC SFC

00396818 00363677

APX TEV

DNP DNP

MRP MRP

SFC SFC

00396826 00363669

APX TEV

DNP DNP

MRP MRP

SFC SFC

00396834 00363650

APX TEV

DNP DNP

MRP MRP

SFC SFC

00463698 00713449

APX TEV

00768820 02167832

TEV SDZ

DNP

N05AE INDOLE DERIVATIVES N05AE04 ZIPRASIDONE Zeldox 20mg Cap Zeldox 40mg Cap Zeldox 60mg Cap Zeldox 80mg Cap E E E E 02298597 02298600 02298619 02298627 PFI PFI PFI PFI

DNP DNP DNP DNP

N05AF THIOXANTHENE DERIVATIVES N05AF01 FLUPENTHIXOL Fluanxol Depot 10% Inj Fluanxol Depot 2% Inj Fluanxol 0.5mg Tab Fluanxol 3mg Tab SFC SFC SFC SFC 02156040 02156032 02156008 02156016 VLH VLH VLH VLH

DNP DNP DNP DNP

December 2012

Nervous System ­ 142

N05AF04

THIOTHIXENE Navane 2mg Cap Navane 5mg Cap Navane 10mg Cap ZUCLOPENTHIXOL Clopixol-Acuphase 50mg/mL Inj Clopixol-Depot 200mg/mL Inj Clopixol 10mg Tab Clopixol 25mg Tab

DNP DNP DNP

SFC SFC SFC

00024430 00024449 00024457 02230405 02230406 02230402 02230403

ERF ERF ERF VLH VLH VLH VLH

N05AF05

N05AG DIPHENYLBUTYLPIPERIDINE DERIVATIVES N05AG02 PIMOZIDE pimozide 2mg tab Apo-Pimozide 2mg Tab Orap 2mg Tab pimozide 4mg tab Apo-Pimozide 4mg Tab Orap 4mg Tab N05AH DIAZEPINES, OXAZEPINES AND THIAZEPINES N05AH01 LOXAPINE Loxapac 50mg/mL IM Inj pms-Loxapine 2.5mg Tab loxapine 5mg tab Xylac 5mg Tab Loxapac 5mg Tab (discontinued) loxapine 10mg tab Xylac 10mg Tab Loxapac 10mg Tab (discontinued) loxapine 25mg tab Xylac 25mg Tab Loxapac 25mg Tab (discontinued) loxapine 50mg tab Xylac 50mg Tab Loxapac 50mg Tab (discontinued) N05AH02 CLOZAPINE clozapine 25mg tab Apo-Clozapine 25mg Tab Gen-Clozapine 25mg Tab Clozaril 25mg Tab Gen-Clozapine 50mg Tab clozapine 100mg tab Apo-Clozapine 100mg Tab Gen-Clozapine 100mg Tab Clozaril 100mg Tab Gen-Clozapine 200mg Tab N05AH03 OLANZAPINE Zyprexa 10mg/vial Inj SFC SFC SFC 02169991 02242868 02230837 SDZ PMS PDP

DNP DNP

MRP MRP

SFC SFC

02245432 00313815

APX PMS

DNP DNP

MRP MRP

SFC SFC

02245433 00313823

APX PMS

DNP DNP

DNP

MRP

DNP

MRP

SFC

02230838

PDP

DNP

MRP

SFC

02230839

PDP

DNP

MRP

SFC

02230840

PDP

02248034 02247243 00894737 02305003 02248035 02247244 00894745 02305011

APX MYL NVR MYL APX MYL NVR MYL

02247099

LIL

December 2012

Nervous System ­ 143

olanzapine 2.5mg tab Apo-Olanzapine 2.5mg Tab MYLAN-Olanzapine 2.5mg Tab Olanzapine 2.5mg Tab pms-Olanzapine 2.5mg Tab Sandoz Olanzapine 2.5mg Tab Teva-Olanzapine 2.5mg Tab Zyprexa 2.5mg Tab olanzapine 5mg tab Apo-Olanzapine 5mg Tab MYLAN-Olanzapine 5mg Tab Olanzapine 5mg Tab pms-Olanzapine 5mg Tab Sandoz Olanzapine 5mg Tab Teva-Olanzapine 5mg Tab Zyprexa 5mg Tab olanzapine 7.5mg tab Apo-Olanzapine 7.5mg Tab MYLAN-Olanzapine 7.5mg Tab Olanzapine 7.5mg Tab pms-Olanzapine 7.5mg Tab Sandoz Olanzapine 7.5mg Tab Teva-Olanzapine 7.5mg Tab Zyprexa 7.5mg Tab olanzapine 10mg tab Apo-Olanzapine 10mg Tab MYLAN-Olanzapine 10mg Tab Olanzapine 10mg Tab pms-Olanzapine 10mg Tab Sandoz Olanzapine 10mg Tab Teva-Olanzapine 10mg Tab Zyprexa 10mg Tab olanzapine 15mg tab Apo-Olanzapine 15mg Tab MYLAN-Olanzapine 15mg Tab Olanzapine 15mg Tab pms-Olanzapine 15mg Tab Sandoz Olanzapine 15mg Tab Teva-Olanzapine 15mg Tab Zyprexa 15mg Tab olanzapine 20mg tab Apo-Olanzapine 20mg Tab Teva-Olanzapine 20mg Tab Zyprexa 20mg Tab olanzapine ODT 5mg tab Apo-Olanzapine ODT 5mg Tab CO Olanzapine ODT 5mg Tab MYLAN-Olanzapine ODT 5mg Tab Novo-Olanzapine OD 5mg Tab Olanzapine ODT 5mg Tab pms-Olanzapine ODT 5mg Tab Sandoz Olanzapine ODT 5mg Tab Zyprexa Zydis 5mg Tab

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

E E E E E E E

02281791 02337878 02372819 02303116 02310341 02276712 02229250

APX MYL SAS PMS SDZ TEV LIL

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

E E E E E E E

02281805 02337886 02372827 02303159 02310368 02276720 02229269

APX MYL SAS PMS SDZ TEV LIL

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

E E E E E E E

02281813 02337894 02372835 02303167 02310376 02276739 02229277

APX MYL SAS PMS SDZ TEV LIL

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

E E E E E E E

02281821 02337908 02372843 02303175 02310384 02276747 02229285

APX MYL SAS PMS SDZ TEV LIL

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

E E E E E E E

02281848 02337916 02372851 02303183 02310392 02276755 02238850

APX MYL SAS PMS SDZ TEV LIL

02333015 02359707 02238851

APX TEV LIL

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E

02360616 02327562 02382709 02321343 02352974 02303191 02327775 02243086

APX COB MYL TEV SAS PMS SDZ LIL

December 2012

Nervous System ­ 144

olanzapine ODT 10mg tab Apo-Olanzapine ODT 10mg Tab CO Olanzapine ODT 10mg Tab MYLAN-Olanzapine ODT 10mg Tab Novo-Olanzapine OD 10mg Tab Olanzapine ODT 10mg Tab pms-Olanzapine ODT 10mg Tab Sandoz Olanzapine ODT 10mg Tab Zyprexa Zydis 10mg Tab olanzapine ODT 15mg tab Apo-Olanzapine ODT 15mg Tab CO Olanzapine ODT 15mg Tab MYLAN-Olzapine ODT 15mg Tab Novo-Olanzapine OD 15mg Tab Olanzapine ODT 15mg Tab pms-Olanzapine ODT 15mg Tab Sandoz Olanzapine ODT 15mg Tab Zyprexa Zydis 15mg Tab olanzapine ODT 20mg tab Apo-Olanzapine ODT 20mg Tab CO Olanzapine ODT 20mg Tab MYLAN-Olzapine ODT 20mg Tab Novo-Olanzapine ODT 20mg Tab Sandoz Olanzapine ODT 20mg Tab Zyprexa Zydis 20mg Tab N05AH04 QUETIAPINE quetiapine 25mg tab Apo-Quetiapine 25mg Tab CO Quetiapine 25mg Tab Jamp-Quetiapine 25mg Tab MYLAN-Quetiapine 25mg Tab Novo-Quetiapine 25mg Tab phl-Quetiapine 25mg Tab pms-Quetiapine 25mg Tab Quetiapine 25mg Tab Sandoz Quetiapine 25mg Tab Seroquel 25mg Tab pms-Quetiapine 50mg Tab quetiapine 100mg tab Apo-Quetiapine 100mg Tab CO Quetiapine 100mg Tab Jamp-Quetiapine 100mg Tab MYLAN-Quetiapine 100mg Tab Novo-Quetiapine 100mg Tab phl-Quetiapine 100mg Tab pms-Quetiapine 100mg Tab Quetiapine 100mg Tab Sandoz Quetiapine 100mg Tab Seroquel 100mg Tab Novo-Quetiapine 150mg Tab

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E

02360624 02327570 02382717 02321351 02352982 02303205 02327783 02243087

APX COB MYL TEV SAS PMS SDZ LIL

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E

02360632 02327589 02382725 02321378 02352990 02303213 02327791 02243088

APX COB MYL TEV SAS PMS SDZ LIL

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

E E E E E E

02360640 02327597 02382733 02321386 02327805 02243089

APX COB MYL TEV SDZ LIL

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF SF

02313901 02316080 02330415 02307804 02284235 02299054 02296551 02353164 02313995 02236951 02361892 02313928 02316099 02330423 02307812 02284243 02299062 02296578 02353172 02314002 02236952 02284251

APX COB JPC MYL TEV PHL PMS SAS SDZ AZE PMS APX COB JPC MYL TEV PHL PMS SAS SDZ AZE TEV

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

December 2012

Nervous System ­ 145

quetiapine 200mg tab Apo-Quetiapine 200mg Tab CO Quetiapine 200mg Tab Jamp-Quetiapine 200mg Tab MYLAN-Quetiapine 200mg Tab Novo-Quetiapine 200mg Tab phl-Quetiapine 200mg Tab pms-Quetiapine 200mg Tab Quetiapine 200mg Tab Sandoz Quetiapine 200mg Tab Seroquel 200mg Tab quetiapine 300mg tab Apo-Quetiapine 300mg Tab CO Quetiapine 300mg Tab Jamp-Quetiapine 300mg Tab MYLAN-Quetiapine 300mg Tab Novo-Quetiapine 300mg Tab phl-Quetiapine 300mg Tab pms-Quetiapine 300mg Tab Quetiapine 300mg Tab Sandoz Quetiapine 300mg Tab Seroquel 300mg Tab N05AH05 ASENAPINE Saphris 5mg SL Tab Saphris 10mg SL Tab LITHIUM lithium 150mg cap Apo-Lithium Carbonate 150mg Cap pms-Lithium Carbonate 150mg Cap Carbolith 150mg Cap lithium 150mg cap Apo-Lithium Carbonate 150mg Cap Lithane 150mg Cap lithium 300mg cap Apo-Lithium Carbonate 300mg Cap pms-Lithium Carbonate 300mg Cap Carbolith 300mg Cap lithium 300mg cap Apo-Lithium Carbonate 300mg Cap Lithane 300mg Cap lithium 600mg cap pms-Lithium Carbonate 600mg Cap Carbolith 600mg Cap lithium 300mg SR tab Lithmax SR 300mg Tab Duralith 300mg Tab (discontinued) N05AX OTHER ANTIPSYCHOTICS N05AX08 RISPERIDONE Risperdal Consta 12.5mg/2mL Inj Risperdal Consta 25mg/2mL Inj Risperdal Consta 37.5mg/2mL Inj Risperdal Consta 50mg/2mL Inj

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF

02313936 02316110 02330458 02307839 02284278 02299089 02296594 02353199 02314010 02236953

APX COB JPC MYL TEV PHL PMS SAS SDZ AZE

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF E E

02313944 02316129 02330466 02307847 02284286 02299097 02296608 02353202 02314029 02244107 02374803 02374811

APX COB JPC MYL TEV PHL PMS SAS SDZ AZE FRS FRS

DNP DNP

N05AN LITHIUM N05AN01

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC

02242837 02216132 00461733

APX PMS VLN

DNP DNP

MRP MRP

SFC SFC

02242837 02013231

APX ERF

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC

02242838 02216140 00236683

APX PMS VLN

DNP DNP

MRP MRP

SFC SFC

02242838 00406775

APX ERF

DNP DNP

MRP MRP

SFC SFC

02216159 02011239

PMS VLN

DNP

MRP

SFC

02266695

AAP

DNP DNP DNP DNP

E E E E

02298465 02255707 02255723 02255758

JAN JAN JAN JAN

December 2012

Nervous System ­ 146

risperidone 1mg/mL o/l Apo-Risperidone 1mg/mL O/L pms-Risperidone 1mg/mL O/L Risperdal 1mg/mL O/L risperidone 0.25mg tab Apo-Risperidone 0.25mg Tab CO Risperidone 0.25mg Tab Jamp-Risperidone 0.25mg Tab Mar-Risperidone 0.25mg Tab MINT-Risperidon 0.25mg Tab MYLAN-Risperidone 0.25mg Tab Novo-Risperidone 0.25mg Tab phl-Risperidone 0.25mg Tab pms-Risperidone 0.25mg Tab RAN-Risperidone 0.25mg Tab Risperidone 0.25mg Tab Sandoz Risperidone 0.25mg Tab Risperdal 0.25mg Tab RAN-Risperidone 0.25mg Tab (discontinued) risperidone 0.5mg tab Apo-Risperidone 0.5mg Tab CO Risperidone 0.5mg Tab Jamp-Risperidone 0.5mg Tab Mar-Risperidone 0.5mg Tab MINT-Risperidon 0.5mg Tab MYLAN-Risperidon 0.5mg Tab Novo-Risperidone 0.5mg Tab phl-Risperidone 0.5mg Tab pms-Risperidone 0.5mg Tab RAN-Risperidone 0.5mg Tab Risperidone 0.5mg Tab Sandoz Risperidone 0.5mg Tab Risperdal 0.5mg Tab RAN-Risperidone 0.5mg Tab (discontinued) risperidone 1mg tab Apo-Risperidone 1mg Tab CO Risperidone 1mg Tab Jamp-Risperidone 1mg Tab Mar-Risperidone 1mg Tab MINT-Risperidon 1mg Tab MYLAN-Risperidone 1mg Tab Novo-Risperidone 1mg Tab phl-Risperidone 1mg Tab pms-Risperidone 1mg Tab RAN-Risperidone 1mg Tab Risperidone 1mg Tab Sandoz Risperidone 1mg Tab Risperdal 1mg Tab RAN-Risperidone 1mg Tab (discontinued)

DNP DNP DNP

MRP MRP MRP

SF SF SF

02280396 02279266 02236950

APX PMS JAN

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF

02282119 02282585 02359529 02371766 02359790 02282240 02282690 02258439 02252007 02328305 02356880 02303655 02240551 02280906

APX COB JPC MAR MNT MYL TEV PHL PMS RAN SAS SDZ JAN RAN

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF

02282127 02282593 02359537 02371774 02359804 02282259 02264188 02258447 02252015 02328313 02356899 02303663 02240552 02280914

APX COB JPC MAR MNT MYL TEV PHL PMS RAN SAS SDZ JAN RAN

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF

02282135 02282607 02359545 02371782 02359812 02282267 02264196 02258455 02252023 02328321 02356902 02279800 02025280 02280922

APX COB JPC MAR MNT MYL TEV PHL PMS RAN SAS SDZ JAN RAN

December 2012

Nervous System ­ 147

risperidone 2mg tab Apo-Risperidone 2mg Tab CO Risperidone 2mg Tab Jamp-Risperidone 2mg Tab Mar-Risperidone 2mg Tab MINT-Risperidon 2mg Tab MYLAN-Risperidone 2mg Tab Novo-Risperidone 2mg Tab phl-Risperidone 2mg Tab pms-Risperidone 2mg Tab RAN-Risperidone 2mg Tab Risperidone 2mg Tab Sandoz Risperidone 2mg Tab Risperdal 2mg Tab RAN-Risperidone 2mg Tab (discontinued) risperidone 3mg tab Apo-Risperidone 3mg Tab CO Risperidone 3mg Tab Jamp-Risperidone 3mg Tab Mar-Risperidone 3mg Tab MINT-Risperidon 3mg Tab MYLAN-Risperidone 3mg Tab Novo-Risperidone 3mg Tab phl-Risperidone 3mg Tab pms-Risperidone 3mg Tab RAN-Risperidone 3mg Tab Risperidone 3mg Tab Sandoz Risperidone 3mg Tab Risperdal 3mg Tab RAN-Risperidone 3mg Tab (discontinued) risperidone 4mg tab Apo-Risperidone 4mg Tab CO Risperidone 4mg Tab Jamp-Risperidone 4mg Tab Mar-Risperidone 4mg Tab MINT-Risperidon 4mg Tab MYLAN-Risperidone 4mg Tab Novo-Risperidone 4mg Tab phl-Risperidone 4mg Tab pms-Risperidone 4mg Tab RAN-Risperidone 4mg Tab Risperidone 4mg Tab Sandoz Risperidone 4mg Tab Risperdal 4mg Tab RAN-Risperidone 4mg Tab (discontinued) risperidone ODT 1mg tab pms-Risperidone ODT 1mg Tab Risperdal M-Tab (1mg) Risperidone ODT 2mg tab pms-Risperidone ODT 2mg Tab Risperdal M-Tab (2mg) Risperidone ODT 3mg tab pms-Risperidone ODT 3mg Tab Risperdal M-Tab (3mg) Risperidone ODT 4mg tab pms-Risperidone ODT 4mg Tab Risperdal M-Tab (4mg) Risperdal M-Tab (0.5mg)

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF

02282143 02282615 02359553 02371790 02359820 02282275 02264218 02258463 02252031 02328348 02356910 02279819 02025299 02280930

APX COB JPC MAR MNT MYL TEV PHL PMS RAN SAS SDZ JAN RAN

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF

02282151 02282623 02359561 02371804 02359839 02282283 02264226 02258471 02252058 02328364 02356929 02279827 02025302 02280949

APX COB JPC MAR MNT MYL TEV PHL PMS RAN SAS SDZ JAN RAN

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF SF

02282178 02282631 02359588 02371812 02359847 02282291 02264234 02258498 02252066 02328372 02356937 02279835 02025310 02280957

APX COB JPC MAR MNT MYL TEV PHL PMS RAN SAS SDZ JAN RAN

DNP DNP

MRP MRP

SF SF

02291789 02247705

PMS JAN

DNP DNP

MRP MRP

SF SF

02291797 02247706

PMS JAN

DNP DNP

MRP MRP

SF SF

02370697 02268086

PMS JAN

DNP DNP DNP

MRP MRP

SF SF SF

02370700 02268094 02247704

PMS JAN JAN

December 2012

Nervous System ­ 148

N05AX12

ARIPIPRAZOLE Abilify 2mg Tab Abilify 5mg Tab Abilify 10mg Tab Abilify 15mg Tab Abilify 20mg Tab Abilify 30mg Tab PALIPERIDONE Invega Sustenna 50mg/0.5mL Inj Invega Sustenna 75mg/0.75mL Inj Invega Sustenna 100mg/1mL Inj Invega Sustenna 150mg/1.5mL Inj

DNP DNP DNP DNP DNP DNP

E E E E E E

02322374 02322382 02322390 02322404 02322412 02322455 02354217 02354225 02354233 02354241

BRI BRI BRI BRI BRI BRI JAN JAN JAN JAN

N05AX13

N05B ANXIOLYTICS N05BA BENZODIAZEPINE DERIVATIVES N05BA01 DIAZEPAM Diastat 5mg/mL Rectal Gel diazepam 5mg/mL inj Diazepam 5mg/mL Inj Valium 5mg/mL Inj (discontinued) Diazemuls 5mg/mL Inj pms-Diazepam 1mg/mL O/L Apo-Diazepam 2mg Tab pms-Diazepam 2mg Tab pms-Diazepam 5mg Tab diazepam 5mg tab Apo-Diazepam 5mg Tab Valium 5mg Tab Vivol 5mg Tab diazepam 10mg tab Apo-Diazepam 10mg Tab Vivol 10mg Tab Valium 10mg Tab (discontinued) pms-Diazepam 10mg Tab N05BA02 CHLORDIAZEPOXIDE Apo-Chlordiazepoxide 5mg Cap Apo-Chlordiazepoxide 10mg Cap Apo-Chlordiazepoxide 25mg Cap OXAZEPAM Apo-Oxazepam 10mg Tab oxazepam 15mg tab Apo-Oxazepam 15mg Tab Serax 15mg Tab (discontinued) oxazepam 30mg tab Apo-Oxazepam 30mg Tab Serax 30mg Tab (discontinued) N05BA05 CLORAZEPATE DIPOTASSIUM clorazepate dipotassium 3.75mg cap Apo-Clorazepate 3.75mg Cap Tranxene 3.75mg Cap (discontinued) clorazepate dipotassium 7.5mg cap Apo-Clorazepate 7.5mg Cap Tranxene 7.5mg Cap (discontinued) SFC SFC SFC SFC SFC SFC SFC SFC 02238162 00399728 02065614 00891797 00405329 02247490 02247491 00362158 00013285 00013765 VLN SDZ PFI PMS APX PMS PMS APX HLR AXS

D

MRP

D D D D D

D D

MRP MRP

D

MRP

SFC

00405337 00013773 02247492 00522724 00522988 00522996 00402680 00402745

APX AXS PMS APX APX APX APX APX

D

SFC SFC SFC SFC SFC SFC

D D D

N05BA04

D

D

MRP

D

MRP

SFC

00402737

APX

D

MRP

SFC

00860689

APX

D

MRP

SFC

00860700

APX

December 2012

Nervous System ­ 149

clorazepate dipotassium 15mg cap Apo-Clorazepate 15mg Cap Tranxene 15mg Cap (discontinued) N05BA06 LORAZEPAM lorazepam 4mg/mL inj Lorazepam 4mg/mL Inj Ativan 4mg/mL Inj (discontinued) lorazepam 0.5mg tab Apo-Lorazepam 0.5mg Tab Lorazepam 0.5mg Tab Novo-Lorazem 0.5mg Tab pms-Lorazepam 0.5mg Tab Ativan 0.5mg Tab lorazepam 1mg tab Apo-Lorazepam 1mg Tab Lorazepam 1mg Tab Novo-Lorazem 1mg Tab pms-Lorazepam 1mg Tab Ativan 1mg Tab lorazepam 2mg tab Apo-Lorazepam 2mg Tab Lorazepam 2mg Tab Novo-Lorazem 2mg Tab pms-Lorazepam 2mg Tab Ativan 2mg Tab Ativan 0.5mg SL Tab Ativan 1mg SL Tab Ativan 2mg SL Tab N05BA08 BROMAZEPAM bromazepam 1.5mg tab Apo-Bromazepam 1.5mg Tab Lectopam 1.5mg Tab (discontinued) bromazepam 3mg tab Apo-Bromazepam 3mg Tab Novo-Bromazepam 3mg Tab Lectopam 3mg Tab bromazepam 6mg tab Apo-Bromazepam 6mg Tab Novo-Bromazepam 6mg Tab Lectopam 6mg Tab N05BA09 CLOBAZAM clobazam 10mg tab Apo-Clobazam 10mg Tab Novo-Clobazam 10mg Tab pms-Clobazam 10mg Tab Frisium 10mg Tab ALPRAZOLAM alprazolam 0.25mg tab Alprazolam 0.25mg Tab Apo-Alpraz 0.25mg Tab MYLAN-Alprazolam 0.25mg Tab Teva-Alprazolam 0.25mg Tab Xanax 0.25mg Tab

D

MRP

SFC

00860697

APX

D

MRP

SFC

02243278

SDZ

D D D D D

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

00655740 02351072 00711101 00728187 02041413

APX SAS TEV PMS PFI

D D D D D

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

00655759 02351080 00637742 00728195 02041421

APX SAS TEV PMS PFI

D D D D D

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

00655767 02351099 00637750 00728209 02041448 02041456 02041464 02041472

APX SAS TEV PMS PFI PFI PFI PFI

D

MRP

SFC

02177153

APX

D D D

MRP MRP MRP

SFC SFC SFC

02177161 02230584 00518123

APX TEV HLR

D D D

MRP MRP MRP

SFC SFC SFC

02177188 02230585 00518131

APX TEV HLR

D D D D

MRP MRP MRP MRP

SF SF SF SF

02244638 02238334 02244474 02221799

APX TEV PMS LBK

N05BA12

D D D D D

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

02349191 00865397 02137534 01913484 00548359

SAS APX MYL TEV PFI

December 2012

Nervous System ­ 150

alprazolam 0.5mg tab Alprazolam 0.5mg Tab Apo-Alpraz 0.5mg Tab MYLAN-Alprazolam 0.5mg Tab Tevo-Alprazolam 0.5mg Tab Xanax 0.5mg Tab alprazolam 1mg tab Apo-Alpraz 1mg Tab MYLAN-Alprazolam 1mg Tab Xanax 1mg Tab alprazolam 2mg tab Apo-Alpraz 2mg Tab MYLAN-Alprazolam 2mg Tab Xanax 2mg Tab N05BB DIPHENYLMETHANE DERIVATIVES N05BB01 HYDROXYZINE hydroxyzine HCl 10mg cap Apo-Hydroxyzine 10mg Cap Novo-Hydroxyzin 10mg Cap Atarax 10mg Cap (discontinued) hydroxyzine HCl 25mg cap Apo-Hydroxyzine 25mg Cap Novo-Hydroxyzin 25mg Cap Atarax 25mg Cap (discontinued) hydroxyzine HCl 50mg cap Apo-Hydroxyzine 50mg Cap Novo-Hydroxyzin 50mg Cap Atarax 50mg Cap (discontinued) hydroxyzine 50mg/mL inj Hydroxyzine 50mg/mL Inj Atarax 50mg/mL Inj (discontinued) Atarax 2mg/mL Syr N05BE AZASPIRODECANEDIONE DERIVATIVES N05BE01 BUSPIRONE buspirone HCl 10mg tab Apo-Buspirone 10mg Tab Novo-Buspirone 10mg Tab pms-Buspirone 10mg Tab Buspar 10mg Tab (discontinued)

D D D D D

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC

02349205 00865400 02137542 01913492 00548367

SAS APX MYL TEV PFI

02243611 02229813 00723770

APX MYL PFI

02243612 02229814 00813958

APX MYL PFI

DNP DNP

MRP MRP

E E

00646059 00738824

APX TEV

DNP DNP

MRP MRP

E E

00646024 00738832

APX TEV

DNP DNP

MRP MRP

E E

00646016 00738840

APX TEV

00742813 E 00024694

SDZ ERF

DNP

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC

02211076 02231492 02230942

APX TEV PMS

N05C HYPNOTICS AND SEDATIVES N05CC ALDEHYDES AND DERIVATIVES N05CC01 CHLORAL HYDRATE Chloral Hydrate-ODAN 100mg/mL Syr pms-Chloral Hydrate 100mg/mL Syr SFC SFC 02247621 00792659 ODN PMS

DNP DNP

N05CD BENZODIAZEPINE DERIVATIVES N05CD01 FLURAZEPAM flurazepam 15mg cap Apo-Flurazepam 15mg Cap Dalmane 15mg Cap (discontinued)

00521698

APX

December 2012

Nervous System ­ 151

flurazepam 30mg cap Apo-Flurazepam 30mg Cap Dalmane 30mg Cap (discontinued) N05CD02 NITRAZEPAM nitrazepam 5mg tab Apo-Nitrazepam 5mg Tab Sandoz Nitrazepam 5mg Tab Mogadon 5mg Tab Nitrazadon 5mg Tab nitrazepam 10mg tab Apo-Nitrazepam 10mg Tab Sandoz Nitrazepam 10mg Tab Mogadon 10mg Tab Nitrazadon 10mg Tab N05CD05 TRIAZOLAM Apo-Triazo 0.125mg Tab Apo-Triazo 0.25mg Tab Halcion 0.125mg Tab (discontinued) Halcion 0.25mg Tab (discontinued) TEMAZEPAM temazepam 15mg cap Apo-Temazepam 15mg Cap CO Temazepam 15mg Cap Novo-Temazepam 15mg Cap Restoril 15mg Cap ratio-Temazepam 15mg Cap (discontinued) temazepam 30mg cap Apo-Temazepam 30mg Cap CO Temazepam 30mg Cap Novo-Temazepam 30mg Cap Restoril 30mg Cap ratio-Temazepam 30mg Cap (discontinued) N05CD08 MIDAZOLAM midazolam 1mg/mL inj Midazolam 1mg/mL Inj Versed 1mg/mL Inj (discontinued) midazolam 5mg/mL inj Midazolam 5mg/mL Inj Versed 5mg/mL Inj (discontinued) N05CF BENZODIAZEPINE RELATED DRUGS N05CF01 ZOPICLONE zopiclone 5mg tab Apo-Zopiclone 5mg Tab CO Zopiclone 5mg Tab MYLAN-Zopiclone 5mg Tab Novo-Zopiclone 5mg Tab phl-Zopiclone 5mg Tab pms-Zopiclone 5mg Tab RAN-Zopiclone 5mg Tab ratio-Zopiclone 5mg Tab Sandoz Zopiclone 5mg Tab Zopiclone 5mg Tab Imovane 5mg Tab SFC SFC

00521701

APX

02245230 02234003 00511528 02229654

APX SDZ VLN VLN

02245231 02234007 00511536 02229655 00808563 00808571

APX SDZ VLN VLN APX APX

D D

N05CD07

D D D D

MRP MRP MRP MRP

SFC SFC SFC SFC

02225964 02244814 02230095 00604453

APX COB TEV SEP

D D D D

MRP MRP MRP MRP

SFC SFC SFC SFC

02225972 02244815 02230102 00604461

APX COB TEV SEP

D

MRP

E

02240285

SDZ

D

MRP

E

02240286

SDZ

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02245077 02271931 02296616 02251450 02294052 02243426 02267918 02246534 02257572 02344122 02216167

APX COB MYL TEV PHL PMS RAN TEV SDZ SAS SAV

December 2012

Nervous System ­ 152

zopiclone 7.5mg tab Apo-Zopiclone 7.5mg Tab CO Zopiclone 7.5mg Tab Jamp-Zopiclone 7.5mg Tab MYLAN-Zopiclone 7.5mg Tab Novo-Zopiclone 7.5mg Tab phl-Zopiclone 7.5mg Tab pms-Zopiclone 7.5mg Tab RAN-Zopiclone 7.5mg Tab ratio-Zopiclone 7.5mg Tab Sandoz Zopiclone 7.5mg Tab Zopiclone 7.5mg Tab Imovane 7.5mg Tab Rhovane 7.5mg Tab

02218313 02271958 02356805 02238596 02251469 02294060 02240606 02267926 02242481 02257580 02282445 01926799 02008203

APX COB JPC MYL TEV PHL PMS RAN TEV SDZ SAS SAV SDZ

N06

PSYCHOANALEPTICS

N06A ANTIDEPRESSANTS N06AA NON-SELECTIVE MONAMINE REUPTAKE INHIBITORS N06AA01 DESIPRAMINE desipramine 10mg tab Apo-Desipramine 10mg Tab Norpramin 10mg Tab (discontinued) desipramine 25mg tab Apo-Desipramine 25mg Tab Norpramin 25mg Tab (discontinued) desipramine 50mg tab Apo-Desipramine 50mg Tab Norpramin 50mg Tab (discontinued) desipramine 75mg tab Apo-Desipramine 75mg Tab Norpramin 75mg Tab (discontinued) desipramine 100mg tab Apo-Desipramine 100mg Tab Norpramin 100mg Tab (discontinued) N06AA02 IMIPRAMINE Imipramine 10mg Tab imipramine 25mg tab Imipramine 25mg Tab Tofranil 25mg Tab (discontinued) imipramine 50mg tab Imipramine 50mg Tab Tofranil 50mg Tab (discontinued) Imipramine 75mg Tab N06AA04 CLOMIPRAMINE clomipramine 10mg tab Apo-Clomipramine 10mg Tab CO Clomipramine 10mg Tab Anafranil 10mg Tab clomipramine 25mg tab Apo-Clomipramine 25mg Tab CO Clomipramine 25mg Tab Anafranil 25mg Tab

DNP

MRP

SFC

02216248

APX

DNP

MRP

SFC

02216256

APX

DNP

MRP

SFC

02216264

APX

DNP

MRP

SFC

02216272

APX

DNP

MRP

SFC

02216280

APX

DNP

SFC SFC

00360201 00312797

AAP AAP

DNP

MRP

DNP

MRP

SFC SFC

00326852 00644579

AAP AAP

DNP

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC

02040786 02244816 00330566

APX COB SEP

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC

02040778 02244817 00324019

APX COB SEP

December 2012

Nervous System ­ 153

clomipramine 50mg tab Apo-Clomipramine 50mg Tab CO Clomipramine 50mg Tab Anafranil 50mg Tab N06AA06 TRIMIPRAMINE trimipramine 12.5mg tab Trimipramine 12.5mg Tab Surmontil 12.5mg Tab (discontinued) trimipramine 25mg tab Trimipramine 25mg Tab Surmontil 25mg Tab (discontinued) trimipramine 50mg tab Trimipramine 50mg Tab Surmontil 50mg Tab (discontinued) trimipramine 75mg cap Trimipramine 75mg Cap Surmontil 75mg Cap (discontinued) trimipramine 100mg tab Trimipramine 100mg Tab Surmontil 100mg Tab (discontinued) N06AA09 AMITRIPTYLINE amitriptyline 10mg tab Elavil 10mg Tab Elavil 10mg Tab (discontinued) amitriptyline 25mg tab Elavil 25mg Tab Elavil 25mg Tab (discontinued) amitriptyline 50mg tab Elavil 50mg Tab Elavil 50mg Tab (discontinued) amitriptyline 75mg tab Elavil 75mg Tab Elavil 75mg Tab (discontinued) N06AA10 NORTRIPTYLINE nortriptyline 10mg cap Apo-Nortriptyline 10mg Cap Novo-Nortriptyline 10mg Cap pms-Nortriptyline 10mg Cap Aventyl 10mg Cap nortriptyline 25mg cap Apo-Nortriptyline 25mg Cap Novo-Nortriptyline 25mg Cap pms-Nortriptyline 25mg Cap Aventyl 25mg Cap N06AA12 DOXEPIN doxepin HCl 10mg cap Apo-Doxepin 10mg Cap Sinequan 10mg Cap doxepin HCl 25mg cap Apo-Doxepin 25mg Cap Novo-Doxepin 25mg Cap Sinequan 25mg Cap

December 2012

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC

02040751 02244818 00402591

APX COB SEP

DNP

MRP

SFC

00740799

AAP

DNP

MRP

SFC

00740802

AAP

DNP

MRP

SFC

00740810

AAP

DNP

MRP

SFC

02070987

AAP

DNP

MRP

SFC

00740829

AAP

DNP

MRP

SFC

00335053 00016322

AAP MSD

DNP

MRP

SFC

00335061 00016330 00335088 00016349

AAP MSD AAP MSD

DNP

MRP

SFC

DNP

MRP

SFC

00754129 00354295

AAP MSD

DNP DNP DNP DNP

MRP MRP MRP MRP

SFC SFC SFC SFC

02223511 02231781 02177692 00015229

APX TEV PMS PDP

DNP DNP DNP DNP

MRP MRP MRP MRP

SFC SFC SFC SFC

02223538 02231782 02177706 00015237

APX TEV PMS PDP

DNP DNP

MRP MRP

SFC SFC

02049996 00024325

APX ERF

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC

02050005 01913425 00024333

APX TEV ERF

Nervous System ­ 154

doxepin HCl 50mg cap Apo-Doxepin 50mg Cap Novo-Doxepin 50mg Cap Sinequan 50mg Cap doxepin HCl 75mg cap Apo-Doxepin 75mg Cap Novo-Doxepin 75mg Cap Sinequan 75mg Cap doxepin HCl 100mg cap Apo-Doxepin 100mg Cap Novo-Doxepin 100mg Cap Sinequan 100mg Cap doxepin HCl 150mg cap Novo-Doxepin 150mg Cap Sinequan 150mg Cap (discontinued) N06AA21 MAPROTILINE maprotiline 25mg tab Novo-Maprotiline 25mg Tab Ludiomil 25mg Tab (discontinued) maprotiline 50mg tab Novo-Maprotiline 50mg Tab Ludiomil 50mg Tab (discontinued) maprotiline 75mg tab Novo-Maprotiline 75mg Tab Ludiomil 75mg Tab (discontinued) N06AB SELECTIVE SEROTONIN REUPTAKE INHIBITORS N06AB03 FLUOXETINE fluoxetine 10mg cap Apo-Fluoxetine 10mg Cap CO Fluoxetine 10mg Cap Fluoxetine 10mg Cap MINT-Fluoxetine 10mg Cap MYLAN-Fluoxetine 10mg Cap phl-Fluoxetine 10mg Cap pms-Fluoxetine 10mg Cap ratio-Fluoxetine 10mg Cap Sandoz Fluoxetine 10mg Cap Teva-Fluoxetine 10mg Cap Zym-Fluoxetine 10mg Cap Prozac 10mg Cap fluoxetine 20mg cap Apo-Fluoxetine 20mg Cap CO Fluoxetine 20mg Cap Fluoxetine 20mg Cap Fluoxetine BP 20mg Cap Jamp-Fluoxetine 20mg Cap MINT-Fluoxetine 20mg Cap MYLAN-Fluoxetine 20mg Cap phl-Fluoxetine 20mg Cap pms-Fluoxetine 20mg Cap ratio-Fluoxetine 20mg Cap Sandoz Fluoxetine 20mg Cap Teva-Fluoxetine 20mg Cap Zym-Fluoxetine 20mg Cap Prozac 20mg Cap

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC

02050013 01913433 00024341

APX TEV ERF

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC

02050021 01913441 00400750

APX TEV ERF

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC

02050048 01913468 00326925

APX TEV ERF

DNP

MRP

SFC

01913476

TEV

DNP

MRP

SFC

02158612

TEV

DNP

MRP

SFC

02158620

TEV

DNP

MRP

SFC

02158639

TEV

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02216353 02242177 02286068 02380560 02237813 02223481 02177579 02241371 02243486 02216582 02302659 02018985

APX COB SAS MNT MYL PHL PMS TEV SDZ TEV ZYM LIL

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02216361 02242178 02286076 02383241 02386402 02380579 02237814 02223503 02177587 02241374 02243487 02216590 02302667 00636622

APX COB SAS AHI JPC MNT MYL PHL PMS TEV SDZ TEV ZYM LIL

December 2012

Nervous System ­ 155

fluoxetine 20mg/5mL syr Apo-Fluoxetine 20mg/5mL Syr Prozac 20mg/5mL Syr (discontinued) N06AB04 CITALOPRAM citialopram 10mg tab phl-Citalopram 10mg Tab pms-Citalopram 10mg Tab MINT-Citalopram 10mg Tab citalopram 20mg tab Apo-Citalopram 20mg Tab Auro-Citalopram 20mg Tab Citalopram 20mg Tab Citalopram-Odan 20mg Tab CO Citalopram 20mg Tab Jamp-Citalopram 20mg Tab Mar-Citalopram 20mg Tab MINT-Citalopram 20mg Tab MYLAN-Citalopram 20mg Tab Novo-Citalopram 20mg Tab phl-Citalopram 20mg Tab pms-Citalopram 20mg Tab RAN-Citalo 20mg Tab ratio-Citalopram 20mg Tab Sandoz Citalopram 20mg Tab Septa-Citalopram 20mg Tab Celexa 20mg Tab Novo-Citalopram 20mg Tab (discontinued) RAN-Citalopram 20mg Tab (discontinued) CTP30 (30mg) Tab citalopram 40mg tab Apo-Citalopram 40mg Tab Auro-Citalopram 40mg Tab Citalopram 40mg Tab Citalopram-Odan 40mg Tab CO Citalopram 40mg Tab Jamp-Citalopram 40mg Tab Mar-Citalopram 40mg Tab MINT-Citalopram 40mg Tab MYLAN-Citalopram 40mg Tab Novo-Citalopram 40mg Tab phl-Citalopram 40mg Tab pms-Citalopram 40mg Tab RAN-Citalo 40mg Tab ratio-Citalopram 40mg Tab Sandoz Citalopram 40mg Tab Septa-Citalopram 40mg Tab Celexa 40mg Tab Novo-Citalopram 40mg Tab (discontinued) RAN-Citalopram 40mg Tab (discontinued) N06AB05 PAROXETINE paroxetine 10mg tab Apo-Paroxetine 10mg Tab CO Paroxetine 10mg Tab Jamp-Paroxetine 10mg Tab MYLAN-Paroxetine10mg Tab Paroxetine 10mg Tab pms-Paroxetine10mg Tab ratio-Paroxetine10mg Tab Sandoz Paroxetine 10mg Tab Teva-Paroxetine 10mg Tab Paxil 10mg Tab

02231328

APX

DNP DNP DNP

MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02273543 02270609 02370077 02246056 02275562 02353660 02306239 02248050 02313405 02371898 02304686 02246594 02293218 02248944 02248010 02285622 02252112 02248170 02355272 02239607

PHL PMS MNT APX ARO SAS ODN COB JPC MAR MNT MYL TEV PHL PMS RAN TEV SDZ SPT VLH

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

DNP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02296152 02246057 02275570 02353679 02306247 02248051 02313413 02371901 02304694 02246595 02293226 02248945 02248011 02285630 02252120 02248171 02355280 02239608

SEP APX ARO SAS ODN COB JPC MAR MNT MYL TEV PHL PMS RAN TEV SDZ SPT VLH

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

02240907 02262746 02368862 02248012 02282844 02247750 02247810 02269422 02248556 02027887

APX COB JPC MYL SAS PMS TEV SDZ TEV GSK

December 2012

Nervous System ­ 156

paroxetine 20mg tab Apo-Paroxetine 20mg Tab CO Paroxetine 20mg Tab Jamp-Paroxetine 20mg Tab MYLAN-Paroxetine 20mg Tab Paroxetine 20mg Tab Paroxetine 20mg Tab pms-Paroxetine 20mg Tab ratio-Paroxetine 20mg Tab Sandoz Paroxetine 20mg Tab Teva-Paroxetine 20mg Tab Paxil 20mg Tab Sandoz Paroxetine 20mg Tab (discontinued) paroxetine 30mg tab Apo-Paroxetine 30mg Tab CO Paroxetine 30mg Tab Jamp-Paroxetine 30mg Tab MYLAN-Paroxetine 30mg Tab Paroxetine 30mg Tab Paroxetine 30mg Tab pms-Paroxetine 30mg Tab ratio-Paroxetine 30mg Tab Sandoz Paroxetine 30mg Tab Teva-Paroxetine 30mg Tab Paxil 30mg Tab pms-Paroxetine 40mg Tab N06AB06 SERTRALINE sertraline 25mg cap Apo-Sertraline 25mg Cap CO Sertraline 25mg Cap GD-Sertraline 25mg Cap Jamp-Sertaline 25mg Cap MYLAN-Sertraline 25mg Cap Novo-Sertraline 25mg Cap phl-Sertraline 25mg Cap pms-Sertraline 25mg Cap RAN-Sertraline 25mg Cap Sandoz Sertraline 25mg Cap Sertraline 25mg Cap Zoloft 25mg Cap sertraline 50mg cap Apo-Sertraline 50mg Cap CO Sertraline 50mg Cap GD-Sertraline 50mg Cap Jamp-Sertaline 50mg Cap MYLAN-Sertraline 50mg Cap Novo-Sertraline 50mg Cap phl-Sertraline 50mg Cap pms-Sertraline 50mg Cap RAN-Sertraline 50mg Cap Sandoz Sertraline 50mg Cap Sertraline 50mg Cap Zoloft 50mg Cap

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02240908 02262754 02368870 02248013 02282852 02248451 02247751 02247811 02269430 02248557 01940481

APX COB JPC MYL SAS MEL PMS TEV SDZ TEV GSK

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02240909 02262762 02368889 02248014 02282860 02248452 02247752 02247812 02269449 02248558 01940473 02293749

APX COB JPC MYL SAS MEL PMS TEV SDZ TEV GSK PMS

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02238280 02287390 02273683 02357143 02242519 02240485 02245824 02244838 02374552 02245159 02353520 02132702

APX COB GMD JPC MYL TEV PHL PMS RAN SDZ SAS PFI

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02238281 02287404 02273691 02357151 02242520 02240484 02245825 02244839 02374560 02245160 02353539 01962817

APX COB GMD JPC MYL TEV PHL PMS RAN SDZ SAS PFI

December 2012

Nervous System ­ 157

sertraline 100mg cap Apo-Sertraline 100mg Cap CO Sertraline 100mg Cap GD-Sertraline 100mg Cap MYLAN-Sertraline 100mg Cap phl-Sertraline 100mg Cap pms-Sertraline 100mg Cap RAN-Sertraline 100mg Cap Sandoz Sertraline 100mg Cap Sertraline 100mg Cap Teva-Sertraline 100mg Cap Zoloft 100mg Cap N06AB08 FLUVOXAMINE fluvoxamine 50mg tab Apo-Fluvoxamine 50mg Tab CO Fluvoxamine 50mg Tab Novo-Fluvoxamine 50mg Tab pms-Fluvoxamine 50mg Tab ratio-Fluvoxamine 50mg Tab Luvox 50mg Tab fluvoxamine 100mg tab Apo-Fluvoxamine 100mg Tab CO Fluvoxamine 100mg Tab Novo-Fluvoxamine 100mg Tab pms-Fluvoxamine 100mg Tab ratio-Fluvoxamine 100mg Tab Luvox 100mg Tab N06AB10 ESCITALOPRAM Cipralex 10mg Tab Cipralex 20mg Tab

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02238282 02287412 02273705 02242521 02245826 02244840 02374579 02245161 02353547 02240481 01962779

APX COB GMD MYL PHL PMS RAN SDZ SAS TEV PFI

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC

02231329 02255529 02239953 02240682 02218453 01919342

APX COB TEV PMS TEV ABB

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC

02231330 02255537 02239954 02240683 02218461 01919369 02263238 02263254

APX COB TEV PMS TEV ABB VLH VLH

N06AF MONOAMINE OXIDASE INHIBITORS, NON-SELECTIVE N06AF03 N06AF04 PHENELZINE Nardil 15mg Tab TRANYLCYPROMINE Parnate 10mg Tab SFC SFC 00476552 01919598 ERF GSK

DNP

DNP

N06AG MONOAMINE OXIDASE A INHIBITORS N06AG02 MOCLOBEMIDE moclobemide 100mg tab Apo-Moclobemide 100mg Tab Novo-Moclobemide 100mg Tab Manerix 100mg Tab (discontinued) moclobemide 150mg tab Apo-Moclobemide 150mg Tab Novo-Moclobemide 150mg Tab Manerix 150mg Tab moclobemide 300mg tab Apo-Moclobemide 300mg Tab Novo-Moclobemide 300mg Tab Manerix 300mg Tab N06AX OTHER ANTIDEPRESSANTS N06AX02 TRYPTOPHAN Tryptan 250mg Tab E 02239326 VLN

DNP DNP

MRP MRP

SFC SFC

02232148 02239746

APX TEV

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC

02232150 02239747 00899356

APX TEV MVL

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC

02240456 02239748 02166747

APX TEV MVL

DNP

December 2012

Nervous System ­ 158

tryptophan 500mg cap Apo-Tryptophan 500mg Cap pms-Tryptophan 500mg Cap ratio-Tryptophan 500mg Cap Tryptan 500mg Cap tryptophan 500mg tab Apo-Tryptophan 500mg Tab ratio-Tryptophan 500mg Tab Tryptan 500mg Tab Tryptan 750mg Tab tryptophan 1g tab Apo-Tryptophan 1g Tab ratio-Tryptophan 1g Tab Tryptan 1g Tab N06AX05 TRAZODONE trazodone 50mg tab Apo-Trazodone 50mg Tab MYLAN-Trazodone 50mg Tab phl-Trazodone 50mg Tab pms-Trazodone 50mg Tab Teva-Trazodone 50mg Tab Trazodone 50mg Tab Desyrel 50mg Tab (discontinued) pms-Trazodone 75mg Tab trazodone 100mg tab Apo-Trazodone 100mg Tab MYLAN-Trazodone 100mg Tab phl-Trazodone 100mg Tab pms-Trazodone 100mg Tab Teva-Trazodone 100mg Tab Trazodone 100mg Tab Desyrel 100mg Tab (discontinued) trazodone 150mg tab Apo-Trazodone 150mg Tab Teva-Trazodone 150mg Tab Trazodone 150mg Tab Desyrel 150mg Tab (discontinued) N06AX11 MIRTAZAPINE Mirtazapine 15mg Tab pms-Mirtazapine 15mg Tab Sandoz Mirtazapine 15mg Tab Zym-Mirtazapine 15mg Tab mirtazapine 30mg tab Apo-Mirtazapine 30mg Tab Mirtazapine 30mg Tab MYLAN-Mirtazapine 30mg Tab Novo-Mirtazapine 30mg Tab Mirtazapine 30mg Tab Mirtazapine 30mg Tab pms-Mirtazapine 30mg Tab Sandoz Mirtazapine 30mg Tab Zym-Mirtazapine 30mg Tab Remeron 30mg Tab ratio-Mirtazapine 30mg Tab (discontinued)

DNP DNP DNP

MRP MRP MRP

E E E

02248540 02241023 02240334 00718149

APX PMS TEV VLN

DNP DNP DNP DNP

MRP MRP MRP

E E E E E E E

02248538 02240333 02029456 02239327 02248539 02237250 00654531

APX TEV VLN VLN APX TEV VLN

DNP DNP DNP

MRP MRP MRP

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02147637 02231683 02236941 01937227 02144263 02348772 02237339 02147645 02231684 02236942 01937235 02144271 02348780

APX MYL PHL PMS TEV SAS PMS APX MYL PHL PMS TEV SAS

DNP

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC

02147653 02144298 02348799

APX TEV SAS

DNP DNP DNP DNP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02281732 02273942 02250594 02325179 02286629 02370689 02256118 02259354 02252279 02370689 02248762 02250608 02325187 02243910

MEL PMS SDZ ZYM APX SAS MYL TEV MEL SAS PMS SDZ ZYM SCH

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

December 2012

Nervous System ­ 159

mirtazapine 15mg RD tab Auro-Mirtazapine OD 15mg Tab GD-Mirtazapine OD 15mg Tab Novo-Mirtazapine OD 15mg Tab Remeron RD 15mg Tab mirtazapine 30mg RD tab Auro-Mirtazapine OD 30mg Tab GD-Mirtazapine OD 30mg Tab Novo-Mirtazapine OD 30mg Tab Remeron RD 30mg Tab mirtazapine 45mg RD tab Auro-Mirtazapine OD 45mg Tab GD-Mirtazapine OD 45mg Tab Novo-Mirtazapine OD 45mg Tab Remeron RD 45mg Tab N06AX12 BUPROPION bupropion 100mg SR tab pms-Bupropion SR 100mg Tab ratio-Bupropion SR 100mg Tab Sandoz Bupropion SR 100mg Tab Wellbutrin SR 100mg Tab (discontinued) bupropion 150mg SR tab pms-Bupropion SR 150mg Tab ratio-Bupropion SR 150mg Tab Sandoz Bupropion SR 150mg Tab Wellbutrin SR 150mg Tab Wellbutrin XL 150mg Tab Wellbutrin XL 300mg Tab N06AX16 VENLAFAXINE venlafaxine 37.5mg ER cap Apo-Venlafaxine XR 37.5mg Cap CO Venlafaxine XR 37.5mg Cap GD-Venlafaxine XR 37.5mg Cap MYLAN-Venlafaxine XR 37.5mg Cap pms-Venlafaxine XR 37.5mg Cap RAN-Venlafaxine XR 37.5mg Cap ratio-Venlafaxine XR 37.5mg Cap Sandoz Venlafaxine XR 37.5mg Cap Teva-Venlafaxine XR 37.5mg Cap Venlafaxine XR 37.5mg Cap Effexor XR 37.5mg Cap venlafaxine 75mg ER cap Apo-Venlafaxine XR 75mg Cap CO Venlafaxine XR 75mg Cap GD-Venlafaxine XR 75mg Cap MYLAN-Venlafaxine XR 75mg Cap Novo-Venlafaxine XR 75mg Cap pms-Venlafaxine XR 75mg Cap RAN-Venlafaxine XR 75mg ratio-Venlafaxine XR 75mg Cap Sandoz Venlafaxine XR 75mg Cap Venlafaxine XR 75mg Cap Effexor XR 75mg Cap

DNP DNP DNP DNP

MRP MRP MRP MRP

SFC SFC SFC SFC

02299801 02352826 02279894 02248542

ARO GMD TEV SCH

DNP DNP DNP DNP

MRP MRP MRP MRP

SFC SFC SFC SFC

02299828 02352834 02279908 02248543

ARO GMD TEV SCH

DNP DNP DNP DNP

MRP MRP MRP MRP

SFC SFC SFC SFC

02299836 02352842 02279916 02248544

ARO GMD TEV SCH

DNP DNP DNP

MRP MRP MRP

SFC SFC SFC

02325373 02285657 02275074

PMS TEV SDZ

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC

02313421 02285665 02275082 02237825 02275090 02275104

PMS TEV SDZ BVL BVL BVL

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02331683 02304317 02360020 02310279 02278545 02380072 02273969 02310317 02275023 02354713 02237279

