POLMED COMPREHENSIVE PMB FORMULARY Aug-18

Size: px
Start display at page:

Download "POLMED COMPREHENSIVE PMB FORMULARY Aug-18"

Transcription

1 POLMED COMPREHENSIVE PMB FORMULARY Aug-18 Depending on the specific scheme option, products included on this chronic medication formulary will not attract a co-payment if authorised by Chronic Medicine Management for a disease on the Chronic Disease List (CDL) and obtained from the Designated Service Provider (where applicable). Reimbursement will however be subject to the Chronic Medicine Management clinical guidelines and protocols and the POLMED Generic Reference Price List. Nappi code Name Active Ingredient Strength Asthma Inhaled B2 agonists DUOVENT HFA 200DOSE aminophylline 50MCG/20MCG INH BEROTEC HFA 200 DOSE Fenoterol 100MCG INH ASTHAVENT 300 DOSE Salbutamol 100MCG INH ASTHAVENT 300D ECOHALER CFC FREE Salbutamol 100MCG INH ASTHAVENT DP Salbutamol 200MCG CPS VENTEZE CFC FREE 200 DOSE Salbutamol 100MCG INH VENTIMAX CFC FREE 200 DOSE Salbutamol 100MCG INH VENTOLIN INHALER 200 CFC FREE Salbutamol 100MCG INH COMBIVENT MDI Salbutamol and other drugs for obstructive airway diseases 20MCG/100MCG INH DUOLIN HFA 200DOSE Salbutamol and other drugs for obstructive airway diseases INH BRICANYL 100 DOSE Terbutaline.5MG/1DOSE TBH BRICANYL TURBOHALER Terbutaline 0.5MG INH Long acting B2 agonists FORADIL DRY oterol 12MCG CPS FORATEC DP CAPS oterol 12MCG CAP FORATEC HFA 120DOSE oterol 12MCG INH OXIS TURBUHALER oterol 9MCG INH SEREVENT ACCUHALER Salmeterol 50MCG INH SEREVENT CFC-FREE 120DOSE Salmeterol 25MCG INH SEREVENT INHAL(60) Salmeterol 25MCG INH INNUVAIR 100MCG/6MCG 120 DOSE oterol and beclometasone 100MCG/6MCG INH DULERA 200/5UG 120 DOSE oterol and mometasone 200MCG/50MCG INH DULERA 100/5UG 120 DOSE oterol and mometasone 100MCG/5MCG INH Inhaled corticosteroids BECEZE DOSE Beclomethasone 50MCG INH BECEZE INHALER COMPLETE Beclomethasone 100MCG INH BECLATE INHALER Beclomethasone 100MCG INH BECLATE INHALER Beclomethasone 200MCG INH Page 1 of 87

2 Nappi code Name Active Ingredient Strength BECLATE INHALER Beclomethasone 50MCG INH BUDEFLAM CFC FREE 200MCG 300 DOSE INH Budesonide 200MCG INH BUDEFLAM CFC FREE 300 DOSE INH Budesonide 100MCG INH BUDEFLAM DP CAPS Budesonide 200MCG CAP INFLAMMIDE 200 NOVOLIZE REFIL Budesonide 200MCG REF INFLAMMIDE 200 NOVOLIZER COMPL Budesonide 200MCG INH INFLAMMIDE AEROSOL COMPLETE (MAC) Budesonide 100MCG INH INFLAMMIDE AEROSOL COMPLETE (MAC) Budesonide 200MCG INH INFLAMMIDE NOVOLIZER COMPLETE 100DOSE Budesonide 400MCG INH INFLAMMIDE NOVOLIZER REFILL 100DOSE Budesonide 400MCG REF PULMICORT 100 TURB (200 DOSE) Budesonide 100MCG ATH PULMICORT 200 TURB (200 DOSE) Budesonide 200MCG ATH ALVESCO 160MCG 120 DOSE Ciclesonide 160MCG INH ALVESCO 160MCG 60 DOSE Ciclesonide 160MCG INH ALVESCO 80MCG 60 DOSE Ciclesonide 80MCG INH CICLOVENT 120 DOSE Ciclesonide 160MCG INH CICLOVENT 120 DOSES Ciclesonide 80MCG INH CICLOVENT 60 DOSE Ciclesonide 160MCG INH CICLOVENT 60 DOSE Ciclesonide 80MCG INH FLIXOTIDE 50 CFC FREE 120 ACT Fluticasone 50MCG INH FLIXOTIDE ACCUHALER Fluticasone 100MCG CAP FLIXOTIDE ACCUHALER Fluticasone 250MCG CAP FLIXOTIDE ACCUHALER Fluticasone 500MCG CAP FLIXOTIDE ACCUHALER Fluticasone 50MCG CAP FLIXOTIDE CFC FREE (120 ACT) Fluticasone 125MCG INH FLIXOTIDE CFC FREE (120 ACT) Fluticasone 250MCG INH VANNAIR 160/4.5MCG PER INHALATION 120 DO formoterol and budesonide 4.5MCG/160MCG INH VANNAIR 80/4.5MCG PER INHALATION 120 DOS formoterol and budesonide 4.5MCG/80MCG INH SYMBICORD TURBO 120 DOSE oterol/budesonide 4.5MCG/160MCG INH SYMBICORD TURBO 60 DOSE oterol/budesonide 4.5MCG/160MCG INH SYMBICORD 320/9MCG PER INHALATION utoterol and other anti- asthmatics 9MCG/320MCG INH SYMBICORD 80/4.5MCG PER INHALATION utoterol and other anti- asthmatics 4.5MCG/80MCG INH ASMANEX TWISTHALER 30 DOSE Mometasone 200MCG/1DOSE TBH ASMANEX TWISTHALER 30 DOSE Mometasone 400MCG/1DOSE TBH ASMANEX TWISTHALER 60 DOSE Mometasone 200MCG/1DOSE TBH ASMANEX TWISTHALER 60 DOSE Mometasone 400MCG/1DOSE TBH FOXAIR 25/ DOSE Salmeterol and other anti-asthmatics 25MCG/125MCG INH FOXAIR 25/ DOSE Salmeterol and other anti-asthmatics 25MCG/250MCG INH FOXAIR 25/ DOSE Salmeterol and other anti-asthmatics 25MCG/50MCG INH FOXAIR 50/100 ACCUHALER Salmeterol/Fluticasone combinations INH FOXAIR 50/250 ACCUHALER Salmeterol/Fluticasone combinations INH FOXAIR 50/500 ACCUHALER Salmeterol/Fluticasone combinations INH SEREFLO 25/125 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/125MCG INH SEREFLO 25/125 HFA SYNCHROBREATHE 120 DO Salmeterol/Fluticasone combinations 25MCG/125MCG INH Page 2 of 87

3 Nappi code Name Active Ingredient Strength SEREFLO 25/250 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/250MCG INH SEREFLO 25/250 HFA SYNCHROBREATHE 120 DO Salmeterol/Fluticasone combinations 25MCG/250MCG INH SEREFLO 25/50 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/50MCG INH SEREFLO 25/50 HFA SYNCHROBREATHE 120 DOS Salmeterol/Fluticasone combinations 25MCG/50MCG INH SERETIDE 120 DOSE Salmeterol/Fluticasone combinations 25MCG/125MCG INH SERETIDE 120 DOSE Salmeterol/Fluticasone combinations 25MCG/250MCG INH SERETIDE 25/ DOSE Salmeterol/Fluticasone combinations 25MCG/50MCG INH SERETIDE 50/100 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/100MCG INH SERETIDE 50/250 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/250MCG INH SERETIDE 50/500 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/500MCG INH RELVAR ELLIPTA 184/22UG 30 DOSE vilanterol and fluticasone furoate 184MCG/22MCG INH RELVAR ELLIPTA 92/22UG 30 DOSE vilanterol and fluticasone furoate 92MCG/22MCG INH Oral Xanthines EUPHYLLIN RETARD Theophylline 250MG SRT NUELIN Theophylline 125MG TAB NUELIN LIQUID Theophylline 25MG/5ML SYR NUELIN SA 250 Theophylline 250MG TAB ROLAB-THEOPHYLLINE ANHYDROUS Theophylline 200MG SRT ROLAB-THEOPHYLLINE ANHYDROUS Theophylline 300MG SRT THEOPHEN Theophylline SYR THEOPLUS Theophylline 200MG SRT THEOPLUS Theophylline 300MG SRT UNIPHYL Theophylline 400MG SRT UNIPHYL Theophylline 600MG SRT Oral Corticosteroids ADCO PREDNISOLONE Prednisolone 15MG/5ML LIQ ASPELONE Prednisolone 15MG/5ML LIQ CAPSOID Prednisolone 5MG TAB LENISOLONE Prednisolone 5MG TAB PREFLAM Prednisolone 15MG/5ML SYR PRELONE Prednisolone 5MG TAB PRELONE Prednisolone 15MG/5ML SYR METICORTEN Prednisone 50MG TAB METICORTEN Prednisone 5MG TAB PANAFCORT Prednisone 5MG TAB PREDNISONE (BE-TABS) Prednisone 5MG TAB PULMISON ORAL SOLUTION Prednisone 5MG/1ML SYR PULMISON TABS Prednisone 20MG TAB TROLIC Prednisone 5MG TAB Addison's disease Oral Corticosteroids COVOCORT Hydrocortisone 10MG TAB FLORINEF ACETATE Fludrocortisone 0.1MG TAB Page 3 of 87

