UPDATE AL Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective 28 September, 2012 SUMMARY OF CHANGES

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1 UPDATE AL Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective 28 September, 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) 8 Manufacturer Requested Discontinued Drug(s) 9 Drug Benefit Price(s) 10 New Manufacturer Name(s) 11 Therapeutic Note Change(s) 12 Discontinued Drug(s) (Removed From Payment & Listing) 13 Limited Use Change(s) 16 Change(s) to the strength of Product(s) 18 Trade Name Change(s) 19 New DiabeticTesting Agent(s) 20 Index 21 Page 1

2 New Single Source Drug(s) DIN PRODUCT GENERIC NAME MFR DBP Complera 200mg & 25mg & 300mg Tab EMTRICITABINE & RILPIVIRINE HCL & TENOFOVIR DISOPROXIL GIL For the treatment of human immunodeficiency virus type 1 (HIV-1) infection in antiretroviral treatment naïve adult patients, or to replace the three components given as dual or triple therapy for patients stabilized on appropriate doses. NOTE: For the treatment of HIV/AIDS, the prescriber must be approved for the Facilitated Access mechanism Trajenta 5mg Tab LINAGLIPTIN BOE Treatment of Type 2 diabetes in patients on maximal doses of metformin (2000mg/day) who have: Inadequate glycemic control (HbA1c >0.07) and on maximal doses of a sulfonylurea and for whom insulin is not an option. Page 2

3 New Multi-Source Drug(s) DIN BRAND STRENGTH DOSAGE FORM MFR DBP Auro-Alendronate 10mg Tab AUR Auro-Alendronate 70mg Tab AUR (Interchangeable with Fosamax) Auro-Fluoxetine 20mg Cap AUR (Interchangeable with Prozac) Auro-Paroxetine 20mg Tab AUR Auro-Paroxetine 30mg Tab AUR (Interchangeable with Paxil) Page 3

4 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Gd-Mirtazapine OD 15mg Orally Disintegrating Tab Gd-Mirtazapine OD 30mg Orally Disintegrating Tab Gd-Mirtazapine OD 45mg Orally Disintegrating Tab (Interchangeable with Remeron RD) GEM GEM GEM Gd-Topiramate 25mg Tab GEM Gd-Topiramate 100mg Tab GEM Gd-Topiramate 200mg Tab GEM (Interchangeable with Topamax) Jamp-Alendronate 70mg Tab JPC (Interchangeable with Fosamax) Jamp-Candesartan 4mg Tab JPC Jamp-Candesartan 8mg Tab JPC Jamp-Candesartan 16mg Tab JPC Jamp-Candesartan 32mg Tab JPC (Interchangeable with Atacand) Page 4

5 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Jamp-Ciprofloxacin 250mg Tab JPC Jamp-Ciprofloxacin 500mg Tab JPC Jamp-Ciprofloxacin 750mg Tab JPC (Interchangeable with Cipro) Reason for Use Code Clinical Criteria For the treatment of patients with: SST/BJ(Gram negative bacteria): Skin/soft tissue and bone/joint infection due to gram negative bacteria; severe diabetic foot infection; severe otitis externa; decubitus ulcers. LU Authorization Period: 1 year. GU Tract: Urinary tract infection/prostatitis/epididymitis caused by (suspected or documented) Pseudomonas; sexually transmitted diseases. LU Authorization Period: 1 year. COPD with risk: Acute bacterial exacerbation of chronic obstructive pulmonary disease (COPD) with risk factors 1 ; bronchiectasis; pneumonic illness with cystic fibrosis. 1 Risk factors include: poor pulmonary lung function (FEV 1 below 50% predicted level), age over 65 years, co-morbid medical illness (congestive heart failure, diabetes, chronic renal failure, chronic liver disease), chronic corticosteroid use, malnutrition, prolonged duration of disease or 4 or more exacerbations per year. LU Authorization Period: 1 year. Step-Down: Step-down therapy after parenteral therapy or hospital/emergency department discharge; febrile neutropenia LU Authorization Period: 1 year. GI: Traveller s diarrhea; enteric fever syndromes; Crohn s disease. LU Authorization Period: 1 year. For the prophylaxis or treatment of B. anthracis exposure. LU Authorization Period: 1 year. Exceptional cases of allergy or intolerance to all other appropriate therapies. LU Authorization Period: 1 year. Page 5