APX COB GMD MYL PMS RAN TEV SDZ TEV SAS PFI

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC

02331691 02304325 02360039 02310287 02275031 02278553 02380080 02273977 02310325 02354721 02237280

APX COB GMD MYL TEV PMS RAN TEV SDZ SAS PFI

December 2012

Nervous System ­ 160

venlafaxine 150mg ER cap Apo-Venlafaxine XR 150mg Cap CO Venlafaxine XR 150mg Cap GD-Venlafaxine XR 150mg Cap MYLAN-Venlafaxine XR 150mg Cap pms-Venlafaxine XR 150mg Cap RAN-Venlafaxine XR 150mg Cap ratio-Venlafaxine XR 150mg Cap Sandoz Venlafaxine XR 150mg Cap Teva-Venlafaxine XR 150mg Cap Venlafaxine XR 150mg Cap Effexor XR 150mg Cap N06AX21 DULOXETINE Cymbalta 30mg Cap Cymbalta 60mg Cap DESVENLAFAXINE Pristiq 50mg ER Tab Pristiq 100mg ER Tab

DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP MRP

SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC SFC E E

02331705 02304333 02360047 02310295 02278561 02380099 02273985 02310333 02275058 02354748 02237282 02301482 02301490 02321092 02321106

APX COB GMD MYL PMS RAN TEV SDZ TEV SAS PFI LIL LIL PFI PFI

DNP DNP

N06AX23

N06B PSYCHOSTIMULANTS, AGENTS USED FOR ADHD AND NOOTROPICS N06BA CENTRALLY ACTING SYMPATHOMIMETICS N06BA01 AMPHETAMINES Adderall XR 5mg Cap Adderall XR 10mg Cap Adderall XR 15mg Cap Adderall XR 20mg Cap Adderall XR 25mg Cap Adderall XR 30mg Cap DEXAMPHETAMINE Dexedrine Spansule 10mg Cap Dexedrine Spansule 15mg Cap Dexedrine 5mg Tab METHYLPHENIDATE Apo-Methylphenidate 5mg Tab pms-Methylphenidate 5mg Tab methylphenidate 10mg tab Apo-Methylphenidate 10mg Tab pms-Methylphenidate 10mg Tab Ritalin 10mg Tab methylphenidate 20mg tab Apo-Methylphenidate 20mg Tab pms-Methylphenidate 20mg Tab Ritalin 20mg Tab methylphenidate 20mg SR tab Apo-Methylphenidate SR 20mg Tab Ritalin SR 20mg Tab Sandoz Methylphenidate SR 20mg Tab Biphentin 10mg Cap Biphentin 15mg Cap Biphentin 20mg Cap Biphentin 30mg Cap Biphentin 40mg Cap Biphentin 50mg Cap Biphentin 60mg Cap Biphentin 80mg Cap SFC SFC SFC SFC SFC SFC SFC SFC 02248808 02248809 02248810 02248811 02248812 02248813 01924559 01924567 01924516 02273950 02234749 02249324 00584991 00005606 SHI SHI SHI SHI SHI SHI PAL PAL PAL APX PMS APX PMS NVR

N06BA02

D D D

N06BA04

D D

D D D

MRP MRP MRP

D D D

MRP MRP MRP

SFC SFC SFC

02249332 00585009 00005614

APX PMS NVR

D D D D D D D D D D D

MRP MRP MRP

SFC SFC SFC E E E E E E E E

02266687 00632775 02320312 02277166 02277131 02277158 02277174 02277182 02277190 02277204 02277212

APX NVR SDZ PFR PFR PFR PFR PFR PFR PFR PFR

December 2012

Nervous System ­ 161

methylphenidate 18mg ER tab Novo-Methylphenidate ER-C 18mg Tab Concerta 18mg Tab methylphenidate 27mg ER tab Novo-Methylphenidate ER-C 27mg Tab Concerta 27mg Tab methylphenidate 36mg ER tab Novo-Methylphenidate ER-C 36mg Tab Concerta 36mg Tab methylphenidate 54mg ER tab Novo-Methylphenidate ER-C 54mg Tab Concerta 54mg Tab N06BA07 MODAFINIL modafinil 100mg tab Modafinil 100mg Tab Alertec 100mg Tab ATOMOXETINE atomoxetine 10mg cap Apo-Atomoxtine 10mg Cap Novo-Atomoxetine 10mg Cap pms-Atomoxetine 10mg Cap Sandoz Atomoxetine 10mg Cap Strattera 10mg Cap atomoxetine 18mg cap Apo-Atomoxetine 18mg Cap MYLAN-Atomoxetine 18mg Cap Novo-Atomoxetine 18mg Cap pms-Atomoxetine 18mg Cap Sandoz Atomoxetine 18mg Cap Strattera 18mg Cap atomoxetine 25mg cap Apo-Atomoxetine 25mg Cap MYLAN-Atomoxetine 25mg Cap Novo-Atomoxetine 25mg Cap pms-Atomoxetine 25mg Cap Sandoz Atomoxetine 25mg Cap Strattera 25mg Cap atomoxetine 40mg cap Apo-Atomoxetine 40mg Cap MYLAN-Atomoxetine 40mg Cap Novo-Atomoxetine 40mg Cap pms-Atomoxetine 40mg Cap Sandoz Atomoxetine 40mg Cap Strattera 40mg Cap atomoxetine 60mg cap Apo-Atomoxetine 60mg Cap MYLAN-Atomoxetine 60mg Cap Novo-Atomoxetine 60mg Cap pms-Atomoxetine 60mg Cap Sandoz Atomoxetine 60mg Cap Strattera 60mg Cap atomoxetine 80mg cap Apo-Atomoxetine 80mg Cap MYLAN-Atomoxetine 80mg Cap Sandoz Atomoxetine 80mg Cap Strattera 80mg Cap

December 2012

D D

MRP MRP

E E

02315068 02247732

TEV JAN

D D

MRP MRP

E E

02315076 02250241

TEV JAN

D D

MRP MRP

E E

02315084 02247733

TEV JAN

D D

MRP MRP

E E

02315092 02247734

TEV JAN

02285398 02239665

AAP SHI

N06BA09

02318024 02314541 02381028 02386410 02262800

APX TEV PMS SDZ LIL

02318032 02378930 02314568 02381036 02386429 02262819

APX MYL TEV PMS SDZ LIL

02318040 02378949 02314576 02381044 02386437 02262827

APX MYL TEV PMS SDZ LIL

02318059 02378957 02314584 02381052 02386445 02262835

APX MYL TEV PMS SDZ LIL

02318067 02378965 02314592 02381060 02386453 02262843

APX MYL TEV PMS SDZ LIL

02318075 02378973 02386461 02279347

APX MYL SDZ LIL

Nervous System ­ 162

atomoxetine 100mg cap Apo-Atomoxetine 100mg Cap MYLAN-Atomoxetine 100mg Cap Sandoz Atomoxetine 100mg Cap Strattera 100mg Cap N06BA12 LISDEXAMFETAMINE Vyvanse 20mg Cap Vyvanse 30mg Cap Vyvanse 40mg Cap Vyvanse 50mg Cap Vyvanse 60mg Cap

02318083 02378981 02386488 02279355 02347156 02322951 02347164 02322978 02347172

APX MYL SDZ LIL SHI SHI SHI SHI SHI

N06D ANTI-DEMENTIA DRUGS N06DA ANTICHOLINESTERASES N06DA02 DONEPEZIL Aricept 5mg Tab Aricept 10mg Tab Aricept RDT 5mg Tab Aricept RDT 10mg Tab RIVASTIGMINE rivastigmine 1.5mg cap Apo-Rivastigmine 1.5mg Cap MYLAN-Rivastigmine 1.5mg Cap Novo-Rivastigmine 1.5mg Cap pms-Rivastigmine 1.5mg Cap ratio-Rivastigmine 1.5mg Cap Sandoz Rivastigmine 1.5mg Cap Exelon 1.5mg Cap rivastigmine 3mg cap Apo-Rivastigmine 3mg Cap MYLAN-Rivastigmine 3mg Cap Novo-Rivastigmine 3mg Cap pms-Rivastigmine 3mg Cap ratio-Rivastigmine 3mg Cap Sandoz Rivastigmine 3mg Cap Exelon 3mg Cap rivastigmine 4.5mg cap Apo-Rivastigmine 4.5mg Cap MYLAN-Rivastigmine 4.5mg Cap Novo-Rivastigmine 4.5mg Cap pms-Rivastigmine 4.5mg Cap ratio-Rivastigmine 4.5mg Cap Sandoz Rivastigmine 4.5mg Cap Exelon 4.5mg Cap rivastigmine 6mg cap Apo-Rivastigmine 6mg Cap MYLAN-Rivastigmine 6mg Cap Novo-Rivastigmine 6mg Cap pms-Rivastigmine 6mg Cap ratio-Rivastigmine 6mg Cap Sandoz Rivastigmine 6mg Cap Exelon 6mg Cap Exelon 2mg/mL O/L Exelon Patch 5 (4.6mg/24hr) Exelon Patch 10 (9.5mg/24hr)

DNP DNP

E E

02232043 02232044 02269457 02269465

PFI PFI PFI PFI

N06DA03

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

E E E E E E E

02336715 02332809 02305984 02306034 02311283 02324563 02242115

APX MYL TEV PMS TEV SDZ NVR

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

E E E E E E E

02336723 02332817 02305992 02306042 02311291 02324571 02242116

APX MYL TEV PMS TEV SDZ NVR

DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

E E E E E E E

02336731 02332825 02306018 02306050 02311305 02324598 02242117

APX MYL TEV PMS TEV SDZ NVR

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E

02336758 02332833 02306026 02306069 02311313 02324601 02242118 02245240 02302845 02302853

APX MYL TEV PMS TEV SDZ NVR NVR NVR NVR

December 2012

Nervous System ­ 163

N06DA04

GALANTAMINE galantamine 8mg ER cap MYLAN-Galantamine ER 8mg Cap PAT-Galantamine ER 8mg Cap Teva-Galantamine ER 8mg Cap Reminyl ER 8mg Cap galantamine 16mg ER cap MYLAN-Galantamine ER 16mg Cap PAT-Galantamine ER 16mg Cap Teva-Galantamine ER 16mg Cap Reminyl ER 16mg Cap galantamine 24mg ER cap MYLAN-Galantamine ER 24mg Cap PAT-Galantamine ER 24mg Cap Teva-Galantamine ER 24mg Cap Reminyl ER 24mg Cap

DNP DNP DNP DNP

MRP MRP MRP MRP

E E E E

02339439 02316943 02377950 02266717

MYL PPH TEV JAN

DNP DNP DNP DNP

MRP MRP MRP MRP

E E E E

02339447 02316951 02377969 02266725

MYL PPH TEV JAN

DNP DNP DNP DNP

MRP MRP MRP MRP

E E E E

02339455 02316978 02377977 02266733

MYL PPH TEV JAN

N06DX OTHER ANTI-DEMENTIA DRUGS N06DX01 MEMANTINE memantine 10mg tab Apo-Memantine 10mg Tab CO Memantine 10mg Tab pms-Memantine 10mg Tab ratio-Memantine 10mg Tab Ebixa 10mg Tab

02366487 02324067 02321130 02320908 02260638

APX COB PMS TEV VLH

N07

OTHER NERVOUS SYSTEM DRUGS

N07A PARASYMPATHOMIMETICS N07AA ANTICHOLINESTERASES N07AA01 NEOSTIGMINE Neostigmine Methylsulfate 0.5mg/mL Inj Neostigmine Methylsulfate 1mg/mL Inj Neostigmine Methylsulfate 2.5mg/mL Inj Prostigmin 15mg Tab PYRIDOSTIGMINE Mestinon 180mg SR Tab Mestinon 60mg Tab 00874957 00885282 01915436 00869945 00869953 00869961 SDZ SDZ SDZ VLN VLN VLN

DNP

SF SF SF

N07AA02

DNP DNP

N07AB CHOLINE ESTERS N07AB02 BETHANECHOL Duvoid 10mg Tab bethanechol chloride 25mg tab Duvoid 25mg Tab Urecholine 25mg Tab (discontinued) Duvoid 50mg Tab N07AX OTHER PARASYMPATHOMIMETICS N07AX01 PILOCARPINE Salagen 5mg Tab E 02216345 PFI SF SF SF 01947958 01947931 01947923 PAL PAL PAL

DNP

DNP

DNP

DNP

December 2012

Nervous System ­ 164

N07B DRUGS USED IN ADDICTIVE DISORDERS N07BA DRUGS USED IN NICOTINE DEPENDENCE N07BA02 BUPROPION Zyban 150mg Tab 02238441 BVL

N07BB DRUGS USED IN ALCOHOL DEPENDENCE N07BB01 N07BB03 N07BB04 DISULFIRAM Disulfiram 250mg Cap ACAMPROSATE Campral 333mg Tab NALTREXONE ReVia 50mg Tab SF E E 00903079 02293269 02213826 CPD MYL APX

DNP

DNP

DNP

N07BC DRUGS USED IN OPIOID DEPENDENCE N07BC02 METHADONE Metadol 1mg/mL O/L Metadol 10mg/mL O/L Methadone (o/l compound) Metadol 1mg Tab Metadol 5mg Tab Metadol 10mg Tab Metadol 25mg Tab BUPRENORPHINE, COMBINATIONS Suboxone 2mg/0.5mg SL Tab Suboxone 8mg/2mg SL Tab 02247694 02241377 00999734 02247698 02247699 02247700 02247701 02295695 02295709 PAL PAL CPD PAL PAL PAL PAL SCH SCH

D D D D D

E E E E E E E

N07BC51

D D

N07C ANTIVERTIGO PREPARATIONS N07CA ANTIVERTIGO PREPARATIONS N07CA01 BETAHISTINE betahistine 16mg tab CO Betahistine 16mg Tab Novo-Betahistine 16mg Tab Serc 16mg Tab betahistine 24mg tab CO Betahistine 24mg Tab Novo-Betahistine 24mg Tab Serc 24mg Tab N07CA03 FLUNARIZINE flunarizine 5mg cap Flunarizine 5mg Cap Sibelium 5mg Cap (discontinued)

DNP DNP DNP

MRP MRP MRP

E E E

02374757 02280191 02243878

COB TEV ABB

DNP DNP DNP

MRP MRP MRP

E E E

02374765 02280205 02247998

COB TEV ABB

DNP

MRP

SF

02246082

AAP

N07X OTHER NERVOUS SYSTEM DRUGS N07XX OTHER NERVOUS SYSTEM DRUGS N07XX02 RILUZOLE riluzole 50mg Tab Apo-Riluzole 50mg Tab MYLAN-Riluzole 50mg Tab Rilutek 50mg Tab TETRABENAZINE Nitoman 25mg Tab

DNP DNP DNP

MRP MRP MRP

E E E SF

02352583 02390299 02242763 02199270

APX MYL SAV BVL

N07XX06

DNP

December 2012

Nervous System ­ 165

December 2012

Antiparasitic Products, Insecticides and Repellents ­ 166

P01

ANTIPROTOZOALS

P01A AGENTS AGAINST AMOEBIASIS AND OTHER PROTOZOAL DISEASES P01AA HYDROXYQUINOLINE DERIVATIVES P01AA99 IODOQUINOL (DIIODOHYDROXYQUINOLINE) Diodoquin 650mg Tab SF 01997750 GLE

DNP

P01AX OTHER AGENTS AGAINST AMOEBIASIS AND OTHER PROTOZOAL DISEASES P01AX06 ATOVAQUONE Mepron 150mg/mL Oral Susp SF 02217422 GSK

DNP

P01B ANTIMALARIALS P01BA AMINOQUINOLINES P01BA01 CHLOROQUINE chloroquine phosphate 250mg tab Novo-Chloroquine 250mg Tab Aralen 250mg Tab (discontinued) HYDROXYCHLOROQUINE hydroxychloroquine 200mg tab Apo-Hydroxyquine 200mg Tab MYLAN-Hydroxychloroquine 200mg Tab Plaquenil 200mg Tab PRIMAQUINE Primaquine 15mg Tab

DNP

MRP

SF

00021261

TEV

P01BA02

DNP DNP DNP

MRP MRP MRP

SF SF SF SF

02246691 02252600 02017709 02017776

APX MYL SAV SAV

P01BA03

DNP

P01BC METHANOLQUINOLINES P01BC01 QUININE Apo-Quinine 200mg Cap Quinine-Odan 200mg Cap quinine sulfate 200mg cap Novo-Quinine 200mg Cap Quinine 200mg Cap (discontinued) quinine sulfate 300mg cap Novo-Quinine 300mg Cap Quinine 300mg Cap (discontinued) Apo-Quinine 300mg Cap Quinine-Odan 300mg Cap Quinine-Odan 300mg Tab P01BC02 MEFLOQUINE mefloquine 250mg tab Mefloquine 250mg Tab Lariam 250mg Tab SF SF

MRP

DNP DNP

02254514 00695440 00021008

APX ODN TEV

DNP

SF

DNP

MRP

SF SF SF SF

00021016 02254522 00695459 00695432

TEV APX ODN ODN

DNP DNP DNP

02244366 02018055

AAP HLR

P01BD DIAMINOPYRIMIDINES P01BD01 PYRIMETHAMINE Daraprim 25mg Tab SF 00004774 GSK

DNP

P02

ANTHELMINTICS

P02C ANTINEMATODALS AGENTS P02CA BENZIMIDAZOLE DERIVATIVES P02CA01 MEBENDAZOLE Vermox 100mg Tab SF 00556734 JAN

DNP

December 2012

Antiparasitic Products, Insecticides and Repellents ­ 167

P03

ECTOPARASITICIDES, INCL. SCABICIDES, INSECTICIDES AND REPELLENTS

P03A ECTOPARASITICIDES, INCL. SCABICIDES P03AX OTHER ECTOPARASITICIDES, INCL. SCABICIDES P03AX99 ISOPROPYL MYRISTATE Resultz 50% Top Sol 02279592 NYC

December 2012

Antiparasitic Products, Insecticides and Repellents ­ 168

R01

NASAL PREPARATIONS

R01A DECONGESTANTS AND OTHER NASAL PREPARATIONS FOR TOPICAL USE R01AB SYMPATHOMINETICS, COMBINATIONS EXCLUDING CORTICOSTEROIDS R01AB01 PHENYLEPHRINE Soframycin Nasal Spray SF 02224860 ERF

DNP

R01AC ANTIALLERGIC AGENTS, EXCLUDING CORTICOSTEROIDS R01AC01 CROMOGLYCATE SODIUM cromoglycate sodium 2% nasal sol Rhinaris-CS Anti-Allergic Nasal Mist Rynacrom 2% Nasal Sol (discontinued) LEVOCABASTINE Livostin 0.5mg/mL Nasal Spray

DNP

MRP

SF

01950541

PMS

R01AC02

DNP

SF

02020017

JAN

R01AD CORTICOSTEROIDS R01AD01 BECLOMETHASONE beclomethasone dipropionate 50mcg/dose aqueous nasal spray DNP MRP Apo-Beclo 50mcg/dose Acq Nasal Sp DNP MRP MYLAN-Beclo 50mcg/dose Acq Nasal Spray Beconase 50mcg/dose Acq Nasal Sp (discontinued) FLUNISOLIDE flunisolide 25mcg/dose nasal mist Apo-Flunisolide 25mcg/dose Nasal Spray Rhinalar 25mcg/dose Nasal Mist (discontinued) BUDESONIDE budesonide 64mcg/dose aqueous nasal spray MYLAN-Budesonide AQ 64mcg/dose Nasal Spray Rhinocort 64mcg/dose Aqua Nasal Spray MYLAN-Budesonide AQ 100mcg/dose Nasal Spray Rhinocort 100mcg/dose Turbuhaler R01AD08 FLUTICASONE fluticasone 50mcg/dose nasal spray Apo-Fluticasone 50mcg/dose Nasal Spray ratio-Fluticasone 50mcg/dose Nasal Spray Flonase 50mcg/dose Nasal Spray MOMETASONE Nasonex 0.05% Nasal Spray TRIAMCINOLONE Nasacort AQ 55mcg/dose Nasal Spray F8

SFC SFC

02238796 02172712

APX MYL

R01AD04

02239288

APX

R01AD05

DNP DNP DNP DNP

MRP MRP

SF SF SF SF

02241003 02231923 02230648 02035324

MYL AZE MYL AZE

02294745 02296071 02213672 02238465 02213834

APX TEV GSK SCH SAV

R01AD09 R01AD11

DNP

R01AX OTHER NASAL PREPARATIONS R01AX03 IPRATROPIUM BROMIDE ipratropium bromide 0.3% nasal spray (21mcg/dose) pms-Ipratropium 21mcg/dose Nasal Spray DNP DNP Atrovent 21mcg/dose Nasal Spray ipratropium bromide 0.6% nasal spray (42mcg/dose) Apo-Ipravent 42mcg/dose Nasal Spray DNP Atrovent 42mcg/dose Nasal Spray DNP

MRP MRP

SF SF

02239627 02163705

PMS BOE

MRP MRP

SF SF

02246084 02163713

APX BOE

8

Full benefit for children aged 3 to 11 years.

Respiratory System ­ 169

December 2012

R01AX10

VARIOUS Dey-Pak Sodium Chloride Inhalation Sol 0.9%

DNP

SF

02058235

DLU

R03

DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

R03A ADRENERGICS, INHALANTS R03AC SELECTIVE BETA2-ADRENOCEPTOR AGONISTS R03AC02 SALBUTAMOL salbutamol 5mg/mL inh sol pms-Salbutamol 5mg/mL Resp Sol ratio-Salbutamol 5mg/mL Resp Sol Sandoz Salbutamol 5mg/mL Resp Sol Ventolin 5mg/mL Resp Sol salbutamol 0.5mg/mL unit dose inh sol pms-Salbutamol 0.5mg/mL Polynebs ratio-Salbutamol 0.5mg/mL Nebules Ventolin 0.5mg/mL Nebules (discontinued) salbutamol 1mg/mL unit dose inh sol MYLAN-Salbutamol 1mg/mL Sterinebs pms-Salbutamol 1mg/mL Polynebs ratio-Salbutamol 1mg/mL Nebules Ventolin 1mg/mL Nebules salbutamol 2mg/mL unit dose inh sol MYLAN-Salbutamol 2mg/mL Sterinebs pms-Salbutamol 2mg/mL Polynebs ratio-Salbutamol 2mg/mL Nebules Ventolin 2mg/mL Nebules salbutamol 100mcg/dose oral inh Airomir 100mcg/act Inh Apo-Salvent 100mcg/dose CFC Free Inh Novo-Salbutamol HFA 100mcg/act Inh Ventolin HFA 100mcg/dose Inh Ventolin 200mcg/dose Diskus R03AC03 R03AC12 TERBUTALINE Bricanyl 0.5mg/dose Turbuhaler SALMETEROL Serevent 50mcg/dose Diskus Serevent 50mcg/dose Diskhaler FORMOTEROL Foradil 12mcg Cap for Inhalation Oxeze 6mcg/dose Turbuhaler Oxeze 12mcg/dose Turbuhaler

DNPM DNPM DNPM DNPM

MRP MRP MRP MRP

E E E E

02069571 00860808 02154412 02213486

PMS TEV SDZ GSK

DNPM DNPM

PRP PRP

E E

02208245 02239365

PMS TEV

DNPM DNPM DNPM DNPM

PRP PRP PRP PRP

E E E E

01926934 02208229 01986864 02213419

MYL PMS TEV GSK

DNPM DNPM DNPM DNPM

PRP PRP PRP PRP

E E E E

02173360 02208237 02239366 02213427

MYL PMS TEV GSK

DNPM DNPM DNPM DNPM DNPM

MRP MRP MRP MRP

SFC SFC SFC SFC SFC SF E E E E E

02232570 02245669 02326450 02241497 02243115 00786616 02231129 02214261 02230898 02237225 02237224

MDS APX TEV GSK GSK AZE GSK GSK NVR AZE AZE

DNP

DNP DNP

R03AC13

DNP DNP DNP

R03AK ADRENERGICS AND OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES R03AK03 R03AK04 FENOTEROL AND OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES Duovent UDV Inh Sol 02148633 SALBUTAMOL AND OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES ipratropium bromide 200mcg/mL & salbutamol 1mg/mL unit dose inh sol MYLAN-Combo Sterinebs DNP MRP E 02272695 DNP MRP E 02243789 ratio-IPRA SAL Inh Sol Combivent UDV Inh Sol DNP MRP E 02231675 BOE

MYL TEV BOE

December 2012

Respiratory System ­ 170

R03AK06

SALMETEROL AND OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES DNP E 02240835 Advair 50/100mcg Diskus Advair 50/250mcg Diskus DNP E 02240836 DNP E 02240837 Advair 50/500mcg Diskus Advair HFA 25/125mcg/dose Inh DNP E 02245126 DNP E 02245127 Advair HFA 25/250mcg/dose Inh FORMOTEROL AND OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES Symbicort 100/6mcg Turbuhaler DNP E 02245385 DNP E 02245386 Symbicort 200/6mcg Turbuhaler Zenhale 5/50mcg Inh 02361744 Zenhale 5/100mcg Inh 02361752 Zenhale 5/200mcg Inh 02361760

GSK GSK GSK GSK GSK AZE AZE FRS FRS FRS

R03AK07

R03B OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES, INHALANTS R03BA GLUCOCORTICOIDS R03BA01 BECLOMETHASONE QVAR 50mcg/dose Inh QVAR 100mcg/dose Inh BUDESONIDE Pulmicort 0.125mg/mL Nebuamps Pulmicort 0.25mg/mL Nebuamps Pulmicort 0.5mg/mL Nebuamps Pulmicort 100mcg/dose Turbuhaler Pulmicort 200mcg/dose Turbuhaler Pulmicort 400mcg/dose Turbuhaler FLUTICASONE Flovent Diskus 50mcg Flovent Diskus 100mcg Flovent Diskus 250mcg Flovent Diskus 500mcg Flovent HFA 50mcg/act Inh Flovent HFA 125mcg/act Inh Flovent HFA 250mcg/act Inh MOMETASONE Asmanex 200mcg/act Twisthaler Asmanex 400mcg/act Twisthaler CICLESONIDE Alvesco 100mcg/dose Inh Alvesco 200mcg/dose Inh Omnaris 50mcg/dose Nasal Spray SFC SFC E E E SF SF SF SF SF SF SF SF SF SF SF SF SF SF 02242029 02242030 02229099 01978918 01978926 00852074 00851752 00851760 02237244 02237245 02237246 02237247 02244291 02244292 02244293 02243595 02243596 02285606 02285614 02303671 MDS MDS AZE AZE AZE AZE AZE AZE GSK GSK GSK GSK GSK GSK GSK FRS FRS NYC NYC NYC

DNP DNP

R03BA02

DNP DNP DNP DNP DNP DNP

R03BA05

DNP DNP DNP DNP DNP DNP DNP

R03BA07

DNP DNP

R03BA08

DNP DNP

R03BB ANTICHOLINERGICS R03BB01 IPRATROPIUM BROMIDE ipratropium bromide 250mcg/mL inh sol (20mL) Apo-Ipravent 250mcg/mL Inh Sol MYLAN-Ipratropium 250mcg/mL Inh Sol Novo-Ipramide 250mcg/mL Inh Sol pms-Ipratropium 250mcg/mL Inh Sol Atrovent 250mcg/mL Inh Sol (discontinued)

DNP DNP DNP DNP

MRP MRP MRP MRP

E E E E

02126222 02239131 02210479 02231136

APX MYL TEV PMS

ipratropium bromide 125mcg/mL unit dose inh sol (2mL) pms-Ipratropium 125mcg/mL Polynebs DNP DNP ratio-Ipratropium 125mcg/mL Nebules Atrovent 125mcg/mL UDV (discontinued) ipratropium bromide 250mcg/mL unit dose inh sol (1mL) MYLAN-Ipratropium 250mcg/mL Sterinebs DNP DNP pms-Ipratropium 250mcg/mL Polynebs ratio-Ipratropium 250mcg/mL Nebules DNP Atrovent 250mcg/mL UDV (discontinued)

December 2012

PRP PRP

E E

02231135 02097176

PMS TEV

PRP PRP PRP

E E E

02216221 02231244 02097168

MYL PMS TEV

Respiratory System ­ 171

ipratropium bromide 250mcg/mL unit dose inh sol (2mL) MYLAN-Ipratropium 250mcg/mL Sterinebs DNP pms-Ipratropium 250mcg/mL Polynebs DNP DNP ratio-Ipratropium 250mcg/mL Nebules Atrovent 250mcg/mL UDV (discontinued) Atrovent HFA 20mcg/dose Inhaler R03BB04 TIOTROPIUM BROMIDE Spiriva 18mcg Cap for Inh

DNP

PRP PRP PRP

E E E SFC E

02216221 02231245 02097168 02247686 02246793

MYL PMS TEV BOE BOE

DNP

R03BC ANTIALLERGIC AGENTS, EXCLUDING CORTICOSTEROIDS R03BC01 CROMOGLYCATE SODIUM cromoglycate sodium 1% unit dose inh sol pms-Sodium Cromoglycate 1% Neb Sol Intal 1% Neb Sol (discontinued)

DNP

MRP

E

02046113

PMS

R03C ADRENERGICS FOR SYSTEMIC USE R03CB NON-SELECTIVE BETA-ADRENOCEPTOR AGONISTS R03CB03 ORCIPRENALINE orciprenaline 2mg/mL syr Apo-Orciprenaline 2mg/mL Syr Alupent 2mg/mL Syr (discontinued)

DNP

MRP

SF

02236783

APX

R03CC SELECTIVE BETA2-ADRENOCEPTOR AGONISTS R03CC02 SALBUTAMOL salbutamol 0.4mg/mL o/l pms-Salbutamol 0.4mg/mL O/L (discontinued) Ventolin 0.4mg/mL O/L (discontinued) salbutamol 2mg tab Apo-Salvent 2mg Tab Ventolin 2mg Tab (discontinued) salbutamol 4mg tab Apo-Salvent 4mg Tab Ventolin 4mg Tab (discontinued)

DNP

MRP

SFC

02146843

APX

DNP

MRP

SFC

02146851

APX

R03D OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES R03DA XANTHINES R03DA02 R03DA04 OXTRIPHYLLINE (CHOLINE THEOPHYLLINATE) Choledyl 20mg/mL Elx THEOPHYLLINE Theolair 80mg/15mL Liq Apo-Theo LA 100mg Tab Novo-Theophyl SR 100mg Tab theophylline 200mg SR tab Novo-Theophyl SR 200mg Tab Theo-DUR 200mg Tab (discontinued) Apo-Theo LA 200mg Tab theophylline 300mg SR tab Novo-Theophyl SR 300mg Tab Theo-DUR 300mg Tab (discontinued) Apo-Theo LA 300mg Tab Uniphyl 400mg Tab SF SF SF SF SF SF SF SF SF 00476366 01966219 00692689 02230085 02230086 00692697 02230087 00692700 02014165 ERF MDS APX TEV TEV APX TEV APX PFR

DNP

DNP DNP DNP

DNP

MRP

DNP

DNP

MRP

DNP DNP

December 2012

Respiratory System ­ 172

Uniphyl 600mg Tab R03DA54

DNP

SF SF SF

02014181 00476374 00317225

PFR ERF TEV

THEOPHYLLINE, COMBINATIONS EXCLUDING PSYCHOLEPTICS DNP Choledyl Expectorant ratio-Bronc O/L DNP

R03DC LEUKOTRIENE RECEPTOR ANTAGONISTS R03DC01 R03DC03 ZAFIRLUKAST Accolate 20mg Tab MONTELUKAST montelukast 4mg/pkt granules Sandoz Montelukast 4mg Granules Singulair 4mg/pkt Granules montelukast 4mg chewtab Montelukast 4mg Chewtabs MYLAN-Montelukast 4mg Chewtabs pms-Montelukast 4mg Chewtabs Sandoz Montelukast 4mg Chewtabs Teva-Montelukast 4mg Chewtabs Singulair 4mg Chewtabs montelukast 5mg chewtab Montelukast 5mg Chewtabs MYLAN-Montelukast 5mg Chewtabs pms-Montelukast 5mg Chewtabs Sandoz Montelukast 5mg Chewtabs Teva Montelukast 5mg Chewtabs Singulair 5mg Chewtabs montelukast 10mg tab Apo-Montelukast 10mg Tab Montelukast 10mg Tab (AHI) Montelukast 10mg Tab (SAS) MYLAN-Montelukast 10mg Tab pms-Montelukast FC 10mg Tab Sandoz Montelukast 10mg Tab Teva Montelukast 10mg Tab Singulair 10mg Tab E 02236606 AZE

DNP

DNP DNP

MRP MRP

E E

02358611 02247997

SDZ FRS

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

E E E E E E

02379317 02380749 02354977 02330385 02355507 02243602

SAS MYL PMS SDZ TEV FRS

DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP

E E E E E E

02379325 02380757 02354985 02330393 02355515 02238216

SAS MYL PMS SDZ TEV FRS

DNP DNP DNP DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP MRP MRP MRP

E E E E E E E E

02374609 02379236 02379333 02368226 02373947 02328593 02355523 02238217

APX AHI SAS MYL PMS SDZ TEV FRS

R03DX OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES R03DX05 R03DX07 OMALIZUMAB Xolair 150mg/vial Inj ROFLUMILAST Daxas 500mcg Tab 02260565 02359456 NVR NYC

R05

COUGH AND COLD PREPARATIONS

R05C EXPECTORANTS, EXCLUDING COMBINATIONS WITH COUGH SUPPRESSANTS R05CA EXPECTORANTS R05CA03 GUAIFENESIN Robitussin 20mg/mL O/L 01931032 WCH

R05CB MUCOLYTICS R05CB01 ACETYLCYSTEINE acetylcysteine 200mg/mL inj Acetylcysteine 200mg/mL Inj Mucomyst 20% Inj

DNP DNP

MRP MRP

SF SF

02243098 02091526

SDZ WLS

December 2012

Respiratory System ­ 173

R05D COUGH SUPPRESSANTS, EXCLUDING COMBINATIONS WITH EXPECTORANTS R05DA OPIUM ALKALOIDS AND DERIVATIVES R05DA04 CODEINE Codeine Contin 50mg Tab Codeine Contin 100mg Tab Codeine Contin 150mg Tab Codeine Contin 200mg Tab Codeine Phosphate 30mg/mL Inj Linctus Codeine Blanc 0.2% Liq Codeine Phosphate 4.7mg/mL Syr ratio-Codeine 5mg/mL Syr ratio-Codeine 15mg Tab ratio-Codeine 30mg Tab E E E E SFC SFC SFC SFC SFC 02230302 02163748 02163780 02163799 00544884 00380571 00050024 00779474 00593435 00593451 PFR PFR PFR PFR SDZ ATL ATL TEV TEV TEV

D D D D D D D D D

R06

ANTIHISTAMINES FOR SYSTEMIC USE

R06A ANTIHISTAMINES FOR SYSTEMIC USE R06AA AMINOALKYL ETHERS R06AA02 DIPHENHYDRAMINE Benadryl 25mg Caplets Benadryl 12.5mg/5mL Elx Diphenhydramine 50mg/mL Inj DOXYLAMINE Diclectin Tab SFC 02017849 02019736 00596612 00609129 JNJ JNJ SDZ DUI

R06AA09

DNPM

R06AE PIPERAZINE DERIVATIVES R06AE07 CETIRIZINE Reactine 5mg Tab cetirizine 10mg tab APC-Cetirizine 10mg Tab Apo-Cetirizine 10mg Tab Extra Strength Allergy Relief 10mg Tab Reactine 10mg Tab R06AX OTHER ANTIHISTAMINES FOR SYSTEMIC USE R06AX13 LORATADINE loratadine 10mg tab APC-Loratadine 10mg Tab Apo-Loratadine 10mg Tab Claritin 10mg Tab KETOTIFEN ketotifen fumarate 1mg/5mL syr Novo-Ketotifen 1mg/5mL Syr Zaditen 1mg/5mL Syr (discontinued) ketotifen fumarate 1mg tab Novo-Ketotifen 1mg Tab Zaditen 1mg Tab R06AX26 FEXOFENADINE Allegra 60mg Tab Allegra 120mg Tab E E E E E 02223546 02231603 02231603 02315955 02223554 JNJ APX APX PDP JNJ

DNP

DNP DNP DNP DNP

MRP MRP MRP MRP

DNP DNP DNP

MRP MRP MRP

E E E

02243880 02243880 00782696

APX APX SCH

R06AX17

DNP

MRP

SF

02176084

TEV

DNP DNP

MRP MRP

SF SF

02230730 00577308 02231462 02242819

TEV TEV SAV SAV

December 2012

Respiratory System ­ 174

R06AX27

DESLORATADINE desloratadine 5mg tab Desloratadine Allergy Control 5mg Tab Aerius 5mg Tab

02298155 02243919

PDP SCH

R07

OTHER RESPIRATORY SYSTEM PRODUCTS

R07A OTHER RESPIRATORY SYSTEM PRODUCTS R07AX OTHER RESPIRATORY SYSTEM PRODUCTS R07AX01 OTHER RESPIRATORY SYSTEM PRODUCTS AreoChamber AC-Boyz AC Boyz Chamber AreoChamber AC-Girlz AC Girlz Chamber AeroChamber Plus Flow-Vu with Mask (Lg) AeroChamber Plus Flow-Vu with Mask (Med) AeroChamber Plus Flow-Vu with Mouthpiece AeroChamber Plus Flow-Vu with Mask (Sm) AeroChamber Max Pediatric with Mask AeroChamber Adult (discontinued) AeroChamber Max Adult (discontinued) AeroChamber Adult with Mask (discontinued) AeroChamber Max Adult with Mask (discontinued) AeroChamber Infant with Mask (discontinued) AeroChamber Max Infant with Mask (discontinued) AeroChamber Pediatric with Mask (discontinued) FC FC FC FC SFC SFC SFC FC FC 96899976 96899962 96899975 96899963 96899969 96899970 96899968 96899971 96899995 TMI TMI TMI TMI TMI TMI TMI TMI TMI

DNP DNP DNP DNP DNP DNP DNP DNP DNP

December 2012

Respiratory System ­ 175

December 2012

Respiratory System ­ 176

S01

OPHTHALMOLOGICALS

S01A ANTIINFECTIVES S01AA ANTIBIOTICS S01AA01 CHLORAMPHENICOL Pentamycetin 1% Oph Oint (discontinued) Pentamycetin 0.25% Oph Sol (discontinued) Pentamycetin 0.5% Oph Sol (discontinued) FRAMYCETIN Soframycin 0.5% Oph Oint Soframycin 0.5% Oph Sol GENTAMICIN gentamicin 0.3% oph oint Sandoz Gentamicin 0.3% Oph Oint (discontinued) Garamycin 0.3% Oph Oint (discontinued) gentamicin 0.3% oph sol pms-Gentamicin 0.3% Oph Sol Sandoz Gentamicin 0.3% Oph Sol Garamycin 0.3% Oph Sol S01AA12 TOBRAMYCIN Tobrex 0.3% Oph Oint tobramycin 0.3% oph sol Sandoz Tobramycin 0.3% Oph Sol Tobrex 0.3% Oph Sol S01AA13 S01AA17 FUSIDIC ACID Fucithalmic 1% Oph Sol ERYTHROMYCIN Erythromycin 0.5% Oph Oint pms-Erythromycin 0.5% Oph Oint ANTIBIOTICS (OPHTHALMIC), COMBINATIONS Polytrim Oph Sol SF SF SF SF 02224895 02224887 ERF ERF

S01AA07

DNPO DNPO

S01AA11

DNPO DNPO

MRP MRP

SF SF SF SF SF

00776521 02229440 00512192 00614254 02241755 00513962 02243862 02326663 01912755 02011956

PMS SDZ SCH ALC SDZ ALC LEO SGQ PMS ALL

DNPO

DNPO DNPO

MRP MRP

DNPMO DNPMO

S01AA30

S01AB SULFONAMIDES S01AB04 SULFACETAMIDE Sodium Sulamyd 10% Oph Oint (discontinued) Sodium Sulamyd 10% Oph Sol

DNPO

SF

00028053

SDZ

S01AD ANTIVIRALS S01AD02 TRIFLURIDINE trifluridine 1% oph sol Viroptic 1% Oph Sol Sandoz Trifluridine 1% Oph Sol (discontinued)

DNPO

SF

00687456

VAL

S01AX OTHER ANTIINFECTIVES S01AX11 OFLOXACIN ofloxacin 0.3% oph sol Apo-Ofloxacin 0.3% Oph Sol pms-Ofloxacin 0.3% Oph Sol Ocuflox 0.3% Oph Sol CIPROFLOXACIN Ciloxan 0.3% Oph Oint

DNPO DNPO DNPO

MRP MRP MRP

E E E E

02248398 02252570 02143291 02200864

APX PMS ALL ALC

S01AX13

DNPO

December 2012

Sensory Organs ­ 177

ciprofloxacin 0.3% oph sol Apo-Ciproflox 0.3% Oph Sol pms-Ciprofloxacin 0.3% Oph Sol Ciloxan 0.3% Oph Sol S01AX21 S01AX22 GATIFLOXACIN Zymar 0.3% Oph Sol MOXIFLOXACIN Vigamox 0.5% Oph Sol

DNPO DNPO

MRP MRP

E E

02263130 02253933 01945270 02257270 02252260

APX PMS ALC ALL ALC

S01B ANTIINFLAMMATORY AGENTS S01BA CORTICOSTEROIDS, PLAIN S01BA01 DEXAMETHASONE Maxidex 0.1% Oph Oint Maxidex 0.1% Oph Susp Ozurdex 0.7mg Intravitreal Implant HYDROCORTISONE Cortamed 2.5% Oph Oint (discontinued) PREDNISOLONE prednisolone acetate 0.12% oph susp Pred Mild 0.12% Oph Susp DNPO Sandoz Prednisolone 0.12% Oph Susp (discontinued) prednisolone acetate 1% oph susp ratio-Prednisolone 1% Oph Susp Sandoz Prednisolone 1% Oph Susp Pred Forte 1% Oph Susp Diopred 1% Oph Susp (discontinued) S01BA07 FLUOROMETHOLONE fluorometholone 0.1% oph sol pms-Fluorometholone 0.1% Liquifilm Oph Sol FML 0.1% Liquifilm Oph Sol FML Forte 0.25% Oph Sol Flarex 0.1% Oph Sol S01BA14 LOTEPREDNOL Lotemax 0.5% Oph Susp SF SF 00042579 00042560 02363445 ALC ALC ALL

DNPO DNPO

S01BA02 S01BA04

SF

00299405

ALL

DNPO DNPO DNPO

MRP MRP MRP

SF SF SF

00700401 01916203 00301175

TEV SDZ ALL

DNPO DNPO DNPO DNPO

MRP MRP

SF SF SF SF

02238568 00247855 00707511 00756784 02321114

PMS ALL ALL ALC BSH

S01BC ANTIINFLAMMATORY AGENTS, NON STEROIDS S01BC03 DICLOFENAC Voltaren 0.1% Oph Sol Voltaren 0.1% Oph Sol (40x0.3mL) KETOROLAC ketorolac 0.5% oph sol Apo-Ketorolac 0.5% Oph Sol ratio-Ketorolac 0.5% Oph Sol Acular 0.5% Oph Sol SF SF 01940414 00903755 ALC ALC

DNPO DNPO

S01BC05

DNPO DNPO DNPO

MRP MRP MRP

SF SF SF

02245821 02247461 01968300

APX TEV ALL

December 2012

Sensory Organs ­ 178

S01C ANTIINFLAMMATORY AGENTS AND ANTIINFECTIVES IN COMBINATION S01CA CORTICOSTEROIDS AND ANTIINFECTIVES IN COMBINATION S01CA01 DEXAMETHASONE AND ANTIINFECTIVES Maxitrol Oph Oint Tobradex Oph Oint Tobradex Oph Sol Maxitrol Oph Susp PREDNISOLONE AND ANTIINFECTIVES Blephamide Oph Oint Blephamide Oph Sol HYDROCORTISONE AND ANTIINFECTIVES hydrocortisone & antiinfectives oph oint Sandoz Cortimyxin Oph Oint (discontinued) Cortisporin Oph Oint (discontinued) SF SF SF SF SF SF 00358177 00778915 00778907 00042676 00307246 00807788 ALC ALC ALC ALC ALL ALL

DNPO DNPO DNPO DNPO

S01CA02

DNPO DNPO

S01CA03

S01E ANTIGLAUCOMA PREPARATIONS AND MIOTICS S01EA SYMPATHOMIMETICS IN GLAUCOMA THERAPY S01EA03 S01EA05 APRACLONIDINE Iopidine 0.5% Oph Sol BRIMONIDINE brimonidine 0.15% oph sol Apo-Brimonidine P 0.15% Oph Sol Alphagan P 0.15% Oph Sol brimonidine 0.2% oph sol Apo-Brimonidine 0.2% Oph Sol pms-Brimonidine 0.2% Oph Sol ratio-Brimonidine 0.2% Oph Sol Sandoz Brimonidine 0.2% Oph Sol Alphagan 0.2% Oph Sol S01EB PARASYMPATHOMIMETICS S01EB01 PILOCARPINE Pilopine HS 4% Oph Gel Isopto Carpine 1% Oph Sol Isopto Carpine 2% Oph Sol Isopto Carpine 4% Oph Sol CARBACHOL Isopto Carbachol 1.5% Oph Sol Isopto Carbachol 3% Oph Sol SF SF SF SF SF SF 00575240 00000841 00000868 00000884 00000655 00000663 ALC ALC ALC ALC ALC ALC SF 02076306 ALC

DNP

02301334 02248151

APX ALL

DNP DNP DNP DNP DNP

MRP MRP MRP MRP MRP

SF SF SF SF SF

02260077 02246284 02243026 02305429 02236876

APX PMS TEV SDZ ALL

DNP DNP DNP DNP

S01EB02

DNP DNP

S01EC CARBONIC ANHYDRASE INHIBITORS S01EC01 ACETAZOLAMIDE acetazolamide 250mg tab Acetazolamide Tablets 250mg Diamox 250mg Tab (discontinued) DORZOLAMIDE dorzolamide HCI 2% oph sol Sandoz Dorzolamide 2% Oph Sol Trusopt 2% Oph Sol Trusopt 2% (PF) Oph Sol S01EC04 S01EC05 BRINZOLAMIDE Azopt 1% Oph Sol METHAZOLAMIDE Methazolamide 50mg Tab

DNP

DNP

MRP

SF

00545015

AAP

S01EC03

DNP DNP

MRP MRP

SF SF

02316307 02216205 02269090

SDZ FRS FRS ALC AAP

SF SF

02238873 02245882

DNP

December 2012

Sensory Organs ­ 179

S01ED BETA BLOCKING AGENTS S01ED01 TIMOLOL timolol 0.25% oph gel Timolol Maleate-EX 0.25% Oph Gel Timoptic-XE 0.25% Oph Gel timolol 0.5% oph gel Timolol Maleate-EX 0.5% Oph Gel Timoptic-XE 0.5% Oph Gel Apo-Timop 0.5% Oph Gel timolol maleate 0.25% oph sol Apo-Timop 0.25% Oph Sol pms-Timolol 0.25% Oph Sol Sandoz Timolol 0.25% Oph Sol MYLAN-Timolol 0.25% Oph Sol (discontinued) Timoptic 0.25% Oph Sol (discontinued) timolol maleate 0.5% oph sol Apo-Timop 0.5% Oph Sol pms-Timolol 0.5% Oph Sol Sandoz Timolol 0.5% Oph Sol Timoptic 0.5% Oph Sol MYLAN-Timolol 0.5% Oph Sol (discontinued) S01ED02 S01ED03 BETAXOLOL Betoptic-S 0.25% Oph Susp LEVOBUNOLOL levobunolol HCl 0.25% oph sol ratio-Levobunolol 0.25% Oph Sol Betagan 0.25% Oph Sol (discontinued) levobunolol HCl 0.5% oph sol pms-Levobunolol 0.5% Oph Sol ratio-Levobunolol 0.5% Oph Sol Sandoz Levobunolol 0.5% Oph Sol Betagan 0.5% Oph Sol S01ED51 TIMOLOL, COMBINATIONS Azarga Oph Susp Combigan Oph Sol

DNP DNP

MRP MRP

SF SF

02242275 02171880

SDZ FRS

DNP DNP DNP

MRP MRP

SF SF SF SF SF SF

02242276 02171899 02290812 00755826 02083353 02166712

SDZ FRS APX APX PMS SDZ

DNP DNP DNP

MRP MRP MRP

DNP DNP DNP DNP

MRP MRP MRP MRP

SF SF SF SF

00755834 02083345 02166720 00451207

APX PMS SDZ FRS

DNP

SF

01908448

ALC

DNP

MRP

SF

02031159

TEV

DNP DNP DNP DNP

MRP MRP MRP MRP

SF SF SF SF SF SF SF SF SF SF SF SF

02237991 02031167 02241716 00637661 02331624 02248347 02299615 02344351 02320525 02240113 02258692 02278251 02246619

PMS TEV SDZ ALL ALC ALL APX SDZ TEV FRS FRS ALC PFI

DNP DNP

dorzolamide HCI 2% & timolol maleate 0.5% oph sol Apo-Dorzo-Timop 2%/0.5% Oph Sol DNP DNP Sandoz Dorzolamide/Timolol 2%/0.5% Oph Sol Teva-Dorzotimol 2%/0.5% Oph Sol DNP DNP Cosopt Oph Sol Cosopt (PF) Oph Sol Duo Trav Oph Sol Xalacom Oph Sol S01EE PROSTAGLANDIN ANALOGUES S01EE01 LATANOPROST latanoprost 50mcg/mL oph sol Apo-Latanoprost 0.005% Oph Sol CO Latanoprost 0.005% Oph Sol GD-Latanoprost 0.005% Oph Sol Xalatan 0.005% Oph Sol

MRP MRP MRP MRP

DNP DNP

DNP DNP DNP DNP

MRP MRP MRP MRP

SF SF SF SF

02296527 02254786 02373041 02231493

APX COB ARO PFI

December 2012

Sensory Organs ­ 180

S01EE03 S01EE04

BIMATOPROST Lumigan RC 0.01% Oph Sol TRAVOPROST Travatan Z 0.004% Oph Sol

DNP

SF SF

02324997 02318008

ALL ALC

DNP

S01F MYDRIATICS AND CYCLOPLEGICS S01FA ANTICHOLINERGICS S01FA01 S01FA04 S01FA05 ATROPINE Isopto Atropine 1% Oph Sol CYCLOPENTOLATE Cyclogyl 1.0% Oph Sol HOMATROPINE Isopto Homatropine 2% Sol Isopto Homatropine 5% Sol TROPICAMIDE Mydriacyl 0.5% Oph Sol Mydriacyl 1% Oph Sol SF SF SF SF SF SF 00035017 00252506 00000779 00000787 00000981 00001007 ALC ALC ALC ALC ALC ALC

DNPO

DNPO

DNPO DNPO

S01FA06

DNPO DNPO

S01G DECONGESTANTS AND ANTIALLERGICS S01GA SYMPATHOMIMETICS USED AS DECONGESTANTS S01GA05 PHENYLEPHRINE Mydfrin 2.5% Oph Sol SF 00465763 ALC

DNPO

S01GX OTHER ANTIALLERGICS S01GX01 CROMOGLYCATE SODIUM cromoglycate sodium 2% oph sol Cromolyn 2% Oph Sol Opticrom 2% Oph Sol EMEDASTINE Emadine 0.5% Oph Drops KETOTIFEN Zaditor 0.25% Oph Sol OLOPATADINE Patanol 0.1% Oph Sol

DNPO DNPO

MRP MRP

SF SF SF

02009277 02230621 02237355 02242324 02233143

PDP ALL ALC NVO ALC

S01GX06 S01GX08 S01GX09

DNPO

S01H LOCAL ANESTHETICS S01HA LOCAL ANESTHETICS S01HA04 PROXYMETACAINE Alcaine 0.5% Drops SF 00035076 ALC

DNPO

S01L OCULAR VASCULAR DISORDER AGENTS S01LA ANTINEOVASCULARISATION AGENTS S01LA01 S01LA03 VERTEPORFIN Visudyne 15mg/vial Inj PEGAPTANIB Macugen 0.3mg/90mcl Pre-filled Syringe E 02242367 02267225 NVO PFI