4 Nappi code Name Active Ingredient Strength Bipolar Mood Disorder Mood Stabilizers DEGRANOL Carbamazepine 200MG TAB ROLAB-CARBAMAZEPINE Carbamazepine 200MG TAB SANDOZ CARBAMAZEPINE CR200 Carbamazepine 200MG SRT SANDOZ CARBAMAZIPINE CR400 Carbamazepine 400MG SRT TEGRETOL Carbamazepine 200MG TAB TEGRETOL CR Carbamazepine 200MG SRT TEGRETOL CR Carbamazepine 400MG SRT TEGRETOL S Carbamazepine 100MG/5ML SUS ZEPTOL Carbamazepine 200MG TAB ASPEN LAMOTRIGINE 100MG Lamotrigine 100MG TAB ASPEN LAMOTRIGINE 25MG Lamotrigine 25MG TAB ASPEN LAMOTRIGINE 50MG Lamotrigine 50MG TAB AUSTELL-LAMOTRIGINE Lamotrigine 100MG TAB AUSTELL-LAMOTRIGINE Lamotrigine 200MG TAB AUSTELL-LAMOTRIGINE Lamotrigine 25MG TAB AUSTELL-LAMOTRIGINE Lamotrigine 50MG TAB DYNA-LAMOTRIGINE Lamotrigine 100MG TAB DYNA-LAMOTRIGINE Lamotrigine 200MG TAB DYNA-LAMOTRIGINE Lamotrigine 25MG TAB DYNA-LAMOTRIGINE Lamotrigine 50MG TAB EPITEC 100MG Lamotrigine 100MG TAB EPITEC 200MG Lamotrigine 200MG TAB EPITEC 25MG Lamotrigine 25MG TAB EPITEC 50MG Lamotrigine 50MG TAB GIROTEC Lamotrigine 50MG TAB GIROTEC Lamotrigine 100MG TAB GIROTEC Lamotrigine 200MG TAB LAMICTIN Lamotrigine 100MG TAB LAMICTIN Lamotrigine 200MG TAB LAMICTIN Lamotrigine 25MG TAB LAMICTIN Lamotrigine 50MG TAB LAMICTIN P100 Lamotrigine 100MG DSP LAMICTIN P2 Lamotrigine 2MG DSP LAMICTIN P200 Lamotrigine 200MG DSP LAMICTIN P25 Lamotrigine 25MG DSP LAMICTIN P5 Lamotrigine 5MG DSP LAMICTIN P50 Lamotrigine 50MG DSP LAMIDUS Lamotrigine 100MG TAB LAMIDUS Lamotrigine 200MG TAB LAMIDUS Lamotrigine 50MG TAB LAMITOR Lamotrigine 100MG TAB Page 4 of 87

5 Nappi code Name Active Ingredient Strength LAMITOR Lamotrigine 25MG TAB LAMITOR Lamotrigine 50MG TAB LAMITOR Lamotrigine 200MG TAB SANDOZ LAMOTRIGINE Lamotrigine 100MG TAB SANDOZ LAMOTRIGINE Lamotrigine 200MG TAB SANDOZ LAMOTRIGINE Lamotrigine 25MG TAB SANDOZ LAMOTRIGINE Lamotrigine 50MG TAB CAMCOLIT Lithium 250MG TAB CAMCOLIT Lithium 400MG TAB QUILONUM RETARD Lithium 450MG TAB CONVULEX Valproic acid 150MG CAP CONVULEX Valproic acid 250MG/5ML SYR CONVULEX Valproic acid 300MG CAP CONVULEX Valproic acid 500MG CAP EPILIM CR Valproic acid 200MG SRT EPILIM CR Valproic acid 300MG SRT EPILIM CR Valproic acid 500MG SRT EPILIM CRUSHABLE Valproic acid 100MG TAB EPILIM SUGAR FREE Valproic acid 200MG/5ML SYR EPILIZINE CR Valproic acid 200MG SRT EPILIZINE CR Valproic acid 300MG SRT EPILIZINE CR Valproic acid 500MG SRT EPROLEP CR 200 Valproic acid 200MG SRT EPROLEP CR 300 Valproic acid 300MG SRT EPROLEP CR 500 Valproic acid 500MG SRT NAVALPRO CR Valproic acid 200MG SRT NAVALPRO CR Valproic acid 300MG SRT NAVALPRO CR Valproic acid 500MG SRT VANAPRO Valproic acid 300MG SRT VANAPRO Valproic acid 500MG SRT Antipsychotic agents SOLIAN Amisulpride 200MG TAB SOLIAN Amisulpride 50MG TAB ABILIFY 10MG Aripiprazole 10MG TAB ABILIFY 15MG Aripiprazole 15MG TAB ABILIFY 5MG Aripiprazole 5MG TAB ARIZOFY Aripiprazole 5MG TAB ARIZOFY Aripiprazole 10MG TAB ARIZOFY Aripiprazole 15MG TAB LARGACTIL Chlorpromazine 100MG TAB LARGACTIL Chlorpromazine 25MG TAB LARGACTIL Chlorpromazine 50MG TAB ASPEN CLOZAPINE Clozapine 100MG TAB ASPEN CLOZAPINE Clozapine 25MG TAB Page 5 of 87

6 Nappi code Name Active Ingredient Strength CLOMENT Clozapine 100MG TAB CLOMENT Clozapine 25MG TAB LEPONEX Clozapine 100MG TAB LEPONEX Clozapine 25MG TAB FLUANXOL Flupentixol.5MG TAB FLUANXOL Flupentixol 1MG TAB FLUANXOL DEPOT 1ML Flupentixol 20MG/1ML INJS FLUANXOL DEPOT 2ML Flupentixol INJ MODECATE 1ML Fluphenazine 25MG/1ML INJS MODECATE+SYRINGE 1ML Fluphenazine 25MG/1ML INJS GULF HALOPERIDOL Haloperidol 5MG TAB ROLAB-HALOPERIDOL Haloperidol 1.5MG TAB ROLAB-HALOPERIDOL Haloperidol 5MG TAB SERENACE Haloperidol 0.5MG CAP SERENACE Haloperidol 10MG TAB SERENACE Haloperidol 5MG TAB ADCO OLANZAPINE Olanzapine 2.5MG TAB ADCO OLANZAPINE Olanzapine 5MG TAB ADCO OLANZAPINE Olanzapine 10MG TAB LANAZYP Olanzapine 10MG TAB LANAZYP Olanzapine 2.5MG TAB LANAZYP Olanzapine 5MG TAB MYLAN OLANZAPINE Olanzapine 10MG TAB MYLAN OLANZAPINE Olanzapine 2.5MG TAB MYLAN OLANZAPINE Olanzapine 5MG TAB OLAWIN Olanzapine 10MG TAB OLAWIN Olanzapine 2.5MG TAB OLAWIN Olanzapine 5MG TAB OLAWIN ORADISPERSIBLE Olanzapine 10MG MLT OLAWIN ORADISPERSIBLE Olanzapine 5MG MLT OLEANZ Olanzapine 10MG TAB OLEANZ Olanzapine 2.5MG TAB OLEANZ Olanzapine 5MG TAB OLEANZ RAPITAB Olanzapine 10MG MLT OLEANZ RAPITAB Olanzapine 5MG MLT OLEXAR Olanzapine 10MG TAB OLEXAR Olanzapine 2.5MG TAB OLEXAR Olanzapine 5MG TAB PREXOLAN Olanzapine 10MG TAB PREXOLAN Olanzapine 2.5MG TAB PREXOLAN Olanzapine 5MG TAB PREXOLAN ODT Olanzapine 10MG MLT PREXOLAN ODT Olanzapine 5MG MLT REDILANZ Olanzapine 10MG TAB Page 6 of 87

