UPDATE AD Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective January 19, 2012 SUMMARY OF CHANGES

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1 UPDATE AD Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective January 19, 2012 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 3 Off Formulary Interchangeable Product(s) 16 Manufacturer Requested Discontinued Drug(s) 17 Delisted Drug(s) 18 Drug Benefit Price(s) 21 New Manufacturer Name(s) 24 Therapeutic Note Change(s) 25 Trade Name Change(s) 26 Index 27 Page 1

2 New Single Source Drug(s) DIN PRODUCT GENERIC NAME MFR DBP Hydromorph Contin 4.5mg CR Cap HYDROMORPHONE HCL PFP Hydromorph Contin 9mg CR Cap HYDROMORPHONE HCL PFP Invega Sustenna 50mg Inj Pref Syr PALIPERIDONE PALMITATE JAN Invega Sustenna 75mg Inj Pref Syr PALIPERIDONE PALMITATE JAN Invega Sustenna 100mg Inj Pref Syr PALIPERIDONE PALMITATE JAN Invega Sustenna 150mg Inj Pref Syr PALIPERIDONE PALMITATE JAN For the treatment of schizophrenia or schizoaffective disorders in patients who have: A history of non-adherence; AND one of the following: (a) Inadequate control or significant side-effects from two or more formulary oral antipsychotic medications, including at least one atypical agent; OR (b) Inadequate control or significant side-effects from one or more conventional depot antipsychotic agents Lumigan RC 0.01% Oph Sol-7.5mL Pk BIMATOPROST ALL Reason for Use Code Clinical Criteria As first line treatment of elevated intraocular pressure in patients who cannot tolerate an ophthalmic beta-blocking agent or where betablocking agents are contraindicated; LU Authorization Period: Indefinite. As second line monotherapy or combination therapy in patients who do not have an adequate intraocular pressure lowering response to ophthalmic beta-blocking agents; LU Authorization Period: Indefinite. 387 For use as adjunctive therapy with an ophthalmic beta-blocking agent in an urgent situation (e.g. patients with a high baseline intraocular pressure) where monotherapy is unlikely to be effective. LU Authorization Period: Indefinite. Page 2

3 New Multi-Source Drug(s) DIN BRAND STRENGTH DOSAGE FORM MFR DBP Apo-Clopidogrel 75mg Tab APX (Interchangeable with Plavix) Reason for Use Code 375 Clinical Criteria For patients immediately post-hospitalization for Acute Coronary Syndrome (ACS), in combination with ASA. ACS is defined as any myocardial infarction (MI) or unstable angina (UA). LU Authorization Period: Indefinite. 376 For patients immediately pre- or post-percutaneous coronary intervention (PCI).* *Therapy may be initiated up to 10 days prior to PCI LU Authorization Period: Indefinite. 411 For patients who experience a stroke or transient ischemic attack (TIA) while taking Aggrenox (dipyridamole and ASA) or ASA alone; or For patients experiencing ongoing severe symptomatic peripheral vascular disease (PVD) (i.e. with Ankle Brachial Index < 0.5) after a vascular event while on ASA. ASA should not be used concomitantly; or For patients requiring ASA with documented severe allergy to ASA, such as anaphylactic reaction or bronchospasm. Gastrointestinal events (GI), including GI bleeds, are excluded. LU Authorization Period: Indefinite. Page 3

4 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Apo-Mycophenolate 250mg Cap APX Apo-Mycophenolate 500mg Tab APX (Interchangeable with Cellcept) Reason for Use Code 190 Clinical Criteria For the prophylaxis of organ rejection in patients receiving allogeneic renal, cardiac or hepatic transplants. LU Authorization Period: Indefinite Co Candesartan 4mg Tab COB Co Candesartan 8mg Tab COB Co Candesartan 16mg Tab COB (Interchangeable with Atacand) Page 4

5 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Co Clopidogrel 75mg Tab COB (Interchangeable with Plavix) Reason for Use Code 375 Clinical Criteria For patients immediately post-hospitalization for Acute Coronary Syndrome (ACS), in combination with ASA. ACS is defined as any myocardial infarction (MI) or unstable angina (UA). LU Authorization Period: Indefinite. 376 For patients immediately pre- or post-percutaneous coronary intervention (PCI).* *Therapy may be initiated up to 10 days prior to PCI LU Authorization Period: Indefinite. 411 For patients who experience a stroke or transient ischemic attack (TIA) while taking Aggrenox (dipyridamole and ASA) or ASA alone; or For patients experiencing ongoing severe symptomatic peripheral vascular disease (PVD) (i.e. with Ankle Brachial Index < 0.5) after a vascular event while on ASA. ASA should not be used concomitantly; or For patients requiring ASA with documented severe allergy to ASA, such as anaphylactic reaction or bronchospasm. Gastrointestinal events (GI), including GI bleeds, are excluded. LU Authorization Period: Indefinite Co Diltiazem CD 120mg LA Cap COB Co Diltiazem CD 180mg LA Cap COB Co Diltiazem CD 240mg LA Cap COB Co Diltiazem CD 300mg LA Cap COB (Interchangeable with Cardizem CD) Co Diltiazem T 120mg SR Cap COB Co Diltiazem T 180mg SR Cap COB Co Diltiazem T 240mg SR Cap COB Co Diltiazem T 300mg SR Cap COB Co Diltiazem T 360mg SR Cap COB (Interchangeable with Tiazac) Page 5

6 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Co Latanoprost 0.005% Oph Sol-2.5mL Pk COB (Interchangeable with Xalatan) Reason for Use Code 171 Clinical Criteria As first line treatment of elevated intraocular pressure in patients who cannot tolerate an ophthalmic beta-blocking agent or where beta-blocking agents are contraindicated; LU Authorization Period: Indefinite. 172 As second line monotherapy or combination therapy in patients who do not have an adequate intraocular pressure lowering response to ophthalmic beta-blocking agents. LU Authorization Period: Indefinite. 387 For use as adjunctive therapy with an ophthalmic beta-blocking agent in an urgent situation (e.g. patients with a high baseline intraocular pressure) where monotherapy is unlikely to be effective. LU Authorization Period: Indefinite Gd-Venlafaxine XR 37.5mg ER Cap GEM Gd-Venlafaxine XR 75mg ER Cap GEM Gd-Venlafaxine XR 150mg ER Cap GEM (Interchangeable with Effexor XR) Jamp-Atenolol 50mg Tab JPC Jamp-Atenolol 100mg Tab JPC (Interchangeable with Tenormin) Jamp-Gabapentin 100mg Cap JPC Jamp-Gabapentin 300mg Cap JPC Jamp-Gabapentin 400mg Cap JPC (Interchangeable with Neurontin) Page 6

7 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Jamp-Lisinopril 5mg Tab JPC Jamp-Lisinopril 10mg Tab JPC Jamp-Lisinopril 20mg Tab JPC (Interchangeable with Zestril) Mar-Amlodipine Tablets 5mg Tab MAR Mar-Amlodipine Tablets 10mg Tab MAR (Interchangeable with Norvasc) Mar-Atenolol 50mg Tab MAR Mar-Atenolol 100mg Tab MAR (Interchangeable with Tenormin) Mar-Citalopram 20mg Tab MAR Mar-Citalopram 40mg Tab MAR (Interchangeable with Celexa) Mar-Letrozole 2.5mg Tab MAR (Interchangeable with Femara) Reason for Use Code Clinical Criteria For the treatment of metastatic breast cancer in hormone receptor positive post-menopausal women. LU Authorization Period: Indefinite. For the treatment of hormone receptor positive early breast cancer in postmenopausal women who have received 5 years of adjuvant tamoxifen therapy. LU Authorization Period: 5 years. As an alternative to tamoxifen for the adjuvant treatment of postmenopausal women with hormone receptor positive early breast cancer for a maximum of five years. LU Authorization Period: 5 years. Page 7