DNP

December 2012

Sensory Organs ­ 181

S01X OTHER OPHTHALMOLOGICALS S01XA OTHER OPHTHALMOLOGICALS S01XA03 SODIUM CHLORIDE, HYPERTONIC Muro 128 (5%) Oph Oint Muro 128 (5%) Oph Sol CICLOSPORIN Restasis 0.05% ARTIFICIAL TEARS AND OTHER INDIFFERENT PREPARATIONS DNPO GenTeal 0.3% Oph Gel GenTeal 3mg/g Oph Sol DNPO DNPO Refresh Celluvisc 1% Liq Refresh 1% Liquigel DNPO Duolube Oph Oint Refresh Lacri-Lube Oph Oint Tears Naturale P.M. Oph Oint Hypotears Oph Oint TearGel Oph Oint DNPO artificial tears 0.5% oph sol Sandoz Eyelube 0.5% Oph Sol Isopto Tears 0.5% Oph Sol artificial tears 1% oph sol Sandoz Eyelube 1% Oph Sol Isopto Tears 1% Oph Sol Artificial Tears 1.4% Oph Sol Bion Tears Oph Sol Hylashield 0.15%/0.4% Allets Hypotears 1% Oph Sol Refresh 1.4% Oph Sol Refresh Plus 0.5% Oph Sol Refresh Tears 0.5% Oph Sol Tears Naturale Oph Sol Tears Naturale II Oph Sol Tears Naturale Free Oph Sol Tears Plus 1.4% Oph Sol SF SF E SF SF SF 00750816 00750824 02355655 02242977 02231289 00870153 02244650 02125706 00210889 02082519 02133288 00999491 00889806 00000809 BSH BSH ALL ALC ALC ALL ALL BSH ALL ALC ALC ALC SDZ ALC

DNPO DNPO

S01XA18 S01XA20

SF

00874965 00000817 02229570 02216051 00999176 02133253 02138670 02049260 02231008 00390291 00743445 01943308 00579408

SDZ ALC PDP ALC IMD ALC ALL ALL ALL ALC ALC ALC ALL

DNPO DNPO DNPO DNPO DNPO DNPO

SF E E E SF E

S02

OTOLOGICALS

S02A ANTIINFECTIVES S02AA ANTIINFECTIVES S02AA14 GENTAMICIN gentamicin 0.3% otic sol Sandoz Gentamicin 0.3% Otic Sol Garamycin 0.3% Otic Sol pms-Gentamicin 0.3% Otic Sol (discontinued) S02AA30 ANTIINFECTIVES, COMBINATIONS Buro-Sol Otic Sol SF 00674222 STI

DNP DNP

MRP MRP

SF SF

02229441 00512184

SDZ SCH

DNP

December 2012

Sensory Organs ­ 182

S02C CORTICOSTEROIDS AND ANTIIFECTIVES IN COMBINATION S02CA CORTICOSTEROIDS AND ANTIINFECTIVES IN COMBINATION S02CA02 S02CA03 FLUMETASONE AND ANTIINFECTIVES Locacorten Vioform Otic Sol SF 00074454 PAL

DNP

HYDROCORTISONE AND ANTIINFECTIVES polymyxin b sulfate, neomycin sulfate & hydrocortisone otic sol Sandoz Cortimyxin Otic Sol DNP MRP DNP MRP Cortisporin Otic Sol DEXAMETHASONE AND ANTIINFECTIVES Ciprodex Otic Susp

SF SF E

02230386 01912828 02252716

SDZ GSK ALC

S02CA06

DNP

S03

OPHTHALMOLOGICAL AND OTOLOGICAL PREPARATIONS

S03A ANTIINFECTIVES S03AA ANTIINFECTIVES S03AA30 ANTIINFECTIVES, COMBINATIONS polymixin b sulfate, neomycin sulfate & gramicidin oph/otic sol Optimyxin Plus Oph/Otic Sol (discontinued) Neosporin Oph/Otic Sol (discontinued)

S03B CORTICOSTEROIDS S03BA CORTICOSTEROIDS S03BA01 DEXAMETHASONE dexamethasone 0.1% oph/otic sol Sandoz Dexamethasone 0.1% Oph/Otic Sol Decadron 0.1% Oph/Otic Sol (discontinued)

DNPO

MRP

SF

00739839

SDZ

S03C CORTICOSTEROIDS AND ANTIINFECTIVES IN COMBINATION S03CA CORTICOSTEROIDS AND ANTIINFECTIVES IN COMBINATION S03CA01 DEXAMETHASONE AND ANTIINFECTIVES dexamethasone, framycetin sulfate & gramicidin oph/otic sol Sofracort Oph/Otic Sol DNPO Sandoz Opticort Oph/Otic Sol (discontinued) HYDROCORTISONE AND ANTIINFECTIVES Pentamycetin HC Oph/Otic Oint (discontinued) Pentamycetin HC Oph/Otic Susp (discontinued) BETAMETHASONE AND ANTIINFECTIVES betamethasone & gentamicin oph/otic sol Sandoz Pentasone Oph/Otic Sol Garasone Oph/Otic Sol

SF

02224623

SAV

S03CA04

S03CA06

DNPO DNPO

MRP MRP

SF SF

02244999 00682217

SDZ SCH

December 2012

Sensory Organs ­ 183

December 2012

Sensory Organs ­ 184

V01

ALLERGENS

V01A ALLERGENS V01AA ALLERGEN EXTRACTS V01AA02 V01AA20 GRASS POLLEN Pollinex-R Inj VARIOUS Allergy Serum E E 00464988 00999938 AGT VAR

DNP

DNP

V03

ALL OTHER THERAPEUTIC PRODUCTS

V03A ALL OTHER THERAPEUTIC PRODUCTS V03AB ANTIDOTES V03AB15 NALOXONE naloxone 0.4mg/mL inj Naloxone 0.4mg/mL Inj Narcan 0.4mg/mL Inj (discontinued) naloxone 1mg/mL inj Naloxone 1mg/mL Inj Narcan 1mg/mL Inj (discontinued) V03AB25 FLUMAZENIL flumazenil 0.1mg/mL inj Flumazenil 0.1mg/mL Inj Anexate 0.1mg/mL Inj (discontinued)

02148706

SDZ

02148714

SDZ

02249561

SDZ

V03AC IRON CHELATING AGENTS V03AC01 DEFEROXAMINE deferoxamine 500mg/vial inj Desferrioxamine 500mg/vial Inj pms-Deferoxamine 500mg/vial Inj Desferal 500mg/vial Inj Desferal 2g/vial Inj V03AC03 DEFERASIROX Exjade 125mg Tab for Susp Exjade 250mg Tab for Susp Exjade 500mg Tab for Susp

DNP DNP DNP DNP

MRP MRP MRP

SF SF SF SF E E E

02241600 02242055 01981242 01981250 02287420 02287439 02287447

HOS PMS NVR NVR NVR NVR NVR

DNP DNP DNP

PRP PRP PRP

V03AE DRUGS FOR TREATMENT OF HYPERKALEMIA AND HYPERPHOSPHATEMIA V03AE01 POLYSTYRENE SULFONATE Kayexalate Powder pms-Sodium Polystyrene Sulfonate Pd Solystat Oral SEVELAMER Renagel 800mg Tab LANTHANUM CARBONATE Fosrenol 250mg Tab Fosrenol 500mg Tab Fosrenol 750mg Tab Fosrenol 1,000mg Tab CALCIUM ACETATE Phoslo 667mg Tab SF SF SF E E E E E 02026961 00755338 00769541 02244310 02287145 02287153 02287161 02287188 02229437 SAV PMS PDP GZM SHI SHI SHI SHI MYL

DNP DNP DNP

V03AE02 V03AE03

DNP

DNP DNP DNP DNP

V03AE99

December 2012

Various ­ 185

V03AF DETOXIFYING AGENTS FOR ANTINEOPLASTIC TREATMENT V03AF03 CALCIUM FOLINATE Lederle Leucovorin 5mg Tab SFC 02170493 PFI

DNP

V03AH DRUGS FOR TREATMENT OF HYPOGLYCEMIA V03AH01 DIAZOXIDE Proglycem 100mg Cap SF 00503347 SCH

DNP

V04

DIAGNOSTIC AGENTS

V04C OTHER DIAGNOSTIC AGENTS V04CA TESTS FOR DIABETES V04CA02 GLUCOSE Diabetic Testing Strips *Diabetic Supplies Benefit List SFD

DNP

V04CJ TESTS FOR THYREOIDEA FUNCTION V04CJ01 THYROTROPIN Thyrogen 0.9mg/mL Inj E 02246016 GZM

DNP

V07

ALL OTHER NON-THERAPEUTIC PRODUCTS

V07A ALL OTHER NON-THERAPEUTIC PRODUCTS V07AB SOLVENTS AND DILUTING AGENTS, INCLUDING IRRIGATING SOLUTIONS VO7AB99 STERILE WATER Bacteriostatic Water for Inj Sterile Water for Inj (WP) SF SF 00038202 02142546 HOS HOS

DNP DNP

V07AS STOMI EQUIPMENT V07AS01 STOMI EQUIPMENT *Ostomy Supplies Benefit List SFC

DNP

V07AY OTHER NON-THERAPEUTIC AUXILIARY PRODUCTS V07AY03 V07AY04 V07AY05 V07AY06 V07AY90 MISCELLANEOUS DEVICES Infusion Pump Cassette INSULIN SYRINGES *Diabetic Supplies Benefit List INSULIN PEN NEEDLES *Diabetic Supplies Benefit List DIABETIC LANCETS *Diabetic Supplies Benefit List PLACEBO Placebo Placebo Tab SFC SFD SFD SFD SFC SFC 00999008 00501190 CPD ODN 00999970 VAR

DNP

DNP

DNP

DNP

DNP DNP

December 2012

Various ­ 186

Diabetic Supplies Benefit List

PIN PRODUCT DESCRIPTION PKG SIZE PRODUCT# MFR

INSULIN PEN NEEDLES 97799527 BD Ultra-Fine Nano Pen Needles 32g x 4mm 97799897 BD Ultra-Fine II Pen Needles, 12.7mm, 29g 97799896 BD Ultra-Fine III Mini Pen Needles, 5mm, 31g 97799895 BD Ultra-Fine III Short Pen Needles. 8mm, 31g 97799566 Insupen, 29g x 12mm 97799567 Insupen, 30g x 8mm 97799568 Insupen, 31g x 8mm 97799569 Insupen, 31g x 6mm 97799570 Insupen, 32g x 8mm 97799571 Insupen, 32g x 6mm 97799909 Novofine Pen Needles 28g X 12mm 97799910 Novofine Pen Needles 30g X 8mm 97799911 Novofine Pen Needles 30g X 6mm 97799764 Novofine ETW Pen Needles 32g 97799467 NovoTwist 30g (8mm) Tip Needles 97799468 NovoTwist 32g (5mm) Tip Needles 97799561 SUPER-FINE Pen Needles (Micro 29g 12.7mm) 97799563 SUPER-FINE Pen Needles (Micro 31g 5mm) 97799562 SUPER-FINE Pen Needles (XTRA 31g 8mm) 97799527 Ulticare Pen Needles 29g x 12mm 97799545 Ulticare Pen Needles 31g x 6mm 97799544 Ulticare Pen Needles 31g x 8mm 97799440 Ulticare Pen Needles 32g x 4mm 97799991 Unifine Pen Needles 29g x 12mm 97799993 Unifine Pen Needles 31g x 6mm 97799992 Unifine Pen Needles 31g x 8mm INSULIN SYRINGES 97799889 BD Ultra-Fine Syringes, 1cc, 29g 97799887 BD Ultra-Fine Syringes, 0.3cc, 29g 97799888 BD Ultra-Fine Syringes, 0.5cc, 29g 97799886 BD Ultra-Fine II Syringes, 0.3cc, 30g 97799885 BD Ultra-Fine II Syringes, 0.5cc. 30g 97799890 BD Ultra-Fine II Syringes, 1cc, 30g 97799760 BD Ultra-Fine II Short Half-Unit Syringes, 0.3cc, 31g 97799786 Monoject Syringes 0.3cc, 29 x 1/2" 97799783 Monoject Syringes 0.3cc, 30g x 5/16" 97799780 Monoject Syringes 0.5cc, 25g x 5/8" 97799788 Monoject Syringes 0.5cc, 28g x 1/2" 97799785 Monoject Syringes 0.5cc, 29g x 1/2" 97799782 Monoject Syringes 0.5cc, 30g x 5/16" 97799779 Monoject Syringes 1cc, 25g x 5/8" 97799778 Monoject Syringes 1cc, 27g x 1/2" 97799787 Monoject Syringes 1cc, 28g x 1/2" 97799777 Monoject Syringes 1cc, 28g x 1/2" 97799784 Monoject Syringes 1cc, 29g x 1/2" 97799781 Monoject Syringes 1cc, 30g x 5/16" 97799999 UltiCare Syringes 0.3cc, 29g 97799996 UltiCare Syringes 0.3cc, 30g 97799998 UltiCare Syringes 0.5cc, 29g

December 2012

100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100

320144 320223 320145 320108 22988 22987 22990 22989 22984 22983 890037 890187 890237 86601 14533 14634 933427927 933427297 933427279 09512 09563 09583 00543 OMAM3529 OMAM3590 OMAM3530

BTD BTD BTD BTD DOM DOM DOM DOM DOM DOM NNO NNO NNO NNO NNO NNO PMS PMS PMS DRX DRX DRX DRX AUT AUT AUT

100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100

320411 320431 320466 320438 320468 320469 320440 8881600145 8881600800 1188528012 8881600004 8881600350 8881600700 1188125058 1188127012 8881601101 1188128012 8881601358 8881601600 UC09239 UC09339 UC09259

BTD BTD BTD BTD BTD BTD BTD TYC TYC TYC TYC TYC TYC TYC TYC TYC TYC TYC TYC AUT AUT AUT

MISCELLANEOUS ­1

Diabetic Supplies Benefit List

PIN 97799995 97799997 97799994 LANCETS *97799691 *97799689 *97799494 *97799495 *97799817 *97799816 *97799946 *97799945 *97799942 *97799917 *97799918 *97799882 *97799883 *97799466 *97799540 *97799825 *97799826 *97799767 *97799766 *97799592 *97799591 *97799810 *97799807 *97799501 *97799431 *97799765 *97799970 *97799948 PRODUCT DESCRIPTION UltiCare Syringes 0.5cc, 30g UltiCare Syringes 1cc, 29g UltiCare Syringes 1cc, 30g PKG SIZE 100 100 100 PRODUCT# UC09359 UC09219 UC09319 MFR AUT AUT AUT

Abbott Thin 28g Lancets Abbott Thin 28g Lancets Accu-Chek Fastclix Lancets Accu-Chek Fastclix Lancets Accu-Chek Multiclix Lancets Accu-Chek Multiclix Lancets Accu-Chek Softclix Lancets Accu-Chek Softclix Lancets Accu-Chek Softclix Pro Lancets Ascensia Microlet Lancets Ascensia Microlet Lancets BD Ultra-Fine Lancets BD Ultra-Fine Lancets BGStar Lancets EZ Health Lancets Finger Stix Lancets FreeStyle Lancets iTest Lancets 33g iTest Lancets 28g Medlance Plus Lite Lancets 25g Medlance Plus Universal Lancets 21g MPD Thin Lancets MPD Ultra Thin Lancets OneTouch Delica Lancets 33G OneTouch Delica Lancets 30G OneTouch SureSoft Lancets 21g OneTouch UltraSoft Safe-T-Pro Lancets

100 200 102 204 102 204 100 200 200 200 100 100 200 100 100 200 100 100 100 200 200 100 100 100 100 200 100 200

7004302 9868203 05353807001 05353815001 4466314119 4466349119 3146707 3146693 3038157 6550PC 6546BA 326571 326572 86476 GMH-L3 5965 83001 IT31003 IT31005 1381 1382 P0555/P0455 P0465/P0565 022-142 022631 021-139 020432 2210916

MID MID BOM BOM BOM BOM BOM BOM BOM BDD BDD BTD BTD SAV THI BDD MID AUT AUT MPD MPD MPD MPD LFS LFS LFS LFS BOM

TESTING STRIPS 97799916 Acetest *97799823 Accu-Chek Advantage Glucose Test Strips *97799824 Accu-Chek Advantage Glucose Test Strips *97799815 Accu-Chek AVIVA Test Strips *97799814 Accu-Chek AVIVA Test Strips *97799963 Accu-Chek Compact Test Strips *97799962 Accu-Chek Compact Test Strips *97799496 Accu-Chek Mobile BG Test Strip Cassette *97799497 Accu-Chek Mobile BG Test Strip Cassette 97799851 Albustix *97799749 Ascensia Breeze 2 Test Strip Disc *97799748 Ascensia Breeze 2 Test Strip Disc *97799703 Ascensia Contour Test Strip *97799702 Ascensia Contour Test Strip *97799464 BGStar Test Strips

100 50 100 50 100 51 102 50 100 100 50 100 50 100 50

2381 2030578 2030551 4454308164 4538412164 3021475 3021475/102 05127670119 05190843119 2870U 1469 1470 7081B 7091B 86366

BDD BOM BOM BOM BOM BOM BOM BOM BOM BDD BDD BDD BDD BDD SAV

* Pharmacare Reimbursement Price

December 2012 MISCELLANEOUS ­2

Diabetic Supplies Benefit List

PIN *97799465 97799950 97799953 97799958 97799957 97799951 97799956 97799915 97799460 97799459 97799914 97799925 *97799564 *97799827 *97799829 *97799596 *97799597 97799849 *97799770 97799912 97799913 97799854 97799853 *97799458 *97799584 *97799583 *97799580 *97799581 *97799582 *97799977 *97799976 *97799983 *97799982 *97799986 *97799985 *97799476 *97799475 *97799841 *97799840 *97799451 *97799479 *97799478 *97799531 *97799532 *97799603 *97799602 *97799601 97799852 PRODUCT DESCRIPTION BGStar Test Strips Chemstrip 4-MD Chemstrip-9 Chemstrip-BG (Accu-Chek) Chemstrip-BG Glucose Strips (Visual Testing) Chemstrip-GP Chemstrip uGK Glucose and Ketone Strips Clinitest Contour NEXT Blood Glucose Test Strips Contour NEXT Blood Glucose Test Strips Diastix Elite Blood Glucose Test Strips EZ Oracle Test Strips FreeStyle Blood Glucose Test Strips FreeStyle Blood Glucose Test Strips FreeStyle Lite Test Strips FreeStyle Lite Test Strips Hemastix iTest Blood Glucose Test Strips Keto-Diastix Ketostix Labstix Multistix MyGlucoHealth Glucose Test Strips NovaMax Test Strips NovaMax Test Strips On-Call Plus Test Strips On-Call Plus Test Strips On-Call Plus Test Strips One-Touch Test Strips One-Touch Test Strips One-Touch FastTake Blood Glucose Test Strips One-Touch FastTake Blood Glucose Test Strips One-Touch Ultra Test Strips One-Touch Ultra Test Strips One-Touch Verio Test Strips One-Touch Verio Test Strips Precision Xtra Test Strips Precision Xtra Test Strips Rapid Response Blood Glucose Test Strips Rightest GS100 Test Strips Rightest GS100 Test Strips TRUEtest Blood Glucose Test Strips TRUEtest Blood Glucose Test Strips TrueTrack Blood Glucose Test Strip TrueTrack Blood Glucose Test Strip Sidekick Blood Glucose Testing System Uristix PKG SIZE 100 50 100 50 25 100 50 100 50 100 50 25 100 50 100 50 100 50 50 100 50 100 100 50 50 100 25 50 100 50 100 50 100 50 100 50 100 50 100 50 50 100 50 100 50 100 50/kit 100 PRODUCT# 86366 704784 398411 1179446 318710 200743 647705 2101 7321 7322 2806 3912A GMH-B1S100 82055 82058 6.99074E+11 6.99074E+11 2524A IT31002 2882U 2880U 2810A 2820A CAN-MGH-TS50 43894 43955 1130069002 1130088501 1130089001 010-501 010-638 010-455 010-456 020-383 020-384 022279 022439 99786 99059 04GLU-68 8539105202 8539110202 E3i20-81 E3i20-80 A-3120-81 A-3120-80 K-05011-47/D-4120-81 2855U MFR SAV BOM BOM BOM BOM BOM BOM BDD BDD BDD BDD BDD THI MID MID MID MID BDD AUT BDD BDD BDD BDD EHS NBM NBM ACO ACO ACO LFS LFS LFS LFS LFS LFS LFS LFS MID MID BTX BNM BNM HOM HOM HOM HOM HOM BDD

* Pharmacare Reimbursement Price

December 2012

MISCELLANEOUS ­3

Ostomy Supplies Benefit List

PIN PRODUCT DESCRIPTION PROD.# MFR PIN 95099868 PRODUCT DESCRIPTION Urihesive Strips PROD.# 173929 MFR CON

SKIN BARRIER / ADHESIVES 95099150 Adapt Barrier Strips 95099149 Adapt Convex Barrier Rings 95099148 Adapt Convex Barrier Rings 95099147 Adapt Convex Barrier Rings 95099151 Adapt Paste 95099146 Adapt Skin Barrier Rings 95099145 Adapt Skin Barrier Rings 95099144 Adapt Skin Barrier Rings 95099143 Adapt Skin Barrier Rings 95099870 Allkare Protective Barrier Wipe 95099871 Allkare Protective Barrier Wipe 95098876 Coloplast Ostomy Paste 95098875 Coloplast Ostomy Strip Paste 95098866 Coloplast Prep Barrier 95098867 Coloplast Prep Barrier Wipe 95098879 Coloplast Skin Barrier 95098878 Coloplast Skin Barrier 95098877 Coloplast Skin Barrier 95098872 Coloplast Skin Barrier Rings 95098871 Coloplast Skin Barrier Rings 95098870 Coloplast Skin Barrier Rings 95098869 Coloplast Skin Barrier Rings 95098868 Coloplast Skin Barrier Rings 95099861 Eakin Cohesive Seals 95099860 Eakin Cohesive Seals 95098352 Eakin Cohesive Seals - Slim 95099859 Eakin Cohesive Skin Barrier 95099858 Eakin Cohesive Skin Barrier 95099157 Flextend Ext Wear Skin Barrier 95099156 Flextend Ext Wear Skin Barrier 95098268 FormaFlex Shape-to-Fit Skin Barrier 95098267 FormaFlex Shape-to-Fit Skin Barrier 95098266 FormaFlex Shape-to-Fit Skin Barrier 95099153 Hollihesive Skin Barrier 95099152 Hollihesive Skin Barrier 95099132 Medical Adhesive 95098252 Mouldable Rings (3.0mm) 95098251 Mouldable Rings (4.2mm) 95099142 Premium Powder 95099155 Premium Skin Barrier 95099154 Premium Skin Barrier 95099134 Skin Gel Protective Wipes 93299587 Skin-Prep Protective Barrier 93299586 Skin-Prep Protective Barrier 95099864 Stomahesive Paste Tube 95099880 Stomahesive Protective Pdr 95099879 Stomahesive Skin Barrier 95099878 Stomahesive Skin Barrier

December 2012

79400 79520 79530 79540 79300 7805 7806 7807 7808 37439 37444 2650 2655 925 2041 3210 3215 3220 2320 2325 2330 2340 2350 839001 839002 839005 839003 839004 8800 8801 14102 14103 14104 7700 7701 7730 12030 12042 7906 7800 7801 7917 420279 420425 183910 25510 21712 21715

HOL HOL HOL HOL HOL HOL HOL HOL HOL CON CON COL COL COL COL COL COL COL COL COL COL COL COL CON CON CON CON CON HOL HOL HOL HOL HOL HOL HOL HOL COL COL HOL HOL HOL HOL SNE SNE CON CON CON CON

SKIN BARRIERS or WAFERS w FLANGE (2 PIECE) 95099118 Assura E-E Wear 2831 95099117 Assura E-E Wear 2832 95099116 Assura E-E Wear 2833 95099105 Assura E-E Wear 14232 95099104 Assura E-E Wear 14233 95099103 Assura E-E Wear 14234 95099102 Assura E-E Wear 14235 95099101 Assura E-E Wear 14236 95099100 Assura E-E Wear 14237 95099099 Assura E-E Wear 14238 95099098 Assura E-E Wear 14239 95099115 Assura E-E Wear 14243 95099114 Assura E-E Wear 14246 95099113 Assura E-E Wear 14249 95099111 Assura E-E Wear 14251 95099110 Assura E-E Wear 14252 95099109 Assura E-E Wear 14254 95099108 Assura E-E Wear 14255 95099107 Assura E-E Wear 14257 95099106 Assura E-E Wear 14258 95098554 Assura E-E Wear 14281 95098553 Assura E-E Wear 14282 95098552 Assura E-E Wear 14283 95098551 Assura E-E Wear 14291 95098550 Assura E-E Wear 14292 95098549 Assura E-E Wear 14293 95098548 Assura E-E Wear 14294 95098547 Assura E-E Wear 14295 95098546 Assura E-E Wear 14296 95098545 Assura E-E Wear 14297 95098544 Assura E-E Wear 14298 95098888 Assura Pediatric 2181 95099097 Assura Std Wear 2881 95099096 Assura Std Wear 2882 95099095 Assura Std Wear 2883 95099082 Assura Std Wear 12701 95099081 Assura Std Wear 12702 95099080 Assura Std Wear 12703 95099079 Assura Std Wear 12704 95099078 Assura Std Wear 12705 95099077 Assura Std Wear 12706 95099076 Assura Std Wear 12707 95099075 Assura Std Wear 12708 95099074 Assura Std Wear 12709 95099094 Assura Std Wear 12716 95099093 Assura Std Wear 12719 95099088 Assura Std Wear 12841 95099087 Assura Std Wear 12842 95099086 Assura Std Wear 12844

COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL

MISCELLANEOUS ­ 4

Ostomy Supplies Benefit List

PIN 95099085 95099084 95099083 95099092 95099091 95099090 95099073 95099072 95099071 95099070 95099069 95099068 95099067 95099066 95099534 95099533 95099532 95099531 95099535 95099539 95099538 95099537 95099536 95099540 95099525 95099524 95099523 95099522 95099521 95099520 95099519 95099518 95099517 95099516 95099529 95099527 95099530 95099528 95099526 95099544 95099543 95099542 95099541 95099545 95099515 95099514 95099512 95099511 95099510 95099513 95099489 95099488

December 2012

PRODUCT DESCRIPTION Assura Std Wear Assura Std Wear Assura Std Wear Assura Std Wear Assura Std Wear Assura Std Wear Assura Std Wear Assura Std Wear Assura Std Wear Assura Std Wear Assura Std Wear Assura Std Wear Assura Std Wear Assura Std Wear CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Floating CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex

PROD.# 12845 12847 12848 14261 14262 14263 14271 14272 14273 14274 14275 14276 14277 14278 3702 3703 3704 3706 3707 3722 3723 3724 3726 3727 3730 3731 3732 3733 3734 3735 3736 3737 3738 3739 3742 3743 3747 3748 3749 3762 3763 3764 3766 3767 37310 37311 8722 8723 8724 8727 8731 8732

MFR COL COL COL COL COL COL COL COL COL COL COL COL COL COL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL

PIN 95099487 95099486 95099485 95099484 95099483 95099482 95099509 95099508 95099507 95099506 95099505 95099504 95099502 95099501 95099500 95099503 95099492 95099491 95099490 95098837 95098836 95098835 95098977 95098839 95098838 95098543 95098468 95098477 95098467 95098466 95099906 95099905 95099904 95099919 95099924 95099923 95099922 95099921 95099920 95099917 95099916 95099915 95099914 95099913 95099912 95099911 95099910 95099909 95099908 95099907 95099918 95098269

PRODUCT DESCRIPTION CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex CenterPointLock Premier Flex Easiflex E-E Wear Easiflex E-E Wear Easiflex E-E Wear Easiflex E-E Wear Easiflex E-E Wear Easiflex E-E Wear Easiflex Std Wear Easiflex Std Wear Easiflex Std Wear Easiflex Std Wear Easiflex Std Wear Esteem Synergy Dura Mold Esteem Synergy Dura Mold Esteem Synergy Dura Mold Esteem Synergy Stomahesive Esteem Synergy Stomahesive Esteem Synergy Stomahesive Esteem Synergy Stomahesive Esteem Synergy Stomahesive Esteem Synergy Stomahesive Esteem Synergy Stomahesive Esteem Synergy Stomahesive Esteem Synergy Stomahesive Esteem Synergy Stomahesive Esteem Synergy Stomahesive Esteem Synergy Stomahesive Esteem Synergy Stomahesive Esteem Synergy Stomahesive Esteem Synergy Stomahesive Esteem Synergy Stomahesive Esteem Synergy Stomahesive Esteem Synergy Stomahesive First Choice Drainable

PROD.# 8733 8734 8735 8736 8737 8738 8743 8744 8745 8746 8747 8748 8752 8753 8754 8757 8774 8778 87711 14301 14302 14303 14304 14305 14306 14309 14401 14402 14403 14406 409268 409269 409270 403948 405456 405457 405458 405467 405468 405472 405473 405474 405475 405476 405477 405478 405479 405480 405481 405482 405483 8131

MFR HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL COL COL COL COL COL COL COL COL COL COL COL CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON HOL

MISCELLANEOUS ­ 5

Ostomy Supplies Benefit List

PIN 95098731 95098730 95098729 95098728 95098727 95098726 95098725 95098724 95098532 95098723 95098722 95098721 95098720 95098719 95098718 95098717 95098716 95098531 95098707 95098706 95098705 95098704 95098703 95098702 95098701 95098700 95098715 95098714 95098713 95098712 95098711 95098710 95098709 95098708 95099646 95099645 95099644 95099612 95099611 95099610 95099609 95099608 95099607 95099606 95099643 95099642 95099641 95099605 95099604 95099603 95098522 95098521

December 2012

PRODUCT DESCRIPTION New Image Flat w Tape New Image Flat w Tape New Image Flat w Tape New Image Flat w Tape New Image Flat w Tape New Image Flat w Tape New Image Flat w Tape New Image Flat w Tape New Image Flat w Tape New Image Flat w Tape New Image Flat w Tape New Image Flat w Tape New Image Flat w Tape New Image Flat w Tape New Image Flat w Tape New Image Flat w Tape New Image Flat w Tape New Image Flat w Tape New Image Flat w/o Tape New Image Flat w/o Tape New Image Flat w/o Tape New Image Flat w/o Tape New Image Flat w/o Tape New Image Flat w/o Tape New Image Flat w/o Tape New Image Flat w/o Tape New Image Flat w/o Tape New Image Flat w/o Tape New Image Flat w/o Tape New Image Flat w/o Tape New Image Flat w/o Tape New Image Flat w/o Tape New Image Flat w/o Tape New Image Flat w/o Tape New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating

PROD.# 14301 14302 14303 14304 14305 14306 14307 14308 14309 14701 14702 14703 14704 14705 14706 14707 14708 14709 16101 16102 16103 16104 16105 16106 16107 16108 16401 16402 16403 16404 16405 16406 16407 16408 14202 14203 14204 14402 14403 14404 14503 14504 14505 14506 14602 14603 14604 14802 14803 14804 14901 14902

MFR HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL

PIN 95099602 95099601 95099600 95099599 95098520 95098519 95098518 95098517 95098516 95099640 95099639 95099638 95099598 95099597 95099596 95099595 95099594 95099593 95099592 95099637 95099636 95099635 95099591 95099590 95099589 95099588 95099587 95099586 95099585 95099628 95099627 95099626 95099625 95099624 95099623 95099622 95099621 95099620 95099619 95099618 95099617 95099616 95099615 95099614 95099613 95099167 95098333 95098332 95098377 95098327 95098326 95098325

PRODUCT DESCRIPTION New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Floating New Image Stationary New Image Stationary New Image Stationary New Image Stationary New Image Stationary New Image Stationary New Image Stationary New Image Stationary New Image Stationary New Image Stationary New Image Stationary New Image Stationary New Image Stationary New Image Stationary New Image Stationary New Image Stationary Pouchkins Pediatric Sensura Flex Skin Sensura Flex Skin Sensura Flex Skin Sensura Flex Skin Sensura Flex Skin Sensura Flex Skin

PROD.# 14903 14904 14905 14906 14907 14908 14909 14910 14911 15202 15203 15204 15402 15403 15404 15503 15504 15505 15506 15602 15603 15604 15802 15803 15804 15903 15904 15905 15906 16301 16302 16303 16304 16305 16306 16307 16308 16701 16702 16703 16704 16705 16706 16707 16708 3770 10101 10102 10103 10108 10111 10113

MFR HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL COL COL COL COL COL COL

MISCELLANEOUS ­ 6

Ostomy Supplies Benefit List

PIN 95098324 95098323 95098322 95098283 95098282 95098281 95098277 95098275 95098274 95098273 95098272 95098363 95098414 95098411 95098410 95098413 95098409 95098408 95098412 95098407 95098406 95098403 95098405 95098402 95098401 95098400 95098404 95098399 95099825 95099824 95099823 95099822 95099821 95099820 95099819 95099818 95099817 95099701 95099673 95099672 95099671 95099670 95099669 95099668 95099667 95099666 95099665 95099664 95099663 95099662 95099661 95099660

December 2012

PRODUCT DESCRIPTION Sensura Flex Skin Sensura Flex Skin Sensura Flex Skin Sensura Flex Skin Sensura Flex Skin Sensura Flex Skin Sensura Flex Skin Sensura Flex Skin Sensura Flex Skin Sensura Flex Skin Sensura Flex Skin Sensura Flex Skin Sensura Std Wear Sensura Std Wear Sensura Std Wear Sensura Std Wear Sensura Std Wear Sensura Std Wear Sensura Std Wear Sensura Std Wear Sensura Std Wear Sensura Std Wear Sensura Std Wear Sensura Std Wear Sensura Std Wear Sensura Std Wear Sensura Std Wear Sensura Std Wear Sur-Fit AutoLock Dura Flex Sur-Fit AutoLock Dura Flex Sur-Fit AutoLock Dura Flex Sur-Fit AutoLock Dura Flex Sur-Fit AutoLock Dura Flex Sur-Fit AutoLock Dura Flex Sur-Fit AutoLock Dura Flex Sur-Fit AutoLock Dura Flex Sur-Fit AutoLock Dura Flex Sur-Fit Natura Dura Flex Sur-Fit Natura Dura Flex Sur-Fit Natura Dura Flex Sur-Fit Natura Dura Flex Sur-Fit Natura Dura Flex Sur-Fit Natura Dura Flex Sur-Fit Natura Dura Flex Sur-Fit Natura Dura Flex Sur-Fit Natura Dura Flex Sur-Fit Natura Dura Flex Sur-Fit Natura Dura Flex Sur-Fit Natura Dura Flex Sur-Fit Natura Dura Flex Sur-Fit Natura Dura Flex Sur-Fit Natura Dura Flex

PROD.# 10114 10116 10117 11301 11302 11303 11307 11312 11313 11314 11315 11316 10011 10012 10013 10021 10022 10023 10031 10032 11011 11012 11021 11022 11023 11024 11031 11032 401304 401305 401306 401307 401308 401429 401430 401431 401432 401905 413153 413154 413155 413156 413157 413159 413160 413161 413162 413163 413164 413165 413166 413167

MFR COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON

PIN 95099659 95099658 95099657 95099656 95099655 95099653 95099654 95099652 95099651 95099650 95099649 95099648 95099647 95099676 95099675 95099674 95098486 95098484 95098482 95098480 95099855 95099787 95099786 95099785 95099784 95099783 95099782 95099781 95099780 95099779 95099778 95099777 95099776 95099775 95099774 95099773 95099772 95099771 95099770 95099769 95099768 95099767 95098485 95098483 95098481 95098479 95099706 95099705 95099704 95099703 95099702 95099700

PRODUCT DESCRIPTION Sur-Fit Natura Dura Flex Sur-Fit Natura Dura Low Prof Sur-Fit Natura Dura Low Prof Sur-Fit Natura Dura Low Prof Sur-Fit Natura Dura Low Prof Sur-Fit Natura Dura Low Prof Sur-Fit Natura Dura Low Prof Sur-Fit Natura Dura Low Prof Sur-Fit Natura Dura Low Prof Sur-Fit Natura Dura Low Prof Sur-Fit Natura Dura Low Prof Sur-Fit Natura Dura Low Prof Sur-Fit Natura Dura Low Prof Sur-Fit Natura Dura Mold Sur-Fit Natura Dura Mold Sur-Fit Natura Dura Mold Sur-Fit Natura Dura Mold Sur-Fit Natura Dura Mold Sur-Fit Natura Dura Mold Sur-Fit Natura Dura Mold Sur-Fit Natura Little Ones Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Flex Sur-Fit Natura Stoma Mold Sur-Fit Natura Stoma Mold Sur-Fit Natura Stoma Mold Sur-Fit Natura Stoma Mold Sur-Fit Natura Stomahesive Sur-Fit Natura Stomahesive Sur-Fit Natura Stomahesive Sur-Fit Natura Stomahesive Sur-Fit Natura Stomahesive Sur-Fit Natura Stomahesive

PROD.# 413168 413177 413178 413179 413180 413182 413181 413183 413184 413185 413186 413187 413188 404592 404593 404594 411800 411802 411804 411806 401925 125257 125258 125259 125260 125261 125262 125263 125264 125265 125266 125267 125268 125269 125270 125271 125272 125273 125274 125275 125276 125277 411801 411803 411805 411807 401573 401574 401575 401576 401577 401906

MFR CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON

MISCELLANEOUS ­ 7

Ostomy Supplies Benefit List

PIN PRODUCT DESCRIPTION POUCHES (OPEN-CLOSED) (2 PIECE) 95098996 Assura Easiclose Drainable 95099065 Assura Easiclose Drainable 95099063 Assura Easiclose Drainable 95099061 Assura Easiclose Drainable 95099060 Assura Easiclose Drainable 95099059 Assura Easiclose Drainable 95099058 Assura Easiclose Drainable 95099057 Assura Easiclose Drainable 95099056 Assura Easiclose Drainable 95099055 Assura Easiclose Drainable 95099054 Assura Easiclose Drainable 95099053 Assura Easiclose Drainable 95098478 Assura Easiclose Drainable 95098475 Assura Easiclose Drainable 95098514 Assura Easiclose Drainable 95098886 Assura Pediatric Drainable 95098887 Assura Pediatric Drainable 95098840 Assura Pediatric Urostomy 95099031 Assura Two-Piece Closed 95099030 Assura Two-Piece Closed 95099029 Assura Two-Piece Closed 95099034 Assura Two-Piece Closed 95099033 Assura Two-Piece Closed 95099032 Assura Two-Piece Closed 95099025 Assura Two-Piece Closed 95099024 Assura Two-Piece Closed 95099023 Assura Two-Piece Closed 95099028 Assura Two-Piece Closed 95099027 Assura Two-Piece Closed 95099026 Assura Two-Piece Closed 95099050 Assura Two-Piece Drainable 95099045 Assura Two-Piece Drainable 95099044 Assura Two-Piece Drainable 95098420 Assura Urostomy 95098419 Assura Urostomy 95098418 Assura Urostomy 95098417 Assura Urostomy 95098416 Assura Urostomy 95098415 Assura Urostomy 95099035 Assura Urostomy Night Bag 95099446 CenterPointLock Closed 95099445 CenterPointLock Closed 95099444 CenterPointLock Closed 95099447 CenterPointLock Closed 95099476 CenterPointLock Drainable 95099475 CenterPointLock Drainable 95099474 CenterPointLock Drainable 95099473 CenterPointLock Drainable 95099477 CenterPointLock Drainable 95099471 CenterPointLock Drainable 95099470 CenterPointLock Drainable

December 2012

PROD.# 13870 13924 13925 13964 13965 13966 13974 13975 13976 13984 13985 13986 14494 14495 14498 14681 14691 1789 12344 12345 12346 12354 12355 12356 12374 12375 12376 12384 12385 12386 2743 2792 2793 14224 14225 14226 14227 14228 14229 21365 3342 3343 3344 3347 3802 3803 3804 3806 3807 3812 3813

MFR COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL

PIN 95099469 95099472 95099459 95099458 95099457 95099460 95099480 95099479 95099478 95099481 95099467 95099466 95099465 95099463 95099462 95099461 95099464 95099442 95099441 95099440 95099443 95099451 95099450 95099449 95099448 95099452 95099455 95099454 95099453 95099456 95099430 95099429 95099428 95099431 95099438 95099437 95099436 95099439 95099434 95099433 95099432 95099435 95098809 95098818 95098816 95098810 95098813 95098811 95098807 95098814 95098812 95098808

PRODUCT DESCRIPTION CenterPointLock Drainable CenterPointLock Drainable CenterPointLock Drainable CenterPointLock Drainable CenterPointLock Drainable CenterPointLock Drainable CenterPointLock Drainable CenterPointLock Drainable CenterPointLock Drainable CenterPointLock Drainable CenterPointLock Drainable CenterPointLock Drainable CenterPointLock Drainable CenterPointLock Drainable CenterPointLock Drainable CenterPointLock Drainable CenterPointLock Drainable CenterPointLock Premier CenterPointLock Premier CenterPointLock Premier CenterPointLock Premier CenterPointLock Premier CenterPointLock Premier CenterPointLock Premier CenterPointLock Premier CenterPointLock Premier CenterPointLock Premier CenterPointLock Premier CenterPointLock Premier CenterPointLock Premier CenterPointLock Premier CenterPointLock Premier CenterPointLock Premier CenterPointLock Premier CenterPointLock Stoma Cap CenterPointLock Stoma Cap CenterPointLock Stoma Cap CenterPointLock Stoma Cap CenterPointLock Urostomy CenterPointLock Urostomy CenterPointLock Urostomy CenterPointLock Urostomy Easiflex Closed Easiflex Closed Easiflex Closed Easiflex Closed Easiflex Closed Easiflex Closed Easiflex Closed Easiflex Closed Easiflex Closed Easiflex Closed

PROD.# 3814 3817 3832 3833 3834 3837 3842 3843 3844 3847 3872 3873 3874 3892 3893 3894 3897 8342 8343 8344 8347 8812 8813 8814 8816 8817 8842 8843 8844 8847 8902 8903 8904 8907 3402 3403 3404 3407 3902 3903 3904 3907 14314 14316 14317 14319 14326 14327 14329 14331 14332 14334

MFR HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL COL COL COL COL COL COL COL COL COL COL

MISCELLANEOUS ­ 8

Ostomy Supplies Benefit List

PIN 95098829 95098823 95098832 95098831 95098826 95098825 95098824 95098821 95098828 95098827 95098822 95098464 95098463 95098465 95098488 95098542 95098462 95099927 95099932 95099931 95099930 95099929 95099928 95099926 95099925 95098653 95098652 95099939 95099938 95099937 95099936 95099935 95099934 95099933 95099899 95099898 95099933 95099897 95099896 95099895 95099894 95098739 95098738 95098737 95098736 95098735 95098734 95098733 95098732 95098651 95098650 95098644

December 2012

PRODUCT DESCRIPTION Easiflex Drainable w Easiclose Easiflex Drainable w Easiclose Easiflex Drainable w Easiclose Easiflex Drainable w Easiclose Easiflex Drainable w Easiclose Easiflex Drainable w Easiclose Easiflex Drainable w Easiclose Easiflex Drainable w Easiclose Easiflex Drainable w Easiclose Easiflex Drainable w Easiclose Easiflex Drainable w Easiclose Easiflex Drainable w Easiclose Easiflex Drainable w Easiclose Easiflex Drainable w Easiclose Easiflex Drainable w Easiclose Easiflex Drainable w Easiclose Easiflex Drainable w Easiclose Esteem Synergy Closed Esteem Synergy Closed Esteem Synergy Closed Esteem Synergy Closed Esteem Synergy Closed Esteem Synergy Closed Esteem Synergy Closed Esteem Synergy Closed Esteem Synergy Drainable Esteem Synergy Drainable Esteem Synergy Drainable Esteem Synergy Drainable Esteem Synergy Drainable Esteem Synergy Drainable Esteem Synergy Drainable Esteem Synergy Drainable Esteem Synergy Drainable Esteem Synergy Drainable Esteem Synergy Drainable Esteem Synergy Drainable Esteem Synergy Drainable Esteem Synergy Drainable Esteem Synergy Drainable Esteem Synergy Drainable Esteem Synergy Invisiclose Esteem Synergy Invisiclose Esteem Synergy Invisiclose Esteem Synergy Invisiclose Esteem Synergy Invisiclose Esteem Synergy Invisiclose Esteem Synergy Invisiclose Esteem Synergy Invisiclose Esteem Synergy Urostomy Esteem Synergy Urostomy Esteem Synergy Urostomy

PROD.# 14342 14344 14346 14347 14349 14356 14357 14359 14361 14362 14364 14520 14521 14524 14525 14527 14528 403946 405430 405431 405432 405436 405437 405441 405442 403995 403997 405400 405401 405402 405403 405404 405405 405406 410803 410804 410805 410806 410807 410808 410809 410810 410811 410812 410813 410814 410815 413353 413354 405446 405447 405448

MFR COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON

PIN 95098643 95098642 95098647 95098646 95098645 95098649 95098077 95098076 95098075 95098074 95098073 95098072 95098071 95098070 95098069 95098068 95098067 95098066 95098065 95098064 95098063 95098062 95098061 95098060 95098059 95098058 95098057 95098056 95098055 95098054 95098053 95098530 95098529 95098528 95098627 95098626 95098625 95098624 95098623 95098622 95098527 95098526 95098525 95099569 95099568 95099567 95099572 95099571 95099570 95099563 95099562 95099561

PRODUCT DESCRIPTION Esteem Synergy Urostomy Esteem Synergy Urostomy Esteem Synergy Urostomy Esteem Synergy Urostomy Esteem Synergy Urostomy Esteem Synergy Urostomy Natura + Drainable Pouch Natura + Drainable Pouch Natura + Drainable Pouch Natura + Drainable Pouch Natura + Drainable Pouch Natura + Drainable Pouch Natura + Drainable Pouch Natura + Drainable Pouch Natura + Drainable Pouch Natura + Drainable Pouch Natura + Drainable Pouch Natura + Closed Pouch Natura + Closed Pouch Natura + Closed Pouch Natura + Closed Pouch Natura + Closed Pouch Natura + Closed Pouch Natura + Closed Pouch Natura + Closed Pouch Natura + Closed Pouch Natura + Closed Pouch Natura + Closed Pouch Natura + Closed Pouch Natura + Closed Pouch Natura + Closed Pouch New Image Closed New Image Closed New Image Closed New Image Closed New Image Closed New Image Closed New Image Closed New Image Closed New Image Closed New Image Closed Mini New Image Closed Mini New Image Closed Mini New Image Drainable New Image Drainable New Image Drainable New Image Drainable New Image Drainable New Image Drainable New Image Drainable New Image Drainable New Image Drainable

PROD.# 405449 405450 405451 405452 405453 405454 416415 416416 416417 416420 416423 416418 416421 416424 416472 416419 416422 416400 416401 416402 416403 416404 416405 416406 416407 416408 416409 416410 416411 416412 416413 18332 18333 18334 18362 18363 18364 18372 18373 18374 18352 18353 18354 18102 18103 18104 18122 18123 18124 18142 18143 18144

MFR CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL

MISCELLANEOUS ­ 9

Ostomy Supplies Benefit List

PIN 95099566 95099565 95099564 95098636 95098635 95098634 95098639 95098638 95098637 95099548 95099547 95099546 95098633 95098632 95098631 95099584 95099583 95099582 95099581 95099580 95099579 95098630 95098629 95099578 95099577 95099576 95099575 95099574 95099573 95098618 95098617 95098616 95099557 95099556 95099555 95099560 95099559 95099558 95098615 95098614 95099166 95099165 95098385 95098384 95098383 95098382 95098381 95098380 95098320 95098319 95098318 95098317

December 2012

PRODUCT DESCRIPTION New Image Drainable New Image Drainable New Image Drainable New Image Dr Lock'n Roll New Image Dr Lock'n Roll New Image Dr Lock'n Roll New Image Dr Lock'n Roll New Image Dr Lock'n Roll New Image Dr Lock'n Roll New Image Irrigator Drain New Image Irrigator Drain New Image Irrigator Drain New Image Lock'n Roll New Image Lock'n Roll New Image Lock'n Roll New Image Lock'n Roll New Image Lock'n Roll New Image Lock'n Roll New Image Lock'n Roll New Image Lock'n Roll New Image Lock'n Roll New Image Lock'n Roll New Image Lock'n Roll New Image Lock'n Roll New Image Lock'n Roll New Image Lock'n Roll New Image Lock'n Roll New Image Lock'n Roll New Image Lock'n Roll New Image Mini New Image Mini New Image Mini New Image Urostomy New Image Urostomy New Image Urostomy New Image Urostomy New Image Urostomy New Image Urostomy New Image Urostomy New Image Urostomy Pouchkins Pediatric Drainable Pouchkins Pediatric Urostomy Sensura Closed Sensura Closed Sensura Closed Sensura Closed Sensura Closed Sensura Closed Sensura Closed Sensura Closed Sensura Closed Sensura Closed

PROD.# 18202 18203 18204 18282 18283 18284 18292 18293 18294 18152 18153 18154 18003 18004 18006 18112 18113 18114 18132 18133 18134 18173 18174 18182 18183 18184 18192 18193 18194 18392 18393 18394 18402 18403 18404 18412 18413 18414 18422 18423 3771 3772 10154 10155 10156 10164 10165 10166 10904 10905 10914 10915

MFR HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL COL COL COL COL COL COL COL COL COL COL

PIN 95098376 95098398 95098397 95098395 95098394 95098393 95098390 95098389 95098388 95098392 95098391 95098387 95098386 95098360 95098359 95098358 95098356 95098361 95098311 95098310 95098309 95098308 95098307 95098306 95099698 95099697 95099696 95099807 95099806 95099805 95099804 95099803 95099802 95099801 95099800 95099791 95099790 95099789 95099788 95099816 95099815 95099814 95099813 95099812 95099811 95099810 95099809 95099808 95099723 95099722 95099721 95099720

PRODUCT DESCRIPTION Sensura Closed Sensura Easiclose Sensura Easiclose Sensura Easiclose Sensura Easiclose Sensura Easiclose Sensura Easiclose Sensura Easiclose Sensura Easiclose Sensura Easiclose Sensura Easiclose Sensura Easiclose Sensura Easiclose Sensura Flex Dr Pouch Sensura Flex Dr Pouch Sensura Flex Dr Pouch Sensura Flex Dr Pouch Sensura Flex Dr Pouch Sensura Urostomy Pouch Sensura Urostomy Pouch Sensura Urostomy Pouch Sensura Urostomy Pouch Sensura Urostomy Pouch Sensura Urostomy Pouch Sur-Fit Natura Flange Cap Sur-Fit Natura Flange Cap Sur-Fit Natura Flange Cap Sur-Fit AutoLock Accuseal Sur-Fit AutoLock Accuseal Sur-Fit AutoLock Accuseal Sur-Fit AutoLock Accuseal Sur-Fit AutoLock Accuseal Sur-Fit AutoLock Accuseal Sur-Fit AutoLock Accuseal Sur-Fit AutoLock Accuseal Sur-Fit AutoLock Closed Sur-Fit AutoLock Closed Sur-Fit AutoLock Closed Sur-Fit AutoLock Closed Sur-Fit AutoLock Drainable Sur-Fit AutoLock Drainable Sur-Fit AutoLock Drainable Sur-Fit AutoLock Drainable Sur-Fit AutoLock Drainable Sur-Fit AutoLock Drainable Sur-Fit AutoLock Drainable Sur-Fit AutoLock Drainable Sur-Fit AutoLock Drainable Sur-Fit Natura Accuseal Sur-Fit Natura Accuseal Sur-Fit Natura Accuseal Sur-Fit Natura Accuseal

PROD.# 10918 11114 11115 11124 11125 11126 11194 11195 11196 11135 11136 11185 11186 11514 11515 11518 11615 11505 11821 11822 11824 11825 11827 11828 401908 401909 401910 401452 401453 401460 401461 401462 401463 401464 401465 401677 401678 401679 401680 401434 401435 401436 401437 401439 401440 401441 401442 401443 401542 401543 401544 401545

MFR COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON

MISCELLANEOUS ­ 10

Ostomy Supplies Benefit List

PIN 95099719 95099718 95099717 95099716 95099715 95099714 95099713 95099712 95099711 95099710 95099732 95099731 95099730 95099729 95099728 95099727 95099726 95099725 95099724 95099744 95099743 95099742 95099741 95099740 95099739 95099738 95099737 95099760 95099759 95099758 95099757 95099756 95099755 95099754 95099753 95099752 95099751 95099750 95099749 95099748 95099747 95099746 95099745 95099689 95099688 95099687 95099686 95099685 95098759 95098758 95098757 95098756

December 2012

PRODUCT DESCRIPTION Sur-Fit Natura Accuseal Sur-Fit Natura Accuseal Sur-Fit Natura Accuseal Sur-Fit Natura Accuseal Sur-Fit Natura Accuseal Sur-Fit Natura Accuseal Sur-Fit Natura Accuseal Sur-Fit Natura Accuseal Sur-Fit Natura Accuseal Sur-Fit Natura Accuseal Sur-Fit Natura Bendable Sur-Fit Natura Bendable Sur-Fit Natura Bendable Sur-Fit Natura Bendable Sur-Fit Natura Bendable Sur-Fit Natura Bendable Sur-Fit Natura Bendable Sur-Fit Natura Bendable Sur-Fit Natura Bendable Sur-Fit Natura Closed Sur-Fit Natura Closed Sur-Fit Natura Closed Sur-Fit Natura Closed Sur-Fit Natura Closed Sur-Fit Natura Closed Sur-Fit Natura Closed Sur-Fit Natura Closed Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable

