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CARTA CIRCULAR #M1101013 14 de enero de 2011 * Página 1

CARTA CIRCULAR #M1101013 14 de enero de 2011 *

A TODOS LOS MÉDICOS Y DENTISTAS PARTICIPANTES DE TRIPLE-S SALUD, INC. ACTUALIZACIÓN DE LA LISTA DE MEDICAMENTOS DE TRIPLE-S SALUD, INC. Programa de Farmacia de Triple-S Salud, Inc. En su esfuerzo por promover terapias costo efectivas, el Comité de Farmacia y Terapéutica de Triple-S Salud, Inc. ha seleccionado diversos productos dentro de las distintas categorías terapéuticas que brindan alternativas de alta calidad. Dichas alternativas han demostrado ser clínicamente efectivas. Los siguientes cambios a la Lista de Medicamentos del Programa de Farmacia de Triple-S Salud, Inc. serán efectivos inmediatamente: Página 9 Sección: CARDIOVASCULARES (CARDIOVASCULARS), Antihiperlipidémicos (Antihyperlipidemics) – Incluir el siguiente producto con las siguientes especificaciones:

choline fenofibrate cap Trilipix Nivel 3 DR 45mg, 135mg

Página 24 Sección: SISTEMA NERVIOSO CENTRAL (CENTRAL NERVOUS SYSTEM), Migraña (Migraine) – Cambiar las especificaciones para el siguiente producto:

sumatriptan nasal soln Imitrex Nivel 3 20mg/act; 5mg/act

Página 37 Sección: ENDOCRINOLOGÍA (ENDOCRINOLOGY), Diabetes (Diabetes), Antihiperglicémicos (Antihyperglycemics), Combinaciones (Combinations) – Cambiar las especificaciones para los siguientes productos:

rosiglitazone & glimepiride tabs Avandaryl Nivel 3, ST

4-1mg; 4-2mg; 4-4mg; 8-2mg; 8-4mg

rosiglitazone & metformin tabs Avandamet Nivel 3, ST 2-1000mg; 2-500mg; 4-1000mg; 4-500mg * Fecha de envío por Correo: 21 de enero de 2011 Si aún no se ha registrado para recibir las Cartas Circulares por medio electrónico, acceda nuestra página de Internet www.ssspr.com, regístrese y únase a Triple-S Salud en la conservación del ambiente.

http://www.ssspr.com/


Página 38 Sección: ENDOCRINOLOGÍA (ENDOCRINOLOGY), Diabetes (Diabetes), Antihiperglicémicos (Antihyperglycemics), Tiazolidinedionas (Thiazolidinediones) – Cambiar las especificaciones para el siguiente producto:

rosiglitazone tabs 2mg; 4mg; 8mg Avandia Nivel 3, ST

Página 38 Sección: ENDOCRINOLOGÍA (ENDOCRINOLOGY), Diabetes (Diabetes), Antihiperglicémicos (Antihyperglycemics), Otros (Others) – Cambiar las especificaciones para los siguientes productos:

exenatide inj 5mcg/0.02ml; Byetta Nivel 4, PA

10mcg/0.04ml liraglutide inj 18mg/3ml (6mg/ml) Victoza Nivel 2, PA Página 41 Sección: GASTROENTEROLOGÍA (GASTROENTEROLOGY), Misceláneos (Miscellaneous) – Incluir el siguiente producto con las siguientes especificaciones: rifaximin 550mg Xifaxan Nivel 4 Página 48 Sección: GLAUCOMA (Glaucoma), Combinaciones (Combinations) – Cambiar las especificaciones para el siguiente producto: brimonidine & timolol Combigan Nivel 3

ophth soln 0.2-0.5% Página 56 Sección: RESPIRATORIOS (RESPIRATORY), Otros (Others) – Incluir el siguiente producto con las siguientes especificaciones:

olopatadine HCL nasal soln 0.6% Patanase Nivel 3

Página 64 Sección: CONDICIONES CRÓNICAS Y DE ALTO RIESGO (CHRONIC AND HIGH RISK CONDITIONS), Esclerosis Múltiple (Multiple Sclerosis) – Incluir el siguiente producto con las siguientes especificaciones:

dalfampridine tab 10mg Ampyra SL Página 65 Sección: CONDICIONES CRÓNICAS Y DE ALTO RIESGO (CHRONIC AND HIGH RISK CONDITIONS), Cáncer (Cancer), Antimetabolitos (Antimetabolites) – Incluir el siguiente producto con las siguientes especificaciones:

fludarabine tab Oforta PA


Página 66 Sección: CONDICIONES CRÓNICAS Y DE ALTO RIESGO (CHRONIC AND HIGH RISK CONDITIONS), Sistema Músculo-Esqueletal/Reumatología (Skeletal-Muscle System/Rheumatology), Misceláneos (Miscellaneous) – Incluir el siguiente producto con las siguientes especificaciones:

tocilizumab inj 20mg/ml Actemra PA, SL Leyenda: PA = Requiere preautorización SL = Límite de especialidad ST = Terapia Escalonada Recuerde lo siguiente:

Los medicamentos en la Lista están sujetos a las exclusiones de la cubierta que

tiene el asegurado. Por los medicamentos excluidos en su cubierta, el asegurado pagará el 100% del precio de venta de la farmacia que los despache.

Esta información aplica solamente a los asegurados con cubierta de Lista de

Medicamentos del plan regular (Comercial) de Triple-S Salud. No aplica a los planes Medicare Advantage.

Para solicitar información sobre estos productos puede comunicarse con el Centro

de Información de Medicamentos al 1-877-741-7470. Adjunto, la versión revisada de la Lista de Medicamentos de Triple-S Salud. Si necesita información adicional, comuníquese con nuestro Departamento de Relaciones Profesionales al 787-749-4700 o al 1-877-357-9777 (libre de cargos para llamadas de larga distancia). Cordialmente, Francisco Joglar Pesquera, MD, FACP Ángela Hernández, MD Director Médico Ejecutivo Director Médico Asociado Asuntos Médicos y Dentales Asuntos Médicos y Dentales División de Gerencia Clínica División de Gerencia Clínica Zoraida Santos, RPh, MBA Gerente, Servicios Clínicos Departamento de Farmacia

vv Anejo

Programa de Farmacia de Triple-S Salud, Inc. TRIPLE-S SALUD, INC.

Pharmacy Program from Triple-S Salud, Inc.

TRIPLE-S SALUD, INC.

Lista de Medicamentos para Médicos y Dentistas Participantes

2010-2011

Drug List for Participating Dentists and Physicians

2010-2011

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TABLA DE CONTENIDO TABLE OF CONTENTS

PREFACIO / PREFACE v

INTRODUCCIÓN / INTRODUCTION ix

PARTE I – DISEÑO DE LA LISTA DE MEDICAMENTOS PART I – DRUG LIST DESIGN xi

Presentación de la Lista de Medicamentos / Drug List presentation xi

Guías de referencia / Reference guidelines xiv

Éditos de análisis de utilización (DUR) / Edits for utilization analysis (DUR) xvii PARTE II – MANEJO DE LA LISTA DE MEDICAMENTOS PART II – DRUG LIST MANAGEMENT xix

Comité de Farmacia y Terapéutica / Therapeutics and Pharmacy Committee xix

Política para el mantenimiento de la Lista de Medicamentos /

Policy for the maintenance of the Drug List xix

Leyenda para los Símbolos y Abreviaturas / Legend for symbols and abbreviations xxi

Política para solicitud de evaluación para inclusión o exclusión de

medicamentos a la Lista de Medicamentos / Policy for requesting the

evaluation for additions or exclusions of drugs from the Drug List xxii

Política para revisión de la Lista de Medicamentos / Policy for the Drug List review xxiii

Editor / Editor xxiv

Comentarios / Comments xxiv

Derechos Reservados / Reserved Rights xxiv

PARTE III – MEDICAMENTOS POR CLASIFICACIÓN TERAPÉUTICA PART III – DRUGS BY THERAPEUTIC CATEGORY 1

PARTE IV – CLASIFICACIONES TERAPÉUTICAS 82 PART IV – THERAPEUTIC CATEGORIES

PARTE V – ÍNDICE PART V – INDEX 87

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PREFACIO

Estimado Médico y Dentista Participante: El costo de los medicamentos tanto en Puerto Rico como en los Estados Unidos continúa registrando un aumento sostenido. En respuesta a esta situación y en nuestro empeño de ofrecer a nuestros asegurados cuidados de salud de alta calidad, Triple-S Salud diseñó cubiertas de farmacia que utilizan una Lista de Medicamentos como la alternativa más efectiva para mantener los costos a un nivel razonable y accesible a nuestros asegurados. Al usted utilizar la Lista de Medicamentos contribuye a que podamos seguir brindando servicios cuya prima permita a nuestros asegurados mantener este beneficio. La Lista de Medicamentos es evaluada por un Comité de Farmacia y Terapéutica, el cual está compuesto por médicos especialistas, farmacéuticos clínicos y profesionales de la salud, quienes se aseguran que los medicamentos incluidos en los Niveles del 1 al 3 cumplan con los requisitos de calidad y costo-efectividad exigidos por Triple-S Salud. El Comité revisa la Lista de Medicamentos dos veces al año, en los meses de febrero y agosto. Los cambios a la Lista de Medicamentos le serán notificados a través de comunicaciones emitidas por Triple-S Salud. Además, podrán obtener información de los cambios a través del Pharma News, el boletín informativo de farmacia que se distribuye cada dos meses durante el año. Dentro del proceso de revisión de la Lista de Medicamentos, el Comité de Farmacia y Terapéutica podría recomendar lo siguiente:

• Incluir nuevos medicamentos a la Lista • Mover medicamentos al Nivel 4: No Preferidos • Pasar medicamentos a la clasificación de Preferidos

El incluir nuevos medicamentos a la Lista o pasar medicamentos a la clasificación de Preferidos, beneficia al asegurado ya que pagaría un copago o coaseguro menor de acuerdo a lo que establece la cubierta de éste. Al mover un medicamento al Nivel 4: No Preferido, debido a que se incluye otro de igual o mejor calidad, el copago o coaseguro que el asegurado tiene que pagar por dicho medicamento es uno mayor. A los fines de que el impacto económico al asegurado sea mínimo, existirá un período de gracia de 90 días a partir de la fecha de efectividad de los cambios a la Lista. Esto permitirá a usted y a

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nuestro asegurado evaluar alternativas de tratamiento con medicamentos de igual potencia y calidad que se encuentren en los Niveles del 1 al 3. Durante este período de gracia de 90 días, el asegurado continuará pagando el copago o coaseguro que aplica a los Niveles del 1 al 3 por este medicamento que se mueve al Nivel 4: No Preferido. Una vez terminado el período de gracia, si usted se mantiene prescribiéndole el mismo medicamento, nuestro asegurado pagará el copago o coaseguro que corresponda a su cubierta para los medicamentos No Preferidos (Nivel 4), los cuales son mayores. En las páginas a continuación presentamos la Lista de Medicamentos, con toda la información requerida para facilitarle su lectura e interpretación. Aprovechamos para agradecerles su apoyo durante todos estos años. Sin su colaboración no hubiéramos podido ser lo que hoy somos, la compañía líder en la industria de seguros de salud y la compañía que brinda cuidados para toda una vida. Cordialmente, Socorro Rivas Presidenta y Principal Oficial Ejecutiva Triple-S Salud, Inc. Triple-S Salud… el que se preocupa por ti, te cuida.

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PREFACE

Dear Participating Dentist and Physician: The drugs costs continue recording a continuous increase both in Puerto Rico and the United States. In response to this situation and in our effort to offer our insureds high quality health care, Triple-S Salud designed pharmacy coverages that use a Drug List as the most effective alternative to maintain the costs at a reasonable and accesible level to our insureds. As you use the Drug List, you contribute so that we can continue bringing services which premium allows our insureds to keep this benefit. The Drug List is evaluated by the Pharmacy and Therapeutic Committee, which is composed of specialized doctors, clinical pharmacists and health professionals, who make sure that the drugs included in Levels 1 to 3 comply with the quality and cost effective requirements demanded by Triple-S Salud. The Committee will review the Drug List twice a year, in February and August. The changes to the Drug List will be notified through communications issued by Triple-S Salud. In addition, you can obtain information of the changes through the Pharma News, the pharmacy bulletin distributed every two months during the year. Within the Drug List revision process, the Pharmacy and Therapeutic Committee could recommend the following:

• Add new drugs in the Drug List • Move drugs out of the Drug List • Classify drugs into the Preferred category

To add new drugs in the Drug List or to classify drugs as Preferred drugs benefits the insured members because they will pay a lower copayment or coinsurance accordingly to their pharmacy coverage. By moving a drug to Level 4: Non-Preferred a new one with the same or better quality was added, the copayment or coinsurance that the insured member has to pay for the Non-Preferred drug is higher. To provide a minimal economic impact to our insureds, there will be a 90-day grace period starting from the effective date of the changes in the Drug List. This will allow you and our insured to evaluate different treatment alternatives with same strength and quality medications that are included in Levels 1 to 3.

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During this 90-day grace period, our insured will continue to pay the copayments or coinsurances applicable to Levels 1 to 3 in the Drug List for the one that has been moved to Level 4 (Non-Preferred). Once the grace period ends, if you continue prescribing the same drugs, our insured will have to pay the corresponding copayments or coinsurances as indicated in his/her pharmacy benefits coverage for Non-Preferred drugs (Level 4), which are higher. In the pages immediately after, we introduce the Drug List with all the required information to make easy its reading and interpretation. We take the opportunity to thank your support during all of this year. Without your cooperation we haven’t achieve what we are, the leader company in the health insurance industry and the company that bring care for the whole life. Cordially, Socorro Rivas President and Chief Executive Office Triple-S Salud, Inc.

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INTRODUCCIÓN INTRODUCTION

Esta Lista de Medicamentos se divide en cinco partes. This Drug List is divided into five parts.

La primera parte es un resumen que le provee información sobre la forma en que se diseñó la Lista de Medicamentos. También se incluye una descripción de los éditos de análisis de utilización para validar dosis e identificar terapias duplicadas. Estos éditos están disponibles a través del sistema de procesamiento y adjudicación de reclamaciones de MC-21 Corporation.

The first part is a summary that provides with information about the way the Drug List was designed. It includes a description of the utilization analysis edits used to validate dosage and identify duplicate therapies. These edits are available through the claim adjudication and processing system of MC-21 Corporation.

La segunda parte incluye las políticas y procedimientos que gobiernan el uso y aplicación de la Lista de Medicamentos. Además, incluye una introducción sobre el Comité de Farmacia y Terapéutica.

The second part includes the policies and procedures that govern the use and application of the Drug List. It also includes an introduction to the Therapeutics and Pharmacy Committee.

La tercera parte contiene los medicamentos por clasificación terapéutica.

The third part contains the drugs by therapeutic categories.

La cuarta parte contiene la lista de las clasificaciones terapéuticas y la quinta parte contiene una lista por orden alfabético (Índice) de los medicamentos de marca y genéricos, disponibles en la Lista de Medicamentos.

The fourth part contains the list of therapeutic categories and the fifth part contains a list in alphabetical order (Index) of brand and generic drugs available in the Drug List.

La inclusión de un medicamento a la Lista de Medicamentos no indica que el medicamento es un medicamento cubierto. La cubierta de farmacia es la que determina si el medicamento está cubierto o excluido en la póliza. Por ejemplo, los medicamentos para dejar de fumar, los agentes para la disfunción eréctil, las hormonas de crecimiento y los medicamentos sin leyenda federal (OTC) usualmente están excluidos de la cubierta de farmacia.

The inclusion of a drug in the Drug List does not mean that the medication is covered. The pharmacy insurance coverage is the one that determines if the drug is covered or excluded by the policy. For example, the smoking cessation drugs, erectile dysfunction drugs, growth hormones and the medications with no federal legend (OTC) usually are excluded from the pharmacy coverage.

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El Comité de Farmacia y Terapéutica revisa la Lista de Medicamentos dos veces al año, en febrero y agosto.

The Therapeutics and Pharmacy Committee revises the Drug List twice a year, in February and August.

Los cambios a la Lista por medicamentos que se mueven al Nivel 4: No Preferidos serán efectivos a la fecha de revisión, febrero y agosto de cada año.

The changes to the Drug List for drugs that are moved to Level 4: Non-Preferred will be effective on the review date; February and August of each year.

Para estos medicamentos existirá un período de gracia de 90 días a partir de la fecha de efectividad de los cambios a la Lista. Durante este período de gracia, el asegurado continuará pagando el copago o coaseguro que aplica a los Niveles del 1 al 3 por este medicamento que se mueve al Nivel 4: No Preferido. Una vez terminado el período de gracia, el asegurado pagará el copago o coaseguro que corresponda a su cubierta para los medicamentos No Preferidos (Nivel 4), los cuales son mayores. For these drugs there will be a 90-day grace period which begins on the effective date of the Drug List changes. During this grace period, our insured will continue to pay the copayments or coinsurances applicable to Levels 1 to 3 in the Drug List for the one that has been moved to Level 4 (Non-Preferred). Once the grace period ends, the insured will have to pay the corresponding copayments or coinsurances as indicated in his/her pharmacy benefits coverage for Non-Preferred drugs (Level 4), which are higher.

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PARTE I PART I

DISEÑO DE LA LISTA DE MEDICAMENTOS DRUG LIST DESIGN

Presentación de la Lista de Medicamentos Drug List Presentation

En el ejemplo a continuación se ilustra la información que se provee para los medicamentos incluidos en la Lista de Medicamentos.

The following example shows the information provided for those drugs included in the Drug List.

Medicamentos Drugs

Presentación Dosage Form

Nombre Comercial Brand Name

Nivel Level

Inst

ANTI-INFECCIOSOS (ANTI-INFECTIVES) CEFALOSPORINAS (CEPHALOSPORINS)

Primera Generación (First Generation)

Cefadroxil cap, susp DURICEF 1

Cefadroxil tab DURICEF 4

Cephalexin cap, susp KEFLEX 1

Cephalexin tab CEPHALEXIN 4

Para cada medicamento incluido en la Lista de Medicamentos aparece su presentación, el nombre comercial, el nivel y si tiene alguna instrucción especial. For every medication included in the Drug List the dosage form, trademark name of the drug, level, and any special instruction will appear.

¿Cómo usar la Lista de Medicamentos? How do I use the Drug List?

La manera más fácil en que usted puede conseguir los medicamentos en la Lista de Medicamentos es buscando el medicamento en el Índice que comienza en la página 87. El Índice provee una lista por orden alfabético de todos los medicamentos incluidos en este documento. Ambos, medicamentos de marca como genéricos están incluidos en el Índice. Busque el Índice y encuentre el medicamento. Al lado del medicamento, usted encontrará el número de la página donde encontrará cómo está cubierto. Voltee a la página indicada en el Índice y encuentre el nombre del medicamento en las columnas.

The easiest way that you can find the prescription drugs is seeking it in the Index that begins on page 87. The Index provides an alphabetical list of all of the drugs included in this document. Both brand-name drugs and generic drugs are listed in the Index. Look in the Index and find the drug. Next to the drug, you will see the page number where you can find coverage information. Turn to the page listed in the Index and find the name of the drug in the columns.

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¿Cuánto paga el asegurado por los medicamentos cubiertos? How much the insured will pay for covered drugs?

Los medicamentos en la lista de medicamentos se clasifican por niveles. Estos niveles identifican los diferentes niveles de costo compartido, o sea, lo que el asegurado paga por los medicamentos en la receta. Estos niveles son los siguientes:

Nivel 1 – Medicamentos Genéricos Nivel 2 – Medicamentos Preferidos Nivel 3 – Medicamentos de Marca Nivel 4 – Medicamentos No Preferidos Nivel 5 – Medicamentos Especializados o Biotecnológicos

The prescription drugs in the Drug List are classified by levels. These levels identify the different levels of cost-sharing, that is, what the insured pay, for the drugs in the prescription. These levels are the following:

Level 1 – Generic Drugs Level 2 – Preferred Drugs Level 3 – Brand drugs Level 4 – Non-Preferred Drugs Level 5 – Specialty or Biotech Drugs

¿Qué son medicamentos genéricos (Nivel 1)? What are generic drugs (Level 1)?

Un medicamento genérico tiene el mismo ingrediente activo en la fórmula que un medicamento de marca. Los medicamentos genéricos usualmente cuestan menos que un medicamento de marca y están aprobados por la Administración Federal de Drogas y Alimentos (FDA, por sus siglas en inglés). A generic drug has the same active-ingredient formula as the brand name drug. Generic drugs usually cost less than brand name drugs and are approved by the Food and Drug Administration (FDA).

Los medicamentos genéricos están escritos en letras negrillas pequeñas en la Lista de Medicamentos (ejemplo, nabumetone). Medicamentos de marca están escritos en letras mayúsculas (ejemplo, RELAFEN). Generic drugs are listed in bold lower-case (e.g., nabumetone) within the Drug List. Brand-name drugs are capitalized in the Drug List (e.g., RELAFEN).

Recomendamos la utilización de los medicamentos genéricos. Estos son iguales en potencia y dosis y también son aprobados por la FDA. We recommend the use of generic drugs. They are equal in strength and dosage and also, approved by the FDA.

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¿Qué son medicamentos preferidos (Nivel 2)? What are preferred drugs (Level 2)?

Hay ciertos medicamentos de marca que han sido seleccionados por el Comité de Farmacia y Terapéutica como agentes preferidos luego de su evaluación de seguridad, eficacia y costo. Los mismos están identificados a la derecha como Nivel 2. En aquellas clases terapéuticas donde no hay genéricos disponibles, les exhortamos a que recete como primera alternativa aquellos medicamentos identificados como preferidos. There are certain brand name drugs classified by the Therapeutics and Pharmacy Committee as preferred agents after a thorough evaluation in terms of safety, efficiency and cost. These are identified with a Level 2 placed to the right of the name of the drug identifies these as Preferred. In those therapeutic classes where there are no generic drugs available, we urge you to prescribe as first alternative those drugs identified as preferred.

¿Qué son medicamentos de Marca (Nivel 3)? What are Brand drugs (Level 3)?

Son los medicamentos que se ofrecen al público bajo un nombre comercial o marca de fábrica. Estos medicamentos están identificados como Nivel 3. Los medicamentos de marca están asociados a un copago mayor que los productos de marca preferidos que son los del Nivel 2 y que los productos genéricos (Nivel 1) incluidos en la Lista de Medicamentos. Those are prescription drugs offered to the public under a commercial name or manufacturing brand. These drugs are identified as Level 3. The brand drugs have a higher copayment than the preferred drugs, which are those in Level 2, and generic drugs (Level 1) included in the Drug List.

¿Qué son medicamentos No Preferidos (Nivel 4)? What are Non-Preferred Drugs (Level 4)?

Un medicamento es clasificado como No Preferido porque existen alternativas en los niveles anteriores con menos efectos secundarios o son más costo-efectivos. Si el asegurado obtiene un medicamento de marca del Nivel 4, tendrá que pagar un costo mayor por el medicamento. A drug is classified as Non-preferred because there are other options in previous levels with lesser side effects or are more cost effective. If the insured obtain a brand drug from Level 4, will have to pay more for that drug.

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¿Qué son medicamentos Especializados o Biotecnológicos (Nivel 5)? What are Specialty or Biotech Drugs (Level 5)?

Algunos medicamentos para condiciones crónicas y de alto riesgo requieren una administración y/o un manejo especial, por su composición compleja. Es por esto que Triple-S Salud ofrece el Programa de Medicamentos para Condiciones Especiales. Este programa cuenta con una red de farmacias especializadas dedicadas a que estos medicamentos sean despachados y administrados correctamente. Los mismos se incluyen en este documento al final de la tabla de los medicamentos y componen el Nivel 5 de la cubierta de farmacia (Página 63). Certain medications for chronic and high-risk conditions require special administration and/or management, due to their complex composition. Therefore, Triple-S Salud offers the Medication Program for Special Conditions. This program boasts a network of specialized pharmacies dedicated to ensuring that these medications are dispensed and administered correctly. These drugs are included in this document at the end of the table of medications and they represent Level 5 of the pharmacy coverage (Page 63).

Lo exhortamos a que utilice la Lista de Medicamentos como referencia cuando vaya a prescribir medicamentos a los asegurados de Triple-S Salud, Inc. que tienen cubierta de farmacia. We urge you to use the Drug List as a guide when prescribing to the Triple-S Salud’ insured persons that have pharmacy coverage.

El prescribir medicamentos No Preferidos resultará en que el asegurado pague un copago/coaseguro mayor. Prescribing Non-Preferred drugs means that the insured person pays a higher copayment/coinsurance.

GUÍAS DE REFERENCIA REFERENCE GUIDELINES

Programa de Terapia Escalonada Step Therapy Program

En algunos casos, requerimos que el asegurado trate primero un medicamento como terapia para su condición antes de que cubramos otro medicamento para esa condición (Terapia Escalonada). Por ejemplo, si el Medicamento A y el Medicamento B se usan ambos para tratar su condición médica, nosotros requerimos que usted recete primero el Medicamento A. Si el Medicamento A no funciona para el asegurado, entonces cubriremos el Medicamento B. In some cases, we require the insured to first try one drug to treat their medical condition before we will cover another drug for that condition (Step Therapy). For example, if Drug A and Drug B both treat their medical condition, we may require you prescribe Drug A first. If Drug A does not work for the insured, then we will cover Drug B.

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Este programa requiere la utilización de medicamentos sin leyenda federal (OTC, por sus siglas en inglés) o medicamentos genéricos antes de utilizar otros medicamentos para tratar su condición médica. Algunas clasificaciones que requieren un medicamento OTC como primer paso incluyen los inhibidores de la bomba de protón (PPI, por sus siglas en inglés), antihistamínicos no-sedantes y agentes para alergias oculares. Otras clasificaciones que requieren un medicamento genérico como primer paso incluyen las estatinas para el colesterol, los bifosfonatos orales para la osteoporosis y los corticosteroides nasales para las alergias. This program will require the utilization of Over-The-Counter (OTC) drugs or Generic drugs before using other drugs to treat your medical condition. Some of the "OTC First" portion includes Proton Pump Inhibitors (PPI), Non-sedating antihistamines, and Ocular allergies agents. Others in the "Generic First" portion includes Cholesterol drugs-Statins, Osteoporosis-Oral Bisphosphonates, and Allergies-Nasal Corticosteroids.

Medicamentos que requieren preautorización (PA) Medications that require a pre-authorization (PA)

Ciertos medicamentos necesitan una preautorización para ser adquiridos por el paciente. Los mismos se han identificado a la derecha con PA (requiere preautorización), en cuyo caso, la farmacia gestiona la preautorización con MC-21 Corporation previo al despacho del medicamento al asegurado.

There are certain drugs that require a preauthorization before being acquired by the patient. A PA (preauthorization is required) placed to the right of the name of the drug identifies them, for which, the pharmacy will process the preauthorization directly to MC-21 Corporation before dispensing it to the insured member.

Los medicamentos que requieren preautorización usualmente son aquellos que presentan efectos adversos, son candidatos al uso inapropiado o están relacionados con un costo elevado.

The medications that require a preauthorization usually are those that present adverse effects, have a potential for inappropriate use or are related to a higher cost.

Aquellos medicamentos que han sido identificados que requieren preautorización deben satisfacer los criterios clínicos establecidos según lo haya determinado el Comité de Farmacia y Terapéutica. Estos criterios clínicos se han desarrollado de acuerdo a la literatura médica actual. Those medications identified as requiring preauthorization must meet the established clinical criteria as determined by the Therapeutics and Pharmacy Committee. These criteria have been developed according to current medical literature.

Medicamentos cuyo costo excedan $500.00 requerirán una preautorización para su despacho. La farmacia enviará copia de la receta a MC-21 Corporation a través del fax 1-866-387-3487 ó 1-866-277-6556 para la autorización de la misma. Medications whose cost exceeds $500.00 will require a pre-authorization in order to be dispensed. The pharmacy will send MC-21 Corporation a copy of the prescription via fax at 1-866-387-3487 ó 1-866-277-6556 for authorization.

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Límites de cantidad (LC) Limits on the amount to be dispensed

Ciertos medicamentos tienen un límite en la cantidad a despacharse. Estas cantidades se establecen de acuerdo a lo sugerido por el manufacturero como la cantidad máxima adecuada que no está asociada a efectos adversos y la cual es efectiva para el tratamiento de una condición. Certain medications have a limit on the amount to be dispensed. These amounts are established according to the manufacturer’s recommendation as to the adequate maximum amount that will not cause adverse effects and which is effective for the treatment of a condition.

El Apéndice I contiene la lista de los medicamentos que tienen límites en la cantidad a despacharse. La misma es vigente al momento de imprimirse esta Lista y está sujeta a cambios. Appendix I includes a list of the medications that currently have a limit amount for dispensing. The list is effective at the moment of the publication of this List and is subject to changes.

Límites de especialidad médica (LE) Medical specialty limits

Algunos medicamentos tienen un límite en la especialidad médica. Estos límites de especialidad se establecen de acuerdo a la literatura médica actual. Some medications have a limit in the medical specialty. These medical specialty limits are established in accordance with the current medical literature.

El Apéndice II contiene la lista de los medicamentos que tienen límite de especialidad médica. La misma es vigente al momento de imprimirse esta Lista y está sujeta a cambios. Appendix II contains the list of medications that has a medical specialty limit. The list is effective at the moment of the impression of this List and is subject to changes.

Límites de edad (AL) Age limits

Algunos medicamentos tienen un límite de edad. El Apéndice III contiene la lista de los medicamentos que tienen un límite de edad. La misma es vigente al momento de imprimirse esta Lista y está sujeta a cambios. Some medications have a limit due to age. Appendix III contains the list of medications that has an age limit. The list is effective at the moment of the impression of this document and is subject to changes.

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Uso de medicamentos investigacionales o experimentales Use of investigational or experimental medications

Los medicamentos recetados para propósitos investigacionales, experimentales o no aprobados por la FDA, no se cubren en ningún plan de salud o cubierta de farmacia. Investigational or experimental drugs, or those not approved by the FDA, are not covered by all health plans or pharmacy coverage.

Recetas de compuestos Compounded prescriptions

Las recetas de compuestos se consideran medicamentos cubiertos si contienen por lo menos un medicamento de la Lista, siempre y cuando no sea para propósitos cosméticos. Compounded prescriptions are considered covered drugs if they contain at least one of the drugs on this List, as long as they are not for cosmetic purposes.

Éditos de análisis de utilización (DUR) Edits for Drug Utilization Analysis

A través del Programa de Beneficio de Farmacia de Triple-S Salud, Inc. se han implantado los siguientes éditos de análisis de utilización (DUR, por sus siglas en inglés) con el propósito de evitar complicaciones a los asegurados, ofreciendo un mejor cuidado. Through the Pharmacy Benefit Management Program, Triple-S Salud has implemented the following edits for drug utilization (DUR) in order to avoid complications to the insured persons while offering a better care.

Édito de Validación de Dosis - coteja para dosis máximas diarias usando como referencia las dosis pediátricas, de adultos y geriátricas de acuerdo a la información suministrada por Medi Span. En la mayoría de los casos, la dosis máxima es aquella aprobada por la FDA. / Dose check edits - verify for daily maximum

dosages using as reference the pediatric, adult and geriatric dosages according to Medi Span. In the majority of cases, the maximum dosage is the one approved by the FDA.

Édito de Terapia Duplicada - verifica el historial de medicamentos del paciente asegurado para recetas duplicadas, de dos formas: / Duplicate Therapy edits - verify the

insured person’s drug history for duplicate prescriptions, in two ways:

1. el paciente asegurado recibe el mismo medicamento (ej. mismo ingrediente activo) con dos recetas distintas (ej. número de receta distinto, puede ser la misma farmacia o farmacias diferentes). / The insured person receives the same

medication (e.g. same active ingredient) with two different prescriptions (e.g. Prescription number is different; it could be through the same pharmacy or different ones).

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2. el paciente asegurado recibe dos medicamentos de la misma clase terapéutica, como por ejemplo, dos antidepresivos o dos analgésicos, entre otros. / The insured person receives two drugs of the same therapeutic class, for example: two

anti-depressants or two analgesics.

Hay ciertas excepciones a estos éditos. Para evitar que el sistema rechace servicio a los asegurados, les solicitamos a los médicos y dentistas que incluyan la siguiente información en la receta del paciente: / There are exceptions to these edits. In order to prevent

the system from denying the service, we suggest that physicians include the following information in the patient’s prescription:

Cambio en dosis Change in dosage

Si aumentó la dosis y el asegurado necesita más medicamentos antes de tiempo, en este caso se necesitará una carta de justificación de parte del médico indicando el cambio en dosis. La farmacia requerirá una preautorización a MC-21 Corporation, luego de que se reciba la información necesaria de la receta. / If the dosage increases and

the insured person needs medication right away, a letter from the physician justifying the dosage change will be required. The pharmacy will require a pre-authorization from MC-21 Corporation after receipt of the necessary information regarding that prescription.

- Si la dosis se determina por el peso del asegurado, el médico debe indicar el peso y la estatura del paciente en la receta. / If the dosage is determined by the

insured person’s weight, the physician must indicate the weight and height of the person in the prescription.

- Cuando la dosis del medicamento se ajuste de acuerdo a los niveles en sangre, el médico debe indicarlo así en la receta (Ej. Ajuste de niveles para tiroide, teofilina, anticonvulsivos, warfarina). / When the dosage of the drug is adjusted

accordingly to blood levels, the physician must indicate it in the prescription (e.g.: adjustments for thyroid, theophyline, anti-convulsivants, and warfarins).

- Cuando para la dosis indicada en la receta no existe su presentación farmacéutica. Por ejemplo, la tableta viene de 25 mg y 50 mg pero el paciente necesita 75 mg (dosis indicada y aceptada). La farmacia requerirá una preautorización a MC-21 Corporation, luego de que se reciba la información necesaria en la receta (se requiere copia de la receta y hoja de preautorizaciones de MC-21). / When the dosage indicated in the prescription does not

exist in the pharmaceutical dosage form of the medication. For example, the tablet exists in 25 mg and 50 mg, but the patient needs a 75 mg dosage (dose required and accepted). The pharmacy will require a pre-authorization from MC-21 Corporation after the receipt of the necessary information for the prescription (a copy of the prescription will be required and copy of the pre-authorization form from MC-21 Corporation).

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PARTE II PART II

MANEJO DE LA LISTA DE MEDICAMENTOS

DRUG LIST MANAGEMENT

COMITÉ DE FARMACIA Y TERAPÉUTICA

THERAPEUTICS AND PHARMACY COMMITTEE

El Comité de Farmacia y Terapéutica está integrado por médicos participantes de Triple-S Salud, Inc., farmacéuticos clínicos y administradores, cuyo propósito primario es recomendar las políticas que deben establecerse en la evaluación, selección y uso terapéutico de medicamentos en el ambiente de cuidado de la salud. Los médicos que no son empleados ni poseen intereses financieros en Triple-S Salud, Inc. o en MC-21 Corporation son los únicos miembros con derecho al voto. Los profesionales de la salud empleados de Triple-S Salud, Inc. y MC-21 Corporation que participan en el Comité de Farmacia y Terapéutica no tienen derecho al voto y asisten a las reuniones en calidad de coordinadores y administradores del plan.

The Therapeutics and Pharmacy Committee is composed of Triple-S Salud’ participating physicians, dentists, pharmacists and administrators whose main purpose is to recommend policies to be established for evaluation, selection and therapeutic use of medications within the health care environment. Physicians not employed by or having business and financial interests in Triple-S Salud, Inc. or MC-21 Corporation are the only members having the right to vote. Health professionals employed by Triple-S Salud, Inc., and MC-21 Corporation participating in the Therapeutics and Pharmacy Committee do not have the right to vote. They attend Committee meetings as coordinators and health plan administrators.

Las decisiones del Comité de Farmacia y Terapéutica serán notificadas a los médicos y dentistas participantes a través de comunicaciones emitidas por la División de Asuntos Médicos de Triple-S Salud, Inc., y a través del Pharma News, un boletín para profesionales de la salud que es distribuido seis veces al año a todos los médicos y dentistas participantes de Triple-S Salud, Inc. Participating physicians and dentists will be notified of the decisions made by the Therapeutics and Pharmacy Committee by communications issued by Triple-S Salud’ Medical Affairs Division and the Pharma News, a bi-monthly newsletter for health care professionals and participating providers in Triple-S Salud’ providers network.

POLÍTICA PARA EL MANTENIMIENTO DE LA LISTA DE MEDICAMENTOS POLICY FOR THE MAINTENANCE OF THE DRUG LIST

El añadir o eliminar los medicamentos en la Lista se hará a base de su eficacia comparativa y de los parámetros específicos del medicamento, tales como los perfiles de efectos secundarios y contraindicaciones. Las evaluaciones se harán a base de información de referencias médicas reconocidas, literatura primaria y guías que establecen las pautas de la práctica (standard practice guidelines). También se

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tomará en cuenta el costo, aunque éste será el último criterio a considerar en la toma de decisiones. Las evaluaciones toman en consideración la siguiente información:

Additions or eliminations of drugs from the Drug List will be based on the comparative efficacy and specific parameters of the drug, such as profiles on secondary effects and contra-indications. The evaluations will be conducted based on information obtained from recognized medical references, primary literature and standard practice guidelines. Also, they will consider the cost, although this is the last criteria considered in the decision making. The evaluation considers the following information:

Seguridad / Safety

Eficacia / Efficacy

Estudios comparativos disponibles en la literatura médica / Comparative studies

available in the medical literature

Indicaciones del producto / Product indications

Perfil de efectos secundarios / Profile on secondary effects

Contraindicaciones / Contra-indications

Perfil farmacocinético / Pharmacokinetic profile

Factores que ayudan o impiden que el paciente asegurado cumpla con la terapia / Factors that help or prevent the insured person from complying with the therapy

Costo y estudios farmacoeconómicos cuando los mismos estén disponibles / Costs and pharmacoeconomic studies, when they are available

El Comité establece las prioridades de los medicamentos a evaluar, de acuerdo a los siguientes criterios: / The Committee establishes the priorities for the evaluation of drugs according

to the following criteria:

Análisis de utilización de medicamentos No Preferidos que son recetados frecuentemente. Estos medicamentos serán considerados para inclusión en otros niveles. / Utilization analysis for Non-Preferred drugs that are frequently prescribed.

These drugs will be considered for future inclusion in other levels.

Medicamentos que han sido aprobados recientemente por la FDA. / Drugs

recently approved by the FDA.

Solicitud por parte de un médico o dentista participante de Triple-S Salud, Inc. (Ver la sección de políticas para que los médicos y dentistas participantes de Triple-S Salud, Inc. soliciten la inclusión y/o exclusión de medicamentos en la Lista de Medicamentos.) / A request made by a participating physician or dentist in Triple-

S Salud’ network. (Please refer to the policies established for participating physicians and dentists to request the inclusion or exclusion of drugs from the Drug List).