7 Nappi code Name Active Ingredient Strength REDILANZ Olanzapine 2.5MG TAB REDILANZ Olanzapine 5MG TAB ZOLANZ Olanzapine 5MG TAB ZOLANZ Olanzapine 10MG TAB ZYLENA Olanzapine 10MG TAB ZYLENA Olanzapine 5MG TAB ZYPREXA Olanzapine 10MG TAB ZYPREXA Olanzapine 2.5MG TAB ZYPREXA Olanzapine 5MG TAB INVEGA Paliperidone 3MG SRT INVEGA Paliperidone 6MG SRT INVEGA Paliperidone 9MG SRT XEPLION PREFILLED SYRINGE 0.5ML Paliperidone 50MG/.5ML INJ XEPLION PREFILLED SYRINGE 0.75ML Paliperidone 75MG/.75ML INJ XEPLION PREFILLED SYRINGE 1.5ML Paliperidone 150MG/1.5ML INJ XEPLION PREFILLED SYRINGE 1ML Paliperidone 100MG/1ML INJ ORAP Pimozide 1MG TAB ORAP Pimozide 4MG TAB DOPAQUEL Quetiapine 100MG TAB DOPAQUEL Quetiapine 200MG TAB DOPAQUEL Quetiapine 25MG TAB DOPAQUEL Quetiapine 300MG TAB KIZOFRIN Quetiapine 200MG TAB KIZOFRIN Quetiapine 25MG TAB KIZOFRIN Quetiapine 100MG TAB KIZOFRIN Quetiapine 300MG TAB MYLAN QUETIAPINE Quetiapine 100MG TAB MYLAN QUETIAPINE Quetiapine 200MG TAB MYLAN QUETIAPINE Quetiapine 25MG TAB MYLAN QUETIAPINE Quetiapine 300MG TAB PSYQUET Quetiapine 100MG TAB PSYQUET Quetiapine 200MG TAB PSYQUET Quetiapine 25MG TAB PSYQUET Quetiapine 300MG TAB QUETIAPINE BIOTECH Quetiapine 100MG TAB QUETIAPINE BIOTECH Quetiapine 200MG TAB QUETIAPINE BIOTECH Quetiapine 25MG TAB QUETIAPINE BIOTECH Quetiapine 300MG TAB QUETOSER Quetiapine 100MG TAB QUETOSER Quetiapine 200MG TAB QUETOSER Quetiapine 25MG TAB QUETOSER Quetiapine 300MG TAB SEREZ Quetiapine 100MG TAB SEREZ Quetiapine 200MG TAB Page 7 of 87

8 Nappi code Name Active Ingredient Strength SEREZ Quetiapine 25MG TAB SEREZ Quetiapine 300MG TAB SEROQUEL Quetiapine 100MG TAB SEROQUEL Quetiapine 200MG TAB SEROQUEL Quetiapine 25MG TAB SEROQUEL Quetiapine 300MG TAB SEROQUEL XR Quetiapine 50MG SRT SEROQUEL XR Quetiapine 150MG SRT SEROQUEL XR Quetiapine 200MG SRT SEROQUEL XR Quetiapine 300MG SRT SEROQUEL XR Quetiapine 400MG SRT SIZONORM Quetiapine 100MG TAB SIZONORM Quetiapine 200MG TAB SIZONORM Quetiapine 25MG TAB SIZONORM Quetiapine 300MG TAB SPEC QUETIAPINE Quetiapine 100MG TAB SPEC QUETIAPINE Quetiapine 150MG TAB SPEC QUETIAPINE Quetiapine 200MG TAB SPEC QUETIAPINE Quetiapine 25MG TAB SPEC QUETIAPINE Quetiapine 300MG TAB TRUVALIN Quetiapine 100MG TAB TRUVALIN Quetiapine 200MG TAB TRUVALIN Quetiapine 25MG TAB TRUVALIN Quetiapine 300MG TAB TRUVALIN XR Quetiapine 50MG SRT TRUVALIN XR Quetiapine 150MG SRT TRUVALIN XR Quetiapine 200MG SRT TRUVALIN XR Quetiapine 300MG SRT TRUVALIN XR Quetiapine 400MG SRT ASPEN RISPERIDONE Risperidone 0.5MG TAB ASPEN RISPERIDONE Risperidone 1MG TAB ASPEN RISPERIDONE Risperidone 2MG TAB ASPEN RISPERIDONE Risperidone 3MG TAB ASPEN RISPERIDONE Risperidone 4MG TAB AUROPERDAL Risperidone.5MG TAB AUROPERDAL Risperidone 1MG TAB AUROPERDAL Risperidone 2MG TAB AUROPERDAL Risperidone 3MG TAB AUROPERDAL Risperidone 4MG TAB AUROPIDONE Risperidone 0.5MG TAB AUROPIDONE Risperidone 1MG TAB AUROPIDONE Risperidone 2MG TAB AUROPIDONE Risperidone 3MG TAB AUROPIDONE Risperidone 4MG TAB Page 8 of 87

9 Nappi code Name Active Ingredient Strength DRL RISPERIDONE Risperidone 0.5MG TAB DRL RISPERIDONE Risperidone 1MG TAB DRL RISPERIDONE Risperidone 2MG TAB DRL RISPERIDONE Risperidone 3MG TAB MYLAN RISPERIDONE Risperidone 0.5MG TAB MYLAN RISPERIDONE Risperidone 1MG TAB MYLAN RISPERIDONE Risperidone 2MG TAB PERIDA Risperidone.5MG TAB PERIDA Risperidone 1MG TAB PERIZAL Risperidone 0.5MG TAB PERIZAL Risperidone 1MG TAB PERIZAL Risperidone 2MG TAB PERIZAL Risperidone 3MG TAB RISNIA Risperidone.5MG TAB RISNIA Risperidone 1MG TAB RISNIA Risperidone 2MG TAB RISNIA Risperidone 3MG TAB RISPACOR Risperidone 0.5MG TAB RISPACOR Risperidone 1MG TAB RISPACOR Risperidone 2MG TAB RISPACOR Risperidone 3MG TAB RISPACOR Risperidone 4MG TAB RISPERDAL Risperidone 0.5MG TAB RISPERDAL Risperidone 1MG TAB RISPERDAL Risperidone 2MG TAB RISPERDAL Risperidone 3MG TAB RISPERDAL CONSTA Risperidone 25MG VIAL RISPERDAL CONSTA Risperidone 37.5MG VIAL RISPERDAL CONSTA Risperidone 50MG VIAL RISPERIDONE HEXAL Risperidone 1MG TAB RISPERIDONE HEXAL Risperidone 2MG TAB RISPERIDONE HEXAL Risperidone 3MG TAB RISPERLET Risperidone 0.5MG TAB RISPERLET Risperidone 1MG TAB RISPERLET Risperidone 2MG TAB RISPEVON Risperidone 1MG TAB RISPEVON Risperidone 2MG TAB RISPEVON Risperidone 3MG TAB RISPEVON Risperidone 4MG TAB RISPIDE Risperidone.5MG TAB RISPIDE Risperidone 1MG TAB RISPIDE Risperidone 2MG TAB RISPONZ Risperidone 1MG TAB RISPONZ Risperidone 2MG TAB Page 9 of 87

10 Nappi code Name Active Ingredient Strength RISPONZ Risperidone 3MG TAB RISPONZ Risperidone 4MG TAB SCHIZOROL Risperidone 0.5MG TAB SCHIZOROL Risperidone 1MG TAB SCHIZOROL Risperidone 2MG TAB ZOXADON Risperidone 3MG TAB ZOXADON Risperidone 4MG TAB ZOXADON Risperidone 0.5MG TAB ZOXADON Risperidone 1MG TAB ZOXADON Risperidone 2MG TAB BIO-SULPIRIDE Sulpiride 200MG TAB STELAZINE Trifluoperazine 1MG TAB STELAZINE Trifluoperazine 5MG TAB GEODON Ziprasidone 20MG CAP GEODON Ziprasidone 40MG CAP GEODON Ziprasidone 60MG CAP GEODON Ziprasidone 80MG CAP CLOPIXOL Zuclopenthixol 10MG TAB CLOPIXOL Zuclopenthixol 2MG TAB CLOPIXOL DEPOT Zuclopenthixol 200MG/1ML INJS Antidepressants GULF AMITRIPTYLINE Amitriptyline 25MG TAB ROLAB-AMITRIPTYLINE HCL Amitriptyline 25MG TAB TREPILINE Amitriptyline 10MG TAB TREPILINE Amitriptyline 25MG TAB ARROW CITALOPRAM Citalopram 20MG TAB ARROW CITALOPRAM Citalopram 40MG TAB AURO-CITALOPRAM Citalopram 20MG TAB AUSTELL-CITALOPRAM Citalopram 10MG TAB AUSTELL-CITALOPRAM Citalopram 20MG TAB AUSTELL-CITALOPRAM Citalopram 40MG TAB BIO CITALOPRAM Citalopram 20MG TAB CILATE Citalopram 20MG TAB CILIFT Citalopram 20MG TAB CILORAM Citalopram 20MG TAB CIPRAMIL Citalopram 20MG TAB CITALOHEXAL Citalopram 20MG TAB CITALOPRAM ACTOR Citalopram 20MG TAB CITALOPRAM-WINTHROP Citalopram 20MG TAB DEPRAMIL 20MG Citalopram 20MG TAB DEPRAMIL Citalopram 40MG TAB DRL CITALOPRAM Citalopram 20MG TAB DRL CITALOPRAM Citalopram 40MG TAB GLENMARK CITALOPRAM Citalopram 20MG TAB Page 10 of 87

