UPDATE AX Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective August 29, 2013 SUMMARY OF CHANGES

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1 UPDATE AX Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective August 29, 2013 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 4 Off Formulary Interchangeable Product(s) 10 Drug Benefit Price(s) 11 New Manufacturer Name(s) 12 Not-A-Benefit Drug(s) 13 Trade Name Change(s) 14 Index 15 Page 1

2 New Single DIN PRODUCT GENERIC NAME MFR DBP Seebri Breezhaler 50mcg Inh Pd-Cap GLYCOPYRRONIUM BROMIDE NOV Note: The dose of Seebri Breezhaler should not exceed 50mcg per day Eliquis 2.5mg Tab APIXABAN BQU Eliquis 5mg Tab APIXABAN BQU Reason for Use Code Clinical Criteria 448 INCLUSION criteria: At risk patients with non-valvular atrial fibrillation, for the prevention of stroke and systemic embolism AND in whom: 1. Anticoagulation is inadequate following at least a 2-month trial on warfarin; OR 2. Anticoagulation using warfarin is contraindicated or not possible due to inability to regularly monitor the patient via International Normalized Ratio (INR) testing (i.e. no access to INR testing services at a laboratory, clinic, pharmacy, and at home) EXCLUSION criteria: 1. Patients with impaired renal function (creatinine clearance or estimated glomerular filtration rate less than 25mL/min); OR 2. Patients who are greater than or equal to 75 years of age and who do not have documented stable renal function; OR 3. Patients who have hemodynamically significant rheumatoid valvular heart disease (especially mitral stenosis); OR 4. Patients who have prosthetic heart valves. Notes: At-risk patients with atrial fibrillation are defined as those with a CHADS2 score of greater than or equal to 1. Prescribers may consider an antiplatelet regimen or oral anticoagulation for patients with a CHADS2 score of 1. Inadequate anticoagulation is defined as INR testing results that are outside the desired INR range for at least 35% of the tests during the monitoring period (i.e., adequate anticoagulation is defined as INR test results that are within the desired INR range for at least 65% of the tests during the monitoring period). Continued on next page. Page 2

3 DIN PRODUCT GENERIC NAME MFR DBP. Continued from previous page Reason for Use Code Clinical Criteria Notes: Documented stable renal function is defined as creatinine clearance or estimated glomerular filtration rate maintained for at least 3 months. Dosing: the usual recommended dose is 5mg twice daily; a reduced dose of apixaban 2.5mg twice daily is recommended for patients with at least two [2] of the following: age greater than or equal to 80 years old, body weight less than or equal to 60 kg, or serum creatinine greater than or equal to 133 micromole/litre. Since renal impairment can increase bleeding risk, renal function should be regularly monitored. Other factors that increase bleeding risk should also be assessed and monitored (see apixaban product monograph). Patients starting apixaban should have ready access to appropriate medical services to manage a major bleeding event. There is currently no data to support that apixaban provides adequate anticoagulation in patients with rheumatic valvular disease or those with prosthetic heart valves. As a result, apixaban is not recommended for these patient populations. LU Authorization Period: Indefinite. Page 3

4 New Multi-Source Drug(s) DIN BRAND STRENGTH DOSAGE FORM MFR DBP Auro-Valsartan HCT 80mg & 12.5mg Tab AUR Auro-Valsartan HCT 160mg & 12.5mg Tab AUR Auro-Valsartan HCT 160mg & 25mg Tab AUR Auro-Valsartan HCT 320mg & 12.5mg Tab AUR Auro-Valsartan HCT 320mg & 25mg Tab AUR (Interchangeable with Diovan HCT) Gd-Latanoprost/Timolol 50mcg/mL & 5mg/mL Oph Sol-2.5mL Pk GEM (Interchangeable with Xalacom) Reason for Use Code 310 Clinical Criteria As second-line therapy for patients who do not have an adequate intraocular pressure lowering response to monotherapy with ophthalmic beta-blocking agents. LU Authorization Period: Indefinite. 393 For use as initial therapy in an urgent situation (e.g. patients with a high baseline intraocular pressure) where monotherapy is unlikely to be effective. LU Authorization Period: Indefinite Jamp-Olanzapine ODT 5mg Rapid Dissolve Tab Jamp-Olanzapine ODT 10mg Rapid Dissolve Tab Jamp-Olanzapine ODT 15mg Rapid Dissolve Tab (Interchangeable with Zyprexa Zydis) JPC JPC JPC Page 4

5 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Mint-Rosuvastatin 5mg Tab MIN Mint-Rosuvastatin 10mg Tab MIN Mint-Rosuvastatin 20mg Tab MIN Mint-Rosuvastatin 40mg Tab MIN (Interchangeable with Crestor) PMS-Galantamine ER 8mg ER Cap PMS PMS-Galantamine ER 16mg ER Cap PMS PMS-Galantamine ER 24mg ER Cap PMS (Interchangeable with Reminyl ER) Reason for Use Code 347 Clinical Criteria Initial Trial: For patients with mild to moderate Alzheimer's Disease (Mini-Mental State Exam [MMSE] 10-26). Patients will be reimbursed for a period of up to 3 months after which continued treatment must be reassessed. Network note: Maximum duration 3 months. LU Authorization Period: 1 year. 348 Continuation: Further reimbursement will be made available to those patients whose disease has not progressed/deteriorated while on this drug. Patients must continue to have a MMSE score of LU Authorization Period: 1 year. Page 5