Cuando se añada un medicamento a una clase terapéutica, se hará una evaluación de los medicamentos de esa clase que podrían ser eliminados, si alguno. When a drug is added to a therapeutic class, an evaluation will be made for those drugs that could be eliminated from that class, if any.

Aquellos medicamentos que reciben la designación No Preferido, indica que luego de la evaluación hecha por el Comité de Farmacia y Terapéutica, éstos no ofrecen ventajas clínicas y económicas en comparación con otras alternativas disponibles. En

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otros casos podría ser que no haya suficiente evidencia disponible en la literatura médica para justificar su uso clínico, al momento de hacer la evaluación. También puede ser que algunas presentaciones de los productos no tienen uso ambulatorio y sólo se utilicen en el hospital. Drugs that are designated as non-Drug List (NF) by the Committee after evaluation are considered not to offer clinical and economical advantages in comparison with other alternatives available. In some instances, it could be that no evidence is available in the medical literature that justifies their clinical use at the time of the evaluation. There may be a possibility that certain presentations do not have an out-patient use and their use is exclusively on an in-patient basis.

El Comité de Farmacia y Terapéutica se reúne cada dos meses, por lo que la Lista de Medicamentos está en constante revisión. Por el proceso dinámico que esto representa, los cambios que impliquen el mover un medicamento al nivel No Preferido, debido a que se incluye otro de igual o mejor calidad dentro la Lista de Medicamentos, tendrán efectividad a partir de febrero o agosto de cada año. Esto permite la evaluación de las clases terapéuticas principales periódicamente, como parte de nuestro compromiso de promover aquellos medicamentos que han probado ser mejores clínicamente y que proveen una terapia costo efectiva. The Therapeutics and Pharmacy Committee meets every two months, meaning that the Drug List is revised constantly. Due to the dynamic process, changes implying moving a drug to the Non-Preferred level, when a drug with the same or better quality is added, will be effective in February or August of each year. This will allow the periodic evaluation of the therapeutic classes, as part of our commitment to promote those drugs that have proved to be clinically better and that provide a cost-effective therapy.

Leyenda para los Símbolos y Abreviaturas Legend for Symbols and Abbreviations

AL Identifica aquellos medicamentos para los cuales existe algún límite

de edad / Identifies those medications for which an age limit exists

Cap Cápsula / Capsule

Conc Concentrado / Concentrated

Cr Crema / Cream

ER, SR, CR Acción prolongada, acción sostenida, acción controlada / Extended release, sustained release, controlled release

Inh Inhalador / Inhaler

Inj Inyectable / Injectable

QL Identifica aquellos medicamentos para los cuales existe algún límite en la cantidad que la farmacia puede despachar / Identifies those medications for which a dispensing limit exists

SL Identifica aquellos medicamentos para los cuales existe algún límite en la especialidad médica que debe manejar la terapia con estos productos / Identifies those medications for which a limit in the medical specialty exists that must manage the therapy with these products

Lot Loción / Lotion

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Negrilla (Bold) Identifica que el medicamento tiene genérico disponible en todas las presentaciones / Identifies if the medication has a generic available in all its dosage forms

Nivel 1 Identifica los medicamentos genéricos / Identifies Generic drugs

Nivel 2 Identifica los medicamentos de marca preferidos / Identifies Preferred drugs

Nivel 3 Identifica los medicamentos de marca / Identifies Brand drugs.

Nivel 4 Identifica los medicamentos no preferidos / Identifies Non-Preferred drugs

Nivel 5 Identifica los medicamentos especializados o biotecnológicos / Identifies Specialty or Biotech drugs.

Oint Ungüento / Ointment

Oph Oftálmico / Ophthalmic

PA Preautorización. La farmacia es responsable de solicitar y obtener una preautorización con MC-21 Corporation o Triple-S Salud, Inc., antes de despacharse el medicamento / Preauthorization. The pharmacy is responsible to request and obtain a prior authorization from MC-21 Corporation or Triple S, Inc. before dispensing the prescription drug

SHA Champú / Shampoo

Sl Sublingual / Sublingual

SNC Sistema Nervioso Central / Central Nervous System

Soln Solución / Solution

ST Terapia Escalonada / Step Therapy

Supp Supositorio / Suppository

Susp Suspensión / Suspension

Tab Tableta / Tablet

Td Transdermal / Transdermal

POLÍTICA PARA SOLICITUD DE EVALUACIÓN PARA INCLUSIÓN O EXCLUSIÓN DE MEDICAMENTOS A LA LISTA DE MEDICAMENTOS POLICY FOR REQUESTING THE EVALUATION FOR ADDITIONS OR EXCLUSIONS OF DRUGS FROM THE DRUG LIST

Todo médico y dentista participante de Triple-S Salud, Inc. puede solicitar la evaluación para incluir y/o excluir medicamentos a la Lista de la siguiente manera:

Any participating physician and/or dentist can request the evaluation of drugs for addition or exclusion from the Drug List following these instructions:

El médico o dentista debe completar la hoja de solicitud de evaluación de medicamentos (Drug List Review Request) en todas sus partes. / The

physician or dentist should complete in all parts the application form for the evaluation of drugs, known as Drug List Review Request.

Para obtener la hoja de solicitud de evaluación de medicamentos (Drug List Review Request), debe comunicarse con el Departamento de Servicios Clínicos de MC-21 Corporation, llamando a través del 787-286-6032 x. 3289 ó 1-877-741-7470. / To obtain the Drug List Review Request form you should

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communicate with the Clinical Services Department in MC-21 Corporation by calling 787-286-6032 x. 3289 or 1-877-741-7470.

Debe enviar la solicitud por correo, luego de que sea completada en todas sus partes, a la siguiente dirección: / After completion of all parts, you should mail

the review request form to the following address:

MC-21 Corporation Attn: Clinical Services Department/Drug List Review Request

Call Box 4908 Caguas, PR 00726

El Departamento de Servicios Clínicos de MC-21 Corporation procederá a preparar la evaluación correspondiente al producto en la solicitud, para ser presentada al Comité de Farmacia y Terapéutica en la fecha designada por los miembros del Comité. Es importante que la solicitud de evaluación para inclusión/exclusión se complete en todas sus partes, ya que la misma formará parte de la evaluación formal que preparará el Departamento Clínico de MC-21 Corporation para dicho producto.

MC-21’s Clinical Service Department will evaluate the product in the Review Request Form for its submission to the Therapeutics and Pharmacy Committee on the designated date. It is important that all parts of the Review Request Form are completed because it will become part of the formal documentation that MC-21’s Clinical Services Department will prepare for each product.

POLÍTICA PARA REVISIÓN DE LA LISTA DE MEDICAMENTOS POLICY FOR THE DRUG LIST REVIEW

Los cambios a esta Lista de Medicamentos serán notificados a los médicos y dentistas a través de comunicaciones emitidas por la División de Asuntos Médicos de Triple-S Salud Inc. y/o a través del Pharma News, un boletín para profesionales de la salud que es distribuido seis veces al año, a todos los médicos y dentistas participantes de Triple-S Salud, Inc. Los cambios a la Lista les serán notificados a los asegurados por medio de comunicaciones escritas. La Lista de Medicamentos se imprime anualmente. Participating physicians and dentists will be notified of changes to the Drug List by communications issued by Triple-S Salud’ Medical Affairs Division and/or through the Pharma News, a bi-monthly newsletter for health care professionals and participating providers in Triple-S Salud’ provider network. Changes to the Drug List will be notified to insured members by written communications. The Drug List is printed annually.

Todas las pautas para las terapias son actuales al momento de imprimirse la edición y están sujetas a cambios. Estas pautas son generales y tal vez no cubran todas las situaciones clínicas. Estas pautas no deben tomarse como sustituto a un juicio clínico.

All guidelines for the therapies are updated at the time of printing of this edition and are subject to changes. These guidelines are general and do not include all clinical situations. These guidelines shall not be construed as a substitute for a clinical judgment.

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EDITOR EDITOR

Sus comentarios y sugerencias, con el propósito de mejorar y actualizar esta Lista de Medicamentos, son bienvenidos. Puede enviar sus comentarios a la siguiente dirección: / Your comments and suggestions to improve and update this Drug List are welcome. You

can send your comments to the following address:

Comité de Farmacia y Terapéutica EDITOR

MC-21 Corporation Call Box 4908

Caguas, PR 00726

COMENTARIOS COMMENTS

La información contenida en esta Lista de Medicamentos no sustituye el conocimiento, la experiencia y el juicio clínico de los médicos. Los médicos deben continuar utilizando su juicio clínico al seleccionar los medicamentos más adecuados para el cuidado individual de cada paciente. MC-21 Corporation y Triple-S Salud, Inc. no se hacen responsables por las acciones u omisiones de los médicos a base de la información contenida en esta Lista de Medicamentos. Para información más detallada, el médico debe consultar la literatura provista por el manufacturero del producto en el inserto del producto (PI) o en libros de referencia. También puede adquirir mayor información llamando al Centro de Información de Medicamentos, un servicio exclusivo para los médicos y dentistas participantes de Triple-S Salud, Inc. ofrecido a través de MC-21 Corporation. The information included in this Drug List shall not be a substitute for knowledge, experience and clinical judgment of the physicians. The physicians shall continue using their clinical judgment when selecting the most appropriate drugs for the care and treatment of each individual patient. MC-21 Corporation and Triple-S Salud, Inc., are not responsible for the actions and omissions of the physicians based on the information provided in this Drug List. For detailed information, the physician must refer to the literature available and provided by the product’s manufacturer in the product insert (PI) or in reference books. Also, more information will be available through the Drug Information Center, an exclusive service offered by MC-21 Corporation to the participating physicians and dentists in Triple-S Salud’ Provider Network.

DERECHOS RESERVADOS RESERVED RIGHTS

La Lista de medicamentos es una propiedad literaria. MC-21 Corporation y Triple-S Salud, Inc. son los propietarios de los derechos de autor. Bajo ninguna circunstancia se podrá copiar o distribuir la Lista de Medicamentos ni cualquier porción de éste sin el consentimiento escrito de MC-21 Corporation y Triple-S Salud, Inc. THE DRUG LIST IS A LITERARY PROPERTY. MC-21 CORPORATION AND TRIPLE-S SALUD, INC. ARE THE PROPRIETORS OF THE AUTHOR’S RIGHTS. UNDER NO CIRCUMSTANCES MAY THIS MATERIAL BE COPIED OR

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DISTRIBUTED IN WHOLE OR ANY PART WITHOUT THE WRITTEN CONSENT OF MC-21 CORPORATION AND TRIPLE-S SALUD, INC.

1

Parte III Part III

MEDICAMENTOS POR CLASIFICACIÓN TERAPÉUTICA

DRUGS BY THERAPEUTIC CATEGORY

Medicamentos Drugs



Nivel Level

Inst

ANESTHETICS (ANESTÉSICOS)

lidocaine inj 1 %, 2 % XYLOCAINE 4

ANTI-INFECTIVES (ANTI-INFECCIOSOS)

Antifungals (Antifungales)

clotrimazole troche 10 mg MYCELEX 1

fluconazole susp 10 mg/ml, 40 mg/ml, tabs 100 mg, 150 mg, 200 mg, 50 mg

DIFLUCAN 1

flucytosine caps 250 mg, 500 mg ANCOBON 3

griseofulvin microsize tabs 500 mg GRIFULVIN 4

griseofulvin microsize

susp 125 mg/5ml GRIFULVIN 4

griseofulvin ultramicrosize

tabs 125 mg, 250 mg GRIS-PEG 3

itraconazole caps 100 mg SPORANOX 1

itraconazole soln 10 mg/ml SPORANOX 3

ketoconazole tabs 200 mg NIZORAL 1

nystatin susp 100000 u/ml, tabs 500000 u

NYSTATIN 1

nystatin powder NYSTATIN 4

posaconazole susp 40 mg/ml NOXAFIL 4 SL

terbinafine tabs 250 mg LAMISIL 1 QL

voriconazole susp 40 mg/ml, tabs 200 mg, 50 mg

VFEND 4 SL

Antimarials (Antimaláricos)

artemether & lumefantrine

tabs 20-120 mg COARTEM 4 QL

atovaquone & proguanil

tabs 250-100 mg, 62.5-25 mg

MALARONE 4 QL

chloroquine tabs 250 mg, 500 mg ARALEN 1

hydroxychloroquine tabs 200 mg PLAQUENIL 1

mefloquine tabs 250 mg LARIAM 1

primaquine tabs 26.3 mg PRIMAQUINE 3

pyrimethamine tabs 25 mg DARAPRIM 3

pyrimethamine & sulfadoxine

tabs 25-500 mg FANSIDAR 4

2

Medicamentos Drugs



Nivel Level

Inst

quinine caps 324 mg QUALAQUIN 4 QL

Antiparasitics (Antiparasitarios)

albendazole tabs 200 mg ALBENZA 3

bacitracin inj 50000 u BACITRACIN 4

iodoquinol tabs 210 mg, 650 mg YODOXIN 3

ivermectin tabs 3 mg STROMECTOL 4

mebendazole chew tab 100 mg VERMOX 3

nitazoxanide susp 100 mg/5ml, tabs 500 mg

ALINIA 3

praziquantel tabs 600 mg BILTRICIDE 4

Antituberculosis (Antituberculosis)

aminosalicylic acid pack 4 gm PASER 4

cycloserine caps 250 mg SEROMYCIN 3

ethambutol tabs 100 mg, 400 mg MYAMBUTOL 1

ethionamide tabs 250 mg TRECATOR 3

isoniazid tabs 100 mg, 300 mg ISONIAZID 1

isoniazid syrup 50 mg/5ml ISONIAZID 3

isoniazid & pyrazinamide & rifampin

tabs 50-300-120 mg RIFATER 4

isoniazid & rifampin caps 150-300 mg RIFAMATE 4

pyrazinamide tabs 500 mg PYRAZINAMIDE 1

rifabutin caps 150 mg MYCOBUTIN 3

rifampin caps 150 mg, 300 mg RIFADIN 1

rifapentine tabs 150 mg PRIFTIN 4

Antivirals (Antivirales)

Antiherpes Virus (Infecciones Herpéticas)

acyclovir caps 200 mg, susp 200 mg/5ml, tabs 400 mg, 800 mg

ZOVIRAX 1

famciclovir tabs 125 mg, 250 mg, 500 mg

FAMVIR 1

valacyclovir tabs 1000 mg, 500 mg VALTREX 1

HIV/AIDS (VIH/SIDA)

Entry Inhibitors (Inhibidores de Entrada)

maraviroc tabs 150 mg, 300 mg SELZENTRY 3 PA SL

raltegravir tabs 400 mg ISENTRESS 3

Non-Nucleoside Reverse Transcriptase Inhibitors (Inhibidores No Nucleósidos de la Transcriptasa)

delavirdine tabs 100 mg, 200 mg RESCRIPTOR 3

efavirenz caps 200 mg, 50 mg, tabs 600 mg

SUSTIVA 3

etravirine tabs 100 mg INTELENCE 3 PA SL

3

Medicamentos Drugs



Nivel Level

Inst

nevirapine susp 50 mg/5ml, tabs 200 mg

VIRAMUNE 3

Nucleoside-Nucleotide Reverse Transcriptase Inhibitors (Inhibidores Nucleósidos-Nucleótidos de la Transcriptasa)

abacavir soln 20 mg/ml, tabs 300 mg

ZIAGEN 3

abacavir & lamivudine tabs 600-300 mg EPZICOM 3

abacavir & lamivudine & zidovudine

tabs 300-150-300 mg TRIZIVIR 3

didanosine soln 2 gm, 4 gm VIDEX 3

didanosine dr caps 125 mg, 200 mg, 250 mg, 400 mg

VIDEX EC 1

efavirenz & emtricitabine & tenofovir

tabs 600-200-300 mg ATRIPLA 3

emtricitabine caps 200 mg EMTRIVA 3

emtricitabine soln 10 mg/ml EMTRIVA 4

emtricitabine & tenofovir

tabs 200-300 mg TRUVADA 3

lamivudine soln 10 mg/ml, tabs 150 mg, 300 mg

EPIVIR 3

lamivudine & zidovudine

tabs 150-300 mg COMBIVIR 3

stavudine caps 15 mg, 20 mg, 30 mg, 40 mg, soln 1 mg/ml

ZERIT 1

tenofovir tabs 300 mg VIREAD 3 PA SL

zidovudine caps 100 mg, syrup 50 mg/5ml, tabs 300 mg

RETROVIR 1

Protease Inhibitors (Inhibidores de Proteasa)

atazanavir caps 100 mg, 150 mg, 200 mg, 300 mg

REYATAZ 3

darunavir tabs 150 mg, 300 mg, 400 mg, 600 mg, 75 mg

PREZISTA 3

fosamprenavir susp 50 mg/ml, tabs 700 mg

LEXIVA 3

indinavir caps 100 mg, 200 mg, 333 mg, 400 mg

CRIXIVAN 3

lopinavir & ritonavir soln 400-100 mg/5ml, tabs 100-25 mg, 200-50 mg

KALETRA 3

nelfinavir powder 50 mg/gm, tabs 250 mg, 625 mg

VIRACEPT 3

ritonavir caps 100 mg, soln 80 mg/ml, tabs 100 mg

NORVIR 3

4

Medicamentos Drugs



Nivel Level

Inst

saquinavir caps 200 mg, tabs 500 mg INVIRASE 3

tipranavir caps 250 mg, soln 100 mg/ml

APTIVUS 3 PA SL

Influenza (Influenza)

amantadine caps 100 mg, syrup 50 mg/5ml

SYMMETREL 1

amantadine tabs 100 mg AMANTADINE 3

oseltamivir caps 30 mg, 45 mg, 75 mg, susp 12 mg/ml

TAMIFLU 4

rimantadine tabs 100 mg FLUMADINE 1

zanamivir inhal 5 mg/blister RELENZA DISKHALER

4

Miscellaneous (Misceláneos)

ganciclovir caps 250 mg, 500 mg CYTOVENE 3

Cephalosporins (Cefalosporinas)

First Generation (Primera Generación)

cefadroxil caps 500 mg, susp 250 mg/5ml, 500 mg/5ml

DURICEF 1

cefadroxil tabs 1 gm DURICEF 4

cephalexin caps 250 mg, 500 mg, susp 125 mg/5ml, 250 mg/5ml

KEFLEX 1

cephalexin tabs 250 mg, 500 mg CEPHALEXIN 4

Second Generation (Segunda Generación)

cefaclor caps 250 mg, 500 mg CECLOR 1

cefaclor susp 125 mg/5ml, 250 mg/5ml, 375 mg/5ml

CECLOR 3

cefaclor sr tabs 12h 500 mg CECLOR CD 4

cefprozil susp 125 mg/5ml, 250 mg/5ml, tabs 250 mg, 500 mg

CEFZIL 1

cefuroxime axetil susp 125 mg/5ml, 250 mg/5ml, tabs 250 mg, 500 mg

CEFTIN 1

Third Generation (Tercera Generación)

cefdinir caps 300 mg, susp 125 mg/5ml, 250 mg/5ml

OMNICEF 1

cefditoren tabs 200 mg, 400 mg SPECTRACEF 4

cefixime tabs 400 mg SUPRAX 4

cefpodoxime susp 100 mg/5ml, 50 mg/5ml, tabs 100 mg, 200 mg

VANTIN 4

5

Medicamentos Drugs



Nivel Level

Inst

ceftibuten caps 400 mg, susp 90 mg/5ml

CEDAX 4

ceftriaxone inj 1 gm, 2 gm ROCEPHIN 4

ceftriaxone inj 1 gm, 10 gm, 2 gm, 250 mg, 500 mg

ROCEPHIN 4

Macrolides (Macrólidos)

azithromycin susp 100 mg/5ml, 200 mg/5ml, tabs 250 mg, 500 mg, 600 mg

ZITHROMAX 1

azithromycin pack 1 gm ZITHROMAX 3

azithromycin susp 2 gm ZMAX 4

clarithromycin susp 125 mg/5ml, 250 mg/5ml, tabs 250 mg, 500 mg

BIAXIN 1

clarithromycin sr tabs 24h 500 mg BIAXIN XL 1

erythromycin tabs 250 mg, 500 mg ERYTHROMYCIN 3

erythromycin & sulfisoxazole

susp 200-600 mg/5ml PEDIAZOLE 1

erythromycin dr tabs 250 mg, 333 mg, 500 mg

ERY-TAB DR 3

erythromycin dr caps 250 mg ERYTHROMYCIN DR 4

erythromycin ec tabs 333 mg, 500 mg PCE 4

erythromycin ethylsuccinate

tabs 400 mg E.E.S. 1

erythromycin ethylsuccinate

susp 200 mg/5ml, 400 mg/5ml

E.E.S./ERYPED 3

erythromycin stearate tabs 250 mg, 500 mg ERYTHROCIN 3


atovaquone susp 750 mg/5ml MEPRON 3

cilastatin sodium and imipenem

inj 500-500 mg PRIMAXIN 4

clindamycin caps 150 mg, 300 mg CLEOCIN 1

clindamycin caps 75 mg, soln 75 mg/5ml

CLEOCIN 3

dapsone tabs 100 mg, 25 mg DAPSONE 3

fosfomycin pack 5.631 gm MONUROL 4

gentamicin inj 10 mg/ml, 10 mg/ml, 40 mg/ml

GENTAMICIN 4

lincomycin inj 300 mg/ml LINCOCIN 4

metronidazole tabs 250 mg, 500 mg FLAGYL 1

metronidazole caps 375 mg FLAGYL 4

metronidazole sr tabs 24h 750 mg FLAGYL ER 4

6

Medicamentos Drugs



Nivel Level

Inst

neomycin tabs 500 mg NEOMYCIN 4

nitrofurantoin susp 25 mg/5ml FURADANTIN 3

nitrofurantoin macrocrystalline

caps 100 mg, 50 mg MACRODANTIN 1

nitrofurantoin macrocrystalline

caps 25 mg MACRODANTIN 3

nitrofurantoin monohydrate macrocrystals

caps 100 mg MACROBID 4

pentamidine neb 300 mg NEBUPENT 3

pentamidine inj 300 mg PENTAM 4

streptomycin inj 1 gm STREPTOMYCIN 3

trimethoprim tabs 100 mg PROLOPRIM 4

vancomycin caps 125 mg, 250 mg VANCOCIN 3

Penicillins (Penicilinas)

amoxicillin caps 250 mg, 500 mg, chew tab 125 mg, 250 mg, susp 125 mg/5ml, 200 mg/5ml, 250 mg/5ml, 400 mg/5ml, tabs 500 mg, 875 mg

AMOXIL 1

amoxicillin chew tab 200 mg, 400 mg, susp 50 mg/ml

AMOXIL 3

amoxicillin & k clavulanate

chew tab 200-28.5 mg, 400-57 mg, susp 200-28.5 mg/5ml, 250-62.5 mg/5ml, 400-57 mg/5ml, 600-42.9 mg/5ml, tabs 250-125 mg, 500-125 mg, 875-125 mg

AUGMENTIN 1

amoxicillin & k clavulanate

chew tab 250-62.5 mg, susp 125-31.25 mg/5ml

AUGMENTIN 3

amoxicillin & k clavulanate sr

tabs 12h 1000-62.5 mg AUGMENTIN XR 4

ampicillin caps 250 mg, 500 mg PRINCIPEN 1

ampicillin susp 125 mg/5ml, 250 mg/5ml

AMPICILLIN 3

ampicillin sodium inj 125 mg AMPICILLIN SODIUM 4

ampicillin sodium inj 1 gm, 2 gm, 250 mg, 500 mg

AMPICILLIN SODIUM 4

dicloxacillin sodium caps 250 mg, 500 mg DICLOXACILLIN SODIUM

4

nafcillin sodium inj 1 gm, 2 gm NAFCILLIN SODIUM 1

nafcillin sodium inj 1 gm, 2 gm NAFCILLIN SODIUM 3

7

Medicamentos Drugs



Nivel Level

Inst

penicillin g benzathine inj 600000 u/ml BICILLIN L-A 3

penicillin g benzathine & penicillin g procaine

inj 300000-300000 u/ml, 300000-900000 u/ml

BICILLIN C-R 3

penicillin g procaine inj 600000 u/ml PENICILLIN G PROCAINE

4

penicillin v potassium

soln 125 mg/5ml, 250 mg/5ml, tabs 250 mg, 500 mg

VEETIDS 1

Quinolones (Quinolonas)

ciprofloxacin tabs 100 mg, 250 mg, 500 mg, 750 mg

CIPRO 1

ciprofloxacin susp 250 mg/5ml, 500 mg/5ml

CIPRO 3

ciprofloxacin sr tabs 24h 1000 mg, 500 mg

CIPRO XR 4 QL

levofloxacin tabs 250 mg, 500 mg, 750 mg

LEVAQUIN 4

moxifloxacin tabs 400 mg AVELOX 2

norfloxacin tabs 400 mg NOROXIN 4

ofloxacin tabs 200 mg, 300 mg, 400 mg

FLOXIN 4

Sulfonamides (Sulfonamidas)

sulfadiazine tabs 500 mg SULFADIAZINE 3

sulfamethoxazole & trimethoprim

susp 200-40 mg/5ml, tabs 400-80 mg, 800-160 mg

SEPTRA 1

sulfisoxazole susp 500 mg/5ml GANTRISIN 3

Tetracyclines (Tetraciclinas)

demeclocycline tabs 150 mg, 300 mg DECLOMYCIN 1

doxycycline calcium syrup 50 mg/5ml VIBRAMYCIN 4

doxycycline hyclate caps 100 mg, 50 mg, tabs 100 mg

VIBRAMYCIN/VIBRATAB

1

doxycycline hyclate caps 50 mg ORAXYL 3

doxycycline hyclate inj 100 mg, tabs 20 mg DOXYCYCLINE 4

doxycycline hyclate dr caps 100 mg DORYX 4

doxycycline monohydrate

susp 25 mg/5ml VIBRAMYCIN 4

doxycycline monohydrate

caps 100 mg, 50 mg, tabs 100 mg, 150 mg, 50 mg, 75 mg

MONODOX 4

minocycline caps 100 mg, 50 mg, 75 mg

MINOCIN 1

minocycline tabs 100 mg, 50 mg, 75 mg

DYNACIN 4

8

Medicamentos Drugs



Nivel Level

Inst

tetracycline caps 250 mg, 500 mg ACHROMYCIN V 1

CANCER (CÁNCER)

Alkylating Agents (Agentes Alquilantes)

altretamine caps 50 mg HEXALEN 3

busulfan tabs 2 mg MYLERAN 3

chlorambucil tabs 2 mg LEUKERAN 3

cyclophosphamide tabs 25 mg, 50 mg CYTOXAN 3

lomustine caps 10 mg, 100 mg, 40 mg

CEENU 3

melphalan tabs 2 mg ALKERAN 3

Androgens/Estrogens/Progestins (Andrógenos/Estrógenos/Progestinas)

Androgens (Andrógenos)

fluoxymesterone tabs 10 mg ANDROXY 3

methyltestosterone caps 10 mg ANDROID 4

methyltestosterone tabs 10 mg METHITEST 4

Antiandrogens (Antiandrógenos)

bicalutamide tabs 50 mg CASODEX 1

flutamide caps 125 mg EULEXIN 1

nilutamide tabs 150 mg NILANDRON 3

Antiestrogens (Antiestrógenos)

tamoxifen citrate tabs 10 mg, 20 mg NOLVADEX 1

toremifene citrate tabs 60 mg FARESTON 4

Aromatase Inihibitor (Inihibidores de la Aromatasa)

anastrozole tabs 1 mg ARIMIDEX 3

exemestane tabs 25 mg AROMASIN 4

letrozole tabs 2.5 mg FEMARA 3

Progestins (Progestinas)

megestrol acetate susp 40 mg/ml, tabs 20 mg, 40 mg

MEGACE 1

Antimetabolites (Antimetabólitos)

mercaptopurine tabs 50 mg PURINETHOL 1

methotrexate tabs 2.5 mg METHOTREXATE 1

methotrexate tabs 10 mg, 15 mg, 2.5 mg, 5 mg, 7.5 mg

TREXALL 3

Immunosuppressives (Inmunosupresores)

azathioprine tabs 50 mg IMURAN 1 SL

mycophenolate mofetil

caps 250 mg, tabs 500 mg CELLCEPT 1 SL

mycophenolate mofetil susp 200 mg/ml CELLCEPT 3 SL


bexarotene caps 75 mg TARGRETIN 4

9

Medicamentos Drugs



Nivel Level

Inst

estramustine phosphate

caps 140 mg EMCYT 3

etoposide caps 50 mg VEPESID 3

hydroxyurea caps 500 mg HYDREA 1

hydroxyurea caps 200 mg, 300 mg, 400 mg

DROXIA 3

leuprolide inj 5 mg/ml LUPRON 1 PA

leuprolide inj 11.25 mg, 15 mg, 22.5 mg, 3.75 mg, 30 mg, 7.5 mg

LUPRON DEPOT 3 PA

mitotane tabs 500 mg LYSODREN 3

procarbazine hcl caps 50 mg MATULANE 3

tretinoin caps 10 mg VESANOID 4

CARDIOVASCULARS (CARDIOVASCULARES)

Antiarrhythmics (Antiarrítmicos)

amiodarone tabs 200 mg CORDARONE 1

amiodarone tabs 100 mg PACERONE 3

amiodarone tabs 300 mg PACERONE 4

amiodarone tabs 400 mg CORDARONE 4

disopyramide caps 100 mg, 150 mg NORPACE 1

disopyramide sr caps 12h 100 mg, 150 mg NORPACE CR 3

flecainide tabs 100 mg, 150 mg, 50 mg

TAMBOCOR 1

mexiletine caps 150 mg, 200 mg, 250 mg

MEXILETINE 3

propafenone tabs 150 mg, 225 mg, 300 mg

RYTHMOL 1

propafenone sr caps 12h 225 mg, 325 mg, 425 mg

RYTHMOL SR 4

quinidine gluconate cr

tabs 324 mg QUINAGLUTE 1

quinidine sulfate tabs 200 mg, 300 mg QUINIDINE SULFATE 4

quinidine sulfate cr tabs 300 mg QUINIDINE SULFATE CR

4

sotalol tabs 120 mg, 160 mg, 240 mg, 80 mg

BETAPACE/BETAPACE AF

1

Antihyperlipidemics (Antihiperlipidémicos)

atorvastatin tabs 10 mg, 20 mg, 40 mg, 80 mg

LIPITOR 2

cholestyramine pack 4 gm, powder 4 gm/dose

QUESTRAN 1

choline fenofibrate cpdr 135 mg, 45 mg TRILIPIX 3

10

Medicamentos Drugs



Nivel Level

Inst

colesevelam pack 3.75 gm, tabs 625 mg

Welchol 4

colestipol granules 5 gm, tabs 1 gm COLESTID 1

ezetimibe tabs 10 mg ZETIA 2

ezetimibe & simvastatin

tabs 10-10 mg, 10-20 mg, 10-40 mg, 10-80 mg

VYTORIN 2

fenofibrate caps 134 mg, 200 mg, 67 mg, tabs 160 mg, 54 mg

LOFIBRA 1

fenofibrate tabs 145 mg, 48 mg TRICOR 2

fenofibrate tabs 160 mg, 50 mg TRIGLIDE 4

fluvastatin caps 20 mg, 40 mg LESCOL 4

fluvastatin sr tabs 24h 80 mg LESCOL XL 4

gemfibrozil tabs 600 mg LOPID 1

lovastatin tabs 10 mg, 20 mg, 40 mg MEVACOR 4

lovastatin & niacin sr tabs 24h 20-1000 mg, 20-500 mg, 20-750 mg, 40-1000 mg

ADVICOR 4

lovastatin sr tabs 24h 20 mg ALTOPREV 4

niacin & simvastatin sr tab 24hr 1000-20 mg, 500-20 mg, 750-20 mg

SIMCOR 4

niacin cr tabs 1000 mg, 500 mg, 750 mg

NIASPAN 2

omega-3-acid ethyl esters

caps 1 gm LOVAZA 4

pravastatin tabs 10 mg, 20 mg, 40 mg, 80 mg

PRAVACHOL 1

rosuvastatin tabs 10 mg, 20 mg, 40 mg, 5 mg

CRESTOR 2

simvastatin tabs 10 mg, 20 mg, 40 mg, 5 mg, 80 mg

ZOCOR 1

Antihypertensives (Antihipertensivos)

ACE Inhibitors (Inhibidores de la Enzima Convertidora de Angiotensina)

benazepril tabs 10 mg, 20 mg, 40 mg, 5 mg

LOTENSIN 1

captopril tabs 100 mg, 12.5 mg, 25 mg, 50 mg

CAPOTEN 1

enalapril tabs 10 mg, 2.5 mg, 20 mg, 5 mg

VASOTEC 1

fosinopril tabs 10 mg, 20 mg, 40 mg MONOPRIL 1

lisinopril tabs 10 mg, 2.5 mg, 20 mg, 30 mg, 40 mg, 5 mg

PRINIVIL / ZESTRIL 1

moexipril tabs 15 mg, 7.5 mg UNIVASC 4

perindopril tabs 2 mg, 4 mg, 8 mg ACEON 4

11

Medicamentos Drugs



Nivel Level

Inst

quinapril tabs 10 mg, 20 mg, 40 mg, 5 mg

ACCUPRIL 1

ramipril caps 1.25 mg, 10 mg, 2.5 mg, 5 mg

ALTACE 4

trandolapril tabs 1 mg, 2 mg, 4 mg MAVIK 4

Alpha-Adrenergic Receptor Blockers (Bloqueadores del Receptor Alfa-Adrenérgico)

doxazosin tabs 1 mg, 2 mg, 4 mg, 8 mg

CARDURA 1

prazosin caps 1 mg, 2 mg, 5 mg MINIPRESS 1

terazosin caps 1 mg, 10 mg, 2 mg, 5 mg

HYTRIN 1

Angiotensin Receptor Blockers (ARBs) (Bloqueadores del Receptor de la Angiotensina)

candesartan tabs 16 mg, 32 mg, 4 mg, 8 mg

ATACAND 4

eprosartan tabs 400 mg, 600 mg TEVETEN 4

irbesartan tabs 150 mg, 300 mg, 75 mg

AVAPRO 2

losartan tabs 100 mg, 25 mg, 50 mg

COZAAR 1

olmesartan tabs 20 mg, 40 mg, 5 mg BENICAR 4

telmisartan tabs 20 mg, 40 mg, 80 mg MICARDIS 4

valsartan tabs 160 mg, 320 mg, 40 mg, 80 mg

DIOVAN 4

Beta Blockers (Bloqueadores Beta)

acebutolol caps 200 mg, 400 mg SECTRAL 4

atenolol tabs 100 mg, 25 mg, 50 mg

TENORMIN 1

betaxolol tabs 10 mg, 20 mg KERLONE 4

bisoprolol tabs 10 mg, 5 mg ZEBETA 4

carteolol tabs 2.5 mg, 5 mg CARTROL 4

carvedilol tabs 12.5 mg, 25 mg, 3.125 mg, 6.25 mg

COREG 1

labetalol tabs 100 mg, 200 mg, 300 mg

NORMODYNE 4

metoprolol succinate sr

tabs 24h 100 mg, 200 mg, 25 mg, 50 mg

TOPROL XL 1

metoprolol tartrate tabs 100 mg, 25 mg, 50 mg

LOPRESSOR 1

nadolol tabs 160 mg CORGARD 4

nadolol tabs 20 mg, 40 mg, 80 mg CORGARD 4

penbutolol tabs 20 mg LEVATOL 4

pindolol tabs 10 mg, 5 mg VISKEN 4

12

Medicamentos Drugs



Nivel Level

Inst

propranolol tabs 10 mg, 20 mg, 40 mg, 60 mg, 80 mg

INDERAL 1

propranolol soln 20 mg/5ml, 40 mg/5ml

INDERAL 3

propranolol sr caps 24h 120 mg, 160 mg, 60 mg, 80 mg

INDERAL LA 1

timolol tabs 10 mg, 20 mg, 5 mg BLOCADREN 4

Calcium Channel Blockers (Antagonistas de Canales de Calcio)

amlodipine tabs 10 mg, 2.5 mg, 5 mg NORVASC 1

diltiazem tabs 120 mg, 30 mg, 60 mg, 90 mg

CARDIZEM 1

diltiazem er beads caps 24h 120 mg, 180 mg, 240 mg, 300 mg, 360 mg, 420 mg

TIAZAC ER 1

diltiazem sr caps 12h 120 mg, 60 mg, 90 mg, caps 24h 120 mg, 180 mg, 240 mg

CARDIZEM SR 1

diltiazem sr coated beads

caps 24h 120 mg, 180 mg, 240 mg, 300 mg

CARDIZEM CD 1

diltiazem sr coated beads

caps 24h 360 mg CARDIZEM CD 3

felodipine sr tabs 24h 10 mg, 2.5 mg, 5 mg

PLENDIL 1

isradipine caps 2.5 mg DYNACIRC 1

isradipine caps 5 mg DYNACIRC 1

isradipine sr tabs 24h 10 mg, 5 mg DYNACIRC-CR 4

nicardipine caps 20 mg, 30 mg CARDENE 1

nicardipine sr caps 12h 30 mg, 45 mg, 60 mg

CARDENE SR 4

nifedipine caps 20 mg PROCARDIA 4

nifedipine caps 10 mg PROCARDIA 4

nifedipine sr tabs 24h 30 mg, 60 mg, 90 mg

ADALAT CC / PROCARDIA XL

1

nimodipine caps 30 mg NIMOTOP 4

nisoldipine sr tabs 24h 20 mg, 30 mg, 40 mg

SULAR 3

verapamil tabs 120 mg, 40 mg, 80 mg

CALAN 1

verapamil cr tabs 120 mg, 180 mg, 240 mg

CALAN SR / ISOPTIN SR

1

verapamil sr caps 24h 120 mg, 180 mg, 240 mg, 360 mg

VERELAN 1

verapamil sr tabs 24h 180 mg, 240 mg COVERA-HS 4

13

Medicamentos Drugs



Nivel Level

Inst

verapamil sr caps 24h 100 mg, 200 mg, 300 mg

VERELAN PM 4

Centrally Acting Antiadrenergics (Antidrenérgicos de Acción Central)

clonidine tabs 0.1 mg, 0.2 mg, 0.3 mg, weekly patch 0.1 mg/24hr, 0.2 mg/24hr, 0.3 mg/24hr