6 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Jamp-Lactulose 667mg/mL O/L JPC (Interchangeable with Cephulac) Jamp-Sertraline 25mg Cap JPC Jamp-Sertraline 50mg Cap JPC Jamp-Sertraline 100mg Cap JPC (Interchangeable with Zoloft) Mar-Olanzapine ODT 5mg Rapid Dissolve Tab MAR Mar-Olanzapine ODT 10mg Rapid Dissolve Tab MAR Mar-Olanzapine ODT 15mg Rapid Dissolve Tab MAR (Interchangeable with Zyprexa Zydis) Mint-Finasteride 5mg Tab MIN (Interchangeable with Proscar) Reason for Use Code 384 Clinical Criteria For use in combination with an alpha blocker for the treatment of men with symptomatic* Benign Prostatic Hyperplasia. LU Authorization Period: Indefinite. 385 For monotherapy, as a second line agent in patients with symptomatic* Benign Prostatic Hyperplasia following treatment failure or intolerance to an alpha blocker. * Symptomatic is defined as having moderate (about half the time) to severe (almost always) symptoms related to the prostate in at least 4 of the following domains: 1. feeling of incomplete emptying of the bladder after voiding 2. needing to urinate again less than 2 hours after previous void 3. stopping and starting urine several times while voiding 4. difficulty postponing urination 5. weak urinary stream 6. pushing or straining to begin voiding 7. the need to get up to void at least 3 times in the night. LU Authorization Period: Indefinite. Page 6

7 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Mint-Losartan/HCTZ 50mg & 12.5mg Tab MIN Mint-Losartan/HCTZ 100mg & 12.5mg Tab MIN (Interchangeable with Hyzaar) Mint-Losartan/HCTZ DS 100mg & 25mg Tab MIN (Interchangeable with Hyzaar DS) Mint-Metformin 500mg Tab MIN (Interchangeable with Glucophage) Quetiapine Tablets 25mg Tab ACH Quetiapine Tablets 100mg Tab ACH Quetiapine Tablets 200mg Tab ACH Quetiapine Tablets 300mg Tab ACH (Interchangeable with Seroquel) Sandoz Anastrozole 1mg Tab SDZ (Interchangeable with Arimidex) Reason for Use Code 365 Clinical Criteria For the treatment of metastatic breast cancer in hormone receptor positive postmenopausal women. LU Authorization Period: Indefinite. 396 As an alternative to tamoxifen for the adjuvant treatment of postmenopausal women with hormone receptor positive breast cancer. LU Authorization Period: Indefinite. Page 7

8 Off Formulary Interchangeable Product(s) DIN BRAND STRENGTH DOSAGE FORM MFR UNIT COST Auro-Pioglitazone 15mg Tab AUR Auro-Pioglitazone 30mg Tab AUR Auro-Pioglitazone 45mg Tab AUR (Interchangeable with Actos) Gd-Gabapentin 600mg Tab GEM Gd-Gabapentin 800mg Tab GEM (Interchangeable with Neurontin) Gd-Terbinafine 250mg Tab GEM (Interchangeable with Lamisil) Jamp-Rizatriptan 5mg Tab JPC Jamp-Rizatriptan 10mg Tab JPC (Interchangeable with Maxalt) Mar-Olanzapine ODT 20mg Rapid Dissolve Tab MAR (Interchangeable with Zyprexa Zydis) Mint-Metformin 850mg Tab MIN (Interchangeable with Glucophage) Sandoz Ciprofloxacin 0.3% Oph Sol-5mL Pk SDZ (Interchangeable with Ciloxan) Page 8

9 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 Jamp-Tamsulosin 0.4mg Cap JPC Nu-Acyclovir 200mg Tab NXP Nu-Acyclovir 400mg Tab NXP Page 9

10 Drug Benefit Price(s) DIN BRAND STRENGTH DOSAGE FORM MFR DBP Airomir HFA 100mcg/Metered Dose Inh-200 dose Pk GRA Novo-Mirtazapine OD 15mg Orally Disintegrating NOP Tab Novo-Mirtazapine OD 30mg Orally Disintegrating NOP Tab Novo-Mirtazapine OD 45mg Orally Disintegrating Tab NOP Page 10