6 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Ran-Lansoprazole 15mg DR Cap RAN Ran-Lansoprazole 30mg DR Cap RAN (Interchangeable with Prevacid) 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 stepdown 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 295 H. pylori-positive Peptic Ulcers For the treatment of H. pylori-positive peptic ulcers where H. pylori is documented, by serology, urea breath test or endoscopy, for a one-week course in combination with antimicrobial therapy. Retreatment of H. pylori-positive peptic ulcers must be documented by persistent H. pylori infection on urea breath test or endoscopy. Maximum duration: 7 days (for retreatment, a four-week period must elapse since the end of the previous treatment). 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 6

7 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 lower-dose proton pump inhibitor (PPI) therapy. LU Authorization Period: 1 year Ran-Olanzapine 2.5mg Tab RAN Ran-Olanzapine 5mg Tab RAN Ran-Olanzapine 7.5mg Tab RAN Ran-Olanzapine 10mg Tab RAN Ran-Olanzapine 15mg Tab RAN (Interchangeable with Zyprexa) Page 7

8 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Ran-Omeprazole DR Cap 20mg RAN (Interchangeable with Losec DR Cap) 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 8

9 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-Quetiapine 25mg Tab RAN Ran-Quetiapine 100mg Tab RAN Ran-Quetiapine 200mg Tab RAN Ran-Quetiapine 300mg Tab RAN (Interchangeable with Seroquel) Page 9

10 Off Formulary Interchangeable Product(s) DIN BRAND STRENGTH DOSAGE FORM MFR UNIT COST Jamp-Olanzapine ODT 20mg Rapid Dissolve Tab (Interchangeable with Zyprexa Zydis) JPC Jamp-Zopiclone Tablets 5mg Tab JPC (Interchangeable with Imovane) Mint-Sildenafil 25mg Tab MIN Mint-Sildenafil 50mg Tab MIN Mint-Sildenafil 100mg Tab MIN (Interchangeable with Viagra) Ran-Levetiracetam 250mg Tab RAN Ran-Levetiracetam 500mg Tab RAN Ran-Levetiracetam 750mg Tab RAN (Interchangeable with Keppra) Ran-Nabilone 0.25mg Cap RAN (Interchangeable with Cesamet) Page 10

11 Drug Benefit Price(s) DIN BRAND STRENGTH DOSAGE FORM MFR DBP PMS-Ramipril-HCTZ 2.5mg & 12.5mg Tab PMS PMS-Ramipril-HCTZ 5mg & 12.5mg Tab PMS PMS-Ramipril-HCTZ 5mg & 25mg Tab PMS PMS-Ramipril-HCTZ 10mg & 12.5mg Tab PMS PMS-Ramipril-HCTZ 10mg & 25mg Tab PMS Teva-Quetiapine XR 50mg ER Tab TEV Teva-Quetiapine XR 150mg ER Tab TEV Teva-Quetiapine XR 200mg ER Tab TEV Teva-Quetiapine XR 300mg ER Tab TEV Teva-Quetiapine XR 400mg ER Tab TEV Page 11

12 New Manufacturer Name(s) DIN BRAND STRENGTH DOSAGE FORM MFR Apo-Clorazepate 3.75mg Cap AAP Apo-Clorazepate 7.5mg Cap AAP Apo-Clorazepate 15mg Cap AAP Apo-Triazo 0.125mg Tab AAP Apo-Triazo 0.25mg Tab AAP BenzaClin 1% & 5% Top Gel VAL Cardizem CD 120mg LA Cap VAL Cardizem CD 180mg LA Cap VAL Cardizem CD 240mg LA Cap VAL Cardizem CD 300mg LA Cap VAL Delatestryl 1000mg/5mL Oily Inj Sol-5mL Pk VAL Elidel 1% Cr VAL Enablex 7.5mg ER Tab MEU Enablex 15mg ER Tab MEU Linessa 21 3 Phase Tabs-21 Pk MEK Linessa 28 3 Phase Tabs-28 Pk MEK Resultz 50% Top Sol-120mL Pk MEF Resultz 50% Top Sol-240mL Pk MEF Wellbutrin XL 150mg Tab VAL Wellbutrin XL 300mg Tab VAL Page 12

13 Not-A-Benefit DIN BRAND STRENGTH DOSAGE FORM MFR Lutera mcg & 20mcg Tab 21-Pk COB Lutera mcg & 20mcg Tab 28-Pk COB (Interchangeable with Alesse) Page 13