CATAPRES 1

guanabenz tabs 4 mg, 8 mg WYTENSIN 4

guanfacine tabs 1 mg, 2 mg TENEX 4

methyldopa tabs 250 mg, 500 mg ALDOMET 1

midodrine tabs 10 mg, 2.5 mg, 5 mg PROAMATINE 4

reserpine tabs 0.1mg, 0.25 mg RESERPINE 4

Combinations (Combinaciones)

amlodipine & atorvastatin

tabs 10-10 mg, 10-20 mg, 10-40 mg, 10-80 mg, 2.5-10 mg, 2.5-20 mg, 2.5-40 mg, 5-10 mg, 5-20 mg, 5-40 mg, 5-80 mg

CADUET 4

amlodipine & benazepril

caps 10-40 mg, 5-40 mg LOTREL 4

amlodipine & benazepril

caps 10-20 mg, 2.5-10 mg, 5-10 mg, 5-20 mg

LOTREL 4

amlodipine & olmesartan

tabs 10-20 mg, 10-40 mg, 5-20 mg, 5-40 mg

AZOR 3 ST

amlodipine & valsartan tabs 10-160 mg, 10-320 mg, 5-160 mg, 5-320 mg

EXFORGE 4 ST

amlodipine & valsartan & hydrochlorthiazide

tabs 10-160-12.5 mg, 10-160-25 mg, 10-320-25 mg, 5-160-12.5 mg, 5-160-25 mg

EXFORGE HCT 4 ST

atenolol & chlorthalidone

tabs 100-25 mg, 50-25 mg TENORETIC 4

benazepril & hydrochlorothiazide

tabs 10-12.5 mg, 20-12.5 mg, 20-25 mg, 5-6.25 mg

LOTENSIN HCT 4

bisoprolol & hydrochlorothiazide

tabs 10-6.25 mg, 2.5-6.25 mg, 5-6.25 mg

ZIAC 4

candesartan & hydrochlorothiazide

tabs 16-12.5 mg, 32-12.5 mg, 32-25 mg

ATACAND HCT 4

captopril & hydrochlorothiazide

tabs 25-15 mg, 25-25 mg, 50-15 mg, 50-25 mg

CAPOZIDE 4

clonidine & chlorthalidone

tabs 0.1-15 mg, 0.2-15 mg, 0.3-15 mg

CLORPRES 4

14

Medicamentos Drugs



Nivel Level

Inst

enalapril & hydrochlorothiazide

tabs 10-25 mg, 5-12.5 mg VASERETIC 4

eprosartan & hydrochlorothiazide

tabs 600-12.5 mg, 600-25 mg

TEVETEN HCT 4

fosinopril & hydrochlorothiazide

tabs 10-12.5 mg, 20-12.5 mg

MONOPRIL HCT 4

hydralazine/hydrochlorothiazide

caps 25-25 mg, 50-50 mg APRESAZIDE 4

irbesartan & hydrochlorothiazide

tabs 150-12.5 mg, 300-12.5 mg, 300-25 mg

AVALIDE 2

lisinopril & hydrochlorothiazide

tabs 10-12.5 mg, 20-12.5 mg, 20-25 mg

PRINZIDE / ZESTORETIC

1

losartan & hydrochlorothiazide

tabs 100-12.5 mg, 100-25 mg, 50-12.5 mg

HYZAAR 1

methyldopa & hydrochlorothiazide

tabs 250-15 mg, 250-25 mg

ALDORIL 4

metoprolol tartrate & hydrochlorothiazide

tabs 100-50 mg LOPRESSOR HCT 4

metoprolol tartrate & hydrochlorothiazide

tabs 100-25 mg, 50-25 mg LOPRESSOR HCT 4

moexipril & hydrochlorothiazide

tabs 15-12.5 mg, 15-25 mg, 7.5-12.5 mg

UNIRETIC 4

nadolol & bendroflumethiazide

tabs 5-40 mg, 5-80 mg CORZIDE 4

olmesartan & hydrochlorothiazide

tabs 20-12.5 mg, 40-12.5 mg, 40-25 mg

BENICAR HCT 4

propranolol & hydrochlorothiazide

tabs 80-25 mg INDERIDE 4

propranolol & hydrochlorothiazide

tabs 40-25 mg INDERIDE 4

quinapril & hydrochlorothiazide

tabs 10-12.5 mg, 20-12.5 mg, 20-25 mg

ACCURETIC 4

telmisartan & hydrochlorothiazide

tabs 40-12.5 mg, 80-12.5 mg, 80-25 mg

MICARDIS HCT 4

trandolapril & verapamil cr

tabs 1-240 mg TARKA 4

trandolapril & verapamil cr

tabs 2-180 mg, 2-240 mg, 4-240 mg

TARKA 4

valsartan & hydrochlorothiazide

tabs 160-12.5 mg, 160-25 mg, 320-12.5 mg, 320-25 mg, 80-12.5 mg

DIOVAN HCT 4

15

Medicamentos Drugs



Nivel Level

Inst

Diuretics (Diuréticos)

Carbonic Anhydrase Inhibitors (Inhibidores de la Anhidrasa Carbónica)

acetazolamide tabs 125 mg, 250 mg DIAMOX 1

acetazolamide sr caps 12h 500 mg DIAMOX SR 1

methazolamide tabs 25 mg, 50 mg NEPTAZANE 1

Loop Diuretics (Diuréticos del Asa de Henle)

bumetanide tabs 0.5 mg, 1 mg, 2 mg BUMEX 1

ethacrynic acid tabs 25 mg EDECRIN 4

furosemide soln 10 mg/ml, tabs 20 mg, 40 mg, 80 mg

LASIX 1

furosemide soln 8 mg/ml LASIX 3

furosemide inj 10 mg/ml LASIX 4

torsemide tabs 10 mg, 100 mg, 20 mg, 5 mg

DEMADEX 4


eplerenone tabs 25 mg, 50 mg INSPRA 1 ST

indapamide tabs 1.25 mg, 2.5 mg LOZOL 1

Potassium Sparing/Combinations (Conservadores de Potasio/Combinaciones)

amiloride tabs 5 mg MIDAMOR 1

amiloride & hydrochlorothiazide

tabs 5-50 mg MODURETIC 1

spironolactone tabs 100 mg, 25 mg, 50 mg

ALDACTONE 1

spironolactone & hydrochlorothiazide

tabs 25-25 mg ALDACTAZIDE 1

spironolactone & hydrochlorothiazide

tabs 50-50 mg ALDACTAZIDE 3

triamterene caps 100 mg, 50 mg DYRENIUM 4

triamterene & hydrochlorothiazide

caps 37.5-25 mg, 50-25 mg, tabs 37.5-25 mg, 50-75 mg

DYAZIDE/MAXZIDE 1

Thiazides (Tiazidas)

chlorothiazide tabs 250 mg, 500 mg DIURIL 1

chlorothiazide susp 250 mg/5ml DIURIL 4

chlorthalidone tabs 25 mg, 50 mg THALITONE 1

chlorthalidone tabs 100mg, 15 mg THALITONE 3

hydrochlorothiazide tabs 25 mg, 50 mg HYDRODIURIL 1

hydrochlorothiazide tabs 12.5 mg HYDROCHLOROTHIAZIDE

4

hydrochlorothiazide caps 12.5 mg HYDRODIURIL 4

methyclothiazide tabs 5 mg METHYCLOTHIAZIDE 4

metolazone tabs 10 mg, 2.5 mg, 5 mg ZAROXOLYN 1

16

Medicamentos Drugs



Nivel Level

Inst

Vasodilators (Vasodilatores)

hydralazine tabs 10 mg, 100 mg, 25 mg, 50 mg

APRESOLINE 1

isosorbide dinitrate subl 2.5 mg, 5 mg, tabs 10 mg, 20 mg, 30 mg, 5 mg

ISORDIL 1

isosorbide dinitrate tabs 40 mg ISORDIL 3

isosorbide dinitrate cr

tabs 40 mg ISORDIL 1

isosorbide dinitrate cr caps 40 mg DILATRATE SR 3

isosorbide mononitrate

tabs 10 mg, 20 mg ISMO / MONOKET 1

isosorbide mononitrate sr

tabs 24h 120 mg, 30 mg, 60 mg

IMDUR 1

isoxsuprine tabs 10 mg VASODILAN 4

isoxsuprine tabs 20 mg VASODILAN 4

minoxidil tabs 10 mg, 2.5 mg LONITEN 1

nitroglycerin 24h patch 0.1 mg/hr, 0.2 mg/hr, 0.4 mg/hr, 0.6 mg/hr, subl 0.3 mg, 0.4 mg, 0.6 mg

NITRO-DUR 1

nitroglycerin 24h patch 0.3 mg/hr, 0.8 mg/hr, topical oint 2 %

NITRO-DUR 3

nitroglycerin translingual spray 0.4 mg/spray

NITROLINGUAL PUMPSPRAY

4

nitroglycerin cr caps 2.5 mg, 6.5 mg, 9 mg NITRO-TIME 4

papaverine hcl caps 150mg PAPAVERINE 4

ranolazine sr tabs 12h 1000 mg, 500 mg

RANEXA 3 PA SL

Glycosides (Glicósidos)

digoxin tabs 0.125 mg, 0.25 mg LANOXIN 1

digoxin soln 0.05 mg/ml DIGOXIN 3

CENTRAL NERVOUS SYSTEM (SISTEMA NERVIOSO CENTRAL)

Alzheimer (Alzheimer)

donepezil odt 10 mg, 5 mg, tabs 10 mg, 5 mg

ARICEPT 2

galantamine tabs 12 mg, 4 mg, 8 mg RAZADYNE 1

galantamine soln 4 mg/ml RAZADYNE 4

galantamine sr caps 24h 16 mg, 24 mg, 8 mg

RAZADYNE ER 1

memantine soln 2 mg/ml, tabs 10 mg, 5 mg, 5&10 mg

NAMENDA 2

17

Medicamentos Drugs



Nivel Level

Inst

rivastigmine 24h patch 4.6 mg/24hr, 9.5 mg/24hr, caps 1.5 mg, 3 mg, 4.5 mg, 6 mg, soln 2 mg/ml

EXELON 3

Analgesics/Narcotics/Combinations (Analgésicos/Narcóticos/Combinaciones)

acetaminophen & butalbital & caffeine & codeine

caps 325-50-40-30 mg FIORICET/CODEINE 4

acetaminophen & caffeine & dihydrocodeine

caps 356.4-30-16 mg PANLOR 4

acetaminophen & caffeine & dihydrocodeine

tabs 712.8-60-32 mg PANLOR 4

acetaminophen & codeine

soln 120-12 mg/5ml, tabs 300-15 mg, 300-30 mg, 300-60 mg

TYLENOL/CODEINE 1


susp 120-12 mg/5ml CAPITAL/CODEINE 3


tabs 650-30 mg VOPAC 4

acetaminophen & hydrocodone

caps 500-5 mg, soln 500-7.5 mg/15ml, tabs 325-10 mg, 325-5 mg, 325-7.5 mg, 500-10 mg, 500-2.5 mg, 500-5 mg, 500-7.5 mg, 650-10 mg, 650-7.5 mg, 660-10 mg, 750-10 mg, 750-7.5 mg

LORTAB/VICODIN 1

acetaminophen & hydrocodone

tabs 400-10 mg, 400-5 mg, 400-7.5 mg

ZYDONE 3

acetaminophen & oxycodone

caps 500-5 mg, tabs 325-10 mg, 325-2.5 mg, 325-5 mg, 325-7.5 mg, 500-7.5 mg, 650-10 mg

PERCOCET 1

acetaminophen & oxycodone

soln 325-5 mg/5ml, tabs 500-10 mg, 500-5 mg

ROXICET 4

acetaminophen & tramadol

tabs 325-37.5 mg ULTRACET 4

aspirin & butalbital & caffeine & codeine

caps 325-50-40-30 mg FIORINAL/CODEINE 1

aspirin & meprobamate tabs 325-200 mg EQUAGESIC 4

aspirin & oxycodone tabs 325-4.5-0.38 mg PERCODAN 1

18

Medicamentos Drugs



Nivel Level

Inst

butalbital & acetaminophen

tabs 50-325 mg, 50-650 mg

PHRENILIN 1


caps 50-650 mg PHRENILIN 3

butalbital & acetaminophen & caffeine

caps 50-325-40 mg, 50-500-40 mg, tabs 50-325-40 mg, 50-500-40 mg

FIORICET 1

butalbital & aspirin & caffeine

caps 50-325-40 mg, tabs 50-325-40 mg

FIORINAL 1

codeine tabs 30 mg, 60 mg CODEINE 1

codeine phosphate 30 mg/ml, inj 15 mg/ml CODEINE PHOSPHATE

4

codeine sulfate tabs 15 mg CODEINE SULFATE 3

fentanyl 72h patch 100 mcg/hr, 12.5 mcg/hr, 25 mcg/hr, 50 mcg/hr, 75 mcg/hr

DURAGESIC 1

fentanyl tabs 100 mcg, 200 mcg, 300 mcg, 400 mcg, 600 mcg, 800 mcg

FENTORA 4

fentanyl lollipop 1200 mcg, 1600 mcg, 200 mcg, 400 mcg, 600 mcg, 800 mcg

ACTIQ 4

fentanyl citrate inj 0.05 mg/ml FENTANYL 4

hydrocodone & ibuprofen

tabs 5-200 mg VICOPROFEN 1

hydrocodone & ibuprofen

tabs 10-200 mg, 7.5-200 mg

IBUDONE 4

hydromorphone inj 1 mg/ml, 10 mg/ml, 2 mg/ml, 4 mg/ml, tabs 2 mg, 4 mg, 8 mg

DILAUDID 1

hydromorphone liq 1 mg/ml, rectal supp 3 mg

DILAUDID 3

levorphanol tabs 2 mg LEVORPHANOL 4

meperidine inj 10 mg/ml, 100 mg/ml, 25 mg/ml, 50 mg/ml, 75 mg/ml, tabs 100 mg, 50 mg

DEMEROL 1

meperidine soln 50 mg/5ml DEMEROL 3

methadone conc 10 mg/ml, tabs 10 mg, 5 mg

METHADONE 1

methadone inj 10 mg/ml, soln 10 mg/5ml, 5 mg/5ml

METHADONE 3

19

Medicamentos Drugs



Nivel Level

Inst

morphine rectal supp 10 mg, 20 mg, 5 mg

MORPHINE SULFATE 1

morphine inj 0.5 mg/ml, 1 mg/ml, 10 mg/ml, 15 mg/ml, 25 mg/ml, 50 mg/ml, 8 mg/ml, soln 20 mg/ml, tabs 15 mg, 30 mg

MORPHINE 1

morphine inj 1 mg/ml, 2 mg/ml, 4 mg/ml, 5 mg/ml, rectal supp 30 mg, soln 10 mg/5ml, 20 mg/5ml

MORPHINE SULFATE 3

morphine beads sr caps 24h 120 mg, 30 mg, 60 mg, 90 mg

AVINZA 4

morphine sr tabs 12h 100 mg, 15 mg, 200 mg, 30 mg, 60 mg

MS CONTIN 1

morphine sr caps 24h 10 mg, 100 mg, 20 mg, 200 mg, 30 mg, 50 mg, 60 mg, 80 mg

KADIAN SR 4

oxycodone tabs 10 mg, 20 mg ROXICODONE 4

oxycodone caps 5 mg, conc 20 mg/ml, soln 5 mg/5ml, tabs 15 mg, 30 mg, 5 mg

ROXICODONE 4

oxycodone sr tabs 12h 15 mg, 30 mg, 40 mg, 60 mg

OXYCONTIN 4

oxycodone sr tabs 12h 10 mg, 20 mg, 80 mg

OXYCONTIN 4

oxymorphone inj 1 mg/ml, tabs 10 mg, 5 mg

OPANA 4

oxymorphone sr tabs 12h 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 5 mg, 7.5 mg

OPANA ER 4

propoxyphene & acetaminophen

tabs 65-650 mg WYGESIC 4

propoxyphene hydrochloride

caps 65 mg DARVON 1

propoxyphene napsylate

tabs 100 mg DARVON-N 4

propoxyphene napsylate & acetaminophen

tabs 100-500 mg, 100-650 mg, 50-325 mg

DARVOCET 1

propoxyphene napsylate & acetaminophen

tabs 100-325 mg BALACET 4

20

Medicamentos Drugs



Nivel Level

Inst

tramadol tabs 50 mg ULTRAM 4

Antianxiety/Hypnotics (Ansiolíticos/Hipnóticos)

alprazolam tabs 0.25 mg, 0.5 mg, 1 mg, 2 mg

XANAX 1

alprazolam sr tabs 24h 0.5 mg, 1 mg, 2 mg, 3 mg

XANAX XR 4

buspirone tabs 10 mg, 15 mg, 30 mg, 5 mg

BUSPAR 1

buspirone tabs 7.5 mg BUSPAR 3

chloral hydrate caps 500 mg, syrup 500 mg/5ml

SOMNOTE 4

chlordiazepoxide caps 10 mg, 25 mg, 5 mg LIBRIUM 1

clorazepate tabs 15 mg, 3.75 mg, 7.5 mg

TRANXENE T 1

clorazepate tabs 24h 11.25 mg, 22.5 mg

TRANXENE-SD 4

diazepam tabs 10 mg, 2 mg, 5 mg VALIUM 1

diazepam inj 5 mg/ml VALIUM 3

estazolam tabs 1 mg, 2 mg PROSOM 4

flurazepam caps 15 mg, 30 mg DALMANE 1

hydroxyzine hydrochloride

inj 25 mg/ml, 50 mg/ml VISTARIL 4

hydroxyzine pamoate caps 100 mg, 25 mg, 50 mg

VISTARIL 4

lorazepam inj 2 mg/ml, 4 mg/ml, tabs 0.5 mg, 1 mg, 2 mg

ATIVAN 1

meprobamate tabs 200 mg, 400 mg EQUANIL 4

midazolam inj 1 mg/ml, 5 mg/ml, syrup 2 mg/ml

VERSED 4

oxazepam caps 10 mg, 15 mg, 30 mg SERAX 1

quazepam tabs 15 mg DORAL 4

temazepam caps 15 mg, 30 mg, 7.5 mg

RESTORIL 1

temazepam caps 22.5 mg RESTORIL 4

triazolam tabs 0.125 mg, 0.25 mg HALCION 4

zaleplon caps 10 mg, 5 mg SONATA 4

zolpidem tabs 10 mg, 5 mg AMBIEN 4

Anticonvulsants (Anticonvulsivos)

carbamazepine chew tab 100 mg, susp 100 mg/5ml, tabs 200 mg

TEGRETOL 1

carbamazepine sr tabs 12h 200 mg, 400 mg TEGRETOL XR 1

carbamazepine sr tabs 12h 100 mg TEGRETOL-XR 3

21

Medicamentos Drugs



Nivel Level

Inst

carbamazepine sr caps 12h 100 mg, 200 mg, 300 mg

CARBATROL SR 4

clonazepam tabs 0.5 mg, 1 mg, 2 mg KLONOPIN 1

clonazepam odt 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, 2 mg

KLONOPIN 4

diazepam rectal gel 10 mg, 2.5 mg, 20 mg

DIASTAT 4

divalproex sprinkle caps 125 mg DEPAKOTE 1

divalproex dr tabs 125 mg, 250 mg, 500 mg

DEPAKOTE EC 1

divalproex sr tabs 24h 250 mg, 500 mg DEPAKOTE ER 1

ethosuximide caps 250 mg, soln 250 mg/5ml

ZARONTIN 1

ethotoin tabs 250 mg PEGANONE 3

felbamate susp 600 mg/5ml, tabs 400 mg, 600 mg

FELBATOL 3

gabapentin caps 100 mg, 300 mg, 400 mg, tabs 600 mg, 800 mg

NEURONTIN 1

gabapentin soln 250 mg/5ml NEURONTIN 3

lacosamide soln 10 mg/ml, tabs 100 mg, 150 mg, 200 mg, 50 mg

VIMPAT 4 PA SL

lamotrigine kit 25 mg, 25&100 mg, odt 25 mg, 5 mg, tabs 100 mg, 150 mg, 200 mg, 25 mg

LAMICTAL 1

levetiracetam soln 100 mg/ml, tabs 1000 mg, 250 mg, 500 mg, 750 mg

KEPPRA 1

methsuximide caps 300 mg CELONTIN 3

oxcarbazepine susp 300 mg/5ml, tabs 150 mg, 300 mg, 600 mg

TRILEPTAL 1

phenobarbital elixir 20 mg/5ml, tabs 100 mg, 15 mg, 16.2 mg, 30 mg, 32.4 mg, 60 mg

PHENOBARBITAL 1

phenobarbital tabs 64.8 mg, 97.2 mg PHENOBARBITAL 3

phenytoin caps 100 mg, 200 mg, 300 mg, susp 125 mg/5ml

DILANTIN 1

phenytoin caps 30 mg, chew tab 50 mg

DILANTIN 3

phenytoin inj 50 mg/ml DILANTIN 4

22

Medicamentos Drugs



Nivel Level

Inst

pregabalin caps 100 mg, 150 mg, 200 mg, 225 mg, 25 mg, 300 mg, 50 mg, 75 mg

LYRICA 3

primidone tabs 250 mg, 50 mg MYSOLINE 1

rufinamide tabs 200 mg, 400 mg BANZEL 4 PA SL

tiagabine tabs 12 mg, 16 mg, 2 mg, 4 mg

GABITRIL 3

topiramate sprinkle caps 15 mg, 25 mg, tabs 100 mg, 200 mg, 25 mg, 50 mg

TOPAMAX 1

valproate sodium syrup 250 mg/5ml DEPAKENE 1

valproate sodium inj 100 mg/ml DEPACON 4

valproic acid caps 250 mg DEPAKENE 1

zonisamide caps 100 mg, 25 mg, 50 mg

ZONEGRAN 1

Antiparkinsons (Antiparkinson)

Anticholinergics (Anticolinérgicos)

benztropine tabs 0.5 mg, 1 mg, 2 mg COGENTIN 1

trihexyphenidyl elixir 0.4 mg/ml, tabs 2 mg, 5 mg

ARTANE 1

COMT Inhibitors (Inhibidores de COMT)

entacapone tabs 200 mg COMTAN 3

tolcapone tabs 100 mg, 200 mg TASMAR 4

Dopamine Receptor Agonists (Agonistas del Receptor de Dopamina)

pramipexole tabs 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, 1.5 mg

MIRAPEX 1

pramipexole tabs 0.75 mg MIRAPEX 3

ropinirole tabs 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg, 5 mg

REQUIP 1

Dopaminergics (Dopaminérgicos)

bromocriptine tabs 2.5 mg PARLODEL 1

bromocriptine caps 5 mg PARLODEL 4

carbidopa tabs 25 mg LODOSYN 4

carbidopa & levodopa

tabs 10-100 mg, 25-100 mg, 25-250 mg

SINEMET 1

carbidopa & levodopa cr

tabs 25-100 mg, 50-200 mg

SINEMET CR 1

selegiline caps 5 mg, tabs 5 mg ELDEPRYL 4

23

Medicamentos Drugs



Nivel Level

Inst

Dopaminergics - COMT Inhibitors (Dopaminérgicos - Inhibidores de COMT)

carbidopa & entacapone & levodopa

tabs 12.5-50-200 mg, 18.75-75-200 mg, 25-100-200 mg, 31.25-125-200 mg, 37.5-150-200 mg, 50-200-200 mg

STALEVO 3


amantadine caps 100 mg, syrup 50 mg/5ml

SYMMETREL 1

amantadine tabs 100 mg AMANTADINE 3

Antivertigo/Antiemetic (Antivértigo/Antieméticos)

aprepitant caps 125 mg, 80 mg, pack 80&125 mg

EMEND 3 QL SL

dolasetron inj 20 mg/ml, tabs 100 mg, 50 mg

ANZEMET 4

dronabinol caps 10 mg, 2.5 mg, 5 mg MARINOL 4

granisetron tabs 1 mg KYTRIL 4

meclizine tabs 12.5 mg, 25 mg ANTIVERT 1

meclizine tabs 50 mg ANTIVERT 4

meclizine tabs 32 mg VERTIN-32 4

ondansetron odt 4 mg, 8 mg, tabs 24 mg, 4 mg, 8 mg

ZOFRAN 1

ondansetron inj 2 mg/ml, soln 4 mg/5ml ZOFRAN 4

prochlorperazine rectal supp 25 mg, tabs 10 mg, 5 mg

COMPAZINE 1

promethazine inj 25 mg/ml, 50 mg/ml, rectal supp 12.5 mg, 25 mg, 50 mg, syrup 6.25 mg/5ml, tabs 12.5 mg, 25 mg, 50 mg

PHENERGAN 1

scopolamine 72h patch 1.5 mg TRANSDERM-SCOP 4

trimethobenzamide caps 300 mg, inj 100 mg/ml

TIGAN 1

Migraine (Migraña)

acetaminophen & butalbital & caffeine & codeine

caps 325-50-40-30 mg FIORICET/CODEINE 4

almotriptan tabs 12.5 mg, 6.25 mg AXERT 4 QL

apap & isometheptene & caffeine

caps 325-65-100 mg MIGRALAM 4

apap & isometheptene & dichloral

caps 325-65-100 mg MIDRIN 4

24

Medicamentos Drugs



Nivel Level

Inst

aspirin & butalbital & caffeine & codeine

caps 325-50-40-30 mg FIORINAL/CODEINE 1


tabs 50-325 mg, 50-650 mg

PHRENILIN 1


caps 50-650 mg PHRENILIN 3

butalbital & acetaminophen & caffeine

caps 50-325-40 mg, 50-500-40 mg, tabs 50-325-40 mg, 50-500-40 mg

FIORICET 1

butalbital & aspirin & caffeine

caps 50-325-40 mg, tabs 50-325-40 mg

FIORINAL 1

dihydroergotamine nasal soln 4 mg/ml MIGRANAL 3

dihydroergotamine inj 1 mg/ml D.H.E. 45 4



DEPAKOTE EC 1


eletriptan tabs 20 mg, 40 mg RELPAX 2 QL

ergotamine subl 2 mg ERGOMAR 3

ergotamine tartrate & caffeine

tabs 1-100 mg CAFERGOT 1

ergotamine tartrate & caffeine

rectal supp 2-100 mg CAFERGOT 3

frovatriptan tabs 2.5 mg FROVA 4 QL

naratriptan tabs 1 mg, 2.5 mg AMERGE 4 QL

rizatriptan odt 10 mg, 5 mg, tabs 10 mg, 5 mg

MAXALT 3 QL

sumatriptan inj 6 mg/0.5ml, tabs 100 mg, 25 mg, 50 mg

IMITREX 1 QL

sumatriptan nasal soln 20 mg/act, 5 mg/act

IMITREX 3 QL

sumatriptan inj 4 mg/0.5ml, 6 mg/0.5ml IMITREX 3 QL

sumatriptan inj 4 mg/0.5ml IMITREX 3 QL

zolmitriptan odt 2.5 mg, 5 mg, tabs 2.5 mg, 5 mg

ZOMIG 4 QL


ergoloid mesylates tabs 1 mg HYDERGINE 1

guanidine tabs 125 mg GUANIDINE 4

neostigmine bromide tabs 15 mg PROSTIGMIN 3

pimozide tabs 1 mg, 2 mg ORAP 4

pyridostigmine tabs 60 mg MESTINON 1

pyridostigmine syrup 60 mg/5ml MESTINON 3

25

Medicamentos Drugs



Nivel Level

Inst

pyridostigmine cr tabs 180 mg MESTINON TIMESPAN

3

riluzole tabs 50 mg RILUTEK 4

Psychotropics (Sicotrópicos)

Antidepressants (Antidepresivos)

MAO Inhibitors (Inhibidores MAO)

isocarboxazid tabs 10 mg MARPLAN 4

phenelzine tabs 15 mg NARDIL 3

tranylcypromine tabs 10 mg PARNATE 1


bupropion tabs 100 mg, 75 mg WELLBUTRIN 1

bupropion sr tabs 12h 100 mg, 150 mg, 200 mg

WELLBUTRIN SR 1

bupropion sr tabs 24h 150 mg, 300 mg WELLBUTRIN XL 4

duloxetine ec caps 20 mg, 30 mg, 60 mg CYMBALTA 3

maprotiline tabs 25 mg, 50 mg, 75 mg LUDIOMIL 4

mirtazapine tabs 15 mg, 30 mg, 45 mg, 7.5 mg

REMERON 1

mirtazapine odt 15 mg, 30 mg, 45 mg REMERON 4

nefazodone tabs 100 mg, 150 mg, 200 mg, 250 mg, 50 mg

SERZONE 4

trazodone tabs 100 mg, 150 mg, 300 mg, 50 mg

DESYREL 1

venlafaxine tabs 100 mg, 25 mg, 37.5 mg, 50 mg, 75 mg

EFFEXOR 1

venlafaxine sr caps 24h 150 mg, 37.5 mg, 75 mg

EFFEXOR XR 2

Selective Serotonine Reuptake Inhibitors (SSRI's) (Inhibidores Selectivos de la Recaptación de Serotonina)

citalopram tabs 10 mg, 20 mg, 40 mg CELEXA 1

citalopram soln 10 mg/5ml CELEXA 4

escitalopram soln 5 mg/5ml, tabs 10 mg, 20 mg, 5 mg

LEXAPRO 4

fluoxetine caps 10 mg, 20 mg, 40 mg, soln 20 mg/5ml, tabs 10 mg, 20 mg

PROZAC 1

fluvoxamine tabs 100 mg, 25 mg, 50 mg

LUVOX 4

paroxetine hcl susp 10 mg/5ml, tabs 10 mg, 20 mg, 30 mg, 40 mg

PAXIL 1

paroxetine hcl sr tabs 24h 12.5 mg, 25 mg PAXIL CR 1

paroxetine hcl sr tabs 24h 37.5 mg PAXIL CR 3

26

Medicamentos Drugs



Nivel Level

Inst

sertraline conc 20 mg/ml, tabs 100 mg, 25 mg, 50 mg

ZOLOFT 1

Tricyclics (Tricíclicos)

amitriptyline tabs 10 mg, 100 mg, 150 mg, 25 mg, 50 mg, 75 mg

ELAVIL 1

amoxapine tabs 100 mg, 150 mg, 25 mg, 50 mg

AMOXAPINE 4

clomipramine caps 25 mg, 50 mg, 75 mg ANAFRANIL 1

desipramine tabs 10 mg, 100 mg, 150 mg, 25 mg, 50 mg, 75 mg

NORPRAMIN 1

doxepin caps 10 mg, 100 mg, 25 mg, 50 mg, 75 mg

SINEQUAN 1

doxepin caps 150 mg SINEQUAN 3

imipramine hydrochloride

tabs 10 mg, 25 mg, 50 mg TOFRANIL 1

imipramine pamoate caps 100 mg, 125 mg, 150 mg, 75 mg

TOFRANIL-PM 4

nortriptyline caps 10 mg, 25 mg, 50 mg, 75 mg, soln 10 mg/5ml

PAMELOR 1

protriptyline tabs 10 mg, 5 mg VIVACTIL 4

trimipramine caps 100 mg, 25 mg, 50 mg

SURMONTIL 4

Antipsychotics (Antisicóticos)

Atypicals (Atípicos)

aripiprazole tabs 10 mg, 15 mg, 2 mg, 20 mg, 30 mg, 5 mg

ABILIFY 2

clozapine tabs 100 mg, 25 mg CLOZARIL 1

clozapine tabs 50 mg CLOZARIL 4

olanzapine odt 10 mg, 15 mg, 20 mg, 5 mg, tabs 10 mg, 15 mg, 2.5 mg, 20 mg, 5 mg, 7.5 mg

ZYPREXA 2

quetiapine tabs 100 mg, 200 mg, 25 mg, 300 mg, 400 mg, 50 mg

SEROQUEL 3

risperidone odt 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg, soln 1 mg/ml, tabs 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg

RISPERDAL 1

risperidone odt 0.25 mg RISPERDAL 3

risperidone inj 12.5 mg, 25 mg, 37.5 mg, 50 mg

RISPERDAL CONSTA 4

27

Medicamentos Drugs



Nivel Level

Inst

ziprasidone caps 20 mg, 40 mg, 60 mg, 80 mg

GEODON 2

Butyrophenones (Butirofenonas)

haloperidol tabs 0.5 mg, 1 mg, 10 mg, 2 mg, 20 mg, 5 mg

HALDOL 1

haloperidol decanoate

inj 100 mg/ml, 50 mg/ml HALDOL DECANOATE

1

haloperidol lactate conc 2 mg/ml HALDOL 1

haloperidol lactate inj 5 mg/ml HALDOL 4


loxapine caps 10 mg, 25 mg, 5 mg, 50 mg

LOXITANE 1

molindone tabs 10 mg, 25 mg, 5 mg, 50 mg

MOBAN 4

thiothixene caps 1 mg, 10 mg, 2 mg, 5 mg

NAVANE 1

thiothixene caps 20 mg NAVANE 3

Phenothiazines (Fenotiazinas)

chlorpromazine tabs 10 mg, 100 mg, 200 mg, 25 mg, 50 mg

THORAZINE 1

chlorpromazine inj 25 mg/ml THORAZINE 4

fluphenazine tabs 1 mg, 10 mg, 2.5 mg, 5 mg

PROLIXIN 1

fluphenazine conc 5 mg/ml, elixir 2.5 mg/5ml

FLUPHENAZINE 3

fluphenazine decanoate

inj 25 mg/ml FLUPHENAZINE 1

perphenazine tabs 16 mg, 2 mg, 4 mg, 8 mg

TRILAFON 4

thioridazine tabs 10 mg, 100 mg, 25 mg, 50 mg

MELLARIL 4

trifluoperazine tabs 1 mg, 10 mg, 2 mg, 5 mg

STELAZINE 1

Attention Deficit and Hyperactivity (Déficit de Atención e Hiperactividad)

amphetamine & dextroamphetamine

tabs 10 mg, 12.5 mg, 15 mg, 20 mg, 30 mg, 5 mg, 7.5 mg

ADDERALL 1

amphetamine & dextroamphetamine sr

caps 24h 10 mg, 15 mg, 20 mg, 25 mg, 30 mg, 5 mg

ADDERALL XR 3

atomoxetine caps 10 mg, 100 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80 mg

STRATTERA 4 PA ST AL

28

Medicamentos Drugs



Nivel Level

Inst

dexmethylphenidate tabs 10 mg, 2.5 mg, 5 mg FOCALIN 1

dexmethylphenidate sr caps 24h 10 mg, 15 mg, 20 mg, 30 mg, 5 mg

FOCALIN XR 2

dextroamphetamine tabs 5 mg DEXTROSTAT 1

dextroamphetamine tabs 10 mg DEXTROSTAT 3

dextroamphetamine sr

caps 24h 10 mg, 15 mg, 5 mg

DEXEDRINE SR 4

methamphetamine tabs 5 mg DESOXYN 4

methylphenidate tabs 10 mg, 20 mg, 5 mg RITALIN 1

methylphenidate cr tabs 10 mg, 20 mg RITALIN SR/METADATE ER

1

methylphenidate cr caps 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg

METADATE CD 2

methylphenidate sa tabs 18 mg, 27 mg, 36 mg, 54 mg

CONCERTA 4

methylphenidate sr caps 24h 10 mg, 20 mg, 30 mg, 40 mg

RITALIN LA 3

modafinil tabs 100 mg, 200 mg PROVIGIL 4


amitriptyline & perphenazine

tabs 10-2 mg, 10-4 mg, 25-2 mg, 25-4 mg, 50-4 mg

PERPHENAZINE/AMITRIPTYLINE

4

chlordiazepoxide & amitriptyline

tabs 10-25 mg LIMBITROL 4

chlordiazepoxide & amitriptyline

tabs 5-12.5 mg LIMBITROL 4

Mood Stabilizers (Estabilizadores del Animo)



DEPAKOTE EC 1


lithium carbonate caps 150 mg, 300 mg, 600 mg

LITHIUM CARBONATE

1

lithium carbonate tabs 300 mg LITHIUM CARBONATE

3

lithium carbonate cr tabs 300 mg, 450 mg LITHOBID 1

lithium citrate soln 8 meq/5ml LITHIUM CITRATE 3

valproate sodium syrup 250 mg/5ml DEPAKENE 1

valproic acid caps 250 mg DEPAKENE 1

DERMATOLOGICALS (DERMATOLÓGICOS)

Acne (Acné)

adapalene topical cream 0.1 % DIFFERIN 4

29

Medicamentos Drugs



Nivel Level

Inst

adapalene topical gel 0.3 % DIFFERIN 4 SL AL

adapalene topical gel 0.1 % DIFFERIN 4

azelaic acid topical cream 20 % AZELEX 4

benzoyl peroxide topical gel 2.5 %, topical liq 5 %

DESQUAM 1

benzoyl peroxide topical liq 2.5 % BENZOYL PEROXIDE 3

benzoyl peroxide topical cream 5 %, topical gel 7 %

BENZASHAVE 4

benzoyl peroxide liq 5.25 %, topical cream 10 %, topical gel 2.75 %, 4 %, 5.25 %, 8 %, topical liq 4 %, 7 %, 8 %, topical lot 3 %, 4 %, 6 %, 8 %, 9 %

BENZIQ WASH 4

benzoyl peroxide & clindamycin

topical gel 5-1 % BENZACLIN 4

benzoyl peroxide & erythromycin

topical gel 5-3 % BENZAMYCIN 1

benzoyl peroxide & erythromycin

topical gel 5-3 % BENZAMYCIN 3

benzoyl peroxide & urea

topical cream 6.5-10 %, 8.5-10 %

ZODERM 4

benzoyl peroxide & urea

topical cleanser 4.5-10 %, 5.75-10 %, 6.5-10 %, 8.5-10 %, topical gel 4.5-10 %, 6.5-10 %, 8.5-10 %, topical pads 4.5-10 %, 6.5-10 %, 8.5-10 %