8 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Mar-Ondansetron 4mg Tab MAR Mar-Ondansetron 8mg Tab MAR (Interchangeable with Zofran) Reason for Use Code 215 Clinical Criteria For the treatment of emesis in cancer patients receiving highly emetogenic chemotherapy. LU Authorization Period: 1 year. 216 For patients receiving intravenous chemotherapy or radiation therapy who have not experienced adequate control with other available anti-emetics. LU Authorization Period: 1 year. 217 For patients receiving intravenous chemotherapy or radiation therapy who experience intolerable side effects with other antiemetics. LU Authorization Period: 1 year. 218 For the treatment of emesis in patients receiving radiation therapy which consists of single fraction treatment to the abdominal cavity, hemi-body irradiation and total body irradiation. NOTE: The therapeutic value of Ondansetron Hydrochloride more than 24 hours after the last dose of chemotherapy is unproven. LU Authorization Period: 1 year Mar-Risperidone 0.25mg Tab MAR Mar-Risperidone 0.5mg Tab MAR Mar-Risperidone 1mg Tab MAR Mar-Risperidone 2mg Tab MAR Mar-Risperidone 3mg Tab MAR Mar-Risperidone 4mg Tab MAR (Interchangeable with Risperdal) Page 8

9 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Mar-Simvastatin 5mg Tab MAR Mar-Simvastatin 10mg Tab MAR Mar-Simvastatin 20mg Tab MAR Mar-Simvastatin 40mg Tab MAR Mar-Simvastatin 80mg Tab MAR (Interchangeable with zocor) Mint-Atenol 50mg Tab MIN Mint-Atenol 100mg Tab MIN (Interchangeable with Tenormin) Myl-Letrozole 2.5mg Tab MYL (Interchangeable with Femara) Reason for Use Code Clinical Criteria For the treatment of metastatic breast cancer in hormone receptor positive post-menopausal women. LU Authorization Period: Indefinite. For the treatment of hormone receptor positive early breast cancer in postmenopausal women who have received 5 years of adjuvant tamoxifen therapy. LU Authorization Period: 5 years. As an alternative to tamoxifen for the adjuvant treatment of postmenopausal women with hormone receptor positive early breast cancer for a maximum of five years. LU Authorization Period: 5 years Mylan-Atorvastatin 10mg Tab MYL Mylan-Atorvastatin 20mg Tab MYL Mylan-Atorvastatin 40mg Tab MYL Mylan-Atorvastatin 80mg Tab MYL (Interchangeable with Lipitor) Page 9

10 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Mylan-Clopidogrel 75mg Tab MYL (Interchangeable with Plavix) Reason for Use Code 375 Clinical Criteria For patients immediately post-hospitalization for Acute Coronary Syndrome (ACS), in combination with ASA. ACS is defined as any myocardial infarction (MI) or unstable angina (UA). LU Authorization Period: Indefinite. 376 For patients immediately pre- or post-percutaneous coronary intervention (PCI).* *Therapy may be initiated up to 10 days prior to PCI LU Authorization Period: Indefinite. 411 For patients who experience a stroke or transient ischemic attack (TIA) while taking Aggrenox (dipyridamole and ASA) or ASA alone; or For patients experiencing ongoing severe symptomatic peripheral vascular disease (PVD) (i.e. with Ankle Brachial Index < 0.5) after a vascular event while on ASA. ASA should not be used concomitantly; or For patients requiring ASA with documented severe allergy to ASA, such as anaphylactic reaction or bronchospasm. Gastrointestinal events (GI), including GI bleeds, are excluded. LU Authorization Period: Indefinite Mylan-Irbesartan 75mg Tab MYL Mylan-Irbesartan 150mg Tab MYL Mylan-Irbesartan 300mg Tab MYL (Interchangeable with Avapro) Page 10

11 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Mylan-Mycophenolate 250mg Cap MYL Mylan-Mycophenolate 500mg Tab MYL (Interchangeable with Cellcept) Reason for Use Code 190 Clinical Criteria For the prophylaxis of organ rejection in patients receiving allogeneic renal, cardiac or hepatic transplants. LU Authorization Period: Indefinite Mylan-Pramipexole 0.25mg Tab MYL (Interchangeable with Mirapex PIN# ) Mylan-Pramipexole 1mg Tab MYL (Interchangeable with Mirapex PIN# ) Mylan-Pramipexole 1.5mg Tab MYL (Interchangeable with Mirapex PIN# ) Novo-Mycophenolate 250mg Cap TEV Novo-Mycophenolate 500mg Tab TEV (Interchangeable with Cellcept) Reason for Use Code 190 Clinical Criteria For the prophylaxis of organ rejection in patients receiving allogeneic renal, cardiac or hepatic transplants. LU Authorization Period: Indefinite. Page 11

12 DIN BRAND STRENGTH DOSAGE FORM MFR DBP PMS-Clobetasol 0.05% Oint PMS (Interchangeable with Dermovate) PMS-Montelukast 4mg Chew Tab PMS (Interchangeable with Singulair) Reason for Use Code 382 Clinical Criteria For the treatment of asthma in patients aged 2-5 years old. LU Authorization Period: 1 Year. Page 12

13 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Ran-Omeprazole DR Tab 20mg RAN (Interchangeable with Losec DR Tab DIN # ) Reason for Use Code 293 Clinical Criteria Gastroesophageal Reflux Disease (GERD) For the treatment of erosive GERD or upper GI malignancy; OR For the treatment of non-erosive GERD after failure of H2-receptor antagonist therapy. Patients with GERD should be reassessed within 6 months after initial treatment with a PPI. The reassessment could include confirmation of need for PPI with endoscopy, a trial of PPI withdrawal, or step down therapy to H2-receptor antagonist therapy. Note: There is a lack of published evidence to support double-dose PPI therapy in this setting. LU Authorization Period: 1 year 297 Confirmed Peptic Ulcers or NSAID-induced Ulcer Prophylaxis: For the treatment of confirmed peptic ulcers and NSAID-induced ulcers; OR For the prophylaxis of NSAID-induced ulcers for patients at increased risk of GI bleeding. Note: There is a lack of published evidence to support double-dose PPI therapy in this setting. LU Authorization Period: 1 year 401 Other Gastrointestinal Disorders For the treatment of gastroduodenal Crohn s disease, short-gut syndrome, scleroderma, or pancreatitis. Note: There is a lack of published evidence to support double-dose PPI therapy in these settings LU Authorization Period: 1 year Continued on next page. Page 13