11 New Manufacturer Name(s) DIN BRAND STRENGTH DOSAGE FORM MFR Apo-Modafinil 100mg Tab AAP Apo-Trimip 25mg Tab AAP Apo-Trimip 50mg Tab AAP Apo-Trimip 100mg Tab AAP Gen-Tamsulosin 0.4mg Cap MYL Novo-Domperidone 10mg Tab TEV Novo-Naprox 250mg Tab TEV Novo-Naprox 375mg Tab TEV Novo-Naprox 500mg Tab TEV Novo-Naprox 250mg Ent Tab TEV Novo-Naprox 375mg Ent Tab TEV Novo-Naprox 500mg Ent Tab TEV Novo-Terazosin 1mg Tab TEV Novo-Terazosin 2mg Tab TEV Novo-Terazosin 5mg Tab TEV Novo-Terazosin 10mg Tab TEV Novo-Trazodone 50mg Tab TEV Novo-Trazodone 100mg Tab TEV Novo-Trazodone 150mg Tab TEV Page 11

12 Therapeutic Note Change(s) DIN BRAND STRENGTH DOSAGE FORM MFR Janumet 500mg & 50mg Tab MEK Janumet 850mg & 50mg Tab MEK Janumet 1000mg & 50mg Tab MEK Treatment of Type 2 diabetes in patients on maximal doses of metformin (2000mg/day) who have:. Inadequate glycemic control (defined as HbA1c>0.07) and intolerance or contraindication to a sulfonylurea; or. Inadequate glycemic control (HbA1c>0.07) and on maximal doses of a sulfonylurea and for whom insulin is not an option Januvia 100mg Tab MFC Treatment of Type 2 diabetes in patients on maximal doses of metformin (2000mg/day) who have:. Inadequate glycemic control (defined as HbA1c>0.07) and intolerance or contraindication to a sulfonylurea; or. Inadequate glycemic control (HbA1c>0.07) and on maximal doses of a sulfonylurea and for whom insulin is not an option Onglyza 5mg Tab BQU Treatment of Type 2 diabetes in patients on maximal doses of metformin (2000mg/day) who have:. Inadequate glycemic control (HbA1c>0.07) and intolerance or contraindication to a sulfonylurea Page 12

13 Discontinued Drug(s) (Removed From Payment & Listing) DIN BRAND STRENGTH DOSAGE FORM MFR Nu-Acebutolol 100mg Tab NXP Nu-Acebutolol 200mg Tab NXP Nu-Acebutolol 400mg Tab NXP Nu-Acyclovir 800mg Tab NXP Nu-Alpraz 0.25mg Tab NXP Nu-Alpraz 0.5mg Tab NXP Nu-Amilzide 5mg & 50mg Tab NXP Nu-Amoxi 250mg Cap NXP Nu-Amoxi 500mg Cap NXP Nu-Amoxi 25mg/mL O/L NXP Nu-Amoxi 50mg/mL O/L NXP Nu-Atenol 50mg Tab NXP Nu-Atenol 100mg Tab NXP Nu-Baclo 10mg Tab NXP Nu-Baclo 20mg Tab NXP Nu-Capto 12.5mg Tab NXP Nu-Capto 25mg Tab NXP Nu-Capto 50mg Tab NXP Nu-Capto 100mg Tab NXP Nu-Carbamazepine 200mg Tab NXP Nu-Cephalex 250mg Tab NXP Nu-Cephalex 500mg Tab NXP Nu-Cimet 300mg Tab NXP Nu-Cimet 400mg Tab NXP Nu-Cimet 600mg Tab NXP Nu-Clonazepam 0.5mg Tab NXP Nu-Clonazepam 2mg Tab NXP Nu-Clonidine 0.1mg Tab NXP Nu-Clonidine 0.2mg Tab NXP Nu-Cotrimox 400mg & 80mg Tab NXP Nu-Cotrimox 800mg & 160mg Tab NXP Nu-Cyclobenzaprine 10mg Tab NXP Nu-Diclo 25mg Ent Tab NXP Nu-Diclo 50mg Ent Tab NXP Nu-Diltiaz 30mg Tab NXP Nu-Diltiaz 60mg Tab NXP Nu-Divalproex 125mg Ent Tab NXP Nu-Divalproex 250mg Ent Tab NXP Nu-Divalproex 500mg Ent Tab NXP Nu-Domperidone 10mg Tab NXP Nu-Famotidine 20mg Tab NXP Nu-Famotidine 40mg Tab NXP Nu-Fluoxetine 20mg Cap NXP Nu-Flurbiprofen 50mg Tab NXP Nu-Flurbiprofen 100mg Tab NXP Nu-Fluvoxamine 50mg Tab NXP Page 13