ZODERM 4

clindamycin topical gel 1 %, topical lot 1 %, topical soln 1 %

CLEOCIN 1

clindamycin topical swab 1 % CLEOCIN 4

erythromycin topical gel 2 %, topical soln 2 %

ERYGEL 1

erythromycin topical oint 2 % AKNE-MYCIN 3

erythromycin topical pads 2 % ERYTHROMYCIN 4

metronidazole topical cream 0.75 %, topical gel 0.75 %, topical lot 0.75 %

METROCREAM 1

metronidazole topical cream 1 % NORITATE 3

metronidazole topical gel 1 % METROGEL 4

sulfacetamide sodium

topical lot 10 % KLARON 4

30

Medicamentos Drugs



Nivel Level

Inst

sulfacetamide sodium & sulfur

topical cream 10-5 %, topical emulsion 0-5 %, 10-1 %, topical lot 10-5 %

PLEXION 1


susp 10-5 %, topical gel 10-5 %

PLEXION 3


topical cloth 10-5 % PLEXION 4

sulfacetamide sodium & sulfur & sunscreens

topical cream 10-5 % ROSAC 4

sulfacetamide sodium & sulfur & urea

topical emulsion 10-4 %, 10-5 %

ROSULA 1

sulfacetamide sodium & sulfur & urea

topical gel 10-5 % ROSULA 4

tretinoin topical cream 0.025 %, 0.05 %, 0.1 %, topical gel 0.01 %, 0.025 %

RETIN-A 1 SL AL

Antibacterials, Topicals (Antibacterianos, Tópicos)

bacitracin & hydrocortisone & neomycin & polymyxin b

topical oint 1 % CORTISPORIN 4

gentamicin topical cream 0.1 %, topical oint 0.1 %

GARAMYCIN 1

hydrocortisone & neomycin & polymyxin b

topical cream 0.5 % CORTISPORIN 4

mupirocin topical oint 2 % BACTROBAN 1

mupirocin calcium topical cream 2 % BACTROBAN 3

mupirocin calcium nasal oint 2 % BACTROBAN 4

silver sulfadiazine topical cream 1 % SILVADENE 1

Antifungals, Topical (Antifungales, Tópicos)

butenafine topical cream 1 % MENTAX 4

ciclopirox topical cream 0.77 %, topical gel 0.77 %, topical susp 0.77 %

LOPROX 4

ciclopirox topical nail lacquer 8 % PENLAC 4 QL

clioquinol & hc topical cream 3-0.5 % ALA-QUIN 4

clotrimazole topical cream 1 %, topical soln 1 %

LOTRIMIN 1

31

Medicamentos Drugs



Nivel Level

Inst

clotrimazole & betamethasone

topical cream 1-0.05 %, topical lot 1-0.05 %

LOTRISONE 4 AL

doxepin topical cream 5 % ZONALON 4

econazole topical cream 1 % SPECTAZOLE 4

haloprogin topical cream 1% HALOTIN 4

iodoquinol & hydrocortisone

topical cream 1 % VYTONE 4

iodoquinol & hydrocortisone & aloe polysaccharide

topical gel 1-2-1 % ALCORTIN A 4

ketoconazole topical cream 2 %, topical shampoo 2 %

NIZORAL 1

naftifine topical cream 1 %, topical gel 1 %

NAFTIN 4

nystatin topical cream 100000 u/gm, topical oint 100000 u/gm

NYSTATIN 1

nystatin topical powder 100000 u/gm

MYCOSTATIN 4

nystatin & triamcinolone

topical cream 100000 u/gm-0.1 %, topical oint 100000 u/gm-0.1 %

MYCOLOG II 1

oxiconazole topical cream 1 %, topical lot 1 %

OXISTAT 3

sodium thiosulfate & salicylic acid

topical lot 25-1 % TINVER 4

sulconazole topical cream 1 %, topical soln 1 %

EXELDERM 4

terbinafine topical soln 1 % LAMISIL 3

Antivirals, Topical (Antivirales,Tópicos)

acyclovir topical oint 5 % ZOVIRAX 3

acyclovir topical cream 5 % ZOVIRAX 4

penciclovir topical cream 1 % DENAVIR 4

Corticosteroids, Topical (Corticosteroides, Tópicos)

High Potency (Alta Potencia)

amcinonide topical lot 0.1 %, topical oint 0.1 %

AMCINONIDE 4 AL

amcinonide topical cream 0.1 % CYCLOCORT 4 AL

augmented betamethasone dipropionate

topical cream 0.05 %, topical gel 0.05 %, topical lot 0.05 %, topical oint 0.05 %

DIPROLENE 1 AL

32

Medicamentos Drugs



Nivel Level

Inst

betamethasone dipropionate

topical cream 0.05 %, topical lot 0.05 %, topical oint 0.05 %

DIPROSONE 1 AL

diflorasone topical cream 0.05 % PSORCON E 4 AL

diflorasone topical cream 0.05 %, topical oint 0.05 %

PSORCON 4 AL

fluocinonide topical cream 0.05 %, topical gel 0.05 %, topical oint 0.05 %, topical soln 0.05 %

LIDEX 4 AL

halcinonide topical cream 0.1 %, topical oint 0.1 %

HALOG 4 AL

Low Potency (Baja Potencia)

alclometasone topical cream 0.05 %, topical oint 0.05 %

ACLOVATE 4

clorcortolone topical cream 0.1 % CLODERM 4

desonide topical cream 0.05 %, topical lot 0.05 %, topical oint 0.05 %

DESOWEN 1

hydrocortisone topical cream 2.5 %, topical lot 2.5 %, topical oint 2.5 %

HYTONE 1

hydrocortisone topical soln 2.5 % TEXACORT 4

hydrocortisone topical cream 1 % PROCTOCORT 4

Medium Potency (Mediana Potencia)

betamethasone valerate

topical cream 0.1 %, topical lot 0.1 %

VALISONE / BETA-VAL

1


topical oint 0.1 % VALISONE / BETA-VAL

1 AL


topical foam 0.12 % LUXIQ 4 AL

desoximetasone topical cream 0.05 %, 0.25 %, topical gel 0.05 %, topical oint 0.25 %

TOPICORT 4 AL

fluocinolone topical oil 0.01 % DERMA-SMOOTHE 3

fluocinolone topical shampoo 0.01 %, topical soln 0.01 %

CAPEX 4

fluocinolone topical cream 0.01 %, 0.025 %, topical oint 0.025 %

SYNALAR 4 AL

flurandrenolide topical cream 0.05 %, topical lot 0.05 %, topical tape 4 mcg/sqcm

CORDRAN 4

33

Medicamentos Drugs



Nivel Level

Inst

fluticasone topical cream 0.05 %, topical oint 0.005 %

CUTIVATE 4

hydrocortisone butyrate

topical cream 0.1 %, topical oint 0.1 %, topical soln 0.1 %

LOCOID 1

hydrocortisone butyrate

topical cream 0.1 %, topical lot 0.1%

LOCOID 4

hydrocortisone probutate

topical cream 0.1 % PANDEL 4 AL

hydrocortisone valerate

topical cream 0.2 %, topical oint 0.2 %

WESTCORT 1

mometasone topical cream 0.1 %, topical oint 0.1 %, topical soln 0.1 %

ELOCON 4

prednicarbate topical cream 0.1 %, topical oint 0.1 %

DERMATOP 4

triamcinolone topical aerosol 0.147 mg/gm, topical oint 0.05 %

KENALOG 4

triamcinolone topical cream 0.025 %, 0.1 %, topical lot 0.025 %, 0.1 %, topical oint 0.025 %, 0.1 %

KENALOG 4

triamcinolone topical cream 0.5 %, topical oint 0.5 %

KENALOG 4 AL

Very High Potency (Muy Alta Potencia)

clobetasol topical cream 0.05 %, topical gel 0.05 %, topical oint 0.05 %, topical soln 0.05 %

TEMOVATE / CLOBEX

1 AL

clobetasol topical foam 0.05 % OLUX 4 AL

halobetasol topical cream 0.05 %, topical oint 0.05 %

ULTRAVATE 4 AL

Dermatologicals, Orals (Dermatológicos, Orales)

acitretin caps 10 mg, 17.5 mg, 22.5 mg, 25 mg, kit 10 mg, 25 mg

SORIATANE 3

bexarotene caps 75 mg TARGRETIN 4

isotretinoin caps 10 mg, 20 mg, 30 mg, 40 mg

ACCUTANE 1

methoxsalen caps 10 mg, 10 mg 8-MOP 3


aluminum chloride topical soln 6.25 % XERAC-AC 4

aluminum chloride soln 20% DRYSOL 4

34

Medicamentos Drugs



Nivel Level

Inst

anthralin topical cream 0.5 %, 1 % DRITHO-SCALP 3

bexarotene topical gel 1 % TARGRETIN 4

calcipotriene topical soln 0.004 % DOVONEX 1

calcipotriene topical cream 0.004 % DOVONEX 3

emollient - cream topical cream MIMYX 4

fluorouracil topical cream 5 %, topical soln 2 %, 5 %

EFUDEX 1

fluorouracil topical cream 0.5 %, 1 % CARAC 4

imiquimod topical cream 5 % ALDARA 4

lactic acid (ammonium lactate

topical cream 12 %, topical lot 12 %

LAC-HYDRIN 4

mafenide topical cream 85 mg/gm, topical soln 50 gm

SULFAMYLON 4

podofilox topical gel 0.5 % CONDYLOX 4

podofilox topical soln 0.5 % CONDYLOX 4

salicylic acid topical lot 6 % SALEX 4

tazarotene topical cream 0.05 %, 0.1 %, topical gel 0.05 %, 0.1 %

TAZORAC 4

urea topical oint 40% GORDON'S UREA 4

urea topical cream 40%, 50%, topical gel 40%, topical lot 40%, topical soln 50%

CARMOL 40 4

urea & hydrocortisone

topical cream 1-10 % CARMOL-HC 4

Scabicides/Pediculicides (Escabicidas/Pediculosis)

lindane topical lot 1 % LINDANE 1

lindane topical shampoo 1 % LINDANE 3

permethrin topical cream 5 % ELIMITE 1

Topical Anesthetics (Anestésicos Tópicos)

lidocaine patch 5 % LIDODERM 4

lidocaine topical cream 3 %, topical gel 2 %, topical oint 5 %

LIDAMANTLE 4

lidocaine & hydrocortisone

topical cream 3-0.5 %, topical lot 3-0.5 %

LIDAMANTLE 4

lidocaine & prilocaine topical cream 2.5-2.5 % EMLA 4

lidocaine hcl topical lot 3 % LIDAMANTLE 4

pramoxine & hc topical cream 1-2.5 % PRAMOSONE 1

pramoxine & hc oint 1-1 %, 1-2.5 %, topical cream 1-1 %, topical lot 1-1 %, 1-2.5 %

PRAMOSONE 3

pramoxine & hc topical foam 1-1 % EPIFOAM 4

35

Medicamentos Drugs



Nivel Level

Inst

Wound Care (Cuidado de Heridas)

becaplermin topical gel 0.01 % REGRANEX 4

collagenase topical oint 250 u/gm SANTYL 4

hexachlorophene topical liq 3 % PHISOHEX 4

physiological irrigation soln PHYSIOLYTE 4

ringer's irrigation soln RINGER'S 4

water irrigation soln IRRIGATION WATER 4

EAR/NOSE/THROAT (OÍDO/NARIZ/GARGANTA)

Mouth/Throat (Boca/Garganta)

antiseptic products soln , topical spray BUCALSEP 4

benzocaine & menthol & cetylpyridinium cl & tannic acid

soln ORASEP 4

chlorhexidine gluconate

buccal soln 0.12 % PERIDEX 1

lidocaine topical soln 2 % XYLOCAINE VISCOUS

1

lidocaine topical soln 4 % XYLOCAINE 4

pilocarpine tabs 5 mg, 7.5 mg SALAGEN 4

sodium fluoride buccal soln 0.05%, 0.2%, dental gel 1%

NAFRINSE 4

sodium fluoride dental cream 1.1 %, dental gel 1.1%, dental paste 1.1%, soln 0.2 %

PREVIDENT 4

stannous fluoride conc 0.63 % GEL-KAM 4

triamcinolone oral paste 0.1 % KENALOG IN ORABASE

1

Otics (Oticas)

acetic acid otic soln 2 % VOSOL 1

acetic acid & aluminum acetate

otic soln 2 % DOMEBORO 1

acetic acid & hydrocortisone

otic soln 2-1 % VOSOL-HC 1

benzocaine & antipyrine

otic soln 1.4-5.4 % BENZOTIC 4

benzocaine-pe-antipyrine

soln EAR-GESIC 4

ciprofloxacin & hydrocortisone

otic susp 0.2-1 % CIPRO HC 4

colistin & hydrocortisone & neomycin & thonzonium

otic susp , 3-10-3.3-0.5 mg/ml

COLY-MYCIN-S 4

36

Medicamentos Drugs



Nivel Level

Inst

cresyl acetate otic soln 25 % CRESYLATE 4

fluocinolone acetonide otic oil 0.01 % DERMOTIC 4

hydrocortisone & neomycin & polymyxin b

otic soln 1 %, otic susp 1 %

CORTISPORIN / PEDIOTIC

1

ofloxacin otic soln 0.3 % FLOXIN 1

pramoxine & hc & chloroxylenol aqueous

soln 10-10-1 mg/ml CORTANE-B 4

pramoxine & hydrocortisone & chloroxylenol

otic soln 10-10-1 mg/ml OTICIN HC 4

ENDOCRINOLOGY (ENDOCRINOLOGÍA)

Corticosteroids (Corticosteroides)

betamethasone soln 0.6 mg/5ml CELESTONE 4

betamethasone acetate & sod phosphate

inj 3-3 mg/ml CELESTONE 1

cortisone acetate tabs 25 mg CORTONE 3

dexamethasone elixir 0.5 mg/5ml, tabs 0.5 mg, 0.75 mg, 1.5 mg, 4 mg, 6 mg

DEXAMETHASONE 1

dexamethasone tabs 1 mg, 2 mg DEXAMETHASONE 3

dexamethasone conc 1 mg/ml, soln 0.5 mg/5ml, tabs 1.5 mg

DEXAMETHASONE 4

dexamethasone sodium phosphate

inj 10 mg/ml, 4 mg/ml DEXAMETHASONE 1

fludrocortisone tabs 0.1 mg FLORINEF 1

hydrocortisone tabs 10 mg, 20 mg, 5 mg CORTEF 1

hydrocortisone sodium succinate

inj 1000 mg, 250 mg, 500 mg

SOLU-CORTEF 4

hydrocortisone sodium succinate

inj 100 mg SOLU-CORTEF 4

methylprednisolone tabs 16 mg, 32 mg, 4 mg, 8 mg

MEDROL 1

methylprednisolone tabs 2 mg MEDROL 3

methylprednisolone acetate

inj 40 mg/ml, 80 mg/ml DEPO-MEDROL 1

methylprednisolone acetate

inj 20 mg/ml DEPO-MEDROL 3

methylprednisolone sodium succinate

inj 2000 mg SOLU-MEDROL 4

37

Medicamentos Drugs



Nivel Level

Inst

methylprednisolone sodium succinate

inj 1000 mg, 125 mg, 40 mg, 500 mg

SOLU-MEDROL 4

prednisolone syrup 15 mg/5ml, 5 mg/5ml

PRELONE 1

prednisolone tabs 50 mg PREDNISONE 3

prednisolone conc 5 mg/ml, tabs 5 mg PREDNISONE 4

prednisolone sod phosphate

soln 15 mg/5ml, 5 mg/5ml ORAPRED/PEDIAPRED

1

prednisone tabs 1 mg, 10 mg, 2.5 mg, 20 mg, 5 mg

PREDNISONE 1

prednisone soln 5 mg/5ml PREDNISONE 4

triamcinolone acetonide

inj 10 mg/ml, 40 mg/ml KENALOG 1

Diabetes (Diabetes)

Antihyperglycemics (Antihiperglicémicos)

Alpha-Glucosidase Inhibitors (Inhibidores de la Alfa-Glucosidasa)

acarbose tabs 100 mg, 25 mg, 50 mg

PRECOSE 1

miglitol tabs 100 mg, 25 mg, 50 mg

GLYSET 4

Biguanides (Biguanidas)

metformin tabs 1000 mg, 500 mg, 850 mg

GLUCOPHAGE 1

metformin sr tabs 24h 500 mg, 750 mg GLUCOPHAGE XR 1


glipizide & metformin tabs 2.5-250 mg, 2.5-500 mg, 5-500 mg

METAGLIP 1

glyburide & metformin

tabs 1.25-250 mg, 2.5-500 mg, 5-500 mg

GLUCOVANCE 1

pioglitazone & glimepiride

tabs 30-2 mg, 30-4 mg DUETACT 4 ST

pioglitazone & metformin

tabs 15-500 mg, 15-850 mg

ACTOPLUS MET 4 ST

rosiglitazone & glimepiride

tabs 4-1 mg, 4-2 mg, 4-4 mg, 8-2 mg, 8-4 mg

AVANDARYL 2 ST

rosiglitazone & metformin

tabs 2-1000 mg, 2-500 mg, 4-1000 mg, 4-500 mg

AVANDAMET 2 ST

sitagliptin & metformin tabs 50-1000 mg, 50-500 mg

JANUMET 2 ST

Human Insulin (Insulina Humana)

insulin-(pen) inj N HUMULIN 3

insulin-(vial) inj 70-30, 50-50, N, R HUMULIN 2

insulin-(pen) inj 70-30, N, R NOVOLIN 2

38

Medicamentos Drugs



Nivel Level

Inst

insulin-(vial) inj 70-30, N, R NOVOLIN 2

Insulin Analog (Insulinas Análogas)

insulin aspart (pen) inj 100 u/ml NOVOLOG 2

insulin aspart (vial) inj 100 u/ml NOVOLOG 2

insulin aspart prot & aspart (pen)

inj 70-30 NOVOLOG MIX 2

insulin aspart prot & aspart (vial)

inj 70-30 NOVOLOG MIX 2

insulin detemir (pen) inj 100 u/ml LEVEMIR 3

insulin detemir (vial) inj 100 u/ml LEVEMIR 3

insulin glargine (pen) inj 100 u/ml LANTUS 3

insulin glargine (vial) inj 100 u/ml LANTUS 3

insulin glulisine (pen) inj 100 u/ml APIDRA 3

insulin glulisine (vial) inj 100 u/ml APIDRA 3

insulin lispro (pen) inj 100 u/ml HUMALOG 2

insulin lispro (vial) inj 100 u/ml HUMALOG 2

insulin lispro prot & lispro (pen)

inj 50-50, 75-25 HUMALOG MIX 2

insulin lispro prot & lispro (vial)

inj 50-50, 75-25 HUMALOG MIX 2

Meglitinides (Meglitinidas)

repaglinide tabs 0.5 mg, 1 mg, 2 mg PRANDIN 3

Sulfonylureas (Sulfonilureas)

chlorpropamide tabs 100 mg, 250 mg DIABINESE 4

glimepiride tabs 1 mg, 2 mg, 4 mg AMARYL 4

glipizide tabs 10 mg, 5 mg GLUCOTROL 1

glipizide sr tabs 24h 10 mg, 2.5 mg, 5 mg

GLUCOTROL XL 1

glyburide tabs 1.25 mg, 2.5 mg, 5 mg

MICRONASE 1

glyburide tabs 1.25 mg, 2.5 mg, 5 mg

DIABETA 3

glyburide micronized tabs 1.5 mg, 3 mg, 6 mg GLYNASE 1

glyburide micronized tabs 4.5 mg GLYCRON 4

tolazamide tabs 250 mg, 500 mg TOLINASE 4

tolbutamide tabs 500 mg TOLBUTAMIDE 4

Thiazolidinediones (Tiazolidinedionas)

pioglitazone tabs 15 mg, 30 mg, 45 mg ACTOS 3 ST

rosiglitazone tabs 2 mg, 4 mg, 8 mg AVANDIA 2 ST

Antihyperglycemics, Others (Antihiperglicémicos, Otros)

exenatide inj 250 mcg/ml BYETTA PEN 3 PA

39

Medicamentos Drugs



Nivel Level

Inst

sitagliptin tabs 100 mg, 25 mg, 50 mg

JANUVIA 2 ST

Hyperglicemics (Hiperglicémicos)

diazoxide susp 50 mg/ml PROGLYCEM 4

glucagon inj 1 mg GLUCAGON 3


Androgens (Andrógenos)

danazol caps 100 mg, 200 mg, 50 mg

DANOCRINE 1

fluoxymesterone tabs 10 mg ANDROXY 3

methyltestosterone caps 10 mg ANDROID 4

methyltestosterone tabs 10 mg METHITEST 4

testosterone 24h patch 2.5 mg/24hr, 5 mg/24hr

ANDRODERM 3

testosterone transdermal gel 1 % ANDROGEL / TESTIM 4

testosterone cypionate

inj 100 mg/ml, 200 mg/ml DEPO-TESTOSTERONE

1

testosterone enanthate

inj 200 mg/ml TESTOSTERONE ENANTHATE

4

Others (Otros)

cabergoline tabs 0.5 mg DOSTINEX 1

calcitonin, salmon inj MIACALCIN 3

desmopressin nasal soln 0.01%, tabs 0.1 mg, 0.2 mg

DESMOPRESSIN 1

desmopressin inj 4 mcg/ml DDAVP 4

ergonovine tabs 0.2 mg ERGOTRATE 4

etidronate tabs 400 mg DIDRONEL 1

etidronate tabs 200 mg DIDRONEL 3

methylergonovine tabs 0.2 mg METHERGINE 4

nafarelin nasal soln 2 mg/ml SYNAREL 4

Thyroid (Tiroide)

Antithyroid (Antitiroideos)

methimazole tabs 10 mg, 5 mg TAPAZOLE 1

methimazole tabs 15 mg, 20 mg NORTHYX 3

propylthiouracil tabs 50 mg PROPYLTHIOURACIL 1

Thyroid Hormones (Hormonas Tiroideas)

levothyroxine tabs 100 mcg, 112 mcg, 125 mcg, 137 mcg, 150 mcg, 175 mcg, 200 mcg, 25 mcg, 300 mcg, 50 mcg, 75 mcg, 88 mcg

LEVOTHYROXINE 1

40

Medicamentos Drugs



Nivel Level

Inst

levothyroxine tabs 100 mcg, 112 mcg, 125 mcg, 137 mcg, 150 mcg, 175 mcg, 200 mcg, 25 mcg, 300 mcg, 50 mcg, 75 mcg, 88 mcg

SYNTHROID 3

liothyronine tabs 25 mcg, 5 mcg, 50 mcg

CYTOMEL 1

thyroid tabs 120 mg, 15 mg, 180 mg, 240 mg, 30 mg, 300 mg, 60 mg, 90 mg

ARMOUR THYROID 4

GASTROENTEROLOGY (GASTROENTEROLOGÍA)

Antidiarrheals (Antidiarreícos)

atropine & difenoxin tabs 1-0.025 mg MOTOFEN 4

diphenoxylate & atropina

tabs 2.5-0.025 mg LOMOTIL 1

diphenoxylate & atropine

liq 2.5-0.025 mg/5ml LOMOTIL 3

loperamide caps 2 mg IMODIUM 1

paregoric elixir 2 mg/5ml PAREGORIC 4

Antispasmodics (Antiespasmódicos)

atro & hyoscy & scopol & simeth

elixir 0.0194-0.1037-0.0065-40 mg/5ml

SIMETYL 4

atropine inj 0.05 mg/ml ATROPINE 4

atropine inj 0.1 mg/ml ATROPINE 4

atropine sulfate inj 0.8 mg/ml ATROPINE 4

atropine sulfate tabs 0.4 mg SAL-TROPINE 4

atropine sulfate inj 0.4 mg/ml, 1 mg/ml ATROPINE 4

belladonna alkaloids & phenobarbital

elixir 16 mg/5ml, tabs 16.2 mg

DONNATAL 1

belladonna alkaloids & phenobarbital cr

tabs 48 mg DONNATAL 4

clidinium & chlordiazepoxide

caps 2.5-5 mg LIBRAX 4

dicyclomine caps 10 mg, inj 10 mg/ml, soln 10 mg/5ml, tabs 20 mg

BENTYL 1

glycopyrrolate inj 0.2 mg/ml, tabs 1 mg, 2 mg

ROBINUL 1

hyoscyamine elixir 0.125 mg/ml, soln 0.125 mg/ml, subl 0.125 mg, tabs 0.125 mg

LEVSIN 1

hyoscyamine odt 0.125 mg LEVSIN 4

41

Medicamentos Drugs



Nivel Level

Inst

hyoscyamine sulfate sr

caps 0.375 mg, tabs 12h 0.375 mg

LEVSINEX 1

hyoscyamine sulfate inj 0.5 mg/ml LEVSIN 3

methscopolamine tabs 2.5 mg, 5 mg PAMINE 4

propantheline tabs 15 mg PROPANTHINE 3

Antiulcers (Ulceras)

H2 Blockers (Antagonistas H2)

cimetidine soln 300 mg/5ml, tabs 300 mg, 400 mg, 800 mg

TAGAMET 1

cimetidine inj 150 mg/ml TAGAMET 4

famotidine inj 10 mg/ml, susp 40 mg/5ml, tabs 20 mg, 40 mg

PEPCID 4

nizatidine caps 150 mg, 300 mg AXID 4

ranitidine caps 150 mg, 300 mg, syrup 15 mg/ml, tabs 150 mg, 300 mg

ZANTAC 1

ranitidine pack 150 mg ZANTAC 4

ranitidine inj 25 mg/ml ZANTAC 4


amoxicillin & clarithromycin & lansoprazole dr

pack 500&500&30 mg PREVPAC 3

bismuth subsalicylate & metronidazole & tetracycline

pack 262.4&250&500 mg HELIDAC 4

misoprostol tabs 100 mcg, 200 mcg CYTOTEC 1

sucralfate tabs 1 gm CARAFATE 1

sucralfate susp 1 gm/10ml CARAFATE 3

Proton Pump Inhibitors (PPI`s) (Inhibidores de la Bomba de Protón)

lansoprazole dr caps 15 mg, 30 mg PREVACID 1

lansoprazole dr odt 15 mg, 30 mg PREVACID 3

lansoprazole dr caps 15 mg PREVACID 24H OTC

omeprazole dr caps 10 mg, 20 mg, 40 mg PRILOSEC 1

omeprazole dr tabs 20 mg PRILOSEC OTC OTC

omeprazole magnesium

cpdr 20.6 mg OMEPRAZOLE OTC

omeprazole-sodium bicarbonate

caps 20-1100 mg ZEGERID OTC OTC

pantoprazole ec tabs 20 mg, 40 mg PROTONIX 1

rabeprazole ec tabs 20 mg ACIPHEX 4

42

Medicamentos Drugs



Nivel Level

Inst

Digestive Enzymes (Enzimas Digestivas)

amylase & lipase & protease

caps CREON 4


caps LIPRAM 4


caps PANCREASE MT 3


caps PANCREASE MT 4


powder, tabs VIOKASE 4


caps PANCRECARB 4


caps ULTRASE 3


caps ULTRASE 4


caps PANCRELIPASE 4

digestive enzymes w/ anticholinergics

caps GASTRINEX 4

Laxatives (Laxantes)

lactulose soln 10 gm/15ml ENULOSE 1

lactulose pack 10 gm, 20 gm KRISTALOSE 4

peg 3350-kcl-na bicarb-nacl-na sulfate

soln 6 gm/100ml OCL 4

polyethylene glycol pack , powder 17 gm/1.7ml

GLYCOLAX 4

polyethylene glycol & potassium chloride & sodium bicarbonate & sodium chloride

soln 420 gm NULYTELY 4

polyethylene glycol & potassium chloride & sodium bicarbonate & sodium chloride & sodium sulfate

soln 227.1 gm GOLYTELY 4

polyethylene glycol & potassium chloride & sodium bicarbonate & sodium chloride & sodium sulfate

soln 236 gm, 240 gm GOLYTELY 4

43

Medicamentos Drugs



Nivel Level

Inst

sodium phosphate, dibasic & monobasic monohydrate

tabs 0.398-1.102 gm VISICOL 4


alosetron tabs 0.5 mg, 1 mg LOTRONEX 4

balsalazide caps 750 mg COLAZAL 4

budesonide sr caps 24h 3 mg ENTOCORT EC 3 PA SL

cromolyn conc 100 mg/5ml GASTROCROM 4

hydrocortisone enema 100 mg/60ml, rectal cream 2.5 %, rectal supp 25 mg

CORTENEMA 1

hydrocortisone rectal foam 90 mg CORTIFOAM 3

hydrocortisone rectal supp 30 mg PROCTOCORT 4

hydrocortisone acetate & pramoxine

rectal cream 1-1 %, 2.5-1 %

ANALPRAM-HC 1

hydrocortisone acetate & pramoxine

rectal foam 1-1 %, rectal lot 2.5-1 %

PROCTOFOAM HC 3

lidocaine & hydrocortisone

rectal cream 2-2 %, 3-0.5 %, 3-1 %, 3-2.5 %

ANAMANTLE HC 4

lubiprostone caps 24 mcg, 8 mcg AMITIZA 4 QL SL

mesalamine enema 4 gm ROWASA 1

mesalamine rectal supp 1000 mg CANASA 2

mesalamine cr caps 250 mg, 500 mg PENTASA 3

mesalamine dr tabs 400 mg, 800 mg ASACOL 3

mesalamine dr tabs 1.2 gm LIALDA 4

methylnaltrexone inj RELISTOR 4 QL PA

metoclopramide soln 5 mg/5ml, tabs 10 mg, 5 mg

REGLAN 1

metoclopramide inj 5 mg/ml REGLAN 4

olsalazine caps 250 mg DIPENTUM 3

sulfasalazine tabs 500 mg AZULFIDINE 1

sulfasalazine dr tabs 500 mg AZULFIDINE EN 1

ursodiol caps 300 mg ACTIGALL 1

ursodiol tabs 250 mg, 500 mg URSO 4

OBSTETRICS/GYNECOLOGY (OBSTETRICIA/GINECOLOGÍA)

Estrogens/Progestins (Estrógenos/Progestinas)

Combinations, Estrogens (Combinaciones, Estrógenos)

esterified estrogens & methyltestosterone

tabs 0.625-1.25 mg, 1.25-2.5 mg

ESTRATEST HS 1

estradiol & norethindrone

tabs 1-0.5 mg ACTIVELLA 1

44

Medicamentos Drugs



Nivel Level

Inst


tabs 0.5-0.1 mg ACTIVELLA 3

estradiol & norgestimate

tabs 1&1-0.09 mg PREFEST 4

estrogens, conjugated & medroxyprogesterone

tabs 0.3-1.5 mg, 0.45-1.5 mg, 0.625&0.625-5 mg, 0.625-2.5 mg, 0.625-5 mg

PREMPRO / PREMPHASE

2

estrogens, conjugated synthetic b

tabs 0.3 mg, 0.45 mg, 0.625 mg, 0.9 mg, 1.25 mg

ENJUVIA 3

ethinyl estradiol & norethindrone

tabs 2.5-0.5 mg, 5-1 mg FEMHRT 4

Estrogens (Estrógenos)

estradiol tabs 0.5 mg, 1 mg, 2 mg ESTRACE 1

estradiol tabs 0.45 mg, 0.9 mg, 1.8 mg, transdermal gel 0.06 %

FEMTRACE 4

estradiol hemihydrate transdermal emulsion 4.35 mg/1.74gm

ESTRASORB 4

estrogens, conjugated tabs 0.3 mg, 0.45 mg, 0.625 mg, 0.9 mg, 1.25 mg

PREMARIN 2

estrogens, conjugated inj 25 mg PREMARIN 3

estrogens, conjugated synthetic a

tabs 0.3 mg, 0.45 mg, 0.625 mg, 0.9 mg, 1.25 mg

CENESTIN 3

estrogens, esterified tabs 0.3 mg, 0.625 mg, 1.25 mg, 2.5 mg

MENEST 3

estropipate tabs 0.75 mg, 1.5 mg, 3 mg

OGEN 1

Progesterones (Progesteronas)

medroxyprogesterone

tabs 10 mg, 2.5 mg, 5 mg PROVERA 1

norethindrone tabs 5 mg AYGESTIN 4

progesterone caps 100 mg, 200 mg PROMETRIUM 4

progesterone inj 50 mg/ml PROGESTERONE 4


Osteoporosis (Osteoporosis)

Biphosphonates (Bifosfonatos)

alendronate tabs 10 mg, 35 mg, 40 mg, 5 mg, 70 mg

FOSAMAX 1

alendronate soln 70 mg/75ml FOSAMAX 3

45

Medicamentos Drugs



Nivel Level

Inst

alendronate & cholecalciferol

tabs 70 mg-2800u, 70 mg-5600u

FOSAMAX PLUS D 3

ibandronate tabs 150 mg, 2.5 mg BONIVA 2

risedronate tabs 150 mg, 30 mg, 35 mg, 5 mg, 75 mg

ACTONEL 2

tiludronate tabs 240 mg SKELID 4

Others (Otros)

calcitonin, salmon nasal soln 200 u/act MIACALCIN 1

Selective Estrogen Receptor Modulator (Modulador Selectivo del Receptor de Estrógeno)

raloxifene tabs 60 mg EVISTA 2

Others (Otros)

danazol caps 100 mg, 200 mg, 50 mg

DANOCRINE 1

Topicals (Tópicos)

Transdermal Patch (Parchos Transdermales)

estradiol weekly patch 0.025 mg/24hr, 0.0375 mg/24hr, 0.05 mg/24hr, 0.06 mg/24hr, 0.075 mg/24hr, 0.1 mg/24hr

CLIMARA 1

estradiol biweekly patch 0.025 mg/24hr, 0.0375 mg/24hr, 0.05 mg/24hr, 0.075 mg/24hr, 0.1 mg/24hr

VIVELLE-DOT 4

estradiol & levonorgestrel

weekly patch 0.045-0.015 mg/day

CLIMARA PRO 3


patch 0.05-0.14 mg/day, 0.05-0.25 mg/day

COMBIPATCH 4

Vaginal, Topical (Vaginales, Tópicos)


acetic acid vaginal gel ACID JELLY 4

acetic acid-oxyquinoline

vaginal gel RELAGARD 4

butoconazole vaginal cream 2 % GYNAZOLE-1 4

clindamycin vaginal cream 2 % CLEOCIN 1

clindamycin vaginal supp 100 mg CLEOCIN 4

metronidazole vaginal gel 0.75 % METROGEL 1

miconazole vaginal supp 200 mg MICONAZOLE 3 3

nystatin tabs 100000 u NYSTATIN 3

sulfanilamide vaginal cream 15 % AVC 4

terconazole vaginal cream 0.4 %, 0.8 %, vaginal supp 80 mg

TERAZOL 1

46

Medicamentos Drugs



Nivel Level

Inst

Hormonal Replacement (Reemplazo Hormonal)

estradiol vaginal tabs 10 mcg, 25 mcg

VAGIFEM 3

estradiol vaginal cream 0.1 mg/gm, vaginal ring 2 mg

ESTRACE 4

estrogens, conjugated vaginal cream 0.625 mg/gm

PREMARIN 3

progesterone vaginal gel 8 % CRINONE 3

Vitamins, Prenatals (Vitaminas, Prenatales)

prenatal caps, tab PRENATAL VITAMIN 4

prenatal caps, tab OBTREX DHA 3

prenatal caps, tab ATABEX 4

OPHTHALMICS (OFTÁLMICOS)

Allergy (Alergia)

Antihistamines (Antihistamínicos)

emedastine ophth soln 0.05 % EMADINE 3

Antihistamines - Mast Cell Stabilizers (Antihistamínicos -Estabilizadores de Mastocitos)

azelastine ophth soln 0.05 % OPTIVAR 1

ketotifen ophth soln 0.025 % ZADITOR / ALAWAY OTC

olopatadine ophth soln 0.1 %, 0.2 % PATANOL / PATADAY 2

Mast Cell Stabilizers (Estabilizadores de Mastocitos)

cromolyn ophth soln 4 % CROLOM 1

lodoxamide ophth soln 0.1 % ALOMIDE 4

nedocromil ophth soln 2 % ALOCRIL 3

Antibiotics (Antibióticos)

bacitracin ophth oint 500 u/gm BACITRACIN 1


ophth oint 1 % CORTISPORIN 1


topical oint 1 % CORTISPORIN 4

bacitracin & neomycin & polymyxin b

ophth oint 400 u/gm-5 mg/gm-10000u/gm

NEOSPORIN 1

bacitracin & polymyxin b

ophth oint 500-10000 u/gm

POLYSPORIN 4

ciprofloxacin ophth soln 0.3 % CILOXAN 1

ciprofloxacin ophth oint 0.3 % CILOXAN 4

47

Medicamentos Drugs



Nivel Level

Inst

dexamethasone & tobramycin

ophth susp 0.1-0.3 % TOBRADEX 1

dexamethasone & tobramycin

ophth oint 0.1-0.3 % TOBRADEX 3

erythromycin ophth oint 5 mg/gm ILOTYCIN 1

gentamicin ophth oint 0.3 %, ophth soln 0.3 %

GARAMYCIN 1

gentamicin & prednisolone acetate

ophth oint 0.3-0.6 %, ophth susp 0.3-1 %

PRED-G 4

moxifloxacin ophth soln 0.5 % VIGAMOX 2

natamycin ophth susp 5 % NATACYN 4

neomycin & polymyxin & dexamethasone

ophth oint 0.1 %, ophth susp 0.1 %

MAXITROL 4

neomycin & polymyxin & gramicidin

ophth soln NEOSPORIN 1

neomycin & polymyxin & hydrocortisone

ophth susp 1 % CORTISPORIN 3

ofloxacin ophth soln 0.3 % OCUFLOX 1

polymyxin b & trimethoprim

ophth soln 10000 u/ml-0.1 %

POLYTRIM 4

sulfacetamide sodium

ophth soln 10 % BLEPH-10 4

sulfacetamide sodium & prednisolone

ophth oint 10-0.2 %, ophth susp 10-0.2 %

BLEPHAMIDE 4

sulfacetamide sodium & prednisolone

ophth soln 10-0.23 % VASOCIDIN 4

tobramycin ophth soln 0.3 % TOBREX 1

tobramycin ophth oint 0.3 % TOBREX 3

trifluridine ophth soln 1 % VIROPTIC 1

Corticosteroids (Corticosteroides)

dexamethasone ophth susp 0.1 % MAXIDEX 3

dexamethasone sodium phosphate

ophth soln 0.1 % DECADRON 1

fluorometholone ophth susp 0.1 % FML 1

fluorometholone ophth oint 0.1 %, ophth susp 0.25 %

FML 3

fluorometholone acetate

ophth susp 0.1 % FLAREX 4

loteprednol ophth susp 0.2 %, 0.5 % ALREX / LOTEMAX 4

prednisolone acetate ophth susp 0.12 % PRED MILD 3

48

Medicamentos Drugs



Nivel Level

Inst

prednisolone sodium phosphate

ophth soln 1 % INFLAMASE 4

rimexolone ophth susp 1 % VEXOL 4

Glaucoma (Glaucoma)