14 Trade Name Change(s) DIN BRAND STRENGTH DOSAGE FORM MFR BenzaClin Topical Gel 1% & 5% Top Gel SAV Clorazepate 3.75mg Cap APX Clorazepate 7.5mg Cap APX Clorazepate 15mg Cap APX Triazolam 0.125mg Tab APX Triazolam 0.25mg Tab APX Page 14

15 CONSOLIDATED INDEX PRODUCT, STRENGTH & DOSAGE FORM DIN MFR UPDATE PAGE 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 BQU AH BQU AT 12 Abilify 5mg Tab BQU AB BQU AH BQU AT 12 Abilify 10mg Tab BQU AB BQU AH BQU AT 12 Abilify 15mg Tab BQU AB BQU AH BQU AT 12 Abilify 20mg Tab BQU AB BQU AH BQU AT 12 Abilify 30mg Tab BQU AB BQU AH BQU AT 12 Accel Citalopram Tablets 20mg Tab ACC AP 2 Accel Citalopram Tablets 40mg Tab ACC AP 2 Accel Clarithromycin 125mg/5mL Ped Gran ACC AP 2 Accel Clarithromycin 250mg/5mL Susp ACC AP 2 Accel Pioglitazone 15mg Tab ACC L 16 Accel Pioglitazone 30mg Tab ACC L 16 Accel Pioglitazone 45mg Tab ACC L 16 Accu-Chek Mobile Blood Glucose Strip ROD AW 16 Accupril 5mg Tab PFI Q PFI Y PFI AG PFI AP 10 Accupril 10mg Tab PFI Q PFI Y PFI AG PFI AP 10 Accupril 20mg Tab PFI Q PFI Y PFI AG 10 Page 15

16 PFI AP 10 Accupril 40mg Tab PFI Q PFI Y PFI AG PFI AP 10 Accuretic 10mg & 12.5mg Tab PFI Q PFI Y PFI AG PFI AP 10 Accuretic 20mg & 12.5mg Tab PFI Q PFI Y PFI AG PFI AP 10 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 AE 6 Acetaminophen Tab 325mg DPC AF DPC AH 12 Acetaminophen Extra Strength 500mg Tab DPC S DPC Z 26 Acetazolamide 250mg Tab APX X 28 AcetOxyl 5% Gel STI M STI U 12 AcetOxyl 10% Gel STI M STI U 12 ACETYLSALICYLIC ACID & BUTALBITAL & CAFFEINE E 8 ACETYLSALICYLIC ACID & BUTALBITAL & CAFFEINE & E 8 Aclasta 5mg/100mL Inj Sol-100mL Pk NOV C NOV H NOV AK 17 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 WAR AG WAR AV 7 Actonel 30mg Tab PGP A WAR AC WAR AG WAR AV 7 Actonel 35mg Tab PGP A 11 Page 16

17 PGP R PGP W WAR AC 12 Actonel 150mg Tab PGP J PGP W WAR Y WAR AV 7 Actonel DR 35mg DR Tab WAR AE WAR AN 6 Actos 15mg Tab TAK L TAK X TAK AG TAK AT 12 Actos 30mg Tab TAK L TAK X TAK AG TAK AT 12 Actos 45mg Tab TAK L TAK X TAK AG TAK AT 12 Acular 0.5% Oph Sol ALL AP 10 Acuvail 0.45% Oph Sol-0.4mL Vial Pk ALL AT 2 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 Adcirca 20mg Tab LIL AT 12 Adderall XR 5mg ER Cap SHI H SHI Q SHI X SHI AD SHI AP 10 Adderall XR 10mg ER Cap SHI H 2 Page 17

18 SHI Q SHI X SHI AD SHI AP 10 Adderall XR 15mg ER Cap SHI H SHI Q SHI X SHI AD SHI AP 10 Adderall XR 20mg ER Cap SHI H SHI Q SHI X SHI AD SHI AP 10 Adderall XR 25mg ER Cap SHI H SHI Q SHI X SHI AD SHI AP 10 Adderall XR 30mg ER Cap SHI H SHI Q SHI X SHI AD SHI AP 10 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 GSK AT 12 Advair /250mcg/Metered Dose Inh-120 Dose Pk GSK H GSK AT 12 Advair Diskus 50/100mcg Inh-60 Dose Pk GSK H GSK AT 12 Advair Diskus 50/250mcg Inh-60 Dose Pk GSK H GSK AT 12 Advair Diskus 50/500mcg Inh-60 Dose Pk GSK H GSK AT 12 Afinitor 5mg Tab NOV AT 12 Afinitor 10mg Tab NOV AT 12 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 Page 18

