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

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1 UPDATE AV Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective June 27, 2013 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 3 Off Formulary Interchangeable Product(s) 5 Manufacturer Requested Discontinued Drug(s) 6 Drug Benefit Price(s) 7 New Manufacturer Name(s) 8 Not-A-Benefit Drug(s) 9 Discontinued Drug(s) (Removed From Payment & Listing) 10 Not-A-Benefit Drug(s) (Removed from Listing) 11 Limited Use Change(s) 12 Trade Name Change(s) 16 Index 17 Page 1

2 New Single Source Drug(s) DIN PRODUCT GENERIC NAME MFR DBP Dexedrine Spansule 10mg SR Tab DEXAMPHETAMINE SULFATE PAL Dexedrine Spansule 15mg SR Tab DEXAMPHETAMINE SULFATE PAL Notes: Patients greater than 6 years of age diagnosed wtih ADHD according to DSM-IV criteria and where symptoms are not due to other medical conditions which affect concentration, and who require 12-hour continuous coverage due to academic and/or psychosocial needs, and who meet the following: 1) Patients who demonstrate significant and problematic disruptive behaviour or who have problems with inattention that interfere with learning; AND 2) Prescribed by or in consultation with a specialist in pediatric psychiatry, pediatrics or a general practitioner with expertise in ADHD; AND 3) Have been tried on methylpenidate immediate release (IR) or methylphenidate slow release (SR) or Dexedrine IR, and have experienced unsatisfactory results due to poor symptom control, side effects, administrative barriers, or societal barriers. Administrative barriers include: inability of a school to dose the child at lunch; the school lunch hour does not coincide with the dosing schedule; poor compliance with noon or afternoon doses; the patient is unable to swallow tablets. Societal barriers include: the patient or patient's caregiver(s) has (have) a history of substance abuse or diversion of listed immediate-release alternatives; the patient or patient's caregiver(s) is/are at risk of substance abuse or diversion of listed immediate-release alternatives. Page 2

3 New Multi-Source Drug(s) DIN BRAND STRENGTH DOSAGE FORM MFR DBP Euro-Lac 667mg/mL O/L EUR (Interchangeable with Cephulac) Mar-Gabapentin 100mg Cap MAR Mar-Gabapentin 300mg Cap MAR Mar-Gabapentin 400mg Cap MAR (Interchangeable with Neurontin) Mint-Sertraline 25mg Cap MIN Mint-Sertraline 50mg Cap MIN Mint-Sertraline 100mg Cap MIN (Interchangeable with Zoloft) PMS-Atorvastatin 10mg Tab PMS PMS-Atorvastatin 20mg Tab PMS PMS-Atorvastatin 40mg Tab PMS PMS-Atorvastatin 80mg Tab PMS (Interchangeable with Lipitor) PMS-Telmisartan-HCTZ 80mg & 12.5mg Tab PMS PMS-Telmisartan-HCTZ 80mg & 25mg Tab PMS (Interchangeable with Micardis Plus) Ran-Topiramate 25mg Tab RAN Ran-Topiramate 100mg Tab RAN Ran-Topiramate 200mg Tab RAN (Interchangeable with Topamax) Page 3

4 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Teva-Candesartan/HCTZ 32mg & 12.5mg Tab TEV Teva-Candesartan/HCTZ 32mg & 25mg Tab TEV (Interchangeable with Atacand Plus) Teva-Letrozole 2.5mg Tab TEV (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 4

5 Off Formulary Interchangeable Product(s) DIN BRAND STRENGTH DOSAGE FORM MFR UNIT COST Apo-Clopidogrel 300mg Tab APX (Interchangeable with Plavix) Apo-Naratriptan 1mg Tab APX Apo-Naratriptan 2.5mg Tab APX (Interchangeable with Amerge) Apo-Rizatriptan RPD 5mg Orally Disintegrating Tab Apo-Rizatriptan RPD 10mg Orally Disintegrating Tab APX APX (Interchangeable with Maxalt RPD) Co Fluoxetine 10mg Cap COB (Interchangeable with Prozac) Jamp-Fluoxetine 10mg Cap JPC (Interchangeable with Prozac) Jamp-Gabapentin Tablets 600mg Tab JPC Jamp-Gabapentin Tablets 800mg Tab JPC (Interchangeable with Neurontin) Jamp-Levetiracetam 250mg Tab JPC Jamp-Levetiracetam 500mg Tab JPC Jamp-Levetiracetam 750mg Tab JPC (Interchangeable with Keppra) Levetiracetam Tablets 250mg Tab ACH Levetiracetam Tablets 500mg Tab ACH Levetiracetam Tablets 750mg Tab ACH (Interchangeable with Keppra) PMS-Tramadol-Acet 37.5mg & 325mg Tab PMS (Interchangeable with Tramacet) Page 5