11 Nappi code Name Active Ingredient Strength MERCK-CITALOPRAM 20 Citalopram 20MG TAB SANDOZ CITALOPRAM Citalopram 20MG TAB SIMAYLA CITALOPRAM Citalopram 20MG TAB TALOMIL Citalopram 20MG TAB SANDOZ DOTHIEPIN HCL Dosulepin 75MG TAB PROTHIADEN Dosulepin 25MG CAP THADEN Dosulepin 25MG CAP THADEN Dosulepin 75MG TAB A-LENNON FLUOXETINE Fluoxetine 20MG CAP DEPROZAN Fluoxetine 20MG CAP FLUOXETINE ACTOR Fluoxetine 20MG CAP LILLY-FLUOXETINE Fluoxetine 20MG CAP LORIEN Fluoxetine 20MG CAP LORIEN 20MG Fluoxetine 20MG TAB NUZAK Fluoxetine 20MG CAP PROHEXAL Fluoxetine 20MG CAP PROHEXAL 20T Fluoxetine 20MG DSP PROHEXAL 40T Fluoxetine 40MG DSP PROLAX Fluoxetine 20MG CAP PROZAC Fluoxetine 20MG TAB PROZAC 20 Fluoxetine 20MG CAP RANFLOCS Fluoxetine 20MG CAP REZAK Fluoxetine 20MG CAP ROLAB-FLUOXETINE Fluoxetine 20MG CAP ZYDUS FLUOXETINE Fluoxetine 20MG CAP ETHIPRAMINE Imipramine 10MG TAB ETHIPRAMINE Imipramine 25MG TAB TOFRANIL Imipramine 10MG TAB TOFRANIL Imipramine 25MG TAB LANTANON Mianserin 10MG TAB LANTANON Mianserin 30MG TAB ADCO-PAROXETINE Paroxetine 20MG TAB AROPAX Paroxetine 20MG TAB AROPAX 30 Paroxetine 30MG TAB AROPAX CR Paroxetine 12.5MG SRT AROPAX CR Paroxetine 25MG SRT AURO PAROXETINE Paroxetine 20MG TAB AUSTELL-PAROXETINE Paroxetine 20MG TAB AUSTELL-PAROXETINE Paroxetine 30MG TAB DEPAROC Paroxetine 20MG TAB PARAX 20 Paroxetine 20MG TAB PAROXETINE UNICORN Paroxetine 20MG TAB PAXIL 20 Paroxetine 20MG TAB SERRAPRESS 20 Paroxetine 20MG TAB Page 11 of 87

12 Nappi code Name Active Ingredient Strength TEXINE Paroxetine 20MG TAB XET 20MG Paroxetine 20MG TAB ZYDUS-PAROXETINE Paroxetine 20MG TAB Bronchiectasis Antibiotic therapy will be evaluated on an individual basis Chronic Obstructive Pulmonary Disease Inhaled B2 agonists ASTHAVENT 300 DOSE Salbutamol 100MCG INH ASTHAVENT 300D ECOHALER CFC FREE Salbutamol 100MCG INH ASTHAVENT DP Salbutamol 200MCG CPS BEROTEC HFA 200 DOSE Fenoterol 100MCG INH BRICANYL TURBOHALER Terbutaline 0.5MG INH BRICANYL 100 DOSE Terbutaline.5MG/1DOSE TBH COMBIVENT MDI Salbutamol and other drugs for obstructive airway diseases 20MCG/100MCG INH DUOLIN HFA 200DOSE Salbutamol and other drugs for obstructive airway diseases INH DUOVENT HFA 200DOSE Fenoterol and ipratropium bromide 50MCG/20MCG INH VENTEZE CFC FREE 200 DOSE Salbutamol 100MCG INH VENTIMAX CFC FREE 200 DOSE Salbutamol 100MCG INH VENTOLIN INHALER 200 CFC FREE Salbutamol 100MCG INH Long acting B2 agonists FORADIL DRY oterol 12MCG CPS FORATEC DP CAPS oterol 12MCG CAP FORATEC HFA 120DOSE oterol 12MCG INH ONBREZ BREEZHALER (30 CAPS & INHALER) Indacaterol KIT OXIS TURBUHALER oterol 9MCG INH SEREVENT ACCUHALER Salmeterol 50MCG INH SEREVENT CFC-FREE 120DOSE Salmeterol 25MCG INH SEREVENT INHAL(60) Salmeterol 25MCG INH INNUVAIR 100MCG/6MCG 120 DOSE oterol and beclometasone 100MCG/6MCG INH DULERA 200/5UG 120 DOSE oterol and mometasone 200MCG/50MCG INH DULERA 100/5UG 120 DOSE oterol and mometasone 100MCG/5MCG INH Inhaled corticosteroids BECEZE DOSE Beclomethasone 50MCG INH BECEZE INHALER COMPLETE Beclomethasone 100MCG INH BECLATE INHALER Beclomethasone 100MCG INH BECLATE INHALER Beclomethasone 200MCG INH BECLATE INHALER Beclomethasone 50MCG INH BUDEFLAM CFC FREE 200MCG 300 DOSE INH Budesonide 200MCG INH BUDEFLAM CFC FREE 300 DOSE INH Budesonide 100MCG INH BUDEFLAM DP CAPS Budesonide 200MCG CAP INFLAMMIDE 200 NOVOLIZE REFIL Budesonide 200MCG REF INFLAMMIDE 200 NOVOLIZER COMPL Budesonide 200MCG INH Page 12 of 87

13 Nappi code Name Active Ingredient Strength INFLAMMIDE AEROSOL COMPLETE (MAC) Budesonide 100MCG INH INFLAMMIDE AEROSOL COMPLETE (MAC) Budesonide 200MCG INH INFLAMMIDE NOVOLIZER COMPLETE 100DOSE Budesonide 400MCG INH INFLAMMIDE NOVOLIZER REFILL 100DOSE Budesonide 400MCG REF PULMICORT 100 TURB (200 DOSE) Budesonide 100MCG ATH PULMICORT 200 TURB (200 DOSE) Budesonide 200MCG ATH ALVESCO 160MCG 120 DOSE Ciclesonide 160MCG INH ALVESCO 160MCG 60 DOSE Ciclesonide 160MCG INH ALVESCO 80MCG 60 DOSE Ciclesonide 80MCG INH CICLOVENT 120 DOSE Ciclesonide 160MCG INH CICLOVENT 120 DOSES Ciclesonide 80MCG INH CICLOVENT 60 DOSE Ciclesonide 160MCG INH CICLOVENT 60 DOSE Ciclesonide 80MCG INH FLIXOTIDE 50 CFC FREE 120 ACT Fluticasone 50MCG INH FLIXOTIDE ACCUHALER Fluticasone 100MCG CAP FLIXOTIDE ACCUHALER Fluticasone 250MCG CAP FLIXOTIDE ACCUHALER Fluticasone 500MCG CAP FLIXOTIDE ACCUHALER Fluticasone 50MCG CAP FLIXOTIDE CFC FREE (120 ACT) Fluticasone 125MCG INH FLIXOTIDE CFC FREE (120 ACT) Fluticasone 250MCG INH VANNAIR 160/4.5MCG PER INHALATION 120 DO formoterol and budesonide 4.5MCG/160MCG INH VANNAIR 80/4.5MCG PER INHALATION 120 DOS formoterol and budesonide 4.5MCG/80MCG INH SYMBICORD TURBO 120 DOSE oterol/budesonide 4.5MCG/160MCG INH SYMBICORD TURBO 60 DOSE oterol/budesonide 4.5MCG/160MCG INH SYMBICORD 320/9MCG PER INHALATION utoterol and other anti- asthmatics 9MCG/320MCG INH SYMBICORD 80/4.5MCG PER INHALATION utoterol and other anti- asthmatics 4.5MCG/80MCG INH ASMANEX TWISTHALER 30 DOSE Mometasone 200MCG/1DOSE TBH ASMANEX TWISTHALER 30 DOSE Mometasone 400MCG/1DOSE TBH ASMANEX TWISTHALER 60 DOSE Mometasone 200MCG/1DOSE TBH ASMANEX TWISTHALER 60 DOSE Mometasone 400MCG/1DOSE TBH FOXAIR 25/ DOSE Salmeterol and other anti-asthmatics 25MCG/125MCG INH FOXAIR 25/ DOSE Salmeterol and other anti-asthmatics 25MCG/250MCG INH FOXAIR 25/ DOSE Salmeterol and other anti-asthmatics 25MCG/50MCG INH FOXAIR 50/100 ACCUHALER Salmeterol/Fluticasone combinations INH FOXAIR 50/250 ACCUHALER Salmeterol/Fluticasone combinations INH FOXAIR 50/500 ACCUHALER Salmeterol/Fluticasone combinations INH SEREFLO 25/125 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/125MCG INH SEREFLO 25/125 HFA SYNCHROBREATHE 120 DO Salmeterol/Fluticasone combinations 25MCG/125MCG INH SEREFLO 25/250 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/250MCG INH SEREFLO 25/250 HFA SYNCHROBREATHE 120 DO Salmeterol/Fluticasone combinations 25MCG/250MCG INH SEREFLO 25/50 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/50MCG INH SEREFLO 25/50 HFA SYNCHROBREATHE 120 DOS Salmeterol/Fluticasone combinations 25MCG/50MCG INH SERETIDE 120 DOSE Salmeterol/Fluticasone combinations 25MCG/125MCG INH SERETIDE 120 DOSE Salmeterol/Fluticasone combinations 25MCG/250MCG INH Page 13 of 87