Adrenergic Selective Agonists (Agonistas Adrenérgicos Selectivos)

apraclonidine ophth soln 1 % IOPIDINE 4

apraclonidine ophth soln 0.5 % IOPIDINE 4

brimonidine ophth soln 0.15 %, 0.2 % ALPHAGAN P 1

brimonidine ophth soln 0.1 % ALPHAGAN P 3

dipivefrin ophth soln 0.1 % PROPINE 4

Beta Blockers (Bloqueadores Beta)

betaxolol ophth soln 0.5 %, ophth susp 0.25 %

BETOPTIC-S / BETAXOLOL

4

carteolol ophth soln 1 % OCUPRESS 4

levobunolol ophth soln 0.25 %, 0.5 % BETAGAN 4

metipranolol ophth soln 0.3 % OPTIPRANOLOL 4

timolol ophth gel soln 0.25 %, 0.5 %, ophth soln 0.25 %, 0.5 %

TIMOPTIC / TIMOPTIC-XE

1

timolol ophth soln 0.25 %, 0.5 % BETIMOL 3

Carbonic Anhydrase Inhibitors (Inhibidores de la Anhidrasa Carbónica)

brinzolamide ophth susp 1 % AZOPT 2

dorzolamide ophth soln 2 % TRUSOPT 1


brimonidine & timolol ophth soln 0.2-0.5 % COMBIGAN 4

dorzolamide & timolol

ophth soln 2-0.5 % COSOPT 1

Miotics (Mióticos)

pilocarpine ophth soln 1 %, 2 %, 4 % ISOPTO CARPINE 1

pilocarpine ophth gel 4 % PILOPINE HS 4

pilocarpine ophth soln 0.5 %, 3 %, 6 %

ISOPTO CARPINE 4

Prostaglandins (Prostaglandinas)

bimatoprost ophth soln 0.03 % LUMIGAN 4

latanoprost ophth soln 0.004 % XALATAN 3

travoprost ophth soln 0.004 % TRAVATAN Z/ TRAVATAN

3


atropine ophth soln 1 %, 1 % ISOPTO ATROPINE 1

cyclopentolate ophth soln 0.5 %, 2 % CYCLOGYL 4

cyclopentolate ophth soln 1 % CYCLOGYL 4

cyclosporine ophth emulsion 0.05 % RESTASIS 4 PA SL

49

Medicamentos Drugs



Nivel Level

Inst

naphazoline ophth soln 0.1 % ALBALON 4

tropicamide ophth soln 0.5 %, 1 % MYDRIACYL 4

Non-Steroidal Anti-Inflamatory Drugs (NSAID`s) (Anti-Inflamatorios No-Esteroidales)

diclofenac ophth soln 0.1 % VOLTAREN 1

flurbiprofen ophth soln 0.03 % OCUFEN 1

ketorolac ophth soln 0.4 %, 0.5 % ACULAR 1

nepafenac ophth susp 0.1 % NEVANAC 2

RESPIRATORY (RESPIRATORIOS)

Antihistamines/Decongestants (Antihistamínicos/Descongestionantes)

Descongestants (Descongestionantes)

acrivastine & pseudoephedrine

caps 8-60 mg SEMPREX-D 4

brompheniramine & phenylephrine

elixir 2-5 mg/5ml, liq 2-7.5 mg/5ml

DECON-A 4

brompheniramine & phenylephrine

liq 4-7.5 mg/5ml VAZOL-D 4

brompheniramine & phenylephrine sr

caps 12h 12-15 mg, 6-7.5 mg

BROMFED 4

brompheniramine & pseudoephedrine

syrup 4-45 mg/5ml SILDEC 4

brompheniramine & pseudoephedrine

liq 1-7.5 mg/ml, 4-60 mg/5ml

J-TAN 4

brompheniramine & pseudoephedrine cr

caps 6-60 mg RESPAHIST 1

brompheniramine & pseudoephedrine sr

tabs 12h 6-45 mg LODRANE 1

brompheniramine & pseudoephedrine sr

caps 12h 9-90 mg BROVEX SR 4

brompheniramine tan & phenylephrine tan

susp 12-20 mg/5ml, 4-5 mg/5ml

BROVEX-D 4

cetirizine & pseudoephedrine sr

tabs 12h 5-120 mg ZYRTEC-D OTC

chlorphen tan & phenyleph tan

tabs 9-25 mg RYNATAN 4

chlorpheniramine & phenylephrine

liq 4-10 mg/5ml ED A-HIST 4


liq 1-2 mg/ml ED A-HIST 4


liq 1-3.5 mg/ml, syrup 4-12.5 mg/5ml

RONDEC 4

chlorpheniramine & phenylephrine cr

tabs 8-20 mg ED A-HIST 4

50

Medicamentos Drugs



Nivel Level

Inst

chlorpheniramine & phenylephrine sr

caps 12h 4-20 mg DALLERGY JR 4

chlorpheniramine & pseudoephedrine

syrup 2-30 mg/5ml DECONAMINE 4

chlorpheniramine & pseudoephedrine

liq 2-30 mg/5ml HISTEX 4

chlorpheniramine & pseudoephedrine cr

caps 8-120 mg DECONAMINE 4

chlorpheniramine & pseudoephedrine sr

tabs 12h 12-120 mg BIOHIST LA 4

chlorpheniramine tan & phenylephrine tan

susp 3-7.5 mg/5ml ALLERX 4


susp 4.5-5 mg/5ml RYNATAN 4


susp 8-10 mg/5ml PEDIATAN D 4

desloratadine & pseudoephedrine sr

tabs 12h 2.5-120 mg, tabs 24h 5-240 mg

CLARINEX-D 2

dexchlorphen tan & pseudoephed tan

susp 3-50 mg/5ml ALLERDUR 4

dexchlorpheniramine syrup 2 mg/5ml DEXCHLORPHENIRAMINE

4

diphenhydramine & phenyleph hcl tannate

tabs chew 12.5-5 mg ALDEX-CT 4

diphenhydramine tan & phenylephrine tan

tabs chew 25-10 mg DYTAN-D 4

fexofenadine & pseudoephedrine sr

tabs 12h 60-120 mg, tabs 24h 180-240 mg

ALLEGRA-D 4

loratadine & pseudoephedrine sr

tabs 12h 5-120 mg, tabs 24h 10-240 mg

CLARITIN-D OTC

phenylephrine & promethazine

syrup 5-6.25 mg/5ml PROMETHAZINE VC 4

pyrilamine tan & phenyleph tan

susp 30-5 mg/5ml, tabs 60-25 mg

RYNA-12 4

tetrahydrozoline nasal soln 0.05 %, 0.1 % TYZINE 4

triprolidine & pseudoephedrine

liq 1.25-45 mg/5ml ZYMINE-D 4

Low Sedation Antihistamines (Anti-histamínicos de Baja Sedación)

carbinoxamine liq 4 mg/5ml, tabs 4 mg PALGIC 4

cetirizine syrup 5 mg/5ml, tabs 10 mg, 5 mg

ZYRTEC OTC

clemastine syrup 0.67 mg/5ml, tabs 2.68 mg

CLEMASTINE 4

51

Medicamentos Drugs



Nivel Level

Inst

cyproheptadine syrup 2 mg/5ml, tabs 4 mg CYPROHEPTADINE 1

diphenhydramine caps 50 mg DIPHENHYDRAMINE 1

diphenhydramine inj 50 mg/ml DIPHENHYDRAMINE 4

fexofenadine tabs 180 mg, 30 mg, 60 mg

ALLEGRA 4

hydroxyzine hydrochloride

syrup 10 mg/5ml, tabs 10 mg, 25 mg, 50 mg

HYDROXYZINE HCL 1

Non-Sedative Antihistamines (Anti-histamínicos No Sedantes)

desloratadine odt 2.5 mg, 5 mg, syrup 0.5 mg/ml, tabs 5 mg

CLARINEX 2

loratadine caps 10 mg, chew tab 5 mg

CLARITIN OTC

loratadine odt 10 mg, syrup 10 mg/10ml, tabs 10 mg

CLARITIN OTC

Antitussives/Expectorants (Antitusivos/Expectorantes)

acetylcysteine inhal 10 %, 20 % ACETYLCYSTEINE 4

benzonatate caps 100 mg, 200 mg TESSALON 1

brompheniramine w/ dm-gg

caps 2-15-200 mg, liq 2-15-200 mg/5ml

TUSNEL 4

carbetapentane & guaifenesin

liq 20-75 mg/5ml EXPECTUSS 4

carbetapentane & guaifenesin

liq 20-100 mg/5ml CARBA-XP 4

carbetapentane cit & pseudoephed hcl tan

susp 20-30 mg/5ml ALLRES D 4

chlorphen tan & carbetapentane tan

tabs 5-60 mg TUSSIZONE-12 4

chlorphen tan & carbetapentane tan

susp 4-30 mg/5ml TUSSI-12 4

chlorphen-pe-methscopolamine

tabs 12h 8-20-2.5 mg EXTENDRYL SR 4

chlorpheniramine & hydrocodone cr

susp 8-10 mg/5ml TUSSIONEX 3

codeine & guaifenesin

tabs 10-300 mg BRONTEX 1

codeine & guaifenesin liq 10-300 mg/20ml BRONTEX 3


liq 200-10 mg/5ml, 300-10 mg/5ml, syrup 10-100 mg/5ml

TUSSO-C 4


syrup 10-100 mg/5ml TUSSI-ORGANIDIN-S NR

4

dextromethorphan & guaifenesin

elixir 20-200 mg/5ml HT-TUSS DM 4

52

Medicamentos Drugs



Nivel Level

Inst


liq 10-100 mg/5ml GANI-TUSS DM NR 4


liq 10-300 mg/5ml, 20-200 mg/5ml, soln 25-225 mg/5ml

TUSSI-ORGANIDIN DM NR

4

dextromethorphan & guaifenesin sr

tabs 12h 28-600 mg RESPA DM 4

dextromethorphan & guaifenesin sr

tabs 12h 60-1200 mg AQUATAB DM 4

dextromethorphan & pot guaiacolsulfonate

liq 15-300 mg/5ml GUIADEX DM 4

guaifenesin liq 250 mg/5ml PHANASIN 4

hydrocodone & homatropine

tabs 5-1.5 mg HYCODAN 4

hydrocodone & homatropine

syrup 5-1.5 mg/5ml HYCODAN 4

phenyleph tan-chlorphen tan-carbet tan

susp 2.5-2-15 mg/ml, 20-8-60 mg/5ml

CARBAPHEN 12 4

phenyleph tan-pyrilamine tan-carbeta tan

susp 5-30-30 mg/5ml, tabs 10-40-60 mg

TUSSI-12D S 4

phenyleph tan-pyrilamine tan-guaifenesin

tabs 25-60-200 mg RYNA-12X 4

phenyleph tan-pyrilamine tan-guaifenesin

susp 5-30-100 mg/5ml RYNA-12X 4

phenyleph-chlorphen w/ dm-gg

liq 5-2-15-150 mg/5ml LARTUS 4

phenyleph-dm-pyril-pot guai-sod cit-cit acid

liq ALBATUSSIN 4

phenyleph-ephed-cpm w/ carbetapentane

tabs 10-10-5-60 mg RYNATUSS 4

phenylephrine & guaifenesin

liq 7.5-100 mg/5ml, 7.5-200 mg/5ml, syrup 7.5-100 mg/5ml

DONATUSSIN 4

phenylephrine & guaifenesin sr

caps 12h 30-400 mg, tabs 12h 18-600 mg

GENEXA LA 4

phenylephrine & guaifenesin sr

tabs 12h 25-1200 mg SIMUC-GP 4

phenylephrine w/ codeine-gg

liq 2.5-3-50 mg/ml GILTUSS PED-C 4

53

Medicamentos Drugs



Nivel Level

Inst

phenylephrine w/ dm-gg

liq 2.5-5-75 mg/5ml TUSSI-PRES 4


syrup 10-15-350 mg/5ml BRONTUSS SF 4


syrup 5-15-100 mg/5ml DESPEC DM 4


tabs 12h 20-30-600 mg GILTUSS TR 4


liq 10-30-200 mg/5ml, 5-15-200 mg/5ml

TUSSAFED EX 4


syrup 10-30-200 mg/5ml DYNATUSS EX 4

phenylephrine-brompheniramine-guaifenesin

liq 2-1-40 mg/ml DECON-G 4

phenylephrine-chlorphen-dihydrocodeine

syrup 7.5-2-3 mg/5ml DESPEC-PD 4

phenylephrine-chlorphen-dm

liq 10-4-15 mg/5ml, 3.5-1-3 mg/ml, syrup 10-2-15 mg/5ml, 12.5-4-15 mg/5ml, tabs 12h 20-8-30 mg

ED-A-HIST 4

potassium iodide liq 600 mg/15ml YODEFAN 4

promethazine & codeine

syrup 6.25-10 mg/5ml PROMETHAZINE/CODEINE

1

promethazine dm syrup 6.25-15 mg/5ml PROMETHAZINE/DEXTROMETHORPHAN

1

promethazine vc & codeine

syrup 5-6.25-10 mg/5ml PROMETHAZINE VC/CODEINE

4

pseudoephed tan-dexchlorphen tan-dm tan

susp 75-2.5-25 mg/5ml TANAFED DMX 4

pseudoephed-bromphen-dm

syrup 45-4-15 mg/5ml CARBOFED DM 4

pseudoephed-chlorphen w/ dm-gg

liq 30-2-30-200 mg/5ml NEOTUSS-D 4

pseudoephed-chlorphen-dm

liq 30-2-15 mg/5ml TUSSAFED 4

pseudoephedrine & guaifenesin

syrup 40-200 mg/5ml PSEUDOEPHEDRINE/GUAIFENESIN

4

pseudoephedrine & guaifenesin

liq 5-50 mg/ml TUSNEL 4

54

Medicamentos Drugs



Nivel Level

Inst

pseudoephedrine & guaifenesin sr

tabs 12h 58-600 mg, 60-550 mg, 75-1200 mg

RESPA-1ST 4

pseudoephedrine w/ cod-gg

syrup 15-5-50 mg/5ml TUSNEL PED-C 4

pseudoephedrine w/ cod-gg

soln 30-10-100 mg/5ml, syrup 30-10-100 mg/5ml

CHERATUSSIN 4

pseudoephedrine w/ dm-gg

liq 15-5-50 mg/5ml TUSNEL PEDIATRIC 4

pseudoephedrine w/ dm-gg

liq 30-15-200 mg/5ml, 5-5-25 mg/ml

TUSNEL 4

pseudoephedrine-dihydrocodeine-gg

syrup 15-7.5-100 mg/5ml DESPEC-EXP 4

sodium chloride neb 3 % SODIUM CHLORIDE 4

Asthma (Asma)

Anticholinergics (Anticolinérgicos)

ipratropium neb 0.02 % ATROVENT 1

ipratropium inhal 17 mcg/act ATROVENT HFA 3

ipratropium nasal soln 0.03 %, 0.06 % ATROVENT 4

tiotropium inhal caps 18 mcg SPIRIVA 2

Beta Agonists, Inhaled (Agonistas Beta, Inhalados)

albuterol neb 0.083 %, 0.5 % PROVENTIL 1

albuterol neb 0.63 mg/3ml, 1.25 mg/3ml

ACCUNEB 4

albuterol inhal 108 mcg/act PROAIR HFA 3

albuterol inhal 108 mcg/act PROVENTIL HFA 2

albuterol inhal 108 mcg/act VENTOLIN HFA 3

formoterol inhal caps 12 mcg FORADIL 2

formoterol neb 20 mcg/2ml PERFOROMIST 4

levalbuterol inhal 45 mcg/act XOPENEX HFA 2

levalbuterol neb 0.31 mg/3ml, 0.63 mg/3ml, 1.25 mg/3ml

XOPENEX 4

levalbuterol nebu 1.25 mg/0.5ml XOPENEX CONC 4

pirbuterol inhal 200 mcg/inh MAXAIR 4

salmeterol inhal 50 mcg/dose SEREVENT 2

Beta Agonists, Oral (Agonistas Beta, Orales)

albuterol syrup 2 mg/5ml, tabs 2 mg, 4 mg

PROVENTIL 1

albuterol sr tabs 12h 4 mg, 8 mg VOSPIRE ER 4

metaproterenol tabs 10 mg, 20 mg METAPROTERENOL 4

metaproterenol syrup 10 mg/5ml ALUPENT 4

terbutaline tabs 2.5 mg, 5 mg BRETHINE 1

55

Medicamentos Drugs



Nivel Level

Inst


albuterol & ipratropium inhal 103-18 mcg/act COMBIVENT 4

budesonide & formoterol

inhal 160-4.5 mcg/act, 80-4.5 mcg/act

SYMBICORT 4

fluticasone & salmeterol

inhal 100-50 mcg/dose, 115-21 mcg/act, 230-21 mcg/act, 250-50 mcg/dose, 45-21 mcg/act, 500-50 mcg/dose

ADVAIR DISKUS / ADVAIR HFA

2

Inhaled Corticostroids (Corticosteroides Inhalados)

beclomethasone inhal 40 mcg/act, 80 mcg/act

QVAR 2

budesonide inhal 0.25 mg/2ml, 0.5 mg/2ml

PULMICORT 1

budesonide inhal 1 mg/2ml PULMICORT 3

budesonide inhal 180 mcg/act, 90 mcg/act

PULMICORT FLEXHALER

4

flunisolide inhal 250 mcg/act AEROBID 4

fluticasone inhal 110 mcg/act, 220 mcg/act, 44 mcg/act

FLOVENT HFA 2

fluticasone propionate inhal 100 mcg, 250 mcg, 50 mcg

FLOVENT DISKUS 2

mometasone inhal 110 mcg, 220 mcg/inh

ASMANEX 3

triamcinolone inhal 75 mcg/act AZMACORT 4


cromolyn neb 20 mg/2ml INTAL 1

cromolyn inhal 800 mcg/act INTAL 3

montelukast chew tab 4 mg, 5 mg, pack 4 mg, tabs 10 mg

SINGULAIR 2

zafirlukast tabs 10 mg, 20 mg ACCOLATE 4

zileuton tabs 600 mg ZYFLO 4

Xanthines (Xantinas)

aminophylline tabs 100 mg, 200 mg AMINOPHYLLINE 4

dyphylline elixir 100 mg/15ml, tabs 200 mg, 400 mg

DYLIX 4

dyphylline-guaifenesin liq 100-100 mg/15ml BRONDIL 4

dyphylline-guaifenesin tabs 200-300 mg DYPHYLLINE GG 4

dyphylline-guaifenesin

elixir 100-100 mg/15ml, tabs 200-200 mg, 200-400 mg

LUFYLLIN-GG 4

theophylline elixir 80 mg/15ml ELIXOPHYLLIN 3

56

Medicamentos Drugs



Nivel Level

Inst

theophylline sr tabs 12h 100 mg, 200 mg, 300 mg, 450 mg

THEO-DUR 1

theophylline sr caps 24h 100 mg, 200 mg, 300 mg, 400 mg, tabs 24h 400 mg, 600 mg

THEO-24 SR 3

Intranasal Steroids (Esteroides Intranasales)

beclomethasone nasal susp 42 mcg/spray BECONASE AQ 4

budesonide nasal susp 32 mcg/act RHINOCORT AQUA 4

flunisolide nasal soln 29 mcg/act NASAREL 4

flunisolide nasal soln 0.025 % NASAREL 4

fluticasone propionate

nasal susp 50 mcg/act FLONASE 1

mometasone nasal susp 50 mcg/act NASONEX 2

triamcinolone nasal aerosol 55 mcg/act NASACORT AQ 3

Others (Otros)

azelastine nasal soln 137 mcg/spray ASTELIN 4

SKELETAL-MUSCULE SYSTEM/RHEUMATOLOGY (SISTEMA MÚSCULO-ESQUELETAL/REUMATOLOGÍA)

Gout (Gota)

allopurinol tabs 100 mg, 300 mg ZYLOPRIM 1

colchicine tabs 0.6 mg COLCHICINE 1

colchicine & probenecid

tabs 0.5-500 mg COLCHICINE/PROBENECID

4

probenecid tabs 500 mg BENEMID 1


acetaminophen & salicylamide

tabs 250-600 mg FRENADOL 4

acetaminophen & salicylamide & phenyltoloxamine

caps 300-200-20 mg LOBAC 4

choline & magnesium salicylates

liq 500 mg/5ml, tabs 1000 mg, 500 mg, 750 mg

TRILISATE 4

leflunomide tabs 10 mg, 20 mg ARAVA 4

magnesium salicylate tabs 600 mg MST 600 4

phenyltoloxamine & acetaminophen

liq 30-500 mg/15ml, tabs 60-500 mg

DOLOGESIC 4

phenyltoloxamine & acetaminophen

tabs 30-500 mg, 50-500 mg, 50-650 mg, 60-650 mg

RELAGESIC 4

phenyltoloxamine & acetaminophen cr

tabs 66-600 mg RELAGESIC 4

57

Medicamentos Drugs



Nivel Level

Inst

Rheumatology (Reumatología)

auranofin caps 3 mg RIDAURA 3

azathioprine tabs 50 mg IMURAN 1 SL

methotrexate tabs 2.5 mg METHOTREXATE 1

methotrexate inj 25 mg/ml METHOTREXATE 1 SL

methotrexate tabs 10 mg, 15 mg, 2.5 mg, 5 mg, 7.5 mg

TREXALL 3

penicillamine caps 125 mg, 250 mg, tabs 250 mg

CUPRIMINE 3

Muscle Relaxants (Relajantes Musculares)

ambenonium tabs 10 mg MYTELASE 4

baclofen tabs 10 mg, 20 mg LIORESAL 1

carisoprodol tabs 350 mg SOMA 1

carisoprodol & aspirin

tabs 200-325 mg SOMA COMPOUND 4

carisoprodol & aspirin & codeine

tabs 200-325-16 mg SOMA COMPOUND/CODEINE

4

chlorzoxazone tabs 500 mg PARAFON 1

cyclobenzaprine tabs 10 mg FLEXERIL 1

cyclobenzaprine tabs 5 mg FLEXERIL 4

dantrolene caps 100 mg, 25 mg, 50 mg

DANTRIUM 1

metaxalone tabs 800 mg SKELAXIN 4

methocarbamol tabs 500 mg, 750 mg ROBAXIN 1

methocarbamol inj 100 mg/ml ROBAXIN 3

orphenadrine inj 30 mg/ml NORFLEX 4

orphenadrine & aspirin & caffeine

tabs 50-770-60 mg ORPHENADRINE/ASA/CAFFEINE

4

orphenadrine & aspirin & caffeine

tabs 25-385-30 mg ORPHENADRINE/ASA/CAFFEINE

4

orphenadrine sr tabs 12h 100 mg NORFLEX 4

tizanidine tabs 2 mg, 4 mg ZANAFLEX 4

Non-Steroidal Anti-Inflamatory Drugs (NSAID`s) (Anti-Inflamatorios No-Esteroidales)

celecoxib caps 100 mg, 200 mg, 50 mg

CELEBREX 2

celecoxib caps 400 mg CELEBREX 2 SL

diclofenac & misoprostol

tabs 50-200 mcg, 75-200 mcg

ARTHROTEC 3

diclofenac dr tabs 50 mg, 75 mg VOLTAREN DR 1

diclofenac dr tabs 25 mg VOLTAREN DR 3

diclofenac potassium tabs 50 mg CATAFLAM 4

58

Medicamentos Drugs



Nivel Level

Inst

diclofenac sr tabs 24h 100 mg VOLTAREN-XR 4

diflunisal tabs 500 mg DIFLUNISAL 3

etodolac caps 200 mg, 300 mg, tabs 400 mg, 500 mg

LODINE 1

etodolac sr tabs 24h 400 mg, 500 mg, 600 mg

LODINE XL 4

fenoprofen caps 200 mg NALFON 4

fenoprofen tabs 600 mg NALFON 4

flurbiprofen tabs 100 mg, 50 mg ANSAID 4

ibuprofen tabs 400 mg, 600 mg, 800 mg

MOTRIN 1

indomethacin caps 25 mg, 50 mg INDOCIN 1

indomethacin susp 25 mg/5ml INDOCIN 3

indomethacin rectal supp 50 mg INDOCIN 4

indomethacin cr caps 75 mg INDOCIN SR 1

ketoprofen caps 50 mg, 75 mg ORUDIS 4

ketoprofen sr caps 24h 200 mg KETOPROFEN SR 4

ketorolac inj 15 mg/ml, 30 mg/ml, tabs 10 mg

KETOROLAC 1 QL

meclofenamate caps 100 mg, 50 mg MECLOFENAMATE 4

mefenamic acid caps 250 mg PONSTEL 4

meloxicam tabs 15 mg, 7.5 mg MOBIC 1

meloxicam susp 7.5 mg/5ml MOBIC 4

nabumetone tabs 500 mg, 750 mg RELAFEN 1

naproxen susp 125 mg/5ml, tabs 250 mg, 375 mg, 500 mg

NAPROSYN 1

naproxen ec tabs 375 mg, 500 mg EC-NAPROSYN 1

naproxen sodium tabs 275 mg, 550 mg ANAPROX 1

naproxen sodium sr tabs 24h 375 mg, 500 mg NAPRELAN 4

oxaprozin tabs 600 mg DAYPRO 1

piroxicam caps 10 mg, 20 mg FELDENE 1

salsalate tabs 500 mg, 750 mg DISALCID 1

sulindac tabs 150 mg, 200 mg CLINORIL 1

tolmetin tabs 200 mg, 600 mg TOLMETIN 4

tolmetin caps 400 mg TOLECTIN DS 4

UROLOGY (UROLOGÍA)

5-Alpha Reductase Inhibitors (Inhibidores de la 5-Alpha Reductasa)

dutasteride caps 0.5 mg AVODART 4

finasteride tabs 5 mg PROSCAR 1

Analgesics (Analgésicos)

phenazopyridine tabs 100 mg, 200 mg PYRIDIUM 1

59

Medicamentos Drugs



Nivel Level

Inst

Antispasmodics (Antiespasmódicos)

flavoxate tabs 100 mg URISPAS 1

hyoscyamine tabs 0.15 mg CYSTOSPAZ 1

oxybutynin syrup 5 mg/5ml, tabs 5 mg DITROPAN 1

oxybutynin sr tabs 24h 10 mg, 15 mg, 5 mg

DITROPAN XL 1

tolterodine tabs 1 mg, 2 mg DETROL 2

tolterodine sr caps 24h 2 mg, 4 mg DETROL LA 2

Cholinergics (Colinérgicos)

bethanechol tabs 10 mg, 25 mg, 5 mg, 50 mg

URECHOLINE 1

Erectil Dysfunction (Disfunción Eréctil)

sildenafil citrate tabs 100 mg, 25 mg, 50 mg

VIAGRA 3 QL SL

tadalafil tabs 10 mg, 2.5 mg, 20 mg, 5 mg

CIALIS 3 QL SL

vardenafil hcl tabs 10 mg, 2.5 mg, 20 mg, 5 mg

LEVITRA 4 QL SL


acetohydroxamic acid tabs 250 mg LITHOSTAT 4

methen & meth blue & benz acd & phenyl sal & atro p & hyosc

tabs 81.6 mg URITACT DS 4

methenamine & hyosc & meth blue & sod phos & phenyl sal

tabs 81.6 mg URIN D/S 1

methenamine & hyosc & meth blue & sod phos & phenyl sal

tabs 120 mg URETRON D/S 3

methenamine hippurate

tabs 1 gm HIPREX/UREX 4

pentosan caps 100 mg ELMIRON 4

sodium chloride 0.9 %, irrigation soln 0.45 %

SODIUM CHLORIDE 4

tamsulosin sr caps 24h 0.4 mg FLOMAX 4

tiopronin tabs 100 mg THIOLA 4

Renal Disease (Enfermedad Renal)

calcium acetate caps 667 mg PHOSLO 1

cinacalcet tabs 30 mg, 60 mg, 90 mg SENSIPAR 3 PA SL

60

Medicamentos Drugs



Nivel Level

Inst

doxercalciferol caps 0.5 mcg, 1 mcg, 2.5 mcg

HECTOROL 2 PA SL

doxercalciferol inj 2 mcg/ml HECTOROL 3 PA SL

lanthanum chew tab 1000 mg, 250 mg, 500 mg, 750 mg

FOSRENOL 4 PA SL

paricalcitol caps 1 mcg, 2 mcg, 4 mcg ZEMPLAR 3 PA SL

sevelamer tabs 400 mg, 800 mg RENAGEL 2 PA SL

sevelamer tabs 800 mg, packs 0.8 gm, 2.4 gm

RENVELA 2 PA SL

VITAMINS/HEMATINICS/ELECTROLYTES (VITAMINAS/HEMATÍNICOS/ELECTRÓLITOS)

Alkalinizer (Alkalinizantes)

pot & sod citrates & citric acid

syrup 550-500-334 mg/5ml

POLYCITRA 4

potassium & sodium citrates

tabs 50-950 mg CITROLITH 4

potassium citrate & citric acid

powder 3300-1002 mg, soln 1100-334 mg/5ml

POLYCITRA 1

potassium citrate cr tabs 1080 mg, 540 mg UROCIT-K 4

sodium citrate & citric acid

soln 500-334 mg/5ml BICITRA 1

sodium citrate & citric acid

soln 490-640 mg/5ml ORACIT 4

Antidotes (Antídotos)

deferasirox susp tab 125 mg, 250 mg, 500 mg

EXJADE 3 PA SL

flumazenil inj 0.1 mg/ml ROMAZICON 4

naloxone inj 0.4 mg/ml NALOXONE 4

naltrexone tabs 50 mg REVIA 4

sodium polystyrene sulfonate

powder 454 gm, rectal supp 30 gm/120ml, susp 15 gm/60ml

KAYEXALATE 1

succimer caps 100 mg CHEMET 4

Coagulant Therapy (Terapia de Coagulación)

Anticoagulant (Anticoagulantes)

dalteparin inj 10000 u/ml, 2500 u/0.2ml, 5000 u/0.2ml

FRAGMIN 4

enoxaparin inj 10 mg/0.1ml, 150 mg/ml

LOVENOX 3

fondaparinux inj 2.5 mg/0.2ml, 2.5 mg/0.5ml

ARIXTRA 3

heparin sodium (porcine)

inj 2000 u/ml, 20000 u/ml, 2500 u/ml

HEPARIN SODIUM 4

61

Medicamentos Drugs



Nivel Level

Inst

heparin sodium (porcine)

inj 1000 u/ml, 10000 u/ml, 5000 u/ml

HEPARIN SODIUM 4

tinzaparin inj 20000 u/ml INNOHEP 4

warfarin tabs 1 mg, 10 mg, 2 mg, 2.5 mg, 3 mg, 4 mg, 5 mg, 6 mg, 7.5 mg

COUMADIN 1

Antiplatelet (Antiplaquetarios)

anagrelide caps 0.5 mg, 1 mg AGRYLIN 4

aspirin & dipyridamole sr

caps 12h 25-200 mg AGGRENOX 4

cilostazol tabs 100 mg, 50 mg PLETAL 4

clopidogrel tabs 75 mg PLAVIX 3

dipyridamole tabs 25 mg, 50 mg, 75 mg PERSANTINE 1

ticlopidine tabs 250 mg TICLID 1


aminocaproic acid tabs 1000 mg AMICAR 4

aminocaproic acid syrup 25 %, tabs 500 mg AMICAR 4

pentoxifylline cr tabs 400 mg TRENTAL 1

Vitamins/Hematinics/Other Supplements (Vitaminas/Hematínicos/OtrosSuplementos)

Nutrients (Nutrientes)

dextrose & sodium chloride

inj 5-0.45 %, 5-0.9 % DEXTROSE/SODIUM CHLORIDE

4

levocarnitine soln 1 gm/10ml, tabs 330 mg

CARNITOR 1

levocarnitine inj 200 mg/ml CARNITOR 4

pot bicarbonate & chloride

tabs 25 meq K-LYTE 4

pot phos monobasic & sod phos dibasic & monobasic

tabs 155-852-130 mg K-PHOS NEUTRAL 4

potassium & sodium acid phosphates

tabs 155-350 mg, 305-700 mg

K-PHOS 4

potassium bicarbonate

tabs 25 meq K-LYTE 4

potassium chloride liq 10 %, 2 %, powder 20 meq, 25 meq

KAON 1

potassium chloride cr

caps 10 meq, tabs 10 meq, 8 meq

MICRO-K/SLOW-K 1

potassium chloride cr caps 8 meq MICRO-K/SLOW-K 3

potassium chloride microencapsulated cr

tabs 10 meq, 20 meq K-DUR 1

potassium chloride microencapsulated cr

tabs 15 meq KLOR-CON 3

62

Medicamentos Drugs



Nivel Level

Inst

sodium chloride inj 0.45 %, 0.9 % SODIUM CHLORIDE 4

sodium fluoride lozenge 1mg, soln 0.25 mg/drop

LOZI-FLUR 4

sodium fluoride tabs 0.5 gm SODIUM FLUORIDE 4

sodium fluoride chew tab 0.25 mg, 0.5 mg, 1 mg, soln 0.125 mg/drop, 0.5 mg/ml, tabs

LURIDE 4

Vitamins (Vitaminas)

ascorbic acid inj 500 mg/ml ASCORBIC ACID 1

b-complex & iron inj ALBAFORT S 3

b-complex vitamin inj B-COMPLEX 4

calcitriol caps 0.25 mcg, 0.5 mcg ROCALTROL 1

calcitriol inj 1 mcg/ml, soln 1 mcg/ml

CALCITRIOL 4

cyanocobalamin inj 1000 mcg/ml CYANOCOBALAMIN 1

ergocalciferol caps 50000 u DRISDOL 4

ferric ammon cit-vit b12-liver

inj ALBAFORT 3

folic acid tabs 1 mg FOLVITE 1

folic acid inj 5 mg/ml FOLIC ACID 4

hydroxocobalamin inj 1000 mcg/ml HYDROXOCOBALAMIN

4

iron dextran inj 50 mg/ml INFED 4

leucovorin tabs 25 mg, 5 mg LEUCOVORIN 1

leucovorin tabs 10 mg, 15 mg LEUCOVORIN 3

multiple vitamin inj CERNEVIT 4

multiple vitamin inj M.V.I. PEDIATRIC 4

phytonadione inj 2 mg/ml VITAMIN K1 1

phytonadione inj 10 mg/ml, tabs 5 mg VITAMIN K1 3

pyridoxine hcl inj 100 mg/ml PYRIDOXINE HCL 1

sodium ascorbate inj 250 mg/ml, 500 mg/ml VITAMIN C 4

thiamine hcl inj 100 mg/ml THIAMINE HCL 1

vitamin a inj 50000/ml AQUASOL A 4

63

Medicamentos Drugs



Nivel Level

Inst

PRODUCTOS ESPECIALIZADOS – LOS SIGUIENTES PRODUCTOS ESPECIALIZADOS, CONOCIDOS TAMBIÉN COMO MEDICAMENTOS PARA EL TRATAMIENTO DE CONDICIONES CRÓNICAS Y DE ALTO RIESGO, POR LO GENERAL SON ASIGNADOS A UN NIVEL ESPECÍFICO BAJO SU BENEFICIO DE FARMACIA. SI SU BENEFICIO DE FARMACIA NO ESTABLECE UN NIVEL ESPECÍFICO PARA ESTOS PRODUCTOS APLICARÁ EL NIVEL INDICADO EN LA COLUMNA DE ESTA SECCIÓN.

SPECIALTY PRODUCTS – THE FOLLOWING SPECIALTY PRODUCTS, KNOWN ALSO AS DRUGS FOR THE TREATMENT OF CHRONIC AND HIGH RISK CONDITIONS, ARE GENERALLY ASSIGNED TO A SPECIFIC LEVEL UNDER YOUR PHARMACY BENEFIT. IF YOUR PHARMACY BENEFIT DOES NOT ESTABLISH A SPECIFIC LEVEL FOR THESE PRODUCTS LEVEL INDICATED IN THE COLUMN OF THIS SECTION WILL APPLY.