19 Aggrenox 200mg/25mg Cap BOE AJ 9 Airomir HFA 100mcg/Metered Dose Inh-200 dose Pk GRA U MMH U GRA AL 10 AJ-Pip/Taz 2g & 250mg Inj Pd-Vial Pk AJC AO 10 AJ-Pip/Taz 3g & 375mg Inj Pd-Vial Pk AJC AO 10 AJ-Pip/Taz 4g & 500mg Inj Pd-Vial Pk AJC AO 10 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 Aldactone 25mg Tab PFI H PFI Q 14 Aldactone 100mg Tab PFI H PFI Q 14 ALENDRONATE N 2 Z 6 AI 2 AJ AK 9 AL 3 AR 2 Alendronate 70mg Tab SAI Z SAI AD 18 Alendronate-FC 70mg Tab PHE V 15 ALENDRONATE & CHOLECALCIFEROL J 2 Alendronate Sodium Tablets 5mg Tab ACH AK 9 Alendronate Sodium Tablets 10mg Tab ACH AI 2 Alendronate Sodium Tablets 70mg Tab ACH AI 2 Alesse 20mcg & 100mcg Tab-21 Pk WAY H WAY Y WAY AG WAY AP PFI AP 15 Alesse 21 20mcg & 100mcg Tab-21 Pk WAY AP 19 Alesse 20mcg & 100mcg Tab-28 Pk WAY H WAY Y WAY AG WAY AP PFI AP 15 Alesse 28 20mcg & 100mcg Tab-28 Pk WAY AP 19 ALFUZOSIN HYDROCHLORIDE C 3 X 5 ALISKIREN D 3 ALITRETINOIN AT 4 Alkeran 2mg Tab GSK H TRT AE TRT AG 10 Page 19

20 Allerdryl 25mg Cap VAL M 14 Allerdryl 50mg Cap VAL N 9 ALLOPURINOL AQ 3 Alomide 0.1% Oph Sol ALC X ALC AG ALC AT 12 Alphagan 0.2% Oph Sol ALL AP 10 Alphagan P 0.15% Oph Sol ALL AP 10 ALPRAZOLAM AB 5 AU 3 Alprazolam 0.25mg Tab SAI AB SAI AD 18 Alprazolam 0.5mg Tab SAI AB SAI AD 18 Altace Cap 1.25mg SAV H SAV AG SAV AT 12 Altace Cap 2.5mg SAV H SAV AG SAV AT 12 Altace Cap 5mg SAV H SAV AG SAV AT 12 Altace Cap 10mg SAV H SAV AG SAV AT 12 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 SAV AG 10 Altace HCT 10mg & 25mg Tab SAV H SAV R SAV X SAV AG 10 Alvesco 100mcg/Actuation Inh-120 Dose Pk NYC H NYC Q NYC R NYC X NYC AG NYC AT 12 Alvesco 200mcg/Actuation Inh-120 Dose Pk NYC H NYC Q 14 Page 20

21 NYC R NYC X NYC AG NYC AT 12 Alysena 21 20mcg & 100mcg Tab-21Pk APX AN 2 Alysena 28 20mcg & 100mcg Tab-28Pk APX AN 2 Amatine 2.5mg Tab SHI Q SHI U SHI AE 16 Amatine 5mg Tab SHI Q SHI U SHI AE 16 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 AE 6 AI 2 AT 6 Amlodipine 5mg Tab SAI Z SAI AD 18 Amlodipine 10mg Tab SAI Z SAI AD 18 Amlodipine-Odan 5mg Tab ODN AI ODN AS 2 Amlodipine-Odan 10mg Tab ODN AI ODN AS 2 Amlodipine Tablets 5mg Tab RAN O RAN S RAN AS 2 Amlodipine Tablets 10mg Tab RAN O RAN S RAN AS 2 AMLODIPINE/ATORVASTATIN AB 6 AMOXICILLIN C 9 AB 7 AO 4 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 Page 21

22 Anandron 50mg Tab SAV X SAV AG SAV AT 12 ANASTROZOLE AL 7 AO 3 AP 3 Anastrozole 1mg Tab ACH AO 3 Androderm 12.2mg Transdermal Patch PAL Q PAL X PAL AG WAT AM WAT AU 7 Androgel 1% 2.5g Foil Packet SPH A SPH AE SPH AR 6 Androgel 1% 5.0g Foil Packet SPH AE SPH AR 6 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 Anzemet 50mg Tab SAV H 7 Anzemet 100mg Tab SAV H SAV AG SAV AT 12 Apidra 100U/mL Inj Sol-5x3mL Pk SAV K 2 Apidra 100U/mL Inj Sol-5x3mL SoloSTAR Pref Pen SAV W SAV X SAV AG SAV AT 12 Apidra 100U/mL Inj Sol-10mL Vial SAV K SAV X SAV AG SAV AT 12 Apidra 100U/mL Inj 5x3mL-Cart ClickStar Pen SAV R SAV AG SAV AT 12 APIXABAN AX 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-Acetaminophen Caplets 325mg Caplet APX AE 6 Page 22

