UPDATE 11 Ontario Drug Benefit Formulary/Comparative Drug Index No. 40 Effective April 09, 2008 SUMMARY OF CHANGES

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1 UPDATE 11 Ontario Drug Benefit Formulary/Comparative Drug Index No. 40 Effective April 09, 2008 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Multi-Source Drug(s) 2 Manufacturer Requested Discontinued Drug(s) 5 Drug Benefit Price(s) 6 New Manufacturer Name(s) 14 Not-A-Benefit Drug(s) 15 Off Formulary Interchangeable Product(s) 16 Palliative Care Drug(s) 17 New DiabeticTesting Agent(s) 18 Consolidated Index of Updates 1 TO Page 1

2 New Multi-Source Drug(s) DIN BRAND STRENGTH DOSAGE FORM MFR DBP Co Venlafaxine XR 37.5mg ER Cap COB Co Venlafaxine XR 75mg ER Cap COB Co Venlafaxine XR 150mg ER Cap COB (Interchangeable with Effexor XR) Novo-Morphine SR 60mg SR Tab NOP Novo-Morphine SR 100mg SR Tab NOP Novo-Morphine SR 200mg SR Tab NOP (Interchangeable with MS Contin) PMS-Clindamycin 300mg Cap PMS (Interchangeable with Dalacin C) PMS-Propafenone 150mg Tab PMS PMS-Propafenone 300mg Tab PMS (Interchangeable with Rythmol). Page 2

3 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Ran-Pantoprazole 40mg Ent Tab RAN (Interchangeable with Pantoloc) Reason for Use Code 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 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 oneweek course in combination with antimicrobial therapy. Retreatment of H. pylori-positive peptic ulcers must be documented by persisten 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 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 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 3

4 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 Sandoz Ramipril 1.25mg Tab SDZ Sandoz Ramipril 2.5mg Tab SDZ Sandoz Ramipril 5mg Tab SDZ Sandoz Ramipril 10mg Tab SDZ (Interchangeable with Altace Cap) Page 4

5 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 Kwellada-P 1% Cr Rinse GSK Kwellada-P 5% Lot GSK Nix Dermal Cream 5% Cr GSK Panoxyl 15% Gel STI R & C Shampoo/Conditioner 0.3% & 3% & 1.2% Top Sol GSK Trasicor 40mg Tab NOV Page 5

6 Drug Benefit Price(s) DIN BRAND STRENGTH DOSAGE FORM MFR DBP TC 10mg/mL O/L GSK TC 150mg Tab GSK TC 300mg Tab GSK Adalat XL 20mg ER Tab BAY Adalat XL 30mg ER Tab BAY Adalat XL 60mg ER Tab BAY Advair /125mcg/Metered Dose Inh-120 Dose Pk GSK Advair /250mcg/Metered Dose Inh-120 Dose Pk GSK Advair Diskus 50/100mcg Inh-60 Dose Pk GSK Advair Diskus 50/250mcg Inh-60 Dose Pk GSK Advair Diskus 50/500mcg Inh-60 Dose Pk GSK Agenerase 50mg Cap GSK Agenerase 150mg Cap GSK Agenerase 15mg/mL O/L GSK Alesse 20mcg & 100mcg Tab-21 Pk WAY Alesse 20mcg & 100mcg Tab-28 Pk WAY Alkeran 2mg Tab GSK Altace 1.25mg Cap SAV Altace 2.5mg Cap SAV Altace 5mg Cap SAV Altace 10mg Cap SAV Amatine 2.5mg Tab SHI Amatine 5mg Tab SHI Anandron 50mg Tab SAV Anzemet 50mg Tab SAV Anzemet 100mg Tab SAV Arixtra 2.5mg Inj-0.5mL Pk GSK Avalide 150 & 12.5mg Tab SAV Avalide 300 & 12.5mg Tab SAV Avapro 75mg Tab SAV Avapro 150mg Tab SAV Avapro 300mg Tab SAV Avodart 0.5mg Cap GSK Betagan 0.5% Oph Sol ALL Botox 100U/Vial Pd Inj-100U Vial Pk ALL Cafergot 1mg & 100mg Tab NOV Calcimar 400IU/2mL Inj Sol-2mL Pk SAV CeeNU 10mg Cap BQU CeeNU 40mg Cap BQU CeeNU 100mg Cap BQU Ceftin 125mg/5mL Susp GSK Ceftin 250mg Tab GSK Page 6

7 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Ceftin 500mg Tab GSK Cefzil 125mg/5mL Oral Susp BQU Cefzil 250mg/5mL Oral Susp BQU Cefzil 250mg Tab BQU Cefzil 500mg Tab BQU Celexa 20mg Tab VLH Celexa 40mg Tab VLH Cipro 10g/100mL Oral Susp BAY Cipro 250mg Tab BAY Cipro 500mg Tab BAY Clavulin 25mg & 6.25mg/mL O/L GSK Clavulin 50mg & 12.5mg/mL O/L GSK Clavulin 250mg & 125mg Tab GSK Clavulin 500mg & 125mg Tab GSK Clavulin (BID) 200mg & 28.5mg/5mL Susp GSK Clavulin (BID) 400mg & 57mg/5mL Susp GSK Clavulin (BID) 875mg & 125mg Tab GSK Codeine Contin 50mg CR Tab PFP Codeine Contin 100mg CR Tab PFP Codeine Contin 150mg CR Tab PFP Codeine Contin 200mg CR Tab PFP Combigan 0.2% & 0.5% Oph Sol-5mL Pk ALL Combivir 150mg & 300mg Tab GSK Comtan 200mg Tab NOV Cortisporin 10000U & 5mg & 10mg/mL Ot Sol GSK Coumadin 1mg Tab BQU Coumadin 2mg Tab BQU Coumadin 2.5mg Tab BQU Coumadin 3mg Tab BQU Coumadin 4mg Tab BQU Coumadin 5mg Tab BQU Coumadin 10mg Tab BQU Cyclocort 0.1% Cr STI Cyclocort 0.1% Lot STI Cyclocort 0.1% Oint STI Cyclomen 50mg Cap SAV Cyclomen 100mg Cap SAV Cyclomen 200mg Cap SAV Demerol 50mg Tab SAV Desquam-X10 10% Gel BQU Dexedrine 5mg Tab GSK Diabeta 2.5mg Tab SAV Diabeta 5mg Tab SAV Diovan 80mg Tab NOV Diovan 160mg Tab NOV Diovan-HCT 80mg/12.5mg Tab NOV Page 7