14 Nappi code Name Active Ingredient Strength SERETIDE 25/ DOSE Salmeterol/Fluticasone combinations 25MCG/50MCG INH SERETIDE 50/100 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/100MCG INH SERETIDE 50/250 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/250MCG INH SERETIDE 50/500 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/500MCG INH RELVAR ELLIPTA 92/22UG 30 DOSE vilanterol and fluticasone furoate 92MCG/22MCG INH Anticholinergic inhalers (short acting) ATROVENT HFA 200 DOSE Ipratropium bromide 20MCG INH IPVENT HFA 200 DOSE Ipratropium bromide 40MCG/1DOSE INH Oral Xanthines EUPHYLLIN RETARD Theophylline 250MG SRT NUELIN Theophylline 125MG TAB NUELIN SA 250 Theophylline 250MG TAB ROLAB-THEOPHYLLINE ANHYDROUS Theophylline 200MG SRT ROLAB-THEOPHYLLINE ANHYDROUS Theophylline 300MG SRT THEOPLUS Theophylline 200MG SRT THEOPLUS Theophylline 300MG SRT UNIPHYL Theophylline 400MG SRT UNIPHYL Theophylline 600MG SRT Oral Corticosteroids CAPSOID Prednisolone 5MG TAB LENISOLONE Prednisolone 5MG TAB METICORTEN Prednisone 50MG TAB METICORTEN Prednisone 5MG TAB PANAFCORT Prednisone 5MG TAB PREDNISONE (BE-TABS) Prednisone 5MG TAB PRELONE Prednisolone 5MG TAB PULMISON TABS Prednisone 20MG TAB TROLIC Prednisone 5MG TAB Cardiac failure/ Cardiomyopathy Anticoagulants WARFARIN Warfarin 5MG TAB CIPLA WARFARIN 1MG Warfarin 1MG TAB CIPLA-WARFARIN Warfarin 3MG TAB CIPLA WARFARIN 5MG Warfarin 5MG TAB Diuretics BURINEX Bumetanide 1MG TAB AUSTELL-FUROSEMIDE Furosemide 40MG TAB AUSTELL-FUROSEMIDE Furosemide 20MG TAB BEURISES Furosemide 40MG TAB DINO-RETIC Furosemide 40MG TAB DIURESIX Furosemide 40MG TAB LASIX Furosemide 20MG TAB LASIX Furosemide 40MG TAB Page 14 of 87

15 Nappi code Name Active Ingredient Strength LASIX Furosemide 500MG TAB LASIX ORAL Furosemide 10MG/1ML SLN MYLAN FUROSEMIDE Furosemide 40MG TAB PURESIS Furosemide 40MG TAB ROLAB-FUROSEMIDE Furosemide 40MG TAB HEXAZIDE Hydrochlorothiazide 25MG TAB RIDAQ Hydrochlorothiazide 25MG TAB RIDAQ Hydrochlorothiazide 12.5MG TAB URIREX-K Hydrochlorothiazide and potassium TAB ADCO-RETIC Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB AMILORETIC Hydrochlorothiazide and potassium-sparing agents 50MG/5MG TAB AMILORETIC HS Hydrochlorothiazide and potassium-sparing agents 2.5MG/25MG TAB BETARETIC Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB DEZRETIC 5MG/50MG Hydrochlorothiazide and potassium-sparing agents 50MG/5MG TAB DYAZIDE Hydrochlorothiazide and potassium-sparing agents 25MG/50MG TAB MODURETIC Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB RENEZIDE Hydrochlorothiazide and potassium-sparing agents 25MG/50MG TAB SPEC-CO-AMILORIDE Hydrochlorothiazide and potassium-sparing agents 50MG/5MG TAB CIPLA-INDAPAMIDE Indapamide 2.5MG TAB DAPAMAX Indapamide 2.5MG TAB DAPTRIL Indapamide 2.5MG TAB DYNA INDAPAMIDE SR Indapamide 1.5MG SRT HYDRO-LESS Indapamide 2.5MG TAB MYLAN-INDAPAMIDE Indapamide 2.5MG TAB NATRILIX SR Indapamide 1.5MG SRT ROLAB-INDAPAMIDE Indapamide 2.5MG TAB ARELIX Piretanide 3MG TAB ARELIX Piretanide 6MG TAB ALDACTONE Spironolactone 100MG TAB ALDACTONE Spironolactone 25MG APP ROLAB-SPIRONOLACTONE Spironolactone 25MG TAB SPIRACTIN Spironolactone 100MG TAB SPIRACTIN Spironolactone 25MG TAB TORASEMIDE BIOTECH Torasemide 5MG TAB TORASEMIDE BIOTECH Torasemide 10MG TAB TORAHEXAL Torasemide 10MG TAB TORAHEXAL Torasemide 2.5MG TAB TORAHEXAL Torasemide 5MG TAB UNAT Torasemide 2.5MG TAB UNAT Torasemide 5MG TAB UNAT Torasemide 10MG TAB Potassium supplementation PLENISH K Potassium chloride 600MG TAB POTASSIUM CHLORIDE UNICORN Potassium chloride 600MG TAB Page 15 of 87

16 Nappi code Name Active Ingredient Strength SANDOZ K-600 Potassium chloride 600MG TAB SLOW-K Potassium chloride 600MG TAB ULTIPOT Potassium chloride 600MG TAB SWISS-KAL SR Potassium chloride SRT ACE inhibitors CIBACE Benazepril 10MG TAB BIO-CAPTOPRIL Captopril 25MG TAB CAPACE Captopril 25MG TAB CAPOTEN Captopril 50MG TAB CAPTOHEXAL Captopril 12.5MG TAB CAPTOHEXAL Captopril 25MG TAB CAPTOHEXAL Captopril 50MG TAB CAPTOMAX Captopril 25MG TAB CAPTOMAX Captopril 50MG TAB MYLAN CAPTOPRIL Captopril 25MG TAB MYLAN-CAPTOPRIL Captopril 50MG TAB ROLAB-CAPTOPRIL Captopril 25MG TAB ROLAB-CAPTOPRIL Captopril 50MG TAB ZAPTO Captopril 25MG TAB ZAPTO Captopril 50MG TAB INHIBACE Cilazapril 5MG TAB ADCO-ENALAPRIL 10MG Enalapril 10MG TAB ADCO-ENALAPRIL 20MG Enalapril 20MG TAB ALAPREN 10 Enalapril 10MG TAB ALAPREN 20 Enalapril 20MG TAB ALAPREN 5 Enalapril 5MG TAB AUSTELL ENALAPRIL Enalapril 10MG TAB AUSTELL ENALAPRIL Enalapril 20MG TAB AUSTELL ENALAPRIL Enalapril 5MG TAB CIPLATEC 10 Enalapril 10MG TAB CIPLATEC 20MG Enalapril 20MG TAB CIPLATEC 5 Enalapril 5MG TAB ENALAPRIL BIOTECH Enalapril 5MG TAB ENALAPRIL BIOTECH Enalapril 10MG TAB ENALAPRIL BIOTECH Enalapril 20MG TAB ENAP 10MG Enalapril 10MG TAB ENAP 20MG Enalapril 20MG TAB ENAP 5MG Enalapril 5MG TAB ENVAS Enalapril 10MG TAB ENVAS Enalapril 5MG TAB HR-ENALAPRIL 10 Enalapril 10MG TAB HR-ENALAPRIL 20 Enalapril 20MG TAB HR-ENALAPRIL 5 Enalapril 5MG TAB Page 16 of 87