14 DIN BRAND STRENGTH DOSAGE FORM MFR DBP. Continued from previous page Reason for Use Code 402 Clinical Criteria Severe Conditions: For the treatment of severe esophagitis, Zollinger-Ellison syndrome, esophageal stricture, persistent symptoms of GERD or persistent erosive esophagitis, or upon hospital discharge following a gastrointestinal bleed. For patients receiving double-dose therapy, the need to continue treatment at higher doses should be reassessed after eight weeks. For re-treatment at higher doses, a four-week period should have elapsed from the end of the previous treatment. Reassessment could include a procedural assessment of the condition or step-down therapy to lowerdose proton pump inhibitor (PPI) therapy. LU Authorization Period: 1 year Ran-Sertraline 25mg Cap RAN Ran-Sertraline 50mg Cap RAN Ran-Sertraline 100mg Cap RAN (Interchangeable with Zoloft) Sandoz Diclofenac 50mg Ent Tab SDZ (Interchangeable with Voltaren) Sandoz Montelukast 4mg Chew Tab SDZ (Interchangeable with Singulair) Reason for Use Code Clinical Criteria 382 For the treatment of asthma in patients aged 2-5 years old. LU Authorization Period: 1 Year. Page 14

15 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Sandoz Mycophenolate 250mg Cap SDZ Sandoz Mycophenolate 500mg Tab SDZ (Interchangeable with Cellcept) Reason for Use Code 190 Clinical Criteria For the prophylaxis of organ rejection in patients receiving allogeneic renal, cardiac or hepatic transplants. LU Authorization Period: Indefinite Teva-Montelukast 4mg Chew Tab TEV (Interchangeable with Singulair) Reason for Use Code 382 Clinical Criteria For the treatment of asthma in patients aged 2-5 years old. LU Authorization Period: 1 Year. Page 15

16 Off Formulary Interchangeable Product(s) DIN BRAND STRENGTH DOSAGE FORM MFR UNIT COST Apo-Montelukast 10mg Tab APX (Interchangeable with Singulair) Co Betahistine 16mg Tab COB Co Betahistine 24mg Tab COB (Interchangeable with Serc) Co Candesartan 32mg Tab COB (Interchangeable with Atacand) Mylan-Montelukast 10mg Tab MYL (Interchangeable with Singulair) Mylan-Pramipexole 0.5mg Tab MYL (Interchangeable with Mirapex) PMS-Montelukast 5mg Chew Tab PMS PMS-Montelukast FC 10mg Tab PMS (Interchangeable with Singulair) Sandoz Montelukast 4mg Gran Pk SDZ Sandoz Montelukast 5mg Chew Tab SDZ Sandoz Montelukast 10mg Tab SDZ (Interchangeable with Singulair) Teva-Montelukast 5mg Chew Tab TEV Teva-Montelukast 10mg Tab TEV (Interchangeable with Singulair) Page 16

17 Manufacturer Requested Discontinued Drug(s) Please note that these discontinued products will remain on the formulary until the current stock is depleted. DIN BRAND STRENGTH DOSAGE FORM MFR PMS-Clobetasol 0.05% Oint PMS Page 17

18 Delisted Drug(s) DIN BRAND STRENGTH DOSAGE FORM MFR Acebutolol 100mg Tab SAI Acebutolol 200mg Tab SAI Acebutolol 400mg Tab SAI Acyclovir 200mg Tab SAI Acyclovir 400mg Tab SAI Acyclovir 800mg Tab SAI Alendronate 70mg Tab SAI Alprazolam 0.25mg Tab SAI Alprazolam 0.5mg Tab SAI Amiodarone 200mg Tab SAI Amlodipine 5mg Tab SAI Amlodipine 10mg Tab SAI Amoxicillin 250mg Chew Tab SAI Atorvastatin 10mg Tab SAI Atorvastatin 20mg Tab SAI Atorvastatin 40mg Tab SAI Atorvastatin 80mg Tab SAI Azathioprine 50mg Tab SAI Azithromycin 250mg Tab SAI Azithromycin 600mg Tab SAI Baclofen 10mg Tab SAI Baclofen 20mg Tab SAI Carvedilol 3.125mg Tab SAI Carvedilol 6.25mg Tab SAI Carvedilol 12.5mg Tab SAI Carvedilol 25mg Tab SAI Cilazapril 1mg Tab SAI Cilazapril 2.5mg Tab SAI Cilazapril 5mg Tab SAI Ciprofloxacin 250mg Tab SAI Ciprofloxacin 500mg Tab SAI Ciprofloxacin 750mg Tab SAI Citalopram 20mg Tab SAI Citalopram 40mg Tab SAI Cyclobenzaprine 10mg Tab SAI Diclofenac K 50mg Tab SAI Diclofenac SR 75mg LA Tab SAI Domperidone 10mg Tab SAI Doxycycline 100mg Tab SAI Famotidine Tablets 20mg Tab SAI Famotidine Tablets 40mg Tab SAI Fenofibrate Micro 200mg Cap SAI Fenofibrate-S 100mg Tab SAI Fenofibrate-S 160mg Tab SAI Fluoxetine 10mg Cap SAI Fluoxetine 20mg Cap SAI Page 18

19 DIN BRAND STRENGTH DOSAGE FORM MFR Gabapentin 100mg Cap SAI Gabapentin 300mg Cap SAI Gabapentin 400mg Cap SAI Gliclazide 80mg Tab SAI Glyburide 2.5mg Tab SAI Glyburide 5mg Tab SAI Lamotrigine 25mg Tab SAI Lamotrigine 100mg Tab SAI Lamotrigine 150mg Tab SAI Lansoprazole 15mg DR Cap SAI Lansoprazole 30mg DR Cap SAI Leflunomide 10mg Tab SAI Leflunomide 20mg Tab SAI Levetiracetam 250mg Tab SAI Levetiracetam 500mg Tab SAI Levetiracetam 750mg Tab SAI Lisinopril/HCTZ (Type Z) 10mg & 12.5mg Tab SAI Lisinopril/HCTZ (Type Z) 20mg & 12.5mg Tab SAI Lisinopril/HCTZ (Type Z) 20mg & 25mg Tab SAI Lovastatin 20mg Tab SAI Lovastatin 40mg Tab SAI Meloxicam 7.5mg Tab SAI Meloxicam 15mg Tab SAI Metformin 500mg Tab SAI Metformin 850mg Tab SAI Naproxen EC 250mg Ent Tab SAI Naproxen EC 375mg Ent Tab SAI Naproxen EC 500mg Ent Tab SAI Omeprazole DR Cap 20mg SAI Omeprazole DR Cap 20mg SAI Oxybutynin 5mg Tab SAI Oxycodone/Acet 5mg & 325mg Tab SAI Paroxetine 10mg Tab SAI Paroxetine 20mg Tab SAI Paroxetine 30mg Tab SAI Propafenone 150mg Tab SAI Propafenone 300mg Tab SAI Quetiapine 25mg Tab SAI Quetiapine 100mg Tab SAI Quetiapine 200mg Tab SAI Quetiapine 300mg Tab SAI Rabeprazole 10mg Tab SAI Rabeprazole 20mg Tab SAI Risperidone 0.25mg Tab SAI Risperidone 0.5mg Tab SAI Risperidone 1mg Tab SAI Risperidone 2mg Tab SAI Risperidone 3mg Tab SAI Risperidone 4mg Tab SAI Ropinirole 0.25mg Tab SAI Page 19