PROD.# 401546 401547 401548 401549 401550 401551 401552 401553 401554 401555 401533 401534 401535 401536 401537 401538 401539 401540 401541 401521 401522 401523 401524 401525 401526 401527 401528 401500 401501 401502 401503 401504 401505 401506 401507 401508 401509 401510 401511 401512 401513 401514 401515 404014 404015 404016 404017 404018 404025 404026 404027 404028

MFR CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON

PIN 95098755 95098754 95098753 95098752 95098751 95098750 95098696 95098695 95098694 95098693 95098692 95098686 95098685 95098684 95098683 95098682 95098691 95098690 95098689 95098688 95098687 95098539 95098538 95098537 95098536 95098535 95098534 95098533 95098743 95098742 95098741 95098740 95098749 95098748 95098747 95098746 95098745 95099854 95099853 95099852 95099851 95099736 95099735 95099734 95099733

PRODUCT DESCRIPTION Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Drainable Sur-Fit Natura Invisiclose Sur-Fit Natura Invisiclose Sur-Fit Natura Invisiclose Sur-Fit Natura Invisiclose Sur-Fit Natura Invisiclose Sur-Fit Natura Invisiclose Sur-Fit Natura Invisiclose Sur-Fit Natura Invisiclose Sur-Fit Natura Invisiclose Sur-Fit Natura Invisiclose Sur-Fit Natura Invisiclose Sur-Fit Natura Invisiclose Sur-Fit Natura Invisiclose Sur-Fit Natura Invisiclose Sur-Fit Natura Invisiclose Sur-Fit Natura Invisiclose Sur-Fit Natura Little Ones Sur-Fit Natura Little Ones Sur-Fit Natura Little Ones Sur-Fit Natura Little Ones Mini Sur-Fit Natura Mini Sur-Fit Natura Mini Sur-Fit Natura Mini Sur-Fit Natura Mini

PROD.# 404029 404030 404031 404032 404033 404034 411263 411264 411265 411266 411267 411288 411289 411290 411291 411292 411489 411490 411491 411492 411493 411309 411310 411311 411312 411360 411361 411362 413311 413312 413313 413314 413332 413333 413334 413335 413336 401927 401928 401929 401930 401529 401530 401531 401532

MFR CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON

ONE-PIECE SYSTEMS 95099977 Active Life Closed-End 95099976 Active Life Closed-End 95099987 Active Life Drainable 95099986 Active Life Drainable

650408 650422 22764 22765

CON CON CON CON

MISCELLANEOUS ­ 11

Ostomy Supplies Benefit List

PIN 95099985 95099984 95099983 95099982 95099981 95098795 95098794 95098792 95098791 95098790 95098789 95098788 95098787 95098786 95098785 95098784 95098783 95099980 95099979 95099978 95098782 95098781 95098780 95098779 95098778 95098777 95098776 95098775 95098774 95098773 95098772 95098771 95098770 95098769 95098768 95098767 95098766 95098765 95099955 95099954 95099953 95099952 95099946 95099945 95099944 95099943 95099857 95099856 95099974 95099973 95099972 95099971

December 2012

PRODUCT DESCRIPTION Active Life Drainable Active Life Drainable Active Life Drainable Active Life Drainable Active Life Drainable Active Life Drainable Active Life Drainable Active Life Drainable Active Life Drainable Active Life Drainable Active Life Drainable Active Life Drainable Active Life Drainable Active Life Drainable Active Life Drainable Active Life Drainable Active Life Drainable Active Life Drainable Active Life Drainable Active Life Drainable Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Dr Durahesive Active Life Durahesive Active Life Durahesive Active Life Durahesive Active Life Durahesive Active Life Little Ones Active Life Little Ones Active Life Pre-Cut Closed Active Life Pre-Cut Closed Active Life Pre-Cut Closed Active Life Pre-Cut Closed

PROD.# 22766 22767 22768 22769 22771 125330 125331 125333 125334 125335 125336 125338 125339 125340 125341 125342 125343 400598 400599 650803 125352 125353 125354 125355 125356 125357 125358 125359 125360 125361 125362 125363 125364 125365 125366 125367 125368 125369 175777 175778 175779 175780 650828 650829 650830 650831 20917 20922 175769 175770 175771 175772

MFR CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON

PIN 95099970 95099969 95099968 95099967 95099966 95099965 95099975 95099940 95099942 95099941 95098991 95098990 95098989 95099064 95098995 95098994 95098993 95098992 95098996 95099007 95098802 95098801 95098800 95098799 95098798 95098797 95099015 95099017 95099012 95099011 95099010 95099009 95098881 95098883 95098880 95098919 95098899 95098918 95098912 95098913 95098911 95098910 95098898 95098908 95098907 95098906 95098905 95098917 95098916 95098895 95098894 95098915

PRODUCT DESCRIPTION Active Life Pre-Cut Closed Active Life Pre-Cut Closed Active Life Pre-Cut Closed Active Life Pre-Cut Closed Active Life Pre-Cut Closed Active Life Pre-Cut Closed Active Life Stoma Cap Active Life Uros Durahesive Active Life Uros Durahesive Active Life Uros Durahesive Assura Drainable Assura Drainable Assura Drainable Assura Drainable Assura Drainable Assura Drainable Assura Drainable Assura Drainable Assura Drainable w Easiclose Assura Drainable w Easiclose Assura Drainable w Easiclose Assura Drainable w Easiclose Assura Drainable w Easiclose Assura Drainable w Easiclose Assura Drainable w Easiclose Assura Drainable w Easiclose Assura E-E Wear Drainable Assura E-E Wear Drainable Assura E-E Wear Drainable Assura E-E Wear Drainable Assura E-E Wear Urostomy Assura E-E Wear Urostomy Assura Pediatric Closed Assura Pediatric Drainable Assura Pediatric Urostomy Assura Std Wear Closed Assura Std Wear Closed Assura Std Wear Closed Assura Std Wear Closed Assura Std Wear Closed Assura Std Wear Closed Assura Std Wear Closed Assura Std Wear Closed Assura Std Wear Closed Assura Std Wear Closed Assura Std Wear Closed Assura Std Wear Closed Assura Std Wear Closed Assura Std Wear Closed Assura Std Wear Closed Assura Std Wear Closed Assura Std Wear Closed

PROD.# 175773 413142 413143 413144 413145 413146 175611 64927 650832 650833 13874 13875 13876 14106 14173 14174 14175 14176 13870 14196 14414 14415 14421 14422 14423 14424 12416 12419 12432 12433 12471 12472 2125 2115 8009 12110 12130 12140 12144 12145 12146 12147 12170 12174 12175 12176 12177 14434 14435 14441 14442 14444

MFR CON CON CON CON CON CON CON CON CON CON COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL

MISCELLANEOUS ­ 12

Ostomy Supplies Benefit List

PIN 95098914 95098903 95098902 95098901 95099006 95099005 95099004 95099003 95099001 95099002 95099000 95098999 95098998 95098997 95098806 95098805 95098804 95098803 95098959 95098962 95098963 95098960 95098931 95098927 95098930 95098929 95098926 95098925 95098924 95098923 95098922 95098921 95098920 95098889 95099022 95099021 95099290 95098119 95098118 95098117 95098116 95098115 95098114 95098113 95098112 95098111 95098110 95098109 95098108 95098107 95098106 95098105

December 2012

PRODUCT DESCRIPTION Assura Std Wear Closed Assura Std Wear Closed Assura Std Wear Closed Assura Std Wear Closed Assura Std Wear Dr Easiclose Assura Std Wear Dr Easiclose Assura Std Wear Dr Easiclose Assura Std Wear Dr Easiclose Assura Std Wear Dr Easiclose Assura Std Wear Dr Easiclose Assura Std Wear Dr Easiclose Assura Std Wear Dr Easiclose Assura Std Wear Dr Easiclose Assura Std Wear Dr Easiclose Assura Std Wear Dr Easiclose Assura Std Wear Dr Easiclose Assura Std Wear Dr Easiclose Assura Std Wear Dr Easiclose Assura Std Wear Drainable Assura Std Wear Drainable Assura Std Wear Drainable Assura Std Wear Drainable Assura Std Wear Urostomy Assura Std Wear Urostomy Assura Std Wear Urostomy Assura Std Wear Urostomy Assura Std Wear Urostomy Assura Std Wear Urostomy Assura Std Wear Urostomy Assura Std Wear Urostomy Assura Std Wear Urostomy Assura Std Wear Urostomy Assura Std Wear Urostomy Assura Stoma Cap Assura Stoma Cap Assura Stoma Cap Contour Stoma Cap Esteem + Closed Pouch Esteem + Closed Pouch Esteem + Closed Pouch Esteem + Closed Pouch Esteem + Closed Pouch Esteem + Closed Pouch Esteem + Closed Pouch Esteem + Closed Pouch Esteem + Closed Pouch Esteem + Closed Pouch Esteem + Closed Pouch Esteem + Closed Pouch Esteem + Closed Pouch Esteem + Closed Pouch Esteem + Closed Pouch

PROD.# 14445 14452 14453 14454 13840 13844 13845 13846 13860 14103 14163 14164 14165 14166 14404 14405 14411 14412 2490 2520 12533 13706 5580 5585 12595 12596 12991 12992 12993 12994 12995 12996 12997 2501 2801 2802 1796 416700 416701 416702 416703 416704 416705 416706 416707 416708 416709 416710 416711 416712 416713 416714

MFR COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL HOL CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON

PIN 95098104 95098103 95098102 95098101 95098100 95098099 95098098 95098097 95098096 95098095 95098094 95098093 95098092 95098091 95098090 95098089 95098088 95098087 95098086 95098084 95098082 95098083 95098081 95098080 95098079 95098078 95099327 95099326 95099322 95099321 95099325 95099323 95099320 95099319 95099318 95099317 95099316 95099315 95099314 95099313 95099312 95099311 95099334 95099333 95099331 95099329 95099328 95099332 95099330 95099354 95099353 95099352

PRODUCT DESCRIPTION Esttem + Closed Pouch Esteem + Drainable Pouch Esteem + Drainable Pouch Esteem + Drainable Pouch Esteem + Drainable Pouch Esteem + Drainable Pouch Esteem + Drainable Pouch Esteem + Drainable Pouch Esteem + Drainable Pouch Esteem + Drainable Pouch Esteem + Drainable Pouch Esteem + Drainable Pouch Esteem + Drainable Pouch Esteem + Closed Pouch Esteem + Closed Pouch Esteem + Closed Pouch Esteem + Closed Pouch Esteem + Closed Pouch Esteem + Closed Pouch Esteem + Drainable Pouch Esteem + Closed Pouch Esteem + Drainable Pouch Esteem + Drainable Pouch Esteem + Drainable Pouch Esteem + Drainable Pouch Esteem + Drainable Pouch First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Closed First Choice Drainable First Choice Drainable First Choice Drainable

PROD.# 416715 416719 416725 416729 416733 416737 416739 416741 416743 416745 416747 416749 416751 416718 416721 416724 416728 416732 416736 416738 416742 416740 416744 416746 416748 416750 3450 3452 3454 3455 3458 3459 3490 3491 3492 3493 3494 3495 3496 3497 3498 3499 3520 3522 3523 3524 3525 3528 3529 3610 3611 3612

MFR CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL

MISCELLANEOUS ­ 13

Ostomy Supplies Benefit List

PIN 95099351 95099350 95099349 95099348 95099347 95099346 95099345 95099362 95099360 95099358 95099356 95099355 95099361 95099359 95099357 95099344 95099343 95099342 95099341 95099340 95099337 95099310 95099309 95099307 95099308 95099304 95099303 95099302 95099301 95099300 95099299 95099298 95099297 95099296 95099295 95099199 95099197 95099195 95099194 95099198 95099196 95099181 95099179 95099177 95099180 95099178 95099174 95099173 95098378 95099171 95099168 95099170

December 2012

PRODUCT DESCRIPTION First Choice Drainable First Choice Drainable First Choice Drainable First Choice Drainable First Choice Drainable First Choice Drainable First Choice Drainable First Choice Drainable First Choice Drainable First Choice Drainable First Choice Drainable First Choice Drainable First Choice Drainable First Choice Drainable First Choice Drainable First Choice Drainable First Choice Drainable First Choice Drainable First Choice Drainable First Choice Drainable First Choice Drainable Kit First Choice Urostomy First Choice Urostomy First Choice Urostomy First Choice Urostomy First Choice Urostomy First Choice Urostomy First Choice Urostomy First Choice Urostomy First Choice Urostomy First Choice Urostomy First Choice Urostomy First Choice Urostomy First Choice Urostomy First Choice Urostomy Kit Hollister Closed Hollister Closed Hollister Closed Hollister Closed Hollister Closed Hollister Closed Lo-Profile Urostomy Lo-Profile Urostomy Lo-Profile Urostomy Lo-Profile Urostomy Lo-Profile Urostomy Pouchkins Pediatric Pouchkins Pediatric Pouchkins Pediatric Pouchkins Pediatric Pouchkins Pediatric Pouchkins Pediatric

PROD.# 3613 3614 3615 3616 3617 3618 3619 3630 3632 3633 3634 3635 3637 3638 3639 3680 3681 3682 3683 3684 3636 1460 1462 1463 1468 1481 1482 1483 1484 1485 1486 1487 1488 1489 1466 3142 3143 3144 3145 3148 3149 1432 1433 1434 1438 1439 3777 3778 3796 9766 9767 9768

MFR HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL

PIN 95099169 95098593 95098592 95098641 95098597 95098596 95098595 95098591 95098590 95099393 95099392 95099391 95099390 95099389 95099388 95099387 95099386 95099385 95099384 95099396 95099395 95099404 95099402 95099400 95099398 95099397 95099403 95099401 95099399 95099411 95099409 95099407 95099405 95099410 95099408 95099406 95099394 95098588 95098586 95098609 95098608 95098607 95098606 95098601 95098600 95098599 95098598 95098661 95098660 95098668 95098667 95098666

PRODUCT DESCRIPTION Pouchkins Pediatric Premier Closed Premier Closed Premier Closed Premier Closed Premier Closed Premier Closed Premier Closed Premier Closed Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Premier Drainable Lock'n Roll Premier Drainable Lock'n Roll Premier Drainable Lock'n Roll Premier Drainable Lock'n Roll Premier Drainable Lock'n Roll Premier Drainable Lock'n Roll Premier Drainable Lock'n Roll Premier Drainable Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll

PROD.# 9769 82100 82125 82300 82325 82330 82335 92130 92135 8610 8611 8612 8613 8614 8615 8616 8617 8618 8619 8624 8628 8631 8632 8633 8634 8635 8637 8638 8639 8641 8642 8643 8644 8647 8648 8649 86211 88300 88700 88325 88330 88335 88340 88725 88730 88735 88740 8504 8508 8510 8511 8512

MFR HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL

MISCELLANEOUS ­ 14

Ostomy Supplies Benefit List

PIN 95098665 95098664 95098663 95098670 95098669 95098681 95098680 95098679 95098678 95098677 95098676 95098675 95098674 95098673 95098672 95098659 95098658 95098657 95098656 95098655 95098654 95098375 95098374 95098373 95098372 95098662 95098371 95098370 95098369 95098368 95098671 95099383 95099381 95099379 95099377 95099382 95099380 95099378 95099376 95099375 95099373 95099372 95099371 95099370 95099369 95099368 95099367 95099366 95099365 95099364 95099374 95099276

December 2012

PRODUCT DESCRIPTION Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Lock'n Roll Premier Urostomy Premier Urostomy Premier Urostomy Premier Urostomy Premier Urostomy Premier Urostomy Premier Urostomy Premier Urostomy Premier Urostomy Premier Urostomy Premier Urostomy Premier Urostomy Premier Urostomy Premier Urostomy Premier Urostomy Premier Urostomy Premier Urostomy Premier Urostomy Premier Urostomy Premier Urostomy Premium Closed

PROD.# 8513 8514 8515 8524 8528 8531 8532 8533 8538 8539 8551 8552 8553 8558 8559 8590 8591 8592 8593 8594 8595 8596 8597 8598 8599 85011 85116 85117 85118 85119 85211 8460 8462 8463 8464 8467 8468 8469 8474 8478 8480 8481 8482 8483 8484 8485 8486 8487 8488 8489 84711 3552

MFR HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL

PIN 95099274 95099272 95099271 95099270 95099275 95099273 95099287 95099285 95099284 95099283 95099288 95099286 95099282 95099280 95099278 95099277 95099281 95099279 95098379 95098458 95098457 95098456 95098455 95098448 95098447 95098446 95098445 95098444 95098443 95098442 95098441 95098460 95098459 95098454 95098453 95098452 95098451 95098450 95098449 95098438 95098437 95098436 95098435 95098434 95098433 95098432 95098431 95098428 95098427 95098426 95098425 95098424

PRODUCT DESCRIPTION Premium Closed Premium Closed Premium Closed Premium Closed Premium Closed Premium Closed Premium Drainable Premium Drainable Premium Drainable Premium Drainable Premium Drainable Premium Drainable Premium Drainable Premium Drainable Premium Drainable Premium Drainable Premium Drainable Premium Drainable Sensura Easiclose Sensura Maxi Closed Sensura Maxi Closed Sensura Maxi Closed Sensura Maxi Closed Sensura Maxi Closed Sensura Maxi Closed Sensura Maxi Closed Sensura Maxi Closed Sensura Maxi Closed Sensura Maxi Closed Sensura Maxi Closed Sensura Maxi Closed Sensura Midi Closed Sensura Midi Closed Sensura Midi Closed Sensura Midi Closed Sensura Midi Closed Sensura Midi Closed Sensura Midi Closed Sensura Midi Closed Sensura Maxi Sensura Maxi Sensura Maxi Sensura Maxi Sensura Maxi Sensura Maxi Sensura Maxi Sensura Maxi Sensura Maxi Sensura Maxi Sensura Maxi Sensura Maxi Sensura Maxi

PROD.# 3553 3554 3555 3556 3558 3559 3603 3604 3605 3606 3608 3609 3662 3663 3664 3665 3668 3669 15821 15405 15406 15407 15408 15470 15472 15473 15474 15480 15482 15483 15484 15403 15404 15412 15413 15414 15415 15441 15450 15521 15522 15523 15524 15531 15532 15533 15534 15605 15606 15607 15608 15632

MFR HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL HOL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL COL

MISCELLANEOUS ­ 15

Ostomy Supplies Benefit List

PIN 95098423 95098422 95098421 95098440 95098439 95098430 95098429 95099185 95099186 PRODUCT DESCRIPTION Sensura Maxi Sensura Maxi Sensura Maxi Sensura Midi Sensura Midi Sensura Midi Sensura Midi Stoma Cap Stoma Cap PROD.# 15633 15634 15635 15501 15511 15603 15604 3184 3186 MFR COL COL COL COL COL COL COL HOL HOL PIN 95098857 95099865 95099160 95099161 95099548 95099547 95099546 95099799 95099795 95099684 95099683 95099682 95099681 95099680 95099679 95099678 95099677 95099766 95099695 95099694 95099693 95099692 PRODUCT DESCRIPTION Drainable Pouch Clamp DuoLock Pouch Closure Irrigator Sleeve w Closure Irrigator Sleeve w Closure New Image Irrigation Sleeve New Image Irrigation Sleeve New Image Irrigation Sleeve Sur-Fit AutoLock Convex Insrt Sur-Fit AutoLock Convex Insrt Sur-Fit Natura Convex Inserts Sur-Fit Natura Convex Inserts Sur-Fit Natura Convex Inserts Sur-Fit Natura Convex Inserts Sur-Fit Natura Convex Inserts Sur-Fit Natura Convex Inserts Sur-Fit Natura Convex Inserts Sur-Fit Natura Convex Inserts Sur-Fit Natura Irrig Closure Sur-Fit Natura Irrig Sleeve Sur-Fit Natura Irrig Sleeve Sur-Fit Natura Irrig Sleeve Sur-Fit Natura Irrig Sleeve PROD.# 9500 175652 7724 7728 18152 18153 18154 401614 401618 404006 404007 404008 404009 404010 404011 404012 404013 175650 401911 401912 401913 401914 MFR COL CON HOL HOL HOL HOL HOL CON CON CON CON CON CON CON CON CON CON CON CON CON CON CON

MISCELLANEOUS 95098862 Assura Irrigation Sleeve 95098861 Assura Irrigation Sleeve 95098860 Assura Irrigation Sleeve 95098859 Assura Irrigation Sleeve 95099426 CenterPointLock Irrig Sleeve 95099425 CenterPointLock Irrig Sleeve 95099424 CenterPointLock Irrig Sleeve 95099423 CenterPointLock Irrig Sleeve 95099427 CenterPointLock Irrig Sleeve 95099163 Cone Irrigator Kit 95099866 ConvaTec Pouch Closure 95099123 Drainable Pouch Clamp

1003 12834 12835 12836 3822 3823 3824 3826 3827 7721 175635 8770

COL COL COL COL HOL HOL HOL HOL HOL HOL CON HOL

December 2012

MISCELLANEOUS ­ 16

Appendix I ­ Abbreviations

Aer Amp Cap CFU Chewtab Cr CD CR DR Drp EC Eff Elx ER FC g Gran IM Inh Inj Ins IR Irr iu IV LA Liq Lot mcg mcl mEq mg mL Aerosol Ampoule Capsule Colony Forming Units Chewable Tablet Cream Controlled Distribution Controlled Release Delayed Release Drops Enteric Coated Effervescent Elixir Extended Release Film Coated Gram Granules Intramuscular Inhaler Injection Insulin Immediate Release Irrigation International Unit Intravenous Long Acting Liquid Lotion Microgram Microliter Milli-equivalent Milligram Milliliter MR Nas Neb OD O/L Oint Oph Otic Pck Pdr PF pkt Pl. Ampule POS Resp RD RPD SL Sod Chl Sol Sp SR Supp Susp Syr Tab TCT UDV USP Vag w/w XL Modified Release Nasal Nebules Orally Disintegrating Oral Liquid Ointment Ophthalmic Ear Package Powder Preservative Free Packet Plastic Ampule Powder for Oral Solution Respirator Rapid Dissolving Rapid Disintegrating Sublingual Sodium Cloride Solution Spray Slow Release Suppository Suspension Syrup Tablet Tincture Unit Dose Vial United States Pharmacopeia Vaginal By Weight Extended Release

December 2012

Appendix I ­ 1

Appendix II ­ Abbreviations of Manufacturers' Names

AAP ABB ACC ACO ACT AGA AHI AKN ALC ALL APX ARO ASL ATL AUR AUT AVD AVP AXC AXS AZE BAX BAY BCH BDD BHC BIG BNM BOE BOM BRI BSH BTD BTX BVL BVT CDX CEL CHU COB COL CON CPD CYI DPT DRX DUI EHS EIS EMD ERF FEI FRS GAC GCH GIL GLE GMD GSK AA Pharma Inc. Abbott Laboratories Ltd. Accel Pharma Inc. Magnum Pharmaceutics Actelion Pharmaceuticals Canada Inc. Amgen Canada Inc. Accord Healthcare Inc. Dioptic Laboratories Alcon Canada Inc. Allergan Inc. Apotex Inc. Auro Pharma Inc Astellas Pharma Canada Inc. Laboratoire Atlas Inc. Aurium Pharma Inc. Auto Control Medical Inc. Alveda Pharma Sanofi Pasteur Limited Arpalis Pharma Canada Inc. Axxess Pharma Inc. AstraZeneca Canada Inc. Baxter Corporation Bayer Inc. Bioniche Inc. Bayer HealthCare, Diabetes Care Division BHC Medical Biogen Idec Canada Inc. Bionime USA Corp Boehringer Ingelheim (Canada) Ltd. Roche Diagnostics, Div.of Hoffmann-LaRoche Bristol-Myers Squibb Canada Inc. Baush & Lomb Canada Inc. Becton Dickinson Canada BTNX Inc Biovail Pharmaceuticals Canada Biovitrum Canderm Pharmaca Inc. Celgene Church and Dwight Canada Corp. Cobalt Pharmaceuticals Company Coloplast Canada ConvaTec Canada Ltd manually compounded Cytex Pharmaceuticals Inc. Dermtek Pharmaceuticals Ltd. Domrex Pharma Inc. Duchesnay Inc. Entra Health Systems Inc Eisai Limited EMD Serono Canada Inc. ERFA Canada Inc. Ferring Inc. Merck Canada Ltd. Galderma Canada Inc. GlaxoSmithKline Consumer Healthcare Inc. Gilead Sciences Inc. Glenwood Laboratories Canada Ltd. GenMed, A Division of Pfizer Canada Inc. GlaxoSmithKline Inc. GZM HLR HLZ HOL HOM HOS HPT IMD IRO JAN JCB JNJ JPC KNG LBK LEO LFS LIL MAR MDS MED MEL MGI MID MJO MMT MNT MOL MPD MRS MSC MYL MVL NBM NEO NGP NNC NNO NVO NVR NYC ODN OMG ORB ORG ORP PAL PDP PER PFI PFR PHL PMS PPB PPC PPH QGT RAN RIV Genzyme Canada Inc. Hoffmann-LaRoche Limited Hill Dermaceuticals, Inc. Hollister Limited Home Diagnostics Inc. Hospira Healthcare Corporation Healthpoint Canada ULC I-Med Pharma Inc. Iroko International LP Janssen-Ortho Inc. Jacobus Pharmaceutical Company Inc. Johnson & Johnson Inc. Jamp Pharma Corporation King Pharma Canada Ltd. Lundbeck Inc. Leo Pharma Inc. Lifescan Canada Ltd. Eli Lilly Canada Inc. Marcan Pharmaceuticals Inc Medicis Canada Ltd. Medican Technologies Inc. Mediapharm Inc. MGI Pharma Inc. Abbott Diabetes Care / Medisense Mead Johnson (Canada) Inc MM Therapeutics Inc. Mint Pharmaceuticals Inc. Molnlycke Health Care Inc. Medical Plastic Devices Inc. Merus Labs Inc. Medisca Pharmaceutique Inc. Mylan Pharmaceuticals ULC. Meda Valeant Pharma Canada Nova Biomedical Neolab Inc. Next Generation Pharma Inc. Novartis Consumer Health Canada Inc. Novo Nordisk Canada Inc. Novartis Ophthalmics Novartis Pharmaceuticals Canada Inc. Nycomed Canada Inc. Odan Laboratories Ltd. Omega Laboratories Ltd. Orbus Pharma Inc. Organon Canada Ltd. Orphan Medical Inc. Paladin Labs Inc. PendoPharm, Division of Pharmascience Inc. Perrigo International Pfizer Canada Inc. Purdue Pharma Pharmel Inc. Pharmascience Inc. Proval Pharma Division of Servier Canada Inc. Pharmaceutical Partners of Canada Inc. Patriot Pharmaceuticals LLC. Sigma-Tau Pharmaceuticals Inc. Ranbaxy Pharmaceuticals Canada Inc. Riva Laboratoire Inc.

Appendix II ­ 1

December 2012

Appendix II ­ Abbreviations of Manufacturers' Names

ROG SAS SAV SCH SDZ SEP SEV SHI SNE SNV SPT STI STR SWS TAK TAR TER TEV THI THR TMI TMP TPH TRB TRI TYC UCB UTC VAL VAR VCO VIV VLH VLN WAM WCH WNC WLS WSQ WTS XPI YNO ZIA ZYM Rougier Pharma, Division of ratiopharm Inc. Sanis Health Inc Sanofi-Aventis Canada Inc. Schering-Plough (Canada) Inc. Sandoz Canada Incorporated Sunovion Pharmaceuticals Canada Inc. Servier Canada Inc. Shire Canada Inc. Smith & Nephew Inc. Sunovion Pharmaceuticals Canada Inc. Septa Pharmaceuticals Inc. Stiefel Canada Inc. SteriMax Inc. Swiss Herbal Remedies Ltd. Takeda Canada Inc. Taro Pharmaceuticals Inc. Tercica Inc. Teva Canada Ltd. Tremblay Harrison Inc. Theramed Corporation Trudell Medical International Teva Neuroscience Canada TaroPharma, Div. of Taro Pharmaceuticals Inc. Tribute Pharma Canada Inc Triton Pharma Inc. Tyco Healthcare UCB Pharma Canada Inc. United Therapeutics Corporation Valeo Pharma Inc. various manufacturers Virco Pharmaceuticals (Canada) Inc. ViiV Health Care Inc. Lundbeck Canada Inc. Valeant Canada Limited Wampole Brands Inc. Wyeth Consumer HealthCare Inc. Warner Chilcott Canada Co Wellspring Pharmaceutical Canada Corp. Westwood Squibb, Div.of Bristol-Myers Squibb Watson Pharma Company Xediton Pharmaceuticals Inc. Bayer Inc., Consumer Care Division Zila Pharmaceuticals Inc. Zymcan Pharmaceuticals Inc.

December 2012

Appendix II ­ 2

Appendix II ­ Abbreviations of Manufacturers' Names

December 2012

Appendix II ­ 3

Appendix III ­ Criteria for Coverage of Exception Status Drugs

Coverage of exception status drugs will be approved according to the following criteria upon review of a prescriber's written request. Included with the Nova Scotia Formulary are forms for Exception Status Drug requests, which may be used to facilitate the approval process. As an alternative to sending a written request to the Pharmacare office, certain exception status drugs have been assigned criteria codes. To allow for on-line payment of these drugs, the criteria code may be provided by the prescriber on the prescription or confirmed by the pharmacist. The use of these codes offers the prescriber and the pharmacist access to immediate coverage for patients who clearly meet the exception status criteria. The criteria codes are indicated within the following exception criteria.

ABATACEPT (Orencia 250mg/vial Injection)

- for patients with a diagnosis of active rheumatoid arthritis (RA) who: · have not responded or who have had intolerable toxicity to an adequate trial1 of combination therapy of at least two traditional DMARDs2 or · if combination therapy is not an option, an adequate trial1 of at least three traditional DMARDs2 in sequence as monotherapy and · patients must have had an adequate trial1 of leflunomide. Exceptions can be considered in cases where leflunomide is contraindicated or not tolerated - therapy must include methotrexate alone or in combination unless contraindicated or not tolerated - written request of a rheumatologist or prescriber with a specialty in rheumatology - coverage will be approved initially for 16 weeks. Can be reassessed for yearly coverage dependent on patient achieving an improvement in symptoms of at least 20%

1 2

An adequate trial is 5 months for IM gold, 6 months for penicillamine, 4 months for hydroxychloroquine and 3 months for all other traditional DMARDs as well as leflunomide, infliximab and etanercept. Traditional agents include methotrexate, IM gold, sulfasalazine, hydroxychloroquine, azathioprine, chloroquine, penicillamine and cyclosporine.

*ABIRATERONE ACETATE (Zytiga 250mg Tablet)

- in combination with prednisone for metastatic castration resistant prostate cancer patients with histologically confirmed prostate cancer, ECOG performance status of 0-2, and progression after previous treatment with docetaxel

ACAMPROSATE (Campral 333mg Tablet)

- for treatment in patients who have been abstinent from alcohol for at least four days and who have contraindications to naltrexone (i.e., acute hepatitis, liver failure or currently receiving opioids)

ADALIMUMAB (Humira 40mg/vial Injection)

- See Anti-Tumor Necrosis Factor (TNF) Agents

ADEFOVIR DIPIVOXIL (Hepsera 10mg Tablet)

- in combination with lamivudine in patients who: · have developed failure to lamivudine (increase in HBV DNA of 1 log10iu/mL over the nadir measured on two separate occasions within an interval of at least one month, after the first 3 months of lamivudine therapy) AND · when failure to lamivudine is not due to poor adherence to therapy - coverage approved for 1 year

*ALENDRONATE (Fosamax 10mg, 40mg, 70mg Tablet and generic brands)

- for the treatment of osteoporosis associated with documented fragility fracture - for the treatment of osteoporosis without documented fracture when the patient is at high 10 year fracture risk (>20%) as indicated by the radiologist on a bone mineral density (BMD) report - as prophylaxis of corticosteroid induced osteoporosis in a patient who will be or has been on oral prednisone therapy for 3 months - for the treatment of Paget's disease of bone (6 month limit) - other requests reviewed on a case by case basis

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 1

ALENDRONATE, VITAMIN D3 (Fosavance 70mg/5600IU)

- for the treatment of osteoporosis associated with documented fragility fracture - for the treatment of osteoporosis without documented fracture when the patient is at high 10 year fracture risk (>20%) as indicated by the radiologist on a bone mineral density (BMD) report - as prophylaxis of corticosteroid induced osteoporosis in a patient who will be or has been on oral prednisone therapy for 3 months

ALGLUCOSIDASE ALFA (Myozyme 50mg Powder for Injection)

- for the treatment of infantile onset Pompe disease in patients who have had the onset of symptoms and confirmed cardiomyopathy before the age of 12 months AND - participation in the long-term evaluation of the efficacy of treatment by periodic medical assessment as outlined in the monitoring of therapy guidelines - initial approval is for 6 months. Continued coverage will be based on evaluation of the efficacy of treatment by regular medical assessment as outlined in the monitoring and discontinuation of therapy guidelines (available from the Pharmacare Office upon request).

ALLERGEN IMMUNOTHERAPY (Allergy Serum, Pollinex-R Injection)

- for immunotherapy with specific, standardized allergenic material, administered in high-dose schedules for carefully selected patients with a diagnosis of: · IgE mediated anaphylactic reactions to insect stings or · severe, seasonal (lasting two or more years) or perennial IgE dependent allergic rhinoconjunctivitis when optimal drug therapy and allergen avoidance have not been sufficiently effective in controlling symptoms or · IgE mediated allergic asthma, specifically where there is a clear temporal association between exposure and signs and symptoms of asthma and when optimal drug therapy and avoidance measures have not been sufficiently effective in controlling symptoms NOTE: The allergy serum must be dispensed from a pharmacy on prescription from a prescriber. Initial authorization is for two years, and can be continued for up to five years if improvement is noted.

ALMOTRIPTAN (Axert 6.25mg, 12.5mg Tablet)

- See Selective 5HT1 - Receptor Agonists

*ALTRETAMINE (Hexalen 50mg Capsule)

- written request from an oncologist or prescriber with a specialty in oncology - for the treatment of ovarian carcinoma

AMBRISENTAN (Volibris 5mg, 10mg Tablet)

- for the treatment of patients with at least Class III pulmonary arterial hypertension (PAH), either idiopathic or associated with connective tissue disease who have failed therapy with sildenafil or who have contraindications to sildenafil. - diagnosis must be confirmed by right heart catheterization - request must be from a PAH specialist

ANAGRELIDE (Agrylin 0.5mg Capsule and generic brands)

Nova Scotia Seniors' Pharmacare Program: - for the treatment of essential thrombocythemia (ET) in patients who have: · failed hydroxyurea therapy (does not provide sufficient platelet reduction) or · intolerable side effects from hydroxyurea therapy Community Services Pharmacare Programs: - for the treatment of essential thrombocythemia (ET) as an alternative to hydroxyurea

ANTI-TUMOR NECROSIS FACTOR (TNF) AGENTS (Adalimumab, Etanercept, Golimumab, Infliximab)

Ankylosing Spondylitis (Adalimumab, Etanercept, Golimumab, Infliximab) - for the treatment of patients with moderate to severe ankylosing spondylitis (e.g., Bath AS Disease Activity Index (BASDAI) score 4 on 10 point scale) who: · have axial symptoms** and who have failed to respond to the sequential use of at least 2 NSAIDs at the optimum dose for a minimum period of 3 months observation, or in whom NSAIDs are contraindicated OR

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 3

· have peripheral symptoms and who have failed to respond to, or have contraindications to, the sequential use of at least 2 NSAIDs at the optimum dose for a minimum period of 3 months observation and have had an inadequate response to an optimal dose or maximal tolerated dose of a DMARD · must be prescribed by a rheumatologist or prescriber with a specialty in rheumatology · requests for renewal must include information showing the beneficial effects of the treatment, specifically: - a decrease of at least 2 points on the BASDAI scale, compared with the pre-treatment score; OR - patient and expert opinion of an adequate clinical response as indicated by a significant functional improvement (measured by outcomes such as HAQ or "ability to return to work") ** Patients with recurrent uveitis (2 or more episodes within 12 months) as a complication of axial disease, do not require a trial of 2 NSAIDs. Initial Coverage Duration and Maximum Dosage approved: Adalimumab - initial period 6 months, maximum dose of 40mg every two weeks and not in combination with other anti-TNF agents Etanercept - initial period 6 months, maximum dose of 50mg per week and not in combination with other anti-TNF agents Golimumab - initial period 16 weeks, maximum dose 50mg per month and not in combination with other anti-TNF agents Infliximab - initial coverage period 6 months, maximum dose 5mg/kg at 0, 2, and 6 weeks then every 6-8 weeks thereafter and not in combination with other anti-TNF agents Crohn's Disease (Adalimumab) - for patients with moderate to severely active Crohn's disease and are: · refractory or have contraindications to an adequate course of 5-aminosalicylic acid and corticosteroids and other immunosuppressive therapy · initial reimbursement is restricted to an induction dose of 150mg followed by 80mg · clinical response to be assessed twelve weeks after the first induction dose and maintenance therapy approved in responders only at a dose not exceeding 40mg every two weeks Crohn's Disease (Infliximab) - for treatment of Crohn's disease in adults, when prescribed by a gastroenterologist or physician with a specialty in gastroenterology: · in patients with moderate to severe active disease refractory to 5-ASA products AND glucocorticoids (e.g., prednisone) AND immunosuppressive therapy (azathioprine or 6-mercaptopurine or methotrexate)**. Initial approval of infliximab will be for a single infusion of 5mg/kg/dose. A second infusion may be warranted in patients not responding to the first infusion or in patients responding initially but then worsening before maintenance therapy is effective. Request for approval beyond induction therapy will be considered on a case by case basis · in patients with fistulizing disease who have actively draining perianal or enterocutaneous fistula(e) that have recurred or persisted despite a course of appropriate antibiotic therapy (e.g., metronidazole +/-ciprofloxacin for a minimum of 3 weeks) AND immunosuppressive therapy (azathioprine or 6-mercaptopurine or methotrexate)**. Initial approval is for three infusions of infliximab of 5mg/kg/dose at 0, 2 and 6 week intervals ** Patients who are very ill and not candidates for surgery may qualify for infliximab therapy without a trial of AZA, 6-MP or MTX, as they may require a more rapid onset of response. Juvenile Rheumatoid Arthritis (Etanercept) - for the treatment of moderate to severely active, polyarticular juvenile rheumatoid arthritis in children (age 4-17) who have not responded to adequate treatment with one or more DMARDs for at least 3 months or have intolerance to DMARDs, and do not have a contraindication to etanercept Psoriasis (Adalimumab, Etanercept, Infliximab) - for patients with severe, debilitating chronic plaque psoriasis (PsO) who meet all of the following criteria: · Body Surface Area (BSA) involvement of >10% and/or significant involvement of the face, hands, feet or genital region · failure to respond to, contraindications to or intolerant of methotrexate and cyclosporine · failure to respond to, intolerant of or unable to access phototherapy - written request of a dermatologist or prescriber with a specialty in dermatology

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 4

- continued coverage is dependent on evidence of improvement, specifically: · 75% reduction in the Psoriasis Area and Severity Index (PASI) score, or · 50% reduction in PASI with a 5 point improvement in DLQI (Dermatology Life Quality Index), or · significant reduction in BSA involved, with consideration of important regions such as the face, hands, feet or genitals - concurrent use of biologics not approved Initial duration and maximum dosage approved: Adalimumab - initial approval for a maximum of 16 weeks - maximum dosage for ongoing coverage is 40mg every two weeks Etanercept - initial approval for a maximum of 12 weeks - maximum dosage approved: 50mg biweekly for the initial 12 weeks then 50mg weekly thereafter Infliximab - initial approval for a maximum of 12 weeks - dosage restricted to infliximab 5mg/kg 0, 2 and 6 weeks then every 8 weeks Psoriatic Arthritis (Adalimumab, Golimumab) - for patients with active psoriatic arthritis who meet all of the following: · have at least three active and tender joints · have not responded to an adequate trial with two DMARDs or have an intolerance or contraindication to DMARDs · not used in combination with other TNF antagonists - written request of a rheumatologist or prescriber with a specialty in rheumatology - after initial coverage period, can be reassessed for yearly coverage dependent on patient achieving an improvement in symptoms of at least 20% Initial Coverage Duration and Maximum Dosage approved: Adalimumab - initial period 3 months, maximum dose of 40mg every two weeks Golimumab - initial period 3 months, maximum dose 50mg per month Psoriatic Arthritis (Etanercept) - for the treatment of active psoriatic arthritis in patients who have not responded to an adequate trial with two DMARDs or who have an intolerance or contraindication to DMARDs - written request of a rheumatologist or prescriber with a specialty in rheumatology - coverage will be approved initially for 3 months. Can be reassessed for yearly coverage dependent on patient achieving an improvement in symptoms of at least 20% Rheumatoid Arthritis (Adalimumab, Etanercept, Golimumab, Infliximab) - for patients with a diagnosis of active rheumatoid arthritis (RA) who: · have not responded or who have had intolerable toxicity to an adequate trial1 of combination therapy of at least two traditional DMARDs2 or · if combination therapy is not an option, an adequate trial1 of at least three traditional DMARDs2 in sequence as monotherapy and · patients must have had an adequate trial1 of leflunomide. Exceptions can be considered in cases where leflunomide is contraindicated or not tolerated - therapy must include methotrexate alone or in combination unless contraindicated or not tolerated - written request of a rheumatologist or prescriber with a specialty in rheumatology - after initial coverage period, can be reassessed for yearly coverage dependent on patient achieving an improvement in symptoms of at least 20% Initial Coverage Duration and Maximum Dosage approved: Adalimumab - initial coverage period 6 months, maximum dose of 40mg every two weeks Etanercept - initial coverage period 6 months Golimumab - initial coverage period 16 weeks, maximum dose 50mg per month Infliximab - initial coverage period 6 months

1

An adequate trial is 5 months for IM gold, 6 months for penicillamine, 4 months for hydroxychloroquine and 3 months for all other traditional DMARDs as well as leflunomide, infliximab and etanercept. 2 Traditional agents include methotrexate, IM gold, sulfasalazine, hydroxychloroquine, azathioprine, chloroquine, penicillamine and cyclosporine. *Please note that the concurrent use of anti-TNF agents will not be approved.

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 5

*APREPITANT (Emend 80mg, 125mg Capsule and Tri-Pack Capsule)

- in combination with a 5-HT3 antagonist and dexamethasone in adult cancer patients treated with chemotherapy that includes cisplatin as a single day therapy greater than or equal to () 70mg/m2 to prevent acute and delayed nausea and vomiting. · aprepitant will only be used with single day cisplatin-based therapy 70mg/m2 (and not multiple day cisplatin chemotherapy) · aprepitant will not be used in patients receiving moderately emetogenic cancer chemotherapy or radiotherapy · the 5-HT3 antagonist should only be used on the first day of cisplatin therapy with aprepitant continuing on Day 2 and Day 3

ARIPIPRAZOLE (Abilify 2mg, 5mg, 10mg, 15mg, 20mg and 30mg Tablet)

- for the treatment of schizophrenia and schizoaffective disorders in patients who have a contraindication to quetiapine and risperidone, or have failed a trial of quetiapine and risperidone due to intolerance or lack of response

ARTIFICIAL TEARS, PRESERVATIVE FREE (Celluvisc, Refresh, Refresh Plus, Refresh Tears, Tears Naturale Free)

- for patients with a diagnosis of dry eye requiring frequent daily doses of artificial tears, to prevent sensitivity to preservatives or in patients in whom preservative sensitivity is suspected - written request from an ophthalmologist or optometrist confirming the diagnosis will be required to initiate coverage

ASENAPINE (Saphris 5mg and 10mg SL Tab)

- for the acute treatment of manic or mixed episodes associated with bipolar I disorder as either: · monotherapy, after a trial of lithium or divalproex sodium has failed, and trials of less expensive atypical antipsychotic agents have failed due to intolerance or lack of response · co-therapy with lithium or divalproex sodium, after trials of less expensive atypical antipsychotic agents have failed due to intolerance or lack of response

*AZITHROMYCIN (Zithromax POS 100mg/5mL, 200mg/5mL and 250mg, 600mg Tablet and generic brands)

- for the treatment of pneumonia in clients over 65 years of age [Criteria Code 65] - for the treatment of infections requiring a macrolide (including community acquired pneumonia in patients < 65 years of age) when there is documented intolerance to erythromycin [Criteria Code 02] - for the treatment of infections when alternatives are not available due to documented patient allergies [Criteria Code 03] - for the treatment of infections when alternatives are not available due to serious intolerance to other agents [Criteria Code 04] - for the treatment of chlamydia trachomatis as a single dose of 1g (4 tablets) [Criteria Code 05] - for the prevention of mycobacterium avium complex (MAC) [Criteria Code 06] - for the treatment of infections requiring a macrolide antibiotic when the patient is taking medications that would interact with erythromycin [Criteria Code 07] - for the treatment of moderate to severe exacerbations of chronic bronchitis [Criteria Code 08]

*BENZYDAMINE HCL (Tantum 0.15% Oral Rinse and generic brands)

- for oncology patients only

BETAHISTINE (Serc 16mg, 24mg Tablet and generic brands)

- for the symptomatic treatment of recurrent episodes of vertigo associated with Meniere's disease

BETAMETHASONE, CALCIPOTRIOL (Dovobet 0.5mg/g/50mcg/g Gel)

- for the treatment of scalp psoriasis after: · failure of a topical steroid · the use of a topical steroid and calcipotriol together as single agents

BOCEPREVIR (Victrelis 200mg Capsule) BOCEPREVIR/RIBAVIRIN PEGINTERFERON ALFA-2B (Victrelis Triple Injection/Capsule)

- for the treatment of chronic hepatitis C genotype 1 infection in combination with peginterferon alpha/ribavirin (PegIFN/RBV), if the following criteria are met:

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 6

· detectable levels of hepatitis C virus (HCV) RNA prior to treatment · fibrosis stage of F2, F3, or F4 as determined by a biopsy/fibroscan where available OR recommendation of a hepatologist or a prescriber with a specialty in hepatitis · patient not co-infected with HIV · one course of treatment only (up to 44 weeks duration)

BOSENTAN (Tracleer 62.5mg, 125mg Tablet and generic brands)

- written initial request from a pulmonary arterial hypertension (PAH) specialist only - diagnosis of PAH should be confirmed by right heart catheterization - IPAH (functional class III and IV) · for the treatment of patients with World Health Organization (WHO) functional class III and IV idiopathic pulmonary arterial hypertension (IPAH) who do not demonstrate vasoreactivity on testing or who do demonstrate vasoreactivity on testing but fail a trial of calcium channel blockers (CCB) or are intolerant to CCB - PAH secondary to scleroderma, congenital heart disease or HIV (functional class III and IV) · for the treatment of patients with World Health Organization (WHO) functional class III and IV pulmonary arterial hypertension (PAH) associated with scleroderma, congenital heart disease or HIV who do not respond to conventional therapy

BUDESONIDE (Pulmicort Nebuamps 0.125mg/mL, 0.25mg/mL, 0.5mg/mL Suspension)

- See Wet Nebulization Solutions

BUPRENORPHINE AND NALOXONE (Suboxone 2mg/0.5mg, 8mg/2mg Sublingual Tablet)

- for the treatment of opioid dependence for patients in whom methadone is contraindicated (e.g., patients at high risk of, or with, QT prolongation, or hypersensitivity to methadone) - must be prescribed by a physician licensed to prescribe methadone for opioid dependence

BUTORPHANOL (10mg/mL Nasal Spray and generic brands)

- for the treatment of migraine, upon the request of a neurologist, prescriber with a specialty in neurology or a specialist in pain management, when conventional forms of therapy are ineffective or inappropriate

CABERGOLINE (Dostinex 0.5mg Tablet and generic brands)

- for the treatment of micro- or macro-adenoma of the pituitary after failure of bromocriptine (as determined by prolactin levels) or if bromocriptine is not tolerated

CALCIPOTRIOL (Dovonex 50mcg/g Ointment, Cream and 50mcg/mL Scalp Solution)

- for the treatment of psoriasis when conventional therapies have been ineffective or inappropriate

*CALCITONIN, INTRANASAL (Miacalcin 200iu Nasal Spray and generic brands)

- for the treatment of osteoporosis associated with documented fragility fracture when alendronate, risedronate and raloxifene are not tolerated or are contraindicated - for the treatment of osteoporosis without documented fracture when patient is at high 10 year fracture risk (using fracture risk tables) and alendronate, risedronate and raloxifene are not tolerated or are contraindicated - for the treatment of pain associated with osteoporotic fragility fractures, bone metastases or pathological fractures (short term up to 3 months) [Criteria Code 90] - other requests reviewed on a case by case basis

*CAPECITABINE (Xeloda 150mg and 500mg Tablet)

- requests must be from an oncologist or a prescriber with a specialty in oncology Neo-Adjuvant and Adjuvant ­ Colon and Rectal Cancer - neo-adjuvant treatment of stage II or stage III rectal cancer as a single agent prior to radiotherapy and/or concurrent with radiotherapy - adjuvant treatment of stage II or stage III rectal cancer as a single agent and/or concurrent with radiotherapy - adjuvant treatment of stage III colon cancer as a single agent

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 7

- adjuvant treatment of stage III colon or rectal cancer as part of the XELOX (CAPOX) regimen as an alternative to infusional 5-FU in the FOLFOX regimen - coverage approved for 6 months, to be renewed as required Metastatic Colorectal Cancer - first line single agent as an alternative to combination chemotherapy - alternative to the infusional 5-FU in the FOLFOX regimen as part of the XELOX (CAPOX) regimen - coverage approved for 3 months, to be renewed as required Advanced or Metastatic Breast Cancer (MBC) - as a single agent or in combination with HER2 directed therapy (e.g. lapatinib or trastuzumab) as one line of therapy in patients with advanced or metastatic breast cancer (MBC) who have an ECOG performance status of 0-2. For any one patient, a capecitabine-based regimen may only be used as one line of therapy for the treatment of MBC - coverage approved for 3 months, to be renewed as required

CARVEDILOL (Coreg 3.125mg, 6.25mg, 12.5mg, 25mg Tablet and generic brands)

- for the treatment of stable symptomatic heart failure with systolic dysfunction (i.e., left ventricular ejection fraction (LVEF) less than or equal to 40%)

CETIRIZINE (Reactine 5mg, 10mg Tablet and generic brands)

- for chronic urticaria, defined as the presence of hives or lesions for longer than six weeks, which has responded to treatment with cetirizine

CHOLINESTERASE INHIBITORS (ChEI) (Donepezil, Galantamine, Rivastigmine)

- for the treatment of mild to moderate probable Alzheimer's disease or possible Alzheimer's disease with vascular component, with Lewy bodies who meet the following criteria: · a Mini-Mental State Examination (MMSE) score of 10 to 30 AND · a Functional Assessment Staging Test (FAST) score of 4 to 5 - initial requests for reimbursement will be considered for a maximum 4 month approval; subsequent requests may be considered for a maximum 12 month approval. Requests to switch from one agent in the class to another will not be considered beyond the initial 4 month approval

CIPROFLOXACIN, OPHTHALMIC (Ciloxan 0.3% Ophthalmic Solution and generic brands and Ointment)

- See Fluoroquinolones, Ophthalmic

*CIPROFLOXACIN, ORAL (Cipro 100mg/mL Oral Liquid and 250mg, 500mg, 750mg Tablet and generic brands)

- See Fluoroquinolones, Oral

*CIPROFLOXACIN XL, ORAL (Cipro XL 1000mg Tablet)

- for the oral treatment of gram-negative infections in complicated urinary tract infections, for which other oral agents are not effective or available [Criteria Code 10] - for the oral treatment of acute uncomplicated pyelonephritis [Criteria Code 11]

CIPROFLOXACIN & DEXAMETHASONE, OTIC (Ciprodex Otic Suspension)

- for the treatment of patients with acute otitis media with otorrhea through tympanostomy tubes [Criteria Code 01] - for the treatment of patients with acute otitis externa in the presence of a tympanostomy tube or known perforation of the tympanic membrane [Criteria Code 02]

*CLARITHROMYCIN (Biaxin 250mg, 500mg, XL 500mg Tablet, generic brands and 125mg/5mL, 250mg/5mL Oral Liquid)

- for the treatment of pneumonia in clients over 65 years of age [Criteria Code 65] - for the treatment of infections requiring a macrolide (including community acquired pneumonia in patients <65 years of age) when there is a documented intolerance to erythromycin [Criteria Code 02] - for the treatment of infections when alternatives are not available due to documented patient allergies [Criteria Code 03] - for the treatment of infections when alternatives are not available due to serious intolerance to other agents [Criteria

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 8

Code 04] - for the eradication of Helicobacter pylori infections when used in combination regimens for the treatment of peptic ulcer disease for a one week duration [Criteria Code 12] - for the prevention and treatment of mycobacterium avium complex (MAC) [Criteria Code 06] - for the treatment of moderate to severe exacerbations of chronic bronchitis [Criteria Code 07]

CLOPIDOGREL (Plavix 75mg Tablet and generic brands)

- for the secondary prevention of the following vascular ischemic events in patients with a history of symptomatic atherosclerotic disease, including: · ischemic stroke/ transient ischemic attack (TIA) in patients with a documented severe allergy to ASA or who experience a recurrent thrombotic event (stroke, symptoms of TIA) while taking ASA or a GI hemorrhage while on ASA, · myocardial infarction (MI) in patients with a documented severe allergy to ASA or who experience a GI hemorrhage while on ASA, · peripheral vascular disease (PVD) in patients with a documented severe allergy to ASA or who experience a GI hemorrhage while on ASA, · unstable angina in patients with a documented severe allergy to ASA or who experience a GI hemorrhage while on ASA - in patients with intravascular stent implantation, the coverage period following insertion is: Bare Metal Stent(s) (BMS) - 30 days Drug Eluting Stent(s) (DES) - 12 months NOTE: The [Criteria Code 30] may be used for the initial 30 days coverage period for all types of intravascular stent implantation. For coverage beyond the initial 30 day online approval a written request from the prescriber is required. - for patients with non-ST-segment elevation acute coronary syndrome (ACS) (i.e., unstable angina or non-ST-segment elevation myocardial infarction), in combination with ASA, for a coverage period of 3 months coverage. Coverage for 12 months is available for high risk patients: · with a second ACS within 12 months, or · with complex or extensive coronary artery disease (CAD) e.g., diffuse 3 vessel CAD not amenable to revascularization, or · who have had a previous stroke, TIA or have symptomatic PVD - other requests on a case by case basis

CLOSTRIDIUM BOTULINUM TOXIN TYPE A (Botox 50iu/vial and 100iu/vial Injection)

- for the treatment of the following Health Canada approved indications: · focal spasticity following stroke in adults · equinus foot deformity in cerebral palsy patients 2 years of age and older · cervical dystonia · blepharospasm, hemifacial spasm (VII nerve disorder) or strabismus in patients 12 years of age and older

CLOSTRIDIUM BOTULINUM TYPE A (Xeomin 100u/vial)

- for the treatment of blepharospasm and cervical dystonia (spasmodic torticollis)

*CODEINE, SUSTAINED RELEASE (Codeine Contin 50mg, 100mg, 150mg and 200mg Tablet)

- for the treatment of mild to moderate chronic pain syndrome, if pain has been controlled by doses less than 200mg q12h - patients may be considered candidates if they are achieving good pain control from immediate-release plain codeine preparations but prefer the convenience of a long-acting preparation, or if they are achieving good pain control from acetaminophen or ASA plus codeine preparations but are limited by the acetaminophen content to no greater than 12 tablets per day - not insured for the treatment of acute pain (e.g., post-operative pain)

CROMOGLYCATE SODIUM (pms-Sodium Cromoglycate1% Nebulizer Solution)

- See Wet Nebulization Solutions

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 9

*CYANOCOBALAMIN, INJECTION (Cyanocobalamin, Vitamin B12 100mcg/mL and 1000mcg/mL Injection)

- for the treatment of documented cyanocobalamin deficiency, when the oral route is inappropriate or contraindicated (criteria applies to all Programs)

- for the treatment of documented cyanocobalamin deficiency in recipients of the Community Services Pharmacare Program, Family Pharmacare Program and Drug Assistance for Cancer Patients; oral cyanocobalamin is fully insured for Seniors' Pharmacare Program

*CYANOCOBALAMIN, ORAL (Vitamin B12 500mcg and 1,000mcg Tablet)

*CYANOCOBALAMIN, ORAL IN COMBINATION (Vitamin B12 1000mcg SL Tablet with Folic Acid)

- for the treatment of documented cyanocobalamin deficiency in recipients of the Community Services Pharmacare Program, Family Pharmacare Program and Drug Assistance for Cancer Patients; oral cyanocobalamin is fully insured for Seniors' Pharmacare Program

CYCLOSPORINE (Neoral 10mg, 25mg, 50mg, 100mg Capsule and 100mg/mL Oral Liquid and generic brands)

- for the treatment of severe psoriasis - for the treatment of severe rheumatoid arthritis

DABIGATRAN (Pradax 110mg and 150mg Capsule)

- Inclusion Criteria: At-risk1 patients with non-valvular atrial fibrillation (AF) who require dabigatran for the prevention of stroke and systemic embolism AND in whom: · anticoagulation is inadequate2 following a reasonable trial3 on warfarin; OR · anticoagulation with warfarin is contraindicated or not possible due to inability to regularly monitor via International Normalized Ratio (INR) testing (i.e. no access to INR testing services at a laboratory, clinic, pharmacy, and at home) - Exclusion Criteria: Patients with impaired renal function4 (creatinine clearance or estimated glomerular filtration rate < 30mL/min) OR 75 years of age and without documented stable renal function5 OR hemodynamically significant rheumatic valvular heart disease6, especially mitral stenosis; OR prosthetic heart valves. *Please Note: Patients starting dabigatran should have ready access to appropriate medical services to manage a major bleeding event. At risk patients with non valvular atrial fibrillation are defined as those with a CHADS2 score of 1. Inadequate anticoagulation is defined as INR testing results that are outside the desired INR range for at least 35% of the tests during the monitoring period (i.e. adequate anticoagulation is defined as INR test results that are within the desired INR range for at least 65% of the tests during the monitoring period). 3 A reasonable trial on warfarin is defined as at least two months of therapy. 4 Since renal impairment can increase bleeding risk, renal function should be regularly monitored. Other factors that increase bleeding risk should also be assessed and monitored (see Pradax® (dabigatran) Product Monograph). 5 Documented stable renal function is defined as creatinine clearance or estimated glomerular filtration rate that is maintained for at least three months (i.e. 30-49mL/min for 110mg twice daily dosing or 50 mL/min for 150 mg twice daily dosing). 6 There is currently no data to support that dabigatran provides adequate anticoagulation in patients with rheumatic valvular disease or those with prosthetic heart valves, so dabigatran is not recommended in these populations.