14 DIN BRAND STRENGTH DOSAGE FORM MFR Nu-Fluvoxamine 100mg Tab NXP Nu-Glyburide 2.5mg Tab NXP Nu-Glyburide 5mg Tab NXP Nu-Indapamide 2.5mg Tab NXP Nu-Indo 25mg Cap NXP Nu-Indo 50mg Cap NXP Nu-Levocarb 100mg & 10mg Tab NXP Nu-Levocarb 100mg & 25mg Tab NXP Nu-Levocarb 250mg & 25mg Tab NXP Nu-Metformin 500mg Tab NXP Nu-Metoclopramide 5mg Tab NXP Nu-Metoclopramide 10mg Tab NXP Nu-Metop 50mg Tab NXP Nu-Metop 100mg Tab NXP Nu-Naprox 250mg Tab NXP Nu-Naprox 375mg Tab NXP Nu-Naprox 500mg Tab NXP Nu-Nortriptyline 10mg Cap NXP Nu-Nortriptyline 25mg Cap NXP Nu-Oxybutyn 5mg Tab NXP Nu-Pen VK 300mg Tab NXP Nu-Pindol 5mg Tab NXP Nu-Pindol 10mg Tab NXP Nu-Pindol 15mg Tab NXP Nu-Pirox 10mg Cap NXP Nu-Pirox 20mg Cap NXP Nu-Pravastatin 10mg Tab NXP Nu-Pravastatin 20mg Tab NXP Nu-Pravastatin 40mg Tab NXP Nu-Prazo 1mg Tab NXP Nu-Prazo 2mg Tab NXP Nu-Prazo 5mg Tab NXP Nu-Ranit 150mg Tab NXP Nu-Ranit 300mg Tab NXP Nu-Selegiline 5mg Tab NXP Nu-Sotalol 160mg Tab NXP Nu-Sucralfate 1g Tab NXP Nu-Sulindac 150mg Tab NXP Nu-Sulindac 200mg Tab NXP Nu-Temazepam 15mg Cap NXP Nu-Temazepam 30mg Cap NXP Nu-Terazosin 1mg Tab NXP Nu-Terazosin 2mg Tab NXP Nu-Terazosin 5mg Tab NXP Nu-Terazosin 10mg Tab NXP Nu-Ticlopidine 250mg Tab NXP Nu-Timolol 5mg Tab NXP Nu-Timolol 10mg Tab NXP Nu-Triazide 25mg & 50mg Tab NXP Nu-Valproic 250mg Cap NXP Page 14

15 DIN BRAND STRENGTH DOSAGE FORM MFR Nu-Verap 80mg Tab NXP Nu-Verap 120mg Tab NXP Page 15

16 Limited Use Change(s) DIN BRAND STRENGTH DOSAGE FORM MFR Stelara 45mg/0.5mL Inj Sol-Pref Syr Pk JAN Reason for Use Code 419 Clinical Criteria For the treatment of severe* plaque psoriasis in patients 18 years of age or older who have experienced failure, intolerance, or have a contraindication to adequate trials of several standard therapies**. Claims for the first 6 months must be written by a dermatologist. Monitoring of patients is required to determine if continuation of therapy beyond 12 weeks is required. Patients not responding adequately at 12 weeks should have treatment discontinued. * Definition of severe plaque psoriasis: Body Surface Area (BSA) involvement of at least 10%, or involvement of the face, hands, feet or genital regions, AND Psoriasis Area and Severity Index (PASI) score of at least 10 (not required if there is involvement of the face, hands, feet or genital regions), AND Dermatology Life Quality Index (DLQI) score of at least 10. ** Definition of failure, intolerance or contraindication to adequate trials of standard therapies: 6 month trial of at least 3 topical agents including vitamin D analogues and steroids; AND 12 week trial of phototherapy (unless not accessible); AND 6 month trial of at least 2 systemic, oral agents used alone or in combination Methotrexate 15-30mg per week Acitretin (could have been used with phototherapy) Cyclosporine Continued on next page. Page 16