23 Apo-Acetaminophen Caplets 500mg Capelt APX AE 6 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 APX AQ 7 Apo-Allopurinol 100mg Tab AAP AG APX AW 14 Apo-Allopurinol 200mg Tab AAP AG APX AW 14 Apo-Allopurinol 300mg Tab AAP AG APX AW 14 Apo-Alpraz 0.25mg Tab APX S 2 Apo-Alpraz 0.5mg Tab APX S 2 Apo-Amiloride 5mg Tab APX H AAP AK 15 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 APX AS 2 Apo-Amlodipine 10mg Tab APX L APX S APX AS 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 50mg & 12.5mg/mL O/L APX AT 12 Apo-Amoxi Clav 250mg & 125mg Tab APX R 14 Apo-Amoxi Clav 875mg & 125mg Tab APX S 2 Apo-Anastrozel 1mg Tab APX AO 3 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 Apo-Atomoxetine 40mg Cap APX V 5 Page 23

24 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 R APX AS 3 Apo-Atorvastatin 20mg Tab APX R APX AS 3 Apo-Atorvastatin 40mg Tab APX R APX AS 3 Apo-Atorvastatin 80mg Tab APX R APX AS 3 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-Benztropine 2mg Tab PMS AN 7 Apo-Benzydamine 0.15% Oral Rinse APX AK APX AV 10 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 1.5mg Tab APX AU 7 Apo-Bromazepam 3mg Tab APX S 2 Apo-Bromazepam 6mg Tab APX S 2 Apo-Bromocriptine 2.5mg Tab APX AG AAP AU 9 Apo-Bromocriptine 5mg Cap APX AG AAP AU 9 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 Apo-Candesartan 4mg Tab APX Z 6 Apo-Candesartan 8mg Tab APX Z 6 Apo-Candesartan 16mg Tab APX Z 6 Apo-Candesartan 32mg Tab APX AQ 3 Apo-Candesartan/HCTZ 16mg & 12.5mg Tab APX AN 2 Apo-Candesartan/HCTZ 32mg & 12.5mg Tab APX AQ 3 Apo-Candesartan/HCTZ 32mg & 25mg Tab APX AQ 3 Page 24

25 Apo-Carbamazepine 200mg Tab APX Z APX AK APX AV 10 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 APX AE 18 Apo-Cefaclor 500mg Cap APX V APX AE 18 Apo-Cefaclor 25mg/mL Oral Susp APX P 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 AAP AR 8 Apo-Chlordiazepoxide 10mg Cap APX H AAP AR 8 Apo-Chlordiazepoxide 25mg Cap APX H AAP AR 8 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 Page 25

26 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-Clonidine 0.025mg Tab APX AK APX AV 11 Apo-Clonidine 0.1mg Tab APX AK APX AV 10 Apo-Clonidine 0.2mg Tab APX AK APX AV 10 Apo-Clopidogrel 75mg Tab APX AD APX AR 10 Apo-Clopidogrel 300mg Tab APX AV 5 Apo-Clorazepate 3.75mg Cap APX R AAP AX 12 Apo-Clorazepate 7.5mg Cap APX R AAP AX 12 Apo-Clorazepate 15mg Cap APX R AAP AX 12 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 AAP AW 13 Apo-Desipramine 50mg Tab APX Z AAP AW 13 Apo-Desipramine 75mg Tab APX Z AAP AW 13 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 Page 26

27 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 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 Page 27

28 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-Eletriptan 20mg Tab APX AU 5 Apo-Eletriptan 40mg Tab APX AU 5 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-Entacapone 200mg Tab APX AH 3 Apo-Entecavir 0.5mg Tab APX AP 6 Apo-Erythro 250mg Tab APX H AAP AK 15 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 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 Page 28

29 Apo-Fluconazole mg Cap APX S 3 Apo-Flunarizine 5mg Cap AAP X 21 Apo-Flunisolide 0.025% Nas Sp-25mL Pk APX J APX AU 7 Apo-Fluoxetine 20mg Cap APX S 3 Apo-Fluphenazine 1mg Tab APX H 8 Apo-Fluphenazine 2mg Tab APX H 8 Apo-Flurazepam 30mg Cap APX AG 10 Apo-Flurazepam 100mg Tab APX AG 10 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-Furosemide 40mg Tab APX AT 12 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 80mg Tab APX S 3 Apo-Gliclazide MR 30mg SR Tab APX A APX C AAP AG 21 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 0.5mg Tab APX AT 12 Apo-Haloperidol 1mg Tab APX AT 12 Apo-Haloperidol 2mg Tab APX AT APX AT 12 Apo-Haloperidol 5mg Tab APX AT APX AT 12 Apo-Haloperidol 10mg Tab APX Z APX AT 12 Apo-Hydralazine 10mg Tab APX Z AAP AU 9 Apo-Hydralazine 25mg Tab APX R AAP AU 9 Apo-Hydralazine 50mg Tab APX Z AAP AU 9 Apo-Hydro 12.5mg Tab APX Q 11 Apo-Hydro 25 25mg Tab APX S 3 Page 29