2 1

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 10

*DARBEPOETIN (Aranesp Syringe Injection)

- for the treatment of transfusion dependent patients with hematologic malignancies who have a baseline anemia of 90g/L and whose transfusion requirements are 2 units of packed red blood cells per month over 3 months - initial approval for 12 weeks with the documentation of dose, hemoglobin and therapeutic outcome (number of transfusions) - approval of further 12 week cycles are dependent on evidence of satisfactory clinical response or reduced treatment requirement to less than 2 units of PRBC monthly NOTE: Specialized request forms are used to request coverage for darbepoetin.

DARIFENACIN (Enablex 7.5mg, 15mg Tablet)

- for the treatment of over-active bladder (not stress incontinence) for patients who cannot tolerate or have insufficient response to an adequate trial of immediate relase oxybutynin (e.g. 3 months) - a three month trial will be approved initially with assessment of the effectiveness of this therapy required if further coverage is considered

*DASATINIB (Sprycel 20mg, 50mg, 70mg Tablet)

- as a single agent for the treatment of adults with chronic, accelerated or blast phase chronic myelogenous leukemia (CML) and Philadelphia chromosome acute lymphoblastic leukemia (Ph ALL) with resistance or intolerance to prior therapy including imatinib - coverage approved for 6 months

DEFERASIROX (Exjade 125mg, 250mg, 500mg Tablet for Suspension)

- for the treatment of patients who require iron chelation and deferoxamine is contraindicated

*DENOSUMAB (Prolia 60mg/mL Pre-filled syringe)

- for women with postmenopausal osteoporosis for whom bisphosphonates are contraindicated due to hypersensitivity or abnormalities of the esophagus (e.g., esophageal stricture or achalasia) and have at least two of the following: · age >75 years · a prior fragility fracture · a bone mineral density (BMD) T-score -2.5

*DENOSUMAB (Xgeva 120mg/1.7mL Solution)

- as a single agent for the prevention of skeletal related events (SREs) for metastatic castrate resistant prostate cancer (CRPC) patients with one or more documented bone metastases and ECOG performance status (PS) 0-2

DIENOGEST (Visanne 2mg Tablet)

- for the management of pelvic pain associated with endometriosis in patients for whom one or more less costly hormonal options are either ineffective or cannot be used

DIPYRIDAMOLE & ASA (Aggrenox 200/25mg Capsule)

- for the secondary prevention of ischemic stroke/transient ischemic attack (TIA) in patients who have experienced a recurrent thrombotic event (stroke, symptoms of TIA) while taking ASA

*DOLASETRON (Anzemet 50mg, 100mg Tablet)

- See Serotonin (5-HT3) Antagonists Recommended dose is 100mg orally 1 hour pre-chemotherapy.

DONEPEZIL (Aricept 5mg, 10mg Tablet)

- See Cholinesterase Inhibitors (ChEI)

*DRONABINOL (Marinol 2.5mg, 5mg Capsule)

- for the treatment of severe nausea and vomiting associated with cancer chemotherapy in patients who have failed a traditional stepwise approach to antiemetic therapy - for second line treatment of acquired immune deficiency syndrome (AIDS)-related anorexia associated with weight loss

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 11

DULOXETINE (Cymbalta 30mg, 60mg Capsule)

- for the treatment of neuropathic pain in diabetic patients who are unresponsive to adequate courses of two alternative agents, such as tricyclic antidepressants and anticonvulsants - dose limited to a maximum of 60mg per day

ENTACAPONE (Comtan 200mg Tablet)

- for the treatment of Parkinson's disease as adjunctive therapy in patients who are not well controlled and are experiencing significant "wearing off" symptoms despite optimal therapy with a levodopa and a decarboxylase inhibitor

ENTECAVIR (Baraclude 0.5mg Tablet)

- for the treatment of chronic hepatitis B infection in patients with: · documented cirrhosis on radiologic or histologic grounds AND · a HBV DNA concentration above 2000iu/mL

EPINEPHRINE (Epipen 1:1000, Epipen Jr. 1:2000 Injection and Twinject 0.15mg, 0.3mg Auto-Injector)

- for the emergency treatment of anaphylactic reactions, when out of reach of immediate medical attention NOTE : Regular benefit, but with a quantity limit of two injections per fiscal year. Additional units require an exception status request.

*ERLOTINIB (Tarceva 100mg, 150mg Tablet)

- as monotherapy for the treatment of patients with locally advanced or metastatic Non-Small Cell Lung Cancer (NSCLC) after failure of at least one prior chemotherapy regimen and whose EGFR expression status is positive or unknown - coverage approved for 6 months

*ERYTHROPOIETIN (Eprex Multidose Vial and Syringe Injection)

- for the treatment of transfusion dependent patients with hematologic malignancies who have a baseline anemia of 90g/L and whose transfusion requirements are 2 units of packed red blood cells per month over 3 months - initial approval for 12 weeks with the documentation of dose, hemoglobin and therapeutic outcome (number of transfusions) - approval of further 12 week cycles are dependent on evidence of satisfactory clinical response or reduced treatment requirement to less than 2 units of PRBC monthly - if transfusion requirements increase to 2 units/ month (over a 3 month period), one dose increase may be attempted (maximum dose 60,000iu per week) NOTE: Specialized request forms are used to request coverage for erythropoietin.

*ESTRADIOL (Climara, Estraderm, Estradot Transdermal Patch, Estrogel Topical Gel and generic brands) *ESTRADIOL/NORETHINDRONE ACETATE (Estalis Transdermal Patch)

- for the treatment of menopausal symptoms in women who cannot tolerate the oral forms of hormone replacement therapy

ETANERCEPT (Enbrel 25mg Powder For Injection and 50mg/Ml Injection)

- See Anti-Tumor Necrosis Factor (TNF) Agents

*ETIDRONATE (200mg Tablet, generic brands) *ETIDRONATE AND CALCIUM (Didrocal Kit and generic brands)

- for the treatment of osteoporosis associated with documented fragility fracture when alendronate, risedronate and raloxifene are not tolerated or are contraindicated - for the treatment of osteoporosis without documented fragility fracture when the patient is at a high 10 year fracture risk (>20% major osteoporotic fracture over 10 years) as indicated by the radiologist on a BMD report, and alendronate, risedronate and raloxifene are not tolerated or are contraindicated - other requests reviewed on a case by case basis

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 12

*EVEROLIMUS (Afinitor 2.5mg, 5mg, and 10mg Tablet)

- as a single agent for metastatic renal cell carcinoma (RCC) patients with documented clear cell histology who have a Karnofsky performance status 70% or higher after progression or intolerance to the VEGF multi-targeted tyrosine kinase inhibitors (TKIs), (e.g., sunitinib, pazopanib and/or sorafenib)

EZETIMIBE (Ezetrol 10mg Tablet)

- for the treatment of hypercholesterolemia, as adjunctive therapy with statins, in patients who have not reached treatment goals on maximum tolerated statin therapy alone - for the treatment of hypercholesterolemia, as monotherapy, in patients who are intolerant to statins and, when appropriate, fibrates

FEBUXOSTAT (Uloric 80mg Tablet)

- for the treatment of symptomatic gout in patients who have documented hypersensitivity to allopurinol

FENOTEROL (Berotec 1mg/mL Solution)

- See Wet Nebulization Solutions

*FENTANYL (Fentanyl 12mcg/hr, 25mcg/hr, 50mcg/hr, 75mcg/hr, 100mcg/hr Transdermal System and generic brands)

- for the treatment of malignant or chronic non-malignant pain in adult patients who were previously receiving continuous opioid administration (i.e., not opioid naive), or who are unable to take oral therapy

FINASTERIDE (Proscar 5mg Tablet and generic brands)

- for the treatment of benign prostatic hypertrophy (BPH) when alpha-antagonists are contraindicated, not tolerated or failed - for the treatment of benign prostatic hypertrophy (BPH) in combination with an alpha-antagonist when alpha-antagonist therapy has been tried as monotherapy and a partial response has been observed

*FLUCONAZOLE (Diflucan Pos 10mg/mL)

- for the treatment of oropharyngeal candidiasis when nystatin has failed, or for systemic infections when oral tablets are not an option

*FLUDARABINE (Fludara 10mg Tablet)

- for the treatment of chronic lymphocytic leukemia (CLL), in patients with an ECOG performance status of 0-2, when: · the patient has failed to respond or relapsed during or after previous therapy with an alkylating agent, and · intravenous administration is not desirable

FLUOROQUINOLONES, OPHTHALMIC (Ciprofloxacin, Ofloxacin)

- for the treatment of eye infections upon the order of an ophthalmologist, ophthalmology resident, prescribing optometrist or other prescriber who has a specialty in ophthalmology [Criteria Code 01]

*FLUOROQUINOLONES, ORAL (Ciprofloxacin, Norfloxacin, Ofloxacin)

- for the treatment of patients intolerant or allergic (hypersensitivity reaction) to all other effective oral agents [Criteria Code 01] - for the treatment of aerobic, gram-negative infections which are resistant to other suitable oral agents [Criteria Code 02] - for the oral treatment of multi-resistant, aerobic, gram-negative infections traditionally requiring parenteral therapy (e.g., osteomyelitis, complicated urinary tract infections, bacterial pneumonia in cystic fibrosis, prostatitis) for which other oral agents are not effective or available [Criteria Code 03] - for infections due to Pseudomonas aeruginosa (ciprofloxacin is the preferred agent) [Criteria Code 04] - for the treatment of necrotizing (malignant) otitis externa [Criteria Code 05] - for the prevention of endophthalmitis in patients who have had cataract surgery involving an unplanned vitrectomy (ciprofloxacin) [Criteria Code 06]

*FLUOROQUINOLONES, RESPIRATORY (Levofloxacin, Moxifloxacin)

- for the completion of therapy instituted in the hospital setting for the treatment of nosocomial pneumonia, community acquired pneumonia (CAP) or acute exacerbation of chronic bronchitis (AECB) [Criteria Code 01]

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 13

- for the treatment of severe pneumonia in nursing home patients [Criteria Code 02] - for the treatment1 of CAP in patients with comorbidity2 upon radiographic confirmation of pneumonia, or who have failed first line therapies (macrolide, doxycycline, amoxicillin-clavulanate) [Criteria Code 03] - for the treatment1 of AECB in complicated patients3 who have failed treatment with one of the following: amoxicillin, doxycycline, TMP-SMX, cefuroxime, macrolide, ketolide or amoxicillin-clavulanate [Criteria Code 04]

1

If treated with an antibiotic within the past 3 months choose an antibiotic from a different class. Comorbidity includes chronic lung disease, malignancy, diabetes, liver failure, renal failure, congestive heart failure, use of antibiotics or steroids in the past 3 months, suspected macroaspiration, hospitalization within last 3 months, HIV/AIDS, smoking, malnutrition or acute weight loss. 3 Complicated AECB defined as increased cough and sputum, sputum purulence and increased dyspnea and FEV1 < 50% predicted or FEV1 50% - 65% and one of the following: 4 exacerbations per year, ischemic heart disease, chronic oral steroid use or antibiotic use in past 3 months

2

FORMOTEROL (Foradil 12ug Capsule For Inhalation and Oxeze 6mcg/Dose, 12mcg/Dose Turbuhaler)

- See Long-Acting Beta2-Agonists

FORMOTEROL, IN COMBINATION (Symbicort 100/6mcg, 200/6mcg Turbuhaler)

- See Long-Acting Beta2-Agonists/Inhaled Corticosteroids

GALANTAMINE (Reminyl Er 8mg, 16mg, 24mg Capsule and generic brands)

- See Cholinesterase Inhibitors (ChEI)

GOLIMUMAB (Simponi 50mg/0.5ml Autoinjector and Pre-filled Syringe)

- See Anti-Tumor Necrosis Factor (TNF) Agents

*GRANISETRON (Kytril 1mg Tablet and generic brands)

- See Serotonin (5-HT3) Antagonists NOTE: Recommended dose is 2mg orally 1 hour pre-chemotherapy or 1mg 1 hour pre-chemotherapy and 1mg 12 hours post-chemotherapy.

HYDROXYZINE (10mg, 25mg, 50mg Capsule, generic brands and Atarax Syrup)

- for chronic urticaria, defined as the presence of hives or lesions for longer than six weeks, which has responded to treatment with hydroxyzine

*IMATINIB (Gleevec 100mg Capsule and 100mg, 400mg Tablet) - as a single agent for adult patients with a histological diagnosis of localized primary Gastrointestinal Stromal Tumors (GIST) (KIT (CD-117)-positive) following surgical complete resection and at a high risk or recurrence · risk of recurrence is dependent on location, size and mitotic rate. Specific parameters for considering adjuvant therapy after resection of GIST along the gastrointestinal tract may include but are not limited to: gastric: any tumor >3cm where the mitotic rate is >5/50 high powered fields (HPFs). Adjuvant treatment could be considered where the mitotic rate is <5HPFs and tumor >10cm duodenal, small bowel, peritoneal, colorectal: any tumor where the mitotic rate is >5HPFs; any tumor >5cm in size coverage duration: 36 months - for the treatment of chronic myelogenous leukemia (CML), as a single agent, in patients who have documented evidence of Philadelphia chromosome positive CML, with an ECOG performance status of 0-2 and who: · are in blast crisis, accelerated phase, or chronic phase OR · as a secondary treatment in patients who demonstrate a hematologic relapse or cytogenetic progression after interferon-alpha (INF-a) therapy · coverage duration: 1 year - requests for other indications will be reviewed on a case by case basis - written request of an oncologist required

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 14

IMIQUIMOD (Aldara 5% Cream)

- for the treatment of external genital and perianal warts and condyloma acuminata in adults - for the treatment of actinic keratosis on the head and neck in patients who have failed treatment with 5FU and cryotherapy - for the treatment of biopsy-confirmed primary superficial basal cell carcinoma: · with a tumor diameter of 2cm AND · located on the trunk, neck or extremities (excluding hands and feet) AND · where surgery or eradication therapy is not medically indicated recurrent lesions in previously irradiated area OR multiple lesions, too numerous to irradiate or remove surgically · approval period: 6 weeks NOTE: Surgical management should be considered first-line for superficial basal cell carcinoma in most patients, especially for isolated lesions

INFLIXIMAB (Remicade 100mg Powder For Injection)

- See Anti-Tumor Necrosis Factor (TNF) Agents

INSULIN ASPART (Novorapid 100iu/Ml Penfill and Vial) INSULIN GLULISINE (Apidra 3ml Pre-filled Pen, 10ml Vial And Cartidges) INSULIN LISPRO (Humalog Insulin, Cartridges and Kwikpen)

- regular benefit for children 18 years and younger, under Community Services, Family Pharmacare and Diabetes Assistance Programs - for the management of Type I and Type II diabetes mellitus in patients 19 years of age and older, who are: · undergoing intensive therapy, i.e., administering three or more injections of insulin per day including basal insulin, and · testing blood glucose levels 4-6 times per day

INSULIN DETEMIR (Levemir 100u/mL Penfill)

- for the treatment of patients who have been diagnosed with Type 1 or Type 2 diabetes requiring insulin and have previously taken NPH and/or premix insulin daily at optimal dosing AND · have experienced unexplained nocturnal hypoglycemia at least once a month despite optimal management OR · have documented severe or continuing systemic or local allergic reaction to existing insulin(s)

INSULIN GLARGINE (Lantus 100u/mL vial, cartridge, and Solostar Pre-filled pen)

- for the treatment of patients who have been diagnosed with Type 1 or Type 2 diabetes requiring insulin and are currently

taking NPH and/or premix insulin daily at optimal dosing for at least three months AND · have experienced unexplained nocturnal hypoglycemia at least once a month despite optimal management OR · have documented severe or continuing systemic or local allergic reaction to existing insulin

*INTERFERON ALPHA-2B (Intron-A Injection and Multidose Pen)

written request of an oncologist only for hairy cell leukemia for AIDS-related Kaposi's sarcoma for chronic hepatitis B or C for chronic myelogenous leukemia (CML) for thrombocytosis associated with CML for malignant melanoma for basal cell carcinoma

*IPRATROPIUM BROMIDE (250mcg/mL Inhaled Solutions - See Formulary Listings For Product Names)

- See Wet Nebulization Solutions

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 15

*IPRATROPIUM BROMIDE, IN COMBINATION (Combivent Inhaled Solution and generic brands)

- See Wet Nebulization Solutions

*ITRACONAZOLE (Sporanox 100mg Capsule)

- for the treatment of severe systemic fungal infections - for the treatment of severe or resistant fungal infections in immunocompromised patients - for the treatment of severe onychomycosis caused by dermatophyte fungi as diagnosed by a dermatologist, attending physician or prescriber with a specialty in dermatology

LACOSAMIDE (Vimpat 50mg, 100mg, 150mg, 200mg Tablet)

- as adjunctive treatment for patients with refractory partial-onset seizures who meet all of the following criteria: · are under the care of a physician experienced in the treatment of epilepsy, and · are currently receiving two or more antiepileptic drugs, and · in whom all other antiepileptic drugs are ineffective or not appropriate

*LACTULOSE (667mg/mL Oral Liquid, generic brands)

- for portal systemic encephalopathy - for pneumatosis cystoides intestinalis

LAMIVUDINE (Heptovir 100mg Tablet and generic brands)

- for the treatment of hepatitis B, upon written request of a specialist - therapy is approved for one year, with reassessment required at that time

LANSOPRAZOLE (Prevacid FasTab 15mg, 30mg Tablet)

- for patients who require the use of a proton pump inhibitor and require administration through a feeding tube.

LANSOPRAZOLE (Prevacid 15mg, 30mg Capsule and generic brands)

- See Proton Pump Inhibitors

LANTHANUM CARBONATE (Fosrenol 250mg, 500mg, 750mg, 1000mg Tablet)

- upon the written request of a nephrologist or other prescriber within the Provincial Dialysis Program - for the treatment of hyperphosphatemia (>1.8mmol/L) and calciphylaxis (calcific arteriolopathy) or hypercalcemia after failure on a calcium-based binder NOTE: The initial coverage will be for a three-month period. Renewals will be at six month intervals when there has been a significant reduction in phosphate levels (a decrease of more than 0.7mmol of phosphate).

*LAPATINIB (Tykerb 250mg Tablet)

- in combination with capecitabine as a treatment option in patients with human epidermal growth factor receptor 2 (HER2) positive advanced or Metastic Breast Cancer (MBC) with trastuzumab refractory disease (previously treated with trastuzumab alone or in combination with chemotherapy such as taxane and/or vinorelbine) who have an ECOG performance status of 0 to 2 and choose to receive systemic chemotherapy. Patients with previous exposure to capecitabine are not considered eligible

LEFLUNOMIDE (Arava 10mg, 20mg Tablet and generic brands)

- written request from a rheumatologist or prescriber with a specialty in rheumatology - for patients with a diagnosis of active rheumatoid arthritis (RA) who · have not responded or who have had intolerable toxicity to an adequate trial1 of combination therapy of at least two traditional DMARDs2 or · if combination therapy is not an option, an adequate trial of at least three traditional DMARDs in sequence as monotherapy - therapy must include methotrexate alone or in combination unless contraindicated or not tolerated - coverage will be approved initially for 6 months. Can be reassessed for yearly coverage dependent on patient achieving an improvement in symptoms of at least 20%

1

An adequate trial is 5 months for IM gold, 6 months for penicillamine, 4 months for hydroxychloroquine and 3 months for

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 16

2

all other traditional DMARDs as well as leflunomide, infliximab and etanercept. Traditional agents include methotrexate, IM gold, sulfasalazine, hydroxychloroquine, azathioprine, chloroquine, penicillamine and cyclosporine.

*LENALIDOMIDE (Revlimid Capsule)

- in combination with dexamethasone in adult patients with progressive myeloma (MM) after at least one previous treatment, not resistant to dexamethasone, documented measurable disease and ECOG performance status of 0-2 - as a single agent in adult myelodysplastic syndrome (MDS) patients with transfusion dependent anemia due to low or intermediate-1 risk MDS associated with a deletion 5q cytogenetic abnormality with or without additional cytogenic abnormalities

LEUKOTRIENE RECEPTOR ANTAGONISTS (Montelukast, Zafirlukast)

- for the treatment of moderate to severe asthma in adults and children who: · despite compliance are not adequately controlled with a moderate or high dose inhaled corticosteroid and require additional symptom control (e.g., cough, awakening at night, missing activities such as school, work or social activities because of asthma symptoms) and · require increasing amounts of short-acting beta2-agonists, indicative of poor control

LEVETIRACETAM (Keppra 250mg, 500mg, 750mg Tablet and generic brands)

- as adjunctive therapy in the management of patients with epilepsy who are not satisfactorily controlled by conventional therapy

LEVOCARNITINE (Carnitor 1g/5mL Injection, 100mg/mL Oral Liquid and 300mg Tablet)

- for the treatment of primary systemic carnitine deficiency

LEVODOPA AND CARBIDOPA AND ENTACAPONE (Stalevo 50mg, 75mg, 100mg, 125mg, 150mg Tablet)

- for the treatment of Parkinson's disease as adjunctive therapy in patients who: · are not well controlled and are experiencing significant "wearing off" symptoms despite optimal therapy with levodopa/carbidopa · were not well controlled and experienced significant "wearing off" symptoms despite optimal therapy with levodopa/carbidopa and are currently using levodopa/carbidopa and entacapone separately

*LEVOFLOXACIN (Levaquin 250mg, 500mg Tablet and generic brands)

- See Fluoroquinolones, Respiratory

LINEZOLID (Zyvoxam 600mg Tablet)

- written request from an infectious disease specialist or prescriber with a specialty in infectious diseases - for the treatment of proven vancomycin-resistant enterococci (VRE) infections - for the treatment of proven methicillin-resistant staphylococcus aureus or epidermidis (MRSA/MRSE) infections in those patients who are unresponsive to, or intolerant of vancomycin

LONG-ACTING BETA2-AGONISTS (Formoterol, Salmeterol) LONG-ACTING BETA2-AGONISTS/INHALED CORTICOSTEROIDS (Formoterol, In Combination; Salmeterol, In Combination)

Asthma - for the treatment of moderate to severe asthma in patients who: · are compliant with inhaled corticosteroids at optimal doses; and · require additional symptom control, (e.g., cough, awakening at night, missing activities such as school, work or social activities because of asthma symptoms); and · require increasing amounts of short-acting beta2-agonists, indicative of poor control Chronic Obstructive Pulmonary Disease - for the treatment of chronic obstructive pulmonary disease (COPD), if symptoms persist after 2-3 months of short-acting bronchodilator therapy (i.e., salbutamol at a maximum dose of 8 puffs/day or ipratropium at maximum dose of 12 puffs/day)

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 17

- coverage can be provided without a trial of short-acting agent if: · there is spirometric evidence of at least moderate to severe airflow obstruction, (i.e., postbronchodilator values FEV1 < 60% and FEV1/FVC ratio < 0.7), and significant symptoms (i.e., MRC score of 3-5*) - combination therapy with tiotropium and a long-acting beta2 agonist/inhaled corticosteroid will only be considered if: · there is spirometric evidence of at least moderate to severe airflow obstruction (postbronchodilator values FEV1 < 60% and FEV1/FVC ratio < 0.7), and significant symptoms (i.e., MRC score of 3-5*) and · there is evidence of one or more moderate-to-severe exacerbations per year, on average, for 2 consecutive years requiring antibiotics and/or systemic (oral or intravenous) corticosteroids NOTE: Coverage of combination therapy with tiotropium and a long-acting beta2 agonist (without an inhaled corticosteroid) will not be considered due to insufficient evidence to support substantial benefit. If spirometry cannot be obtained, reasons must be clearly explained and other evidence regarding severity of condition must be provided for consideration (i.e., MRC scale). Spirometry reports from any point in time will be accepted. * Canadian Thoracic Society COPD Classification By Symptom/Disability: Moderate - (MRC 3-4) Shortness of breath from COPD causing the patient to stop after walking about 100 meters (or after a few minutes) on the level. Severe - (MRC 5) Shortness of breath from COPD resulting in the patient being too breathless to leave the house or breathless after undressing, or the presence of chronic respiratory failure or clinical signs of right heart failure. MRC= Medical Research Council Dyspnea Scale

LORATADINE (Claritin 10mg Tablet and generic brands)

- for chronic urticaria, defined as the presence of hives or lesions for longer than six weeks, which has responded to treatment with loratadine

MAGNESIUM GLUCOHEPTONATE (5mg/mL Solution and generic brands)

- for the treatment of hypomagnesemia

*METHADONE (Metadol 1mg, 5mg, 10mg, 25mg Tablet)

- for the management of severe chronic or malignant pain as an alternative to other opiates - written request of a physician authorized to prescribe methadone

*METHADONE, ORAL LIQUID (Methadone o/l Compound)

- for the management of severe chronic or malignant pain as an alternative to other opiates - for the management of patients undergoing therapy for drug dependence - written request of a physician authorized to prescribe methadone

METHYLPHENIDATE (Biphentin 10mg, 15mg, 20mg 30mg, 40mg, 50mg, 60mg and 80mg Capsule) METHYLPHENIDATE ER (Novo-Methylphenidate ER-C 18mg, 27mg, 36mg, and 54mg Tablets)

- for patients 6-25 years of age diagnosed with attention deficit hyperactivity disorder (ADHD) who require 12-hour continuous coverage due to academic and/or psychosocial needs, and who meet the following: · patients who demonstrate significant and problematic disruptive behaviour or who have problems with inattention that interfere with learning AND · prescribed by or in consultation with a specialist in pediatric psychiatry, pediatrics, general practitioners or other prescribers with expertise in ADHD AND · have been tried on immediate release or slow release methylphenidate with unsatisfactory results

*MIDAZOLAM (1mg/mL, 5mg/mL Injection and generic brands)

- for adjunctive therapy of pain management in palliative care patients outside the hospital setting [Criteria Code 01]

MONTELUKAST (Singulair 4mg, 5mg Chewtabs, 4mg/pkt Granules and 10mg Tablets and generic brands)

- See Leukotriene Receptor Antagonists

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 18

*MOXIFLOXACIN (Avelox 400mg Tablet)

- See Fluoroquinolones, Respiratory

*NABILONE (Cesamet 0.25mg, 0.5mg and 1mg Capsule)

- for the management of severe nausea and vomiting associated with cancer chemotherapy

NALTREXONE (Revia 50mg Tablet)

- for the treatment of alcohol dependence, as an adjunct to a comprehensive psychotherapeutic or psychological alcoholism counseling program to support abstinence, and reduce the risk of relapse - eligibility is initially restricted to a three month period with reassessment at that time for further coverage

NARATRIPTAN (Amerge 1mg, 2.5mg Tablet and generic brands)

- See Selective 5HT1 - Receptor Agonists

*NILOTINIB (Tasigna 150mg & 200mg Capsule)

- as a single line agent for the treatment of adults with chronic or accelerated phase Chronic Myeloid Leukemia (CML) with resistance or intolerance to prior therapy. This would include: · patients with CML in chronic phase who are intolerant to imatinib or dasatinib or both · patients with CML in chronic phase who are resistant to imatinib 600mg/day · patients with CML that have progressed to accelerated phase while on imatinib - sequential use of dasatinib and nilotinib is not permitted except in the circumstance described above (i.e. intolerance) - coverage approved for 6 months

*NORFLOXACIN (400mg Tablet, generic brands)

- See Fluoroquinolones, Oral

OFLOXACIN, OPHTHALMIC (Ocuflox 0.3% Ophthalmic Solution and generic brands)

- See Fluoroquinolones, Ophthalmic

*OFLOXACIN, ORAL (300mg and 400mg Tablet and generic brands)

- See Fluoroquinolones, Oral

OLANZAPINE (Zyprexa 2.5mg, 5mg, 7.5mg, 10mg, 15mg Tablet and generic brands) OLANZAPINE, ORAL DISINTEGRATING (Zyprexa Zydis 5mg, 10mg, 15mg, 20mg Tablet and generic brands)

- for the treatment of schizophrenia and related psychotic disorders upon the written request of a psychiatrist, either first line or upon failure of other antipsychotic agents - for the acute treatment of manic or mixed episodes in bipolar I disorder in patients with intolerance or a history of failure to one other atypical antipsychotic - for maintenance therapy in patients with bipolar disease who are currently stabilized on olanzapine

OMEPRAZOLE (Losec 10mg, 20mg Capsule/Tablet and generic brands)

- See Proton Pump Inhibitors NOTE: Omeprazole is available as a full benefit if the dose does not exceed the standard dose of 20mg per day (maximum of 425 tablets/capsules per year). If the dosage is greater than 20mg per day then the criteria for coverage must be met.

*ONDANSETRON (Zofran 4mg, 8mg Tablet, 4mg/5mL Oral Liquid and generic brands and ODT Tablet)

- See Serotonin (5-HT3) Antagonists NOTE: Only requests for the oral dosage forms are eligible for consideration. Although the dose may vary, usually a single oral 8mg dose pre-chemotherapy is sufficient to control symptoms. As well, some patients may require additional therapy up to 48 hours after the last dose of chemotherapy or last radiation treatment. Benefit beyond 48 hours has not been established and is therefore, not insured.

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 19

*OSELTAMIVIR (Tamiflu 30mg, 45mg, 75mg Capsule, 12mg/mL Oral Suspension)

- for the treatment of long-term care residents with clinically suspected or lab confirmed influenza A or B. A clinically suspected case is one in which the patient meets the criteria of influenza-like illness and there is confirmation of influenza A or B circulating within the facility or surrounding community - for the prophylaxis of influenza A or B in long-term care residents where the facility has an outbreak - a protocol has been developed by Public Health for the treatment of patients in long-term care facilities. The facility must contact the Medical Officer of Health or local Public Health Office, who will notify the Pharmacare office (or dispensing pharmacy after office hours) if coverage is required

OXCARBAZEPINE (Trileptal 60mg/mL Oral Liquid and 150mg, 300mg, 600mg Tablet and generic brands)

- for the treatment of epileptic seizures in patients who have had an inadequate response to or are intolerant of at least three other formulary agents (prior or current use) including carbamazepine

OXYBUTYNIN XL (Ditropan XL and Uromax 5mg, 10mg Tablet)

- for the treatment of over-active bladder (not stress incontinence) for patients who cannot tolerate immediate relase oxybutinin after an adequate trial (e.g. 3 months) - a three month trial will be approved initially with assessment of the effectiveness of this therapy required if further coverage is considered

PANTOPRAZOLE MAGNESIUM (Tecta 40mg Tablet)

- See Proton Pump Inhibitors NOTE: Pantoprazole magnesium is available as a full benefit if the dose does not exceed the standard dose of 40mg per day (maximum of 425 tablets per year). If the dosage is greater than 40mg per day then the criteria for coverage must be met.

PANTOPRAZOLE SODIUM (Pantoloc 20mg, 40mg Ec Tablet and generic brands)

- See Proton Pump Inhibitors

*PAZOPANIB (Votrient 200mg Tablet) - as an alternate single agent first line treatment for patients with documented evidence of histologically confirmed

advanced or metastatic clear cell renal cell carcinoma (RCC) who have an ECOG performance status (PS) of 0 or 1 and are unable to tolerate sunitinib

PEGINTERFERON ALFA-2A (Pegasys 180mcg Injection)

- for the treatment of hepatitis C in patients who are treatment naive, upon the written request of a hepatologist or prescriber with a specialty in hepatitis - a 24 week period will be initially approved at which time a further request will be required documenting the patient's response. If a positive response occurs, coverage can be continued for an additional 24 weeks (48 weeks total) - for the treatment of HBeAg negative Chronic Hepatitis B (CHB) patients with compensated liver disease, liver inflammation and evidence of viral replication with demonstrated intolerance to or failure of lamivudine therapy, upon written request of a hepatologist or prescriber with a specialty in hepatitis. Maximum duration of coverage is 48 weeks

PEGINTERFERON ALFA-2A AND RIBAVIRIN (Pegasys RBV Injection/Tablet) PEGINTERFERON ALFA-2B AND RIBAVIRIN (Pegetron and Pegetron Redipen Injection/Capsule)

- for the treatment of hepatitis C in patients who are treatment naive, upon the written request of a hepatologist or prescriber with a specialty in hepatitis - a 24 week period will initially be approved at which time a further request will be required documenting the patient's response. If a positive response occurs, coverage can be continued for an additional 24 weeks (48 weeks total) - as combination therapy with new protease inhibitors (i.e., boceprevir or telaprevir); futility rules being enforced. Patients should stop all therapy (both protease inhibitor and PegIFN/RBV) if hepatitis C virus levels are: · with boceprevir, 100 IU/mL at 12 weeks or detectable at 24 weeks · with telaprevir, 1,000 IU/mL at 4 weeks or 12 weeks, or detectable at 24 weeks

PENTOXIFYLLINE (Trental 400mg Tablet and generic brands)

- for the treatment of patients with ulcers due to ischemia of critical limbs

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 20

*PILOCARPINE, ORAL (Salagen 5mg Tablet)

- for oncology patients only - for the treatment of the symptoms of xerostomia due to salivary gland hypofunction caused by radiotherapy for cancer of the head and neck

PIOGLITAZONE (Actos 15mg, 30mg, 45mg Tablet and generic brands)

- for treatment of Type II diabetes in patients who have: · inadequate glycemic control on optimal doses of sulfonylurea and metformin; or · demonstrated intolerance or contraindication to metformin and are on optimal doses of sulfonylurea; or · demonstrated intolerance or contraindication to sulfonylurea and are on optimal does of metformin - patients must have a recent A1C of < 10% unless insulin therapy is inappropriate for the patient. Duration of intial approval will be 6 months; further coverage will require demonstrated evidence of efficacy (a reduction of A1C of 0.7 observed to continue coverage)

PROTON PUMP INHIBITORS (PPIs)

Omeprazole, Rabeprazole, and Pantoprazole magnesium (higher than standard daily doses) - failed standard daily doses of full benefit PPIs (20mg of omeprazole, 20mg of rabeprazole or 40mg of pantoprazole magnesium) - coverage duration: 8 week trial, followed by up to one year of coverage. Use beyond the 8 week trial will be considered if step down to standard dose is not successful NOTE: Omeprazole, rabeprazole and pantoprazole magnesium are available as full benefits if the dose does not exceed the standard dose of 20mg per day for omeprazole and rabeprazole and 40mg per day for pantoprazole magnesium (maximum of 425 tablets/capsules per year). Pantoprazole Sodium and Lansoprazole - failure of a trial of all open benefit PPIs (omeprazole, rabeprazole, and pantoprazole magnesium) - coverage duration: yearly coverage at standard dose (maximum 425 tablets/capsules per year). Higher than standard doses may be considered on a case by case basis

*QUINAGOLIDE (Norprolac 0.025mg, 0.05mg, 0.075mg, 0.15mg Tablet)

- for the treatment of hyperprolactinemia (idiopathic or originating from a prolactin secreting micro or macro-adenoma of the pituitary) after failure of bromocriptine (as determined by prolactin levels) or if bromocriptine is not tolerated

RABEPRAZOLE (Pariet 10mg, 20mg Tablet and generic brands)

- See Proton Pump Inhibitors NOTE: Rabeprazole is available as a full benefit if the dose does not exceed the standard dose of 20mg per day (maximum of 425 tablets per year). If the dosage is greater than 20mg per day then the criteria for coverage must be met.

RALOXIFENE (Evista 60mg Tablet and generic brands)

- for the treatment of postmenopausal osteoporosis associated with documented fragility fracture when bisphosphonates are not tolerated or are contraindicated - for the treatment of postmenopausal osteoporosis without documented fractures when patient is at high 10 year fracture risk (using fracture risk tables) and bisphosphonates are not tolerated or are contraindicated - other requests reviewed on a case by case basis

RILUZOLE (Rilutek 50mg Tablet and generic brands)

- for the treatment of amyotrophic lateral sclerosis (ALS) or Lou Gehrig's Disease, when initiated by a neurologist with expertise in the management of ALS, when the patient has: · probable or definite diagnosis of ALS · ALS symptoms for less than five years · FVC >60% predicted upon initiation of therapy · no tracheostomy for invasive ventilation - coverage to be reviewed every six months - coverage cannot be renewed once the patient has a tracheostomy for the purpose of invasive ventilation or mechanical ventilation

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 21

*RISEDRONATE (Actonel 5mg, 30mg, 35mg Tablet and generic brands)

- for the treatment of osteoporosis associated with documented fragility fracture - for the treatment of osteoporosis without documented fracture when patient is at high 10 year fracture risk (>20%) as indicated by the radiologist on a bone mineral density (BMD) report - as prophylaxis of corticosteroid induced osteoporosis in patients who will be, or have been, on oral prednisone therapy for 3 months - Paget's disease of bone (2 month limit, one re-treatment course may be considered) - other requests reviewed on a case by case basis

RISPERIDONE (Risperdal Consta 12.5mg/2mL 25mg/2mL, 37.5mg/2mL, 50mg/2mL Injection)

- for patients having problems with compliance on an oral antipsychotic or - for patients who are currently receiving a conventional depot antipsychotic and are experiencing significant side effects (EPS or TD) or lack of efficacy

RITUXIMAB (Rituxan 10mg/mL Injection)

- for the treatment of adult patients with severe active rheumatoid arthritis who have failed to respond to an adequate trial with an anti-TNF agent - cannot be used concomitantly with anti-TNF agents - written request from a rheumatologist or prescriber with a specialty in rheumatology - approval for re-treatment with rituximab will only be considered for patients who have achieved a response, followed by a subsequent loss of effect and, after an interval of no less than six months from the previous dose

RIVAROXABAN (Xarelto 10mg Tablet)

- for the prophylaxis of venous thromboembolism following total knee replacement surgery for up to 14 days, as an alternative to low molecular weight heparins [Criteria Code 14] - for the prophylaxis of venous thromboembolism following total hip replacement surgery for up to 35 days, as an alternative to low molecular weight heparins [Criteria Code 35]

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 22

RIVAROXABAN (Xarelto 15mg and 20mg Tablet)

- Inclusion Criteria: 1 - At-risk patients with non-valvular atrial fibrillation (AF) who require rivaroxaban for the prevention of stroke and systemic embolism AND in whom: · Anticoagulation is inadequate2 following a reasonable trial3 on warfarin; OR · Anticoagulation with warfarin is contraindicated or not possible due to inability to regularly monitor via International Normalized Ratio (INR) testing (i.e. no access to INR testing services at a laboratory, clinic, pharmacy, and at home) - Exclusion Criteria: - Patients with impaired renal function4 (creatinine clearance or estimated glomerular filtration rate < 30 mL/min) OR 75 years of age and without documented stable renal function5 OR hemodynamically significant rheumatic valvular heart disease6, especially mitral stenosis; OR prosthetic heart valves * Please Note: Patients starting rivaroxaban should have ready access to appropriate medical services to manage a major bleeding event.

1

At-risk patients with non-valvular atrial fibrillation are defined as those with a CHADS2 score of 1. Although the ROCKET-AF trial included patients with higher CHADS2 scores ( 2), other landmark studies with the other newer oral anticoagulants demonstrated a therapeutic benefit in patients with a CHADS2 score of 1. Prescribers may consider an antiplatelet regimen or oral anticoagulation for patients with a CHADS2 score of 1. 2 Inadequate anticoagulation is defined as INR testing results that are outside the desired INR range for at least 35% of the tests during the monitoring period (i.e. adequate anticoagulation is defined as INR test results that are within the desired INR range for at least 65% of the tests during the monitoring period). 3 A reasonable trial on warfarin is defined as at least two months of therapy. 4 Since renal impairment can increase bleeding risk, renal function should be regularly monitored. Other factors that increase bleeding risk should also be assessed and monitored (see Xarelto® (rivaroxaban) Product Monograph). 5 Documented stable renal function is defined as creatinine clearance or estimated glomerular filtration rate of 30-49 mL/min for 15mg once daily dosing or 50 mL/min for 20mg once daily dosing that is maintained for at least 3 months. 6 There is currently no data to support that rivaroxaban provides adequate anticoagulation in patients with rheumatic valvular disease or those with prosthetic heart valves, so rivaroxaban is not recommended in these populations.

RIVASTIGMINE (Exelon 2mg/mL Oral Liquid and 1.5mg, 3mg, 4.5mg, 6mg Capsule and generic brands)

- See Cholinesterase Inhibitors (ChEI)

RIZATRIPTAN (Maxalt 5mg, 10mg Tablet and 5mg, 10mg Wafer and generic brands)

- See Selective 5HT1 - Receptor Agonists

RUFINAMIDE (Banzel 100mg, 200mg and 400mg Tablet)

- for the adjunctive treatment of seizures associated with Lennox-Gastaut syndrome for patients who meet all of the following criteria: · are under the care of a physician experienced in treating Lennox-Gastaut syndrome-associated seizures, AND · are currently receiving two or more antiepileptic drugs, AND · in whom less costly antiepileptic drugs are ineffective or not appropriate

*SACCHARATED IRON OXIDE (Venofer 20mg/mL Injection)

- for patients in whom parenteral iron is indicated and who have had a hypersensitivity or anaphylactic reaction to IV iron dextran

*SALBUTAMOL (0.5mg/mL, 1mg/mL, 2mg/mL Unit Dose Inhaled Solution And 5mg/mL Inhaled Solution- See Formulary Listings For Product Names)

- See Wet Nebulization Solutions

*SALBUTAMOL, IN COMBINATION (Combivent Inhaled Solution and generic brands)

- See Wet Nebulization Solutions

SALMETEROL (Serevent 50mcg/dose Diskhaler and 50mcg/dose Diskus)

- See Long-Acting Beta2-Agonists

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 23

SALMETEROL IN COMBINATION (Advair 50/100mcg, 50/250mcg, 50/500mcg Diskus and HFA 25/125 mcg/dose, HFA 25/250 mcg/dose Inhaler)

- See Long-Acting Beta2-Agonists/Inhaled Corticosteroids

- for the treatment of migraine1 headache of moderate2 intensity when other therapies (e.g., NSAIDs, acetaminophen, DHE spray) are not effective, AND patients have not responded to oral sumatriptan. - for the treatment of migraine1 headache of severe2 or ultra severe2 intensity when patients have not responded to oral sumatriptan NOTE: Coverage limited to 18 doses every 3 months 3.

1 2

SELECTIVE 5HT1 - RECEPTOR AGONISTS (Almotriptan Tablet, Naratriptan Tablet, Rizatriptan Tablet & Wafer, Sumatriptan Nasal Spray, Zolmitriptan Tablet & Nasal Spray)

As diagnosed based on current Canadian Guidelines Definitions: Moderate - pain is distracting causing need to slow down and limit activities; Severe - pain affects ability to concentrate and very difficult to continue with daily activities; Ultra severe - unable to speak or think clearly, not able to function, likely lying down or sleeping. 3 A quantity limit of 6 doses per month will be instituted for all clients. This will be adjudicated by limiting the quantity payable each quarter (e.g., Jan to Mar) to 18 doses*. Patients with >3 migraines/month who are on prophylactic therapy may qualify for additional doses, upon written request. * Please note: One dose = one tablet, one wafer, one spray or one 0.5mL pre-filled syringe.

- for the treatment of emesis in patients who are: · receiving moderately or severely emetogenic chemotherapy [Criteria Code 01] or · receiving intravenous chemotherapy or radiotherapy and who have not experienced adequate control with other available antiemetics [Criteria Code 02] or · receiving intravenous chemotherapy or radiotherapy and who are experiencing intolerable side effects to other antiemetics, including steroids and anti-dopaminergic agents [Criteria Code 03] NOTE: Use of criteria codes is limited to appropriate doses pre and post chemotherapy or radiation. Criteria codes must not be used for claims related to other causes of nausea and vomiting or for long term, daily management of nausea and vomiting.

*SEROTONIN (5-HT3) ANTAGONISTS (Dolasetron, Granisetron, Ondansetron)

SEVELAMER (Renagel 800mg Tablet)

- upon the written request of a nephrologist or other prescriber within the Provincial Dialysis Program - for the treatment of hyperphosphatemia (>1.8 mmol/L) and calciphylaxis (calcific arteriolopathy) or hypercalcemia after failure on a calcium-based binder NOTE: The initial coverage will be for a three-month period. Renewals will be at six month intervals when there has been a significant reduction in phosphate levels (a decrease of more than 0.7mmol of phosphate).

SILDENAFIL (Revatio 20mg Tablet and generic brands)

- written request from a pulmonary arterial hypertension (PAH) specialist only - diagnosis of PAH should be confirmed by right heart catheterization - dose of sildenafil will be limited to 20mg tid - IPAH (functional class III) · for the treatment of patients with World Health Organization (WHO) functional class III idiopathic pulmonary arterial hypertension (IPAH) who do not demonstrate vasoreactivity on testing, or who do demonstrate vasoreactivity on testing but fail a trial of calcium channel blockers (CCB), or are intolerant to CCB - PAH secondary to connective tissue disease (functional class III) · for the treatment of patients with World Health Organization (WHO) functional class III pulmonary hypertension associated with connective tissue disease who do not respond to conventional therapy

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 24

SITAGLIPTIN (Januvia 100mg Tablet)

- for treatment of Type II diabetes in patients who have: · inadequate glycemic control on optimal doses of sulfonylurea and metformin; or · demonstrated intolerance or contraindication to metformin and are on optimal doses of sulfonylurea; or · demonstrated intolerance or contraindication to sulfonylurea and are on optimal doses of metformin; · patients must have a recent A1C of <10% unless insulin therapy is inappropriate for the patient. Duration of initial approval will be 6 months; further coverage will require demonstrated evidence of efficacy (a reduction of A1C of 0.7 observed to continue coverage)

SITAGLIPTIN AND METFORMIN (Janumet 50/500mg, 50/850mg, and 50/1000mg Tablet)

- for combination treatment of type 2 diabetes mellitus for patients already stabilized on combination treatment with the individual components of metformin and sitagliptin

- for the treatment of over-active bladder (not stress incontinence) for patients who cannot tolerate or have insufficient response to an adequate trial of immediate release oxybutynin (e.g. 3 months) - a three month trial will be approved initially with assessment of the effectiveness of this therapy required if further coverage is considered

SOLIFENACIN (Vesicare 5mg, 10mg Tablet)

SOMATROPIN (Humatrope, Nutropin, Nutropin Aq, Saizen Injection and Cartridge)

- for treatment of growth hormone deficiency in patients with Turner Syndrome, upon the request of an endocrinologist or prescriber with a specialty in endocrinology NOTE: The larger 8.8mg/vial format can be approved when suitable for dosing requirements, if it does not result in drug wastage.