17 Nappi code Name Active Ingredient Strength HYPACE Enalapril 5MG TAB HYPACE Enalapril 5MG TAB PHARMAPRESS Enalapril 10MG TAB PHARMAPRESS Enalapril 20MG TAB PHARMAPRESS Enalapril 5MG TAB RENITEC Enalapril 10MG TAB RENITEC Enalapril 2.5MG TAB RENITEC Enalapril 20MG TAB RENITEC Enalapril 5MG TAB MONOPRIL Fosinopril 20MG TAB MONOPRIL Fosinopril 20MG TAB MYLAN-FOSINOPRIL 10 Fosinopril 10MG TAB MYLAN-FOSINOPRIL 20 Fosinopril 20MG TAB APEX-LISINOPRIL Lisinopril 20MG TAB AURO-LISINOPRIL Lisinopril 10MG TAB AURO-LISINOPRIL Lisinopril 20MG TAB AURO-LISINOPRIL Lisinopril 5MG TAB AUSTELL LISINOPRIL 2.5MG Lisinopril 2.5MG TAB AUSTELL LISINOPRIL 20MG Lisinopril 20MG TAB AUSTELL-LISINOPRIL Lisinopril 10MG TAB HEXAL-LISINOPRIL Lisinopril 10MG TAB HEXAL-LISINOPRIL Lisinopril 20MG TAB HEXAL-LISINOPRIL Lisinopril 5MG TAB LYSIN Lisinopril 10MG TAB LYSIN Lisinopril 5MG TAB SIMAYLA LISINOPRIL Lisinopril 10MG TAB SIMAYLA LISINOPRIL Lisinopril 20MG TAB SINOPREN 10 Lisinopril 10MG TAB SINOPREN 20 Lisinopril 20MG TAB SINOPREN 5 Lisinopril 5MG TAB ZEMAX 10 Lisinopril 10MG TAB ZEMAX 20 Lisinopril 20MG TAB ZEMAX 5 Lisinopril 5MG TAB ZESTRIL Lisinopril 10MG TAB ZESTRIL Lisinopril 20MG TAB ZESTRIL Lisinopril 5MG TAB ZETOMAX (ZESTOMAX) 10MG Lisinopril 10MG TAB ZETOMAX (ZESTOMAX) 20MG Lisinopril 20MG TAB ZETOMAX (ZESTOMAX) 5MG Lisinopril 5MG TAB PERDIX 15MG Moexipril 15MG TAB PERDIX 7.5MG Moexipril 7.5MG TAB ACESYL Perindopril 4MG TAB ACTI-PREX (GLENMARK PERINDOPRIL) Perindopril 4MG TAB Page 17 of 87

18 Nappi code Name Active Ingredient Strength AURO PERINDOPRIL Perindopril 4MG TAB AURO PERINDOPRIL Perindopril 8MG TAB BINDACE Perindopril 4MG TAB BINDACE Perindopril 8MG TAB CIPLA-PERINDOPRIL Perindopril 4MG TAB CIPLA-PERINDOPRIL Perindopril 8MG TAB CIPLASYL Perindopril 4MG TAB CIPLASYL Perindopril 8MG TAB COVERSYL Perindopril 4MG TAB COVERSYL Perindopril 10MG TAB PEARINDA Perindopril 4MG TAB PEARINDA Perindopril 8MG TAB PERINDOPRIL UNICORN Perindopril 4MG TAB PERINDOPRIL UNICORN Perindopril 8MG TAB PERISTAR Perindopril 4MG TAB PERISTAR Perindopril 8MG TAB PREXUM Perindopril 4MG TAB PREXUM Perindopril 5MG TAB PREXUM Perindopril 10MG TAB RAN-PERINDOPRIL Perindopril 4MG TAB SPEC-PERINDOPRIL Perindopril 4MG TAB SPEC-PERINDOPRIL Perindopril 8MG TAB VECTORYL Perindopril 4MG TAB VECTORYL Perindopril 8MG TAB ZYDUS PERINDOPRIL Perindopril 4MG TAB ACCUMAX Quinapril 10MG TAB ACCUMAX Quinapril 20MG TAB ACCUPRIL Quinapril 5MG TAB ACCUPRIL Quinapril 10MG TAB ACCUPRIL Quinapril 20MG TAB ACCUPRIL Quinapril 40MG TAB QUINAGEN Quinapril 5MG TAB QUINAGEN Quinapril 10MG TAB QUINAGEN Quinapril 20MG TAB QUINAGEN Quinapril 40MG TAB QUINASPEN 10MG Quinapril 10MG TAB QUINASPEN 20MG Quinapril 20MG TAB APEX-RAMIPRIL Ramipril 10MG CAP APEX-RAMIPRIL Ramipril 2.5MG CAP APEX-RAMIPRIL Ramipril 5MG CAP AUSTELL-RAMIPRIL 1.25MG Ramipril 1.25MG CAP AUSTELL-RAMIPRIL 10MG Ramipril 10MG CAP AUSTELL-RAMIPRIL 2.5MG Ramipril 2.5MG CAP AUSTELL-RAMIPRIL 5MG Ramipril 5MG CAP Page 18 of 87

19 Nappi code Name Active Ingredient Strength RAMIPRIL HEXAL Ramipril 2.5MG TAB RAMIPRIL HEXAL Ramipril 5MG TAB RAMIWIN Ramipril 2.5MG CAP RAMIWIN Ramipril 5MG CAP RAMPIL 1.25MG Ramipril 1.25MG CAP RAMPIL 10MG Ramipril 10MG CAP RAMPIL 2.5MG Ramipril 2.5MG CAP RAMPIL 5MG Ramipril 5MG CAP RAN RAMIPRIL Ramipril 10MG CAP RETACE Ramipril 2.5MG TAB RETACE Ramipril 5MG TAB SIMAYLA RAMIPRIL Ramipril 10MG CAP TRITACE Ramipril 1.25MG TAB TRITACE Ramipril 2.5MG TAB TRITACE Ramipril 5MG TAB TRITACE Ramipril 10MG CAP MAVIK (PREVIOUSLY GOPTEN) Trandolapril 2MG CAP MAVIK (PREVIOUSLY GOPTEN) Trandolapril 0.5MG CAP ACE inhibitor and diuretic combinations ZAPTO-CO Captopril and diuretics 50MG/25MG TAB INHIBACE PLUS Cilazapril and diuretics 5MG/12.5MG TAB CO-RENITEC Enalapril and diuretics 20MG/12.5MG TAB ENAP-CO Enalapril and diuretics 20MG/12.5MG TAB PHARMAPRESS CO Enalapril and diuretics 20MG/12.5MG TAB AURO-LISINOPRIL CO Lisinopril and diuretics 10MG/12.5MG TAB AURO-LISINOPRIL CO Lisinopril and diuretics 20MG/12.5MG TAB DIACE CO Lisinopril and diuretics 20MG/12.5MG TAB HEXAL LISINOPRIL CO 10 Lisinopril and diuretics 10MG/12.5MG TAB HEXAL LISINOPRIL CO 20 Lisinopril and diuretics 20MG/12.5MG TAB LISINOPRIL CO UNICORN 10MG/12.5MG Lisinopril and diuretics 10MG/12.5MG TAB LISINOPRIL CO UNICORN 20MG/12.5MG Lisinopril and diuretics 20MG/12.5MG TAB LISINOZIDE Lisinopril and diuretics 20MG/12.5MG TAB LISINOZIDE Lisinopril and diuretics 10MG/12.5MG TAB LISORETIC 10/12.5 Lisinopril and diuretics 10MG/12.5MG TAB LISORETIC 20/12.5 Lisinopril and diuretics 20MG/12.5MG TAB LISOZIDE 10MG/12.5MG Lisinopril and diuretics 10MG/12.5MG TAB LISOZIDE 20MG/12.5MG Lisinopril and diuretics 20MG/12.5MG TAB ZESTORETIC Lisinopril and diuretics 10MG/12.5MG TAB ZESTORETIC Lisinopril and diuretics 20MG/12.5MG TAB ZESTOZIDE 20 Lisinopril and diuretics 20MG/12.5MG TAB ZETOMAX CO 10/12.5 Lisinopril and diuretics 10MG/12.5MG TAB ZETOMAX CO 20/12.5 Lisinopril and diuretics 20MG/12.5MG TAB ACESYL CO Perindopril and diuretics 1.25MG/4MG TAB ARIPREL PLUS 4MG/1.25MG Perindopril and diuretics 1.25MG/4MG TAB Page 19 of 87