Anti-Infectives (Anti-Infecciosos)


amphotericin b inj 100 mg, 5 mg/ml, 50 mg

AMPHOTEC 4

amphotericin b inj 50 mg AMPHOTERICIN B 4

anidulafungin inj 100 mg, 50 mg ERAXIS 4 SL

caspofungin inj 50 mg, 70 mg CANCIDAS 4 SL

fluconazole & dextrose

inj 200 mg/100ml, 400 mg/200ml

DIFLUCAN 4 SL

fluconazole & sodium chloride

inj 200 mg/100ml, 400 mg/200ml

DIFLUCAN 4 SL

micafungin inj 100 mg, 50 mg MYCAMINE 4 SL

voriconazole inj 200 mg VFEND 4 SL


tobramycin neb 300 mg/5ml TOBI 3

tobramycin inj 10 mg/ml TOBRAMYCIN 4

tobramycin inj 1.2 gm, 10 mg/ml, 40 mg/ml

TOBRAMYCIN 4

Antivirals (Antivirales)

Hepatitis B (Hepatitis B)

adefovir tabs 10 mg HEPSERA 3 PA SL

entecavir soln 0.05 mg/ml, tabs 0.5 mg, 1 mg

BARACLUDE 3 PA SL

lamivudine soln 5 mg/ml, tabs 100 mg EPIVIR HBV 3 PA SL

telbivudine tabs 600 mg TYZEKA 3 PA SL

Hepatitis C (Hepatitis C)

interferon alfacon-1 inj 30 mcg/ml INFERGEN 3

peginterferon alfa-2a inj 180 mcg/0.5ml, 180 mcg/ml

PEGASYS 2 PA SL

64

Medicamentos Drugs



Nivel Level

Inst

peginterferon alfa-2b inj 120 mcg/0.5ml, 150 mcg/0.5ml, 50 mcg/0.5ml, 80 mcg/0.5ml

PEG-INTRON 2 PA SL

ribavirin caps 200 mg, tabs 200 mg COPEGUS / REBETOL

1 PA SL

ribavirin inhal 6 gm VIRAZOLE 3

ribavirin pack 400&600 mg RIBAPAK 3 PA SL

HIV/AIDS (VIH/SIDA)

Fusion Inihibitor (Inhibidores de la Fusion)

enfuvirtide inj 90 mg FUZEON 3 PA SL

Biotechnology (Biotecnología)

Enzyme Replacement (Remplazo Enzimático)

alglucerase inj 80 u/ml CEREDASE 4

betain soln CYSTADANE 4

cysteamine caps 150 mg, 50 mg CYSTAGON 4

imiglucerase inj 200 u, 400 u CEREZYME 4

pegademase inj 250 u/ml ADAGEN 4

proteinase inhibitor inj 1000 mg, 500 mg PROLASTIN 4

sodium phenylbutyrate powder 3 gm/5ml, tabs 500 mg

BUPHENYL 4

Erythropoiesis Stimulating Proteins (Estimulantes Esteroides)

epoetin alfa inj 10000 u/ml, 2000 u/ml, 20000 u/ml, 3000 u/ml, 4000 u/ml, 40000 u/ml

PROCRIT 2 PA

epoetin alfa inj 10000 u/ml, 2000 u/ml, 20000 u/ml, 3000 u/ml, 4000 u/ml, 40000 u/ml

EPOGEN 3 PA

oprelvekin inj 5 mg NEUMEGA 4

Multiple Sclerosis (Esclerosios Múltiple)

glatiramer inj 20 mg/ml COPAXONE 2

interferon beta-1a inj 30 mcg, 30 mcg/0.5ml AVONEX 2

interferon beta-1a inj 22 mcg/0.5ml, 44 mcg/0.5ml, 8.8 mcg/0.2ml&22 mcg/0.5ml

REBIF 3

interferon beta-1b inj 0.3 mg BETASERON 3

natalizumab inj 300 mg/15ml TYSABRI 4

Myeloid Stimulating Agents (Estimulantes Mieloides)

filgrastim inj 300 mcg/ml, 600 mcg/ml

NEUPOGEN 3

pegfilgrastim inj 6 mg/0.6ml NEULASTA 4

sargramostim inj 250 mcg LEUKINE 3

sargramostim inj 500 mcg/ml LEUKINE 4

65

Medicamentos Drugs



Nivel Level

Inst

Cancer (Cáncer)

Alkylating Agents (Agentes Alquilantes)

temozolomide caps 100 mg, 140 mg, 180mg, 20 mg, 250 mg, 5 mg

TEMODAR 4

Antimetabolites (Antimetabólitos)

capecitabine tabs 150 mg, 500 mg XELODA 4

fludarabine tabs 10 mg OFORTA 4 PA SL


dasatinib tabs 100 mg, 20 mg, 50 mg, 70 mg

SPRYCEL 4 PA SL

erlotinib tabs 100 mg, 150 mg, 25 mg

TARCEVA 3 PA SL

everolimus tabs 10 mg, 5 mg AFINITOR 4 PA SL

imatinib mesylate tabs 100 mg, 400 mg GLEEVEC 3 PA SL

lapatinib ditosylate tabs 250 mg TYKERB 3 PA SL

lenalidomide caps 10 mg, 15 mg, 25 mg, 5 mg

REVLIMID 4 PA SL

mitoxantrone inj 2 mg/ml NOVANTRONE 4

nilotinib caps 200 mg TASIGNA 4 PA SL

pazopanib tabs 200 mg VOTRIENT 3 PA SL

sorafenib tosylate tabs 200 mg NEXAVAR 3 PA SL

sunitinib malate caps 12.5 mg, 25 mg, 50 mg

SUTENT 3 PA SL

thalidomide caps 100 mg, 150 mg, 200 mg, 50 mg

THALOMID 4

vorinostat caps 100 mg ZOLINZA 4 PA SL

Cardiovasculars (Cardiovasculares)

ambrisentan tabs 10 mg, 5 mg LETAIRIS 4 PA SL

bosentan tabs 125 mg, 62.5 mg TRACLEER 4 PA SL

epoprostenol sodium inj 0.5 mg, 1.5 mg FLOLAN 4 PA SL

iloprost inhal 10 mcg/ml, 20 mcg/ml

VENTAVIS 4 PA SL

sildenafil tabs 20 mg REVATIO 4 PA SL

treprostinil inj 1 mg/ml, 10 mg/ml, 2.5 mg/ml, 5 mg/ml

REMODULIN 4 PA SL

Central Nervous System (Sistema Nervioso Central)

sodium oxybate soln 50 mg/5ml XYREM 4 PA SL

Endocrinology (Endocrinológicos)

Growth Hormones (Hormonas de Crecimiento)

somatropin inj 1 mg GENOTROPIN 3 PA SL

somatropin inj 5 mg, 8.8 mg SAIZEN 3 PA SL

66

Medicamentos Drugs



Nivel Level

Inst

somatropin inj 0.2 mg, 0.4 mg, 0.6 mg, 0.8 mg, 1.2 mg, 1.4 mg, 1.6 mg, 1.8 mg, 13.8 mg, 2 mg

GENOTROPIN 3 PA SL

somatropin inj 4 mg, 5 mg, 6 mg SEROSTIM 3 PA SL

somatropin inj 10 mg, 20 mg/2ml, 5 mg, 5 mg/ml

NUTROPIN 3 PA SL

somatropin inj 12 mg, 24 mg, 5 mg, 6 mg

HUMATROPE 4 PA SL

somatropin inj 5 mg/1.5ml, 5.8 mg OMNITROPE 3 PA SL

somatropin inj 5 mg TEV-TROPIN 3 PA SL

somatropin inj 15 mg/1.5ml, 5 mg/1.5ml

NORDITROPIN 3 PA SL


lanreotide acetate inj 120 mg/0.5ml, 60 mg/0.2ml, 90 mg/0.3ml

SOMATULINE DEPOT 4 PA SL

octreotide inj 0.05 mg/ml, 0.1 mg/ml, 0.2 mg/ml, 0.5 mg/ml, 1 mg/ml

SANDOSTATIN 1 PA SL

octreotide inj 10 mg, 20 mg, 30 mg SANDOSTATIN LAR 3 PA SL

Others (Otros)

desmopressin nasal soln 1.5 mg/ml STIMATE 3

Obstretrics/Ginegology (Obstetricia/Ginecología)

Osteoporosis (Osteoporosis)

Biphosphonates (Bifosfonatos)

ibandronate inj 3 mg/3ml BONIVA 4 PA

pamidronate inj 6 mg/ml AREDIA 4

pamidronate inj 3 mg/ml, 30 mg, 9 mg/ml, 90 mg

AREDIA 4

zoledronic soln 5 mg/100ml RECLAST 4 QL PA


teriparatide inj 750 mcg/3ml FORTEO 3 PA SL

Respiratory (Respiratorios)

Others (Otros)

dornase alfa inhal 1 mg/ml PULMOZYME 4

Skeletal-Muscule System/Rheumatology (Sistema Músculo-Esqueletal/Reumatología)


abatacept inj 250 mg ORENCIA 3 PA SL

adalimumab inj 20 mg/0.4ml, 40 mg/0.8ml

HUMIRA 2 PA SL

etanercept inj 25 mg, 50 mg/ml ENBREL 2 PA SL

67

Medicamentos Drugs



Nivel Level

Inst

Vitamins/Hematinics/Other Supplements (Vitaminas/Hematínicos/OtrosSuplementos)

Coagulant Theraphy (Terapia de Coagulación)


antihemophilic factor inj 401-800 u, 500 u, 801-1700 u

HEMOFIL M 3 PA SL

antihemophilic factor (human)

inj 1000 u, 1000 u, 1500 u, 1701-2000 u, 220-400 u, 220-400 u, 250 u, 250 u, 401-800 u, 500 u

KOATE-DVI 3 PA SL

antihemophilic factor (human)

inj 450-450 u, 900-900 u WILATE 4 PA SL

antihemophilic factor (recombinant)

inj 1000 u, 2000 u, 250 u, 500 u, 801-1240 u

REFACTO 3 PA SL

antihemophilic factor rahf-pfm

inj 1000 u, 1500 u, 2000 u, 250 u, 3000 u, 500 u

ADVATE 4 PA SL

antihemophilic factor/vwf

inj 250-500 u, 250-600 u HUMATE-P 3 PA SL

antihemophilic factor/vwf (human)

inj 1000 u, 1000-2000 u, 1000-2400 u, 1500 u, 250 u, 500 u, 500-1000 u, 500-1200 u

ALPHANATE 3 PA SL

antiinhibitor coagulant complex

inj FEIBA VH 3 PA SL

coagulation factor ix inj , 1000 u, 1500 u, 500 u MONONINE 3 PA SL

coagulation factor ix (recombinant)

inj BENEFIX 3 PA

coagulation factor ix (recombinant)

inj , 1000 u, 2000 u BENEFIX 3 PA SL

coagulation factor viia (recombinant)

inj 1 mg, 1200 mcg, 2 mg, 2400 mcg, 4800 mcg, 5 mg

NOVOSEVEN 3 PA SL

factor ix complex inj 1000 u, 1500 u, 200-1200 u, 500 u

PROFILNINE 3 PA SL

68

APÉNDICE I / APPENDIX I

QL - Límite de cantidad / Quantity Limit

Dentro de la Lista se encuentran medicamentos asociados a las iniciales QL. QL significa que estos medicamentos tienen un límite de cantidad. Los siguientes productos indican un límite de cantidad. / The List includes drugs associated to the QL initials. QL means that those medications have a limit in the quantity. The following list indicates the quantity limits.

1. Aprepitant (Emend®)

a. Emend® Therapy Pack- se despachará un (1) empaque cada siete (7) días. / Emend® Therapy Pack – up to one (1) pack every 7 days will be dispensed.

b. Emend® 125mg- se despachará una (1) cápsula cada siete (7) días. / Emend® 125mg – up to one (1) capsule every 7 days will be dispensed.

c. Emend® 80mg- se despacharán dos (2) cápsulas cada siete (7) días. / Emend® 80mg – up to two (2) capsules every 7 days will be dispensed.

2. Artemether & lumefantrine (Coartem®) - se despachará una cantidad máxima de

veinticuatro (24) tabletas en 365 días de terapia / up to twenty four (24) tablets every 365 days of therapy.

3. Ciclopirox soln 8% (Penlac®) - se despachará una (1) botella en noventa (90)

días/ up to one (1) bottle every nighty (90) days.

4. Ciprofloxacin XR (Cipro XR®)

b. Cipro XR 500mg – se despachará una cantidad máxima para tres (3) días de terapia. / Cipro XR 500mg- up to (3) three days of therapy will be dispensed.

c. Cipro XR 1000mg – se despachará una cantidad máxima para catorce (14) días de terapia. / Cipro XR 1000mg- up to (14) fourteen days of therapy will be dispensed.

5. Ketorolac (Toradol ) - se despachará una cantidad máxima para cinco (5) días de terapia / up to (5) five days of therapy will be dispensed.

6. Lubiprostone (Amitiza ) - se despachará una cantidad máxima de sesenta (60) tabletas para 30 días de terapia / up to sixty (60) tablets every 30 days of therapy.

7. Methylnaltrexone (Relistor )

a. Vials - Se despachará 7 (siete) vials (1vial = 0.6 ml) para 15 días de terapia / up to 7 (seven) vials (1vial =0.6 ml) every 15 days of therapy.

b. Kits - Se despachará 7 (siete) kits para 15 días de terapia / up to 7 (seven) kits every 15 days of therapy.

69

8. Triptanos – La siguiente tabla se presenta solamente como referencia. Para

información sobre cuáles de los productos están incluidos en el Formulario referiérase a la Sección 3.2 – Migraña. / The following table is presented as reference only. For information about which product are included in the Formulary refer to Section 3.2 – Migraine.

Producto Product

Nombre genérico Generic Name

Cantidad máxima en un período de 30 días

Maximun quantity within a 30-day period

Imitrex Injection 6mg single dose vials (0.5ml in 2ml)

a Sumatriptan 5 ampolletas / 5 ampoule

Imitrex pre-filled syringe

a Sumatriptan 8 jeringuillas / 8 syringes

Imitrex STATdose systema

Sumatriptan 4 kits (8 jeringuillas / 8 syringes)

Imitrex STATdose system Refill

a Sumatriptan

4 kits (8 jeringuillas /8 syringes)

Imitrex Nasal Spray 5mg

b Sumatriptan 6 dosis (1 caja / 1 box)

Imitrex Nasal Spray 20mg

b Sumatriptan

6 dosis (1 caja /1 box)

Imitrex 25mg

c, d Sumatriptan 18 tabs

Imitrex 50mg

c, d Sumatriptan 18 tabs

Imitrex 100mg

c,d Sumatriptan 9 tabs

Zomig 2.5mge

Zolmitriptan 6 tabs

Zomig 5mge

Zolmitriptan 6 tabs

Zomig Nasal Spray 5mge Zolmitriptan 6 dosis / 6 doses

Amerge 1mgf

Naratriptan 9 tabs

Amerge 2.5mgf

Naratriptan 9 tabs

Maxalt 5mgg, h

Rizatriptan

24 tabs; 12 tabs si toma propranolol concurrentemente / if takes propranolol concurrently

Maxalt 10mgg, h

Rizatriptan

12 tabs; No se debe utilizar en pacientes que toman propranolol concurrentemente / It shouldn’t use in patients that take propranolol concurrently

70

Producto Product

Nombre genérico Generic Name

Cantidad máxima en un período de 30 días

Maximun quantity within a 30-day period

Axert 6.25mg i Almotriptan

6 tabs

Axert 12.5mg

i Almotriptan 6 tabs

Frova 2.5mg

j Frovatriptan 9 tabs

Relpax 20mg

k Eletriptan 6 tabs

Relpax 40mg

k Eletriptan 6 tabs

a. Si no se observa respuesta adecuada, se puede repetir la dosis una vez luego de 2 horas hasta un máximo de

12mg en 24 horas. / If adequate response is not observed, the dose can be repeated once again alter two hours up to a maximum of 12 mg in 24 hours.

b. Si no se observa respuesta adecuada, se puede repetir la dosis una vez luego de 2 horas hasta un máximo de 40mg en 24 horas. /If adequate response is not observed, the dose can be repeated once again alter two hours up to a maximum of 40 mg in 24 hours.

c. Si no se observa respuesta adecuada, se puede repetir la dosis una vez luego de 2 horas hasta un máximo de 200mg en 24 horas. / If adequate response is not observed, the dose can be repeated once again alter two hours up to a maximum of 200 mg in 24 hours.

d. Si el producto inyectable se usa concomitantemente, la dosis oral máxima no debe exceder 100mg / If the injectable product is used jointly, the maximum oral dose should not exceed 100mg.

e. Los estudios clínicos no han establecido la efectividad de una segunda dosis si la primera es inefectiva. Si no se observa respuesta adecuada, se puede repetir la dosis una vez luego de 2 horas hasta un máximo de 10mg en 24 horas. / The clinical studies have not established the effectiveness of a second dose if the first one is ineffective. If adequate response is not observed, the dose can be repeated once again after two hours up to a maximum of 10mg in 24 hours.

f. Si no se observa respuesta adecuada, se puede repetir la dosis una vez luego de 4 horas hasta un máximo de 5mg en 24 horas. / If adequate response is not observed, the dose can be repeated after four hours up to a maximum of 5mg in 24 hours.

g. Si no se observa respuesta adecuada, se puede repetir la dosis luego de 2 horas hasta un máximo de 30mg en 24 horas. / If adequate response is not observed, the dose can be repeated after two hours up to a maximum of 30mg in 24 hours.

h. En pacientes que reciben propranolol concomitantemente, la dosis de 5mg de rizatriptan debe usarse hasta un máximo de 3 dosis (15mg) en 24 horas. / In patients that receive propranolol jointly, the 5mg dose of rizatriptan should be up to a maximum of three doses (15mg) in 24 hours.

i. Si no se observa respuesta adecuada, se puede repetir la dosis una vez luego de 2 horas hasta un máximo de 25mg en 24 horas. / If adequate response is not observed, the dose can be repeated after two hours up to a maximum of 25mg in 24 hours.

j. Si no se observa respuesta adecuada, se puede repetir la dosis en 2 horas hasta un máximo de 7.5mg en 24 horas. / If adequate response is not observed, the dose can be repeated after two hours up to a maximum of 7.5mg in 24 hours.

k. Si no se observa respuesta adecuada, se puede repetir la dosis en 2 horas hasta un máximo de 80mg en 24 horas. No exceder de 40mg por dosis. / If adequate response is not observed, the dose can be repeated after two hours up to a maximum of 80mg in 24 hours. Do not exceed 40mg per dose.

9. Sildenafil (Viagra®), Tadalafil (Cialis®), Vardenafil (Levitra®)

a. Se despachará una cantidad máxima de seis (6) tabletas en 30 días de

terapia / up to six (6) tablets every 30 days of therapy.

10. Atovaquone & proguanil (Malarone®)

a. Atovaquone & proguanil 62.5-25mg - se despachará una cantidad máxima de cuarenta y ocho (48) tabletas en 365 días de terapia / up to fourty eight (48) tablets every 365 days of therapy.

71

b. Atovaquone & proguanil 250-100mg - se despachará una cantidad máxima de doce (12) tabletas en 365 días de terapia / up to twelve (12) tablets every 365 days of therapy.

11. Quinine sulfate (Qualaquin®) - se despachará una cantidad máxima de cuarenta y

dos (42) cápsulas en 365 días de terapia / up to forty-two (42) capsules every 365 days of therapy.

12. Terbinafine (Lamisil®) - se despachará una cantidad máxima de ochenta y cuatro

(84) tabletas en 365 días de terapia / up to eighty four (84) tablets every 365 days of therapy.

13. Zoledronic acid (Reclast®) – se despachará una cantidad máxima de cien (100) ml

en 274 días de terapia / up to one hundred (100) ml every 274 days of therapy.

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APÉNDICE II / APPENDIX II

SL - Límite de especialidad / Specialty Limit

Dentro de la Lista se encuentran medicamentos asociados a las iniciales SL. SL significa que estos medicamentos requieren que un especialista evalúe el paciente y los recete. La siguiente tabla enumera cuáles son estos productos y señala el especialista que debe prescribirlos. / This List includes drugs associated to the SL initials. SL means that those medications require that a specialist evaluates the patient and prescribe it. The following table enumerates which are those products and indicate the specialist that must prescribe it.

Producto Product

Especialista Specialist

Afinitor Hematólogo-Oncólogo / Hematologist-Oncologist

Amitiza Gastroenterólogo, Medicina Interna / Gastroenterologist, Internal Medicine

Aptivus Infectólogo / Infectologist

Banzel Neurólogo, Neurólogo Pediátrico/ Neurologist, Pediatric Neurologist

Baraclude Gastroenterólogo, Infectólogo / Gastroenterologist, Infectologist

Cancidas Infectólogo, Hematólogo-Oncólogo / Infectologist, Hematologist-Oncologist

Celebrex 400mg Gastroenterólogo / Gastroenterologist

Cellcept Reumatólogo / Rheumatologist

Cialis Urólogo, Endocrinólogo / Urologist, Endocrinologist

Antihemophilic & Coagulation Factors

Hematólogo /Hematologist

Copegus Gastroenterólogo, Infectólogo / Gastroenterologist, Infectologist

Differin gel 0.3% Dermatólogo/ Dermatologist

Diflucan inj Infectólogo, Hematólogo-Oncólogo / Infectologist, Hematologist-Oncologist

Emend Oncólogo / Oncologist

Enbrel Reumatólogo, Dermatólogo / Rheumatologist, Dermatologist

Entocort EC Gastroenterólogo / Gastroenterologist

Epivir HBV Gastroenterólogo, Infectólogo / Gastroenterologist, Infectologist

Eraxis Infectólogo, Hematólogo-Oncólogo / Infectologist, Hematologist-Oncologist

Exjade Hematólogo-Oncólogo / Hematologist-Oncologist

Flolan Cardiólogo, Neumólogo, Intensivista/ Cardiologist, Pneumologist, Intensivist

Forteo Endocrinólogo, Reumatólogo / Endocrinologist, Rheumatologist

Fosrenol Nefrólogo/ Nephrologist

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Producto Product


Fuzeon Infectólogo / Infectologist

Gleevec Oncólogo / Oncologist

Hectorol Nefrólogo / Nephrologist

Hepsera Gastroenterólogo, Infectólogo / Gastroenterologist, Infectologist

Hormonas de Crecimiento / Growth Hormone

Endocrinólogo / Endocrinologist

Humira Reumatólogo, Dermatólogo, Gastroenterólogo / Rheumatologist, Dermatologist, Gastroenterologist

Imuran Reumatólogo, Dermatólogo, Nefrólogo, Neumólogo, Gastroenterólogo / Rheumatologist, Dermatologist, Nephrologist, Pneumologist, Gastroenterologist

Intelence Infectólogo / Infectologist

Letairis Cardiólogo, Neumólogo, Intensivista/ Cardiologist, Pneumologist, Intensivist

Levitra Urólogo, Endocrinólogo / Urologist, Endocrinologist

Methotrexate inj. Reumatólogo / Rheumatologist

Mycamine Infectólogo, Hematólogo-Oncólogo / Infectologist, Hematologist-Oncologist

Nexavar Gastroenterólogo, Hematólogo-Oncólogo / Gastroenterologist, Hematologist-Oncologist

Noxafil Infectólogo / Infectologist

Oforta Hematólogo-Oncológo / Hematologist-Oncologist

Orencia Reumatólogo / Rheumatologist

Peg-Intron Gastroenterólogo, Infectólogo / Gastroenterologist, Infectologist

Pegasys Gastroenterólogo, Infectólogo / Gastroenterologist, Infectologist

Ranexa Cardiólogo / Cardiologist

Rebetol Gastroenterólogo, Infectólogo / Gastroenterologist, Infectologist

Renagel, Renvela Nefrólogo/ Nephrologist

Remodulin Cardiólogo, Neumólogo, Intensivista/ Cardiologist, Pneumologist, Intensivist

Restasis Oftalmólogo/ Ophthalmologist

Retin A Dermatólogo / Dermatologist

Revatio Cardiólogo, Neumólogo, Intensivista/ Cardiologist, Pneumologist, Intensivist

Revlimid Hematólogo-Oncológo / Hematologist-Oncologist

Ribapak Gastroenterólogo, Infectólogo / Gastroenterologist, Infectologist

Sandostatin, Sandostatin LAR Endocrinólogo, Gastroenterólogo, Hematólogo-Oncólogo/ Endocrinologist, Gastroenterologist, Hematologist-Oncologist

Sensipar Nefrólogo / Nephrologist

Selzentry Infectólogo / Infectologist

Somatuline Endocrinólogo/ Endocrinologist

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Producto Product


Sprycel Hematólogo-Oncológo / Hematologist-Oncologist

Sutent Hematólogo-Oncológo / Hematologist-Oncologist

Tarceva Oncólogo / Oncologist

Tasigna Hematólogo-Oncológo / Hematologist-Oncologis

Tracleer Cardiólogo, Neumólogo, Intensivista/ Cardiologist, Pneumologist, Intensivist

Tykerb Hematólogo-Oncológo / Hematologist-Oncologist

Tyzeka Gastroenterólogo, Infectólogo / Gastroenterologist, Infectologist

Ventavis Cardiólogo, Neumólogo, Intensivista/ Cardiologist, Pneumologist, Intensivist

Vimpat Neurólogo, Neurólogo Pediatrico/ Neurologist, Pediatric Neurologist

Viread Gastroenterólogo, Infectólogo / Gastroenterologist, Infectologist

Vfend Infectólogo, Hematólogo-Oncólogo / Infectologist, Hematologist-Oncologist

Viagra Urólogo, Endocrinólogo / Urologist, Endocrinologist

Votrient Hematólogo-Oncológo / Hematologist-Oncologist

Xyrem Neumólogo, Neurólogo, Siquiatra / Pneumologist, Neurologist, Psychatrist

Zemplar Nefrólogo / Nephrologist

Zolinza Dermatólogo, Hematólogo-Oncólogo / Dermatologist, Hematologist-Oncologist

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APÉNDICE III / APPENDIX III

AL - Límite de edad / Age Limit

Dentro de la Lista se encuentran medicamentos asociados a las iniciales AL. AL significa que estos medicamentos tienen un límite de edad. / This List includes medications associated to the initials AL. AL means that those medications have a limit in the age.

Producto Product

Límite de Edad Age Limit

AMCINONIDE AL BETA-VAL AL

CLOBEX AL

CYCLOCORT AL DIFFERIN AL

DIPROLENE AL

DIPROSONE AL HALOG AL

KENALOG AL

LIDEX AL LOTRISONE AL

LUXIQ AL

OLUX AL PANDEL AL

PSORCON / PSORCON E AL

RETIN-A AL STRATTERA AL*

SYNALAR AL

TEMOVATE AL TOPICORT AL

ULTRAVATE AL

VALISONE AL *De 6-18 años serán manejados por terapia escalonada (ST); mayores de 19 años serán manejados por pre-autorización (PA) / From 6-18 years a step therapy (ST) will apply; older than 19 years will be managed by pre-authorization (PA).

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APÉNDICE IV / APPENDIX IV

PA - Preautorización / Pre-Authorization

Dentro de la Lista se encuentran medicamentos asociados a las iniciales PA. PA significa preautorización. Triple-S Salud debe aprobar estos medicamentos antes de que sean despachados. La siguiente tabla enumera cuáles son estos productos. / This List includes drugs associated to the PA initials. PA means preauthorization. Triple-S Salud must authorize those medications before the pharmacy dispense it. The following table enumerates which are those products.

Nombre de la Pre-Autorización Pre-Authorization Description

Medicamentos Drugs


ABATACEPT ABATACEPT ORENCIA

ADALIMUMAB ADALIMUMAB HUMIRA

ATOMOXETINE ATOMOXETINE STRATTERA*

BUDESONIDE BUDESONIDE SR ENTOCORT EC

CINACALCET CINACALCET SENSIPAR

CORTICOTROPIN CORTICOTROPIN ACTHAR HP

CYCLOSPORINE CYCLOSPORINE RESTASIS

DASATINIB DASATINIB SPRYCEL

DEFERASIROX DEFERASIROX EXJADE

DOXERCALCIFEROL DOXERCALCIFEROL HECTOROL

ENFUVIRTIDE ENFUVIRTIDE FUZEON

ERLOTINIB ERLOTINIB TARCEVA

ERYTHROPOIESIS STIMULATING AGENTS

EPOETIN ALFA

EPOGEN

PROCRIT

ETANERCEPT ETANERCEPT ENBREL

ETRAVIRINE ETRAVIRINE INTELENCE

EVEROLIMUS EVEROLIMUS AFINITOR

EXENATIDE EXENATIDE BYETTA PEN

GROWTH HORMONE

SOMATROPIN

GENOTROPIN

HUMATROPE

NORDITROPIN

NUTROPIN

OMNITROPE

SAIZEN

SEROSTIM

TEV-TROPIN

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Medicamentos Drugs


HEMOPHILIA MANAGEMENT

ANTIHEMOPHILIC & COAGULATION FACTORS

ADVATE

ALPHANATE

ALPHANINE

BEBULIN BH

BENEFIX

FEIBA VH

HEMOFIL M

HUMATE-P

KOATE-DVI

HEMOPHILIA MANAGEMENT

ANTIHEMOPHILIC & COAGULATION FACTORS

MONOCLATE-P

MONONINE

NOVOSEVEN

PROFILNINE

PROFILNINE SD

RECOMBINATE

REFACTO

WILATE

HEPATITIS MANAGEMENT ADEFOVIR HEPSERA

ENTECAVIR BARACLUDE

LAMIVUDINE EPIVIR HBV

PEGINTERFERON ALFA-2A

PEGASYS

PEGINTERFERON ALFA-2B

PEG-INTRON

RIBAVIRIN

COPEGUS

REBETOL

RIBAPAK

TELBIVUDINE TYZEKA

IBANDRONATE IBANDRONATE BONIVA

IMATINIB IMATINIB MESYLATE GLEEVEC

LACOSAMIDE LACOSAMIDE VIMPAT

LANREOTIDE LANREOTIDE ACETATE

SOMATULINE DEPOT

LAPATINIB LAPATINIB DITOSYLATE

TYKERB

LENALIDOMIDE LENALIDOMIDE REVLIMID

LEUPROLIDE

LEUPROLIDE

LUPRON

LUPRON DEPOT

LUPRON DEPOT-PED

MARAVIROC MARAVIROC SELZENTRY

METHYLNALTREXONE METHYLNALTREXONE RELISTOR

NILOTINIB NILOTINIB TASIGNA

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Medicamentos Drugs


NON-CALCIUM CONTAINING PHOSPHATE BINDER

LANTHANUM FOSRENOL

SEVELAMER

RENAGEL

RENVELA

OCTREOTIDE

OCTREOTIDE

SANDOSTATIN

SANDOSTATIN LAR

PARICALCITOL PARICALCITOL ZEMPLAR

PAZOPANIB PAZOPANIB VOTRIENT

PULMONARY HYPERTENSION

AMBRISENTAN LETAIRIS

BOSENTAN TRACLEER

EPOPROSTENOL SODIUM

FLOLAN

ILOPROST VENTAVIS

SILDENAFIL REVATIO

TREPROSTINIL REMODULIN

RANOLAZINE RANOLAZINE SR RANEXA

RUFINAMIDE RUFINAMIDE BANZEL

SODIUM OXYBATE SODIUM OXYBATE XYREM

SORAFENIB SORAFENIB TOSYLATE

NEXAVAR

SUNITINIB SUNITINIB MALATE SUTENT

TENOFOVIR TENOFOVIR VIREAD

TERIPARATIDE TERIPARATIDE FORTEO

TIPRANAVIR TIPRANAVIR APTIVUS

VORINOSTAT VORINOSTAT ZOLINZA

ZOLEDRONIC ACID ZOLEDRONIC RECLAST

* De 6-18 años serán manejados por terapia escalonada (ST); mayores de 19 años serán manejados por pre-autorización (PA) / From 6-18 years a step therapy (ST) will apply; older than 19 years will be managed by pre-authorization (PA).

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APÉNDICE V / APPENDIX V

ST - Terapia Escalonada / Step Therapy

Dentro de la Lista se encuentran incluidos medicamentos asociados a las iniciales ST. ST significa terapia escalonada. La siguiente tabla enumera cuáles son estos productos. / This List includes drugs associated to the ST initials. ST means step therapy. The following table enumerates which are those products.

Nombre de la Terapia Escalonada

Step Therapy Descritpion

Medicamentos Drugs


AMLODIPINE & OLMESARTAN

AMLODIPINE & OLMESARTAN

AZOR

AMLODIPINE & VALSARTAN AMLODIPINE & VALSARTAN

EXFORGE

AMLODIPINE & VALSARTAN & HYDROCHLOROTHIAZIDE

AMLODIPINE & VALSARTAN & HYDROCHLOROTHIAZIDE

EXFORGE HCT

ATOMOXETINE ATOMOXETINE STRATTERA*

BIPHOSPHONATES

ALENDRONATE FOSAMAX

ALENDRONATE & CHOLECALCIFEROL

FOSAMAX PLUS D

IBANDRONATE BONIVA

RISEDRONATE ACTONEL

RISEDRONATE & CALCIUM CARBONATE

ACTONEL WITH CALCIUM

TILUDRONATE SKELID

EPLERENONE EPLERENONE INSPRA

FLUTICASONE

BECLOMETHASONE BECONASE AQ

BUDESONIDE RHINOCORT AQUA

CICLESONIDE OMNARIS

FLUNISOLIDE NASAREL

MOMETASONE NASONEX

TRIAMCINOLONE NASACORT AQ

H1 BLOCKING AGENTS, MIDLY/NON-SEDATING

DESLORATADINE CLARINEX

DESLORATADINE & PSEUDOEPHEDRINE SR

CLARINEX-D

FEXOFENADINE ALLEGRA

FEXOFENADINE & PSEUDOEPHEDRINE SR

ALLEGRA-D

LEVOCETIRIZINE XYZAL

LEUKOTRIENE RECEPTOR ANTAGONISTS

MONTELUKAST SINGULAIR

ZAFIRLUKAST ACCOLATE

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Nombre de la Terapia Escalonada

Step Therapy Descritpion

Medicamentos Drugs


OCULAR ALLERGIES AZELASTINE OPTIVAR

EMEDASTINE EMADINE

EPINASTINE ELESTAT

OCULAR ALLERGIES NEDOCROMIL ALOCRIL

OLOPATADINE

PATADAY

PATANOL

PEMIROLAST ALAMAST

PROTON PUMP INHIBITORS

ESOMEPRAZOLE NEXIUM

LANSOPRAZOLE DR PREVACID

PANTOPRAZOLE EC PROTONIX

RABEPRAZOLE EC ACIPHEX

SITAGLIPTIN SITAGLIPTIN JANUVIA

SITAGLIPTIN & METFORMIN SITAGLIPTIN & METFORMIN

JANUMET

STATINS

ATORVASTATIN LIPITOR

EZETIMIBE & SIMVASTATIN VYTORIN

FLUVASTATIN LESCOL

FLUVASTATIN SR LESCOL XL

LOVASTATIN SR ALTOPREV

ROSUVASTATIN CRESTOR

THIAZOLIDINEDIONES

PIOGLITAZONE ACTOS

PIOGLITAZONE & GLIMEPIRIDE

DUETACT

PIOGLITAZONE & METFORMIN

ACTOPLUS MET

ROSIGLITAZONE AVANDIA

ROSIGLITAZONE & GLIMEPIRIDE

AVANDARYL

ROSIGLITAZONE & METFORMIN

AVANDAMET

* De 6-18 años serán manejados por terapia escalonada (ST); mayores de 19 años serán manejados por pre-autorización (PA) / From 6-18 years a step therapy (ST) will apply; older than 19 years will be managed by pre-authorization (PA)

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APÉNDICE VI / APPENDIX VI

OTC – Medicamentos Over-the-Counter / OTC Drugs

Dentro de la Lista se encuentran medicamentos OTC**. La siguiente tabla enumera

cuáles son estos productos. / This List includes OTC** drugs. The following table

enumerates which are those products.

Producto Product

Limitación Limit

ALAVERT® OTC

ALAWAY® OTC

CETIRIZINE OTC

CLARITIN® OTC

LORATADINE OTC

OMEPRAZOLE OTC (TAB) OTC

PREVACID 24HR® (CAP 15MG) OTC

PRILOSEC® OTC (TAB) OTC

ZADITOR® OTC OTC

ZEGERID® OTC OTC

ZYRTEC® OTC ** Se requiere presentar en la farmacia receta del médico para el medicamento OTC. / It is a requirement to submit the physician’s prescription for the OTC drug at the pharmacy.