6 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-Atrovastatin 10mg Tab PMS PMS-Atrovastatin 20mg Tab PMS PMS-Atrovastatin 40mg Tab PMS PMS-Atrovastatin 80mg Tab PMS PMS-Ofloxacin 0.3% Oph Sol PMS PMS-Tobramycin 0.3% Oph Sol PMS Page 6

7 Drug Benefit Price(s) DIN BRAND STRENGTH DOSAGE FORM MFR DBP Actonel 5mg Tab WAR Actonel 30mg Tab WAR Actonel 150mg Tab WAR Asacol 400mg Tab WAR Asacol 800mg Tab WAR Viroptic 1% Oph Sol THE Page 7

8 New Manufacturer Name(s) DIN BRAND STRENGTH DOSAGE FORM MFR Humira 40mg/0.8mL Inj Sol-Pref Pen Pk ABV Humira 40mg/0.8mL Inj Sol-Pref Syr Pk ABV Kaletra 80mg/mL & 20mg/mL O/L ABV Kaletra 100mg & 25mg Tab ABV Kaletra 200mg & 50mg Tab ABV Page 8

9 Not-A-Benefit Drug(s) DIN BRAND STRENGTH DOSAGE FORM MFR Avalide 300mg & 25mg Tab SAV Capoten 25mg Tab BQU Dilaudid-HP-Plus 20mg/mL Inj PFP Dilaudid-XP 50mg/mL Inj-1mL Pk PFP Lotensin 10mg Tab NOV Tofranil 50mg Tab NOV Page 9

10 Discontinued Drug(s) (Removed From Payment & Listing) DIN BRAND STRENGTH DOSAGE FORM MFR Apo-Benzydamine 0.15% Oral Rinse APX Apo-Carbamazepine 200mg Tab APX Apo-Clonidine 0.1mg Tab APX Apo-Clonidine 0.2mg Tab APX Apo-Hydroxyurea 500mg Cap APX Apo-Indomethacin 25mg Cap APX Apo-Indomethacin 50mg Cap APX Apo-Metoclop 5mg Tab APX Apo-Metoclop 10mg Tab APX Desocort 0.05% Lot GAC Desocort 0.05% Oint GAC Euglucon 5mg Tab PMS Gen-Timolol 0.25% Oph Sol GEN Jamp-Tamsulosin 0.4mg Cap JPC M.O.S mg Tab VAL Marinol 2.5mg Cap SPH Marinol 5mg Cap SPH Mylan-Amilazide 5mg & 50mg Tab MYL Phenazo 200mg Tab VAL Page 10

11 Not-A-Benefit Drug(s) (Removed From Listing) DIN BRAND STRENGTH DOSAGE FORM MFR Apo-Clonidine 0.025mg Tab APX Pyridium 200mg Tab PDA Page 11

12 Limited Use Change(s) DIN BRAND STRENGTH DOSAGE FORM MFR Xarelto 15mg Tab BAH Xarelto 20mg Tab BAH Reason for Use Code 435 Clinical Criteria For the prevention of stroke and systemic embolism in at-risk patients who have non-valvular atrial fibrillation (AF) AND in whom: 1) Anticoagulation is inadequate following a reasonable trial on warfarin; OR 2) Anticoagulation with warfarin is contraindicated or not possible due to inability to regularly monitor via International Normalized Ratio (INR) testing (i.e., no access to INR testing services at a laboratory, clinic, pharmacy, and at home). Exclusion Criteria: Patients who: (a) have impaired renal function (creatinine clearance or estimated glomerular filtration rate less than 30mL/min); OR (b) are greater than or equal to 75 years in age without documented stable renal function; OR (c) have hemodynamically significant rheumatic valvular heart disease, especially mitral stenosis; OR (d) have prosthetic heart valves. Definitions and Clarification: (a) documented stable renal function is defined as creatinine clearance or estimated glomerular filtration rate that maintained for at least 3 months (i.e., 30-49mL/min for 15mg once daily dosing or greater than or equal to 50mL/min for 20mg once daily dosing for at least 3 months). (b) at-risk patients with atrial fibrillation are defined as those with a CHADS2 score of greater than or equal to 1. Although the ROCKET-AF trial included patients with higher CHADS2 score (greater than or equal to 2), other landmark studies with the other newer oral anticoagulants demonstrated a therapeutic benefit in patients with a CHADS2 score of 1. Prescribers may consider an antiplatelet regimen or oral anticoagulation for patients with a CHADS2 score of 1. Continued on the next page: Page 12