30 Apo-Hydro 50 50mg Tab APX S 3 Apo-Hydromorphone 1mg Tab APX AI 2 Apo-Hydromorphone 2mg Tab APX AI 2 Apo-Hydromorphone 4mg Tab APX AI 2 Apo-Hydromorphone 8mg Tab APX AI 29 Apo-Hydroxyurea 500mg Cap APX AJ APX AV 10 Apo-Ibuprofen 200mg Tab APX Z APX AU 7 Apo-Ibuprofen 300mg Tab APX Z 24 Apo-Ibuprofen 400mg Tab APX Z 24 Apo-Ibuprofen 600mg Tab APX Z 24 Apo-Imatinib 100mg Tab APX AU 2 Apo-Imatinib 400mg Tab APX AU 2 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-Indomethacin 25mg Cap APX AK APX AV 10 Apo-Indomethacin 50mg Cap APX AK APX AV 10 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-Irbesartan 75mg Tab APX AK 2 Apo-Irbesartan 150mg Tab APX AK 2 Apo-Irbesartan 300mg Tab APX AK 2 Apo-Irbesartan/HCTZ 150mg & 12.5mg Tab APX AR 2 Apo-Irbesartan/HCTZ 300mg & 12.5mg Tab APX AR 2 Apo-Irbesartan/HCTZ 300mg & 25mg Tab APX AR 2 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 AAP AH 11 Apo-Keto-E 50mg Ent Tab APX J AAP AH 11 Apo-Keto-E 100mg Ent Tab APX H AAP AI 9 Apo-Keto SR 200mg LA Tab APX H AAP AG 21 Page 30

31 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-Lactulose Solution 667mg/mL O/L APX AL 18 Apo-Lamivudine 150mg Tab APX AJ 5 Apo-Lamivudine 300mg Tab APX AJ 5 Apo-Lamivudine HBV 100mg Tab APX AN 5 Apo-Lamivudine-Zidovudine 150mg & 300mg Tab APX AJ 5 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 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 AAP AG 21 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 Page 31

32 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-Losartan 25mg Tab APX AF 2 Apo-Losartan 50mg Tab APX AF 2 Apo-Losartan 100mg Tab APX AF 2 Apo-Losartan/HCTZ 50mg & 12.5mg Tab APX AF 2 Apo-Losartan/HCTZ 100mg & 12.5mg Tab APX AF 2 Apo-Losartan/HCTZ 100mg & 25mg Tab APX AF 2 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 APX AG 10 Apo-Mefenamic 250mg Cap APX R AAP AG 21 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 Apo-Memantine 10mg Tab APX AC 10 Apo-Metformin 500mg Tab APX S 4 Apo-Metformin ER 500mg ER Tab APX R 10 Apo-Methazolamide 50mg Tab APX H AAP X 21 Apo-Methoprazine 2mg Tab APX H AAP AU 9 Apo-Methoprazine 5mg Tab APX AC AAP AU 9 Apo-Methoprazine 25mg Tab APX AC AAP AU 9 Apo-Methoprazine 50mg Tab APX AC AAP AU 9 Apo-Methyldopa 125mg Tab APX H AAP X 21 Apo-Methyldopa 250mg Tab APX H AAP X 21 Page 32

33 Apo-Methyldopa 500mg Tab APX H AAP X 21 Apo-Methylphenidate 10mg Tab APX X 10 Apo-Methylphenidate ER 54mg SR Tab APX U 11 Apo-Methylphenidate SR 20mg ER Tab APX J 8 Apo-Metoclop 5mg Tab APX AK APX AV 10 Apo-Metoclop 10mg Tab APX AK APX AV 10 Apo-Metoprolol 50mg Tab APX S 4 Apo-Metoprolol 100mg Tab APX S 4 Apo-Metoprolol (Type L) 50mg Tab APX S 4 Apo-Metoprolol (Type L) 100mg Tab APX S 4 Apo-Metoprolol SR 100mg LA Tab APX C 7 Apo-Metoprolol SR 200mg LA Tab APX C 7 Apo-Metronidazole 250mg Tab APX H AAP X 21 Apo-Metronidazole 500mg Cap APX R AAP X 21 Apo-Midodrine 2.5mg Tab APX H AAP X 21 Apo-Midodrine 5mg Tab APX H AAP X 21 Apo-Mirtazapine 30mg Tab APX S 4 Apo-Misoprostol 100mcg Tab APX H AAP X 21 Apo-Misoprostol 200mcg Tab APX H AAP X 21 Apo-Moclobemide 150mg Tab APX S 4 Apo-Moclobemide 300mg Tab APX S 4 Apo-Modafinil 100mg Tab AAP AL 11 Apo-Montelukast 4mg Chew Tab APX AE 6 Apo-Montelukast 5mg Chew Tab APX AE 10 Apo-Montelukast 10mg Tab APX AD 16 Apo-Mycophenolate 250mg Cap APX AD 4 Apo-Mycophenolate 500mg Tab APX AD 4 Apo-Nadol 160mg Tab APX AC 11 Apo-Naproxen 125mg Tab APX H 8 Apo-Naproxen 500mg Tab APX Z 24 Apo-Naproxen SR 750mg SR Tab APX H APX Y APX AJ 12 Apo-Naratriptan 1mg Tab APX AV 5 Apo-Naratriptan 2.5mg Tab APX AV 5 Apo-Nifed 5mg Cap APX H AAP X 21 Apo-Nifed 10mg Cap APX J AAP X 21 Apo-Nifed PA 10mg LA Tab APX H APX P 8 Page 33