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Parte IV Part IV

Clasificaciones Terapéuticas

Therapeutic Categories

ANESTHETICS (ANESTÉSICOS) ........................................................................ 1

ANTI-INFECTIVES (ANTI-INFECCIOSOS) .......................................................... 1

Antifungals (Antifungales) ............................................................................................................ 1 Antimarials (Antimaláricos) .......................................................................................................... 1 Antiparasitics (Antiparasitarios) .................................................................................................. 2 Antituberculosis (Antituberculosis) ............................................................................................ 2 Antivirals (Antivirales) .................................................................................................................. 2

Antiherpes Virus (Infecciones Herpéticas) .................................................................................. 2 HIV/AIDS (VIH/SIDA) ................................................................................................................. 2 Influenza (Influenza) .................................................................................................................... 4 Miscellaneous (Misceláneos) ...................................................................................................... 4

Cephalosporins (Cefalosporinas) ................................................................................................ 4 First Generation (Primera Generación) ....................................................................................... 4 Second Generation (Segunda Generación) ................................................................................ 4 Third Generation (Tercera Generación) ...................................................................................... 4

Macrolides (Macrólidos) ............................................................................................................... 5 Miscellaneous (Misceláneos) ....................................................................................................... 5 Penicillins (Penicilinas) ................................................................................................................. 6 Quinolones (Quinolonas) .............................................................................................................. 7 Sulfonamides (Sulfonamidas) ...................................................................................................... 7 Tetracyclines (Tetraciclinas) ........................................................................................................ 7

CANCER (CÁNCER) ............................................................................................ 8 Alkylating Agents (Agentes Alquilantes) .................................................................................... 8 Androgens/Estrogens/Progestins (Andrógenos/Estrógenos/Progestinas) ............................ 8

Androgens (Andrógenos) ............................................................................................................ 8 Antiandrogens (Antiandrógenos) ................................................................................................ 8 Antiestrogens (Antiestrógenos) ................................................................................................... 8 Aromatase Inihibitor (Inihibidores de la Aromatasa) ................................................................... 8 Progestins (Progestinas) ............................................................................................................. 8

Antimetabolites (Antimetabólitos) ............................................................................................... 8 Immunosuppressives (Inmunosupresores) ................................................................................ 8 Miscellaneous (Misceláneos) ....................................................................................................... 8

CARDIOVASCULARS (CARDIOVASCULARES) ............................................... 9 Antiarrhythmics (Antiarrítmicos) ................................................................................................. 9 Antihyperlipidemics (Antihiperlipidémicos) ............................................................................... 9 Antihypertensives (Antihipertensivos) ..................................................................................... 10

ACE Inhibitors (Inhibidores de la Enzima Convertidora de Angiotensina) ................................ 10 Alpha-Adrenergic Receptor Blockers (Bloqueadores del Receptor Alfa-Adrenérgico) ............. 11 Angiotensin Receptor Blockers (ARBs) (Bloqueadores del Receptor de la Angiotensina) ...... 11

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Beta Blockers (Bloqueadores Beta) .......................................................................................... 11 Calcium Channel Blockers (Antagonistas de Canales de Calcio) ............................................ 12 Centrally Acting Antiadrenergics (Antidrenérgicos de Acción Central) ..................................... 13 Combinations (Combinaciones) ................................................................................................ 13 Diuretics (Diuréticos) ................................................................................................................. 15 Vasodilators (Vasodilatores) ..................................................................................................... 16

Glycosides (Glicósidos) .............................................................................................................. 16

CENTRAL NERVOUS SYSTEM (SISTEMA NERVIOSO CENTRAL) ............... 16

Alzheimer (Alzheimer) ................................................................................................................. 16 Analgesics/Narcotics/Combinations (Analgésicos/Narcóticos/Combinaciones) ................. 17 Antianxiety/Hypnotics (Ansiolíticos/Hipnóticos) ..................................................................... 20 Anticonvulsants (Anticonvulsivos) ........................................................................................... 20 Antiparkinsons (Antiparkinson) ................................................................................................. 22

Anticholinergics (Anticolinérgicos) ............................................................................................ 22 COMT Inhibitors (Inhibidores de COMT) .................................................................................. 22 Dopamine Receptor Agonists (Agonistas del Receptor de Dopamina) .................................... 22 Dopaminergics (Dopaminérgicos) ............................................................................................. 22 Dopaminergics - COMT Inhibitors (Dopaminérgicos - Inhibidores de COMT) .......................... 23 Miscellaneous (Misceláneos) .................................................................................................... 23

Antivertigo/Antiemetic (Antivértigo/Antieméticos) .................................................................. 23 Migraine (Migraña) ....................................................................................................................... 23 Miscellaneous (Misceláneos) ..................................................................................................... 24 Psychotropics (Sicotrópicos) ..................................................................................................... 25

Antidepressants (Antidepresivos) ............................................................................................. 25 Antipsychotics (Antisicóticos) .................................................................................................... 26 Attention Deficit and Hyperactivity (Déficit de Atención e Hiperactividad) ................................ 27 Miscellaneous (Misceláneos) .................................................................................................... 28 Mood Stabilizers (Estabilizadores del Animo) ........................................................................... 28

DERMATOLOGICALS (DERMATOLÓGICOS) ................................................. 28

Acne (Acné) .................................................................................................................................. 28 Antibacterials, Topicals (Antibacterianos, Tópicos) ................................................................ 30 Antifungals, Topical (Antifungales, Tópicos) ........................................................................... 30 Antivirals, Topical (Antivirales,Tópicos) ................................................................................... 31 Corticosteroids, Topical (Corticosteroides, Tópicos) ............................................................. 31

High Potency (Alta Potencia) .................................................................................................... 31 Low Potency (Baja Potencia) .................................................................................................... 32 Medium Potency (Mediana Potencia) ....................................................................................... 32 Very High Potency (Muy Alta Potencia) .................................................................................... 33

Dermatologicals, Orals (Dermatológicos, Orales) ................................................................... 33 Miscellaneous (Misceláneos) ..................................................................................................... 33 Scabicides/Pediculicides (Escabicidas/Pediculosis) .............................................................. 34 Topical Anesthetics (Anestésicos Tópicos) ............................................................................. 34 Wound Care (Cuidado de Heridas) ............................................................................................ 35

EAR/NOSE/THROAT (OÍDO/NARIZ/GARGANTA) ........................................... 35

Mouth/Throat (Boca/Garganta) ................................................................................................... 35 Otics (Oticas) ............................................................................................................................... 35

ENDOCRINOLOGY (ENDOCRINOLOGÍA) ...................................................... 36

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Corticosteroids (Corticosteroides) ............................................................................................ 36 Diabetes (Diabetes) ..................................................................................................................... 37

Antihyperglycemics (Antihiperglicémicos) ................................................................................. 37 Antihyperglycemics, Others (Antihiperglicémicos, Otros) ......................................................... 38 Hyperglicemics (Hiperglicémicos) ............................................................................................. 39

Miscellaneous (Misceláneos) ..................................................................................................... 39 Androgens (Andrógenos) .......................................................................................................... 39 Others (Otros) ........................................................................................................................... 39

Thyroid (Tiroide) .......................................................................................................................... 39 Antithyroid (Antitiroideos) .......................................................................................................... 39 Thyroid Hormones (Hormonas Tiroideas) ................................................................................. 39

GASTROENTEROLOGY (GASTROENTEROLOGÍA) ....................................... 40

Antidiarrheals (Antidiarreícos) ................................................................................................... 40 Antispasmodics (Antiespasmódicos) ....................................................................................... 40 Antiulcers (Ulceras) ..................................................................................................................... 41

H2 Blockers (Antagonistas H2) ................................................................................................. 41 Miscellaneous (Misceláneos) .................................................................................................... 41 Proton Pump Inhibitors (PPI`s) (Inhibidores de la Bomba de Protón) ...................................... 41

Digestive Enzymes (Enzimas Digestivas) ................................................................................. 42 Laxatives (Laxantes) ................................................................................................................... 42 Miscellaneous (Misceláneos) ..................................................................................................... 43

OBSTETRICS/GYNECOLOGY (OBSTETRICIA/GINECOLOGÍA) .................... 43

Estrogens/Progestins (Estrógenos/Progestinas) .................................................................... 43 Combinations, Estrogens (Combinaciones, Estrógenos) ......................................................... 43 Estrogens (Estrógenos)............................................................................................................. 44 Progesterones (Progesteronas) ............................................................................................... 44

Miscellaneous (Misceláneos) ..................................................................................................... 44 Osteoporosis (Osteoporosis) .................................................................................................... 44 Others (Otros) ........................................................................................................................... 45

Topicals (Tópicos) ....................................................................................................................... 45 Transdermal Patch (Parchos Transdermales) .......................................................................... 45

Vaginal, Topical (Vaginales, Tópicos) ....................................................................................... 45 Antifungals (Antifungales) ......................................................................................................... 45 Hormonal Replacement (Reemplazo Hormonal) ...................................................................... 46

Vitamins, Prenatals (Vitaminas, Prenatales) ............................................................................. 46

OPHTHALMICS (OFTÁLMICOS) ....................................................................... 46 Allergy (Alergia) ........................................................................................................................... 46

Antihistamines (Antihistamínicos) ............................................................................................. 46 Antihistamines - Mast Cell Stabilizers (Antihistamínicos -Estabilizadores de Mastocitos) ....... 46 Mast Cell Stabilizers (Estabilizadores de Mastocitos) .............................................................. 46

Antibiotics (Antibióticos) ............................................................................................................ 46 Corticosteroids (Corticosteroides) ............................................................................................ 47 Glaucoma (Glaucoma) ................................................................................................................ 48

Adrenergic Selective Agonists (Agonistas Adrenérgicos Selectivos) ....................................... 48 Beta Blockers (Bloqueadores Beta) .......................................................................................... 48 Carbonic Anhydrase Inhibitors (Inhibidores de la Anhidrasa Carbónica) ................................. 48 Combinations (Combinaciones) ................................................................................................ 48

85

Miotics (Mióticos) ....................................................................................................................... 48 Prostaglandins (Prostaglandinas) ............................................................................................. 48

Miscellaneous (Misceláneos) ..................................................................................................... 48 Non-Steroidal Anti-Inflamatory Drugs (NSAID`s) (Anti-Inflamatorios No-Esteroidales) ...... 49

RESPIRATORY (RESPIRATORIOS) ................................................................. 49

Antihistamines/Decongestants (Antihistamínicos/Descongestionantes) ............................. 49 Descongestants (Descongestionantes) .................................................................................... 49 Low Sedation Antihistamines (Anti-histamínicos de Baja Sedación) ........................................ 50 Non-Sedative Antihistamines (Anti-histamínicos No Sedantes) ............................................... 51

Antitussives/Expectorants (Antitusivos/Expectorantes) ........................................................ 51 Asthma (Asma) ............................................................................................................................ 54

Anticholinergics (Anticolinérgicos) ............................................................................................ 54 Beta Agonists, Inhaled (Agonistas Beta, Inhalados) ................................................................. 54 Beta Agonists, Oral (Agonistas Beta, Orales) ........................................................................... 54 Combinations (Combinaciones) ................................................................................................ 55 Inhaled Corticostroids (Corticosteroides Inhalados) ................................................................. 55 Miscellaneous (Misceláneos) .................................................................................................... 55 Xanthines (Xantinas) ................................................................................................................. 55

Intranasal Steroids (Esteroides Intranasales) .......................................................................... 56 Others (Otros) .............................................................................................................................. 56

SKELETAL-MUSCULE SYSTEM/RHEUMATOLOGY (SISTEMA MÚSCULO-ESQUELETAL/REUMATOLOGÍA) .................................................................... 56

Gout (Gota) ................................................................................................................................... 56 Miscellaneous (Misceláneos) ..................................................................................................... 56

Rheumatology (Reumatología) ................................................................................................. 57 Muscle Relaxants (Relajantes Musculares) .............................................................................. 57 Non-Steroidal Anti-Inflamatory Drugs (NSAID`s) (Anti-Inflamatorios No-Esteroidales) ...... 57

UROLOGY (UROLOGÍA) ................................................................................... 58 5-Alpha Reductase Inhibitors (Inhibidores de la 5-Alpha Reductasa) ................................... 58 Analgesics (Analgésicos) ........................................................................................................... 58 Antispasmodics (Antiespasmódicos) ....................................................................................... 59 Cholinergics (Colinérgicos) ........................................................................................................ 59 Erectil Dysfunction (Disfunción Eréctil) .................................................................................... 59 Miscellaneous (Misceláneos) ..................................................................................................... 59 Renal Disease (Enfermedad Renal) ........................................................................................... 59

VITAMINS/HEMATINICS/ELECTROLYTES (VITAMINAS/HEMATÍNICOS/ELECTRÓLITOS) ............................................... 60 Alkalinizer (Alkalinizantes) ........................................................................................................ 60 Antidotes (Antídotos) .................................................................................................................. 60 Coagulant Therapy (Terapia de Coagulación) .......................................................................... 60

Anticoagulant (Anticoagulantes) ............................................................................................... 60 Antiplatelet (Antiplaquetarios) ................................................................................................... 61 Miscellaneous (Misceláneos) .................................................................................................... 61

Vitamins/Hematinics/Other Supplements (Vitaminas/Hematínicos/OtrosSuplementos) ..... 61 Nutrients (Nutrientes) ................................................................................................................ 61 Vitamins (Vitaminas) ................................................................................................................. 62

86

CHRONIC AND HIGH RISK CONDITIONS (CONDICIONES CRÓNICAS Y DE ALTO RIESGO) .................................................................................................. 63 Anti-Infectives (Anti-Infecciosos) .............................................................................................. 63

Antifungals (Antifungales) ......................................................................................................... 63 Miscellaneous (Misceláneos) .................................................................................................... 63

Antivirals (Antivirales) ................................................................................................................ 63 Hepatitis B (Hepatitis B) ............................................................................................................ 63 Hepatitis C (Hepatitis C) ............................................................................................................ 63 HIV/AIDS (VIH/SIDA) ................................................................................................................ 64

Biotechnology (Biotecnología) .................................................................................................. 64 Enzyme Replacement (Remplazo Enzimático) ......................................................................... 64 Erythropoiesis Stimulating Proteins (Estimulantes Esteroides) ................................................ 64 Multiple Sclerosis (Esclerosios Múltiple) ................................................................................... 64 Myeloid Stimulating Agents (Estimulantes Mieloides) .............................................................. 64

Cancer (Cáncer) ........................................................................................................................... 65 Alkylating Agents (Agentes Alquilantes) ................................................................................... 65 Antimetabolites (Antimetabólitos) .............................................................................................. 65 Miscellaneous (Misceláneos) .................................................................................................... 65

Cardiovasculars (Cardiovasculares) ......................................................................................... 65 Central Nervous System (Sistema Nervioso Central) .............................................................. 65 Endocrinology (Endocrinológicos) ............................................................................................ 65

Growth Hormones (Hormonas de Crecimiento) ........................................................................ 65 Miscellaneous (Misceláneos) .................................................................................................... 66

Obstretrics/Ginegology (Obstetricia/Ginecología) ................................................................... 66 Respiratory (Respiratorios) ........................................................................................................ 66

Others (Otros) ........................................................................................................................... 66 Skeletal-Muscule System/Rheumatology (Sistema Músculo-Esqueletal/Reumatología) .... 66

Miscellaneous (Misceláneos) .................................................................................................... 66 Vitamins/Hematinics/Other Supplements (Vitaminas/Hematínicos/OtrosSuplementos) ..... 67 Coagulant Theraphy (Terapia de Coagulación) ........................................................................ 67

APÉNDICE I / APPENDIX I ................................................................................ 68

APÉNDICE II / APPENDIX II .............................................................................. 72

APÉNDICE III / APPENDIX III ............................................................................ 75

APÉNDICE IV / APPENDIX IV ........................................................................... 76

APÉNDICE V / APPENDIX V ............................................................................. 79

APÉNDICE VI / APPENDIX VI ........................................................................... 81

87

Parte V Part V

ÍNDICE

INDEX

8

8-MOP ............................... 33

A

abacavir ............................... 3 abatacept ..................... 66, 76 ABILIFY.............................. 26 acarbose ........................... 37

ACCOLATE .................. 55, 79 ACCUNEB ......................... 54 ACCUPRIL ......................... 11 ACCURETIC ...................... 14 ACCUTANE ....................... 33 acebutolol ......................... 11

ACEON .............................. 10 acetaminophen ..... 17, 23, 56 acetazolamide .................. 15 acetic ........................... 35, 45

acetohydroxamic ................ 59 acetylcysteine .................. 51

ACETYLCYSTEINE ........... 51 ACHROMYCIN .................... 8 ACID .................................. 45 ACIPHEX ..................... 41, 80 acitretin .............................. 33 ACLOVATE ........................ 32 acrivastine .......................... 49 ACTHAR HP ...................... 76 ACTIGALL.......................... 43 ACTIQ ................................ 18 ACTIVELLA .................. 43, 44 ACTONEL .................... 45, 79 ACTONEL WITH CALCIUM

...................................... 79 ACTOPLUS .................. 37, 80 ACTOS......................... 38, 80 ACULAR ............................ 49 acyclovir ....................... 2, 31

ADAGEN ............................ 64 ADALAT ............................. 12 adalimumab ................. 66, 76 adapalene .................... 28, 29 ADDERALL ........................ 27 adefovir .............................. 63 ADEFOVIR ......................... 77 ADVAIR.............................. 55 ADVATE....................... 67, 77 ADVICOR........................... 10

AEROBID ........................... 55 AFINITOR .............. 65, 72, 76 AGGRENOX ...................... 61 AGRYLIN ........................... 61 AKNE-MYCIN .................... 29 ALAMAST .......................... 80 ALA-QUIN .......................... 30 ALAVERT ........................... 81 ALAWAY ............................ 46 ALBAFORT ........................ 62 ALBALON .......................... 49 ALBATUSSIN ..................... 52 albendazole .......................... 2 ALBENZA ............................. 2 albuterol ...................... 54, 55

albuterol. ............................ 54 albuterol.. ........................... 54 albuterol... .......................... 54 alclometasone .................. 32

ALCORTIN ......................... 31 ALDACTAZIDE .................. 15 ALDACTONE ..................... 15 ALDARA ............................. 34 ALDEX-CT ......................... 50 ALDOMET .......................... 13 ALDORIL ............................ 14 alendronate ........... 44, 45, 79

alglucerase ......................... 64 ALINIA .................................. 2 ALKERAN ............................ 8 ALLEGRA .................... 51, 79 ALLEGRA-D ................. 50, 79 ALLERDUR ........................ 50 ALLERX ............................. 50 allopurinol ......................... 56

ALLRES ............................. 51 almotriptan ................... 23, 70 ALOCRIL ...................... 46, 80 ALOMIDE ........................... 46 alosetron ............................ 43 ALPHAGAN ....................... 48 ALPHANATE ................ 67, 77 ALPHANINE ....................... 77 alprazolam ........................ 20

ALREX ............................... 47 ALTACE ............................. 11 ALTOPREV .................. 10, 80 altretamine ........................... 8 aluminum ........................... 33 ALUPENT .......................... 54 amantadine ................... 4, 23

AMANTADINE ............... 4, 23

AMARYL ............................38 ambenonium ......................57 AMBIEN .............................20 ambrisentan .................65, 78 amcinonide .........................31 AMCINONIDE ..............31, 75 AMERGE......................24, 69 AMICAR .............................61 amiloride ...........................15

aminocaproic ......................61 aminophylline .....................55 AMINOPHYLLINE ..............55 aminosalicylic ...................... 2 amiodarone ........................ 9

AMITIZA ................. 43, 68, 72 amitriptyline ................26, 28 amlodipine ..................12, 13

AMLODIPINE & OLMESARTAN ..............79

AMLODIPINE & VALSARTAN .................79

AMLODIPINE & VALSARTAN & HYDROCHLOROTHIAZIDE ....................................79

amoxapine..........................26 AMOXAPINE ......................26 amoxicillin.....................6, 41

AMOXIL............................... 6 amphetamine ....................27

AMPHOTEC .......................63 amphotericin .......................63 AMPHOTERICIN ................63 ampicillin............................ 6

AMPICILLIN ........................ 6 amylase ..............................42 ANAFRANIL .......................26 anagrelide .........................61

ANALPRAM-HC .................43 ANAMANTLE .....................43 ANAPROX..........................58 anastrozole.......................... 8 ANCOBON .......................... 1 ANDRODERM ....................39 ANDROGEL .......................39 ANDROID.......................8, 39 ANDROXY .....................8, 39 anidulafungin ......................63 ANSAID ..............................58 anthralin .............................34 antihemophilic ....................67

88

ANTIHEMOPHILIC & COAGULATION FACTORS ............... 72, 77

antiinhibitor......................... 67 antiseptic ............................ 35 ANTIVERT ......................... 23 ANZEMET .......................... 23 apap ................................... 23 APIDRA.............................. 38 apraclonidine ...................... 48 aprepitant ..................... 23, 68 APRESAZIDE .................... 14 APRESOLINE .................... 16 APTIVUS.................. 4, 72, 78 AQUASOL.......................... 62 AQUATAB .......................... 52 ARALEN............................... 1 ARAVA ............................... 56 AREDIA.............................. 66 ARICEPT ........................... 16 ARIMIDEX............................ 8 aripiprazole ........................ 26 ARIXTRA ........................... 60 ARMOUR ........................... 40 AROMASIN .......................... 8 ARTANE ............................ 22 artemether............................ 1 artemether & lumefantrine

...................................... 68 ARTHROTEC ..................... 57 ASACOL ............................ 43 ascorbic ............................ 62

ASCORBIC ........................ 62 ASMANEX ......................... 55 aspirin ................... 17, 24, 61

ASTELIN ............................ 56 ATABEX ............................. 46 ATACAND .................... 11, 13 atazanavir ............................ 3 atenolol ....................... 11, 13

ATIVAN .............................. 20 atomoxetine ................. 27, 76 ATOMOXETINE ................. 79 atorvastatin .................... 9, 80 atovaquone ...................... 1, 5 atovaquone & proguanil ..... 70 ATRIPLA .............................. 3 atro ..................................... 40 atropine ........................ 40, 48 ATROPINE ......................... 40 ATROVENT ....................... 54 augmented ........................ 31

AUGMENTIN ....................... 6 auranofin ............................ 57 AVALIDE ............................ 14 AVANDAMET ............... 37, 80 AVANDARYL ............... 37, 80 AVANDIA ..................... 38, 80 AVAPRO ............................ 11 AVC ................................... 45 AVELOX............................... 7 AVINZA .............................. 19

AVODART .......................... 58 AVONEX ............................ 64 AXERT ......................... 23, 70 AXID ................................... 41 AYGESTIN ......................... 44 azathioprine .................. 8, 57

azelaic ................................ 29 azelastine .................... 46, 56

AZELASTINE ..................... 80 AZELEX ............................. 29 azithromycin ....................... 5

AZMACORT ....................... 55 AZOPT ............................... 48 AZOR ........................... 13, 79 AZULFIDINE ...................... 43

B

bacitracin ................ 2, 30, 46

BACITRACIN ................. 2, 46 baclofen ............................ 57

BACTROBAN ..................... 30 BALACET ........................... 19 balsalazide ........................ 43

BANZEL ................. 22, 72, 78 BARACLUDE ......... 63, 72, 77 b-complex .......................... 62 B-COMPLEX ...................... 62 BEBULIN BH ...................... 77 becaplermin ....................... 35 beclomethasone ..... 55, 56, 79 BECONASE ....................... 56 BECONASE AQ ................. 79 belladonna ........................ 40 benazepril ................... 10, 13

BENEFIX ...................... 67, 77 BENEMID ........................... 56 BENICAR ..................... 11, 14 BENTYL ............................. 40 BENZACLIN ....................... 29 BENZAMYCIN ................... 29 BENZASHAVE ................... 29 BENZIQ .............................. 29 benzocaine ......................... 35 benzocaine-pe-antipyrine ... 35 benzonatate ...................... 51

BENZOTIC ......................... 35 benzoyl .............................. 29

BENZOYL .......................... 29 benztropine ....................... 22

BETAGAN .......................... 48 betain ................................. 64 betamethasone ........... 32, 36

BETAPACE/BETAPACE ...... 9 BETASERON ..................... 64 BETA-VAL .................... 32, 75 betaxolol ..................... 11, 48 bethanechol ...................... 59

BETIMOL ........................... 48 BETOPTIC-S ..................... 48 bexarotene ............... 8, 33, 34 BIAXIN ................................. 5

bicalutamide ...................... 8

BICILLIN.............................. 7 BICITRA .............................60 BILTRICIDE ........................ 2 bimatoprost ........................48 BIOHIST .............................50 BIPHOSPHONATES ..........79 bismuth ..............................41 bisoprolol ....................11, 13

BLEPH-10 ..........................47 BLEPHAMIDE ....................47 BLOCADREN .....................12 BONIVA............ 45, 66, 77, 79 bosentan ......................65, 78 BRETHINE .........................54 brimonidine .......................48

brinzolamide .......................48 BROMFED .........................49 bromocriptine ...................22

brompheniramine .........49, 51 BRONDIL ...........................55 BRONTEX ..........................51 BRONTUSS .......................53 BROVEX ............................49 BROVEX-D ........................49 BUCALSEP ........................35 budesonide. 43, 55, 56, 76, 79 bumetanide .......................15

BUMEX ..............................15 BUPHENYL ........................64 bupropion .........................25

BUSPAR ............................20 buspirone ..........................20

busulfan .............................. 8 butalbital .....................18, 24

butenafine ..........................30 butoconazole ......................45 BYETTA .......................38, 76

C

cabergoline .......................39

CADUET ............................13 CAFERGOT .......................24 CALAN ...............................12 calcipotriene .....................34

calcitonin, .....................39, 45 calcitriol ............................62

CALCITRIOL ......................62 calcium ..............................59

CANASA ............................43 CANCIDAS...................63, 72 candesartan .................11, 13 capecitabine .......................65 CAPEX ...............................32 CAPITAL/CODEINE ...........17 CAPOTEN ..........................10 CAPOZIDE .........................13 captopril ......................10, 13

CARAC ..............................34 CARAFATE ........................41 carbamazepine ...........20, 21

89

CARBAPHEN ..................... 52 CARBATROL ..................... 21 CARBA-XP ......................... 51 carbetapentane .................. 51 carbidopa ..................... 22, 23 carbinoxamine .................. 50

CARBOFED ....................... 53 CARDENE ......................... 12 CARDIZEM ........................ 12 CARDURA ......................... 11 carisoprodol ..................... 57

CARMOL............................ 34 CARMOL-HC ..................... 34 CARNITOR ........................ 61 carteolol ....................... 11, 48 CARTROL .......................... 11 carvedilol .......................... 11

CASODEX ........................... 8 caspofungin........................ 63 CATAFLAM ........................ 57 CATAPRES ........................ 13 CECLOR .............................. 4 CEDAX................................. 5 CEENU ................................ 8 cefaclor ............................... 4 cefadroxil ....................... xi, 4 cefdinir ................................ 4

cefditoren ............................. 4 cefixime ................................ 4 cefpodoxime ....................... 4 cefprozil .............................. 4

ceftibuten ............................. 5 CEFTIN ................................ 4 ceftriaxone ........................... 5 cefuroxime .......................... 4

CEFZIL................................. 4 CELEBREX .................. 57, 72 celecoxib ............................ 57 CELESTONE ..................... 36 CELEXA ............................. 25 CELLCEPT .................... 8, 72 CELONTIN ......................... 21 CENESTIN ......................... 44 cephalexin ..................... xi, 4

CEPHALEXIN ................. xi, 4 CEREDASE ....................... 64 CEREZYME ....................... 64 CERNEVIT ......................... 62 cetirizine ..................... 49, 50

CETIRIZINE ....................... 81 CHEMET ............................ 60 CHERATUSSIN ................. 54 chloral ................................ 20 chlorambucil ......................... 8 chlordiazepoxide ........ 20, 28 chlorhexidine .................... 35 chloroquine ........................ 1 chlorothiazide ................... 15 chlorphen.................... 49, 51

chlorpheniramine ... 49, 50, 51 chlorphen-pe-

methscopolamine ........ 51

chlorpromazine ................ 27 chlorpropamide ................ 38 chlorthalidone .................. 15 chlorzoxazone .................. 57 cholestyramine ................... 9

choline ............................ 9, 56 CIALIS .................... 59, 70, 72 ciclesonide ......................... 79 ciclopirox .................... 30, 68

cilastatin ............................... 5 cilostazol ........................... 61

CILOXAN ........................... 46 cimetidine ......................... 41

cinacalcet ..................... 59, 76 CIPRO ............................ 7, 35 CIPRO XR .......................... 68 ciprofloxacin ........... 7, 35, 46 ciprofloxacin XR ............... 68 citalopram ......................... 25

CITROLITH ........................ 60 CLARINEX ................... 51, 79 CLARINEX-D ............... 50, 79 clarithromycin .................... 5

CLARITIN ........................... 51 CLARITIN-D ....................... 50 clemastine ........................ 50

CLEMASTINE .................... 50 CLEOCIN ................. 5, 29, 45 clidinium ........................... 40

CLIMARA ........................... 45 clindamycin ............ 5, 29, 45

CLINORIL .......................... 58 clioquinol ............................ 30 clobetasol ......................... 33

CLOBEX ...................... 33, 75 CLODERM ......................... 32 clomipramine .................... 26 clonazepam ...................... 21 clonidine ........................... 13

clopidogrel .......................... 61 clorazepate ....................... 20

clorcortolone ...................... 32 CLORPRES ....................... 13 clotrimazole ............ 1, 30, 31 clozapine ........................... 26

CLOZARIL ......................... 26 coagulation ......................... 67 COARTEM ..................... 1, 68 codeine ....................... 18, 51

CODEINE ........................... 18 COGENTIN ........................ 22 COLAZAL ........................... 43 colchicine ......................... 56

COLCHICINE ..................... 56 COLCHICINE/PROBENECID

...................................... 56 colesevelam ....................... 10 COLESTID ......................... 10 colestipol .......................... 10

colistin ................................ 35 collagenase ........................ 35 COLY-MYCIN-S ................. 35

COMBIGAN ........................48 COMBIPATCH ...................45 COMBIVENT ......................55 COMBIVIR .......................... 3 COMPAZINE ......................23 COMTAN............................22 CONCERTA .......................28 CONDYLOX .......................34 COPAXONE .......................64 COPEGUS ............. 64, 72, 77 CORDARONE ..................... 9 CORDRAN .........................32 COREG ..............................11 CORGARD .........................11 CORTANE-B ......................36 CORTEF ............................36 CORTENEMA ....................43 corticotropin........................76 CORTIFOAM ......................43 cortisone.............................36 CORTISPORIN 30, 36, 46, 47 CORTONE .........................36 CORZIDE ...........................14 COSOPT ............................48 COUMADIN ........................61 COVERA-HS ......................12 COZAAR ............................11 CREON ..............................42 CRESTOR....................10, 80 cresyl ..................................36 CRESYLATE ......................36 CRINONE...........................46 CRIXIVAN ........................... 3 CROLOM ...........................46 cromolyn................. 43, 46, 55 CUPRIMINE .......................57 CUTIVATE .........................33 cyanocobalamin ...............62

CYANOCOBALAMIN .........62 cyclobenzaprine ...............57

CYCLOCORT ...............31, 75 CYCLOGYL........................48 cyclopentolate ....................48 cyclophosphamide .............. 8 cycloserine .......................... 2 cyclosporine .................48, 76 CYMBALTA ........................25 cyproheptadine ................51

CYPROHEPTADINE ..........51 CYSTADANE .....................64 CYSTAGON .......................64 cysteamine .........................64 CYSTOSPAZ .....................59 CYTOMEL ..........................40 CYTOTEC ..........................41 CYTOVENE ........................ 4 CYTOXAN ........................... 8

D

D.H.E. ................................24 DALLERGY ........................50

90

DALMANE.......................... 20 dalteparin ........................... 60 danazol........................ 39, 45

DANOCRINE ............... 39, 45 DANTRIUM ........................ 57 dantrolene ......................... 57

dapsone ............................... 5 DAPSONE ........................... 5 DARAPRIM .......................... 1 darunavir .............................. 3 DARVOCET ....................... 19 DARVON............................ 19 DARVON-N ........................ 19 dasatinib....................... 65, 76 DAYPRO ............................ 58 DDAVP............................... 39 DECADRON ...................... 47 DECLOMYCIN ..................... 7 DECON-A .......................... 49 DECONAMINE ................... 50 DECON-G .......................... 53 deferasirox ................... 60, 76 delavirdine............................ 2 DEMADEX ......................... 15 demeclocycline .................. 7

DEMEROL ......................... 18 DENAVIR ........................... 31 DEPACON ......................... 22 DEPAKENE ................. 22, 28 DEPAKOTE ........... 21, 24, 28 DEPO-MEDROL ................ 36 DEPO-TESTOSTERONE .. 39 DERMA-SMOOTHE ........... 32 DERMATOP ....................... 33 DERMOTIC ........................ 36 desipramine ...................... 26

desloratadine ............... 50, 51 DESLORATADINE ............. 79 desmopressin ............. 39, 66

DESMOPRESSIN .............. 39 desonide ........................... 32

DESOWEN ........................ 32 desoximetasone ............... 32

DESOXYN ......................... 28 DESPEC ............................ 53 DESPEC-EXP .................... 54 DESPEC-PD ...................... 53 DESQUAM ......................... 29 DESYREL .......................... 25 DETROL ............................ 59 dexamethasone .......... 36, 47

DEXAMETHASONE .......... 36 dexchlorphen ..................... 50 dexchlorpheniramine .......... 50 DEXCHLORPHENIRAMINE

...................................... 50 DEXEDRINE ...................... 28 dexmethylphenidate ........ 28 dextroamphetamine ......... 28

dextromethorphan ........ 51, 52 dextrose ............................ 61

DEXTROSE/SODIUM ........ 61

DEXTROSTAT ................... 28 DIABETA ............................ 38 DIABINESE ........................ 38 DIAMOX ............................. 15 DIASTAT ............................ 21 diazepam ..................... 20, 21

diazoxide ............................ 39 diclofenac ............. 49, 57, 58 dicloxacillin ........................ 6

DICLOXACILLIN .................. 6 dicyclomine ...................... 40

didanosine ............................ 3 DIDRONEL ........................ 39 DIFFERIN ........ 28, 29, 72, 75 diflorasone ......................... 32 DIFLUCAN ............... 1, 63, 72 diflunisal ............................. 58 DIFLUNISAL ...................... 58 digestive ............................. 42 digoxin .............................. 16

DIGOXIN ............................ 16 dihydroergotamine ............. 24 DILANTIN ........................... 21 DILATRATE ....................... 16 DILAUDID .......................... 18 diltiazem ............................ 12

DIOVAN ....................... 11, 14 DIPENTUM ........................ 43 diphenhydramine.......... 50, 51 DIPHENHYDRAMINE ........ 51 diphenoxylate ................... 40

dipivefrin ............................. 48 DIPROLENE ................ 31, 75 DIPROSONE ............... 32, 75 dipyridamole ..................... 61

DISALCID .......................... 58 disopyramide ...................... 9

DITROPAN ........................ 59 DIURIL ............................... 15 divalproex ............. 21, 24, 28

dolasetron .......................... 23 DOLOGESIC ...................... 56 DOMEBORO ...................... 35 DONATUSSIN ................... 52 donepezil ............................ 16 DONNATAL ....................... 40 DORAL ............................... 20 dornase .............................. 66 DORYX ................................ 7 dorzolamide ...................... 48

DOSTINEX ......................... 39 DOVONEX ......................... 34 doxazosin ......................... 11 doxepin ....................... 26, 31

doxercalciferol .............. 60, 76 doxycycline .......................... 7 DOXYCYCLINE ................... 7 DRISDOL ........................... 62 DRITHO-SCALP ................ 34 dronabinol ........................ 23

DROXIA ............................... 9 DRYSOL ............................ 33

DUETACT ....................37, 80 duloxetine ...........................25 DURAGESIC ......................18 DURICEF ........................ xi, 4 dutasteride .........................58 DYAZIDE/MAXZIDE ...........15 DYLIX .................................55 DYNACIN ............................ 7 DYNACIRC ........................12 DYNACIRC-CR ..................12 DYNATUSS ........................53 dyphylline ...........................55 DYPHYLLINE .....................55 dyphylline-guaifenesin ........55 DYRENIUM ........................15 DYTAN-D ...........................50

E

E.E.S. .................................. 5 E.E.S./ERYPED .................. 5 EAR-GESIC .......................35 EC-NAPROSYN .................58 econazole ..........................31

ED ......................................49 ED-A-HIST .........................53 EDECRIN ...........................15 efavirenz...........................2, 3 EFFEXOR ..........................25 EFUDEX.............................34 ELAVIL ...............................26 ELDEPRYL ........................22 ELESTAT ...........................80 eletriptan ......................24, 70 ELIMITE .............................34 ELIXOPHYLLIN ..................55 ELMIRON ...........................59 ELOCON ............................33 EMADINE .....................46, 80 EMCYT ............................... 9 emedastine...................46, 80 EMEND .................. 23, 68, 72 EMLA .................................34 emollient .............................34 emtricitabine ........................ 3 EMTRIVA ............................ 3 enalapril ......................10, 14

ENBREL ................. 66, 72, 76 enfuvirtide.....................64, 76 ENJUVIA ............................44 enoxaparin .........................60 entacapone ........................22 entecavir.............................63 ENTECAVIR .......................77 ENTOCORT .......................43 ENTOCORT EC ...........72, 76 ENULOSE ..........................42 EPIFOAM ...........................34 epinastine ...........................80 EPIVIR ...........................3, 63 EPIVIR HBV .................72, 77 eplerenone ........................15

91

EPLERENONE .................. 79 epoetin ............................... 64 EPOETIN ALFA ................. 76 EPOGEN...................... 64, 76 epoprostenol .............. 65, 78

eprosartan .................... 11, 14 EPZICOM............................. 3 EQUAGESIC ...................... 17 EQUANIL ........................... 20 ERAXIS ........................ 63, 72 ergocalciferol ................... 62 ergoloid ............................. 24

ERGOMAR ........................ 24 ergonovine ......................... 39 ergotamine ......................... 24 ERGOTRATE ..................... 39 erlitinib ............................... 76 erlotinib .............................. 65 ERYGEL ............................ 29 ERY-TAB ............................. 5 ERYTHROCIN ..................... 5 erythromycin ............ 5, 29, 47 ERYTHROMYCIN .......... 5, 29 ERYTHROPOIESIS

STIMULATING AGENTS ...................................... 76

escitalopram ....................... 25 esomeprazole .................... 80 estazolam.......................... 20 esterified ........................... 43

ESTRACE .................... 44, 46 estradiol .......... 43, 44, 45, 46

estramustine ........................ 9 ESTRASORB ..................... 44 ESTRATEST ...................... 43 estrogens, .................... 44, 46 estropipate ........................ 44

etanercept .................... 66, 76 ethacrynic........................... 15 ethambutol .......................... 2

ethinyl ................................ 44 ethionamide ......................... 2 ethosuximide .................... 21

ethotoin .............................. 21 etidronate.......................... 39 etodolac ............................ 58

etoposide ............................. 9 etravirine ........................ 2, 76 EULEXIN.............................. 8 everolimus.................... 65, 76 EVISTA .............................. 45 EXELDERM ....................... 31 EXELON ............................ 17 exemestane ......................... 8 exenatide ..................... 38, 76 EXFORGE ................... 13, 79 EXFORGE HCT ................. 79 EXJADE ................. 60, 72, 76 EXPECTUSS ..................... 51 EXTENDRYL ..................... 51 ezetimibe............................ 10 ezetimibe & simvastatin ..... 80

F

factor .................................. 67 famciclovir .......................... 2 famotidine ......................... 41

FAMVIR ............................... 2 FANSIDAR ........................... 1 FARESTON ......................... 8 FEIBA ................................. 67 FEIBA VH ........................... 77 felbamate ........................... 21 FELBATOL ......................... 21 FELDENE .......................... 58 felodipine .......................... 12

FEMARA .............................. 8 FEMHRT ............................ 44 FEMTRACE ....................... 44 fenofibrate ........................ 10

fenoprofen .......................... 58 fentanyl ............................. 18

FENTANYL ........................ 18 FENTORA .......................... 18 ferric ................................... 62 fexofenadine .......... 50, 51, 79 filgrastim ............................. 64 finasteride ......................... 58

FIORICET .................... 18, 24 FIORICET/CODEINE ... 17, 23 FIORINAL .................... 18, 24 FIORINAL/CODEINE ... 17, 24 FLAGYL ............................... 5 FLAREX ............................. 47 flavoxate ........................... 59 flecainide ............................ 9

FLEXERIL .......................... 57 FLOLAN ................. 65, 72, 78 FLOMAX ............................ 59 FLONASE .......................... 56 FLORINEF ......................... 36 FLOVENT .......................... 55 FLOXIN .......................... 7, 36 fluconazole ................... 1, 63

flucytosine ............................ 1 fludarabine ......................... 65 fludrocortisone ................. 36

FLUMADINE ........................ 4 flumazenil ......................... 60

flunisolide ............... 55, 56, 79 fluocinolone .................. 32, 36 fluocinonide ...................... 32 fluorometholone ............... 47 fluorouracil ....................... 34 fluoxetine .......................... 25

fluoxymesterone ............. 8, 39 fluphenazine ..................... 27

FLUPHENAZINE ................ 27 flurandrenolide ................... 32 flurazepam ........................ 20 flurbiprofen ................. 49, 58 flutamide ............................. 8 fluticasone ...... 33, 55, 56, 79

fluvastatin ..................... 10, 80

fluvoxamine ......................25

FML ....................................47 FOCALIN............................28 folic ....................................62

FOLIC ................................62 FOLVITE ............................62 fondaparinux ......................60 FORADIL............................54 formoterol ...........................54 FORTEO ................ 66, 72, 78 FOSAMAX.............. 44, 45, 79 FOSAMAX PLUS D ............79 fosamprenavir ..................... 3 fosfomycin ........................... 5 fosinopril .....................10, 14

FOSRENOL ........... 60, 72, 78 FRAGMIN...........................60 FRENADOL ........................56 FROVA .........................24, 70 frovatriptan ...................24, 70 FURADANTIN ..................... 6 furosemide ........................15

FUZEON ................ 64, 73, 76

G

gabapentin ........................21

GABITRIL ...........................22 galantamine ......................16

ganciclovir ........................... 4 GANI-TUSS ........................52 GANTRISIN ......................... 7 GARAMYCIN ...............30, 47 GASTRINEX ......................42 GASTROCROM .................43 GEL-KAM ...........................35 gemfibrozil ........................10

GENEXA ............................52 GENOTROPIN ....... 65, 66, 76 gentamicin .............. 5, 30, 47

GENTAMICIN ...................... 5 GEODON ...........................27 GILTUSS ......................52, 53 glatiramer ...........................64 GLEEVEC .............. 65, 73, 77 glimepiride ..................38, 80 glipizide .......................37, 38

glucagon.............................39 GLUCAGON .......................39 GLUCOPHAGE ..................37 GLUCOTROL .....................38 GLUCOVANCE ..................37 glyburide .....................37, 38

GLYCOLAX ........................42 glycopyrrolate ..................40

GLYCRON .........................38 GLYNASE ..........................38 GLYSET .............................37 GOLYTELY ........................42 GORDON'S ........................34 granisetron .......................23

GRIFULVIN ......................... 1

92

griseofulvin ........................... 1 GRIS-PEG ........................... 1 GROWTH HORMONE ....... 76 guaifenesin......................... 52 guanabenz ......................... 13 guanfacine ........................ 13

guanidine ........................... 24 GUANIDINE ....................... 24 GUIADEX ........................... 52 GYNAZOLE-1 .................... 45

H

H1 BLOCKING AGENTS, MIDLY/NON-SEDATING ...................................... 79

halcinonide ......................... 32 HALCION ........................... 20 HALDOL............................. 27 halobetasol ....................... 33