20 DIN BRAND STRENGTH DOSAGE FORM MFR Ropinirole 1mg Tab SAI Ropinirole 2mg Tab SAI Ropinirole 5mg Tab SAI Sertraline 25mg Cap SAI Sertraline 50mg Cap SAI Sertraline 100mg Cap SAI Simvastatin 5mg Tab SAI Simvastatin 10mg Tab SAI Simvastatin 20mg Tab SAI Simvastatin 40mg Tab SAI Simvastatin 80mg Tab SAI Sumatriptan 50mg Tab SAI Sumatriptan 100mg Tab SAI Terbinafine 250mg Tab SAI Ticlopidine 250mg Tab SAI Topiramate 25mg Tab SAI Topiramate 100mg Tab SAI Topiramate 200mg Tab SAI Trazodone 50mg Tab SAI Trazodone 100mg Tab SAI Trazodone 150mg Tab SAI Venlafaxine XR 37.5mg ER Cap SAI Venlafaxine XR 75mg ER Cap SAI Venlafaxine XR 150mg ER Cap SAI Warfarin 1mg Tab SAI Warfarin 2mg Tab SAI Warfarin 2.5mg Tab SAI Warfarin 3mg Tab SAI Warfarin 4mg Tab SAI Warfarin 5mg Tab SAI Warfarin 6mg Tab SAI Warfarin 10mg Tab SAI Zopiclone 5mg Tab SAI Zopiclone 7.5mg Tab SAI Page 20

21 Drug Benefit Price(s) DIN BRAND STRENGTH DOSAGE FORM MFR DBP Adalat XL 20mg ER Tab BAY Adderall XR 5mg ER Cap SHI Adderall XR 10mg ER Cap SHI Adderall XR 15mg ER Cap SHI Adderall XR 20mg ER Cap SHI Adderall XR 25mg ER Cap SHI Adderall XR 30mg ER Cap SHI Avelox 400mg Tab BAY Bonefos 400mg Cap BAY Cipro 10g/100mL Oral Susp BAY Cipro XL 500mg ER Tab BAY Cipro XL 1000mg ER Tab BAY Cotazym 8000 & & USP Units Cap ORG Cotazym ECS & & USP Units Cotazym ECS & & USP Units Cotazym ECS & & USP Units Ent Microsph Cap ORG Ent Microsph Cap ORG Ent Microsph Cap ORG Cyclen 0.25mg & 0.035mg Tab-21 Pk JNO Cyclen 0.25mg & 0.035mg Tab-28 Pk JNO Eprex 20,000IU/0.5mL Pref Syr - 0.5mL Pk JAN Eprex 40,000IU/mL Pref Syr - 1mL Pk JAN Euflex 250mg Tab SCH Glucobay 50mg Tab BAY Glucobay 100mg Tab BAY Intelence 100mg Tab JAN Invega 3mg ER Tab JAN Invega 6mg ER Tab JAN Invega 9mg ER Tab JAN Kivexa 600mg/300mg Tab VIH Leustatin 1mg/mL Inj JNO Levaquin 250mg Tab JAN Levaquin 500mg Tab JAN Marvelon mg & 0.03mg Tab-21 Pk ORG Marvelon mg & 0.03mg Tab-28 Pk ORG Mevacor 20mg Tab MFC Mevacor 40mg Tab MFC Mezavant 1.2g Delayed & ER Tab SHI Micronor 0.35mg Tab-28 Pk JNO Mirena 52mg Insert BAY Nexavar 200mg Tab BAY Novo-5-ASA 400mg Tab NOP Page 21

22 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Novo-Doxepin 150mg Cap NOP Novo-Fibre Tab NOP Novo-Risedronate 5mg Tab NOP Novo-Risedronate 30mg Tab NOP Novo-Spiroton 25mg Tab NOP Novo-Spiroton 100mg Tab NOP Novo-Spirozine-25 25mg & 25mg Tab NOP Novo-Spirozine-50 50mg & 50mg Tab NOP Novo-Theophyl SR 300mg LA Tab NOP Ortho 0.5/ mg & 0.5mg Tab-21 Pk JAN Ortho 0.5/ mg & 0.5mg Tab-28 Pk JAN Ortho 1/ mg & 1mg Tab-21 Pk JAN Ortho 1/ mg & 1mg Tab-28 Pk JAN Ortho 7/7/7 3 Phase Tab-21 Pk JNO Ortho 7/7/7 3 Phase Tab-28 Pk JNO Ortho-Cept 0.15mg & 0.03mg Tab-28 Pk JAN Pancrease MT & & Ent Microsph Cap JNO USP Units Pariet 10mg Tab JAN Pariet 20mg Tab JAN Pediatrix 80mg/mL O/L RPH Pepcid 20mg Tab MFC Pepcid 40mg Tab MFC Prezista 75mg Tab JAN Prezista 400mg Tab JAN Prezista 600mg Tab JAN Prinivil 5mg Tab MFC Prinivil 10mg Tab MFC Prinivil 20mg Tab MFC Prinzide 10mg & 12.5mg Tab MFC Prinzide 20mg & 12.5mg Tab MFC Ratio-Amcinonide 0.1% Lot RPH Ratio-Amcinonide 0.1% Oint RPH Ratio-Bisacodyl 10mg Sup RPH Ratio-Codeine 5mg/mL O/L RPH Ratio-Codeine 30mg Tab RPH Ratio-Nystatin U/g Oint RPH Ratio-Nystatin U/mL O/L RPH Ratio-Nystatin U/g Vag Cr RPH Ratio-Oxycodan 5mg & 325mg Tab RPH Remeron 30mg Tab ORG Reminyl ER 8mg ER Cap JAN Reminyl ER 16mg ER Cap JAN Reminyl ER 24mg ER Cap JAN Risperdal 1mg/mL O/L JAN Risperdal 0.25mg Tab JAN Risperdal 0.5mg Tab JAN Risperdal 1mg Tab JAN Risperdal 2mg Tab JAN Page 22

23 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Risperdal 3mg Tab JAN Risperdal 4mg Tab JAN Risperdal Consta 25mg Pd for Inj-Vial Pk JAN Risperdal Consta 37.5mg Pd for Inj-Vial Pk JAN Risperdal Consta 50mg Pd for Inj-Vial Pk JAN Sinemet 100mg & 10mg Tab MFC Sinemet 100mg & 25mg Tab MFC Sinemet 250mg & 25mg Tab MFC Sinemet CR 100mg & 25mg Tab MFC Sinemet CR 200mg & 50mg Tab MFC Stelara 45mg/0.5mL Inj Sol-Pref Syr Pk JAN Terazol 7 0.4% Cr JNO Timoptic 0.5% Oph Sol MFC Timoptic-XE 0.25% Oph Gellan Sol MFC Timoptic-XE 0.5% Oph Gellan Sol MFC Topamax 25mg Tab JNO Topamax 100mg Tab JNO Topamax 200mg Tab JNO Topamax Sprinkle 15mg Sprinkle Cap JNO Topamax Sprinkle 25mg Sprinkle Cap JNO Tri-Cyclen 3 Phase Tab-21 Pk JNO Tri-Cyclen 3 Phase Tab-28 Pk JNO Tri-Cyclen Lo 3 Phase Tab-21 Pk JAN Tri-Cyclen Lo 3 Phase Tab-28 Pk JAN Triquilar 21 3 Phase Tab-21 Pk BAY Triquilar 28 3 Phase Tab-28 Pk BAY Vasotec 2.5mg Tab MFC Vasotec 5mg Tab MFC Vasotec 10mg Tab MFC Vasotec 20mg Tab MFC Vermox 100mg Tab JNO Yasmin mg & 0.03mg Tab-21 Pk BAH Yasmin mg & 0.03mg Tab-28 Pk BAH Yaz 3.0mg & 0.02mg Tab-28 Pk BAH Zocor 5mg Tab MFC Zocor 10mg Tab MFC Zocor 20mg Tab MFC Zocor 40mg Tab MFC Zocor 80mg Tab MFC Page 23