34 APX S APX X 24 Apo-Nifed PA 20mg LA Tab APX H APX P APX S APX X 24 Apo-Nitrazepam 5mg Tab APX X 10 Apo-Nitrazepam 10mg Tab APX X 10 Apo-Nitrofurantoin 50mg Tab APX H AAP X 21 Apo-Nitrofurantoin 100mg Tab APX H AAP X 21 Apo-Nizatidine 150mg Cap APX S 4 Apo-Nizatidine 300mg Cap APX S 4 Apo-Norflox 400mg Tab APX S 4 Apo-Nortriptyline 10mg Cap APX S 4 Apo-Nortriptyline 25mg Cap APX S 4 Apo-Oflox 200mg Tab AAP X 21 Apo-Oflox 300mg Tab AAP X 21 Apo-Oflox 400mg Tab AAP X 21 Apo-Ofloxacin 0.3% Oph Sol APX Z 24 Apo-Olanzapine 2.5mg Tab APX O APX P APX S 4 Apo-Olanzapine 5mg Tab APX O APX P APX S 4 Apo-Olanzapine 7.5mg Tab APX O APX P APX S 4 Apo-Olanzapine 10mg Tab APX O APX P APX S 4 Apo-Olanzapine 15mg Tab APX O APX P APX S 4 Apo-Olanzapine 20mg Tab APX O 19 Apo-Olanzapine ODT 5mg Rapid Dissolve Tab APX Y 3 Apo-Olanzapine ODT 10mg Rapid Dissolve Tab APX Y 3 Apo-Olanzapine ODT 15mg Rapid Dissolve Tab APX Y 3 Apo-Olanzapine ODT 20mg Rapid Dissolve Tab APX Y 5 Apo-Olopatadine 0.1% Oph Sol APX AP 6 Apo-Omeprazole 20mg Cap APX S APX AS 4 Apo-Omeprazole 20mg Cap APX S APX AS 4 Apo-Ondansetron 4mg/5mL O/L APX I AAP X 21 Apo-Ondansetron 4mg Tab APX S 4 Apo-Ondansetron 8mg Tab APX S 4 Page 34

35 Apo-Orciprenaline 2mg/mL O/L APX R 14 Apo-Oxcarbazepine 300mg Tab APX AK 14 Apo-Oxcarbazepine 600mg Tab APX AK 14 Apo-Oxybutynin 5mg Tab APX S 4 Apo-Oxycodone/Acet 5mg & 325mg Tab APX L 3 Apo-Pantoprazole 40mg Ent Tab APX S 4 Apo-Paroxetine 20mg Tab APX S 4 Apo-Paroxetine 30mg Tab APX S 4 Apo-Pen V-K 60mg/mL O/L APX V 13 Apo-Pen V-K 300mg Tab APX V APX AU 7 Apo-Pentoxifylline 400mg SR Tab APX Z 24 Apo-Perindopril 8mg Tab APX S APX AF 10 Apo-Perphenazine 2mg Tab APX H AAP X 22 Apo-Perphenazine 4mg Tab APX H AAP X 22 Apo-Perphenazine 8mg Tab APX H AAP X 22 Apo-Perphenazine 16mg Tab APX H AAP X 22 Apo-Pimozide 2mg Tab APX AC 11 Apo-Pindol 5mg Tab APX S 4 Apo-Pindol 10mg Tab APX S 4 Apo-Pindol 15mg Tab APX S 4 Apo-Piroxicam 10mg Cap APX S 4 Apo-Piroxicam 20mg Cap APX S 4 Apo-Pramipexole 0.25mg Tab APX S 4 Apo-Pramipexole 1mg Tab APX S 5 Apo-Pramipexole 1.5mg Tab APX S 5 Apo-Pravastatin 10mg Tab APX S 5 Apo-Pravastatin 20mg Tab APX S 5 Apo-Pravastatin 40mg Tab APX S 5 Apo-Prednisone 1mg Tab APX H 8 Apo-Prednisone 50mg Tab APX R APX AF APX AU 7 Apo-Pregabalin 25mg Cap APX AT APX AW 12 Apo-Pregabalin 50mg Cap APX AT APX AW 12 Apo-Pregabalin 75mg Cap APX AT APX AW 12 Apo-Pregabalin 150mg Cap APX AT APX AW 12 Apo-Pregabalin 225mg Cap APX AT 9 Apo-Pregabalin 300mg Cap APX AT APX AW 12 Apo-Primidone 125mg Tab APX H 8 Page 35