*SORAFENIB (Nexavar 200mg Tablet)

- as a single agent first line systemic therapy option in adult patients with a diagnosis of hepatocellular carcinoma (HCC) with Child-Pugh Class A liver dysfunction (mild hepatic impairment) with ECOG performance status 0-1; and who have either progression of disease, or who are not candidates for curative intent treatments (transplantation, hepatic resection), or other well established palliative interventions (ablation, transcatheter arterial chemo-embolization (TACE), internal radiation) - as a single agent for second line treatment of patients with documented evidence of histologically confirmed advanced or metastatic clear cell renal cell carcinoma, considered to be intermediate or low risk (according to Memorial SloanKettering (MSKCC) prognostic score), have an ECOG performance status of 0 or 1 and progressed after prior cytokine therapy (or intolerance) within the previous 8 months. In any one patient all of the following conditions must be met: · sorafenib may be a second line option only after cytokine therapy · sorafenib may not be used after another tyrosine kinase inhibitor (i.e., sunitinib) as sequential therapy · In the event of severe toxicity within the first 8 weeks of therapy, a switch to another tyrosine kinase inhibitor (i.e., sunitinib) may be allowed - coverage approved for 5 months with reassessment

SUMATRIPTAN (Imitrex 50mg, 100mg Tablet and generic brands)

- for the treatment of migraine1 headache when: · migraines are moderate2 in severity and other therapies (e.g., NSAIDs, acetaminophen, DHE spray) are not effective, or · migraine attacks are severe2 or ultra severe2 NOTE: Coverage limited to 18 doses every 3 months 3. 1 As diagnosed based on current Canadian Guidelines 2 Definitions: Moderate - pain is distracting causing need to slow down and limit activities; Severe - pain affects ability to concentrate and very difficult to continue with daily activities; Ultra severe - unable to speak or think clearly, not able to function, likely lying down or sleeping. 3. A quantity limit of 6 doses per month will be instituted for all clients. This will be adjudicated by limiting the quantity payable each quarter (e.g., Jan to Mar) to 18 doses*. Patients with >3 migraines/month who are on prophylactic therapy may qualify for additional doses, upon written request. * Please note: One dose = one tablet, one wafer, one spray or one 0.5mL pre-filled syringe.

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 25

- for the treatment of migraine1 headache of moderate2 intensity when other therapies (e.g., NSAIDs, acetaminophen, DHE spray) are not effective, AND oral and nasal triptans are not appropriate - for the treatment of migraine1 headache of severe2 or ultra severe2 intensity when oral and nasal triptans are not appropriate NOTE: Coverage limited to 18 doses every 3 months 3.

1

SUMATRIPTAN (Imitrex 6mg/Syringe Injection)

As diagnosed based on current Canadian Guidelines Definitions: Moderate - pain is distracting causing need to slow down and limit activities; Severe - pain affects ability to concentrate and very difficult to continue with daily activities; Ultra severe - unable to speak or think clearly, not able to function, likely lying down or sleeping. 3 A quantity limit of 6 doses per month will be instituted for all clients. This will be adjudicated by limiting the quantity payable each quarter (e.g., Jan to Mar) to 18 doses*. Patients with >3 migraines/month who are on prophylactic therapy may qualify for additional doses, upon written request. * Please note: One dose = one tablet, one wafer, one spray or one 0.5mL pre-filled syringe.

2

*SUNITINIB (Sutent 12.5mg, 25mg, 50mg Capsule)

- as a single agent first line treatment in patients with documented evidence of histologically confirmed advanced or metastatic clear cell renal cell carcinoma who have an ECOG performance status of 0 or 1. In any one patient all of the following conditions must be met: · sunitinib may be a first line option · sunitinib may not be used after another tyrosine kinase inhibitor (i.e., sorafenib, or pazopanib) as sequential therapy · in the event of significant toxicity, a switch to another tyrosine kinase inhibitor (i.e., sorafenib or pazopanib) may be allowed - as a single agent for the treatment of advanced gastrointestinal stromal tumor (GIST) patients after failure of imatinib due to intolerance or resistance - coverage approved for 9 months with reassessment

TACROLIMUS (Protopic 0.03%, 0.1% Ointment)

- for children greater than 2 years of age with refractory atopic dermatitis. Coverage will be renewed yearly - for the intermittent use for moderate to severe atopic dermatitis in adults who have: · failed or are intolerant to a site appropriate strength of corticosteroid therapy (i.e., low potency on face versus intermediate to high potency for trunk and extremities)

TAZAROTENE (Tazorac 0.05%, 0.1% Gel)

- for use in psoriasis therapy when conventional therapies have been ineffective or inappropriate

TELAPREVIR (Incivek 375mg Tablet)

- for the treatment of chronic hepatitis C genotype 1 infection in combination with peginterferon alpha/ribavirin (PegIFN/RBV), if the following criteria are met: · detectable levels of hepatitis C virus (HCV) RNA prior to treatment · fibrosis stage of F2, F3, or F4 as determined by a biopsy/fibroscan where available OR recommendation of a hepatologist or a prescriber with a specialty in hepatitis · patient not co-infected with HIV · one course treatment only (12 weeks duration) *TEMOZOLOMIDE (Temodal 5mg, 20mg, 100mg, 200mg Capsule) - in combination with radiotherapy (concomitant therapy) and as adjuvant therapy (post radiation for 6 cycles) for newly diagnosed high grade glioma patients with a good performance status (PS) (Karnofsky 60) and who choose to receive first line systemic chemotherapy - use as a single agent may be considered for patients with recurrent high grade glioma and a good PS (Karnofsky 60) who have not previously been treated with first line combination (temozolomide and radiation) therapy

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 26

- use as a single agent may be considered for patients with high grade glioma who have recurrent disease occurring during their initial adjuvant therapy. Other systemic treatment options such as etoposide, nitrosourea based therapy or a clinical trial should be considered for patients who recur immediately following temozolomide therapy. Rechallenge with temozolomide could be considered for patients with a temozolomide free interval of six months

TENOFOVIR DISOPROXIL (Viread 300mg Tablet)

- for the treatment of chronic hepatitis B infection in patients with: · documented cirrhosis on radiologic or histologic grounds AND · a HBV DNA concentration above 2000iu/mL

TERBINAFINE (Lamisil 250mg Tablet and generic brands)

- for the treatment of severe onychomycosis caused by dermatophyte fungi. (Suggested treatment periods: 6 weeks for fingernails and 12 weeks for toenails. Longer periods of time will be considered on a case by case basis) - for the treatment of dermatophyte infection unresponsive to other treatments or unlikely to respond to other treatments due to the site or severity of the infection

*TESTOSTERONE, TOPICAL (Androderm Patch, Androgel Gel Packet & Testim Gel)

- for the treatment of congenital and acquired primary or secondary hypogonadism in males with a specific diagnosis of: · Primary: cryptorchidism, Klinefelter's, orchidectomy, and other established causes · Secondary: pituitary-hypothalamic injury due to tumors, trauma, radiation · deficiency should be clearly demonstrated by clinical features and confirmed by two separate biochemical tests before initiating any therapy NOTE: Maximum dose approved is 5g per day or a 5mg patch per day. This will be adjudicated by limiting the quantity payable each quarter (e.g. Jan-Mar) to: · 120 Androderm Patches (2.5mg or 5mg Patch); · 300g of Androgel 2.5g gel (packet); · 600g of Androgel 5g gel (packet); or · 600g of Testim Gel. Please be reminded that topical gels are to be billed per gram (not per packet).

*THYROTROPIN (Thyrogen 0.9mg/mL Injection)

- to monitor for recurrence and metastatic disease, in patients who have documented evidence of thyroid cancer and who have undergone appropriate surgical and/or medical management. This includes: · primary use in patients with inability to raise an endogenous TSH level (25 mu/L) with thyroid hormone withdrawal · primary use in cases of documented morbidity in patients for whom severe hypothyroidism could be life-threatening · secondary use in patients with previous thyroid hormone withdrawal resulting in a documented life-threatening event - as a single agent for the preparation of radioiodine remnant ablation in patients with papillary or follicular thyroid cancer who have undergone thyroidectomy as treatment for thyroid cancer · thyrotropin is a reasonable alternate to thyroid hormone withdrawal in patients who are unable to tolerate the prolonged hypothyroid state or who cannot achieve satisfactory elevation of endogenous TSH · thyrotropin may be used in new patients or patients with previously incomplete remnant ablation or who have a recurrence of thyroid cancer and require therapeutic remnant ablation

TICLOPIDINE (Ticlid 250mg Tablet and generic brands)

- for the secondary prevention of ischemic stroke or transient ischemic attack (TIA) in patients with a documented severe allergy to ASA or who experience a recurrent thrombotic event (stroke, symptoms of TIA) while taking ASA [Criteria Code 01] - for the prevention of thrombosis in patients post intracoronary stent implantation for a period of up to 30 days following insertion [Criteria Code 02] - other requests on a case by case basis

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 27

TICAGRELOR (Brilinta 90mg Tablet)

-

to be taken in combination with ASA 75 mg -150mg daily1 for patients with acute coronary syndrome (i.e. ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), or unstable angina (UA), as follows: STEMI2,3 · STEMI patients undergoing primary percutaneous coronary intervention (PCI) NSTEMI or UA2,3 · presence of high risk features irrespective of intent to perform revascularization: high GRACE risk score (>140) high TIMI risk score (5-7) second ACS within 12 months complex or extensive coronary artery disease e.g. diffuse three vessel disease definite documented cerebrovascular or peripheral vascular disease previous CABG OR · undergoing PCI + high risk angiographic anatomy4

-

coverage duration 12 months

NOTE: Criteria Code 30 may be used for the initial 30 day coverage period, however a written request submitted to the Pharmacare office is required to allow coverage for the remaining duration of treatment.

1 2

3 4

Co-administration of ticagrelor with high maintenance dose ASA (>150 mg daily) is not recommended. In the PLATO study more patients on ticagrelor experienced non CABG related major bleeding than patients on clopidogrel, however, there was no difference between the rate of overall major bleeding, between patients treated with ticagrelor and those treated with clopidogrel. As with all other antiplatelet treatments the benefit/risk ratio of antithrombotic effect vs. bleeding complications should be evaluated. Ticagrelor is contraindicated in patients with active pathological bleeding, in those with a history of intracranial hemorrhage and moderate to severe hepatic impairment. High risk angiographic anatomy is defined as any of the following: left main stenting, high risk bifurcation stenting (i.e., two-stent techniques), long stents 38 mm or overlapping stents, small stents 2.5 mm in patients with diabetes.

TIOTROPIUM BROMIDE (Spiriva 18mcg Cap For Inhalation)

- for the treatment of chronic obstructive pulmonary disease (COPD), if symptoms persist after 2-3 months of short-acting bronchodilator therapy (i.e., salbutamol at a maximum dose of 8 puffs/day or ipratropium at maximum dose of 12 puffs/day) - coverage can be provided without a trial of short-acting agent if: · there is spirometric evidence of at least moderate to severe airflow obstruction, (i.e., postbronchodilator values FEV1 < 60% and FEV1/FVC ratio < 0.7), and significant symptoms (i.e., MRC score of 3-5**) - combination therapy with tiotropium and a long-acting beta2 agonist/inhaled corticosteroid will only be considered if: · there is spirometric evidence of at least moderate to severe airflow obstruction (postbronchodilator values FEV1 < 60% and FEV1/FVC ratio < 0.7), and significant symptoms (i.e., MRC score of 3-5**) and · there is evidence of one or more moderate-to-severe exacerbations per year, on average, for 2 consecutive years requiring antibiotics and/or systemic (oral or intravenous) corticosteroids NOTE: Coverage of combination therapy with tiotropium and a long-acting beta2 agonist (without an inhaled corticosteroid) will not be considered due to insufficient evidence to support substantial benefit. If spirometry cannot be obtained, reasons must be clearly explained and other evidence regarding severity of condition must be provided for consideration (i.e., MRC scale). Spirometry reports from any point in time will be accepted. __________________________ ** Canadian Thoracic Society COPD Classification By Symptom/Disability: Moderate - (MRC 3-4) Shortness of breath from COPD causing the patient to stop after walking about 100 meters (or after a few minutes) on the level. Severe - (MRC 5) Shortness of breath from COPD resulting in the patient being too breathless to leave the

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 28

house or breathless after undressing, or the presence of chronic respiratory failure or clinical signs of right heart failure. MRC= Medical Research Council Dyspnea Scale

TIZANIDINE (Zanaflex 4mg Tablet and generic brands)

- for the treatment of spasticity resulting from traumatic brain injury, multiple sclerosis (MS), spinal cord injury (SCI) or cerebral vascular accident (CVA) in patients for whom baclofen is not indicated, ineffective or not tolerated

TOCLIZUMAB (Actemra 80mg/4mL, 200mg/10mL, 400mg/20mL Injection)

- for patients with a diagnosis of moderate-to-severely active RA who have failed to resond to an adequate trial of both disease-modifying antirheumatic drugs (DMARDs) and a tumour necrosis factor (TNF)-alpha inhibitor - therapy must include methotrexate unless contraindicated or not tolerated - written request of rheumatologist or prescriber with a specialty in rheumatology - intial coverage for 16 weeks at dose of 4mg/kg, yearly coverage dependent on patient achieving an improvement in symptoms of at least 20% - maximum dose: 800 mg every 4 weeks

TOLTERODINE (Detrol 1mg, 2mg and Detrol LA 2mg, 4mg Tablet)

- for the treatment of over-active bladder (not stress incontinence) for patients who cannot tolerate immediate release oxybutynin after an adequate trial (e.g. 3 months) - a three month trial will be approved initially with assessment of the effectiveness of this therapy required if further coverage is considered

TOPIRAMATE (Topamax 25mg, 100mg, 200mg Tablet and generic brands and Topamax 15mg, 25mg Sprinkle Capsule)

- for adjunctive management of epilepsy not satisfactorily controlled by conventional therapy

TRETINOIN (Vitamin A Acid Topical Preparations)

- regular benefit for beneficiaries 30 years and under - for treatment of actinic keratosis in benificiaries over the age of 30

TROSPIUM (Trosec 20mg Tablet)

- for the treatment of over-active bladder (not stress incontinence) for patients who cannot tolerate immediate release oxybutynin after an adequate trial (e.g. 3 months) - a three month trial will be approved initially with assessment of the effectiveness of this therapy required if further coverage is considered

TRYPTOPHAN (Tryptan 500mg Capsule and 500mg, 750mg, 1g Tablet and generic brands)

- as an adjunct for the treatment of depression in the management of patients suffering from bipolar affective disorders

URSODIOL (Urso 250mg, DS 500mg Tablet)

- for dissolution of radiolucent, noncalcified gallstones of less than 20mm size for patients who cannot undergo a cholecystectomy - for management of cholestatic liver disease such as primary biliary cirrhosis

USTEKINUMAB (Stelara 45mg/0.5mL Injection)

- for patients with severe, debilitating chronic plaque psoriasis (PsO) who meet all of the following criteria: · Body Surface Area (BSA) involvement of >10% and/or significant involvement of the face, hands, feet or genitals · failure to respond to, contraindication to or intolerant of methotrexate and cyclosporine · failure to respond to, intolerant of or unable to access phototherapy - written request of a dermatologist or prescriber with a specialty in dermatology - continued coverage is dependent on evidence of improvement, specifically: · 75% reduction in the Psoriasis Area and Severity Index (PASI) score, or · 50% reduction in PASI with a 5 point improvement in DLQI (Dermatology Life Quality Index), or · significant reduction in BSA involved, with consideration of important regions such as the face, hands, feet or genitals

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 29

- concurrent use of biologics not approved - initial approval for a maximum of 16 weeks - dosage restricted to 45mg at 0, 4 and 16 weeks, response must be assessed prior to fourth dose - maintenance dosing every 12 weeks

VALGANCICLOVIR (Valcyte 450mg Tablet)

- for the treatment of cytomegalovirus (CMV) retinitis in HIV-positive patients, upon the request of an infectious disease specialist or prescriber with a specialty in infectious disease - for the prevention of CMV disease post solid organ transplantation in patients at high-risk (D+ / R-) (i.e., donor positive/recipient negative). Coverage will be for a maximum of 90 days

*VANCOMYCIN (Vancocin 125mg, 250mg Capsule and generic brands)

- for the treatment of pseudomembranous colitis (PMC) when patients have not responded to initial therapy with metronidazole, or for initial treatment of severe PMC, or when drug interactions or intolerance, prevent the use of metronidazole [Criteria Code 01]

VERTEPORFIN (Visudyne 15mg/vial Injection)

- for the treatment of wet age-related macular degeneration (AMD) as prescribed by an authorized ophthalmologist [Criteria Code 01]

VIGABATRIN (Sabril 0.5g Sachet and 500mg Tablet)

- for adjunctive management of epilepsy not satisfactorily controlled by conventional therapy

VITAMIN B12, INJECTION VITAMIN B12, ORAL

- See Cyanocobalamin, Injection - See Cyanocobalamin, Oral

VORICONAZOLE (Vfend 50mg, 200mg Tablet)

- for the treatment of patients with invasive aspergillosis - for the treatment of invasive candidiasis (proven on culture) with documented resistance to fluconazole

*WET NEBULIZATION SOLUTIONS (Budesonide, Cromoglycate Sodium, Fenoterol, Ipratropium Bromide, Salbutamol)

- for adult patients with a vital capacity of 900mL or less - for adult patients with a respiratory rate greater than 25 breaths/minute - for patients who have demonstrated they cannot follow instructions, cannot hold the spacer device or cannot hold the device long enough to actuate it - other requests reviewed on a case by case basis

ZAFIRLUKAST (Accolate 20mg Tablet)

- See Leukotriene Receptor Antagonists

*ZANAMIVIR (Relenza 5mg Powder For Inhalation)

- for the treatment of long-term care residents with clinically suspected or lab confirmed influenza A or B, when there is documented resistance to oseltamivir or when oseltamivir is contraindicated. A clinically suspected case is one in which the patient meets the criteria of influenza-like illness and there is confirmation of influenza A or B circulating within the facility or surrounding community - for the prophylaxis of influenza A or B in long term care residents where the facility has an outbreak, when there is documented resistance to oseltamivir or when oseltamivir is contraindicated. - a protocol has been developed by Public Health for the treatment of patients in long-term care facilities. The facility must contact the Medical Officer of Health or local Public Health Office, who will notify the Pharmacare office (or dispensing pharmacy after office hours) if coverage is required

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 30

ZIPRASIDONE (Zeldox 20mg, 40mg, 60mg, 80mg Capsule)

- for the treatment of schizophrenia and schizoaffective disorder

*ZOLEDRONIC ACID (Aclasta 5mg/100ml Injection)

- for the treatment of Paget's disease - for women with postmenopausal osteoporosis for whom oral bisphosphonates are contraindicated due to abnormalities of the esophagus (e.g. esophageal stricture or achalasia) and have at least two of the following: · age > 75 years · a prior fragility fracture · a bone mineral density (BMD) T-score -2.5

ZOLMITRIPTAN (Zomig, Zomig Rapimelt 2.5mg Tablet)

- See Selective 5HT1 - Receptor Agonists

NOTE: Exception status drugs for Drug Assistance for Cancer Patients are indicated by an asterisk (*).

December 2012

Appendix III ­ 31

Product Index

292 .................................................................................. 126 3TC ................................................................................. 100 5-aminosalicylic acid ......................................................11 abatacept .......................................................................109 Abilify .............................................................................. 149 abiraterone .................................................................... 107 Abstral ............................................................................. 127 AC Boyz Chamber .......................................................... 175 AC Girlz Chamber ........................................................... 175 acamprosate ..................................................................165 acarbose ..........................................................................15 Accel Pioglitazone ....................................................... 15, 16 Accolate .......................................................................... 173 Accupril .............................................................................45 Accuretic ...........................................................................47 Accutane ...........................................................................69 acebutolol ........................................................................37 Acebutolol .........................................................................37 acenocoumarol ...............................................................20 acetaminophen..............................................................129 acetaminophen, comb. excl. psycholeptics ............... 129 acetazolamide ...............................................................179 Acetazolamide ................................................................ 179 acetylcysteine ...............................................................173 Acetylcysteine ................................................................. 173 acetylsalicylic acid (ASA) .............................................128 acetylsalicylic acid (ASA) comb. w psycholeptics..... 129 acetylsalicylic acid (ASA), comb. excl. psycholeptics ...................................................................................129 acitretin ............................................................................63 Aclasta ............................................................................ 121 Actemra........................................................................... 110 Actonel ............................................................................ 121 Actos ...........................................................................15, 16 Acular .............................................................................. 178 acyclovir ....................................................................64, 98 Acyclovir............................................................................98 Adalat ................................................................................40 Adalat XL ..........................................................................40 Adalat XL Plus ..................................................................40 adalimumab ...................................................................110 Adcirca ..............................................................................77 Adderall XR ..................................................................... 161 adefovir dipivoxil ..........................................................100 Advagraf.......................................................................... 110 Advair .............................................................................. 171 Advicor ..............................................................................58 Aerius .............................................................................. 175 AeroChamber.................................................................. 175 AeroChamber Max .......................................................... 175 Afinitor ............................................................................. 109 Aggrenox...........................................................................21 Agrylin ............................................................................. 105 Airomir ............................................................................ 170 Alcaine ............................................................................ 181 Aldactazide .......................................................................32 Aldactone ..........................................................................31 Aldara ...............................................................................64 Aldomet .............................................................................28 Aldurazyme .......................................................................18 alefacept ........................................................................109 alendronate....................................................................121 Alendronate..................................................................... 121 Alendronate-FC............................................................... 121

December 2012

alendronic acid ............................................................. 121 alendronic acid and colecalciferol.............................. 122 Alertec ............................................................................ 162 Alesse .............................................................................. 73 alfacalcidol ..................................................................... 17 Alfenta ............................................................................ 123 alfentanil ....................................................................... 123 Alfentanil ........................................................................ 123 alfuzosin ......................................................................... 78 algucosidase alfa ........................................................... 18 aliskiren .......................................................................... 52 alitretinoin ....................................................................... 69 Alkeran ........................................................................... 103 Allegra ............................................................................ 174 Allergy Serum................................................................. 185 allopurinol ..................................................................... 120 almotriptan ................................................................... 132 Alphagan ........................................................................ 179 Alphagan P .................................................................... 179 alprazolam .................................................................... 150 Alprazolam ..............................................................150, 151 Altace ..........................................................................44, 45 Altace HCT ....................................................................... 47 altretamine .................................................................... 105 aluminum hydroxide ........................................................ 1 Alupent ........................................................................... 172 Alvesco .......................................................................... 171 Alysena ............................................................................ 73 amantadine ................................................................... 138 Amaryl .........................................................................14, 15 Amatine ............................................................................ 27 ambrisentan .................................................................... 30 amcinonide ..................................................................... 66 Amerge .......................................................................... 131 Amevive ......................................................................... 109 amikacin .......................................................................... 93 Amikacin .......................................................................... 93 Amikin .............................................................................. 93 amiloride ......................................................................... 32 aminobenzoate potassium, systemic ........................... 70 amiodarone ..................................................................... 26 Amiodarone ...................................................................... 26 amitriptyline .................................................................. 154 amlodipine ...................................................................... 39 Amlodipine ....................................................................... 39 Amlodipine-ODAN ............................................................ 39 amoxicillin ...................................................................... 87 Amoxicillin ........................................................................ 87 amoxicillin and enzyme inhibitor .................................. 88 Amoxicillin Sugar Reduced .............................................. 87 Amoxil .............................................................................. 87 amphetamines .............................................................. 161 amphotericin................................................................... 97 ampicillin ........................................................................ 86 Anafranil ..................................................................153, 154 anagrelide ..................................................................... 105 anakinra ........................................................................ 110 Anandron ....................................................................... 106 Anaprox .......................................................................... 116 Anaprox DS .................................................................... 116 anastrozole ................................................................... 107 Andriol .............................................................................. 74 Androcur .......................................................................... 76 Androderm ....................................................................... 74

Product Index ­ 32

Product Index

Androgel............................................................................74 anethole trithone .............................................................18 Anexate ........................................................................... 185 Anodan-HC .......................................................................33 Ansaid ............................................................................. 117 antacids, ordinary salt comb. ..........................................1 antacids, ordinary salt comb. and antiflatulents ............1 Anthraforte ........................................................................62 anthralin ...........................................................................62 Anthralin ............................................................................62 Anthranol...........................................................................62 Anthrascalp .......................................................................62 antibiotics (ophthalmic), comb. ...................................177 antibiotics, comb. ...........................................................63 antiinfectives, comb. ...................................... 23, 182, 183 antispasmodics, comb. ....................................................6 Anturan ........................................................................... 120 Anugesic-HC .....................................................................33 Anusol-HC.........................................................................33 Anzemet ..............................................................................8 APC-Cetirizine ................................................................ 174 APC-Ferrous Gluconate ....................................................22 APC-Ibuprofen ................................................................ 115 APC-Loratadine .............................................................. 174 Apidra ...............................................................................12 Apo-Acebutolol..................................................................37 Apo-Acyclovir .............................................................. 98, 99 Apo-Alendronate ............................................................. 121 Apo-Alfuzosin ....................................................................78 Apo-Alpraz .............................................................. 150, 151 Apo-Amilzide .....................................................................32 Apo-Amiodarone ...............................................................26 Apo-Amlodipine.................................................................39 Apo-Amoxi ........................................................................87 Apo-Amoxi Clav ................................................................88 Apo-Anastrozole ............................................................. 107 Apo-Atenidone ............................................................ 38, 39 Apo-Atenol ........................................................................36 Apo-Atomoxetine .................................................... 162, 163 Apo-Atomoxtine ..............................................................162 Apo-Atorvastatin ......................................................... 55, 56 Apo-Azathioprine ............................................................ 110 Apo-Azithromycin ..............................................................92 Apo-Baclofen .................................................................. 119 Apo-Beclo ....................................................................... 169 Apo-Benztropine ............................................................. 138 Apo-Benzydamine ...............................................................1 Apo-Bicalutamide ............................................................ 107 Apo-Bisacodyl .....................................................................9 Apo-Bisoprolol...................................................................37 Apo-Brimonidine ............................................................. 179 Apo-Brimonidine P .......................................................... 179 Apo-Bromazepam ........................................................... 150 Apo-Bromocriptine ............................................................72 Apo-Buspirone ................................................................ 151 Apo-Butorphanol ............................................................. 128 Apo-Calcitonin...................................................................85 Apo-Candesartan ........................................................ 49, 50 Apo-Candesartan/HCTZ ...................................................52 Apo-Capto ................................................................... 42, 43 Apo-Carbamazepine ....................................................... 133 Apo-Carvedilol ..................................................................38 Apo-Cefadroxil ..................................................................89 Apo-Cefprozil .............................................................. 89, 90 Apo-Cefuroxime ................................................................89 Apo-Cephalex ...................................................................89

December 2012

Apo-Cetirizine................................................................. 174 Apo-Chlorax ....................................................................... 6 Apo-Chlordiazepoxide .................................................... 149 Apo-Chlorpropamide ........................................................ 14 Apo-Chlorthalidone .......................................................... 30 Apo-Ciclopirox .................................................................. 61 Apo-Cilazapril ..............................................................45, 46 Apo-Cilazapril/HCTZ ........................................................ 47 Apo-Cimetidine............................................................... 1, 2 Apo-Ciproflox ......................................................94, 95, 178 Apo-Ciprofloxacin ............................................................. 94 Apo-Citalopram .............................................................. 156 Apo-Clarithromycin........................................................... 92 Apo-Clindamycin .............................................................. 93 Apo-Clobazam ............................................................... 150 Apo-Clomipramine ..................................................153, 154 Apo-Clonazepam ........................................................... 133 Apo-Clonidine................................................................... 28 Apo-Clopidogrel ............................................................... 20 Apo-Clorazepate .....................................................149, 150 Apo-Clozapine................................................................ 143 Apo-Cyclobenzaprine ..................................................... 119 Apo-Cyclosporine ........................................................... 110 Apo-Cyproterone .............................................................. 76 Apo-Desipramine ........................................................... 153 Apo-Desmopressin........................................................... 81 Apo-Dexamethasone ....................................................... 83 Apo-Diazepam ............................................................... 149 Apo-Diclo ................................................................113, 114 Apo-Diflunisal ................................................................. 129 Apo-Diltiaz ........................................................................ 42 Apo-Diltiaz CD.................................................................. 41 Apo-Diltiaz TZ .............................................................41, 42 Apo-Dipyridamole............................................................. 21 Apo-Dipyridamole-FC ....................................................... 21 Apo-Divalproex............................................................... 134 Apo-Domperidone .............................................................. 7 Apo-Dorzo-Timop ........................................................... 180 Apo-Doxazosin ................................................................. 29 Apo-Doxepin ...........................................................154, 155 Apo-Doxy ......................................................................... 86 Apo-Enalapril.................................................................... 43 Apo-Enalapril Maleate/HCTZ ........................................... 46 Apo-Erythro ...................................................................... 91 Apo-Erythro-EC ................................................................ 91 Apo-Erythro-ES ................................................................ 92 Apo-Erythro-S .................................................................. 92 Apo-Esomeprazole............................................................. 5 Apo-Etodolac ................................................................. 114 Apo-Famciclovir ............................................................... 99 Apo-Famotidine .............................................................. 2, 3 Apo-Feno-Micro ............................................................... 57 Apo-Feno-Super............................................................... 57 Apo-Ferrous Gluconate .................................................... 22 Apo-Finasteride ................................................................ 79 Apo-Flecainide ................................................................. 26 Apo-Floctafenine ............................................................ 130 Apo-Fluconazole .............................................................. 97 Apo-Flunarizine .............................................................. 165 Apo-Flunisolide .............................................................. 169 Apo-Fluoxetine ........................................................155, 156 Apo-Fluphenazine .......................................................... 141 Apo-Flurazepam......................................................151, 152 Apo-Flurbiprofen ............................................................ 117 Apo-Flutamide ................................................................ 106 Apo-Fluticasone ............................................................. 169

Product Index ­ 33

Product Index

Apo-Fluvoxamine ............................................................ 158 Apo-Folic Acid ...................................................................23 Apo-Fosinopril ...................................................................46 Apo-Furosemide ...............................................................31 Apo-Gabapentin ...................................................... 136, 137 Apo-Gain ...........................................................................70 Apo-Gemfibrozil ................................................................57 Apo-Gliclazide ...................................................................14 Apo-Glimepiride .......................................................... 14, 15 Apo-Glyburide ...................................................................14 Apo-Granisetron..................................................................8 Apo-Haloperidol .............................................................. 142 Apo-Hydralazine ...............................................................29 Apo-Hydro .........................................................................30 Apo-Hydroxyquine .......................................................... 167 Apo-Hydroxyzine............................................................. 151 Apo-Ibuprofen ................................................................. 115 Apo-Imipramine............................................................... 153 Apo-Indapamide................................................................31 Apo-Indomethacin ........................................................... 113 Apo-Ipravent ........................................................... 169, 171 Apo-Irbesartan ..................................................................49 Apo-ISDN ..........................................................................28 Apo-ISMN .........................................................................28 Apo-K ................................................................................17 Apo-Keto ......................................................................... 117 Apo-Ketoconazole .............................................................97 Apo-Keto-E ..................................................................... 117 Apo-Ketorolac ......................................................... 114, 178 Apo-Lactulose ...................................................................10 Apo-Lamivudine .............................................................. 100 Apo-Lamivudine HBV ...................................................... 100 Apo-Lamotrigine.............................................................. 135 Apo-Lamuvudine-Zidovudine .......................................... 101 Apo-Lansoprazole ...............................................................4 Apo-Latanoprost ............................................................. 180 Apo-Leflunomide ............................................................. 109 Apo-Letrozole.................................................................. 107 Apo-Levetiracetam .......................................................... 137 Apo-Levocarb.................................................................. 138 Apo-Levofloxacin ..............................................................95 Apo-Lisinopril .............................................................. 43, 44 Apo-Lisinopril/HCTZ .................................................... 46, 47 Apo-Lithium Carbonate ................................................... 146 Apo-Loratadine ............................................................... 174 Apo-Losartan .............................................................. 47, 48 Apo-Losartan/HCTZ .................................................... 50, 51 Apo-Lovastatin ..................................................................54 Apo-Medroxy.....................................................................75 Apo-Mefenamic ............................................................... 117 Apo-Mefloquine ............................................................... 167 Apo-Megestrol......................................................... 105, 106 Apo-Meloxicam ............................................................... 115 Apo-Memantine............................................................... 164 Apo-Metformin ..................................................................13 Apo-Methazolamide ........................................................ 179 Apo-Methoprazine ........................................................... 140 Apo-Methotrexate ........................................................... 103 Apo-Methyldopa ................................................................28 Apo-Methylphenidate ...................................................... 161 Apo-Metoclop ......................................................................6 Apo-Metoprolol............................................................ 35, 36 Apo-Metoprolol SR ............................................................36 Apo-Metoprolol-L ........................................................ 35, 36 Apo-Metronidazole ............................................................96 Apo-Midodrine...................................................................27

December 2012

Apo-Minocycline ............................................................... 86 Apo-Mirtazapine ............................................................. 159 Apo-Misoprostol ................................................................. 3 Apo-Moclobemide .......................................................... 158 Apo-Montelukast ............................................................ 173 Apo-Mycophenolate ....................................................... 109 Apo-Nabumetone ........................................................... 118 Apo-Nadol ........................................................................ 35 Apo-Napro-Na ................................................................ 116 Apo-Napro-Na DS .......................................................... 116 Apo-Naproxen .........................................................115, 116 Apo-Nitrazepam ............................................................. 152 Apo-Nitrofurantoin ............................................................ 96 Apo-Nizatidine .................................................................... 3 Apo-Norflox ...................................................................... 95 Apo-Nortriptyline ............................................................ 154 Apo-Oflox ......................................................................... 94 Apo-Ofloxacin................................................................. 177 Apo-Olanzapine ......................................................144, 145 Apo-Omeprazole ................................................................ 3 Apo-Ondansetron ............................................................... 7 Apo-Orciprenaline .......................................................... 172 Apo-Oxaprozin ............................................................... 117 Apo-Oxazepam .............................................................. 149 Apo-Oxcarbazepine ....................................................... 134 Apo-Oxybutynin................................................................ 77 Apo-Oxycodone/Acet ..................................................... 129 Apo-Pantoprazole .............................................................. 4 Apo-Paroxetine .......................................................156, 157 Apo-Pen VK ..................................................................... 87 Apo-Pentoxifylline ............................................................ 32 Apo-Perphenazine ......................................................... 141 Apo-Pimozide ................................................................. 143 Apo-Pindol ..................................................................33, 34 Apo-Pioglitazone .........................................................15, 16 Apo-Piroxicam ................................................................ 114 Apo-Pramipexole.....................................................139, 140 Apo-Pravastatin...........................................................54, 55 Apo-Prazo ........................................................................ 29 Apo-Prednisone ............................................................... 84 Apo-Primidone ............................................................... 132 Apo-Prochlorazine.......................................................... 141 Apo-Propafenone ............................................................. 26 Apo-Propranolol ............................................................... 34 Apo-Quetiapine .......................................................145, 146 Apo-Quinine ................................................................... 167 Apo-Rabeprazole ........................................................... 4, 5 Apo-Raloxifene................................................................. 76 Apo-Ramipril ...............................................................44, 45 Apo-Ranitidine.................................................................... 2 Apo-Repaglinide............................................................... 16 Apo-Riluzole ................................................................... 165 Apo-Risedronate ............................................................ 121 Apo-Risperidone .....................................................147, 148 Apo-Rivastigmine ........................................................... 163 Apo-Rosuvastatin ........................................................56, 57 Apo-Salvent ............................................................170, 172 Apo-Selegiline ................................................................ 140 Apo-Sertraline .........................................................157, 158 Apo-Sildenafil ................................................................... 77 Apo-Simvastatin ..........................................................53, 54 Apo-Sotalol ...................................................................... 35 Apo-Sucralfate ................................................................... 5 Apo-Sulfatrim ................................................................... 91 Apo-Sulfatrim DS ............................................................. 91 Apo-Sulfinpyrazone ........................................................ 120

Product Index ­ 34

Product Index

Apo-Sulin ........................................................................ 113 Apo-Sumatriptan ..................................................... 130, 131 Apo-Tamox ..................................................................... 106 Apo-Tamsulosin ................................................................78 Apo-Temazepam ............................................................ 152 Apo-Tenoxicam ............................................................... 115 Apo-Terazosin............................................................. 78, 79 Apo-Terbinafine ................................................................62 Apo-Tetra ..........................................................................86 Apo-Theo ........................................................................ 172 Apo-Theo LA ................................................................... 172 Apo-Tiaprofenic............................................................... 117 Apo-Ticlopidine .................................................................20 Apo-Timol..........................................................................34 Apo-Timop ...................................................................... 180 Apo-Tizanidine ................................................................ 119 Apo-Tolbutamide ...............................................................14 Apo-Topiramate ...................................................... 135, 136 Apo-Tramadol /Acet Tab ................................................. 128 Apo-Trazodone ............................................................... 159 Apo-Triazide......................................................................32 Apo-Triazo ...................................................................... 152 Apo-Trifluoperazine ......................................................... 141 Apo-Trihex ...................................................................... 137 Apo-Trimebutine .................................................................5 Apo-Trimethoprim .............................................................91 Apo-Trimip ...................................................................... 154 Apo-Tryptophan .............................................................. 159 Apo-Valacyclovir ...............................................................99 Apo-Valproic ................................................................... 134 Apo-Valsartan ....................................................... 48, 49, 51 Apo-Valsartan/HCTZ .........................................................51 Apo-Venlafaxine...................................................... 160, 161 Apo-Verap ................................................................... 40, 41 Apo-Warfarin ............................................................... 19, 20 Apo-Zidovudine ............................................................... 100 Apo-Zopiclone ......................................................... 152, 153 apraclonidine.................................................................179 aprepitant...........................................................................8 Apresoline .........................................................................29 Apri 21 ..............................................................................73 Apri 28 ..............................................................................73 Aptivus ............................................................................ 100 Aralen ............................................................................. 167 Aranesp ............................................................................23 Arava .............................................................................. 109 Aredia ............................................................................. 121 AreoChamber.................................................................. 175 Aricept ............................................................................. 163 Arimidex .......................................................................... 107 Aristocort ...........................................................................65 Arixtra ...............................................................................21 Aromasin ......................................................................... 107 Arthrotec ......................................................................... 114 artificial tears.................................................................182 Artificial Tears ................................................................. 182 Asacol ...............................................................................11 ASATAB .......................................................................... 128 asenapine ...................................................................... 146 Asmanex ......................................................................... 171 Atacand .......................................................................49, 50 Atacand Plus .....................................................................52 Atarax ............................................................................. 151 Atasol ...................................................................... 126, 129 atazanavir ......................................................................100 atenolol and other diuretics ...........................................38

December 2012

Ativan ............................................................................. 150 atomoxetine .................................................................. 162 atorvastatin ..................................................................... 55 Atorvastatin .................................................................55, 56 atorvastatin and amlodipine.......................................... 58 atovaquone ................................................................... 167 Atripla ............................................................................. 101 atropine ......................................................................6, 181 Atropine .............................................................................. 6 Atrovent ...........................................................169, 171, 172 auranofin ....................................................................... 118 Auro-Cefprozil .............................................................89, 90 Auro-Cefuroxime .............................................................. 89 Auro-Citalopram ............................................................. 156 Auro-Cyclobenzaprine .................................................... 119 Auro-Gabapentin ............................................................ 136 Auro-Levetiracetam ........................................................ 137 Auro-Mirtazapine ............................................................ 160 Auro-Nevirapine ............................................................. 101 Auro-Terbinafine .............................................................. 62 Auro-Topiramate .....................................................135, 136 Avalide ........................................................................51, 52 Avandamet ....................................................................... 15 Avandia ............................................................................ 15 Avapro .............................................................................. 49 Avelox .............................................................................. 95 Aventyl ........................................................................... 154 Aviane .............................................................................. 73 Avodart ............................................................................. 79 Avonex ........................................................................... 108 Axert ............................................................................... 132 Axid .................................................................................... 3 Azarga ............................................................................ 180 azathioprine .................................................................. 110 Azathioprine ................................................................... 110 Azilect ............................................................................ 140 azithromycin ................................................................... 92 Azithromycin ...............................................................92, 93 Azopt .............................................................................. 179 aztreonam ....................................................................... 90 Bacid ................................................................................ 11 bacitracin ........................................................................ 63 Bacitracin ......................................................................... 63 baclofen ........................................................................ 119 Baclofen ......................................................................... 119 Bacteriostatic Water ....................................................... 186 Bactroban ......................................................................... 63 Banzel ............................................................................ 134 Baraclude ....................................................................... 100 Basaljel .............................................................................. 1 BCG vaccine ................................................................. 108 beclomethasone ....................................................169, 171 Beconase ....................................................................... 169 belimumab .................................................................... 109 Bellergal ............................................................................. 6 Benadryl ......................................................................... 174 benazepril ....................................................................... 45 Benazepril ................................................................. 45, See Benlysta ......................................................................... 109 Bentylol .............................................................................. 5 Benuryl ........................................................................... 120 BenzaClin ......................................................................... 69 benzethonium chloride, comb. ..................................... 68 benzoyl peroxide ............................................................ 69 benztropine ................................................................... 138 benzydamine .................................................................... 1

Product Index ­ 35

Product Index

Betaderm ..........................................................................65 Betadine ............................................................................68 Betagan .......................................................................... 180 betahistimine .................................................................165 betaine .............................................................................18 Betaject .............................................................................82 Betaloc ........................................................................35, 36 betamethasone.............................................. 11, 65, 68, 82 betamethasone and antibiotics .....................................67 betamethasone and antiinfectives ..............................183 Betaseron........................................................................ 108 Betaxin ..............................................................................17 betaxolol ........................................................................180 bethanechol ...................................................................164 Betnesol ............................................................................11 Betoptic-S ....................................................................... 180 bezafibrate .......................................................................57 Bezalip ..............................................................................57 Biaxin ................................................................................92 bicalutamide ..................................................................107 Biclutamide ..................................................................... 107 bimatoprost ...................................................................181 Bion Tears....................................................................... 182 Biphentin ......................................................................... 161 bisacodyl ...........................................................................9 Bisacodyl-ODAN .................................................................9 bismuth subsalicylate ....................................................10 bisoprolol.........................................................................37 Blephamide ..................................................................... 179 Blocadren ..........................................................................34 boceprevir...................................................................... 100 Bonefos ........................................................................... 120 bosentan ..........................................................................30 Botox ............................................................................... 118 botulinum toxin .............................................................118 Bretylate ............................................................................26 bretylium tosylate ...........................................................26 Bretylium Tosylate ............................................................26 Brevicon ............................................................................72 Bricanyl ........................................................................... 170 Brilinta ...............................................................................21 brimonidine ...................................................................179 brinzolamide ..................................................................179 bromazepam ..................................................................150 bromocriptine ..................................................................72 budesonide ...................................................... 11, 169, 171 bumetanide ......................................................................31 bupivacaine ...................................................................123 buprenorphine............................................................... 128 buprenorphine, comb. ..................................................165 bupropion .............................................................. 160, 165 Burinex ..............................................................................31 Buro-Sol .................................................................... 68, 182 Buscopan ............................................................................8 buserelin ........................................................................106 Buspar ............................................................................ 151 buspirone.......................................................................151 busulfan .........................................................................103 butoconazole ...................................................................71 butorphanol ...................................................................128 BuTrans .......................................................................... 128 C.E.S. ...............................................................................75 cabergoline ......................................................................72 Caduet ........................................................................ 58, 59 Cafergot .......................................................................... 130 Calcimar ............................................................................85

December 2012

calcipotriol ...................................................................... 63 calcipotriol, comb. ......................................................... 63 calcitonin (salmon synthetic) ........................................ 85 calcitriol .......................................................................... 17 calcium acetate ............................................................ 185 calcium folinate ............................................................ 186 Campral ......................................................................... 165 Candasartan .................................................................... 49 candesartan .................................................................... 49 Candesartan ...............................................................49, 50 candesartan and diuretics ............................................. 52 Candesartan Cilexetil ..................................................49, 50 Canesten .....................................................................61, 71 cannabinoid (thc) derivatives.......................................... 8 cannabinoid derivatives, comb. .................................. 130 capecitabine ................................................................. 104 Capoten ......................................................................42, 43 captopril .......................................................................... 42 carbachol ...................................................................... 179 carbamazepine ............................................................. 133 carbohydrates ................................................................ 23 Carbolith ......................................................................... 146 Cardizem .......................................................................... 42 Cardizem CD.................................................................... 41 Cardura ............................................................................ 29 Carnitor ............................................................................ 18 carvedilol ........................................................................ 38 Carvedilol ......................................................................... 38 Casodex ......................................................................... 107 Catapres .......................................................................... 28 Cayston ............................................................................ 90 Ceclor ............................................................................... 89 CeeNU ........................................................................... 103 cefaclor ........................................................................... 89 cefadroxil ........................................................................ 89 cefazolin .......................................................................... 89 Cefazolin Sodium ............................................................. 89 cefepime ......................................................................... 90 Cefepime .......................................................................... 90 cefixime ........................................................................... 90 cefotaxime ...................................................................... 90 cefprozil .......................................................................... 89 ceftazidime ..................................................................... 90 Ceftin................................................................................ 89 ceftriaxone ...................................................................... 90 Ceftriaxone ....................................................................... 90 cefuroxime ...................................................................... 89 Cefzil ...........................................................................89, 90 Celebrex ......................................................................... 117 celecoxib ....................................................................... 117 Celestoderm-V ................................................................. 65 Celestone ......................................................................... 82 Celexa ............................................................................ 156 Cellcept .......................................................................... 109 Celontin .......................................................................... 132 Celsentri ......................................................................... 101 cephalexin ...................................................................... 88 Cesamet ............................................................................. 8 cetirizine ....................................................................... 174 chloral hydrate ............................................................. 151 Chloral hydrate-ODAN ................................................... 151 chlorambucil ................................................................. 103 chloramphenicol .....................................................86, 177 chlordiazepoxide .......................................................... 149 chlorhexidine .................................................................... 1 Chloromycetin Succinate ................................................. 86

Product Index ­ 36

Product Index

chloroquine ...................................................................167 chlorpromazine .............................................................140 Chlorpromazine............................................................... 140 chlorpropamide ...............................................................14 chlorthalidone .................................................................30 Choledyl .................................................................. 172, 173 cholestyramine................................................................58 choline theophyllinate ..................................................172 Chronulac..........................................................................10 ciclesonide ....................................................................171 ciclopirox .........................................................................61 cilazapril...........................................................................45 Cilazapril ..................................................................... 45, 46 cilazapril and diuretics ...................................................47 Ciloxan .................................................................... 177, 178 cimetidine ..........................................................................1 Cimzia ............................................................................. 110 cinacalet...........................................................................85 Cipralex ........................................................................... 158 Cipro ...........................................................................94, 95 Ciprodex.......................................................................... 183 ciprofloxacin............................................................ 94, 177 Ciprofloxacin ............................................................... 94, 95 Citalopram....................................................................... 156 Citalopram-Odan............................................................. 156 Citro Mag ..........................................................................10 Citrodan ............................................................................10 Claforan ............................................................................90 clarithromycin .................................................................92 Claritin ............................................................................. 174 Clarus ...............................................................................69 Clavulin .............................................................................88 clidinium and psycholeptics ............................................6 Climara ....................................................................... 74, 75 clindamycin ......................................................... 69, 71, 93 Clindamycin ......................................................................93 clindamycin, comb. .........................................................69 Clindoxyl Gel .....................................................................69 Clinoril ............................................................................. 113 clobazam........................................................................150 clobetasol ........................................................................67 clobetasone .....................................................................64 clodronate......................................................................120 clodronic acid................................................................120 Clomid ...............................................................................76 clomifene .........................................................................76 clomipramine.................................................................153 clonazepam ...................................................................132 clonidine ..........................................................................28 Clonidine ...........................................................................28 clopidogrel.......................................................................20 Clopixol ........................................................................... 143 Clopixol-Acuphase .......................................................... 143 Clopixol-Depot ................................................................ 143 clorazepate dipotassium ..............................................149 clostridiopepitidase ........................................................62 Clotrimaderm .............................................................. 61, 71 clotrimazole ...............................................................61, 71 cloxacillin.........................................................................87 clozapine........................................................................143 Clozaril ............................................................................ 143 CO Alendronate .............................................................. 121 CO Amlodipine ..................................................................39 CO Anastrozole............................................................... 107 CO Atenolol.......................................................................36 CO Atorvastatin........................................................... 55, 56

December 2012

CO Azithromycin .........................................................92, 93 CO Betahistine ............................................................... 165 CO Bicalutamide ............................................................ 107 CO Bosentan.................................................................... 30 CO Cabergoline ............................................................... 72 CO Candesartan .........................................................49, 50 CO Candesartan/HCT ...................................................... 52 CO Ciprofloxacin .........................................................94, 95 CO Citalopram ............................................................... 156 CO Clomipramine....................................................153, 154 CO Clonazepam............................................................. 133 CO Clopidogrel................................................................. 20 CO Diltiazem .................................................................... 41 CO Diltiazem T ................................................................. 42 CO Enalapril ..................................................................... 43 CO Etidrocal ................................................................... 122 CO Etidronate ................................................................ 120 CO Exemestane ............................................................. 107 CO Famciclovir................................................................. 99 CO Finasteride ................................................................. 79 CO Fluconazole ............................................................... 97 CO Fluoxetine ................................................................ 155 CO Fluvoxamine ............................................................ 158 CO Gabapentin .............................................................. 136 CO Irbesartan................................................................... 49 CO Irbesartan/HCT .....................................................51, 52 CO Latanoprost .............................................................. 180 CO Levetiracetam .......................................................... 137 CO Levofloxacin ............................................................... 95 CO Lisinopril ...............................................................43, 44 CO Losartan ................................................................47, 48 CO Lovastatin .................................................................. 54 CO Meloxicam................................................................ 115 CO Memantine ............................................................... 164 CO Metformin ................................................................... 13 CO Mycophenolate ........................................................ 109 CO Norfloxacin ................................................................. 95 CO Olanzapine........................................................144, 145 CO Ondansetron ................................................................ 7 CO Pantoprazole................................................................ 4 CO Paroxetine.........................................................156, 157 CO Pioglitazone ..........................................................15, 16 CO Pramipexole ......................................................139, 140 CO Pravastatin ............................................................54, 55 CO Quetiapine ........................................................145, 146 CO Raloxifene .................................................................. 76 CO Ramipril ................................................................44, 45 CO Ranitidine ..................................................................... 2 CO Repaglinide ................................................................ 16 CO Risperidone.......................................................147, 148 CO Rizatriptan................................................................ 131 CO Ropinirole................................................................. 139 CO Rosuvastatin .........................................................56, 57 CO Sertraline ..........................................................157, 158 CO Sildenafil .................................................................... 77 CO Simvastatin ...........................................................53, 54 CO Sotalol ........................................................................ 35 CO Sumatriptan ......................................................130, 131 CO Temazepam ............................................................. 152 CO Terbinafine ................................................................. 62 CO Topiramate........................................................135, 136 CO Tramadol/Acet ......................................................... 128 CO Valacyclovir................................................................ 99 CO Valsartan...............................................................48, 49 CO Venlafaxine .......................................................160, 161 CO Zopiclone ..........................................................152, 153

Product Index ­ 37

Product Index

coal tar .............................................................................62 codeine ..........................................................................174 Codeine Contin ............................................................... 174 Codeine Phosphate ........................................................ 174 Codeine, comb. excl. psycholeptics ...........................126 Cogentin.......................................................................... 138 CO-Irbesartan ...................................................................49 Colace .................................................................................9 colchicine ......................................................................120 Colchicine ....................................................................... 120 Colestid .............................................................................58 Colestid Orange ................................................................58 colestipol .........................................................................58 collagenase .....................................................................62 CoLyte ................................................................................9 Combigan........................................................................ 180 Combivent ....................................................................... 170 Combivir .......................................................................... 101 Complera ........................................................................ 101 Comtan ........................................................................... 140 Concerta ......................................................................... 162 Condyline ..........................................................................64 conjugated estrogens .....................................................75 Copaxone........................................................................ 108 Cordarone .........................................................................26 Coreg ................................................................................38 Corgard .............................................................................35 Cortamed ........................................................................ 178 Cortef ................................................................................84 Cortenema ........................................................................11 Cortifoam ..........................................................................11 cortisone ..........................................................................84 Cortisone Acetate .............................................................84 Cortisporin......................................................... 67, 179, 183 Cortoderm .........................................................................64 Cosopt ............................................................................ 180 Cotazym ............................................................................12 Cotazym ECS ...................................................................12 Cotazym-65B ....................................................................12 Coumadin....................................................................19, 20 CO-Valsartan ....................................................................48 Coversyl ............................................................................44 Coversyl Plus ....................................................................47 Cozaar ........................................................................47, 48 Creon ................................................................................12 Crestor ........................................................................56, 57 Crixivan .............................................................................99 cromoglycate sodium ............................. 11, 169, 172, 181 Cromolyn......................................................................... 181 CTP30 ............................................................................. 156 Cubicin ..............................................................................96 Cuprimine........................................................................ 118 cyanocobalamin ..............................................................22 Cyanocobalamin ...............................................................22 cyanocobalamin, comb. .................................................22 Cyclen ...............................................................................73 cyclobenzaprine ............................................................119 Cyclobenzaprine ............................................................. 119 Cyclocort ...........................................................................66 Cyclogyl .......................................................................... 181 Cyclomen ..........................................................................76 cyclopentolate ...............................................................181 cyclophosphamide .......................................................103 cyclosporine ..................................................................110 Cyestra-35 ........................................................................76 Cyklokapron ......................................................................21