24 New Manufacturer Name(s) DIN BRAND STRENGTH DOSAGE FORM MFR Axid 150mg Cap MMT Cyclen 0.25mg & 0.035mg Tab-21 Pk JAN Cyclen 0.25mg & 0.035mg Tab-28 Pk JAN Micronor 0.35mg Tab-28 Pk JAN PMS-Cholestyramine 9g Pk Oral Pd-Pouch Pk MMT PMS-Cholestyramine Sugar Free Oral Pd-Pouch Pk MMT 5g Pk PMS-Loxapine 5mg Tab MMT PMS-Loxapine 10mg Tab MMT PMS-Loxapine 25mg Tab MMT PMS-Loxapine 50mg Tab MMT Tri-Cyclen 3 Phase Tab-21 Pk JAN Tri-Cyclen 3 Phase Tab-28 Pk JAN Vermox 100mg Tab JAN Page 24

25 Therapeutic Note Change(s) DIN BRAND STRENGTH DOSAGE FORM MFR Risperdal Consta 25mg Pd for Inj-Vial Pk JAN Risperdal Consta 37.5mg Pd for Inj-Vial Pk JAN Risperdal Consta 50mg Pd for Inj-Vial Pk JAN For the treatment of schizophrenia or schizoaffective disorders in patients who have: A history of non-adherence; AND one of the following: (a) Inadequate control or significant side-effects from two or more formulary oral antipsychotic medications, including at least one atypical agent; OR (b) Inadequate control or significant side-effects fom one or more conventional depot antipsychotic agents. Page 25

26 Trade Name Change(s) DIN BRAND STRENGTH DOSAGE FORM MFR Olestyr Oral Pd-4g/5g Pouch Pk PMS Olestyr Oral Pd-4g/9g Pouch Pk PMS Xylac 5mg Tab PMS Xylac 10mg Tab PMS Xylac 25mg Tab PMS Xylac 50mg Tab PMS Page 26

27 CONSOLIDATED INDEX mg Tab PEN P 10 3TC 10mg/mL O/L GSK H VIH X 21 3TC 150mg Tab GSK H VIH X 21 3TC 300mg Tab GSK H VIH X 21 5-AMINOSALICYLIC ACID E 3 H 3 5-Benzagel 5% Gel NOV F 6 Abilify 2mg Tab BQU AB 2 Abilify 5mg Tab BQU AB 2 Abilify 10mg Tab BQU AB 2 Abilify 15mg Tab BQU AB 2 Abilify 20mg Tab BQU AB 2 Abilify 30mg Tab BQU AB 2 Accel Pioglitazone 15mg Tab ACC L 16 Accel Pioglitazone 30mg Tab ACC L 16 Accel Pioglitazone 45mg Tab ACC L 16 Accupril 5mg Tab PFI Q PFI Y 7 Accupril 10mg Tab PFI Q PFI Y 7 Accupril 20mg Tab PFI Q PFI Y 7 Accupril 40mg Tab PFI Q PFI Y 7 Accuretic 10mg & 12.5mg Tab PFI Q PFI Y 7 Accuretic 20mg & 12.5mg Tab PFI Q PFI Y 7 Accuretic 20mg & 25mg Tab PFI H PFI Q PFI Y 7 ACEBUTOLOL Z 4 Acebutolol 100mg Tab SAI Z SAI AD 18 Acebutolol 200mg Tab SAI Z SAI AD 18 Acebutolol 400mg Tab SAI Z SAI AD 18 Acetaminophen Extra Strength 500mg Tab DPC S DPC Z 26 Acetazolamide 250mg Tab APX X 28 AcetOxyl 5% Gel STI M STI U 12 Page 27

28 AcetOxyl 10% Gel STI M STI U 12 ACETYLSALICYLIC ACID & BUTALBITAL & CAFFEINE E 8 ACETYLSALICYLIC ACID & BUTALBITAL & CAFFEINE & E 8 CODEINE PHOSPHATE Aclasta 5mg/100mL Inj Sol-100mL Pk NOV C NOV H 7 Actemra 80mg/4mL Inj Sol-Vial Pk HLR Y 7 Actemra 200mg/10mL Inj Sol-Vial Pk HLR Y 7 Actemra 400mg/20mL Inj Sol-Vial Pk HLR Y 7 Actonel 5mg Tab PGP A WAR AC 12 Actonel 30mg Tab PGP A WAR AC 12 Actonel 35mg Tab PGP A PGP R PGP W WAR AC 12 Actonel 150mg Tab PGP J PGP W WAR Y 9 Actos 15mg Tab TAK L TAK X 10 Actos 30mg Tab TAK L TAK X 10 Actos 45mg Tab TAK L TAK X 10 ACYCLOVIR Z 5 Z 20 Acyclovir 200mg Tab SAI Z SAI AD 18 Acyclovir 400mg Tab SAI Z SAI AD 18 Acyclovir 800mg Tab SAI Z SAI AB SAI AD 18 Adalat PA 10 10mg LA Tab BAH X 25 Adalat PA 20 20mg LA Tab BAH X 25 Adalat XL 20mg ER Tab BAY F BAY O BAY AD 21 Adalat XL 30mg ER Tab BAY F BAY O BAY T 11 Adalat XL 60mg ER Tab BAY F BAY T 11 ADALIMUMAB I 2 Adderall XR 5mg ER Cap SHI H SHI Q 14 Page 28

29 SHI X SHI AD 21 Adderall XR 10mg ER Cap SHI H SHI Q SHI X SHI AD 21 Adderall XR 15mg ER Cap SHI H SHI Q SHI X SHI AD 21 Adderall XR 20mg ER Cap SHI H SHI Q SHI X SHI AD 21 Adderall XR 25mg ER Cap SHI H SHI Q SHI X SHI AD 21 Adderall XR 30mg ER Cap SHI H SHI Q SHI X SHI AD 21 Adrenalin 30mg/30mL Inj Sol-30mL Pk ERF C ERF F ERF P ERF X 10 Advagraf 0.5mg ER Cap ASE H 2 Advagraf 1mg ER Cap ASE H 2 Advagraf 3mg ER Cap ASE W 2 Advagraf 5mg ER Cap ASE H 2 Advair /125mcg/Metered Dose Inh-120 Dose Pk GSK H 7 Advair /250mcg/Metered Dose Inh-120 Dose Pk GSK H 7 Advair Diskus 50/100mcg Inh-60 Dose Pk GSK H 7 Advair Diskus 50/250mcg Inh-60 Dose Pk GSK H 7 Advair Diskus 50/500mcg Inh-60 Dose Pk GSK H 7 Agenerase 50mg Cap GSK H GSK Q 23 Agenerase 150mg Cap GSK H GSK Q 23 Agenerase 15mg/mL O/L GSK H GSK Q 23 Airomir HFA 100mcg/Metered Dose Inh-200 dose Pk GRA U MMH U 16 Alcomicin 0.3% Oph Sol ALC M ALC U 12 Aldactazide-25 25mg & 25mg Tab PFI H PFI Q 14 Aldactazide-50 50mg & 50mg Tab PFI H PFI Q 14 Page 29