8 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Diovan-HCT 160mg/12.5mg Tab NOV Diovan-HCT 160mg/25mg Tab NOV Effexor XR 37.5mg ER Cap WAY Effexor XR 75mg ER Cap WAY Effexor XR 150mg ER Cap WAY Eltroxin 0.05mg Tab GSK Eltroxin 0.1mg Tab GSK Eltroxin 0.15mg Tab GSK Eltroxin 0.2mg Tab GSK Emo-Cort 1% Cr STI Emo-Cort 2.5% Cr STI Emo-Cort 1% Lot STI Emo-Cort 2.5% Lot STI Exelon 1.5mg Cap NOV Exelon 3mg Cap NOV Exelon 4.5mg Cap NOV Exelon 6mg Cap NOV Famvir 500mg Tab NOV Femara 2.5mg Tab NOV Flagyl 500mg Cap SAV Flagyl 10% Vag Cr-App SAV Flagystatin 500mg & U/g Vag Cr-App SAV Flagystatin 500mg & U Vag Sup SAV Flovent Diskus 250mcg/Blister Pd Inh-60 Dose Pk GSK Flovent Diskus 500mcg/Blister Pd Inh-60 Dose Pk GSK Flovent HFA 50mcg/Metered Dose Inh-120 Dose Pk GSK Flovent HFA 125mcg/Metered Dose Inh-120 Dose Pk GSK Flovent HFA 250mcg/Metered Dose Inh-120 Dose Pk GSK Fluanxol 0.5mg Tab VLH Fluanxol 3mg Tab VLH Fluanxol Depot 200mg/2mL Inj Sol- 2mL Pk VLH Fluanxol Depot 200mg/10mL Inj Sol-10mL Pk VLH Fludara 10mg Tab BAY FML 0.1% Oph Susp ALL Foradil 12mcg/Cap Inh Pd-Device Pk NOV Fraxiparine 9500IU/mL Pref Syr-0.3mL Pk GSK Fraxiparine 9500IU/mL Pref Syr-0.4mL Pk GSK Fraxiparine 9500IU/mL Pref Syr-0.6mL Pk GSK Fraxiparine 9500IU/mL Pref Syr-0.8mL Pk GSK Fraxiparine 9500IU/mL Pref Syr-1.0mL Pk GSK Fraxiparine Forte 19000IU/mL Pref Syr-0.6mL Pk GSK Fraxiparine Forte 19000IU/mL Pref Syr-0.8mL Pk GSK Fraxiparine Forte 19000IU/mL Pref Syr-1.0mL Pk GSK Gleevec 100mg Tab NOV Gleevec 400mg Tab NOV Glucagon 1mg/Vial Inj Pd-Vial Pk LIL Page 8

9 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Glucophage 500mg Tab SAV Halog 0.1% Cr BQU Halog 0.1% Oint BQU Humulin 30/70 100U/mL Inj Susp-5x3mL Pk LIL Humulin 30/ U/10mL Inj Susp-10mL Pk LIL Humulin N 100U/mL Inj Susp-5x3mL Pk LIL Humulin NPH 1000U/10mL Inj Susp-10mL Pk LIL Humulin R 100U/mL Inj Sol-5x3mL Pk LIL Humulin Regular 1000U/10mL Inj Sol-10mL Pk LIL Hycodan 1mg/mL O/L BQU Hydromorph Contin 3mg CR Cap PFP Hydromorph Contin 6mg CR Cap PFP Hydromorph Contin 12mg CR Cap PFP Hydromorph Contin 18mg CR Cap PFP Hydromorph Contin 24mg CR Cap PFP Hydromorph Contin 30mg CR Cap PFP Imuran 50mg Tab GSK K mEq/mL O/L GSK Kayexalate 1mEq/g Oral Pd-454g Pk SAV Kenalog-Orabase Oral Top Oint BQU Kivexa 600mg/300mg Tab GSK Lamictal 25mg Tab GSK Lamictal 100mg Tab GSK Lamictal 150mg Tab GSK Lanvis 40mg Tab GSK Lasix 10mg/mL O/L SAV Lasix 20mg Tab SAV Lasix 40mg Tab SAV Lasix Special 500mg Tab SAV Lescol 20mg Cap NOV Lescol 40mg Cap NOV Lescol XL 80mg ER Tab NOV Leucovorin Calcium 5mg Tab WAY Leukeran 2mg Tab GSK Lioresal 10mg Tab NOV Lioresal DS 20mg Tab NOV Lopresor 50mg Tab NOV Lopresor 100mg Tab NOV Lopresor SR 100mg LA Tab NOV Lopresor SR 200mg LA Tab NOV Lotensin 5mg Tab NOV Lotensin 10mg Tab NOV Lotensin 20mg Tab NOV Marinol 2.5mg Cap SPH Marinol 5mg Cap SPH Mesasal 500mg Ent Tab GSK Page 9

10 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Min-Ovral 0.03mg & 0.15mg Tab-21 Pk WAY Min-Ovral 0.03mg & 0.15mg Tab-28 Pk WAY Monopril 10mg Tab BQU Monopril 20mg Tab BQU MS Contin 15mg SR Tab PFP MS Contin 30mg SR Tab PFP MS Contin 60mg SR Tab PFP MS Contin 100mg SR Tab PFP MS Contin 200mg SR Tab PFP MS-IR 20mg Tab PFP MS-IR 30mg Tab PFP Myleran 2mg Tab GSK Myochrysine 10mg/mL Inj Sol-1mL Pk SAV Myochrysine 25mg/mL Inj Sol-1mL Pk SAV Myochrysine 50mg/mL Inj Sol-1mL Pk SAV Nerisone 0.1% Cr STI Nerisone 0.1% Oint STI Nerisone 0.1% Oily Cr STI Nimotop 30mg SG Cap BAY Nitrolingual Pump Spray 0.4mg/Metered Dose Spray-200 Dose Pk SAV Ocuflox 0.3% Oph Sol ALL Ovral 0.05mg & 0.25mg Tab-21 Pk WAY Oxycontin 10mg SR Tab PFP Oxycontin 20mg SR Tab PFP Oxycontin 40mg SR Tab PFP Oxycontin 80mg SR Tab PFP Panoxyl 5% Gel STI Panoxyl 10% Gel STI Panoxyl 20% Gel STI Panoxyl Aquagel 5% Gel STI Parnate 10mg Tab GSK Paxil 20mg Tab GSK Paxil 30mg Tab GSK Pediapred Oral Liquid 6.7mg/5mL O/L SAV Phyllocontin 225mg SR Tab PFP Phyllocontin mg SR Tab PFP Piportil L4 25mg/mL Inj Sol-1mL Pk SAV Piportil L4 50mg/mL Inj Sol-1mL Pk SAV Piportil L4 100mg/2mL Inj Sol-2mL Pk SAV Plaquenil 200mg Tab SAV Plavix 75mg Tab SAV Pravachol 10mg Tab BQU Pravachol 20mg Tab BQU Pravachol 40mg Tab BQU Pred Mild 0.12% Oph Susp ALL Premarin 0.3mg Tab WAY Page 10

11 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Premarin 0.625mg Tab WAY Premarin 1.25mg Tab WAY Premarin 0.625mg/g Vag Cr WAY Premplus 0.625mg/2.5mg Tab-28 Day Pk WAY Premplus 0.625mg/5mg Tab-28 Day Pk WAY Prozac 20mg Cap LIL Rapamune 1mg/mL O/L WAY Rapamune 1mg Tab WAY Renedil 2.5mg SR Tab SAV Renedil 5mg SR Tab SAV Renedil 10mg SR Tab SAV ReQuip 0.25mg Tab GSK ReQuip 1mg Tab GSK ReQuip 2mg Tab GSK ReQuip 5mg Tab GSK Rifadin 150mg Cap SAV Rifadin 300mg Cap SAV Ritalin 10mg Tab NOV Ritalin SR 20mg LA Tab NOV Rythmodan 100mg Cap SAV Rythmodan 150mg Cap SAV Sandostatin LAR 10mg Inj Kit Pk NOV Sandostatin LAR 20mg Inj Kit Pk NOV Sandostatin LAR 30mg Inj Kit Pk NOV Sansert 2mg Tab NOV Sectral 100mg Tab SAV Sectral 200mg Tab SAV Sectral 400mg Tab SAV SereVent Diskhaler Disks 50mcg/Blister Diskhaler-60 Disk Pk GSK SereVent Diskus 50mcg Pd Inh-60 Dose Pk GSK Sinemet CR 100mg & 25mg Tab MFC Sinemet CR 200mg & 50mg Tab MFC Sofracort 5mg & 50mcg & 0.5mg/mL Oph/Ot Sol SAV Suprax 20mg/mL Oral Susp SAV Suprefact 1mg/mL Inj Sol-5.5mL Pk SAV Suprefact 1mg/mL Nas Sp-10mL Pk SAV Suprefact Depot 6.3mg Implant Kit SAV Suprefact Depot 9.45mg Implant Kit SAV Synacthen Depot 1mg/mL Inj Susp-1mL Pk NOV Tambocor 50mg Tab MMH Tambocor 100mg Tab MMH Tamofen 10mg Tab SAV Tamofen 20mg Tab SAV Tantum 0.15% Oral Rinse MMH Tegretol 100mg Chew Tab NOV Tegretol 200mg Chew Tab NOV Page 11