13 DIN BRAND STRENGTH DOSAGE FORM MFR Reason for Use Code Continued from the previous page Clinical Criteria Definitions and Clarification: (c) inadequate anticoagulation is defined as INR testing results that are outside of 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). (d) a reasonable trial on warfarin is defined as at least 2 months of therapy. (e) Since renal impairment can increase bleeding risk, renal function should be regularly monitored. Other factors that increase bleeding risk should also be assessed and monitored (see Xarelto product monograph). (f) Patients starting rivaroxaban should have ready access to appropriate medical services to manage a major bleeding event. (g) There is currently no data to support that rivaroxaban provides adequate anticoagulation in patients with rheumatic valvular disease or those with prosthetic heart valves, so rivaroxaban is not recommended in these populations. LU Authorization Period: Indefinite 444 For the treatment of deep vein thrombosis (DVT) without symptomatic pulmonary embolism (PE) for up to six (6) months. LU Authorization Period: 6 months. Notes:. The recommended dose of rivaroxaban for patients initiating DVT treatment is 15mg twice daily for 3 weeks, followed by 20mg once daily.. ODB Program coverage for rivaroxaban is an alternative to heparin/warfarin for up to 6 months. When used for greater than 6 months, rivaroxaban is more costly than heparin/warfarin. As such, patients with an intended duration of therapy greater than 6 months should be considered for initiation on heparin/warfarin.. Since renal impairment can increase bleeding risk, it is impotant to monitor renal function regularly. Other factors that increase bleeding risks should also be assessed and monitored (see product monograph). Page 13

14 DIN BRAND STRENGTH DOSAGE FORM MFR Lucentis 10mg/mL Inj Sol-0.23mL Vial Pk NOV Reason for Use Code Clinical Criteria 422 For the treatment of patients with new onset (< 3 months) neovascular (wet) age-related macular degeneration (AMD) in a verteporfin PDT (Visudyne)-naïve eye. Initial diagnosis should be confirmed by an appropriate diagnostic procedure and administration should be done by a qualified ophthalmologist experienced in intravitreal injections. Patients receiving concurrent administration of verteporfin PDT (Visudyne) are not eligible for reimbursement. Treatment should be initiated with a loading phase of one injection per month for three consecutive months, followed by a maintenance phase. During the maintenance phase, patients should be monitored for best corrected visual acuity or continued disease activity. If there is clinical or diagnostic evidence of disease activity such as a loss of greater than 5 letters in visual acuity (Early Treatment Diabetic Retinopathy Score (ETDRS) chart or one Snellen line equivalent), Lucentis may be administered. The interval between two doses should not be shorter than one month. LU Authorization Period: 1 year 439 For the treatment of patients with clinically significant diabetic macular edema (DME) for whom laser photocoagulation is also indicated; and a hemoglobin A1c of less than 11%. Treatment to be given monthly and continued until maximum visual acuity is achieved, confirmed by stable visual acuity for three consecutive monthly assessments performed while on Lucentis treatment. Thereafter patients should be monitored monthly for visual acuity. Treatment is resumed with monthly injections when monitoring indicates a loss of visual acuity due to DME and continued until stable visual acuity is reached again for three consecutive monthly assessments. LU Authorization Period: 1 year Continued on next page Page 14

15 DIN BRAND STRENGTH DOSAGE FORM MFR Continued from previous page Reason for Use Code Clinical Criteria 445 For the treatment of patients with clinically significant macular edema secondary to branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO). Treatment to be given monthly and continued until maximum visual acuity is achieved, confirmed by stable visual acuity for three consecutive monthly assessments performed while on Lucentis treatment. Thereafter patients should be monitored monthly for visual acuity. Treatment is resumed with monthly injections when monitoring indicates a loss of visual acuity due to macular edema secondary to retinal vein occlusion and contined until stable visual acuity is reached again for three consecutive monthly assessments. LU Authorization Period: 1 year Page 15

16 Trade Name Change(s) DIN BRAND STRENGTH DOSAGE FORM MFR PurAmino A+ 5kcal/g Pd-400g Pk MJN Page 16

17 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 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 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 PFI AP 10 Page 17

18 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 PGP R 14 Page 18

19 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 SHI Q 14 Page 19

20 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 Aggrenox 200mg/25mg Cap BOE AJ 9 Page 20

21 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 Allerdryl 25mg Cap VAL M 14 Page 21

22 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 NYC R 14 Page 22

23 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 Anandron 50mg Tab SAV X 10 Page 23

24 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 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 7 Page 24

25 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 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 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 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 Page 25

26 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 Apo-Carbamazepine 200mg Tab APX Z APX AK APX AV 10 Apo-Carbamazepine CR 200mg LA Tab APX M APX P 16 Page 26

27 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 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 Page 27

28 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 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 APX U 9 Apo-Diflunisal 250mg Tab APX Z 24 Apo-Diflunisal 500mg Tab APX H 7 Apo-Digoxin mg Tab APX K 6 Page 28

29 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 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 Page 29

30 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 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 Page 30

31 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 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 Page 31

32 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 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 Page 32

33 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 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 Page 33

34 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 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 Page 34

35 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 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 8 Page 35

36 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 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 Page 36

37 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 6 Apo-Pregabalin 50mg Cap APX AT 6 Apo-Pregabalin 75mg Cap APX AT 6 Apo-Pregabalin 150mg Cap APX AT 6 Apo-Pregabalin 225mg Cap APX AT 9 Apo-Pregabalin 300mg Cap APX AT 6 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 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 4 Page 37

38 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 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 Page 38

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

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

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