30 Aldactone 25mg Tab PFI H PFI Q 14 Aldactone 100mg Tab PFI H PFI Q 14 ALENDRONATE N 2 Z 6 Alendronate 70mg Tab SAI Z SAI AD 18 Alendronate-FC 70mg Tab PHE V 15 ALENDRONATE & CHOLECALCIFEROL J 2 Alesse 20mcg & 100mcg Tab-21 Pk WAY H WAY Y 7 Alesse 20mcg & 100mcg Tab-28 Pk WAY H WAY Y 7 ALFUZOSIN HYDROCHLORIDE C 3 X 5 ALISKIREN D 3 Alkeran 2mg Tab GSK H 7 Allerdryl 25mg Cap VAL M 14 Allerdryl 50mg Cap VAL N 9 Alomide 0.1% Oph Sol ALC X 10 ALPRAZOLAM AB 5 Alprazolam 0.25mg Tab SAI AB SAI AD 18 Alprazolam 0.5mg Tab SAI AB SAI AD 18 Altace Cap 1.25mg SAV H 7 Altace Cap 2.5mg SAV H 7 Altace Cap 5mg SAV H 7 Altace Cap 10mg SAV H 7 Altace HCT 2.5mg & 12.5mg Tab SAV R SAV Z 24 Altace HCT 5mg & 12.5mg Tab SAV H SAV R SAV X 10 Altace HCT 5mg & 25mg Tab SAV H SAV R SAV X 10 Altace HCT 10mg & 12.5mg Tab SAV H SAV R SAV X 10 Altace HCT 10mg & 25mg Tab SAV H SAV R SAV X 10 Alvesco 100mcg/Actuation Inh-120 Dose Pk NYC H NYC Q NYC R NYC X 10 Alvesco 200mcg/Actuation Inh-120 Dose Pk NYC H 7 Page 30

31 NYC Q NYC R NYC X 10 Amatine 2.5mg Tab SHI Q SHI U 8 Amatine 5mg Tab SHI Q SHI U 8 Amiodarone 200mg Tab SAI AB SAI AD 18 AMIODARONE HCL R 5 AB 5 AMLODIPINE L 3 O 2 Q 5 S1 5 W 8 Z 6 AD 7 Amlodipine 5mg Tab SAI Z SAI AD 18 Amlodipine Tablets 5mg Tab RAN O RAN S 2 Amlodipine 10mg Tab SAI Z SAI AD 18 Amlodipine Tablets 10mg Tab RAN O RAN S 2 AMLODIPINE/ATORVASTATIN AB 6 AMOXICILLIN C 9 AB 7 Amoxicillin 250mg Chewable Tab SAI AB 7 Amoxicillin 250mg Chew Tab SAI AD 18 Amytal Sodium 60mg Cap LIL M LIL U 12 Amytal Sodium 200mg Cap LIL M LIL U 12 Anandron 50mg Tab SAV X 10 Androderm 12.2mg Transdermal Patch PAL Q PAL X 10 Androgel 1% 2.5g Foil Packet SPH A 11 Ansaid 50mg Tab PFI Q 14 Ansaid 100mg Tab PFI Q 14 Anthraforte 1 1% Oint MEI F 6 Anthraforte 2 2% Oint MEI F 6 Anthranol 0.1% Cr MEI F 6 Anthranol 0.2% Cr MEI F 6 Anthranol 0.4% Cr MEI F 6 Anusol 0.5% Oint PFI M PFI U PFI W 16 Page 31

32 Anzemet 50mg Tab SAV H 7 Anzemet 100mg Tab SAV H 7 Apidra 100U/mL Inj Sol-5x3mL Pk SAV K 2 Apidra 100U/mL Inj Sol-5x3mL SoloSTAR Pref Pen SAV W SAV X 10 Apidra 100U/mL Inj Sol-10mL Vial SAV K SAV X 10 Apidra 100U/mL Inj 5x3mL-Cart ClickStar Pen SAV R 2 Apo-Acebutolol 100mg Tab APX S 2 Apo-Acebutolol 200mg Tab APX S 2 Apo-Acebutolol 400mg Tab APX S 2 Apo-Acetaminophen 325mg Tab APX Z 24 Apo-Acetaminophen 500mg Tab APX Z 24 Apo-Acetazolamide 250mg Tab APX H AAP X 21 Apo-Acyclovir 800mg Tab APX S APX AB 11 Apo-Alendronate 10mg Tab APX S 2 Apo-Alendronate 70mg Tab APX S 2 Apo-Alfuzosin 10mg Prolong-Rel Tab APX C APX D 9 Apo-Alpraz 0.25mg Tab APX S 2 Apo-Alpraz 0.5mg Tab APX S 2 Apo-Amiloride 5mg Tab APX H 7 Apo-Amilzide 5mg & 50mg Tab APX S 2 Apo-Amiodarone 200mg Tab APX S 2 Apo-Amitriptyline 10mg Tab APX R AAP Y 9 Apo-Amitriptyline 25mg Tab APX R AAP Y 9 Apo-Amitriptyline 50mg Tab APX R AAP Y 9 Apo-Amlodipine 5mg Tab APX L APX S 2 Apo-Amlodipine 10mg Tab APX L APX S 2 Apo-Amoxi 250mg Cap APX V 13 Apo-Amoxi 500mg Cap APX V 13 Apo-Amoxi 25mg/mL O/L APX V 13 Apo-Amoxi 50mg/mL O/L APX V 13 Apo-Amoxi Clav 250mg & 125mg Tab APX R 14 Apo-Amoxi Clav 875mg & 125mg Tab APX S 2 Apo-Atenidone 50 & 25mg Tab APX A 11 Apo-Atenidone 100 & 25mg Tab APX A 11 Apo-Atenol 50mg Tab APX S 2 Apo-Atenol 100mg Tab APX S 2 Apo-Atomoxetine 10mg Cap APX V 5 Apo-Atomoxetine 18mg Cap APX V 5 Apo-Atomoxetine 25mg Cap APX V 5 Page 32