12 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Tegretol 100mg/5mL Oral Susp NOV Tegretol CR 200mg LA Tab NOV Tegretol CR 400mg LA Tab NOV Telzir 700mg Tab GSK Teveten 400mg Tab SPH Teveten 600mg Tab SPH Teveten Plus 600mg & 12.5mg Tab SPH Theolair Alcohol Free Oral 5.3mg/mL O/L GRA Liquid Tofranil 50mg Tab NOV Trental 400mg SR Tab SAV Triquilar 21 3 Phase Tab-21 Pk BAY Triquilar 28 3 Phase Tab-28 Pk BAY Trizivir 300mg/150mg/300mg Tab GSK Uniphyl 400mg SR Tab PFP Uniphyl 600mg SR Tab PFP Uremol-HC 1% & 10% Cr STI Uremol-HC 1% & 10% Lot STI Valtrex 500mg Cap GSK Ventolin 0.4mg/mL O/L GSK Ventolin 5mg/mL Inh Sol-10mL Pk GSK Ventolin Nebules P.F. 1mg/mL Inh Sol- 2.5mL Pk GSK Ventolin Nebules P.F. 2mg/mL Inh Sol- 2.5mL Pk GSK Vepesid 50mg Cap BQU Viskazide 10/25 10mg & 25mg Tab NOV Viskazide 10/50 10mg & 50mg Tab NOV Visken 5mg Tab NOV Visken 10mg Tab NOV Visken 15mg Tab NOV Voltaren 50mg Ent Tab NOV Voltaren 50mg Sup NOV Voltaren 100mg Sup NOV Xatral 10mg Prolong-Rel Tab SAV Zantac 50mg/2mL Inj Sol-2mL Pk GSK Zantac 15mg/mL Oral Sol GSK Zantac 150mg Tab GSK Zantac 300mg Tab GSK Zaroxolyn 2.5mg Tab SAV Ziagen 20mg/mL O/L GSK Ziagen 300mg Tab GSK Zofran 4mg/5mL O/L GSK Zofran 4mg Tab GSK Zofran 8mg Tab GSK Zofran ODT 4mg Tab GSK Zofran ODT 8mg Tab GSK Zovirax 800mg Tab GSK Page 12

13 DIN BRAND STRENGTH DOSAGE FORM MFR DBP Zyprexa 2.5mg Tab LIL Zyprexa 5mg Tab LIL Zyprexa 7.5mg Tab LIL Zyprexa 10mg Tab LIL Zyprexa 15mg Tab LIL Zyprexa Zydis 5mg Rapid Dissolve Tab LIL Zyprexa Zydis 10mg Rapid Dissolve Tab LIL Zyprexa Zydis 15mg Rapid Dissolve Tab LIL Page 13

14 New Manufacturer Name(s) DIN BRAND STRENGTH DOSAGE FORM MFR Minitran 0.4mg/Hr/13.3 Sq Cm Patch GRA Minitran 0.6mg/Hr/20 Sq Cm Patch GRA QVAR 50mcg/Metered Dose Aero Inh-200 Dose Pk GRA QVAR 100mcg/Metered Dose Aero Inh-200 Dose Pk GRA Tambocor 50mg Tab GRA Tambocor 100mg Tab GRA Tantum 0.15% Oral Rinse GRA Page 14

15 Not-A-Benefit Drug(s) DIN BRAND STRENGTH DOSAGE FORM MFR Apo-Amoxi Clav 400mg & 57mg/5mL Susp APX (Interchangeable with Clavulin (BID) ) Gen-Domperidone 10mg Tab GEN (Interchangeable with Apo-Domperidone) Page 15

16 Off Formulary Interchangeable Product(s) DIN BRAND STRENGTH DOSAGE FORM MFR UNIT COST Gen-Metformin 850mg Tab GEN PMS-Metformin 850mg Tab PMS (Interchangeable with Glucophage) PMS-Minocycline 50mg Cap PMS PMS-Minocycline 100mg Cap PMS (Interchangeable with Minocin) Ran-Metformin 850mg Tab RAN (Interchangeable with Glucophage) Page 16

17 Palliative Care Drug(S) DIN BRAND STRENGTH DOSAGE FORM MFR Phenobarbital 120mg/mL Inj Sol-1mL Pk HOS Page 17

18 New Diabetic Testing Agent(s) PIN PRODUCT MFR COST/ UNIT AMT MOH PAYS AMT PATIENT PAYS Ascensia Breeze 2 Strip BAH Page 18

19 CONSOLIDATED INDEX mg Tab PEN 2 6 3TC 10mg/mL O/L GSK GSK TC 150mg Tab GSK GSK TC 300mg Tab GSK GSK 11 6 Actonel 5mg Tab PGP 2 11 Actonel 30mg Tab PGP 2 11 Actonel 35mg Tab PGP 2 11 Actos 15mg Tab LIL 4 9 Actos 30mg Tab LIL 4 9 Actos 45mg Tab LIL 4 9 ACYCLOVIR 8 14 Adalat XL 20mg ER Tab BAY BAY 11 6 Adalat XL 30mg ER Tab BAY BAY 11 6 Adalat XL 60mg ER Tab BAY BAY 11 6 Advair /125mcg/Metered Dose Inh-120 Dose Pk GSK GSK 11 6 Advair /250mcg/Metered Dose Inh-120 Dose Pk GSK GSK 11 6 Advair Diskus 50/100mcg Inh-60 Dose Pk GSK GSK 11 6 Advair Diskus 50/250mcg Inh-60 Dose Pk GSK GSK 11 6 Advair Diskus 50/500mcg Inh-60 Dose Pk GSK GSK 11 6 Agenerase 50mg Cap GSK GSK 11 6 Agenerase 150mg Cap GSK GSK 11 6 Agenerase 15mg/mL O/L GSK GSK 11 6 Aldoril mg & 15mg Tab MSD 3 13 Aldoril mg & 25mg Tab MSD 3 13 ALENDRONATE Alesse 20mcg & 100mcg Tab-21 Pk WAY 11 6 Alesse 20mcg & 100mcg Tab-28 Pk WAY 11 6 Page 19

20 Alkeran 2mg Tab GSK GSK 11 6 ALPRAZOLAM 10 9 Altace 1.25mg Cap SAV SAV 11 6 Altace 2.5mg Cap SAV SAV 11 6 Altace 5mg Cap SAV SAV 11 6 Altace 10mg Cap SAV SAV 11 6 Altace HCT 2.5mg & 12.5mg Tab SAV 2 2 Altace HCT 5mg & 12.5mg Tab SAV 2 2 Altace HCT 5mg & 25mg Tab SAV 2 2 Altace HCT 10mg & 12.5mg Tab SAV 2 2 Altace HCT 10mg & 25mg Tab SAV 2 2 Alvesco 100mcg/Actuation Inh-120 Dose Pk ALA NYC 4 10 Alvesco 200mcg/Actuation Inh-120 Dose Pk ALA NYC 4 10 Amatine 2.5mg Tab SHI SHI 11 6 Amatine 5mg Tab SHI SHI 11 6 Anandron 50mg Tab SAV SAV 11 6 Androderm 12.2mg Transdermal Patch PAL 9 6 Anzemet 50mg Tab SAV SAV 11 6 Anzemet 100mg Tab SAV SAV 11 6 Apo-Acyclovir 200mg Tab APX 8 14 Apo-Acyclovir 400mg Tab APX 8 14 Apo-Alendronate 5mg Tab APX 5 10 Apo-Allopurinol 100mg Tab APX 3A 2 Apo-Allopurinol 200mg Tab APX 3A 2 Apo-Allopurinol 300mg Tab APX 3A 2 Apo-Alpraz 1mg Tab APX 10 9 Apo-Alpraz TS 2mg Tab APX 10 9 Apo-Amoxi 250mg Cap APX 8 13 Apo-Amoxi 500mg Cap APX 8 13 Apo-Amoxi 25mg/mL O/L APX 8 13 Apo-Amoxi 50mg/mL O/L APX 8 13 Apo-Amoxi Clav 400mg & 57mg/5mL Susp APX Apo-Benazepril 5mg Tab APX 5 2 Apo-Benazepril 10mg Tab APX 5 2 Page 20