20 Nappi code Name Active Ingredient Strength BIOCOVERSYL PLUS 10MG/2.5MG Perindopril and diuretics 10MG/2.5MG TAB BIOPREXUM PLUS 10MG/2.5MG Perindopril and diuretics 10MG/2.5MG TAB COVERSYL PLUS Perindopril and diuretics 4MG/1.25MG TAB COVERSYL PLUS 5MG/1.25MG Perindopril and diuretics 5MG/1.25MG TAB PEARINDA PLUS Perindopril and diuretics 1.25MG/4MG TAB PERINDOPRIL CO UNICORN 4MG/1.25MG Perindopril and diuretics 1.25MG/4MG TAB PREXUM PLUS Perindopril and diuretics 4MG/1.25MG TAB PREXUM PLUS 5MG/1.25MG Perindopril and diuretics 5MG/1.25MG TAB SPEC-PERINDOPRIL PLUS Perindopril and diuretics 1.25MG/4MG TAB VECTORYL PLUS Perindopril and diuretics 1.25MG/4MG TAB ZYDUS PERINDOPRIL CO 4MG/1.25MG Perindopril and diuretics 1.25MG/4MG TAB ACCUMAX CO Quinapril and diuretics 10MG/12.5MG TAB ACCUMAX CO Quinapril and diuretics 20MG/12.5MG TAB ACCURETIC Quinapril and diuretics 10MG/12.5MG TAB ACCURETIC Quinapril and diuretics 20MG/12.5MG TAB ADCO-QUINARETIC 10/12.5MG Quinapril and diuretics 10MG/12.5MG TAB ADCO-QUINARETIC 20/12.5MG Quinapril and diuretics 20MG/12.5MG TAB AURO QUINAPRIL CO 10MG/12.5MG Quinapril and diuretics 10MG/12.5MG TAB AURO QUINAPRIL CO 20MG/12.5MG Quinapril and diuretics 20MG/12.5MG TAB BIQURETIC 10MG/12.5MG Quinapril and diuretics 10MG/12.5MG TAB BIQURETIC 20MG/12.5MG Quinapril and diuretics 20MG/12.5MG TAB QUINAZIDE 10/12.5 Quinapril and diuretics 10MG/12.5MG TAB QUINAZIDE 20/12.5 Quinapril and diuretics 20MG/12.5MG TAB CO-RAMIWIN 2.5MG/12.5MG Ramipril and diuretics 2.5MG/12.5MG TAB CO-RAMIWIN 5MG/12.5MG Ramipril and diuretics 5MG/12.5MG TAB CO-RAMIWIN 10MG/12.5MG Ramipril and diuretics 10MG/12.5MG TAB TRITACE PLUS 10MG/12.5MG Ramipril and diuretics 10MG/12.5MG TAB TRITACE PLUS 5MG/12.5MG Ramipril and diuretics 5MG/12.5MG TAB TRITACE PLUS 5MG/25MG Ramipril and diuretics 5MG/25MG TAB Angiotensin Receptor Blockers ABECARD Candesartan 8MG TAB ABECARD Candesartan 16MG TAB ATACAND Candesartan 16MG TAB ATACAND Candesartan 8MG TAB ATERWIN Candesartan 8MG TAB ATERWIN Candesartan 16MG TAB CANDAGEN Candesartan 16MG TAB CANDAGEN Candesartan 8MG TAB MYLACAND Candesartan 16MG TAB MYLACAND Candesartan 8MG TAB ATACAND PLUS Candesartan and diuretics 16MG/12.5MG TAB CANDEPRES PLUS 16MG/12.5MG Candesartan and diuretics 16MG/12.5MG TAB MYLACAND PLUS 16MG/12.5MG Candesartan and diuretics 16MG/12.5MG TAB Page 20 of 87

21 Nappi code Name Active Ingredient Strength JUBITAN Irbesartan 150MG TAB JUBITAN Irbesartan 300MG TAB ADCO IRBESARTAN Irbesartan 150MG TAB ADCO IRBESARTAN Irbesartan 300MG TAB ANTOSART Irbesartan 150MG TAB ANTOSART Irbesartan 300MG TAB APROVEL Irbesartan 150MG TAB APROVEL Irbesartan 300MG TAB DYNARB Irbesartan 150MG TAB DYNARB Irbesartan 300MG TAB IRBEWIN Irbesartan 150MG TAB IRBEWIN Irbesartan 300MG TAB IRTANEL Irbesartan 150MG TAB IRTANEL Irbesartan 300MG TAB ISART Irbesartan 150MG TAB ISART Irbesartan 300MG TAB AURO LOSARTAN Losartan 100MG TAB AURO LOSARTAN Losartan 50MG TAB AUSTELL LOSARTAN Losartan 100MG TAB AUSTELL LOSARTAN Losartan 50MG TAB CIPLA-LOSARTAN Losartan 100MG TAB CIPLA-LOSARTAN Losartan 50MG TAB CIPLAZAR Losartan 100MG TAB CIPLAZAR Losartan 50MG TAB COZAAR Losartan 50MG TAB COZAAR Losartan 100MG TAB LOS-ARB Losartan 50MG TAB LOSARTAN UNICORN Losartan 100MG TAB LOSARTAN UNICORN Losartan 50MG TAB LOSARTAN-WINTHROP Losartan 50MG TAB LOZAAN Losartan 100MG TAB LOZAAN Losartan 50MG TAB NORMOTEN Losartan 50MG TAB NORMOTEN Losartan 100MG TAB RASOL Losartan 100MG TAB RASOL Losartan 50MG TAB RENICARD Losartan 50MG TAB SPEC-LOSARTAN Losartan 100MG TAB SPEC-LOSARTAN Losartan 50MG TAB ZARTAN Losartan 50MG TAB ZARTAN Losartan 100MG TAB MICARDIS Telmisartan 40MG TAB MICARDIS Telmisartan 80MG TAB MIZART Telmisartan 40MG TAB Page 21 of 87

22 Nappi code Name Active Ingredient Strength MIZART Telmisartan 80MG TAB MYCARBIS (NAMIBIA ONLY) Telmisartan 40MG TAB MYCARBIS (NAMIBIA ONLY) Telmisartan 80MG TAB PRITOR Telmisartan 40MG TAB PRITOR Telmisartan 80MG TAB TELGEN Telmisartan 40MG TAB TELGEN Telmisartan 80MG TAB TESAR Telmisartan 40MG TAB TESAR Telmisartan 80MG TAB DIOLO Valsartan 160MG TAB DIOLO Valsartan 80MG TAB DIOVAN 160 Valsartan 160MG TAB DIOVAN 80 Valsartan 80MG TAB DYNAVAL Valsartan 80MG TAB DYNAVAL Valsartan 160MG TAB MIGROBEN Valsartan 160MG TAB MIGROBEN Valsartan 80MG TAB TAREG Valsartan 160MG TAB TAREG Valsartan 80MG TAB VALANT Valsartan 160MG TAB VALANT Valsartan 40MG TAB VALANT Valsartan 80MG TAB VALSARTAN UNICORN Valsartan 160MG TAB VALSARTAN UNICORN Valsartan 80MG TAB VASOVAN Valsartan 80MG TAB VASOVAN Valsartan 160MG TAB ZOMEVEK Valsartan 160MG TAB ZOMEVEK Valsartan 80MG TAB Angiotensin Receptor Blockers and diuretic combinations COAPROVEL Irbesartan and diuretics 150MG/12.5MG TAB CO-IRBEWIN Irbesartan and diuretics 150MG/12.5MG TAB ISART CO 150MG/12.5MG Irbesartan and diuretics 150MG/12.5MG TAB COAPROVEL Irbesartan and diuretics 300MG/12.5MG TAB CO-IRBEWIN Irbesartan and diuretics 300MG/12.5MG TAB ISART CO 300MG/12.5MG Irbesartan and diuretics 300MG/12.5MG TAB CO-IRBEWIN 300MG/25MG Irbesartan and diuretics 300MG/25MG TAB COZAAR COMP 100MG/12.5MG Losartan and diuretics 100MG/12.5MG TAB CIPLAZAR CO 100MG/25MG Losartan and diuretics 100MG/25MG TAB FORTZAAR Losartan and diuretics 100MG/25MG TAB HYTENZA CO 100MG/25MG Losartan and diuretics 100MG/25MG TAB LOHYPE FORTE PLUS 100MG/25MG Losartan and diuretics 100MG/25MG TAB LOSAAR PLUS 100MG/25MG Losartan and diuretics 100MG/25MG TAB LOSARTAN CO UNICORN 100MG/25MG Losartan and diuretics 100MG/25MG TAB Page 22 of 87