33 Apo-Atomoxetine 40mg Cap APX V 5 Apo-Atomoxetine 60mg Cap APX V 5 Apo-Atomoxetine 80mg Cap APX V 5 Apo-Atomoxetine 100mg Cap APX V 5 Apo-Atorvastatin 10mg Tab APX R1 2 Apo-Atorvastatin 20mg Tab APX R1 2 Apo-Atorvastatin 40mg Tab APX R1 2 Apo-Atorvastatin 80mg Tab APX R1 2 Apo-Azathioprine 50mg Tab APX S 2 Apo-Azithromycin 250mg Tab APX S 2 Apo-Baclofen 10mg Tab APX S 2 Apo-Baclofen 20mg Tab APX S 2 Apo-Benazepril 5mg Tab APX R AAP X 21 Apo-Benazepril 10mg Tab APX R AAP X 21 Apo-Benazepril 20mg Tab APX R AAP X 21 Apo-Bicalutamide 50mg Tab APX S 2 Apo-Bisoprolol 5mg Tab APX S 2 Apo-Bisoprolol 10mg Tab APX S 2 Apo-Brimonidine 0.2% Oph Sol APX S 2 Apo-Brimonidine P 0.15% Oph Sol APX B APX C APX M 15 Apo-Bromazepam 3mg Tab APX S 2 Apo-Bromazepam 6mg Tab APX S 2 Apo-C 100mg Tab APX X 25 Apo-C 250mg Tab APX X 25 Apo-C 1000mg Tab APX X 25 Apo-Cal 250 Eq to 250mg Elemental Calcium Tab APX AC 14 Apo-Cal 500 Eq to 500mg Elemental Calcium Tab APX AC 14 Apo-Calcitonin Nasal Spray 200IU Metered Dose Nas Sp-2x APX X 8 DosePk Apo-Candesartan 4mg Tab APX Z 6 Apo-Candesartan 8mg Tab APX Z 6 Apo-Candesartan 16mg Tab APX Z 6 Apo-Carbamazepine 200mg Tab APX Z 24 Apo-Carbamazepine CR 200mg LA Tab APX M APX P 16 Apo-Carbamazepine CR 400mg LA Tab APX M APX P 16 Apo-Carvedilol 3.125mg Tab APX S 2 Apo-Carvedilol 6.25mg Tab APX S 2 Apo-Carvedilol 12.5mg Tab APX S 2 Apo-Carvedilol 25mg Tab APX S 2 Apo-Cefaclor 250mg Cap APX V 6 Apo-Cefaclor 500mg Cap APX V 6 Apo-Cefaclor 25mg/mL Oral Susp APX P 8 Page 33

34 APX X 24 Apo-Cefaclor 50mg/mL Oral Susp APX P APX X 24 Apo-Cefaclor 375mg/5mL Oral Susp APX I 7 Apo-Cefprozil 125mg/5mL Oral Susp-75mL Pk APX R APX R APX X 10 Apo-Cefprozil 125mg/5mL Oral Susp-100mL Pk APX R APX R APX R APX X 10 Apo-Cefprozil 250mg/5mL Oral Susp-75mL Pk APX R APX R APX X 10 Apo-Cefprozil 250mg/5mL Oral Susp-100mL Pk APX R APX R APX R APX X 10 Apo-Cefprozil 250mg Tab APX X 10 Apo-Cefprozil 500mg Tab APX X 10 Apo-Cetirizine 10mg Tab APX O 16 Apo-Chlordiazepoxide 5mg Cap APX H 7 Apo-Chlordiazepoxide 10mg Cap APX H 7 Apo-Chlordiazepoxide 25mg Cap APX H 7 Apo-Chlorthalidone 50mg Tab APX H AAP X 21 Apo-Chlorthalidone 100mg Tab APX S APX Z 26 Apo-Cilazapril 1mg Tab APX S 2 Apo-Cilazapril 2.5mg Tab APX S 2 Apo-Cilazapril 5mg Tab APX S 2 Apo-Cilazapril/HCTZ 5mg/12.5mg Tab APX H APX J 8 Apo-Cimetidine 200mg Tab APX Z 24 Apo-Cimetidine 600mg Tab APX S 2 Apo-Ciproflox 0.3% Oph Sol-5mL Pk APX R 10 Apo-Ciproflox 250mg Tab APX S 2 Apo-Ciproflox 500mg Tab APX S 2 Apo-Ciproflox 750mg Tab APX S 2 Apo-Citalopram 20mg Tab APX S 2 Apo-Citalopram 40mg Tab APX S 2 Apo-Clarithromycin 250mg Tab APX S 2 Apo-Clindamycin 150mg Cap APX S 2 Apo-Clindamycin 300mg Cap APX S 2 Apo-Clobazam 10mg Tab APX S 2 Apo-Clonazepam 0.5mg Tab APX S 2 Apo-Clonazepam 2mg Tab APX S 3 Apo-Clopidogrel 75mg Tab APX AD 3 Apo-Clorazepate 3.75mg Cap APX R 14 Page 34

35 Apo-Clorazepate 7.5mg Cap APX R 14 Apo-Clorazepate 15mg Cap APX R 14 Apo-Cloxi 250mg Cap APX V 13 Apo-Cloxi 500mg Cap APX V 13 Apo-Cloxi 25mg/mL O/L APX V 13 Apo-Cromolyn 1% Inh Sol-2mL Pk APX H 19 Apo-Cromolyn 2% Nas Sol-26mL Pk APX S APX Z 26 Apo-Cyclosporine Oral Solution 100mg/mL O/L APX F 3 Apo-Cyproterone 50mg Tab AAP X 21 Apo-Desipramine 25mg Tab APX R 14 Apo-Desipramine 50mg Tab APX Z 24 Apo-Desipramine 75mg Tab APX Z 24 Apo-Desmopressin 10mcg/Metered Dose Nas Sp-2.5mL Pk APX H AAP X 21 Apo-Desmopressin 0.1mg Tab APX S 3 Apo-Desmopressin 0.2mg Tab APX S 3 Apo-Dexamethasone 0.5mg Tab APX S 3 Apo-Dexamethasone 4mg Tab APX S 3 Apo-Diclo 25mg Ent Tab APX F APX S 3 Apo-Diclo 50mg Ent Tab APX S 3 Apo-Diclo SR 75mg LA Tab APX S APX U 9 Apo-Diclo SR 100mg LA Tab APX S APX U 9 Apo-Diflunisal 250mg Tab APX Z 24 Apo-Diflunisal 500mg Tab APX H 7 Apo-Digoxin mg Tab APX K APX M 13 Apo-Digoxin 0.125mg Tab APX N APX S APX S 32 Apo-Digoxin 0.25mg Tab APX N APX S APX S 32 Apo-Diltiaz CD 120mg LA Cap APX S 3 Apo-Diltiaz CD 180mg LA Cap APX S 3 Apo-Diltiaz CD 240mg LA Cap APX S 3 Apo-Diltiaz CD 300mg LA Cap APX S 3 Apo-Diltiaz SR 60mg LA Cap APX H APX P APX S APX X 24 Apo-Diltiaz SR 90mg LA Cap APX H APX P APX S APX X 24 Apo-Diltiaz SR 120mg LA Cap APX H 7 Page 35

36 APX P APX S APX X 24 Apo-Diltiaz TZ 120mg SR Cap APX F APX S 3 Apo-Diltiaz TZ 180mg SR Cap APX F APX S 3 Apo-Diltiaz TZ 240mg SR Cap APX F APX S 3 Apo-Diltiaz TZ 300mg SR Cap APX F APX S 3 Apo-Diltiaz TZ 360mg SR Cap APX F APX S 3 Apo-Dipyridamole 25mg Tab APX G 7 Apo-Dipyridamole 50mg Tab APX G 7 Apo-Dipyridamole 75mg Tab APX G 7 Apo-Divalproex 125mg Ent Tab APX S 3 Apo-Divalproex 250mg Ent Tab APX S 3 Apo-Divalproex 500mg Ent Tab APX S 3 Apo-Domperidone 10mg Tab APX S 3 Apo-Dorzo-Timop 2% & 0.5% Oph Sol APX AC 5 Apo-Doxazosin 1mg Tab APX S 3 Apo-Doxazosin 2mg Tab APX S 3 Apo-Doxazosin 4mg Tab APX S 3 Apo-Doxepin 10mg Cap APX H 7 Apo-Doxy-Tabs 100mg Tab APX I 13 Apo-Enalapril 2.5mg Tab APX E APX V1 4 Apo-Enalapril 5mg Tab APX E APX V1 4 Apo-Enalapril 10mg Tab APX E APX V1 4 Apo-Enalapril 20mg Tab APX E APX V1 4 Apo-Enalapril Maleate/HCTZ 5mg & 12.5mg Tab APX X 8 Apo-Enalapril Maleate/HCTZ 10mg & 25mg Tab APX X 8 Apo-Erythro 250mg Tab APX H 7 Apo-Erythro-ES 600mg Tab APX H AAP X 21 Apo-Erythro-S 250mg Tab APX H AAP X 21 Apo-Erythro-S 500mg Tab APX H AAP X 21 Apo-Esomeprazole 20mg DR Tab APX W 9 Apo-Esomeprazole 40mg DR Tab APX W 9 Apo-Famciclovir 500mg Tab APX S 3 Apo-Famotidine 20mg Tab APX S 3 Apo-Famotidine 40mg Tab APX S 3 Apo-Feno-Micro 200mg Cap APX X 10 Page 36