21 Apo-Bicalutamide 50mg Tab APX 8 2 Apo-Buspirone 10mg Tab APX 6A 2 Apo-Cefaclor 250mg Cap APX APX 8A APX 8A 4 Apo-Cefaclor 500mg Cap APX APX 8A APX 8A 4 Apo-Cefaclor 25mg/mL Oral Susp APX 8A 2 Apo-Cefaclor 50mg/mL Oral Susp APX 8A 2 Apo-Cefaclor 375mg/5mL Oral Susp APX 8A 3 Apo-Cefprozil 125mg/5mL Oral Susp APX 4 3 Apo-Cefprozil 250mg/5mL Oral Susp APX 4 3 Apo-Cefprozil 250mg Tab APX 2 3 Apo-Cefprozil 500mg Tab APX 2 3 Apo-Cephalex 250mg Tab APX APX 8A APX 8A 4 Apo-Cephalex 500mg Tab APX APX 8A APX 8A 4 Apo-Cetirizine 10mg Tab APX 7 6 Apo-Cilazapril/HCTZ 5mg/12.5mg Tab APX 7 5 Apo-Cimetidine 60mg/mL O/L APX 1 9 Apo-Clarithromycin 250mg Tab APX 4 3 Apo-Clarithromycin 500mg Tab APX 5 10 Apo-Clonidine 0.025mg Tab APX 2 7 Apo-Cloxi 250mg Cap APX 8 13 Apo-Cloxi 500mg Cap APX 8 13 Apo-Cloxi 25mg/mL O/L APX 8 13 Apo-Clozapine 25mg Tab APX 4 12 Apo-Clozapine 100mg Tab APX 4 12 Apo-Cyclosporine 100mg/mL O/L APX 1 9 Apo-Desmopressin 0.1mg Tab APX 5 7 Apo-Desmopressin 0.2mg Tab APX 5 7 Apo-Diclo Rapide 50mg Tab APX 8 14 Apo-Digoxin mg Tab APX 7 5 Apo-Doxepin 150mg Cap APX 1 9 Apo-Enalapril 2.5mg Tab APX 7 2 Apo-Enalapril 5mg Tab APX 7 2 Apo-Enalapril 10mg Tab APX 7 2 Apo-Enalapril 20mg Tab APX 7 2 Apo-Erythro E-C 250mg Ent Pel Cap APX 8 13 Apo-Etodolac 200mg Cap APX 6 8 Apo-Etodolac 300mg Cap APX 6 8 Apo-Famciclovir 125mg Tab APX 4 12 Page 21

22 Apo-Famciclovir 250mg Tab APX 4 12 Apo-Feno-Micro 67mg Cap APX 8 14 Apo-Fluoxetine 10mg Cap APX 9 10 Apo-Fluticasone 50mcg/Actuation Nas Sp-120 Dose Pk APX 6 8 Apo-Furosemide 20mg Tab APX 3A 2 Apo-Furosemide 40mg Tab APX 3A 2 Apo-Gemfibrozil 600mg Tab APX 9 10 Apo-Gliclazide 80mg Tab APX 2 3 Apo-Glimepiride 1mg Tab APX 6 8 Apo-Glimepiride 2mg Tab APX 6 8 Apo-Glimepiride 4mg Tab APX 6 8 Apo-Hydro 25 25mg Tab APX 5 7 Apo-Hydro 50 50mg Tab APX 5 7 Apo-Ipravent 125mcg/mL Inh Sol-2mL UDV Pk APX 1 9 Apo-Ipravent Sterule 250mcg/mL Inh Sol-2mL UDV Pk APX 1 9 Apo-Levetiracetam 250mg Tab APX 6 8 Apo-Levetiracetam 500mg Tab APX 6 8 Apo-Levetiracetam 750mg Tab APX 6 8 Apo-Levobunolol 0.25% Oph Sol APX 6 9 Apo-Lisinopril 5mg Tab APX APX 6 12 Apo-Lisinopril 10mg Tab APX APX 6 12 Apo-Lisinopril 20mg Tab APX APX 6 12 Apo-Lisinopril/HCTZ 10mg & 12.5mg Tab APX 7 9 Apo-Lisinopril/HCTZ 20mg & 12.5mg Tab APX 8 2 Apo-Lisinozide 10mg & 12.5mg Tab APX APX 7 8 Apo-Loratadine 10mg Tab APX 7 6 Apo-Mefloquine 250mg Tab APX 2 7 Apo-Methazide mg & 15mg Tab APX 3 12 Apo-Methazide mg & 25mg Tab APX 3 12 Apo-Methylphenidate 20mg Tab APX 8 14 Apo-Metoprolol SR 100mg LA Tab APX 6 3 Apo-Metoprolol SR 200mg LA Tab APX 6 3 Apo-Minocycline 50mg Cap APX 8 14 Apo-Minocycline 100mg Cap APX 8 14 Apo-Nabumetone 500mg Tab APX 4 12 Apo-Napro-Na 275mg Tab APX 7 6 Apo-Napro-Na DS 550mg Tab APX 7 6 Apo-Naproxen EC 250mg Ent Tab APX 8 14 Apo-Naproxen EC 375mg Ent Tab APX 8 14 Apo-Naproxen EC 500mg Ent Tab APX 8 14 Apo-Omeprazole 20mg Cap APX 6 11 Apo-Oxaprozin 600mg Tab APX 3 14 Page 22

23 Apo-Oxtriphylline 100mg Tab APX 3 12 Apo-Oxtriphylline 200mg Tab APX 3 12 Apo-Oxtriphylline 300mg Tab APX 3 12 Apo-Oxybutynin 1mg/mL O/L APX 3 12 Apo-Paroxetine 10mg Tab APX 2 7 Apo-Pen V-K 25mg/mL O/L APX 8A 2 Apo-Pen V-K 60mg/mL O/L APX 8 13 Apo-Pen V-K 300mg Tab APX 8 13 Apo-Pioglitazone 15mg Tab APX 8 2 Apo-Pioglitazone 30mg Tab APX 8 2 Apo-Pioglitazone 45mg Tab APX 8 2 Apo-Pramipexole 0.5mg Tab APX 4 12 Apo-Procainamide 250mg Cap APX 3 12 Apo-Procainamide 375mg Cap APX 3 12 Apo-Procainamide 500mg Cap APX 3 12 Apo-Ranitidine 15mg/mL Oral Sol APX 4 3 Apo-Sotalol 80mg Tab APX 7 6 Apo-Sulfatrim 40mg & 8mg/mL O/L APX 6 9 Apo-Sumatriptan 50mg Tab APX 2 7 Apo-Sumatriptan 100mg Tab APX 2 7 Apo-Terbinafine 250mg Tab APX 7 6 Apo-Tizanidine 4mg Tab APX 2 7 Apo-Tobramycin 0.3% Oph Sol APX 1 9 Apo-Triazide 25mg & 50mg Tab APX 3A 2 Apo-Triazo 0.125mg Tab APX 3A 2 Apo-Triazo 0.25mg Tab APX 3A 2 Apo-Trimebutine 100mg Tab APX 8 14 Apo-Trimebutine 200mg Tab APX 8 14 Apo-Verap SR 120mg LA Tab APX 4 12 Apo-Zopiclone 5mg Tab APX 4 12 Apo-Zopiclone 7.5mg Tab APX 4 12 Aranesp 200mcg/0.4mL Pref Syr-0.4mL Pk AMG 4 9 Arava 10mg Tab SAV 3 4 Arava 20mg Tab SAV 3 4 Arixtra 2.5mg Inj-0.5mL Pk GSK GSK 11 6 Asacol 400mg Tab PGP 8 9 Ascensia Autodisc Strip BAY BAY 2 13 Ascensia Breeze 2 Strip BAH Ascensia Contour Strip BAY 3 15 Ascensia Elite Strip BAY BAY 2 13 Ascensia Microfill Strip BAY BAY 2 13 Atacand 8mg Tab AZC 7 5 Page 23