HALOG ........................ 32, 75 haloperidol ........................ 27

haloprogin .......................... 31 HALOTIN ........................... 31 HECTOROL ........... 60, 73, 76 HELIDAC ........................... 41 HEMOFIL ........................... 67 HEMOFIL M ....................... 77 HEMOPHILIA

MANAGEMENT ............ 77 heparin ......................... 60, 61 HEPARIN ..................... 60, 61 HEPSERA .............. 63, 73, 77 hexachlorophene ............... 35 HEXALEN ............................ 8 HIPREX/UREX ................... 59 HISTEX .............................. 50 HORMONAS DE

CRECIMIENTO ............. 73 HT-TUSS ........................... 51 HUMALOG ......................... 38 HUMATE-P .................. 67, 77 HUMATROPE .............. 66, 76 HUMIRA ................. 66, 73, 76 HUMULIN........................... 37 HYCODAN ......................... 52 HYDERGINE ...................... 24 hydralazine ....................... 16

hydralazine/hydrochlorothiazide .................................. 14

HYDREA .............................. 9 hydrochlorothiazide ......... 15

HYDROCHLOROTHIAZIDE ...................................... 15

hydrocodone .............. 18, 52

hydrocortisone 30, 32, 33, 36, 43

HYDRODIURIL .................. 15 hydromorphone ............... 18

hydroxocobalamin .............. 62 HYDROXOCOBALAMIN .... 62 hydroxychloroquine .......... 1

hydroxyurea ....................... 9 hydroxyzine ................ 20, 51

HYDROXYZINE ................. 51 hyoscyamine ........ 40, 41, 59

HYTONE ............................ 32 HYTRIN .............................. 11 HYZAAR ............................ 14

I

ibandronate ...... 45, 66, 77, 79 IBUDONE ........................... 18 ibuprofen .......................... 58

iloprost ......................... 65, 78 ILOTYCIN .......................... 47 imatinib ......................... 65, 77 IMDUR ............................... 16 imiglucerase ....................... 64 imipramine ........................ 26

imiquimod ........................... 34 IMITREX ...................... 24, 69 IMODIUM ........................... 40 IMURAN ................... 8, 57, 73 indapamide ....................... 15

INDERAL ........................... 12 INDERIDE .......................... 14 indinavir ................................ 3 INDOCIN ............................ 58 indomethacin .................... 58

INFED ................................ 62 INFERGEN ........................ 63 INFLAMASE ....................... 48 INNOHEP ........................... 61 INSPRA ........................ 15, 79 insulin ................................. 38 insulin-(pen) ....................... 37 insulin--(pen) ...................... 37 insulin-(vial) ........................ 37 insulin--(vial) ....................... 38 INTAL ................................. 55 INTELENCE ............. 2, 73, 76 interferon ...................... 63, 64 INVIRASE ............................ 4 iodoquinol ....................... 2, 31 IOPIDINE ........................... 48 ipratropium ....................... 54

irbesartan ..................... 11, 14 iron .................................... 62

IRRIGATION ...................... 35 ISENTRESS ......................... 2 ISMO .................................. 16 isocarboxazid ..................... 25 isoniazid .............................. 2

ISONIAZID ........................... 2 ISOPTO ............................. 48 ISORDIL ............................. 16 isosorbide ......................... 16 isotretinoin ....................... 33

isoxsuprine ......................... 16 isradipine ............................ 12 itraconazole ........................ 1

ivermectin ............................. 2

J

JANUMET ....................37, 80 JANUVIA ......................39, 80 J-TAN .................................49

K

KADIAN ..............................19 KALETRA ............................ 3 KAON .................................61 KAYEXALATE ....................60 K-DUR ................................61 KEFLEX .......................... xi, 4 KENALOG ........ 33, 35, 37, 75 KEPPRA.............................21 KERLONE ..........................11 ketoconazole ................1, 31 ketoprofen.........................58

KETOPROFEN ..................58 ketorolac ............... 49, 58, 68

KETOROLAC .....................58 ketotifen ............................46

KETOTIFEN .......................46 KLARON ............................29 KLONOPIN.........................21 KLOR-CON ........................61 K-LYTE ..............................61 KOATE-DVI ..................67, 77 K-PHOS .............................61 KRISTALOSE .....................42 KYTRIL ..............................23

L

labetalol.............................11

LAC-HYDRIN .....................34 lacosamide ...................21, 77 lactic ..................................34 lactulose............................42

LAMICTAL..........................21 LAMISIL ................... 1, 31, 71 lamivudine ......................3, 63 LAMIVUDINE .....................77 lamotrigine ........................21

LANOXIN ...........................16 lanreotide .....................66, 77 lansoprazole ...............41, 80

lanthanum ....................60, 78 LANTUS .............................38 lapatinib ........................65, 77 LARIAM ............................... 1 LARTUS .............................52 LASIX .................................15 latanoprost .........................48 leflunomide .......................56

lenalidomide .................65, 77 LESCOL .......................10, 80 LESCOL XL........................80 LETAIRIS ............... 65, 73, 78

93

letrozole ............................... 8 leucovorin ......................... 62

LEUCOVORIN ................... 62 LEUKERAN .......................... 8 LEUKINE............................ 64 LEUKOTRIENE RECEPTOR

ANTAGONISTS ............ 79 leuprolide ...................... 9, 77

levalbuterol......................... 54 LEVAQUIN ........................... 7 LEVATOL ........................... 11 LEVEMIR ........................... 38 levetiracetam .................... 21

LEVITRA ................ 59, 70, 73 levobunolol ....................... 48 levocarnitine ..................... 61

levocetirizine ...................... 79 levofloxacin .......................... 7 levorphanol ........................ 18 LEVORPHANOL ................ 18 levothyroxine .............. 39, 40

LEVOTHYROXINE ............ 39 LEVSIN ........................ 40, 41 LEVSINEX ......................... 41 LEXAPRO .......................... 25 LEXIVA ................................ 3 LIALDA............................... 43 LIBRAX .............................. 40 LIBRIUM ............................ 20 LIDAMANTLE .................... 34 LIDEX .......................... 32, 75 lidocaine ........... 1, 34, 35, 43

LIDODERM ........................ 34 LIMBITROL ........................ 28 LINCOCIN ............................ 5 lincomycin ............................ 5 lindane .............................. 34

LINDANE ........................... 34 LIORESAL ......................... 57 liothyronine ...................... 40

LIPITOR ......................... 9, 80 LIPRAM.............................. 42 lisinopril ...................... 10, 14 lithium ............................... 28

LITHIUM............................. 28 LITHOBID .......................... 28 LITHOSTAT ....................... 59 LOBAC ............................... 56 LOCOID ............................. 33 LODINE.............................. 58 LODOSYN ......................... 22 lodoxamide......................... 46 LODRANE.......................... 49 LOFIBRA............................ 10 LOMOTIL ........................... 40 lomustine.............................. 8 LONITEN ........................... 16 loperamide ........................ 40

LOPID ................................ 10 lopinavir................................ 3 LOPRESSOR ............... 11, 14 LOPROX ............................ 30

loratadine .................... 50, 51

LORATADINE .................... 81 lorazepam ......................... 20

LORTAB/VICODIN ............. 17 losartan ....................... 11, 14

LOTENSIN ................... 10, 13 loteprednol ......................... 47 LOTREL ............................. 13 LOTRIMIN .......................... 30 LOTRISONE ................ 31, 75 LOTRONEX ....................... 43 lovastatin .................... 10, 80

LOVAZA ............................. 10 LOVENOX .......................... 60 loxapine ............................ 27

LOXITANE ......................... 27 LOZI-FLUR ........................ 62 LOZOL ............................... 15 lubiprostone ................. 43, 68 LUDIOMIL .......................... 25 LUFYLLIN-GG ................... 55 LUMIGAN ........................... 48 LUPRON ........................ 9, 77 LURIDE .............................. 62 LUVOX ............................... 25 LUXIQ .......................... 32, 75 LYRICA .............................. 22 LYSODREN ......................... 9

M

M.V.I. .................................. 62 MACROBID .......................... 6 MACRODANTIN .................. 6 mafenide ............................ 34 magnesium ........................ 56 MALARONE ................... 1, 70 maprotiline ......................... 25 maraviroc ....................... 2, 77 MARINOL ........................... 23 MARPLAN .......................... 25 MATULANE ......................... 9 MAVIK ................................ 11 MAXAIR ............................. 54 MAXALT ....................... 24, 69 MAXIDEX ........................... 47 MAXITROL ......................... 47 mebendazole ....................... 2 meclizine ........................... 23

meclofenamate .................. 58 MECLOFENAMATE ........... 58 MEDROL ............................ 36 medroxyprogesterone ..... 44

mefenamic ......................... 58 mefloquine .......................... 1

MEGACE ............................. 8 megestrol ............................ 8

MELLARIL .......................... 27 meloxicam ........................ 58

melphalan ............................ 8 memantine ......................... 16 MENEST ............................ 44

MENTAX ............................30 meperidine ........................18 meprobamate ....................20

MEPRON ............................ 5 mercaptopurine ................. 8 mesalamine .......................43

MESTINON ..................24, 25 METADATE ........................28 METAGLIP .........................37 metaproterenol ...................54 METAPROTERENOL ........54 metaxalone .......................57 metformin....................37, 80

METFORMIN .....................80 metforming .........................80 methadone ........................18

METHADONE ....................18 methamphetamine ...........28 methazolamide .................15

methen ...............................59 methenamine ....................59

METHERGINE ...................39 methimazole .....................39

METHITEST ...................8, 39 methocarbamol ................57 methotrexate .................8, 57

METHOTREXATE .... 8, 57, 73 methoxsalen .......................33 methscopolamine .............41

methsuximide .....................21 methyclothiazide ................15 METHYCLOTHIAZIDE .......15 methyldopa .................13, 14

methylergonovine ...............39 methylnaltrexone .... 43, 68, 77 methylphenidate ...............28 methylprednisolone ...36, 37

methyltestosterone .........8, 39 metipranolol ......................48 metoclopramide ...............43 metolazone .......................15 metoprolol...................11, 14

METROCREAM .................29 METROGEL .................29, 45 metronidazole ......... 5, 29, 45

MEVACOR .........................10 mexiletine ............................ 9 MEXILETINE ....................... 9 MIACALCIN ..................39, 45 micafungin ..........................63 MICARDIS....................11, 14 miconazole .........................45 MICONAZOLE ...................45 MICRO-K/SLOW-K ............61 MICRONASE .....................38 MIDAMOR ..........................15 midazolam.........................20 midodrine ..........................13

MIDRIN ..............................23 miglitol ................................37 MIGRALAM ........................23 MIGRANAL ........................24

94

MIMYX ............................... 34 MINIPRESS ....................... 11 MINOCIN ............................. 7 minocycline ........................ 7 minoxidil ........................... 16

MIRAPEX ........................... 22 mirtazapine ....................... 25 misoprostol ...................... 41

mitotane ............................... 9 mitoxantrone .................... 65

MOBAN .............................. 27 MOBIC ............................... 58 modafinil............................. 28 MODURETIC ..................... 15 moexipril ..................... 10, 14

molindone .......................... 27 mometasone ... 33, 55, 56, 79

MONOCLATE-P ................. 77 MONODOX .......................... 7 MONONINE ................. 67, 77 MONOPRIL .................. 10, 14 montelukast ........................ 55 MONTELUKAST ................ 79 MONUROL ........................... 5 morphine ............................ 19 MORPHINE ........................ 19 MOTOFEN ......................... 40 MOTRIN ............................. 58 moxifloxacin ................... 7, 47 MS ..................................... 19 MST ................................... 56 multiple............................... 62 mupirocin.......................... 30

MYAMBUTOL ...................... 2 MYCAMINE .................. 63, 73 MYCELEX ............................ 1 MYCOBUTIN ....................... 2 MYCOLOG ......................... 31 mycophenolate ................... 8

MYCOSTATIN ................... 31 MYDRIACYL ...................... 49 MYLERAN............................ 8 MYSOLINE ........................ 22 MYTELASE ........................ 57

N

nabumetone ...................... 58

nadolol ......................... 11, 14 nafarelin ............................. 39 nafcillin ............................... 6

NAFCILLIN ........................... 6 NAFRINSE ......................... 35 naftifine .............................. 31 NAFTIN .............................. 31 NALFON ............................ 58 naloxone ........................... 60

NALOXONE ....................... 60 naltrexone ......................... 60

NAMENDA ......................... 16 naphazoline ...................... 49

NAPRELAN ........................ 58

NAPROSYN ....................... 58 naproxen ........................... 58

naratriptan .................... 24, 69 NARDIL .............................. 25 NASACORT ....................... 56 NASACORT AQ ................. 79 NASAREL .................... 56, 79 NASONEX ................... 56, 79 NATACYN .......................... 47 natalizumab ........................ 64 natamycin ........................... 47 NAVANE ............................ 27 NEBUPENT ......................... 6 nedocromil ................... 46, 80 nefazodone ........................ 25 nelfinavir ............................... 3 neomycin ...................... 6, 47

NEOMYCIN .......................... 6 NEOSPORIN ............... 46, 47 neostigmine ........................ 24 NEOTUSS-D ...................... 53 nepafenac .......................... 49 NEPTAZANE ..................... 15 NEULASTA ........................ 64 NEUMEGA ......................... 64 NEUPOGEN ...................... 64 NEURONTIN ...................... 21 NEVANAC .......................... 49 nevirapine ............................ 3 NEXAVAR .............. 65, 73, 78 niacin .................................. 10 NIASPAN ........................... 10 nicardipine ........................ 12

nifedipine ............................ 12 NILANDRON ........................ 8 nilotinib ......................... 65, 77 nilutamide ............................. 8 nimodipine ........................ 12

NIMOTOP .......................... 12 nisoldipine .......................... 12 nitazoxanide ......................... 2 NITRO-DUR ....................... 16 nitrofurantoin ........................ 6 nitroglycerin ..................... 16

NITROLINGUAL................. 16 NITRO-TIME ...................... 16 nizatidine .......................... 41

NIZORAL ....................... 1, 31 NOLVADEX ......................... 8 NON-CALCIUM

CONTAINING PHOSPHATE BINDER .. 78

NORDITROPIN ............ 66, 76 norethindrone ................... 44

NORFLEX .......................... 57 norfloxacin ............................ 7 NORITATE ......................... 29 NORMODYNE ................... 11 NOROXIN ............................ 7 NORPACE ........................... 9 NORPRAMIN ..................... 26 NORTHYX ......................... 39

nortriptyline ......................26

NORVASC .........................12 NORVIR .............................. 3 NOVANTRONE ..................65 NOVOLIN .....................37, 38 NOVOLOG .........................38 NOVOSEVEN ..............67, 77 NOXAFIL ........................1, 73 NULYTELY.........................42 NUTROPIN ..................66, 76 nystatin ................... 1, 31, 45

NYSTATIN ............... 1, 31, 45

O

OBTREX ............................46 OCL ....................................42 octeotride ...........................78 octreotide ..........................66

OCUFEN ............................49 OCUFLOX ..........................47 OCULAR ALLERGIES .......80 OCUPRESS .......................48 ofloxacin ................. 7, 36, 47

OFORTA ......................65, 73 OGEN ................................44 olanzapine ..........................26 olmesartan ...................11, 14 olopatadine.........................46 Olopatadine ........................80 olsalazine ...........................43 OLUX ...........................33, 75 omega-3-acid .....................10 omeprazole .......................41

OMEPRAZOLE OTC ..........81 omeprazole-sodium ............41 OMNARIS ..........................79 OMNICEF............................ 4 OMNITROPE ...............66, 76 ondansetron .....................23

OPANA ..............................19 oprelvekin ...........................64 OPTIPRANOLOL ...............48 OPTIVAR .....................46, 80 ORACIT..............................60 ORAP .................................24 ORAPRED/PEDIAPRED ....37 ORASEP ............................35 ORAXYL.............................. 7 ORENCIA ............... 66, 73, 76 orphenadrine ....................57

ORPHENADRINE/ASA/CAFFEINE ..............................57

ORUDIS .............................58 oseltamivir ........................... 4 OTICIN ...............................36 oxaprozin ..........................58 oxazepam ..........................20 oxcarbazepine ..................21

oxiconazole ........................31 OXISTAT ............................31 oxybutynin ........................59

95

oxycodone.......................... 19 OXYCONTIN ...................... 19 oxymorphone ..................... 19

P

PACERONE ......................... 9 PALGIC .............................. 50 PAMELOR ......................... 26 pamidronate ....................... 66 PAMINE ............................. 41 PANCREASE ..................... 42 PANCRECARB .................. 42 PANCRELIPASE ............... 42 PANDEL....................... 33, 75 PANLOR ............................ 17 pantoprazole ............... 41, 80 papaverine ........................ 16

PAPAVERINE .................... 16 paracalcitol ......................... 78 PARAFON.......................... 57 paregoric........................... 40

PAREGORIC ..................... 40 paricalcitol .......................... 60 PARLODEL ........................ 22 PARNATE .......................... 25 paroxetine ......................... 25

PASER ................................. 2 PATADAY .................... 46, 80 PATANOL .................... 46, 80 PAXIL ................................. 25 pazopanib .......................... 65 PAZOPANIB ...................... 78 PCE ..................................... 5 PEDIATAN ......................... 50 PEDIAZOLE ......................... 5 peg ..................................... 42 pegademase ...................... 64 PEGANONE ....................... 21 PEGASYS .............. 63, 73, 77 pegfilgrastim ....................... 64 peginterferon ................ 63, 64 PEGINTERFERON ALFA-2A

...................................... 77 PEGINTERFERON ALFA-2B

...................................... 77 PEG-INTRON ........ 64, 73, 77 pemirolast .......................... 80 penbutolol .......................... 11 penciclovir .......................... 31 penicillamine ...................... 57 penicillin ............................... 7 PENICILLIN ......................... 7 PENLAC....................... 30, 68 PENTAM .............................. 6 pentamidine ......................... 6 PENTASA .......................... 43 pentosan ............................ 59 pentoxifylline .................... 61

PEPCID.............................. 41 PERCOCET ....................... 17 PERCODAN ....................... 17

PERFOROMIST ................. 54 PERIDEX ........................... 35 perindopril ........................ 10 permethrin ........................ 34 perphenazine .................... 27

PERPHENAZINE/AMITRIPTYLINE ............................ 28

PERSANTINE .................... 61 PHANASIN ......................... 52 phenazopyridine............... 58

phenelzine .......................... 25 PHENERGAN .................... 23 phenobarbital ................... 21

PHENOBARBITAL ............. 21 phenyleph .......................... 52 phenyleph-chlorphen.......... 52 phenyleph-dm-pyril-pot ...... 52 phenyleph-ephed-cpm ....... 52 phenylephrine ...... 50, 52, 53

phenylephrine-brompheniramine-guaifenesin .................... 53

phenylephrine-chlorphen-dihydrocodeine ............ 53

phenylephrine-chlorphen-dm ................................. 53

phenyltoloxamine ............... 56 phenytoin .......................... 21

PHISOHEX ........................ 35 PHOSLO ............................ 59 PHRENILIN .................. 18, 24 physiological .................... 35

PHYSIOLYTE .................... 35 phytonadione ................... 62 pilocarpine .................. 35, 48

PILOPINE .......................... 48 pimozide ............................. 24 pindolol ............................... 11 pioglitazone ............ 37, 38, 80 pirbuterol ............................ 54 piroxicam .......................... 58

PLAQUENIL ......................... 1 PLAVIX .............................. 61 PLENDIL ............................ 12 PLETAL .............................. 61 PLEXION ........................... 30 podofilox ............................. 34 POLYCITRA ....................... 60 polyethylene ..................... 42 polymyxin ......................... 47

POLYSPORIN .................... 46 POLYTRIM ......................... 47 PONSTEL .......................... 58 posaconazole ....................... 1 pot ................................ 60, 61 potassium ............... 53, 60, 61 pramipexole ...................... 22

PRAMOSONE .................... 34 pramoxine ................... 34, 36

PRANDIN ........................... 38 PRAVACHOL ..................... 10 pravastatin ........................ 10

praziquantel......................... 2 prazosin ............................11

PRECOSE..........................37 PRED .................................47 PRED-G .............................47 prednicarbate ...................33 prednisolone ......... 37, 47, 48 prednisone ........................37

PREDNISONE ...................37 PREFEST...........................44 pregabalin ..........................22 PRELONE ..........................37 PREMARIN ..................44, 46 PREMPHASE .....................44 PREMPRO .........................44 prenatal .............................46

PRENATAL ........................46 PREVACID ...................41, 80 PREVIDENT .......................35 PREVPAC ..........................41 PREZISTA........................... 3 PRIFTIN .............................. 2 PRILOSEC .........................41 primaquine .......................... 1 PRIMAQUINE ..................... 1 PRIMAXIN ........................... 5 primidone ..........................22

PRINCIPEN ......................... 6 PRINIVIL ............................10 PRINZIDE ..........................14 PROAIR .............................54 PROAMATINE ...................13 probenecid ........................56

procarbazine ....................... 9 PROCARDIA ......................12 prochlorperazine ..............23

PROCRIT .....................64, 76 PROCTOCORT ............32, 43 PROCTOFOAM .................43 PROFILNINE ................67, 77 PROFILNINE SD ................77 progesterone ................44, 46 PROGESTERONE .............44 PROGLYCEM ....................39 PROLASTIN .......................64 PROLIXIN ..........................27 PROLOPRIM ....................... 6 promethazine ..............23, 53

PROMETHAZINE .........50, 53 PROMETHAZINE/CODEINE

......................................53 PROMETHAZINE/DEXTROM

ETHORPHAN ................53 PROMETRIUM ...................44 propafenone ...................... 9

propantheline .....................41 PROPANTHINE .................41 PROPINE ...........................48 propoxyphene ..................19 propranolol .................12, 14 propylthiouracil ................39

PROPYLTHIOURACIL .......39

96

PROSCAR ......................... 58 PROSOM ........................... 20 PROSTIGMIN .................... 24 proteinase .......................... 64 PROTON PUMP

INHIBITORS .................. 80 PROTONIX .................. 41, 80 protriptyline ...................... 26

PROVENTIL ....................... 54 PROVERA ......................... 44 PROVIGIL .......................... 28 PROZAC ............................ 25 pseudoephed ..................... 53 pseudoephed-bromphen-

dm ................................. 53

pseudoephed-chlorphen .... 53 pseudoephed-chlorphen-dm

...................................... 53 pseudoephedrine ......... 53, 54 PSEUDOEPHEDRINE/GUAI

FENESIN ....................... 53 pseudoephedrine-

dihydrocodeine-gg ......... 54 PSORCON ................... 32, 75 PSORCON E ..................... 75 PULMICORT ...................... 55 PULMONARY

HYPERTENSION .......... 78 PULMOZYME .................... 66 PURINETHOL ...................... 8 pyrazinamide ...................... 2

PYRAZINAMIDE .................. 2 PYRIDIUM ......................... 58 pyridostigmine ........... 24, 25 pyridoxine ......................... 62

PYRIDOXINE ..................... 62 pyrilamine ......................... 50

pyrimethamine ..................... 1

Q

QUALAQUIN .................. 2, 71 quazepam .......................... 20 QUESTRAN ......................... 9 quetiapine .......................... 26 QUINAGLUTE ...................... 9 quinapril ...................... 11, 14 quinidine ............................. 9

QUINIDINE .......................... 9 quinine ................................. 2 quinine sulfate .................... 71 QVAR ................................. 55

R

rabeprazole .................. 41, 80 raloxifene ........................... 45 raltegravir ............................. 2 ramipril .............................. 11

RANEXA ................ 16, 73, 78 ranitidine ........................... 41

ranolazine .......................... 16 ranolazineE ........................ 78 RAZADYNE ....................... 16 REBETOL .............. 64, 73, 77 REBIF ................................ 64 RECLAST .............. 66, 71, 78 RECOMBINATE ................. 77 REFACTO .................... 67, 77 REGLAN ............................ 43 REGRANEX ....................... 35 RELAFEN .......................... 58 RELAGARD ....................... 45 RELAGESIC ...................... 56 RELENZA ............................ 4 RELISTOR ............. 43, 68, 77 RELPAX ....................... 24, 70 REMERON ......................... 25 REMODULIN ......... 65, 73, 78 RENAGEL .............. 60, 73, 78 RENVELA .............. 60, 73, 78 repaglinide ......................... 38 REQUIP ............................. 22 RESCRIPTOR ..................... 2 reserpine ............................ 13 RESERPINE ...................... 13 RESPA ............................... 52 RESPA-1ST ....................... 54 RESPAHIST ....................... 49 RESTASIS ............. 48, 73, 76 RESTORIL ......................... 20 RETIN A ............................. 73 RETIN-A ....................... 30, 75 RETROVIR .......................... 3 REVATIO ............... 65, 73, 78 REVIA ................................ 60 REVLIMID .............. 65, 73, 77 REYATAZ ............................ 3 RHINOCORT ..................... 56 RHINOCORT AQUA .......... 79 Ribapak .............................. 73 RIBAPAK ..................... 64, 77 ribavirin ............................. 64

RIBAVIRIN ......................... 77 RIDAURA ........................... 57 rifabutin ................................ 2 RIFADIN ............................... 2 RIFAMATE ........................... 2 rifampin ............................... 2

rifapentine ............................ 2 RIFATER .............................. 2 RILUTEK ............................ 25 riluzole ................................ 25 rimantadine ......................... 4

rimexolone ......................... 48 ringer's .............................. 35

RINGER'S .......................... 35 risedronate ................... 45, 79 risedronate & calcium

carbonate ...................... 79 RISPERDAL ....................... 26 risperidone ....................... 26

RITALIN ............................. 28

ritonavir ............................... 3 rivastigmine ........................17 rizatriptan .....................24, 69 ROBAXIN ...........................57 ROBINUL ...........................40 ROCALTROL .....................62 ROCEPHIN ......................... 5 ROMAZICON .....................60 RONDEC............................49 ropinirole...........................22

ROSAC ..............................30 rosiglitazona .......................80 rosiglitazone ........... 37, 38, 80 ROSULA ............................30 rosuvastatin ..................10, 80 ROWASA ...........................43 ROXICET ...........................17 ROXICODONE ...................19 rufinamide ....................22, 78 RYNA-12 ............................50 RYNA-12X..........................52 RYNATAN ....................49, 50 RYNATUSS ........................52 RYTHMOL........................... 9

S

SAIZEN ........................65, 76 SALAGEN ..........................35 SALEX ...............................34 salicylic .............................34

salmeterol...........................54 salsalate ............................58

SAL-TROPINE ...................40 SANDOSTATIN ............66, 78 SANDOSTATIN,

SANDOSTATIN LAR .....73 SANTYL .............................35 saquinavir ............................ 4 sargramostim .....................64 scopolamine .......................23 SECTRAL...........................11 selegiline ...........................22

SELZENTRY ............ 2, 73, 77 SEMPREX-D ......................49 SENSIPAR ............. 59, 73, 76 SEPTRA .............................. 7 SERAX ...............................20 SEREVENT ........................54 SEROMYCIN ...................... 2 SEROQUEL .......................26 SEROSTIM ..................66, 76 sertraline ...........................26

SERZONE ..........................25 sevelamer.....................60, 78 sevelamer- .........................60 SILDEC ..............................49 sildenafil ........... 59, 65, 70, 78 SILVADENE .......................30 silver ..................................30

SIMCOR .............................10 SIMETYL ............................40

97

SIMUC-GP ......................... 52 simvastatin ....................... 10

SINEMET ........................... 22 SINEQUAN ........................ 26 SINGULAIR .................. 55, 79 sitagliptin ...................... 37, 39 SITAGLIPTIN ..................... 80 sitagliptin & metformin ........ 80 SKELAXIN ......................... 57 SKELID ........................ 45, 79 sodium31, 35, 43, 54, 59, 60,

62, 64, 65 SODIUM................. 54, 59, 62 sodium oxybate .................. 78 SOLU-CORTEF ................. 36 SOLU-MEDROL ........... 36, 37 SOMA ................................ 57 somatropin ................... 65, 76 somatropin. ........................ 66 somatropin-. ....................... 66 somatropin-.- ...................... 66 somatropin.- ....................... 66 somatropin.. ....................... 66 somatropin--.. ..................... 65 somatropin..- ...................... 66 somatropin... ...................... 66 SOMATULINE ........ 66, 73, 77 SOMNOTE ......................... 20 SONATA ............................ 20 sorafenib ...................... 65, 78 SORIATANE ...................... 33 sotalol ................................. 9

SPECTAZOLE ................... 31 SPECTRACEF ..................... 4 SPIRIVA ............................. 54 spironolactone ................. 15

SPORANOX ......................... 1 SPRYCEL .............. 65, 74, 76 STALEVO .......................... 23 stannous ........................... 35

STATINS ............................ 80 stavudine ............................ 3

STELAZINE ....................... 27 STIMATE ........................... 66 STRATTERA .... 27, 75, 76, 79 streptomycin ......................... 6 STREPTOMYCIN ................ 6 STROMECTOL .................... 2 succimer............................. 60 sucralfate .......................... 41

SULAR ............................... 12 sulconazole ........................ 31 sulfacetamide ....... 29, 30, 47

sulfadiazine .......................... 7 SULFADIAZINE ................... 7 sulfamethoxazole ............... 7

SULFAMYLON ................... 34 sulfanilamide ...................... 45 sulfasalazine ..................... 43

sulfisoxazole ........................ 7 sulindac ............................ 58 sumatriptan ................ 24, 69

sunitinib ........................ 65, 78 SUPRAX .............................. 4 SURMONTIL ...................... 26 SUSTIVA .............................. 2 SUTENT ................. 65, 74, 78 SYMBICORT ...................... 55 SYMMETREL ................. 4, 23 SYNALAR .................... 32, 75 SYNAREL .......................... 39 SYNTHROID ...................... 40

T

tadalafil ......................... 59, 70 TAGAMET .......................... 41 TAMBOCOR ........................ 9 TAMIFLU .............................. 4 tamoxifen ............................ 8 tamsulosin ........................ 59

TANAFED .......................... 53 TAPAZOLE ........................ 39 TARCEVA .............. 65, 74, 76 TARGRETIN ............ 8, 33, 34 TARKA ............................... 14 TASIGNA ............... 65, 74, 77 TASMAR ............................ 22 tazarotene .......................... 34 TAZORAC .......................... 34 TEGRETOL ........................ 20 TEGRETOL-XR.................. 20 telbivudine .......................... 63 TELBIVUDINE ................... 77 telmisartan ................... 11, 14 temazepam ....................... 20

TEMODAR ......................... 65 TEMOVATE ................. 33, 75 temozolomide ..................... 65 TENEX ............................... 13 tenofovir ......................... 3, 78 TENORETIC ...................... 13 TENORMIN ........................ 11 TERAZOL .......................... 45 terazosin ........................... 11 terbinafine ............... 1, 31, 71 terbutaline ......................... 54 terconazole ....................... 45

teriparatide ................... 66, 78 TESSALON ........................ 51 testosterone ....................... 39 TESTOSTERONE .............. 39 tetracycline ......................... 8

tetrahydrozoline ................. 50 TEVETEN .................... 11, 14 TEV-TROPIN ............... 66, 76 TEXACORT ....................... 32 thalidomide ......................... 65 THALITONE ....................... 15 THALOMID ........................ 65 THEO-24 ............................ 56 THEO-DUR ........................ 56 theophylline .................. 55, 56 thiamine ............................ 62

THIAMINE ..........................62 THIAZOLIDINEDIONES .....80 THIOLA ..............................59 thioridazine .......................27 thiothixene ........................27

THORAZINE ......................27 thyroid ................................40 tiagabine.............................22 TIAZAC ..............................12 TICLID ................................61 ticlopidine .........................61

TIGAN ................................23 tiludronate ....................45, 79 timolol ...........................12, 48 TIMOPTIC ..........................48 TINVER ..............................31 tinzaparin............................61 tiopronin .............................59 tiotropium ...........................54 tipranavir ............................. 4 tipranivir..............................78 tizanidine...........................57

TOBI ...................................63 TOBRADEX .......................47 tobramycin ..................47, 63

TOBRAMYCIN ...................63 TOBREX ............................47 TOFRANIL .........................26 TOFRANIL-PM ...................26 tolazamide ..........................38 tolbutamide.........................38 TOLBUTAMIDE ..................38 tolcapone............................22 TOLECTIN .........................58 TOLINASE .........................38 tolmetin ..............................58 TOLMETIN .........................58 tolterodine ..........................59 TOPAMAX..........................22 TOPICORT...................32, 75 topiramate .........................22

TOPROL ............................11 TORADOL .........................68

toremifene ........................... 8 torsemide ..........................15

TRACLEER ............ 65, 74, 78 tramadol ............................20 trandolapril .................11, 14

TRANSDERM-SCOP .........23 TRANXENE ........................20 TRANXENE-SD .................20 tranylcypromine ...............25

TRAVATAN ........................48 travoprost ...........................48 trazodone ..........................25

TRECATOR ........................ 2 TRENTAL ...........................61 treprostinil.....................65, 78 tretinoin ..........................9, 30 TREXALL .......................8, 57 triamcinolone ... 33, 35, 37, 55,

56, 79

98

triamterene ......................... 15 triazolam ........................... 20

TRICOR ............................. 10 trifluoperazine .................. 27 trifluridine ......................... 47

TRIGLIDE .......................... 10 trihexyphenidyl ................ 22

TRILAFON ......................... 27 TRILEPTAL ........................ 21 TRILIPIX .............................. 9 TRILISATE ......................... 56 trimethobenzamide .......... 23 trimethoprim ....................... 6

trimipramine ....................... 26 triprolidine .......................... 50 TRIZIVIR .............................. 3 tropicamide ....................... 49

TRUSOPT .......................... 48 TRUVADA ............................ 3 TUSNEL ................. 51, 53, 54 TUSSAFED ........................ 53 TUSSI-12 ........................... 51 TUSSI-12D ......................... 52 TUSSIONEX ...................... 51 TUSSI-ORGANIDIN ........... 52 TUSSI-ORGANIDIN-S ....... 51 TUSSI-PRES ..................... 53 TUSSIZONE-12 ................. 51 TUSSO-C ........................... 51 TYKERB................. 65, 74, 77 TYLENOL/CODEINE ......... 17 TYSABRI............................ 64 TYZEKA ................. 63, 74, 77 TYZINE .............................. 50

U

ULTRACET ........................ 17 ULTRAM ............................ 20 ULTRASE .......................... 42 ULTRAVATE ................ 33, 75 UNIRETIC .......................... 14 UNIVASC ........................... 10 urea .................................... 34 URECHOLINE ................... 59 URETRON ......................... 59 URIN .................................. 59 URISPAS ........................... 59 URITACT ........................... 59 UROCIT-K.......................... 60 URSO ................................ 43 ursodiol ............................. 43

V

VAGIFEM ........................... 46 valacyclovir ........................ 2

VALISONE ................... 32, 75 VALIUM.............................. 20 valproate ..................... 22, 28 valproic ....................... 22, 28

valsartan ...................... 11, 14 VALTREX ............................. 2 VANCOCIN .......................... 6 vancomycin .......................... 6 VANTIN ................................ 4 vardenafil ..................... 59, 70 VASERETIC ....................... 14 VASOCIDIN ....................... 47 VASODILAN ...................... 16 VASOTEC .......................... 10 VAZOL-D ........................... 49 VEETIDS .............................. 7 venlafaxine ....................... 25

VENTAVIS ............. 65, 74, 78 VENTOLIN ......................... 54 VEPESID ............................. 9 verapamil .................... 12, 13

VERELAN .................... 12, 13 VERMOX ............................. 2 VERSED ............................ 20 VERTIN-32 ......................... 23 VESANOID .......................... 9 VEXOL ............................... 48 VFEND ..................... 1, 63, 74 VIAGRA ................. 59, 70, 74 VIBRAMYCIN ....................... 7 VIBRAMYCIN/VIBRATAB .... 7 VICOPROFEN ................... 18 VIDEX .................................. 3 VIGAMOX .......................... 47 VIMPAT .................. 21, 74, 77 VIOKASE ........................... 42 VIRACEPT ........................... 3 VIRAMUNE .......................... 3 VIRAZOLE ......................... 64 VIREAD .......................... 3, 78 VIREAD .............................. 74 VIROPTIC .......................... 47 VISICOL ............................. 43 VISKEN .............................. 11 VISTARIL ........................... 20 vitamin ................................ 62 VITAMIN ............................ 62 VIVACTIL ........................... 26 VIVELLE-DOT .................... 45 VOLTAREN .................. 49, 57 VOLTAREN-XR.................. 58 VOPAC .............................. 17 voriconazole ................... 1, 63 vorinostat ..................... 65, 78 VOSOL ............................... 35 VOSOL-HC ........................ 35 VOSPIRE ........................... 54 VOTRIENT ............. 65, 74, 78 VYTONE ............................ 31 VYTORIN ..................... 10, 80

W

warfarin ............................. 61 water .................................. 35

Welchol .............................. 10

WELLBUTRIN ....................25 WESTCORT .......................33 WILATE ........................67, 77 WYGESIC ..........................19 WYTENSIN ........................13

X

XALATAN ...........................48 XANAX ...............................20 XELODA.............................65 XERAC-AC.........................33 XOPENEX ..........................54 XYLOCAINE ...................1, 35 XYREM .................. 65, 74, 78 XYZAL ................................79

Y

YODEFAN ..........................53 YODOXIN............................ 2

Z

ZADITOR ...........................46 ZADITOR OTC ...................81 zafirlukast ...........................55 ZAFIRLUKAST ...................79 zaleplon .............................20

ZANAFLEX.........................57 zanamivir ............................. 4 ZANTAC .............................41 ZARONTIN .........................21 ZAROXOLYN .....................15 ZEBETA .............................11 ZEGERID ...........................41 ZEGERID® OTC ................81 ZEMPLAR .............. 60, 74, 78 ZERIT .................................. 3 ZETIA .................................10 ZIAC ...................................13 ZIAGEN ............................... 3 zidovudine ......................... 3

zileuton ...............................55 ziprasidone .........................27 ZITHROMAX ....................... 5 ZMAX .................................. 5 ZOCOR ..............................10 ZODERM............................29 ZOFRAN ............................23 zoledronic ...........................66 Zoledronic acid ...................71 ZOLEDRONIC ACID ..........78 ZOLINZA ................ 65, 74, 78 zolmitriptan ...................24, 69 ZOLOFT .............................26 zolpidem............................20

ZOMIG .........................24, 69 ZONALON ..........................31 ZONEGRAN .......................22

99

zonisamide ....................... 22

ZOVIRAX ....................... 2, 31 ZYDONE ............................ 17

ZYFLO ............................... 55 ZYLOPRIM ......................... 56 ZYMINE-D .......................... 50

ZYPREXA ..........................26 ZYRTEC .............................50 ZYRTEC-D .........................49

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