37 Apo-Feno-Super 100mg Tab APX D 10 Apo-Feno-Super 160mg Tab APX F APX S 3 Apo-Fenofibrate 100mg Cap APX J 8 Apo-Finasteride 5mg Tab APX AA 3 Apo-Flecainide 50mg Tab APX H AAP X 21 Apo-Flecainide 100mg Tab APX H AAP X 21 Apo-Floctafenine 200mg Tab APX H AAP X 21 Apo-Floctafenine 400mg Tab APX H AAP X 21 Apo-Fluconazole 50mg Tab APX S 3 Apo-Fluconazole 100mg Tab APX S 3 Apo-Fluconazole mg Cap APX S 3 Apo-Flunarizine 5mg Cap AAP X 21 Apo-Flunisolide 0.025% Nas Sp-25mL Pk APX J 8 Apo-Fluoxetine 20mg Cap APX S 3 Apo-Fluphenazine 1mg Tab APX H 8 Apo-Fluphenazine 2mg Tab APX H 8 Apo-Fluvoxamine 50mg Tab APX S 3 Apo-Fluvoxamine 100mg Tab APX S 3 Apo-Fosinopril 10mg Tab APX S 3 Apo-Fosinopril 20mg Tab APX S 3 Apo-Gabapentin 100mg Cap APX S APX U APX U 18 Apo-Gabapentin 300mg Cap APX S APX U APX U 18 Apo-Gabapentin 400mg Cap APX S APX U APX U 18 Apo-Gabapentin 600mg Tab APX A 14 Apo-Gabapentin 800mg Tab APX A 14 Apo-Gemfibrozil 300mg Cap APX S 3 Apo-Gliclazide MR 30mg SR Tab APX A APX C 7 Apo-Gliclazide 80mg Tab APX S 3 Apo-Glyburide 2.5mg Tab APX S 3 Apo-Glyburide 5mg Tab APX S 3 Apo-Granisetron 1mg Tab APX I AAP X 21 Apo-Haloperidol 10mg Tab APX Z 24 Apo-Hydralazine 10mg Tab APX Z 24 Apo-Hydralazine 25mg Tab APX R 14 Apo-Hydralazine 50mg Tab APX Z 24 Apo-Hydro 12.5mg Tab APX Q 11 Page 37

38 Apo-Hydro 25 25mg Tab APX S 3 Apo-Hydro 50 50mg Tab APX S 3 Apo-Ibuprofen 200mg Tab APX Z 24 Apo-Ibuprofen 300mg Tab APX Z 24 Apo-Ibuprofen 400mg Tab APX Z 24 Apo-Ibuprofen 600mg Tab APX Z 24 Apo-Imipramine 10mg Tab APX H AAP X 21 Apo-Imipramine 25mg Tab APX H AAP X 21 Apo-Imipramine 50mg Tab APX H AAP X 21 Apo-Indapamide 1.25mg Tab APX S 3 Apo-Indapamide 2.5mg Tab APX S 3 Apo-Ipravent 0.03% Nasal Spray APX H APX Q 23 Apo-Ipravent 0.06% Nasal Spray APX J 10 Apo-Ipravent Inhalation Solution 250mcg/mL Inh Sol-20mL Pk APX S 3 Apo-ISDN 5mg SL Tab APX H AAP X 21 Apo-ISDN 10mg Tab APX H AAP X 21 Apo-ISDN 30mg Tab APX H AAP X 21 Apo-Keto 50mg Cap APX H 8 Apo-Keto-E 50mg Ent Tab APX J 8 Apo-Keto-E 100mg Ent Tab APX H 8 Apo-Keto SR 200mg LA Tab APX H 8 Apo-Ketorolac 10mg Tab APX B 7 Apo-Labetalol 100mg Tab APX H APX L APX Q 23 Apo-Labetalol 200mg Tab APX H APX L APX Q 23 Apo-Lamotrigine 25mg Tab APX S APX AB 11 Apo-Lamotrigine 100mg Tab APX S APX AB 11 Apo-Lamotrigine 150mg Tab APX S APX AB 11 Apo-Lansoprazole 15mg DR Cap APX K APX N APX S 4 Apo-Lansoprazole 30mg DR Cap APX K APX N APX S 4 Apo-Latanoprost 0.005% Oph Sol-2.5mL Pk APX AC 5 Page 38

39 Apo-Leflunomide 10mg Tab APX S APX AA 11 Apo-Leflunomide 20mg Tab APX S APX AA 11 Apo-Letrozole 2.5mg Tab APX X 4 Apo-Levobunolol 0.5% Oph Sol APX S APX Z 26 Apo-Levocarb CR 100mg & 25mg Tab APX K 5 Apo-Levocarb CR 200mg & 50mg Tab APX H APX S APX Z 26 Apo-Levofloxacin 250mg Tab APX L APX S 4 Apo-Levofloxacin 500mg Tab APX L APX S 4 Apo-Levofloxacin 750mg Tab APX L 16 Apo-Lisinopril 5mg Tab APX X APX X 10 Apo-Lisinopril 10mg Tab APX X APX X 10 Apo-Lisinopril 20mg Tab APX X APX X 10 Apo-Lisinopril/HCTZ 10 & 12.5mg Tab APX S 4 Apo-Lisinopril/HCTZ 20 & 12.5mg Tab APX S 4 Apo-Lisinopril/HCTZ 20 & 25mg Tab APX A 14 Apo-Lithium Carbonate SR 300mg ER Tab APX N 6 Apo-Loperamide 2mg Caplet APX S 4 Apo-Lovastatin 20mg Tab APX S 4 Apo-Lovastatin 40mg Tab APX S 4 Apo-Loxapine 5mg Tab APX H APX Q 23 Apo-Loxapine 10mg Tab APX H APX Q 23 Apo-Loxapine 25mg Tab APX H APX Q 23 Apo-Loxapine 50mg Tab APX H APX Q 23 Apo-Medroxy 2.5mg Tab APX S 4 Apo-Medroxy 5mg Tab APX S 4 Apo-Medroxy 10mg Tab APX S 4 Apo-Medroxy 100mg Tab APX H 8 Apo-Mefenamic 250mg Cap APX R 14 Apo-Mefloquine 250mg Tab AAP X 21 Apo-Megestrol 40mg Tab APX H AAP X 21 Apo-Megestrol 160mg Tab APX J AAP X 21 Apo-Meloxicam 7.5mg Tab APX S 4 Apo-Meloxicam 15mg Tab APX S 4 Page 39

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