24 Atacand 16mg Tab AZC 7 5 Atacand Plus 16mg/12.5mg Tab AZC 7 5 ATENOLOL & CHLORTHALIDONE 9 3 Atrovent 250mcg/mL Inh Sol-20mL Pk BOE 5 8 Atrovent UDV 125mcg/mL Inh Sol-2mL UDV Pk BOE 5 8 Atrovent UDV 250mcg/mL Inh Sol-2mL UDV Pk BOE 5 8 Avalide 150 & 12.5mg Tab SAV SAV 11 6 Avalide 300 & 12.5mg Tab SAV SAV 11 6 Avalide 300 & 25mgTab SAV 3 4 Avapro 75mg Tab SAV SAV 11 6 Avapro 150mg Tab SAV SAV 11 6 Avapro 300mg Tab SAV SAV 11 6 Avelox 400mg Tab BAY 4 9 Aviane 21 20mcg & 100mcg Tab-21 Pk BAR 8 2 Aviane 28 20mcg & 100mcg Tab-28 Pk BAR 8 2 Avodart 0.5mg Cap GSK GSK 11 6 Bactroban 2% Cr GSK 3 4 Bactroban 2% Oint GSK 3 4 Balminil DM 3mg/mL O/L TCH 1 9 BENAZEPRIL 5 2 Berotec Inh Pd-200 Dose Pk BOE 5 9 Berotec 0.1% Inh Sol-20mL Pk BOE 5 9 Betagan 0.25% Oph Sol ALL 1 9 Betagan 0.5% Oph Sol ALL ALL 11 6 BETAHISTINE DIHYDROCHLORIDE 4 12 Betnesol 5mg/100mL Enema-100mL Pk SQI SQI 9 6 Biaxin 125mg/5mL Ped Gran ABB 8 9 Biaxin 250mg Tab ABB 8 9 Biaxin 250mg/5mL Susp ABB 8 9 BICALUTAMIDE BISOPROLOL FUMARATE 9 3 Bleph-10 10% Oph Sol ALL 2 10 Boost 1.0 Standard 1.06kcal/mL Liq-237mL Pk NON 5 11 Boost 1.5 Plus Calories 1.5kcal/mL Liq-237mL Pk NON 5 11 Boost Plus Calories Liq-237mL Pk NON 5 6 Botox 100U/Vial Pd Inj-100U Vial Pk ALL 11 6 BUPROPION HCL 6 2 Page 24

25 6A 2 BUSPIRONE HYDROCHLORIDE 6 8 Cafergot 1mg/100mg Tab NOV NOV 11 6 Calcimar 400IU/2mL Inj Sol-2mL Pk SAV SAV 11 6 Cardizem CD 120mg LA Cap BIO 9 6 Cardizem CD 180mg LA Cap BIO 9 6 Cardizem CD 240mg LA Cap BIO 9 6 Cardizem CD 300mg LA Cap BIO 9 6 CeeNU 10mg Tab BQU BQU 11 6 CeeNU 40mg Tab BQU BQU 11 6 CeeNU 100mg Tab BQU BQU 11 6 CEFPROZIL Ceftin 125mg/5mL Susp GSK GSK 11 6 Ceftin 250mg Tab GSK GSK 11 6 Ceftin 500mg Tab GSK GSK 11 7 Ceftriaxone 1g/Vial Inj Pd-1 Vial Pk SDZ 1 3 Ceftriaxone 2g/Vial Inj Pd-1 Vial Pk SDZ 1 3 CEFTRIAXONE DISODIUM Ceftriaxone Sodium for Injection NOP g/Vial Inj Pd-1 Vial Pk Ceftriaxone Sodium for Injection, BP MAY g/Vial Inj Pd-1 Vial Pk Ceftriaxone Sodium for Injection, BP MAY 4 3 1g/Vial Inj Pd-1 Vial Pk Ceftriaxone Sodium for Injection, BP MAY 4 3 2g/Vial Inj Pd-1 Vial Pk Ceftriaxone for Injection USP ORC 8 2 1g/Vial Inj Pd-1 Vial Pk Ceftriaxone for Injection USP ORC 8 2 2g/Vial Inj Pd-1 Vial Pk Cefzil 125mg/5mL Oral Susp BQU BQU 11 7 Cefzil 250mg/5mL Oral Susp BQU 3 4 Page 25

26 BQU 11 7 Cefzil 250mg Tab BQU BQU 11 7 Cefzil 500mg Tab BQU BQU 11 7 Celexa 20mg Tab VLH VLH 11 7 Celexa 40mg Tab VLH VLH 11 7 CETIRIZINE HYDROCHLORIDE 7 6 Choledyl 100mg Tab PDA 3 13 Choledyl 200mg Tab PDA 3 13 Choledyl 300mg Tab PDA 3 13 CICLESONIDE 2 2 Cipro 10g/100mL Oral Susp BAY 11 7 Cipro 250mg Tab BAY 11 7 Cipro 500mg Tab BAY 11 7 CIPROFLOXACIN 10 4 Cipro XL 500mg ER Tab BAY 4 9 Cipro XL 1000mg ER Tab BAY 4 9 CITALOPRAM HYDROBROMIDE CLARITHROMYCIN Clavulin 25mg & 6.25mg/mL O/L GSK GSK 11 7 Clavulin 50mg & 12.25mg/mL O/L GSK GSK 11 7 Clavulin 250mg & 125mg Tab GSK GSK GSK 11 7 Clavulin 500mg & 125mg Tab GSK GSK 11 7 Clavulin (BID) 200mg & 28.5mg/5mL Susp GSK GSK 11 7 Clavulin (BID) 400mg & 57mg/5mL Susp GSK GSK 11 7 Clavulin (BID) 875mg & 125mg Tab GSK GSK 11 7 CLINDAMYCIN HCL 11 2 CLONIDINE HCL 2 7 CLOZAPINE 4 12 Codeine Contin 50mg CR Tab PFP 11 7 Codeine Contin 100mg CR Tab PFP 11 7 Page 26