17 DIN BRAND STRENGTH DOSAGE FORM MFR. Continued from previous page Reason for Use Code Clinical Criteria Maintenance/Renewal: After 3 months of therapy, patients who respond to therapy should have: At least a 50% reduction in PASI, AND at least a 50% reduction in BSA involvement, AND at least a 5 point reduction in DLQI score Approvals will only allow for standard dosing for Stelara 45mg to be administered at weeks 0, 4 and every 12 weeks thereafter. Alternatively, 90mg may be used in patients with a body weight of over 100 kg. In patients weighing over 100 kg, both the 45mg and 90mg doses were shown to be efficacious. However, 90mg was efficacious in a higher percentage of these patients. If the patient has not responded after 12 weeks of treatment, the physician should consider switching to an alternative biologic agent. LU Authorization Period: 1 year Page 17

18 Change(s) made to the strength of product (rounding to the decimal point) DIN BRAND STRENGTH DOSAGE FORM MFR Apo-Lactulose Solution 667mg/mL O/L APX Cephulac (Not a Benefit) 667mg/mL O/L MRR Ratio-Lactulose 667mg/mL O/L RPH Page 18

19 Trade Name Change(s) DIN BRAND STRENGTH DOSAGE FORM MFR Modafinil 100mg Tab APX Mylan-Tamsulosin 0.4mg Cap GEN Teva-Domperidone 10mg Tab NOP Teva-Naproxen 250mg Tab NOP Teva-Naproxen 375mg Tab NOP Teva-Naproxen 500mg Tab NOP Teva-Naproxen EC 250mg Ent Tab NOP Teva-Naproxen EC 375mg Ent Tab NOP Teva-Naproxen EC 500mg Ent Tab NOP Teva-Terazosin 1mg Tab NOP Teva-Terazosin 2mg Tab NOP Teva-Terazosin 5mg Tab NOP Teva-Terazosin 10mg Tab NOP Teva-Trazodone 50mg Tab NOP Teva-Trazodone 100mg Tab NOP Teva-Trazodone 150mg Tab NOP Trimipramine 25mg Tab APX Trimipramine 50mg Tab APX Trimipramine 100mg Tab APX Page 19

20 New Diabetic Testing Agent(s) PIN PRODUCT MFR COST/ UNIT AMT MOH PAYS AMT PATIENT PAYS BGStar Blood Glucose Strips 2.7IU SAC Page 20

21 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 10 Abilify 5mg Tab BQU AB BQU AH 10 Abilify 10mg Tab BQU AB BQU AH 10 Abilify 15mg Tab BQU AB BQU AH 10 Abilify 20mg Tab BQU AB BQU AH 10 Abilify 30mg Tab BQU AB BQU AH 10 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 PFI AG 10 Accupril 10mg Tab PFI Q PFI Y PFI AG 10 Accupril 20mg Tab PFI Q PFI Y PFI AG 10 Accupril 40mg Tab PFI Q PFI Y PFI AG 10 Accuretic 10mg & 12.5mg Tab PFI Q PFI Y PFI AG 10 Accuretic 20mg & 12.5mg Tab PFI Q PFI Y PFI AG 10 Accuretic 20mg & 25mg Tab PFI H PFI Q PFI Y 7 Page 21

22 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 CODEINE PHOSPHATE 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 10 Actonel 30mg Tab PGP A WAR AC WAR AG 10 Actonel 35mg Tab PGP A PGP R PGP W WAR AC 12 Actonel 150mg Tab PGP J PGP W WAR Y 9 Actonel DR 35mg DR Tab WAR AE 2 Actos 15mg Tab TAK L TAK X TAK AG 10 Actos 30mg Tab TAK L TAK X TAK AG 10 Actos 45mg Tab TAK L TAK X TAK AG 10 Page 22

23 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 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 Page 23

24 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 Aggrenox 200mg/25mg Cap BOE AJ 9 Airomir HFA 100mcg/Metered Dose Inh-200 dose Pk GRA U MMH U GRA AL 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 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 10 Alesse 20mcg & 100mcg Tab-28 Pk WAY H WAY Y WAY AG 10 ALFUZOSIN HYDROCHLORIDE C 3 X 5 Page 24

25 ALISKIREN D 3 Alkeran 2mg Tab GSK H TRT AE TRT AG 10 Allerdryl 25mg Cap VAL M 14 Allerdryl 50mg Cap VAL N 9 Alomide 0.1% Oph Sol ALC X ALC AG 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 SAV AG 10 Altace Cap 2.5mg SAV H SAV AG 10 Altace Cap 5mg SAV H SAV AG 10 Altace Cap 10mg SAV H SAV AG 10 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 10 Alvesco 200mcg/Actuation Inh-120 Dose Pk NYC H NYC Q NYC R NYC X NYC AG 10 Amatine 2.5mg Tab SHI Q SHI U 8 Page 25