36 AAP X 22 Apo-Primidone 250mg Tab APX H AAP X 22 Apo-Prochlorazine 5mg Tab APX AC 11 Apo-Prochlorazine 10mg Tab APX AC 11 Apo-Propafenone 150mg Tab APX S 5 Apo-Propafenone 300mg Tab APX S 5 Apo-Propranolol 10mg Tab APX S APX AT 11 Apo-Propranolol 20mg Tab APX X 10 Apo-Propranolol 40mg Tab APX S APX AT 11 Apo-Propranolol 80mg Tab APX S APX AT 11 Apo-Propranolol 120mg Tab APX H 8 Apo-Quetiapine 25mg Tab APX D APX S 5 Apo-Quetiapine 100mg Tab APX D APX S 5 Apo-Quetiapine 200mg Tab APX D APX E APX S 5 Apo-Quetiapine 300mg Tab APX D APX E APX S 5 Apo-Rabeprazole 10mg Tab APX R APX S APX AS 4 Apo-Rabeprazole 20mg Tab APX R APX S APX AS 4 Apo-Raloxifene 60mg Tab APX I APX M 10 Apo-Ramipril 1.25mg Cap APX S 5 Apo-Ramipril Cap 1.25mg APX AS 5 Apo-Ramipril 2.5mg Cap APX S 5 Apo-Ramipril Cap 2.5mg APX AS 5 Apo-Ramipril 5mg Cap APX S 5 Apo-Ramipril Cap 5mg APX AS 5 Apo-Ramipril 10mg Cap APX S 5 Apo-Ramipril Cap 10mg APX AS 5 Apo-Ramipril 15mg Cap APX J 10 Apo-Ranitidine 15mg/mL Oral Sol APX AT 12 Apo-Ranitidine 150mg Tab APX S APX X 10 Apo-Ranitidine 300mg Tab APX S APX X 10 Apo-Repaglinide 0.5mg Tab APX AE 10 Apo-Repaglinide 1mg Tab APX AE 10 Apo-Repaglinide 2mg Tab APX AE 10 Page 36

37 Apo-Riluzole 50mg Tab APX AN 5 Apo-Risedronate 35mg Tab APX U 3 Apo-Risedronate 150mg Tab APX AI 2 Apo-Risperidone 1mg/mL O/L APX X 10 Apo-Risperidone 0.25mg Tab APX S 5 Apo-Risperidone 0.5mg Tab APX S 5 Apo-Risperidone 1mg Tab APX S 5 Apo-Risperidone 2mg Tab APX S 5 Apo-Risperidone 3mg Tab APX S 5 Apo-Risperidone 4mg Tab APX S 5 Apo-Rivastigmine 1.5mg Cap APX P APX S 5 Apo-Rivastigmine 3mg Cap APX P APX S 5 Apo-Rivastigmine 4.5mg Cap APX P APX S 5 Apo-Rivastigmine 6mg Cap APX P APX S 5 Apo-Rizatriptian 5mg Tab APX AO 10 Apo-Rizatriptian 10mg Tab APX AO 10 Apo-Rizatriptan RPD 5mg Orally Disintegrating Tab APX AV 5 Apo-Rizatriptan RPD 10mg Orally Disintegrating Tab APX AV 5 Apo-Ropinirole 0.25mg Tab APX Q APX S 5 Apo-Ropinirole 1mg Tab APX Q APX S 5 Apo-Ropinirole 2mg Tab APX Q APX S 5 Apo-Ropinirole 5mg Tab APX Q APX S 5 Apo-Rosuvastatin 5mg Tab APX AH 3 Apo-Rosuvastatin 10mg Tab APX AH 3 Apo-Rosuvastatin 20mg Tab APX AH 3 Apo-Rosuvastatin 40mg Tab APX AH 3 Apo-Salvent 100mcg/Metered Dose Inh-200 dose Pk APX S 32 Apo-Salvent 2mg Tab APX H 8 Apo-Salvent 4mg Tab APX H 9 Apo-Salvent CFC Free 100mcg/Metered Dose Inh-200 dose Pk APX N APX V 8 Apo-Salvent Ipravent Sterules 500mcg/2.5mg/2.5mL Inh Sol APX A APX K 11 Apo-Salvent Sterule 1mg/mL Inh Sol-2.5mL Pk APX H 19 Apo-Salvent Sterule 2mg/mL Inh Sol-2.5mL Pk APX H 19 Apo-Sibutramine 10mg Cap APX P 15 Apo-Selegiline 5mg Tab APX S 5 Apo-Sertraline 25mg Cap APX S 5 Apo-Sertraline 50mg Cap APX S 5 Apo-Sertraline 100mg Cap APX S 5 Apo-Sibutramine 15mg Cap APX P 15 Apo-Sildenafil 25mg Tab APX AP 6 Page 37

UPDATE AV Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective June 27, 2013 SUMMARY OF CHANGES

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