27 Codeine Contin 150mg CR Tab PFP 11 7 Codeine Contin 200mg CR Tab PFP 11 7 Co Enalapril 2.5mg Tab COB 7 2 Co Enalapril 5mg Tab COB 7 2 Co Enalapril 10mg Tab COB 7 2 Co Enalapril 20mg Tab COB 7 2 Co Fluconazole 50mg Tab COB 8 3 Co Fluconazole 100mg Tab COB 8 3 Co Glimepiride 1mg Tab COB 3 14 Co Glimepiride 2mg Tab COB 3 14 Co Glimepiride 4mg Tab COB 3 14 Co Levetiracetam 250mg Tab COB 7 6 Co Levetiracetam 500mg Tab COB 7 6 Co Levetiracetam 750mg Tab COB 7 6 Co Lisinopril 5mg Tab COB 7 2 Co Lisinopril 10mg Tab COB 7 2 Co Lisinopril 20mg Tab COB 7 2 Co Metformin 850mg Tab COB 7 6 Co Paroxetine 10mg Tab COB 2 7 Co Pioglitazone 15mg Tab COB 8 3 Co Pioglitazone 30mg Tab COB 8 3 Co Pioglitazone 45mg Tab COB 8 3 Co Ramipril 1.25mg Cap COB 6 3 Co Ramipril 2.5mg Cap COB 7 2 Co Ramipril 5mg Cap COB 7 2 Co Ramipril 10mg Cap COB 6 3 Co Sotalol 80mg Tab COB 7 6 Co Sumatriptan 25mg Tab COB 2 7 Co Sumatriptan 50mg Tab COB 2 7 Co Sumatriptan 100mg Tab COB 2 7 Co Terbinafine 250mg Tab COB 7 6 Co Topiramate 25mg Tab COB 5 2 Co Topiramate 100mg Tab COB 5 2 Co Topiramate 200mg Tab COB 5 2 Co Venlafaxine XR 37.5mg ER Cap COB 11 2 Co Venlafaxine XR 75mg ER Cap COB 11 2 Co Venlafaxine XR 150mg ER Cap COB 11 2 Co Zopiclone 5mg Tab COB 4 12 Co Zopiclone 7.5mg Tab COB 4 12 Combigan 0.2% & 0.5% Oph Sol-5mL Pk ALL 11 7 Combivent 20mcg/100mcg/md Aero Inh BOE 8 8 Combivir 150mg & 300mg Tab GSK GSK 11 7 Comtan 200mg Tab NOV NOV 11 7 Coreg 3.125mg Tab GSK 3 11 Page 27

28 Coreg 6.25mg Tab GSK 3 11 Coreg 12.5mg Tab GSK 3 11 Coreg 25mg Tab GSK 3 11 Cortisporin 10000U & 5mg & 10mg/mL Ot Sol GSK GSK 11 7 Cosopt 2% & 0.5% Oph Sol MFC 8 9 Coumadin 1mg Tab BQU BQU 11 7 Coumadin 2mg Tab BQU BQU 11 7 Coumadin 2.5mg Tab BQU BQU 11 7 Coumadin 3mg Tab BQU BQU 11 7 Coumadin 4mg Tab BQU BQU 11 7 Coumadin 5mg Tab BQU BQU 11 7 Coumadin 10mg Tab BQU BQU 11 7 Cozaar 25mg Tab MFC 8 9 Cozaar 50mg Tab MFC 8 9 Cozaar 100mg Tab MFC 8 9 Criticare HN Liq-235mL Pk NON 5 6 Cyclen 0.25mg & 0.035mg Tab-21 Pk JNO 8 9 Cyclen 0.25mg & 0.035mg Tab-28 Pk JNO 8 9 Cyclocort 0.1% Cr STI 11 7 Cyclocort 0.1% Lot STI 11 7 Cyclocort 0.1% Oint STI 11 7 Cyclomen 50mg Cap SAV SAV 11 7 Cyclomen 100mg Cap SAV SAV 11 7 Cyclomen 200mg Cap SAV SAV 11 7 Cyestra-35 2mg & 0.035mg Tab PMS 7 7 CYPROTERONE ACETATE/ETHINYL ESTRADIOL 7 7 Cytovene 500mg/Vial Pd Inj-10mL Pk SYN 1 9 Cytoxan 25mg Tab BQU 3 5 Cytoxan 50mg Tab BQU 3 5 Dantrium 25mg Cap PGP 8 9 Dantrium 100mg Cap PGP 8 9 DARUNAVIR 1 2 DDAVP Melt 60mcg Orally Disintegrating Tab FEI 2 2 DDAVP Melt 120mcg Orally Disintegrating Tab FEI 2 2 DEFEROXAMINE MESYLATE 8 15 Page 28

29 Demerol 50mg Tab SAV SAV 11 7 Depakene 250mg Cap ABB 8 9 Depakene 500mg Ent Cap ABB 3 11 Depakene 50mg/mL O/L ABB 8 9 DESMOPRESSIN ACETATE Desquam-X10 10% Gel BQU BQU 11 7 Dexedrine 5mg Tab GSK GSK 11 7 Diabeta 2.5mg Tab SAV SAV 11 7 Diabeta 5mg Tab SAV SAV 11 7 Diclectin 10mg & 10mg SR Tab DUI 2 6 DICLOFENAC POTASSIUM DICLOFENAC SODIUM 10 5 Didrocal 400mg/500mg Tab-90 Tablets Kit PGP 8 9 Didronel 200mg Tab PGP 8 9 Diflucan 50mg Tab PFI 3 3 Diflucan 100mg Tab PFI 3 3 DIGOXIN 6 3 Diocarpine 1% Oph Sol DKT 1 8 Diocarpine 2% Oph Sol DKT 1 8 Diovan 80mg Tab NOV NOV 11 7 Diovan 160mg Tab NOV NOV 11 7 Diovan 320mg Tab NOV 9 2 Diovan-HCT 80mg/12.5mg Tab NOV NOV 11 7 Diovan-HCT 160mg/12.5mg Tab NOV NOV 11 8 Diovan-HCT 160mg/25mg Tab NOV NOV 11 8 Dipentum 250mg Cap KAP VLH 3 10 Ditropan 5mg Tab PGP 1 8 Dovonex 50mcg/g Cr LEO 9 6 Dovonex 50mcg/g Oint LEO 9 6 Drisdol 8288IU/mL SAV 3 5 DROSPIRENONE & ETHINYL ESTRADIOL 2 2 Duragesic 25 25mcg/hr Trans Patch JNO 8 9 Duragesic 50 50mcg/hr Trans Patch JNO 8 9 Page 29

30 Duragesic 75 75mcg/hr Trans Patch JNO 8 9 Duragesic mcg/hr Trans Patch JNO 8 9 Duvoid 10mg Tab SQI SQI 9 6 Duvoid 25mg Tab SQI SQI 9 6 Duvoid 50mg Tab SQI SQI 9 6 Effexor XR 37.5mg ER Cap WAY 11 8 Effexor XR 75mg ER Cap WAY 11 8 Effexor XR 150mg ER Cap WAY 11 8 Elidel 1% Cr NOV 3 5 Elocom 0.1% Cr SCH 9 6 Elocom 0.1% Lot SCH 9 6 Eltroxin 0.05mg Tab GSK GSK 11 8 Eltroxin 0.1mg Tab GSK GSK 11 8 Eltroxin 0.15mg Tab GSK GSK 11 8 Eltroxin 0.2mg Tab GSK GSK 11 8 Emo-Cort 1% Cr STI 11 8 Emo-Cort 2.5% Cr STI 11 8 Emo-Cort 1% Lot STI 11 8 Emo-Cort 2.5% Lot STI 11 8 EMTRICITABINE & TENOFOVIR 4 2 DISOPROXIL FUMARATE ENALAPRIL MALEATE Endodan 5mg & 325mg Tab BQU 9 8 Epival 125mg Ent Tab ABB 8 9 Epival 250mg Ent Tab ABB 8 9 Epival 500mg Ent Tab ABB 8 9 ETHINYL ESTRADIOL & LEVONORGESTREL ETODOLAC 6 8 Eumovate 0.05% Cr GSK 3 5 Evista 60mg Tab LIL 4 9 Exelon 1.5mg Cap NOV 11 8 Exelon 3mg Cap NOV 11 8 Exelon 4.5mg Cap NOV 11 8 Exelon 6mg Cap NOV 11 8 FAMCICLOVIR Page 30