December 2012

Cymbalta ........................................................................ 161 cyproterone .................................................................... 76 cyproterone and estrogen ............................................. 76 Cystadane ........................................................................ 18 Cytomel ............................................................................ 85 Cytotec ............................................................................... 3 Cytovene .......................................................................... 99 dabigatran etexilate ....................................................... 21 Dalacin ............................................................................. 71 Dalacin C ......................................................................... 93 Dalacin C Phos ................................................................ 93 Dalacin T .......................................................................... 69 Dalmane ..................................................................151, 152 dalteparin ........................................................................ 20 danazol ............................................................................ 76 Dantrium ........................................................................ 120 dantrolene ..................................................................... 120 dapsone .......................................................................... 98 Dapsone ........................................................................... 98 daptomycin ..................................................................... 96 Daraprim ........................................................................ 167 darbepoetin..................................................................... 23 darunavir ....................................................................... 100 dasatinib ....................................................................... 105 Daxas ............................................................................. 173 Daypro ........................................................................... 117 DDAVP ........................................................................81, 82 Decadron ..................................................................83, 183 deferasirox .................................................................... 185 deferoxamine ................................................................ 185 degarelix ....................................................................... 107 dehydrocholic acid .......................................................... 9 Delatestryl ........................................................................ 74 delta-9-tetrahydrocannabinol .......................................... 8 Deltasone ......................................................................... 84 Demerol ..................................................................126, 127 Demulen ........................................................................... 72 Depakene ....................................................................... 134 Depo-Medrol ...............................................................83, 84 Depo-Provera ................................................................... 74 Depo-Testosterone .......................................................... 74 Derma-Smoothe ............................................................... 66 Dermovate ....................................................................... 67 Desferal .......................................................................... 185 Desferrioxamine ............................................................. 185 desipramine .................................................................. 153 desloratadine ................................................................ 175 Desloratadine Allergy Control ........................................ 175 desmopressin ................................................................. 81 desogestrel and estrogen ............................................. 73 desonide ......................................................................... 65 desoximetasone ............................................................. 66 Desyrel ........................................................................... 159 Detrol ............................................................................... 77 Detrol LA .......................................................................... 77 dexamethasone ...............................................83, 178, 183 Dexamethasone ............................................................... 83 dexamethasone and antiinfectives ......................179, 183 dexamphetamine .......................................................... 161 Dexasone ......................................................................... 83 Dexedrine ....................................................................... 161 DexIron ............................................................................ 22 dextriferron ..................................................................... 22 Dextrose ........................................................................... 23 Dey-Pak ......................................................................... 170 Diabeta ............................................................................. 14

Product Index ­ 38

Product Index

diabetic insulin pen needles ........................................186 diabetic insulin syringes ..............................................186 diabetic lancets .............................................................186 Diabinese ..........................................................................14 Diamicron ..........................................................................14 Diamicron MR ...................................................................14 Diamox ............................................................................ 179 Diane-35 ...........................................................................76 Diarr-eze ...........................................................................10 Diastat ............................................................................. 149 Diazemuls ....................................................................... 149 diazepam........................................................................149 Diazepam ........................................................................ 149 diazoxide........................................................................186 Dicetel .................................................................................6 Diclectin .......................................................................... 174 diclofenac ...................................................... 113, 118, 178 Diclofenac Potassium ..................................................... 113 Diclofenac Sodium .......................................................... 114 diclofenac, comb. ..........................................................114 dicyclomine .......................................................................5 Dicyclomine.........................................................................5 dicycloverine .....................................................................5 Didrocal Kit...................................................................... 122 Didronel .......................................................................... 120 dienogest .........................................................................75 Diflucan .............................................................................97 diflucortolone ............................................................66, 68 diflunisal ........................................................................129 digoxin .............................................................................25 Digoxin ..............................................................................25 dihydroergotamine .......................................................130 Dihydroergotamine .......................................................... 130 diiodohydroxyquinoline ...............................................167 Dilantin ............................................................................ 132 Dilaudid ........................................................................... 125 Dilaudid HP ..................................................................... 125 Dilaudid XP ..................................................................... 125 Dilovan-HCT .....................................................................51 diltiazem...........................................................................41 Diltiazem Hydrochloride ....................................................42 dimenhydrinate .................................................................8 Dimenhydrinate ...................................................................8 dimethyl sulfoxide ..........................................................78 Dimethyl Sulfoxide ............................................................78 dinoprostone ...................................................................71 Diodoquin ........................................................................ 167 Diopred ........................................................................... 178 Diovan .........................................................................48, 49 Diovan-HCT ......................................................................51 Diovol ..................................................................................1 Dipentum...........................................................................11 diphenhydramine ..........................................................174 Diphenhydramine ............................................................ 174 diphenoxylate ..................................................................10 Diprolene...........................................................................65 Diprosalic ..........................................................................68 Diprosone..........................................................................65 dipyridamole....................................................................21 disopyramide...................................................................25 disulfiram .......................................................................165 Disulfiram ........................................................................ 165 dithranol...........................................................................62 Ditropan ......................................................................76, 77 divalproex sodium ........................................................134 Dixarit ................................................................................28

December 2012

dobutamine ..................................................................... 27 Dobutamine ...................................................................... 27 Dobutrex .......................................................................... 27 Docetaxel ....................................................................... 104 docusate sodium.............................................................. 9 Docusate Sodium ............................................................... 9 dolasetron ......................................................................... 8 Dolobid ........................................................................... 129 domperidone .............................................................7, 114 Domperidone...................................................................... 7 donepezil ...................................................................... 163 dorzolamide .................................................................. 179 Dostinex ........................................................................... 72 Dovobet gel ...................................................................... 68 Dovobet ointment ............................................................. 63 Dovonex ........................................................................... 63 doxazosin ....................................................................... 29 doxepin ......................................................................... 154 Doxycin ............................................................................ 86 doxycycline ................................................................ 1, 86 Doxycycline ...................................................................... 86 doxylamine ................................................................... 174 dronabinol ........................................................................ 8 dronedarone ................................................................... 26 droperidol ..................................................................... 142 Droperidol ...................................................................... 142 drospirenone and estrogen ........................................... 73 Dulcolax ............................................................................. 9 duloxetine ..................................................................... 161 DULOXETINE ................................................................ 161 Duo Trav ........................................................................ 180 Duodopa ........................................................................ 138 Duolube .......................................................................... 182 Duovent UDV ................................................................. 170 Duragesic ....................................................................... 127 Duralith ........................................................................... 146 Duricef .............................................................................. 89 dutasteride ...................................................................... 79 Duvoid ............................................................................ 164 Dyazide ............................................................................ 32 Dycholium .......................................................................... 9 Ebixa .............................................................................. 164 Edecrin ............................................................................. 31 Edurant .......................................................................... 101 EES .............................................................................91, 92 Effexor .....................................................................160, 161 Efudex ............................................................................ 104 Elaprase ........................................................................... 18 Elavil .............................................................................. 154 Eldepryl .......................................................................... 140 eletriptan ....................................................................... 132 Elidel ................................................................................ 69 Eligard ............................................................................ 106 Elmiron ............................................................................. 33 Elocom ............................................................................. 66 eltrombopag ................................................................... 22 Eltroxin ............................................................................. 85 Emadine ......................................................................... 181 Emcyt ............................................................................. 105 emedastine ................................................................... 181 Emend ................................................................................ 8 Emo-Cort .......................................................................... 64 emtricitabine, tenofovir disoproxil & rilpivirine ......... 101 Enablex ............................................................................ 77 enalapril .......................................................................... 43 enalapril and diurtetics .................................................. 46

Product Index ­ 39

Product Index

Enbrel ............................................................................. 109 Endantadine .................................................................... 138 Endocet ........................................................................... 129 enfuvirtide......................................................................101 enoxaparin .......................................................................20 entacapone ....................................................................140 entecavir ........................................................................100 Enteric Coated ASA ................................................ 128, 129 Entocort ............................................................................11 Entrophen ....................................................................... 128 epinephrine......................................................................27 Epinephrine .......................................................................27 Epipen ...............................................................................27 Epiriubicin ....................................................................... 104 epirubicin ....................................................................... 104 Epival .............................................................................. 134 eplerenone .......................................................................32 Eprex ................................................................................23 eprosartan .......................................................................48 eprosartan and diuretics ................................................51 Erdol .................................................................................16 ergocalciferol ..................................................................16 Ergodryl .......................................................................... 130 ergoloid mesylates .........................................................32 ergotamine, comb. excluding psycholeptics.............. 130 erlotinib ..........................................................................105 ERYC ................................................................................91 erythromycin ........................................................... 91, 177 Erythromycin ................................................................... 177 erythromycin, comb. .......................................................69 erythropoietin ..................................................................23 escitalopram ..................................................................158 ESME ................................................................................73 esomeprazole ....................................................................5 Estalis ...............................................................................75 Estalis-Sequi .....................................................................76 Estrace ..............................................................................75 Estracomb .........................................................................76 Estraderm .........................................................................75 estradiol ...........................................................................74 Estradot ...................................................................... 74, 75 Estragyn ............................................................................75 estramustine..................................................................105 Estring ...............................................................................75 Estrogel .............................................................................75 estrone .............................................................................75 etacrynic acid ..................................................................31 etanercept ......................................................................109 ethambutol.......................................................................98 ethinyl estradiol and etonogestrel .................................72 ethopropazine ...............................................................137 ethosuximide .................................................................132 ethynodiol and estrogen ................................................72 Etibi ...................................................................................98 Etidrocal Kit ..................................................................... 122 etidronate.......................................................................120 etidronic acid.................................................................120 etidronic acid and calcium ...........................................122 etodolac .........................................................................114 etoposide .......................................................................104 etravirine ........................................................................101 Euflex .............................................................................. 106 Euglucon ...........................................................................14 everolimus ..................................................................... 109 Evista ................................................................................76 Evra ..................................................................................73

December 2012

Exelon ............................................................................ 163 Exelon Patch .................................................................. 163 exemestane .................................................................. 107 Exjade ............................................................................ 185 Extavia ........................................................................... 108 Extra Strength Allergy Relief .......................................... 174 ezetimibe ......................................................................... 58 Ezetrol .............................................................................. 58 famciclovir ...................................................................... 99 famotidine ......................................................................... 2 Famotidine ..................................................................... 2, 3 Famotidine Omega............................................................. 2 Famvir .............................................................................. 99 febuxostat ..................................................................... 120 Feldene ...................................................................114, 115 felodipine ........................................................................ 39 Fem HRT ......................................................................... 75 Femara ........................................................................... 107 fenofibrate ...................................................................... 57 Fenofibrate Micro ............................................................. 57 Fenofibrate-S ................................................................... 57 fenoterol & other obst. airway disease drugs............ 170 fentanyl ..................................................................123, 127 Fentanyl Citrate .............................................................. 123 Fermentol ......................................................................... 12 Ferodan ............................................................................ 22 Ferodan Infant Drops ....................................................... 22 ferrous fumarate............................................................. 22 ferrous glucconate ......................................................... 22 ferrous sulfate ................................................................ 22 fexofenadine ................................................................. 174 filgrastim ....................................................................... 107 Finacea ............................................................................ 69 finasteride ....................................................................... 79 Finasteride ....................................................................... 79 Fiorinal ........................................................................... 129 Firmagon ........................................................................ 107 Flagyl ..........................................................................71, 96 Flagystatin ........................................................................ 71 Flamazine ........................................................................ 64 Flarex ............................................................................. 178 flavoxate ......................................................................... 76 flecainide ........................................................................ 26 Flexeril ........................................................................... 119 flocatafenine ................................................................. 130 Flomax ............................................................................. 78 Flonase .......................................................................... 169 Florinef ............................................................................. 82 Flovent ........................................................................... 171 Floxin ............................................................................... 94 Fluanxol ......................................................................... 142 Fluanxol Depot ............................................................... 142 fluconazole ..................................................................... 97 Fluconazole ...................................................................... 97 Fludara ........................................................................... 103 fludarabine .................................................................... 103 fludrocortisone ............................................................... 82 flumazenil ..................................................................... 185 Flumazenil ...................................................................... 185 flumetasone and antibiotics .......................................... 67 flumetasone and antiinfectives ................................... 183 flunarizine ..................................................................... 165 flunisolide ..................................................................... 169 fluocinolone acetonide .................................................. 66 fluocinonide .................................................................... 66 fluorometholone ........................................................... 178

Product Index ­ 40

Product Index

fluorouracil ....................................................................104 Fluorouracil ..................................................................... 104 fluoxetine .......................................................................155 Fluoxetine ....................................................................... 155 Fluoxetine BP.................................................................. 155 flupenthixol....................................................................142 fluphenazine ..................................................................140 Fluphenazine Omega ...................................................... 140 flurazepam .....................................................................151 flurbiprofen ....................................................................117 flutamide ........................................................................106 fluticasone ............................................................. 169, 171 fluvastatin ........................................................................55 fluvoxamine ...................................................................158 FML ................................................................................. 178 FML Forte ....................................................................... 178 folic acid ..........................................................................23 Folic Acid ..........................................................................23 fondaparinux ...................................................................21 Foradil ............................................................................. 170 formoterol ......................................................................170 formoterol & other obst. airway disease drugs .......... 171 Fortaz ................................................................................90 Forteo ...............................................................................85 Fosamax ......................................................................... 121 fosamprenavir ...............................................................100 Fosavance ...................................................................... 122 fosinopril..........................................................................46 Fosrenol .......................................................................... 185 Fragmin .............................................................................20 framycetin ................................................................ 68, 177 Frisium ............................................................................ 150 Fucidin ........................................................................ 63, 67 Fucithalmic ...................................................................... 177 Fungizone .........................................................................97 furosemide.......................................................................31 Furosemide .......................................................................31 fusidic acid .............................................................. 63, 177 Fuzeon ............................................................................ 101 gabapentin .....................................................................136 Gabapentin ..................................................................... 136 galantamine ...................................................................164 ganciclovir .......................................................................99 Garamycin......................................................... 93, 177, 182 Garasone ........................................................................ 183 gatifloxacin ....................................................................178 GD-Amlodipine..................................................................39 GD-Amlodipine/Atorvastatin ........................................ 58, 59 GD-Atorvastatin .......................................................... 55, 56 GD-Azithromycin ...............................................................92 GD-Eletriptan .................................................................. 132 GD-Gabapentin ....................................................... 136, 137 GD-Latanoprost .............................................................. 180 GD-Mirtazapine ............................................................... 160 GD-Sertraline .......................................................... 157, 158 GD-Terbinafine .................................................................62 GD-Topiramate ....................................................... 135, 136 GD-Venlafaxine ....................................................... 160, 161 gefitinib ..........................................................................105 Gelnique............................................................................77 gemcitabine ................................................................... 104 Gemcitabine .................................................................... 104 gemfibrozil .......................................................................57 Gemzar ........................................................................... 104 Gen-Clozapine ................................................................ 143 gentamicin ................................................. 63, 93, 177, 182

December 2012

Gentamicin ....................................................................... 93 GenTeal ......................................................................... 182 glatiramer acetate ........................................................ 108 Gleevec .......................................................................... 104 glibenclamide ................................................................. 14 gliclazide ......................................................................... 14 Gliclazide ......................................................................... 14 glimepiride ...................................................................... 14 GlucaGen ......................................................................... 85 GlucaGen Hypokit ............................................................ 85 glucagon ......................................................................... 85 Glucagon .......................................................................... 85 Glucobay .......................................................................... 15 GlucoNorm ....................................................................... 16 Glucophage ...................................................................... 13 glucose ......................................................................... 186 glyburide ......................................................................... 14 Glyburide .......................................................................... 14 glyceryl trinitrate ............................................................ 27 glycopyrolate .................................................................... 5 Glycopyrrolate .................................................................... 5 glycopyrronium ................................................................ 5 golimumab .................................................................... 110 goserelin ....................................................................... 106 granisetron ....................................................................... 8 grass pollen .................................................................. 185 Gravol ................................................................................ 8 guaifenesin ................................................................... 173 Gynazole .......................................................................... 71 Halcion ........................................................................... 152 Haldol ............................................................................. 142 Haldol LA ....................................................................... 142 haloperidol .................................................................... 142 Haloperidol ..................................................................... 142 Haloperidol LA................................................................ 142 heparin ............................................................................ 20 Heparin ............................................................................ 20 Hepsera ......................................................................... 100 Heptovir .......................................................................... 100 Herplex-D ......................................................................... 64 hexachlorophene ........................................................... 68 Hexalen .......................................................................... 105 histrelin ........................................................................... 82 homatropine ................................................................. 181 Hp-PAC .............................................................................. 5 Humalog ......................................................................12, 13 Humatin ............................................................................ 10 Humatrope ....................................................................... 81 Humira ........................................................................... 110 Humulin Insulin................................................................. 13 Humulin N Insulin ............................................................. 12 Humulin R Insulin ............................................................. 12 Hycamtin ........................................................................ 105 Hydergine ......................................................................... 32 Hyderm ............................................................................ 64 hydralazine ..................................................................... 29 Hydrea ........................................................................... 105 hydrochloride ................................................................. 90 hydrochlorothiazide ....................................................... 30 Hydrochlorothiazide ......................................................... 30 hydrochlorothiazide and potassium-sparing agents .. 32 Hydrocorisone .................................................................. 64 hydrocortisone ................................ 11, 33, 64, 67, 84, 178 Hydrocortisone ............................................................61, 64 hydrocortisone and antibiotics ..................................... 67 hydrocortisone and antiinfectives .......................179, 183

Product Index ­ 41

Product Index

Hydrodiuril .........................................................................30 Hydromoprh Contin ......................................................... 125 Hydromorph Contin ......................................................... 125 hydromorphone ............................................................125 Hydromorphone .............................................................. 125 Hydromorphone HP ........................................................ 125 Hydroval ............................................................................64 hydroxycarbamide ........................................................105 hydroxychloroquine .....................................................167 hydroxyurea ..................................................................105 Hydroxyurea.................................................................... 105 hydroxyzine ...................................................................151 Hydroxyzine .................................................................... 151 Hylashield ....................................................................... 182 Hyoscine Butylbromide .......................................................8 hyoscyamine .....................................................................6 Hypotears........................................................................ 182 Hytrin .......................................................................... 78, 79 Hyzaar ........................................................................ 50, 51 ibuprofen .......................................................................115 Idarac .............................................................................. 130 idoxuridine.......................................................................64 idursulfase .......................................................................18 Ilaris ................................................................................ 110 imatinib ..........................................................................104 Imdur .................................................................................28 imidazole derivatives, comb. .........................................61 imipenem and enzyme inhibitor ....................................91 imipramine .....................................................................153 imiquimod ........................................................................64 Imitrex ............................................................................. 130 Imitrex DF ............................................................... 130, 131 ImmuCyst ........................................................................ 108 Imodium ............................................................................10 Imovane .................................................................. 152, 153 Imuran ............................................................................. 110 Incivek ............................................................................. 100 indapamide ......................................................................31 Inderal ...............................................................................34 Inderal-LA .........................................................................34 indinavir ...........................................................................99 Indocid ............................................................................ 113 indomethacin.................................................................113 infliximab .......................................................................109 Infufer ................................................................................22 Infusion Pump Cassette .................................................. 186 Inhibace ...................................................................... 45, 46 Inhibace Plus ....................................................................47 Innohep .............................................................................20 Inspra ................................................................................32 insulin (human) ......................................................... 12, 13 insulin aspart...................................................................12 insulin detemir ................................................................13 insulin glargine ...............................................................13 insulin glulisine ...............................................................12 insulin lispro..............................................................12, 13 Intal ................................................................................. 172 Intelence ......................................................................... 101 interferon alpha-2b .......................................................108 interferon beta-1a ..........................................................108 interferon beta-1b .........................................................108 Intron A ........................................................................... 108 Invega Sustenna ............................................................. 149 Invirase .............................................................................99 iodoquinol......................................................................167 Iopidine ........................................................................... 179

December 2012

ipratropium bromide .............................................169, 171 Irbesartan ......................................................................... 49 Irbesartan/HCTZ .........................................................51, 52 iresartan and diuretics................................................... 51 Iressa ............................................................................. 105 iron, multivitamins and folic acid ................................. 22 iron, multivitamins and minerals .................................. 22 Isentress ........................................................................ 101 isoniazid .......................................................................... 98 isopropyl myristate ...................................................... 168 Isoptin .........................................................................40, 41 Isoptin IV .......................................................................... 40 Isopto Atropine ............................................................... 181 Isopto Carbachol ............................................................ 179 Isopto Carpine ................................................................ 179 Isopto Homatropine ........................................................ 181 Isopto Tears ................................................................... 182 Isordil ............................................................................... 28 isosorbide dinitrate ........................................................ 28 isosorbide mononitrate ................................................. 28 Isotamine ......................................................................... 98 isotretinoin ..................................................................... 69 itraconazole .................................................................... 97 IUD with progestogen .................................................... 72 Jamp-Acet-Tramadol...................................................... 128 Jamp-Alendronate .......................................................... 121 Jamp-Amlodipine ............................................................. 39 Jamp-Anastrozole .......................................................... 107 Jamp-Atenolol .................................................................. 36 Jamp-Bicalutamide......................................................... 107 Jamp-Bisacodyl .................................................................. 9 Jamp-Candesartan......................................................49, 50 Jamp-Carvedilol ............................................................... 38 Jamp-Ciprofloxacin .....................................................94, 95 Jamp-Citalopram ............................................................ 156 Jamp-Cyclobenzaprine .................................................. 119 Jamp-Docusate Sodium ..................................................... 9 Jamp-Domperidone............................................................ 7 Jamp-Finasteride ............................................................. 79 Jamp-Fluoxetine............................................................. 155 Jamp-Fosinopril................................................................ 46 Jamp-Gabapentin........................................................... 136 Jamp-Ibuprofen .............................................................. 115 Jamp-Indapamide ............................................................ 31 JAMP-K20 ........................................................................ 17 JAMP-K8 .......................................................................... 17 Jamp-Lactulose ................................................................ 10 Jamp-Letrozole .............................................................. 107 Jamp-Lisinopril ............................................................43, 44 Jamp-Loperamide ............................................................ 10 Jamp-Magnesium............................................................. 17 Jamp-Metformin ............................................................... 13 Jamp-Metformin Blackberry ............................................. 13 Jamp-Metoprolol-L ......................................................35, 36 Jamp-Mycophenolate ..................................................... 109 Jamp-Mycophenolate Mofetil ......................................... 109 Jamp-Ondansetron ............................................................ 7 Jamp-Paroxetine .....................................................156, 157 Jamp-Pioglitazone.......................................................15, 16 Jamp-Pravastatin ........................................................54, 55 Jamp-Quetiapine .....................................................145, 146 Jamp-Ramipril .............................................................44, 45 Jamp-Risedronate .......................................................... 121 Jamp-Risperidone ...................................................147, 148 Jamp-Rizatriptan ............................................................ 131 Jamp-Sennosides .............................................................. 9

Product Index ­ 42

Product Index

Jamp-Sertaline ................................................................ 157 Jamp-Simvastatin ....................................................... 53, 54 Jamp-Sotalol .....................................................................35 Jamp-Tamsulosin..............................................................78 Jamp-Terbinafine ..............................................................62 Jamp-Zopiclone .............................................................. 153 Janumet ............................................................................15 Januvia .............................................................................16 Junista ............................................................................ 125 K-10 ..................................................................................17 Kadian ............................................................................. 123 Kaletra ............................................................................ 100 Kayexalate ...................................................................... 185 K-Dur ................................................................................17 Keflex .......................................................................... 88, 89 Keletra ............................................................................ 100 Kemadrin......................................................................... 137 Kenacomb .........................................................................67 Kenalog .........................................................................1, 84 Keppra ............................................................................ 137 Ketalar ............................................................................ 123 ketamine ........................................................................123 Ketamine ......................................................................... 123 ketoconazole .............................................................61, 97 Ketoderm ..........................................................................61 ketoprofen .....................................................................117 Ketoprofen ...................................................................... 117 ketorolac ................................................................ 114, 178 Ketorolac ......................................................................... 114 ketotifen ................................................................. 174, 181 Kineret ............................................................................ 110 Kivexa ............................................................................. 101 K-Lyte ...............................................................................17 Kytril ....................................................................................8 labetalol ...........................................................................37 Labetalol ...........................................................................37 lactic acid producing organisms ...................................11 lactulose ..........................................................................10 Lamictal .......................................................................... 135 Lamisil ......................................................................... 61, 62 lamivudine .....................................................................100 lamivudine and abacavir ..............................................101 lamotrigine.....................................................................135 Lamotrigine ..................................................................... 135 Lanoxin .............................................................................25 lanreotide .........................................................................82 lansoprazole ......................................................................4 Lansoprazole ......................................................................4 lansoprazole, clarithromycin and amoxicillin.................5 lanthanum carbonate ....................................................185 Lantus ...............................................................................13 Lanvis ............................................................................. 103 lapatinib .........................................................................105 Largactil .......................................................................... 140 Larium ............................................................................. 167 laronidase ........................................................................18 Lasix .................................................................................31 Lasix Special .....................................................................31 latanoprost ....................................................................180 LCD (coal tar)....................................................................62 Lectopam ........................................................................ 150 Lederle Leucovorin ......................................................... 186 leflunomide ....................................................................109 Leflunomide .................................................................... 109 lenaidomide ...................................................................111 Lescol ...............................................................................55

December 2012

letrozole ........................................................................ 107 Letrozole ........................................................................ 107 Leukeran ........................................................................ 103 leuprolide ...................................................................... 106 leuprorelin .................................................................... 106 Levaquin .......................................................................... 95 Levemir ............................................................................ 13 Levetiracetam................................................................. 137 levitracetam .................................................................. 137 levobunolol ................................................................... 180 levocabastine ............................................................... 169 Levocarb ........................................................................ 138 levocarnitine ................................................................... 18 levodopa and decarboxylase inhibitor ....................... 138 levodopa, decarboxylase inhibitor and comt inhibitor .................................................................................. 138 levofloxacin .................................................................... 95 levomepromazine ......................................................... 140 levonorgestrel ................................................................ 74 levonorgestrel and estrogen ......................................... 73 Levophed ......................................................................... 27 levothyroxine sodium .................................................... 84 Levsin................................................................................. 6 Librax ................................................................................. 6 Lidemol ............................................................................ 66 Lidex ................................................................................ 66 lidocaine ..................................................................62, 123 lidocaine, comb. ........................................................... 123 Lidodan ............................................................................ 62 Lidodan Entracheal ........................................................ 123 Lincocin ............................................................................ 93 lincomycin ...................................................................... 93 Linctus Codeine Blanc ................................................... 174 Linessa ............................................................................. 73 linezolid ........................................................................... 96 Lioresal .......................................................................... 119 Lioresal DS .................................................................... 119 Lioresal Intrathecal ......................................................... 119 liothyronine sodium ....................................................... 85 Lipidil EZ .......................................................................... 57 Lipidil Micro ...................................................................... 57 Lipidil Supra ..................................................................... 57 Lipitor ..........................................................................55, 56 liraglutide ........................................................................ 16 lisdexamfetamine ......................................................... 163 lisinopril .......................................................................... 43 lisinopril and diuretics ................................................... 46 Lisinopril/HCTZ ...........................................................46, 47 Lithane ........................................................................... 146 lithium ........................................................................... 146 Lithmax .......................................................................... 146 Livostin ........................................................................... 169 Locacorten Vioform ...................................................67, 183 LoEstrin ............................................................................ 72 Lomotil ............................................................................. 10 lomustine ...................................................................... 103 Loniten ............................................................................. 30 loperamide ...................................................................... 10 Lopid ................................................................................ 57 Lopresor ......................................................................35, 36 Loprox .............................................................................. 61 loratadine ...................................................................... 174 lorazepam ..................................................................... 150 Lorazepam ..................................................................... 150 losartan ........................................................................... 47 Losartan ......................................................................47, 48

Product Index ­ 43

Product Index

losartan and diuretics .....................................................50 Losec ..................................................................................3 Lotemax .......................................................................... 178 Lotensin ............................................................................45 loteprednol .................................................................... 178 Lotriderm ...........................................................................61 Lovastatin..........................................................................54 lovastatin and nicotinic acid ..........................................58 Lovenox ............................................................................20 Lovenox HP ......................................................................20 Loxapac .......................................................................... 143 loxapine .........................................................................143 Lozide ...............................................................................31 Ludiomil .......................................................................... 155 Lumigan .......................................................................... 181 Lupron ............................................................................. 106 Luvox .............................................................................. 158 Lyderm ..............................................................................66 Lyrica .............................................................................. 137 Macrobid ...........................................................................96 Macrodantin ......................................................................96 macrogol ..........................................................................10 Macugen ......................................................................... 181 Magic Mouthwash .............................................................62 magnesium citrate ..........................................................10 magnesium glucoheptonate ..........................................17 magnesium hydroxide ....................................................78 Magnesium-Odan .............................................................17 Majeptil ........................................................................... 141 Mandelamine ....................................................................96 Manerix ........................................................................... 158 maprotiline.....................................................................155 Mar-Amlodipine .................................................................39 Mar-Anastrozole .............................................................. 107 Mar-Antenolol....................................................................36 Mar-Atenolol......................................................................36 maraviroc .......................................................................101 Marcaine ......................................................................... 123 Mar-Ciprofloxacin ........................................................ 94, 95 Mar-Citalopram ............................................................... 156 Marinol ................................................................................8 Mar-Letrozole .................................................................. 107 Mar-Metformin...................................................................13 Mar-Ondansetron ................................................................7 Mar-Risperidone ..................................................... 147, 148 Mar-Rizatriptan ............................................................... 131 Mar-Simvastatin .......................................................... 53, 54 Mar-Tramadol/Acet ......................................................... 128 Marvelon ...........................................................................73 Matulane ......................................................................... 104 Mavik ................................................................................46 Maxalt ............................................................................. 131 Maxeran ..............................................................................6 Maxidex .......................................................................... 178 Maxipime...........................................................................90 Maxitrol ........................................................................... 179 mebendazole .................................................................167 MED-Anastrozole ............................................................ 107 MED-Letrozole ................................................................ 107 Medrol ...............................................................................84 medroxyprogesterone .............................................. 74, 75 Medroxyprogesterone Acetate ..........................................74 mefenamic acid .............................................................117 mefloquine .....................................................................167 Megace ................................................................... 105, 106 Megace OS ..................................................................... 105

December 2012

megestrol ...................................................................... 105 meloxicam .................................................................... 115 Meloxicam ...................................................................... 115 melphalan ..................................................................... 103 memantine .................................................................... 164 meperidine .................................................................... 126 Meperidine ..............................................................126, 127 Mepron ........................................................................... 167 mercaptopurine ............................................................ 103 mesalamine .................................................................... 11 Mesasal ............................................................................ 11 M-Eslon ...................................................................123, 124 Mestinon ........................................................................ 164 mesuximide .................................................................. 132 Metadol .......................................................................... 165 metformin ....................................................................... 13 Metformin ......................................................................... 13 metformin and rosiglitazone ......................................... 15 methadone .................................................................... 165 Methadone ..................................................................... 165 methazolamide ............................................................. 179 methenamine .................................................................. 96 methimazole ................................................................... 85 methocarbamol ............................................................ 118 methocarbamol, comb. excluding psycholeptics ..... 118 methotrexate................................................................. 103 Methotrexate .................................................................. 103 methotrimeprazine ....................................................... 140 Methoxacet .................................................................... 118 Methoxisal ...................................................................... 119 methoxsalen ................................................................... 63 methsuximide ............................................................... 132 methyldopa (racemic) .................................................... 28 methylnaltrexone bromide ............................................ 10 methylphenidate........................................................... 161 methylprednisolone ..................................................68, 83 Methylprednisolone Acetate ............................................. 83 Methylprednisolone Sod. Succ. ........................................ 83 methylprednisolone, comb............................................ 84 metoclopamide ................................................................. 6 Metoclopramide.................................................................. 6 metolazone ..................................................................... 31 metoprolol ...................................................................... 35 Metoprolol ...................................................................35, 36 MetroCream ..................................................................... 64 MetroGel .......................................................................... 64 MetroLotion ...................................................................... 64 metronidazole ......................................................64, 71, 96 Mevacor ........................................................................... 54 mexiletine ....................................................................... 25 Mexitil ............................................................................... 25 Mezavant ......................................................................... 11 Miacalcin .......................................................................... 85 Micardis ............................................................................ 50 Micardis Plus .................................................................... 52 Micatin .............................................................................. 61 miconazole ................................................................61, 71 Micozole ........................................................................... 71 Micro-K ............................................................................. 17 Micronor ........................................................................... 74 Midamor ........................................................................... 32 midazolam .................................................................... 152 Midazolam ...................................................................... 152 midodrine ........................................................................ 27 miglustat ......................................................................... 18 Migranal ......................................................................... 130

Product Index ­ 44

Product Index

mineral salts in comb. ......................................................9 MinEstrin ...........................................................................72 Minipres ............................................................................29 Minirin ...............................................................................82 Minitran .............................................................................27 Minocin .............................................................................86 minocycline .....................................................................86 Minocycline .......................................................................86 Min-Ovral ..........................................................................73 minoxidil ....................................................................30, 70 MINT-Amlodipine ..............................................................39 MINT-Atenol ......................................................................36 MINT-Atenolol ...................................................................36 MINT-Ciprofloxacin ..................................................... 94, 95 MINT-Citalopram............................................................. 156 MINT-Finasteride ..............................................................79 MINT-Fluoxetine ............................................................. 155 MINT-Ondansetron .............................................................7 MINT-Pioglitazone ...................................................... 15, 16 MINT-Pravastatin ........................................................ 54, 55 MINT-Risperidon ..................................................... 147, 148 MINT-Risperidone ........................................................... 147 MINT-Simvastatin ....................................................... 53, 54 MINT-Topiramate .................................................... 135, 136 Mirapex ................................................................... 139, 140 Mirena ...............................................................................72 mirtazapine ....................................................................159 Mirtazapine ..................................................................... 159 misoprostol .......................................................................3 Mobenol ............................................................................14 Mobicox .......................................................................... 115 Mobiflex .......................................................................... 115 moclombemide..............................................................158 modafinil ........................................................................162 Modafinil.......................................................................... 162 Modecate ........................................................................ 141 Modulon ..............................................................................5 Moduret .............................................................................32 Mogadon ......................................................................... 152 mometasone .......................................................... 169, 171 Monistat ...................................................................... 61, 71 Monitan .............................................................................37 Monocor ............................................................................37 Monopril ............................................................................46 montelukast ...................................................................173 Montelukast..................................................................... 173 morphine........................................................................123 Morphine ......................................................................... 124 Morphine HP ................................................................... 124 Morphine LP.................................................................... 124 Morphine Sulfate ............................................................. 124 Morpine ........................................................................... 124 MOS ................................................................................ 124 MOS Sulphate................................................................. 124 Motilium...............................................................................7 Motrin .............................................................................. 115 Motrin IB.......................................................................... 115 moxifloxacin ............................................................ 95, 178 MS Contin ....................................................................... 124 MS-IR .............................................................................. 124 Mucomyst........................................................................ 173 Multaq ...............................................................................26 multienzymes ..................................................................12 mupirocin.........................................................................63 Muro 128 ......................................................................... 182 Myambutol .................................................................. 98, 99

December 2012

Mycobutin ......................................................................... 98 mycophenolic acid ....................................................... 109 Mycostatin ...................................................................10, 61 Mydfrin ........................................................................... 181 Mydriacyl ........................................................................ 181 Myfortic .......................................................................... 109 MYLAN-Acebutolol ........................................................... 37 MYLAN-Acyclovir ........................................................98, 99 MYLAN-Alendronate ...................................................... 121 MYLAN-Alprazolam.................................................150, 151 MYLAN-Amantadine ...................................................... 138 MYLAN-Amilazide ............................................................ 32 MYLAN-Amiodarone ........................................................ 26 MYLAN-Amlodipine .......................................................... 39 MYLAN-Amoxicillin........................................................... 87 MYLAN-Anagrelide ........................................................ 105 MYLAN-Anastrozole....................................................... 107 MYLAN-Atenolol............................................................... 36 MYLAN-Atomoxetine ...............................................162, 163 MYLAN-Atorvastatin....................................................55, 56 MYLAN-Azathioprine...................................................... 110 MYLAN-Azithromycin ....................................................... 92 MYLAN-Baclofen............................................................ 119 MYLAN-Beclo................................................................. 169 MYLAN-Bicalutamide ..................................................... 107 MYLAN-Bisoprolol ............................................................ 37 MYLAN-Bosentan ............................................................ 30 MYLAN-Budesonide....................................................... 169 MYLAN-Candesartan ..................................................49, 50 MYLAN-Candesartan HCTZ ............................................ 52 MYLAN-Captopril ........................................................42, 43 MYLAN-Carbamazepine ................................................ 133 MYLAN-Carvedilol............................................................ 38 MYLAN-Cilazapril ........................................................45, 46 MYLAN-Cimetidine......................................................... 1, 2 MYLAN-Ciprofloxacin ..................................................94, 95 MYLAN-Citalopram ........................................................ 156 MYLAN-Clarithromycin ..................................................... 92 MYLAN-Clindamycin ........................................................ 93 MYLAN-Clobetasol........................................................... 67 MYLAN-Clonazepam ..................................................... 133 Mylan-Clopidogrel ............................................................ 20 MYLAN-Combo Sterinebs .............................................. 170 MYLAN-Cyclobenzaprine ............................................... 119 MYLAN-Domperidone ........................................................ 7 MYLAN-Doxazosin ........................................................... 29 MYLAN-Enalapril.............................................................. 43 MYLAN-Esomeprazole ....................................................... 5 MYLAN-Eti-Cal ............................................................... 122 MYLAN-Etidronate ......................................................... 120 MYLAN-Famotidine ........................................................ 2, 3 MYLAN-Fenofibrate Micro ................................................ 57 MYLAN-Finasteride .......................................................... 79 MYLAN-Fluconazole ........................................................ 97 MYLAN-Fluoxetine ......................................................... 155 MYLAN-Fosinopril ............................................................ 46 MYLAN-Gabapentin ....................................................... 136 MYLAN-Galantamine ..................................................... 164 MYLAN-Gemfibrozil ......................................................... 57 MYLAN-Gliclazide ............................................................ 14 MYLAN-Glybe .................................................................. 14 MYLAN-Hydroxychloroquine .......................................... 167 MYLAN-Hydroxyurea ..................................................... 105 MYLAN-Indapamide ......................................................... 31 MYLAN-Ipratropium ................................................171, 172 MYLAN-Irbesartan ........................................................... 49

Product Index ­ 45

Product Index

MYLAN-Lamotrigine ........................................................ 135 MYLAN-Lansoprazole .........................................................4 MYLAN-Leflunomide ....................................................... 109 MYLAN-Levofloxacin ........................................................95 MYLAN-Lisinopril ........................................................ 43, 44 MYLAN-Lisinopril/HCTZ .............................................. 46, 47 MYLAN-Losartan .................................................. 47, 48, 51 MYLAN-Losartan HCTZ ....................................................50 MYLAN-Lovastatin ............................................................54 MYLAN-Meloxicam ......................................................... 115 MYLAN-Metformin ............................................................13 MYLAN-Metoprolol ...................................................... 35, 36 MYLAN-Minocycline ..........................................................86 MYLAN-Mirtazapine ........................................................ 159 MYLAN-Montelukast ....................................................... 173 MYLAN-Mycophenolate .................................................. 109 MYLAN-Nabumetone ...................................................... 118 MYLAN-Naproxen ........................................................... 116 MYLAN-Nevirapine ......................................................... 101 MYLAN-Nifedipine ER ......................................................40 MYLAN-Nitro .....................................................................27 MYLAN-Olanzapine ................................................ 144, 145 MYLAN-Olzapine ............................................................ 145 MYLAN-Omeprazole ...........................................................3 MYLAN-Ondansetron ..........................................................7 MYLAN-Oxybutynin ..........................................................77 MYLAN-Pantoprazole .........................................................4 MYLAN-Paroxetine ................................................. 156, 157 MYLAN-Pioglitazone ................................................... 15, 16 MYLAN-Pramipexole .............................................. 139, 140 MYLAN-Pravastatin .................................................... 54, 55 MYLAN-Propafenone ........................................................26 MYLAN-Quetiapine ................................................. 145, 146 MYLAN-Ramipril ......................................................... 44, 45 MYLAN-Ranitidine ..............................................................2 MYLAN-Riluzole.............................................................. 165 MYLAN-Risedronate ....................................................... 121 MYLAN-Risperidone ............................................... 147, 148 MYLAN-Rivastigmine ...................................................... 163 MYLAN-Rizatriptan ODT ................................................. 131 MYLAN-Rosuvastatin .................................................. 56, 57 MYLAN-Salbutamol ........................................................ 170 MYLAN-Selegiline ........................................................... 140 MYLAN-Sertraline ................................................... 157, 158 MYLAN-Simvastatin .................................................... 53, 54 MYLAN-Sotalol .................................................................35 MYLAN-Sumatriptan ............................................... 130, 131 Mylanta ...............................................................................1 MYLAN-Tamoxifen .......................................................... 106 MYLAN-Tamsulosin ..........................................................78 MYLAN-Telmisartan ..........................................................50 MYLAN-Telmisartan HCTZ ...............................................52 MYLAN-Terbinafine ..........................................................62 MYLAN-Ticlopidine ...........................................................20 MYLAN-Timolol ............................................................... 180 MYLAN-Tizanidine .......................................................... 119 MYLAN-Topiramate ................................................ 135, 136 MYLAN-Trazodone ......................................................... 159 MYLAN-Valacyclovir .........................................................99 MYLAN-Valproic ............................................................. 134 MYLAN-Valsartan ....................................................... 48, 49 MYLAN-Valsartan HCTZ ...................................................51 MYLAN-Venlafaxine ................................................ 160, 161 MYLAN-Verapamil ...................................................... 40, 41 MYLAN-Warfarin ......................................................... 19, 20 MYLAN-Zolmitriptan ........................................................ 131

December 2012

MYLAN-Zopiclone ...................................................152, 153 Myleran .......................................................................... 103 Myl-Letrozole.................................................................. 107 Myl-Ranitidine .................................................................... 2 Myochrysine ................................................................... 118 Myozyme .......................................................................... 18 Mysoline ......................................................................... 132 nabilone ............................................................................ 8 nabumetone .................................................................. 118 Nabumetone .................................................................. 118 nadolol ............................................................................ 35 nafarelin .......................................................................... 82 Nalcrom ............................................................................ 11 naloxone ....................................................................... 185 Naloxone ........................................................................ 185 naltrexone ..................................................................... 165 Naprosyn .................................................................115, 116 Naprosyn-E .................................................................... 116 naproxen ....................................................................... 115 Naproxen ....................................................................... 116 Naproxen Sodium .......................................................... 116 Naproxen Sodium DS .................................................... 116 naratriptan .................................................................... 131 Narcan ........................................................................... 185 Nardil .............................................................................. 158 Nasacort AQ .................................................................. 169 Nasonex ......................................................................... 169 nateglinide ...................................................................... 16 Navane ........................................................................... 143 Navelbine ....................................................................... 104 Nebcin .............................................................................. 93 nelfinavir ......................................................................... 99 Neo-Medrol Acne ............................................................. 68 neomycin ........................................................................ 63 Neoral ............................................................................ 110 Neosporin ............................................................23, 63, 183 neostigmine .................................................................. 164 Neostigmine Methylsulfate ............................................. 164 Neo-Synephrine ............................................................... 27 Nerisalic ........................................................................... 68 Nerisone ........................................................................... 66 Neulasta ......................................................................... 108 Neuleptil ......................................................................... 141 Neupogen ...................................................................... 107 Neurontin ................................................................136, 137 Nexavar .......................................................................... 105 Nexium ............................................................................... 5 Niaspan ............................................................................ 58 Niaspan FCT .................................................................... 58 nicotinic acid .................................................................. 58 NidaGel ............................................................................ 71 nifedipine ........................................................................ 40 Nifedipine ......................................................................... 40 nifedipine, comb............................................................. 40 nilotinib ......................................................................... 105 nilutamide ..................................................................... 106 nimodipine ...................................................................... 40 Nimotop ............................................................................ 40 Ni-ODAN .......................................................................... 58 Nitoman .......................................................................... 165 Nitrazadon ...................................................................... 152 nitrazepam .................................................................... 152 Nitro-Dur .......................................................................... 27 nitrofurantoin.................................................................. 96 nitroglycerin ................................................................... 27 Nitroglycerin ..................................................................... 27

Product Index ­ 46

Product Index

Nitrol .................................................................................27 Nitrolingual ........................................................................27 Nitrostat.............................................................................27 nizatidine ...........................................................................3 Nizoral ......................................................................... 61, 97 Nolvadex ......................................................................... 106 Nolvadex-D ..................................................................... 106 norelgestromin and estrogen ........................................73 norepinephrine ................................................................27 Norepinephrine Bitartrate ..................................................27 norethindrone..................................................................74 norethindrone and estrogen .............................. 72, 73, 75 norethisterone and estrogen .........................................76 Norflex ............................................................................ 119 norfloxacin.......................................................................95 norgestimate and estrogen ............................................73 Noritate .............................................................................64 Noroxin .............................................................................95 Norpramin ....................................................................... 153 Norprolac ..........................................................................72 nortriptyline ...................................................................154 Norvasc .............................................................................39 Norvir ................................................................................99 Novamilor ..........................................................................32 Novamoxin ........................................................................87 Novasen .......................................................................... 128 Novo-5-ASA ......................................................................11 Novo-Acebutolol................................................................37 Novo-Acyclovir ............................................................ 98, 99 Novo-Alendronate ........................................................... 121 Novo-Alfuzosin ..................................................................78 Novo-Alprazol ......................................................... 150, 151 Novo-Amiodarone .............................................................26 Novo-Amlodipine...............................................................39 Novo-Ampicillin .................................................................86 Novo-Atenol ......................................................................36 Novo-Atomoxetine .......................................................... 162 Novo-Atorvastatin ....................................................... 55, 56 Novo-Azathioprine .......................................................... 110 Novo-Azithromycin ............................................................92 Novo-Benzydamine .............................................................1 Novo-Betahistine............................................................. 165 Novo-Bicalutamide .......................................................... 107 Novo-Bisoprolol.................................................................37 Novo-Bromazepam ......................................................... 150 Novo-Buspirone .............................................................. 151 Novo-Captoril .............................................................. 42, 43 Novo-Carbamaz .............................................................. 133 Novo-Cefadroxil ................................................................89 Novo-Chloroquine ........................................................... 167 Novo-Cilazapril............................................................ 45, 46 Novo-Cilazapril/HCTZ .......................................................47 Novo-Ciprofloxacin ...................................................... 94, 95 Novo-Citalopram ............................................................. 156 Novo-Clavamoxin ..............................................................88 Novo-Clindamycin .............................................................93 Novo-Clobazam .............................................................. 150 Novo-Clobetasol ...............................................................67 Novo-Clonazepam .......................................................... 133 Novo-Clonidine .................................................................28 Novo-Cloxin ................................................................ 87, 88 Novo-Cycloprine ............................................................. 119 Novo-Cyproterone/Ethinyl Estradiol ..................................76 Novo-Desmopressin .........................................................81 Novo-Difenac .......................................................... 113, 114 Novo-Diflunisal ................................................................ 129

December 2012

Novo-Diltazem.................................................................. 42 Novo-Diltazem CD ........................................................... 41 Novo-Diltazem ER.......................................................41, 42 Novo-Divalproex............................................................. 134 Novo-Docusate .................................................................. 9 Novo-Domperidone ............................................................ 7 Novo-Doxazosin ............................................................... 29 Novo-Doxepin .........................................................154, 155 Novo-Doxylin .................................................................... 86 Novo-Enalapril.................................................................. 43 Novo-Enalapril/HCTZ ....................................................... 46 Novo-Etidronatecal Kit ................................................... 122 Novo-Famotidine ............................................................ 2, 3 Novo-Fenofibrate ............................................................. 57 Novo-Fenofibrate Micronized ........................................... 57 Novo-Fenofibrate-S .......................................................... 57 Novo-Fentanyl ................................................................ 127 Novo-Ferrogluc ................................................................ 22 Novo-Finasteride .............................................................. 79 Novo-Fluconazole ............................................................ 97 Novo-Fluoxetine ............................................................. 155 Novo-Flurprofen ............................................................. 117 Novo-Flutamide .............................................................. 106 Novo-Fluvoxamine ......................................................... 158 Novo-Fosinopril ................................................................ 46 Novo-Furantoin ................................................................ 96 Novo-Gemfibrozil ............................................................. 57 Novo-Gliclazide ................................................................ 14 Novo-Glimepiride ........................................................14, 15 Novo-Glyburide ................................................................ 14 Novo-Hydrazide ............................................................... 30 Novo-Hydroxyzin ............................................................ 151 Novo-Indapamide ............................................................. 31 Novo-Ipramide................................................................ 171 Novo-Ketoconazole .......................................................... 97 Novo-Ketorolac .............................................................. 114 Novo-Ketotifen ............................................................... 174 Novo-Lamotrigine ........................................................... 135 Novo-Lansoprazole ............................................................ 4 Novo-Leflunomide .......................................................... 109 Novo-Levocarbidopa ...................................................... 138 Novo-Levofloxacin............................................................ 95 Novo-Lexin ..................................................................88, 89 Novolin GE Insulin.......................................................12, 13 Novo-Lisinopril ................................................................. 43 Novo-Lisinopril P .............................................................. 44 Novo-Lisinopril Z .........................................................43, 44 Novo-Lisinopril/HCTZ ..................................................46, 47 Novo-Loperamide............................................................. 10 Novo-Lorazem................................................................ 150 Novo-Lovastatin ............................................................... 54 Novo-Maprotiline ............................................................ 155 Novo-Medrone ................................................................. 75 Novo-Meloxicam ............................................................ 115 Novo-Metformin................................................................ 13 Novo-Methacin ............................................................... 113 Novo-Methylphenidate ................................................... 162 Novo-Metoprol.............................................................35, 36 Novo-Mexiletine ............................................................... 25 Novo-Minocycline ............................................................. 86 Novo-Mirtazapine ....................................................159, 160 NovoMix ........................................................................... 12 Novo-Moclobemide ........................................................ 158 Novo-Morphine............................................................... 124 Novo-Mycophenolate ..................................................... 109 Novo-Mycopheolate ....................................................... 109

Product Index ­ 47

Product Index

Novo-Nabumetone .......................................................... 118 Novo-Nadolol ....................................................................35 Novo-Naprox ................................................................... 116 Novo-Naprox Sodium ...................................................... 116 Novo-Naratriptan ............................................................. 131 Novo-Nizatidine...................................................................3 Novo-Norfloxacin ..............................................................95 Novo-Nortriptyline ........................................................... 154 Novo-Ofloxacin .................................................................94 Novo-Olanzapine .................................................... 144, 145 Novo-Omeprazole Delayed-Release ..................................3 Novo-Ondansetron ..............................................................7 Novo-Oxybutynin ..............................................................77 Novo-Pantoprazole .............................................................4 Novo-Paroxetine ..................................................... 156, 157 Novo-Pen-VK ....................................................................87 Novo-Peridol ................................................................... 142 Novo-Pindol ................................................................ 33, 34 Novo-Pioglitazone ....................................................... 15, 16 Novo-Pirocam ................................................................. 114 Novo-Pramipexole .................................................. 139, 140 Novo-Pranol ......................................................................34 Novo-Pravastatin ........................................................ 54, 55 Novo-Prazin ......................................................................29 Novo-Prednisone ..............................................................84 Novo-Profen .................................................................... 115 Novo-Purol ...................................................................... 120 Novo-Quetiapine ..................................................... 145, 146 Novo-Quinine .................................................................. 167 Novo-Rabeprazole .......................................................... 4, 5 Novo-Raloxifene ...............................................................76 Novo-Ramipril ............................................................. 44, 45 Novo-Ranidine ....................................................................2 Novo-Ranitidine ..................................................................2 Novo-Risedronate ........................................................... 121 Novo-Risperidone ................................................... 147, 148 Novo-Rivastigmine .......................................................... 163 Novo-Rythro EES..............................................................91 Novo-Rythro EST ..............................................................91 Novo-Salbutamol HFA .................................................... 170 Novo-Selegiline ............................................................... 140 Novo-Semide ....................................................................31 Novo-Sertraline ....................................................... 157, 158 Novo-Sildenafil ..................................................................77 Novo-Simvastatin ..............................................................53 Novo-Sotalol .....................................................................35 Novo-Spiroton ...................................................................31 Novo-Spirozine .................................................................32 Novo-Sucralate ...................................................................5 Novo-Sumatriptan ........................................................... 131 Novo-Sumatriptan DF ............................................. 130, 131 Novo-Sundac .................................................................. 113 Novo-Tamoxifen.............................................................. 106 Novo-Tamsulosin ..............................................................78 Novo-Temazepam .......................................................... 152 Novo-Terazosin........................................................... 78, 79 Novo-Terbinafine ..............................................................62 Novo-Theophyl................................................................ 172 Novo-Tiaprofenic ............................................................. 117 Novo-Ticlopidine ...............................................................20 Novo-Timol........................................................................34 Novo-Topiramate .................................................... 135, 136 Novo-Trazodone ............................................................. 159 Novo-Triamzide.................................................................32 Novo-Trimel ......................................................................91 Novo-Valproic ................................................................. 134