26 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 Amlodipine 5mg Tab SAI Z SAI AD 18 Amlodipine 10mg Tab SAI Z SAI AD 18 Amlodipine-Odan 5mg Tab ODN AI 2 Amlodipine-Odan 10mg Tab ODN AI 2 Amlodipine Tablets 5mg Tab RAN O RAN S 2 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 SAV AG 10 ANASTROZOLE AL 7 Androderm 12.2mg Transdermal Patch PAL Q PAL X PAL AG 10 Androgel 1% 2.5g Foil Packet SPH A SPH AE 13 Androgel 1% 5.0g Foil Packet SPH AE 13 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 Page 26

27 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 10 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 10 Apidra 100U/mL Inj Sol-10mL Vial SAV K SAV X SAV AG 10 Apidra 100U/mL Inj 5x3mL-Cart ClickStar Pen SAV R SAV AG 10 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 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 9 Apo-Allopurinol 100mg Tab AAP AG 21 Apo-Allopurinol 200mg Tab AAP AG 21 Apo-Allopurinol 300mg Tab AAP AG 21 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 3 Page 27

28 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 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-Benzydamine 0.15% Oral Rinse APX AK 11 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-Bromocriptine 2.5mg Tab APX AG 10 Apo-Bromocriptine 5mg Cap APX AG 10 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 Page 28

29 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 APX AK 11 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 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 Page 29

30 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-Clonidine 0.025mg Tab APX AK 11 Apo-Clonidine 0.1mg Tab APX AK 11 Apo-Clonidine 0.2mg Tab APX AK 11 Apo-Clopidogrel 75mg Tab APX AD 3 Apo-Clorazepate 3.75mg Cap APX R 14 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 32 Page 30

31 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 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 Page 31

32 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-Entacapone 200mg Tab APX AH 3 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 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-Flurazepam 30mg Cap APX AG 10 Apo-Flurazepam 100mg Tab APX AG 10 Page 32

33 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 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 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 Apo-Hydro 25 25mg Tab APX S 3 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 8 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-Indomethacin 25mg Cap APX AK 11 Page 33

34 Apo-Indomethacin 50mg Cap APX AK 11 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-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 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-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 Page 34

35 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 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 Page 35

36 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 8 Apo-Methoprazine 5mg Tab APX AC 11 Apo-Methoprazine 25mg Tab APX AC 11 Apo-Methoprazine 50mg Tab APX AC 11 Apo-Methyldopa 125mg Tab APX H AAP X 21 Apo-Methyldopa 250mg Tab APX H AAP X 21 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 11 Apo-Metoclop 10mg Tab APX AK 11 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 Page 36

37 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-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 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 10 Page 37

38 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-Omeprazole 20mg Cap APX S 4 Apo-Omeprazole 20mg Cap APX S 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 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 13 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 Page 38

39 Apo-Prednisone 50mg Tab APX R APX AF 8 Apo-Primidone 125mg Tab APX H 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 5 Apo-Propranolol 20mg Tab APX X 10 Apo-Propranolol 40mg Tab APX S 5 Apo-Propranolol 80mg Tab APX S 5 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 5 Apo-Rabeprazole 20mg Tab APX R APX S 5 Apo-Raloxifene 60mg Tab APX I APX M 10 Apo-Ramipril 1.25mg Cap APX S 5 Apo-Ramipril 2.5mg Cap APX S 5 Apo-Ramipril 5mg Cap APX S 5 Apo-Ramipril 10mg Cap APX S 5 Apo-Ramipril 15mg Cap APX J 10 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 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 Page 39

40 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-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 7 Apo-Salvent Ipravent Sterules 500mcg/2.5mg/2.5mL Inh Sol- 2.5mL Pk APX V 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-Simvastatin 5mg Tab APX S 5 Apo-Simvastatin 10mg Tab APX S 5 Apo-Simvastatin 20mg Tab APX S 5 Apo-Simvastatin 40mg Tab APX S 5 Apo-Simvastatin 80mg Tab APX S 5 Apo-Sucralfate 1g Tab APX S 5 Apo-Sulfinpyrazone 200mg Tab APX H AAP X 22 Apo-Tamsulosin CR Tab 0.4mg APX AC 6 Page 40

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

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