31 Famvir 500mg Tab NOV NOV 11 8 Femara 2.5mg Tab NOV NOV 11 8 FENOFIBRATE Flagyl 500mg Cap SAV 11 8 Flagyl 10% Vag Cr-App SAV 11 8 Flagystatin 500mg & U/g Vag Cr-App SAV SAV 11 8 Flagystatin 500mg & U Vag Sup SAV SAV 11 8 Flomax 0.4mg Cap BOE 1 8 Florinef 0.1mg Tab SHI SQI SQI 9 6 Flovent Diskus 250mcg/Blister Pd Inh-60 Dose Pk GSK GSK 11 8 Flovent Diskus 500mcg/Blister Pd Inh-60 Dose Pk GSK GSK 11 8 Flovent HFA 50mcg/Metered Dose Inh-120 Dose Pk GSK GSK 11 8 Flovent HFA 125mcg/Metered Dose Inh-120 Dose Pk GSK GSK 11 8 Flovent HFA 250mcg/Metered Dose Inh-120 Dose Pk GSK GSK 11 8 Floxin 300mg Tab JNO 1 8 Floxin 400mg Tab JNO 1 8 Fluanxol 0.5mg Tab VLH VLH 11 8 Fluanxol 3mg Tab VLH VLH 11 8 Fluanxol Depot 200mg/2mL Inj Sol-2mL Pk VLH VLH 11 8 Fluanxol Depot 200mg/10mL Inj Sol-10mL Pk VLH VLH 11 8 FLUCONAZOLE Fludara 10mg Tab BAY 11 8 Fluotic 20mg Tab SAV 3 6 FLUOXETINE HCL 9 10 FLUTICASONE PROPIONATE 6 8 FML 0.1% Oph Susp ALL ALL 11 8 Foradil 12mcg/Cap Inh Pd-Device Pk NOV NOV 11 8 Page 31

32 Fosamax 10mg Tab MFC 8 9 Fosamax 70mg Tab MFC 8 9 Fosavance 70mg/70mcg Tab MFC 8 9 Fraxiparine 9500IU/mL Pref Syr-0.3mL Pk GSK GSK 11 8 Fraxiparine 9500IU/mL Pref Syr-0.4mL Pk GSK GSK 11 8 Fraxiparine 9500IU/mL Pref Syr-0.6mL Pk GSK GSK 11 8 Fraxiparine 9500IU/mL Pref Syr-0.8mL Pk GSK GSK 11 8 Fraxiparine 9500IU/mL Pref Syr-1.0mL Pk GSK GSK 11 8 Fraxiparine Forte 19000IU/mL Pref Syr-0.6mL Pk GSK GSK 11 8 Fraxiparine Forte 19000IU/mL Pref Syr-0.8mL Pk GSK GSK 11 8 Fraxiparine Forte 19000IU/mL Pref Syr-1.0mL Pk GSK GSK 11 8 Frisium 10mg Tab OVA 3 10 Fucidin Leo Suspension 49.2mg/mL Oral Susp LEO 9 8 Fungizone Inj Pd-50mg Pk BQU 3 6 GABAPENTIN 2 8 Gabapentin 300mg Cap GEN GEN 2 5 Gastrolyte Oral Pd-1 Sach Pk SAV 3 6 GEMFIBROZIL 9 10 Gen-Acyclovir 200mg Tab GEN 8 14 Gen-Acyclovir 400mg Tab GEN 8 14 Gen-Alendronate 5mg Tab GEN 6 8 Gen-Alprazolam 1mg Tab GEN 10 9 Gen-Alprazolam 2mg Tab GEN 10 9 Gen-Amoxicillin 250mg Cap GEN 8A 3 Gen-Amoxicillin 500mg Cap GEN 8A 3 Gen-Bicalutamide 50mg Tab GEN 10 3 Gen-Buspirone 10mg Tab GEN 6 8 Gen-Clarithromycin 250mg Tab GEN 4 3 Gen-Clarithromycin 500mg Tab GEN 5 10 Gen-Clomipramine 10mg Tab GEN 10 6 Gen-Clomipramine 25mg Tab GEN 10 6 Gen-Clomipramine 50mg Tab GEN 10 6 Gen-Clozapine 25mg Tab GEN 4 12 Gen-Clozapine 100mg Tab GEN 4 12 Gen-Diltiazem 30mg Tab GEN 10 6 Gen-Diltiazem 60mg Tab GEN 10 6 Gen-Domperidone 10mg Tab GEN Page 32

33 Gen-Enalapril 2.5mg Tab GEN 7 2 Gen-Enalapril 5mg Tab GEN 7 2 Gen-Enalapril 10mg Tab GEN 7 2 Gen-Enalapril 20mg Tab GEN 7 2 Gen-Fluoxetine 10mg Cap GEN 9 10 Gen-Gemfibrozil 600mg Tab GEN 9 10 Gen-Gliclazide 80mg Tab GEN 4 3 Gen-Glimepiride 1mg Tab GEN 2 7 Gen-Glimepiride 2mg Tab GEN 2 7 Gen-Glimepiride 4mg Tab GEN 2 7 Gen-Lisinopril 5mg Tab GEN 7 2 Gen-Lisinopril 10mg Tab GEN 7 2 Gen-Lisinopril 20mg Tab GEN 7 2 Gen-Lisinopril HCTZ 10mg & 12.5mg Tab GEN 8 4 Gen-Lisinopril HCTZ 20mg & 12.5mg Tab GEN 8 4 Gen-Metformin 850mg Tab GEN Gen-Minocycline 50mg Cap GEN 8 14 Gen-Minocycline 100mg Cap GEN 8 14 Gen-Nabumetone 500mg Tab GEN 3 14 Gen-Naproxen EC 250mg Ent Tab GEN 8 14 Gen-Naproxen EC 375mg Ent Tab GEN 8 14 Gen-Naproxen EC 500mg Ent Tab GEN 8 14 Gen-Ondansetron 4mg Tab GEN 4 4 Gen-Ondansetron 8mg Tab GEN 4 4 Gen-Paroxetine 10mg Tab GEN 2 7 Gen-Pioglitazone 15mg Tab GEN 8 4 Gen-Pioglitazone 30mg Tab GEN 8 4 Gen-Pioglitazone 45mg Tab GEN 8 4 Gen-Sotalol 80mg Tab GEN 7 7 Gen-Sumatriptan 25mg Tab GEN 2 7 Gen-Sumatriptan 50mg Tab GEN 2 7 Gen-Sumatriptan 100mg Tab GEN 2 7 Gen-Tamsulosin 0.4mg Cap GEN 5 3 Gen-Terbinafine 250mg Tab GEN 7 7 Gen-Tizanidine 4mg Tab GEN 2 7 Gen-Triazolam 0.125mg Tab GEN 3A 2 Gen-Triazolam 0.25mg Tab GEN 3A 2 Gen-Verapamil SR 120mg LA Tab GEN 5 10 Gen-Zopiclone 5mg Tab GEN 4 12 Gen-Zopiclone 7.5mg Tab GEN 4 12 Gleevec 100mg Tab NOV NOV 11 8 Gleevec 400mg Tab NOV NOV 11 8 GLICLAZIDE Page 33