December 2012

Novo-Venlafaxine ....................................................160, 161 Novo-Veramil ................................................................... 41 Novo-Warfarin .................................................................. 19 Novo-Zopiclone .......................................................152, 153 Nozinan .......................................................................... 140 Nplate ............................................................................... 21 Nucynta CR .................................................................... 128 Nutropin ........................................................................... 81 NuvaRing ......................................................................... 72 Nyaderm .....................................................................61, 71 nystatin ................................................................10, 61, 71 nystatin, comb. ............................................................... 71 Octostim ........................................................................... 81 octreotide ........................................................................ 82 Octreotide Acetate Omega ............................................... 82 Ocuflox ........................................................................... 177 ODAN K-20 ...................................................................... 17 Oesclim ............................................................................ 75 ofloxacin ..................................................................94, 177 olanzapine .................................................................... 143 Olanzapine ..............................................................144, 145 Olestyr .............................................................................. 58 olmesartan medoxomil .................................................. 50 olmesartan medoxomil and diuretics ........................... 52 Olmetec ............................................................................ 50 Olmetec Plus .................................................................... 52 olopatadine ................................................................... 181 olsalazine ........................................................................ 11 omalizumab .................................................................. 173 omeprazole ....................................................................... 3 Omeprazole ....................................................................... 3 Omnaris ......................................................................... 171 Omnitrope ........................................................................ 81 ondansetron ..................................................................... 7 Ondansetron-Odan ............................................................ 7 One-Alpha ........................................................................ 17 Onglyza ............................................................................ 16 Onsolis ........................................................................... 127 opium .............................................................................. 10 Opticrom ........................................................................ 181 Optimyxin Plus ............................................................... 183 Oracort ............................................................................... 1 Orap ............................................................................... 143 Orbenin .......................................................................87, 88 orciprenaline................................................................. 172 Orencia .......................................................................... 109 Orfenace ........................................................................ 119 orlistat ............................................................................. 11 orphenadrine (citrate) .................................................. 119 Ortho ...........................................................................72, 73 Orthocept ......................................................................... 73 Orudis ............................................................................ 117 Orudis-E ......................................................................... 117 oseltamivir .................................................................... 101 other nasal preparations, comb. ................................. 170 other respiratory system products ............................. 175 Ovol.................................................................................... 6 oxaprozin ...................................................................... 117 oxazepam ...................................................................... 149 oxcarbazepine .............................................................. 134 Oxeze............................................................................. 170 Oxsoralen ......................................................................... 63 oxtriphylline .................................................................. 172 oxybutynin ...................................................................... 76 Oxybutynin ....................................................................... 77 oxycodone .................................................................... 126

Product Index ­ 48

Product Index

Oxycodone/Acet.............................................................. 129 OxyContin ....................................................................... 126 Oxy-IR ............................................................................. 126 OxyNEO .......................................................................... 126 Oxytrol ..............................................................................77 Ozurdex .......................................................................... 178 Palafer ..............................................................................22 Palafer CF .........................................................................22 paliperidone................................................................... 149 pamidronate ..................................................................120 Pamidronate.................................................................... 121 Pamidronate Disodium Omega ....................................... 121 pamidronic acid ............................................................120 Pancrease MT...................................................................12 Panoxyl .............................................................................69 PanOxyl ............................................................................69 Pantoloc ..............................................................................4 pantoprazole......................................................................4 Pantoprazole .......................................................................4 papaverine .........................................................................5 Papaverine ..........................................................................5 paracetamol ...................................................................129 Pariet .............................................................................. 4, 5 Parlodel .............................................................................72 Parnate ........................................................................... 158 paromycin ........................................................................10 paroxetine ......................................................................156 Paroxetine ............................................................... 156, 157 Parsitan ........................................................................... 137 Patanol ............................................................................ 181 PAT-Galantamine ........................................................... 164 PAT-Rabeprazole ........................................................... 4, 5 PAT-Tramadol/Acet 37.5/325mg Tab ............................. 128 Paxil ........................................................................ 156, 157 pazopanib ...................................................................... 105 Pediapred..........................................................................84 PEG 3350 .........................................................................10 pegaptanib .....................................................................181 Pegasys .......................................................................... 108 Pegasys RBV .................................................................. 108 Pegetron ......................................................................... 108 pegfilgrastim .................................................................108 peginterferon alfa-2a ....................................................108 Peglyte ................................................................................9 pegvisomant ....................................................................81 Penbritin ............................................................................86 penicillamine .................................................................118 penicillin v .......................................................................87 Penlac ...............................................................................61 Pennsaid ......................................................................... 118 Pentamycetin .......................................................... 177, 183 Pentasa .............................................................................11 pentazocine ...................................................................128 pentosan polysulfate sodium ........................................33 pentoxifylline ...................................................................32 Pen-Vee ............................................................................87 Pepcid ............................................................................. 2, 3 pepsin ..............................................................................12 PeptoBismol ......................................................................10 Percocet .......................................................................... 129 Perichlor ..............................................................................1 pericyazine ....................................................................141 Peridex ................................................................................1 perindopril .......................................................................44 perindopril and diuretics ................................................47 Periostat ..............................................................................1

December 2012

perphenazine ................................................................ 141 Persantine ........................................................................ 21 pethidine ....................................................................... 126 Pharmorubicin ................................................................ 104 phenelzine .................................................................... 158 Phenobarb ..................................................................... 132 phenoxymethylpenicillin ............................................... 87 phentolamine .................................................................. 32 Phentolamine Mesylate .................................................... 32 phenylephrine..................................................27, 169, 181 Phenylephrine .................................................................. 27 phenytoin ...................................................................... 132 pHisoHex ......................................................................... 68 phl-Amiodarone ................................................................ 26 phl-Amlodipine ................................................................. 39 phl-Atenolol ...................................................................... 36 phl-Azithromycin............................................................... 92 phl-Baclofen ................................................................... 119 phl-Carvedilol ................................................................... 38 phl-Citalopram ................................................................ 156 phl-Clonazepam ............................................................. 133 phl-Cyclobenzaprine ...................................................... 119 phl-Fluoxetine................................................................. 155 phl-Gabapentin............................................................... 136 phl-Meloxicam ................................................................ 115 phl-Mirtazapine............................................................... 159 phl-Ondansetron ................................................................ 7 phl-Paroxetine ................................................................ 157 phl-Pioglitazone...........................................................15, 16 phl-Pravastatin ............................................................54, 55 phl-Quetiapine .........................................................145, 146 phl-Risperidone .......................................................147, 148 phl-Sertraline ...........................................................157, 158 phl-Simvastatin............................................................53, 54 phl-Topiramate ........................................................135, 136 phl-Trazodone ................................................................ 159 phl-Zopiclone...........................................................152, 153 Phoslo ............................................................................ 185 Phosphate-Novartis.......................................................... 17 phytonadione.................................................................. 21 pilocarpine .............................................................164, 179 Pilopine HS .................................................................... 179 pimecrolimus .................................................................. 69 pimozide ....................................................................... 143 pinaverium ........................................................................ 6 pindolol ........................................................................... 33 pindolol and other diuretics .......................................... 38 pioglitazone .................................................................... 15 Pioglitazone ................................................................15, 16 piperacillin and enzyme inhibitor ................................. 88 Piperacillin and Tazobactam ............................................ 88 Piportil L4 ....................................................................... 142 pipotiazine .................................................................... 142 piroxicam ...................................................................... 114 pizotifen ........................................................................ 132 placebo ......................................................................... 186 Placebo .......................................................................... 186 Plan B .............................................................................. 74 Plaquenil ........................................................................ 167 platelet aggregation inhibitors, comb. ......................... 21 Plavix ............................................................................... 20 Plendil .........................................................................39, 40 pms-Acetaminophen ...................................................... 129 pms-Alendronate-FC ...................................................... 121 pms-Amantadine ............................................................ 138 pms-Amiodarone .............................................................. 26

Product Index ­ 49

Product Index

pms-Amlodipine ................................................................39 pms-Amoxicillin .................................................................87 pms-Anastrozole ............................................................. 107 pms-ASA ......................................................................... 128 pms-atenolol .....................................................................36 pms-Atenolol .....................................................................36 pms-Atomoxetine ............................................................ 162 pms-Atorvastatin ......................................................... 55, 56 pms-Azithromycin ....................................................... 92, 93 pms-Baclofen .................................................................. 119 pms-Benztropine ............................................................. 138 pms-Benzydamine ..............................................................1 pms-Bicalutamide ........................................................... 107 pms-Bisacodyl.....................................................................9 pms-Bisoprolol ..................................................................37 pms-Bosentan ...................................................................30 pms-Brimonidine ............................................................. 179 pms-Bromocriptine ............................................................72 pms-Bupropion................................................................ 160 pms-Buspirone ................................................................ 151 pms-Candesartan ....................................................... 49, 50 pms-Candesartan HCTZ ...................................................52 pms-Captopril....................................................................42 pms-Carbamazepine ....................................................... 133 pms-Carvedilol ..................................................................38 pms-Chloral Hydrate ....................................................... 151 pms-Cilazapril ............................................................. 45, 46 pms-Ciprofloxacin ............................................... 94, 95, 178 pms-Citalopram............................................................... 156 pms-Clarithromycin ...........................................................92 pms-Clobazam ................................................................ 150 pms-Clobetasol .................................................................67 pms-Clonazepam .................................................... 132, 133 pms-Clonazepam-R ........................................................ 133 pms-Clopidogrel ................................................................20 pms-Cyclobenzaprine ..................................................... 119 pms-Deferoxamine .......................................................... 185 pms-Desmopressin ...........................................................81 pms-Desonide ...................................................................65 pms-Dexamethasone ........................................................83 pms-Diazepam ................................................................ 149 pms-Diclofenac ....................................................... 113, 114 pms-Diclofenac-K............................................................ 113 pms-Diltiazem CD .............................................................41 pms-Docusate Sodium ........................................................9 pms-Domperidone ..............................................................7 pms-Doxazosin .................................................................29 pms-Enalapril ....................................................................43 pms-Erythromycin ........................................................... 177 pms-Famciclovir ................................................................99 pms-Fenofibrate Micro ......................................................57 pms-Fentanyl .................................................................. 127 pms-Fentanyl MTX.......................................................... 127 pms-Ferrous Sulfate .........................................................22 pms-Finasteride .......................................................... 70, 79 pms-Fluconazole ...............................................................97 pms-Fluorometholone ..................................................... 178 pms-Fluoxetine ............................................................... 155 pms-Fluphenazine .......................................................... 141 pms-Flutamide ................................................................ 106 pms-Fluvoxamine ............................................................ 158 pms-Gabapentin ..................................................... 136, 137 pms-Gemfibrozil ................................................................57 pms-Gentamicin ...................................................... 177, 182 pms-Glyburide...................................................................14 pms-Hydrochlorothiazide ..................................................30

December 2012

pms-Hydromorphone ..................................................... 125 pms-Indapamide .............................................................. 31 pms-Ipratropium ..............................................169, 171, 172 pms-Irbesartan ................................................................. 49 pms-Irbesartran-HCTZ ................................................51, 52 pms-ISMN ........................................................................ 28 pms-Isoniazid ................................................................... 98 pms-Ketoprofen.............................................................. 117 pms-Lactulose .................................................................. 10 pms-Lamotrigine ............................................................ 135 pms-Leflunomide............................................................ 109 pms-Letrozole ................................................................ 107 pms-Levetiracetam......................................................... 137 pms-Levobunolol ............................................................ 180 pms-Levofloxacin ............................................................. 95 pms-Lidocaine .................................................................. 62 pms-Lisinopril ..............................................................43, 44 pms-Lithium Carbonate .................................................. 146 pms-Loperamide .............................................................. 10 pms-Losartan ........................................................47, 48, 50 pms-Losartan HCTZ....................................................50, 51 pms-Lovastatin ................................................................. 54 pms-Loxapine................................................................. 143 pms-Meloxicam .............................................................. 115 pms-memantine ............................................................. 164 pms-Metformin ................................................................. 13 pms-Methylphenidate ..................................................... 161 pms-Metoclopramide.......................................................... 6 pms-Metoprolol-L ........................................................35, 36 pms-Metronidazole........................................................... 96 pms-Minocycline .............................................................. 86 pms-Mirtazapine............................................................. 159 pms-Mirtazepine............................................................. 159 pms-Montelukast ............................................................ 173 pms-Morphine Sulfate .................................................... 124 pms-Nabilone ..................................................................... 8 pms-Naproxen.........................................................115, 116 pms-Nizatidine ................................................................... 3 pms-Norfloxacin ............................................................... 95 pms-Nortriptyline ............................................................ 154 pms-Nystatin .................................................................... 10 pms-Ofloxacin ................................................................ 177 pms-Olanzapine ......................................................144, 145 pms-Omeprazole................................................................ 3 pms-Ondansetron .............................................................. 7 pms-Oxybutynin ..........................................................76, 77 pms-Oxycodone ............................................................. 126 pms-Pantoprazole .............................................................. 4 pms-Paroxetine .......................................................156, 157 pms-Pindolol ...............................................................33, 34 pms-Pioglitazone.........................................................15, 16 pms-Piroxicam ............................................................... 115 pms-Potassium Chloride .................................................. 17 pms-Pramipexole ....................................................139, 140 pms-Pravastatin ..........................................................54, 55 pms-Prednisolone ............................................................ 84 pms-Prochloperazine ..................................................... 141 pms-Prochlorperazine .................................................... 141 pms-Procyclidine ............................................................ 137 pms-Propafenone............................................................. 26 pms-Quetiapine .......................................................145, 146 pms-Rabeprazole ........................................................... 4, 5 pms-Raloxifene ................................................................ 76 pms-Ramipril ...............................................................44, 45 pms-Ramipril-HCTZ ......................................................... 47 pms-Ranitidine ................................................................... 2

Product Index ­ 50

Product Index

pms-Repaglinide ...............................................................16 pms-Risedronate............................................................. 121 pms-Risperidone ..................................................... 147, 148 pms-Rivastigmine ........................................................... 163 pms-Rizatriptan ............................................................... 131 pms-Ropinirole ................................................................ 139 pms-Rosuvastatin ....................................................... 56, 57 pms-Salbutamol ...................................................... 170, 172 pms-Sertraline......................................................... 157, 158 pms-Sildenafil ...................................................................77 pms-Simvastatin ......................................................... 53, 54 pms-Sodium Cromoglycate ............................................. 172 pms-Sodium Polystyrene Sulfonate ................................ 185 pms-Sotalol .......................................................................35 pms-Sulfasalazine .............................................................11 pms-Sumatriptan..................................................... 130, 131 pms-Telmisartan ...............................................................50 pms-Terazosin ............................................................ 78, 79 pms-Terbinafine ................................................................62 pms-Testosterone .............................................................74 pms-Timolol .................................................................... 180 pms-Topiramate ...................................................... 135, 136 pms-Trazodone ............................................................... 159 pms-Tryptophan .............................................................. 159 pms-Ursodiol C ...................................................................9 pms-Valacyclovir ...............................................................99 pms-Valproic ................................................................... 134 pms-Valsartan ............................................................. 48, 49 pms-Vancomycin ..............................................................96 pms-Venlafaxine ..................................................... 160, 161 pms-Verapamil ..................................................................41 pms-Zolmitriptan ............................................................. 131 pms-Zopiclone ........................................................ 152, 153 Podofilm ............................................................................64 podophyllotoxin ..............................................................64 Pollinex-R........................................................................ 185 polystyrene sulfonate ...................................................185 Polytrim ........................................................................... 177 Ponstan ........................................................................... 117 Pontocaine ...................................................................... 123 Portia ................................................................................73 posaconazole ..................................................................97 Posanol .............................................................................97 Potaba ..............................................................................70 potassium chloride .........................................................17 potassium citrate ............................................................17 povidone-iodine ..............................................................68 Pradax ..............................................................................21 pramipexole ...................................................................139 Pramox HC .......................................................................67 Pravachol .................................................................... 54, 55 pravastatin .......................................................................54 Pravastatin .................................................................. 54, 55 prazosin ...........................................................................29 Pred Forte ....................................................................... 178 Pred Mild ......................................................................... 178 prednisolone ........................................................... 84, 178 prednisolone and antiinfectives ..................................179 prednisone.......................................................................84 pregabalin ......................................................................137 PregVit ..............................................................................22 Premarin ...........................................................................75 Pressyn .............................................................................81 Prevacid ..............................................................................4 Prevex B ...........................................................................65 Prevex HC.........................................................................64

December 2012

Prezista .......................................................................... 100 primaquine .................................................................... 167 Primaquine ..................................................................... 167 Primaxin ........................................................................... 91 primidone ...................................................................... 132 Prinivil .........................................................................43, 44 Prinzide .......................................................................46, 47 Pristiq ............................................................................. 161 Probenacid ..................................................................... 120 probenecid .................................................................... 120 procainamide .................................................................. 25 Procainamide ................................................................... 25 Procan .............................................................................. 25 procarbazine ................................................................. 104 prochlorperazine .......................................................... 141 Prochlorperazine ............................................................ 141 Proctodan-HC .................................................................. 33 Proctofoam HC................................................................. 33 Proctol .............................................................................. 33 Proctosedyl ...................................................................... 33 procyclidine .................................................................. 137 Procytox ......................................................................... 103 profenamine.................................................................. 137 progesterone .................................................................. 75 Proglycem ...................................................................... 186 Prolopa ........................................................................... 138 Proloprim .......................................................................... 91 Prometrium ...................................................................... 75 Pronestyl .......................................................................... 25 propafenone ................................................................... 26 Propafenone .................................................................... 26 Propecia ........................................................................... 70 propericyazine .............................................................. 141 propranolol ..................................................................... 34 Propranolol ....................................................................... 34 propylthiouracil .............................................................. 85 Propyl-Thyracil ................................................................. 85 Proscar ............................................................................. 79 Prostigmin ...................................................................... 164 Prostin .............................................................................. 71 protease inhibitors, comb. .......................................... 100 Protopic ............................................................................ 69 Provastatin ....................................................................... 55 Provera ............................................................................ 75 proxymetacaine ............................................................ 181 Prozac .....................................................................155, 156 prucalopride ..................................................................... 6 Pulmicort ........................................................................ 171 Purinethol ....................................................................... 103 PVF 500 ........................................................................... 87 PVF K............................................................................... 87 pyrazinamide .................................................................. 98 pyridostigmine ............................................................. 164 pyrimethamine.............................................................. 167 Questran .......................................................................... 58 quetiapine ..................................................................... 145 Quetiapine ...............................................................145, 146 quinagolide ..................................................................... 72 quinapril .......................................................................... 45 quinapril and diuretics ................................................... 47 quinine .......................................................................... 167 Quinine ........................................................................... 167 Quinine-Odan ................................................................. 167 QVAR ............................................................................. 171 rabeprazole ....................................................................... 4 Rabeprazole ................................................................... 4, 5

Product Index ­ 51

Product Index

Ralivia ............................................................................. 128 raloxifene .........................................................................76 raltegravir ......................................................................101 ramipril .............................................................................44 Ramipril ....................................................................... 44, 45 ramipril and diuretics .....................................................47 RAN-Amlodipine ...............................................................39 RAN-Anastrozole ............................................................ 107 RAN-Atenolol ....................................................................36 RAN-Atorvastatin ........................................................ 55, 56 RAN-Bicalutamide ........................................................... 107 RAN-Carvedilol .................................................................38 RAN-Cefprozil ............................................................. 89, 90 RAN-Ciproflox ............................................................. 94, 95 RAN-Ciprofloxacin ...................................................... 94, 95 RAN-Citalo ...................................................................... 156 RAN-Citalopram .............................................................. 156 RAN-Clarithromycin ..........................................................92 RAN-Clopidogrel ...............................................................20 RAN-Domperidone ..............................................................7 RAN-Enalapril ...................................................................43 RAN-Fentanyl MTX ......................................................... 127 RAN-Finasteride ...............................................................79 RAN-Fosinopril..................................................................46 RAN-Gabapentin............................................................. 136 RAN-Gapapentin............................................................. 136 RAN-Irbesartan HCTZ ................................................ 51, 52 ranitidine ............................................................................2 Ranitidine ............................................................................2 RAN-Letrozole ................................................................ 107 RAN-Lisinopril ............................................................. 43, 44 RAN-Lovastatin .................................................................54 RAN-Metformin .................................................................13 RAN-Nabilone .....................................................................8 RAN-Omeprazole ................................................................3 RAN-Ondansetron ..............................................................7 RAN-Pantoprazole ..............................................................4 RAN-Pioglitazone ........................................................ 15, 16 RAN-Pravastatin ......................................................... 54, 55 RAN-Rabeprazole ........................................................... 4, 5 RAN-Ramipril .............................................................. 44, 45 RAN-Ranitidine ...................................................................2 RAN-Risperidone .................................................... 147, 148 RAN-Ropinirole ............................................................... 139 RAN-Rosuvastatin ...................................................... 56, 57 RAN-Sertaline ......................................................... 157, 158 RAN-Simvastatin ......................................................... 53, 54 RAN-Tamsulosin ...............................................................78 RAN-Valsartan ..................................................................48 RAN-Venlafaxine XR .............................................. 160, 161 RAN-Zopiclone........................................................ 152, 153 rasagiline .......................................................................140 Rasilez ..............................................................................52 ratio-Aclavulanate .............................................................88 ratio-Acyclovir ............................................................. 98, 99 ratio-Amcinonide ...............................................................66 ratio-Amiodarone ..............................................................26 ratio-Amlodipine ................................................................39 ratio-Atenolol .....................................................................36 ratio-Atorvastatin ......................................................... 55, 56 ratio-Azithromycin .............................................................92 ratio-Baclofen .................................................................. 119 ratio-Bicalutamide ........................................................... 107 ratio-Brimonidine ............................................................. 179 ratio-Bronc ...................................................................... 173 ratio-Bupropion ............................................................... 160

December 2012

ratio-Carvedilol ................................................................. 38 ratio-Cefuroxime............................................................... 89 ratio-Ciprofloxacin .......................................................94, 95 ratio-Citalopram.............................................................. 156 ratio-Clarithromycin .......................................................... 92 ratio-Clobetasol ................................................................ 67 ratio-Codeine.................................................................. 174 ratio-Diltiazem CD ............................................................ 41 ratio-Docusate Sodium ....................................................... 9 ratio-Domperidone ............................................................. 7 ratio-Ectosone .............................................................65, 66 ratio-Emtec ..................................................................... 126 ratio-Fenofibrate MC ........................................................ 57 ratio-Fentanyl ................................................................. 127 ratio-Finasteride ............................................................... 79 ratio-Fluoxetine .............................................................. 155 ratio-Fluticasone............................................................. 169 ratio-Fluvoxamine........................................................... 158 ratio-Gabapentin ............................................................ 136 ratio-Gentamicin ............................................................... 63 ratio-Glimepiride ..........................................................14, 15 ratio-Glyburide.................................................................. 14 ratio-Hemcort HC ............................................................. 33 ratio-Indomethacin ......................................................... 113 ratio-IPRA SAL ............................................................... 170 ratio-Ipratropium ......................................................171, 172 ratio-Irbesartan ................................................................. 49 ratio-Irbesartan-HCTZ .................................................51, 52 ratio-Ketorolac ................................................................ 178 ratio-Lactulose.................................................................. 10 ratio-Lamotrigine ............................................................ 135 ratio-Lenoltec ..........................................................126, 129 ratio-Levobunolol............................................................ 180 ratio-Lisinopril P ..........................................................43, 44 ratio-Lisinopril Z...........................................................43, 44 ratio-Lovastatin................................................................. 54 ratio-Meloxicam .............................................................. 115 ratio-Memantine ............................................................. 164 ratio-Metformin ................................................................. 13 ratio-Methotrexate Sodium ............................................. 103 ratio-Mirtazapine ............................................................ 159 ratio-Mometasone ............................................................ 66 ratio-Morphine ................................................................ 124 ratio-Nystatin .........................................................10, 61, 71 ratio-Omeprazole ............................................................... 3 ratio-Ondansetron .............................................................. 7 ratio-Oxycocet ................................................................ 129 ratio-Oxycodan ............................................................... 129 ratio-Paroxetine .......................................................156, 157 ratio-Pioglitazone ........................................................15, 16 ratio-Prednisolone .......................................................... 178 ratio-Proctosone ............................................................... 33 ratio-Ramipril .................................................................... 44 ratio-Ranitidine ................................................................... 2 ratio-Risedronate............................................................ 121 ratio-Rivastigmine .......................................................... 163 ratio-Salbutamol ............................................................. 170 ratio-Sildenafil-R............................................................... 77 ratio-Simvastatin .........................................................53, 54 ratio-Sotalol ...................................................................... 35 ratio-Tamsulosin............................................................... 78 ratio-Tecnal .................................................................... 129 ratio-Temazepam ........................................................... 152 ratio-Terazosin ............................................................78, 79 ratio-Topilene ................................................................... 65 ratio-Topisalic ................................................................... 68

Product Index ­ 52

Product Index

ratio-Topisone ...................................................................65 ratio-Tryptophan.............................................................. 159 ratio-Valproic ................................................................... 134 ratio-Venlafaxine ..................................................... 160, 161 ratio-Zopiclone ........................................................ 152, 153 Reactine .......................................................................... 174 Rebif ............................................................................... 108 Refresh ........................................................................... 182 Refresh Celluvisc ............................................................ 182 Refresh Lacri-Lube ......................................................... 182 Refresh Plus ................................................................... 182 Refresh Tears ................................................................. 182 Relafen ........................................................................... 118 Relenza ........................................................................... 101 Relistor ..............................................................................10 Relpax ............................................................................. 132 Remeron ................................................................. 159, 160 Remicade ........................................................................ 109 Reminyl ........................................................................... 164 Remodulin .........................................................................21 Renagel .......................................................................... 185 Renedil ........................................................................ 39, 40 ReQuip ............................................................................ 139 Resotran .............................................................................6 Restoril ............................................................................ 152 Resultz ............................................................................ 168 Retin-A ..............................................................................68 Retrovir ........................................................................... 100 Revatio ..............................................................................77 ReVia .............................................................................. 165 Revlimid .......................................................................... 111 Revolade ...........................................................................22 Reyataz ........................................................................... 100 Rhinalar .......................................................................... 169 Rhinaris-CS..................................................................... 169 Rhinocort......................................................................... 169 Rho-Nitro...........................................................................27 Rhotral ..............................................................................37 Rhovane.......................................................................... 153 ribavirin, comb. .............................................................108 Ridaura ........................................................................... 118 rifabutin............................................................................98 Rifadin .........................................................................97, 98 rifampicin .........................................................................97 rifampin ............................................................................97 rifampin and isoniazid ....................................................98 Rifater ...............................................................................98 rilpivirine ........................................................................ 101 Rilutek ............................................................................. 165 riluzole ...........................................................................165 Rimso-50...........................................................................78 risedronate ....................................................................121 Risedronate..................................................................... 121 risedronic acid ..............................................................121 Risperdal ......................................................... 146, 147, 148 Risperdal Consta ............................................................ 146 risperidone ............................................................ 146, 149 Risperidone ..................................................................... 147 Ritalin .............................................................................. 161 ritonavir............................................................................99 Rituxan ............................................................................ 104 rituximab ........................................................................104 rivaroxaban......................................................................21 rivastigmine ...................................................................163 Rivotril ............................................................................. 133 rizatriptan.......................................................................131

December 2012

Robaxacet ...................................................................... 119 Robaxin .......................................................................... 118 Robaxisal C .................................................................... 119 Robitussin ...................................................................... 173 Rocaltrol ........................................................................... 17 Rocephin .......................................................................... 90 Rofact ..........................................................................97, 98 Rogaine ............................................................................ 70 romiplostim..................................................................... 21 ropinirole ...................................................................... 139 Ropinirole ....................................................................... 139 Rosasol ............................................................................ 64 rosiglitazone ................................................................... 15 rosuvastatin .................................................................... 56 Rougier-Magnesium ......................................................... 17 Rovamycine ..................................................................... 92 rufinamide ..................................................................... 134 Rynacrom ....................................................................... 169 Rythmodan ....................................................................... 25 Rythmodan-LA ................................................................. 25 Rythmol ............................................................................ 26 Sabril .............................................................................. 134 saccharated iron oxide .................................................. 22 Saizen .............................................................................. 81 Salagen .......................................................................... 164 Salazopyrin ...................................................................... 11 salbutamol .............................................................170, 172 salbutamol & other obst. airway disease drugs ........ 170 salicylic acid ................................................................... 61 Salicylic Acid .................................................................... 61 salmeterol ..................................................................... 170 salmeterol & other obst. airway disease drugs ......... 171 Salofalk ............................................................................ 11 Sandomigran .................................................................. 132 Sandomigran DS ............................................................ 132 Sandostatin ...................................................................... 82 Sandoz Alendronate....................................................... 121 Sandoz Alfuzosin ............................................................. 78 Sandoz Amiodarone......................................................... 26 Sandoz Amlodipine .......................................................... 39 Sandoz Anagrelide ......................................................... 105 Sandoz Anastrozole ....................................................... 107 Sandoz Anuzinc ............................................................... 33 Sandoz Atenolol ............................................................... 36 Sandoz Atomoxetine ...............................................162, 163 Sandoz Atorvastatin ....................................................55, 56 Sandoz Azithromycin ....................................................... 92 Sandoz Bicalutamide ..................................................... 107 Sandoz Bisoprolol ............................................................ 37 Sandoz Bosentan ............................................................. 30 Sandoz Brimonidine ....................................................... 179 Sandoz Bupropion.......................................................... 160 Sandoz Calcitonin ............................................................ 85 Sandoz Candesartan ..................................................49, 50 Sandoz Candesartan Plus ............................................... 52 Sandoz Carbamazepine ................................................. 133 Sandoz Cefprozil .........................................................89, 90 Sandoz Ciprofloxacin ..................................................94, 95 Sandoz Citalopram......................................................... 156 Sandoz Clarithromycin ..................................................... 92 Sandoz Clonazepam ...................................................... 133 Sandoz Clopidogrel .......................................................... 20 Sandoz Cortimyxin ..................................................179, 183 Sandoz Cyclosporine ..................................................... 110 Sandoz Dexamethasone ................................................ 183 Sandoz Diclofenac ..................................................113, 114

Product Index ­ 53

Product Index

Sandoz Diltiazem CD ........................................................41 Sandoz Diltiazem T ..................................................... 41, 42 Sandoz Dorzolamide ....................................................... 179 Sandoz Dorzolamide/Timolol .......................................... 180 Sandoz Enalapril ...............................................................43 Sandoz Entacapone ........................................................ 140 Sandoz Estradiol Derm .....................................................74 Sandoz Eyelube .............................................................. 182 Sandoz Famciclovir ...........................................................99 Sandoz Felodipine ...................................................... 39, 40 Sandoz Fenofibrate S .......................................................57 Sandoz Fentanyl ............................................................. 127 Sandoz Finasteride ...........................................................79 Sandoz Fluoxetine .......................................................... 155 Sandoz Gentamicin ................................................. 177, 182 Sandoz Glimepiride ..................................................... 14, 15 Sandoz Glyburide .............................................................14 Sandoz Idoxuridine ...........................................................64 Sandoz Indomethacin ..................................................... 113 Sandoz Irbesartan .............................................................49 Sandoz Irbesartan HCT .............................................. 51, 52 Sandoz Lansoprazole .........................................................4 Sandoz Leflunomide ....................................................... 109 Sandoz Letrozole ............................................................ 107 Sandoz Levobunolol ....................................................... 180 Sandoz Levofloxacin .........................................................95 Sandoz Lisinopril ............................................. 43, 44, 46, 47 Sandoz Lisinopril HCT ......................................................46 Sandoz Loperamide ..........................................................10 Sandoz Losartan ......................................................... 47, 48 Sandoz Losartan HCT ................................................ 50, 51 Sandoz Lovastatin ............................................................54 Sandoz Metformin .............................................................13 Sandoz Methylphenidate ................................................ 161 Sandoz Metoprolol ...................................................... 35, 36 Sandoz Minocycline ..........................................................86 Sandoz Mirtazapine ........................................................ 159 Sandoz Montelukast ....................................................... 173 Sandoz Morphine ............................................................ 124 Sandoz Mycophenolate Mofetil ....................................... 109 Sandoz Mycopheolate Mofetil ......................................... 109 Sandoz Naratriptan ......................................................... 131 Sandoz Nitrazepam ........................................................ 152 Sandoz Olanzapine ......................................................... 144 Sandoz Omeprazole ...........................................................3 Sandoz Ondansetron ..........................................................7 Sandoz Opium & Belladonna ............................................10 Sandoz Opticort .............................................................. 183 Sandoz Orphenadrine ..................................................... 119 Sandoz Oxycodone ......................................................... 129 Sandoz Pantoprazole ..........................................................4 Sandoz Paroxetine .................................................. 156, 157 Sandoz Pentasone .......................................................... 183 Sandoz Pindolol .......................................................... 33, 34 Sandoz Pioglitazone ................................................... 15, 16 Sandoz Pramipexole ............................................... 139, 140 Sandoz Pravastatin ..................................................... 54, 55 Sandoz Prednisolone ...................................................... 178 Sandoz Proctomyxin .........................................................33 Sandoz Quetiapine ................................................. 145, 146 Sandoz Ramipril.......................................................... 44, 45 Sandoz Ranitidine ...............................................................2 Sandoz Repaglinide ..........................................................16 Sandoz Risedronate ....................................................... 121 Sandoz Risperidone ................................................ 147, 148 Sandoz Rivastigmine ...................................................... 163

December 2012

Sandoz Rizatriptan ......................................................... 131 Sandoz Rosuvastatin ..................................................56, 57 Sandoz Salbutamol ........................................................ 170 Sandoz Sennosides ........................................................... 9 Sandoz Sertraline....................................................157, 158 Sandoz Simvastatin ....................................................53, 54 Sandoz Sotalol ................................................................. 35 Sandoz Sumatriptan................................................130, 131 Sandoz Tamsulosin.......................................................... 78 Sandoz Telmisartan ......................................................... 50 Sandoz Terbinafine .......................................................... 62 Sandoz Timolol .............................................................. 180 Sandoz Tobramycin ....................................................... 177 Sandoz Topiramate .................................................135, 136 Sandoz Trifluridine ......................................................... 177 Sandoz Valsartan ........................................................48, 49 Sandoz Valsartan/HCT .................................................... 51 Sandoz Venlafaxine ................................................160, 161 Sandoz Zolmitripran ....................................................... 131 Sandoz Zolmitriptan ....................................................... 131 Sandoz Zopiclone ...................................................152, 153 Sandoz-Irbesartan............................................................ 49 Sandoz-Olanzapine.................................................144, 145 Sandoz-Rabeprazole ..................................................... 4, 5 Santyl ............................................................................... 62 Saphris ........................................................................... 146 saquinavir ....................................................................... 99 Sarna HC ......................................................................... 64 Sativex ........................................................................... 130 scopolamine ..................................................................... 8 Scopolamine ...................................................................... 8 Seasonale ........................................................................ 73 Sebivo ............................................................................ 100 Sectral .............................................................................. 37 Selax .................................................................................. 9 Select ............................................................................... 72 selegiline ....................................................................... 140 selenium sulfide ............................................................. 61 senna glycosides ............................................................. 9 senna glycosides, comb. ................................................. 9 Senokot .............................................................................. 9 Sensipar ........................................................................... 85 Sensorcaine ................................................................... 123 Septa Metformin ............................................................... 13 Septa-Amlodipine ............................................................. 39 Septa-Atenolol.................................................................. 36 Septa-Ciprofloxacin .....................................................94, 95 Septa-Citalopram ........................................................... 156 Septa-Metformin............................................................... 13 Septra .............................................................................. 91 Serax.............................................................................. 149 Serc................................................................................ 165 Serevent ......................................................................... 170 Serophene ....................................................................... 76 Seroquel ..................................................................145, 146 sertraline ....................................................................... 157 Sertraline .................................................................157, 158 sevelamer ..................................................................... 185 Sialor ................................................................................ 18 Sibelium ......................................................................... 165 sildenafil ......................................................................... 77 silicones ............................................................................ 6 Silkis ................................................................................. 63 silver sulfadiazine .......................................................... 64 Simponi .......................................................................... 110 simvastatin ..................................................................... 53

Product Index ­ 54

Product Index

Simvastatin ................................................................. 53, 54 Sinemet ........................................................................... 138 Sinequan .................................................................154, 155 Singulair .......................................................................... 173 Sintrom .............................................................................20 sitagliptin .........................................................................16 sitagliptin/metformin ......................................................15 Slow Fe .............................................................................22 Slow-Fe Folic ....................................................................22 Slow-K ..............................................................................17 sodium aurothiomalate.................................................118 Sodium Aurothiomalate ................................................... 118 sodium chloride ..............................................................23 Sodium Chloride ...............................................................23 sodium chloride, hypertonic ........................................182 sodium phosphate ..........................................................17 Sodium Sulamyd ............................................................. 177 Sofracort ......................................................................... 183 Soframycin ........................................................ 63, 169, 177 Sofra-Tulle ........................................................................68 solifenacin .......................................................................77 soltalol .............................................................................35 Solu-Cortef ........................................................................84 Solugel ..............................................................................69 Solu-Medrol.......................................................................83 somatropin ......................................................................81 Somatuline Autogel ...........................................................82 Somavert...........................................................................81 sorafenib ........................................................................105 Soriatane...........................................................................63 Sotacor .............................................................................35 Spectro Eczemacare Medicated Cream ...........................64 spiramycin .......................................................................92 Spiriva ............................................................................. 172 spironolactone ................................................................31 Sporanox...........................................................................97 Sprycel ............................................................................ 105 Stadol .............................................................................. 128 Stalevo ............................................................................ 138 Starlix ................................................................................16 Statex ...................................................................... 124, 125 stavudine .......................................................................100 Stelara ............................................................................ 110 Stelazine ......................................................................... 141 Stemetil ........................................................................... 141 Sterile Vancomycin HCI ....................................................96 sterile water ...................................................................186 Sterile Water ................................................................... 186 Stieprox .............................................................................61 Stieva-A ...................................................................... 68, 69 Stievamycin.......................................................................69 Strattera .................................................................. 162, 163 Suboxone ........................................................................ 165 sucralfate ...........................................................................5 Sufenta ........................................................................... 123 sufentanil .......................................................................123 Sufentanil Citrate ............................................................ 123 Sulcrate ...............................................................................5 suldinpyrazone..............................................................120 sulfacetamide ................................................................177 Sulfacet-R .........................................................................68 sulfamethoxazole and thrimethoprim ...........................91 sulfasazine.......................................................................11 sulindac .........................................................................113 sulphur .............................................................................68 sumatriptan ...................................................................130

December 2012

Sumatriptan .............................................................130, 131 sunitinib ........................................................................ 105 Supeudol ........................................................................ 126 Suprax .............................................................................. 90 Suprefact ........................................................................ 106 Surgam .......................................................................... 117 Surmontil ........................................................................ 154 Sutent ............................................................................. 105 Symbicort ....................................................................... 171 Symmetrel ...................................................................... 138 Synarel ............................................................................. 82 Synphasic ........................................................................ 73 Synthroid .....................................................................84, 85 tacrolimus ................................................................69, 110 Tagamet ......................................................................... 1, 2 Talwin ............................................................................. 128 Tambocor ......................................................................... 26 Tamiflu ........................................................................... 101 Tamofen ......................................................................... 106 tamoxifen ...................................................................... 106 tamsulosin ...................................................................... 78 Tantum Oral Rinse ............................................................. 1 Tapazole .......................................................................... 85 tapentadol ..................................................................... 128 Tar Pomade ..................................................................... 62 Tarceva .......................................................................... 105 Tarka ................................................................................ 47 Taro-Amcinonide .............................................................. 66 Taro-Anastrozole............................................................ 107 Taro-Carbamazepine ..................................................... 133 Taro-Ciclopirox ................................................................. 61 Taro-Clindamycin ............................................................. 69 Taro-Clobetasol................................................................ 67 Taro-Mometasone ............................................................ 66 Taro-Mupirocin ................................................................. 63 Taro-Phenytoin............................................................... 132 Taro-Sone ........................................................................ 65 Taro-Warfarin ..............................................................19, 20 Tasigna .......................................................................... 105 Taxotere ......................................................................... 104 tazarotene ....................................................................... 63 Tazocin ............................................................................ 88 Tazorac ............................................................................ 63 TearGel .......................................................................... 182 Tears Naturale ............................................................... 182 Tears Plus ...................................................................... 182 Tebrazid ........................................................................... 98 Tecta .................................................................................. 4 Tegretol .......................................................................... 133 telaprevir ....................................................................... 100 telbivudine .................................................................... 100 telmisartan ...................................................................... 50 Telmisartan ...................................................................... 50 telmisartan and diuretics ............................................... 52 Telzir .............................................................................. 100 temazepam ................................................................... 152 Temodal ......................................................................... 103 temozolomide ............................................................... 103 tenofovir disoproxil and emtricitabine ....................... 101 tenofovir disproxil ........................................................ 100 Tenoretic .....................................................................38, 39 Tenormin .......................................................................... 36 tenoxicam ..................................................................... 115 Terazol-3 .......................................................................... 71 terazosin ......................................................................... 78 Terazosin ....................................................................78, 79

Product Index ­ 55

Product Index

terbinafine..................................................................61, 62 Terbinafine ........................................................................62 terbutaline......................................................................170 terconazole ......................................................................71 teriparatide ......................................................................85 Testim ...............................................................................74 testosterone ....................................................................74 Testosterone Cypionate ....................................................74 tetrabenazine .................................................................165 tetracaine .......................................................................123 tetracycline ......................................................................86 Teva Montelukast............................................................ 173 Teva Zolmitriptan ............................................................ 131 Teva-Anastrozole ............................................................ 107 Teva-Atenolol/Chlorthalidone ...................................... 38, 39 Teva-Candesartan ...................................................... 49, 50 Teva-Clopidogrel ...............................................................20 Teva-Diclofenac-K .......................................................... 113 Teva-Dorzotimol.............................................................. 180 Teva-Entacapone ............................................................ 140 Teva-Gabapentin .................................................... 136, 137 Teva-Galantamine ER .................................................... 164 Teva-Hydrazide.................................................................30 Teva-Hydromorphone ..................................................... 125 Teva-Irbesartan.................................................................49 Teva-Irbesartan/HCTZ ................................................ 51, 52 Teva-Lactulose .................................................................10 Teva-Lamivudine/Zidovudine .......................................... 101 Teva-Losartan ............................................................. 47, 48 Teva-Losartan/HCTZ .................................................. 50, 51 Teva-Montelukast ........................................................... 173 Teva-Nabilone.....................................................................8 Teva-Nevirapine.............................................................. 101 Teva-Olanzapine ............................................................. 144 Teva-Rosuvastatin ...................................................... 56, 57 Teva-Simvastatin ........................................................ 53, 54 Teva-Telmisartan ..............................................................50 Teva-Telmisartan HCTZ....................................................52 Teva-Tramadol/Acetaminophen ...................................... 128 Teva-Valsartan............................................................ 48, 49 Teva-Valsartan/HCT .........................................................51 Teva-Valsartan/HCTZ .......................................................51 Teva-Zolmitriptan ............................................................ 131 Teveten ....................................................................... 48, 51 Theo-DUR ....................................................................... 172 Theolair ........................................................................... 172 theophylline ...................................................................172 theophylline, comb. exclding psycholeptics .............. 173 thiamazole .......................................................................85 Thiamiject..........................................................................17 Thiamine ...........................................................................17 thiamine (Vit B1) ..............................................................17 thioguanine....................................................................103 thioproperazine .............................................................141 thiothixene .....................................................................143 Thyrogen ......................................................................... 186 Thyroid ..............................................................................85 thyroid gland preparations.............................................85 thyrotropin .....................................................................186 Tiamol ...............................................................................66 tiaprofenic acid .............................................................117 Tiazac ER ................................................................... 41, 42 Tiazac XC .........................................................................42 ticagrelor..........................................................................21 Ticlid .................................................................................20 ticlopidine ........................................................................20

December 2012

Ticlopidine ........................................................................ 20 timolol ......................................................................34, 180 Timolol Maleate-EX ........................................................ 180 timolol, comb. ............................................................... 180 Timoptic ......................................................................... 180 Timoptic-XE ................................................................... 180 Tinactin ............................................................................ 61 tinzaparin ........................................................................ 20 tiotropium bromide ...................................................... 172 tipranavir ....................................................................... 100 tizandine ....................................................................... 119 TOBI................................................................................. 93 Tobradex ........................................................................ 179 tobramycin ...............................................................93, 177 Tobramycin ...................................................................... 93 Tobrex ............................................................................ 177 Toctino ............................................................................. 69 Tofranil ........................................................................... 153 tolbutamide ..................................................................... 14 tolnaftate ......................................................................... 61 Toloxin ............................................................................. 25 tolterodine ...................................................................... 77 Topamax .................................................................135, 136 Topicort ............................................................................ 66 topiramate ..................................................................... 135 Topiramate ..............................................................135, 136 Topotecan HCI ............................................................... 105 Toradol ........................................................................... 114 Tracleer ............................................................................ 30 Tramacet ........................................................................ 128 tramadol ........................................................................ 128 tramadol, comb. ........................................................... 128 Trandate ........................................................................... 37 trandolapril and verapamil ............................................ 47 trandolparil ..................................................................... 46 tranexamic acid .............................................................. 21 Tranexamic Acid .............................................................. 21 Transderm-Nitro ............................................................... 27 Transderm-V ...................................................................... 8 Tranxene .................................................................149, 150 tranylcypromine ........................................................... 158 Travatan Z ...................................................................... 181 travoprost ..................................................................... 181 Trazedone ...................................................................... 159 trazodone ...................................................................... 159 Trazodone ...................................................................... 159 Trelstar ........................................................................... 106 Trental .............................................................................. 32 treprostinil ...................................................................... 21 tretinoin ........................................................................... 68 Triaderm ........................................................................... 65 triamcinolone.................................................1, 65, 84, 169 Triamcinolone................................................................... 84 triamicinolone and antibiotics ...................................... 67 triazolam ....................................................................... 152 Tri-Cyclen ......................................................................... 73 Tridesilon ......................................................................... 65 trifluoperazine .............................................................. 141 trifluridine ..................................................................... 177 trihexyphenidyl............................................................. 137 Trilafon ........................................................................... 141 Trileptal .......................................................................... 134 trimebutine ....................................................................... 5 trimethoprim ................................................................... 91 trimipramine ................................................................. 154 Trimipramine .................................................................. 154

Product Index ­ 56

Product Index

Trinipatch ..........................................................................27 Triquilar .............................................................................73 tropicamide....................................................................181 Trosec ...............................................................................77 trospium...........................................................................77 Trusopt ............................................................................ 179 Truvada ........................................................................... 101 Tryptan .................................................................... 158, 159 tryptophan .....................................................................158 Twinject .............................................................................27 Twynsta.............................................................................52 Tykerb ............................................................................. 105 Tylenol .................................................................... 126, 129 Uloric ............................................................................... 120 Ultradol ........................................................................... 114 Ultrase ..............................................................................12 Uniphyl .................................................................... 172, 173 Urecholine ....................................................................... 164 Uremol HC ........................................................................67 Urispas ..............................................................................76 Urologic G .........................................................................78 Uromax .............................................................................77 Urso ....................................................................................9 ursodeoxycholic acid .......................................................9 ursodiol ..............................................................................9 ustekinumab ..................................................................110 Vagifem .............................................................................75 valacyclovir .....................................................................99 Valcyte ..............................................................................99 valganciclovir ..................................................................99 Valisone ............................................................................66 Valisone G ........................................................................67 Valium ............................................................................. 149 valproic acid ..................................................................134 valsartan ..........................................................................48 Valsartan ..................................................................... 48, 49 valsartan and diuretics ...................................................51 Valsartan HCT ..................................................................51 Valtrex ...............................................................................99 Val-Vanco .........................................................................96 Vancocin ...........................................................................96 Vancocin CP .....................................................................96 vancomycin .....................................................................96 Vancomycin ......................................................................96 Vantas ...............................................................................82 Vaseretic ...........................................................................46 vasopressin .....................................................................81 Vasopressin ......................................................................81 Vasotec .............................................................................43 venlafaxine ....................................................................160 Venlafaxine ............................................................. 160, 161 Venofer .............................................................................22 Ventolin ................................................................... 170, 172 Vepesid ........................................................................... 104 verapamil .........................................................................40 Verapamil ..........................................................................40 Vermox ........................................................................... 167 Versed ............................................................................ 152 Versel ................................................................................61 verteporfin .....................................................................181 Vesicare ............................................................................77 Vfend ................................................................................97 Viaderm KC.......................................................................67 Viagra ...............................................................................77 Vibramycin ........................................................................86 Vibra-Tabs ........................................................................86

December 2012

Victoza ............................................................................. 16 Victrelis .......................................................................... 100 Victrelis Triple................................................................. 108 vigabatrin ...................................................................... 134 Vigamox ......................................................................... 178 Vimpat ............................................................................ 137 vinorelbine .................................................................... 104 Vioform HC ...................................................................... 67 Viokase ............................................................................ 12 Viracept ............................................................................ 99 Viramune ........................................................................ 101 Viread ............................................................................. 100 Viroptic ........................................................................... 177 Visanne ............................................................................ 75 Viskazide .......................................................................... 38 Visken .........................................................................33, 34 Visudyne ........................................................................ 181 Vitamin A Acid .................................................................. 69 Vitamin B1 ........................................................................ 17 Vitamin B12 ....................................................................... 22 Vitamin K1 ........................................................................ 21 Vivelle .............................................................................. 74 Vivol ............................................................................... 149 Volibris ............................................................................. 30 Voltaren ...........................................................113, 114, 178 voriconazole ................................................................... 97 Votrient ........................................................................... 105 Vyvanse ......................................................................... 163 warfarin ........................................................................... 19 Warfarin ......................................................................19, 20 Wartec .............................................................................. 64 Wellbutrin ....................................................................... 160 Wellbutrin XL .................................................................. 160 Westcort ........................................................................... 64 Winpred ............................................................................ 84 Xalacom ......................................................................... 180 Xalatan ........................................................................... 180 Xanax ......................................................................150, 151 Xarelto .............................................................................. 21 Xatral ................................................................................ 78 Xeloda ............................................................................ 104 Xenical ............................................................................. 11 Xeomin ........................................................................... 118 Xgeva ............................................................................. 122 Xolair .............................................................................. 173 Xylac .............................................................................. 143 Xylocaine ..................................................................62, 123 Yasmin ............................................................................. 73 Yaz ................................................................................... 73 Zaditen ........................................................................... 174 Zaditor ............................................................................ 181 zafirlukast ..................................................................... 173 Zanaflex ......................................................................... 119 zanamivir ...................................................................... 101 Zantac ................................................................................ 2 Zarontin .......................................................................... 132 Zaroxolyn ......................................................................... 31 Zavesca ........................................................................... 18 Zeldox ............................................................................ 142 Zenhale .......................................................................... 171 Zerit ................................................................................ 100 Zestoretic ....................................................................46, 47 Zestril ..........................................................................43, 44 zidovudine .................................................................... 100 ziprasidone ................................................................... 142 Zithromax ....................................................................92, 93

Product Index ­ 57

Product Index

Zocor ...........................................................................53, 54 Zofran .................................................................................7 Zoladex ........................................................................... 106 zoledronic acid ..............................................................121 zolmitriptan....................................................................131 Zoloft ....................................................................... 157, 158 Zometa ............................................................................ 121 Zomig .............................................................................. 131 zopiclone .......................................................................152 Zopiclone ................................................................ 152, 153 Zovirax .................................................................. 64, 98, 99 zuclopenthixol ...............................................................143 Zyban .............................................................................. 165 Zyloprim ......................................................................... 120 Zymar ............................................................................. 178 Zym-Carvedilol ................................................................. 38 Zym-Clonazepam ........................................................... 133 Zym-Fluoxetine .............................................................. 155 Zym-Metformin ................................................................. 13 Zym-Mirtazapine ............................................................ 159 Zym-Pioglitazone ........................................................15, 16 Zym-Topiramate ......................................................135, 136 Zyprexa ...........................................................143, 144, 145 Zytiga ............................................................................. 107 Zytram ............................................................................ 128 Zyvoxam .......................................................................... 96

December 2012

Product Index ­ 58

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