34 GLIMEPIRIDE Glucagon 1mg/Vial Inj Pd-Vial Pk LIL 11 8 Glucobay 50mg Tab BAY 4 9 Glucobay 100mg Tab BAY 4 9 Glucophage 500mg Tab SAV SAV 11 9 Halcion 0.25mg Tab PFI 3 3 Halog 0.1% Cr BQU BQU BQU 11 9 Halog 0.1% Oint BQU BQU BQU 11 9 Hepalean 25000USP U/mL Inj Sol-2mL Pk ORG 3 3 Hp-PAC 30mg & 500mg & 500mg Tab/Cap Pk ABB 8 9 Humulin 30/70 100U/mL Inj Susp-5x3mL Pk LIL 11 9 Humulin 30/ U/10mL Inj Susp-10mL Pk LIL 11 9 Humulin N 100U/mL Inj Susp-5x3mL Pk LIL 11 9 Humulin NPH 1000U/10mL Inj Susp-10mL Pk LIL 11 9 Humulin R 100U/mL Inj Susp-5x3mL Pk LIL 11 9 Humulin Regular 1000U/10mL Inj Sol-10mL Pk LIL 11 9 Hycodan 1mg/mL O/L BQU BQU 11 9 HYDROCHLOROTHIAZIDE 4 5 Hydromorph Contin 3mg CR Cap PFP 11 9 Hydromorph Contin 6mg CR Cap PFP 11 9 Hydromorph Contin 12mg CR Cap PFP 11 9 Hydromorph Contin 18mg CR Cap PFP 11 9 Hydromorph Contin 24mg CR Cap PFP 11 9 Hydromorph Contin 30mg CR Cap PFP 11 9 Hytrin 1mg Tab ABB 8 9 Hytrin 2mg Tab ABB 8 9 Hytrin 5mg Tab ABB 8 9 Hytrin 10mg Tab ABB 8 9 Hyzaar 50mg/12.5mg Tab MFC 8 9 Hyzaar DS 100mg/25mg Tab MFC 8 9 Imuran 50mg Tab GSK GSK 11 9 INSULIN ASPART 6 2 Isocal Liq-250mL Pk NON 5 6 Isocal with Fibre Liq-250mL Pk NON 5 6 ISOPROPYL MYRISTATE 9 2 Isoptin SR 180mg LA Tab ABB 8 9 Isoptin SR 240mg LA Tab ABB 8 9 Page 34

35 K mEq/mL O/L GSK GSK 11 9 Kadian 10mg SR Cap ABB 8 9 Kadian 20mg SR Cap ABB 8 9 Kadian 50mg SR Cap ABB 8 9 Kadian 100mg SR Cap ABB 8 9 Kaletra 200mg & 50mg Tab ABB 4 2 Kaon 1.33mEq/mL O/L PMJ 1 10 Kayexalate 1mEq/g Oral Pd-454g Pk SAV SAV 11 9 Kenalog-Orabase Oral Top Oint BQU BQU 11 9 Kidrolase Inj Pd-10000IU Pk OPS 1 5 Kivexa 600mg/300mg Tab GSK GSK 11 9 Kwellada-P 1% Cr Rinse GSK GSK 11 5 Kwellada-P 5% Lot GSK 11 5 Lacri-Lube 55%/42.5% Oph Oint-3.5g Pk ALL 3 6 Lamictal 25mg Tab GSK GSK 11 9 Lamictal 100mg Tab GSK GSK 11 9 Lamictal 150mg Tab GSK GSK 11 9 Lamisil 1% Cr NOV 3 6 Lanvis 40mg Tab GSK GSK 11 9 Lasix 10mg/mL O/L SAV SAV 11 9 Lasix 20mg Tab SAV SAV 11 9 Lasix 40mg Tab SAV SAV 11 9 Lasix Special 500mg Tab SAV SAV 11 9 LEFLUNOMIDE 2 4 Lescol 20mg Cap NOV NOV 11 9 Lescol 40mg Cap NOV NOV 11 9 Lescol XL 80mg ER Tab NOV NOV 11 9 Leucovorin Calcium 5mg Tab WAY 11 9 Leukeran 2mg Tab GSK GSK 11 9 Page 35

36 Leustatin 1mg/mL Inj JNO 8 9 Levaquin 250mg Tab JNO 8 9 Levaquin 500mg Tab JNO 8 9 LEVETIRACETAM Lioresal 10mg Tab NOV NOV 11 9 Lioresal DS 20mg Tab NOV NOV 11 9 Liquifilm Tears 1.4% Oph Sol ALL 3 6 LISINOPRIL 7 2 LISINOPRIL & HYDROCHLOROTHIAZIDE Locacorten-Vioform 0.02% & 1% Ot Sol SQI 9 6 Loestrin 1.5/ mg & 1.5mg Tab-21 Pk WAR SQI 9 7 Loestrin 1.5/ mg & 1.5mg Tab-28 Pk WAR SQI 9 7 LOPINAVIR & RITONAVIR 4 2 Lopresor 50mg Tab NOV NOV 11 9 Lopresor 100mg Tab NOV NOV 11 9 Lopresor SR 100mg LA Tab NOV NOV 11 9 Lopresor SR 200mg LA Tab NOV NOV 11 9 LORATADINE 7 6 Losec 20mg Cap AST 6 7 Lotensin 5mg Tab NOV NOV 11 9 Lotensin 10mg Tab NOV NOV 11 9 Lotensin 20mg Tab NOV NOV 11 9 Lovenox 100mg/mL Inj Sol-3mL Vial Pk SAV 3 7 Lovenox 30mg/0.3mL Pref Syr-0.3mL Pk SAV 3 7 Lovenox 40mg/0.4mL Pref Syr-0.4mL Pk SAV 3 7 Lovenox 60mg/0.6mL Pref Syr-0.6mL Pk SAV 8 10 Lovenox 80mg/0.8mL Pref Syr-0.8mL Pk SAV 8 10 Lovenox 100mg/mL Pref Syr-1mL Pk SAV 8 10 Lovenox HP 120mg/0.8mL Pref Syr-0.8mL Pk SAV 8 10 Lovenox HP 150mg/mL Pref Syr-1mL Pk SAV 3 7 Lucentis 10mg/mL Inj Sol-0.3mL Vial Pk NOV 10 2 Lupron Depot PDS 3.75mg Inj-Kit ABB 8 10 Lupron Depot PDS 11.25mg Inj-Kit ABB 8 10 Page 36

37 MacroBID 100mg Cap PGP 8 10 Marinol 2.5mg Cap SPH 11 9 Marinol 5mg Cap SPH 11 9 Mavik 1mg Cap ABB 8 10 Mavik 2mg Cap ABB 8 10 Mavik 4mg Cap ABB 8 10 MEFLOQUINE HCL 2 7 Megacillin IU Tab FRS Mesasal 500mg Ent Tab GSK GSK 11 9 METFORMIN HYDROCHLORIDE METHYLPHENIDATE HCL 8 14 METOPROLOL TARTRATE 6 3 Mevacor 20mg Tab MFC 8 10 Mevacor 40mg Tab MFC 8 10 Micronor 0.35mg Tab-28 Pk JNO 8 10 Minestrin 1/ mg & 1mg Tab-21 Pk WAR SQI 9 7 Minestrin 1/ mg & 1mg Tab-28 Pk WAR SQI 9 7 Minitran 0.4mg/Hr/13.3 Sq Cm Patch GRA Minitran 0.6mg/Hr/20 Sq Cm Patch GRA MINOCYCLINE HCL Min-Ovral 0.03mg & 0.15mg Tab-21Pk WAY Min-Ovral 0.03mg & 0.15mg Tab-28Pk WAY Mirena 52mg Insert BAY 4 9 Monocor 5mg Tab BIO 9 6 Monopril 10mg Tab BQU BQU Monopril 20mg Tab BQU BQU MORPHINE SULFATE 11 2 MS Contin 15mg SR Tab PFP MS Contin 30mg SR Tab PFP MS Contin 60mg SR Tab PFP MS Contin 100mg SR Tab PFP MS Contin 200mg SR Tab PFP MS-IR 20mg Tab PFP MS-IR 30mg Tab PFP Myleran 2mg Tab GSK GSK Myochrysine 10mg/mL Inj Sol-1mL Pk SAV SAV Myochrysine 25mg/mL Inj Sol-1mL Pk SAV 1 8 Page 37