23 Nappi code Name Active Ingredient Strength LOZAAN CO 100/25 Losartan and diuretics 100MG/25MG TAB NETRASOL CO 100/25MG Losartan and diuretics 100MG/25MG TAB SARTOC 100MG/25MG Losartan and diuretics 100MG/25MG TAB ZARTAN CO 100MG/25MG Losartan and diuretics 100MG/25MG TAB AUSTELL LOSARTAN CO 50MG/12.5MG Losartan and diuretics 50MG/12.5 MG TAB COZAAR COMP Losartan and diuretics 50MG/12.5 MG TAB CIPLAZAR CO 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB HYTENZA CO 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB LOHYPE PLUS 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB LOSAAR PLUS 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB LOSACAR CO 50MG/12,5MG Losartan and diuretics 50MG/12.5MG TAB LOSARTAN CO UNICORN 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB LOZAAN CO 50/12.5 Losartan and diuretics 50MG/12.5MG TAB MEDI-LOSARCO (NAMIBIA ONLY) 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB NETRASOL CO 50/12.5MG Losartan and diuretics 50MG/12.5MG TAB SARTOC 50/12.5 Losartan and diuretics 50MG/12.5MG TAB ZARTAN CO 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB CO-PRITOR 40/12.5 MG Telmisartan + Hydrochlorothiazide 40MG/12.5MG TAB CO-PRITOR 80/12.5MG Telmisartan + Hydrochlorothiazide 80MG/12.5MG TAB CO-MICARDIS 80MG/25MG Telmisartan + Hydrochlorothiazide 80MG/25MG TAB CO-MICARDIS 40/12.5MG Telmisartan + Hydrochlorothiazide 40MG/12.5MG TAB CO-MICARDIS 80/12.5MG Telmisartan + Hydrochlorothiazide 80MG/12.5MG TAB CO-TAREG 160MG/12.5MG Valsartan and diuretics 160MG/12.5MG TAB DIOLO CO 160MG/12.5MG Valsartan and diuretics 160MG/12.5MG TAB DYNAVAL CO 160MG/12.5MG Valsartan and diuretics 160MG/12.5MG TAB CO-DIOVAN Valsartan and diuretics 160MG/12.5MG TAB DYNAVAL CO 160MG/25MG Valsartan and diuretics 160MG/25MG TAB CO-DIOVAN PLUS Valsartan and diuretics 160MG/25MG TAB CO-TAREG PLUS Valsartan and diuretics 160MG/25MG TAB CO-TAREG 80MG/12.5MG Valsartan and diuretics 80MG TAB DIOLO CO 80MG/12.5MG Valsartan and diuretics 80MG/12.5MG TAB DYNAVAL CO 80MG/12.5MG Valsartan and diuretics 80MG/12.5MG TAB CO-DIOVAN Valsartan and diuretics 80MG/12.5MG TAB CO-MIGROBEN 160MG/12.5MG Valsartan and diuretics TAB CO-MIGROBEN 160MG/25MG Valsartan and diuretics TAB CO-MIGROBEN 80MG/12.5MG Valsartan and diuretics TAB CO-ZOMEVEK 160MG/12.5MG Valsartan and diuretics TAB CO-ZOMEVEK 80MG/12.5MG Valsartan and diuretics TAB CO-ZOMEVEK160MG/25MG Valsartan and diuretics TAB Beta-blockers ADCO-ATENOLOL Atenolol 100MG TAB ADCO-ATENOLOL Atenolol 50MG TAB ADCO BISOCOR 10MG Bisoprolol 10MG TAB Page 23 of 87

24 Nappi code Name Active Ingredient Strength ADCO BISOCOR 5MG Bisoprolol 5MG TAB MYLAN BISOPROLOL Bisoprolol 10MG TAB MYLAN BISOPROLOL Bisoprolol 5MG TAB B-BLOCK Atenolol 100MG TAB B-BLOCK Atenolol 50MG TAB BETACOR Bisoprolol 10MG TAB BETACOR Bisoprolol 5MG TAB BILOCOR 10 Bisoprolol 10MG TAB BILOCOR 5 Bisoprolol 5MG TAB BISLO Bisoprolol 5MG TAB BISLO Bisoprolol 10MG TAB BISBETA Bisoprolol 10MG TAB BISBETA Bisoprolol 5MG TAB BISOHEXAL 10 Bisoprolol 10MG TAB BISOHEXAL 5 Bisoprolol 5MG TAB BISOPROLOL HEXAL Bisoprolol 10MG TAB BISOPROLOL HEXAL Bisoprolol 5MG TAB BISOPROLOL UNICORN Bisoprolol 10MG TAB BISOPROLOL UNICORN Bisoprolol 5MG TAB BISOPROLOL ZYDUS Bisoprolol 10MG TAB BISOPROLOL ZYDUS Bisoprolol 5MG TAB CARDICOR 10MG Bisoprolol 10MG TAB CARDICOR 2.5MG Bisoprolol 2.5MG TAB CARDICOR 5MG Bisoprolol 5MG TAB CONCOR Bisoprolol 10MG TAB CONCOR Bisoprolol 5MG TAB RETOCAR Bisoprolol 10MG TAB RETOCAR Bisoprolol 5MG TAB BISOPROLOL UNICHEM Bisoprolol 5MG TAB BISOPROLOL UNICHEM Bisoprolol 10MG TAB GULF ATENOLOL Atenolol 100MG TAB GULF ATENOLOL Atenolol 50MG TAB HEXA-BLOK Atenolol 100MG TAB HEXA-BLOK Atenolol 50MG TAB INDERAL Propranolol 10MG TAB INDERAL LA Propranolol 80MG CAP INDOBLOK 10 Propranolol 10MG TAB INDOBLOK 40 Propranolol 40MG TAB LOVISPES Nebivolol 5MG TAB NEBILET 5MG Nebivolol 5MG TAB NORTON-ATENOLOL Atenolol 100MG TAB NORTON-ATENOLOL Atenolol 50MG TAB PRODOROL Propranolol 10MG TAB PRODOROL Propranolol 40MG TAB Page 24 of 87

25 Nappi code Name Active Ingredient Strength PURBLOKA Propranolol 10MG TAB PURBLOKA Propranolol 40MG APP ROLAB-ATENOLOL Atenolol 100MG TAB ROLAB-ATENOLOL Atenolol 50MG TAB SOTAHEXAL Sotalol 160MG TAB SOTAHEXAL Sotalol 80MG TAB TEN-BLOKA Atenolol 100MG TAB TEN-BLOKA Atenolol 50MG TAB TENOPRESS Atenolol 100MG TAB TENOPRESS Atenolol 25MG TAB TENOPRESS Atenolol 50MG TAB TENORMIN Atenolol 25MG TAB TENORMIN Atenolol 100MG TAB TENORMIN Atenolol 50MG TAB ZETENOL Atenolol 100MG TAB ZETENOL Atenolol 50MG TAB ZIAPRO Bisoprolol 10MG TAB ZIAPRO Bisoprolol 5MG TAB Alpha-beta blockers ASPEN CARVEDILOL Carvedilol 12.5MG TAB ASPEN CARVEDILOL Carvedilol 25MG TAB ASPEN CARVEDILOL Carvedilol 6.25MG TAB CARLOC Carvedilol 25MG TAB CARLOC 6.25 Carvedilol 6.25MG TAB CARLOC 12.5 Carvedilol 12.5MG TAB CARVEDILOL-HEXAL Carvedilol 12.5MG TAB CARVEDILOL-HEXAL Carvedilol 25MG TAB CARVEDILOL-HEXAL Carvedilol 6.25MG TAB CARVEDILOL UNICORN Carvedilol 12.5MG TAB CARVEDILOL UNICORN Carvedilol 25MG TAB CARVEDILOL UNICORN Carvedilol 6.25MG TAB CARVETREND 12.5MG Carvedilol 12.5MG TAB CARVETREND 25MG Carvedilol 25MG TAB CARVETREND 6.25MG Carvedilol 6.25MG TAB DILATREND Carvedilol 12.5MG TAB DILATREND Carvedilol 25MG TAB DILATREND Carvedilol 6.25MG TAB VEDIBLOK Carvedilol 12.5MG TAB VEDIBLOK Carvedilol 25MG TAB VEDIBLOK Carvedilol 6.25MG TAB Beta-blocker and diuretic combinations BILOCOR CO 10MG/6.25MG Bisoprolol and thiazides 10MG/6.25MG TAB BILOCOR CO 2.5MG/6.25MG Bisoprolol and thiazides 2.5MG/6.25MG TAB BILOCOR CO 5MG/6.25MG Bisoprolol and thiazides 5MG/6.25MG TAB Page 25 of 87

COMPREHENSIVE PMB FORMULARY 1-Dec-16

COMPREHENSIVE PMB FORMULARY 1-Dec-16 COMPREHENSIVE PMB FORMULARY 1-Dec-16 Depending on the specific scheme option, products included on this chronic medicines formulary will not attract a co-payment if authorised by Chronic Medicine Management

More information

YES = formulary NO = non-formulary NO BENEFIT = excluded. Beat4 Beat1 Beat 3 Pace2 Beat2 Pace1 Pace3 Pace4 A NO BENEFIT SANDOZ AMITRIPTYLINE 25

YES = formulary NO = non-formulary NO BENEFIT = excluded. Beat4 Beat1 Beat 3 Pace2 Beat2 Pace1 Pace3 Pace4 A NO BENEFIT SANDOZ AMITRIPTYLINE 25 Benefits are subject to the following: Pre-authorisation Bestmed guidelines Bestmed protocols Mediscor Reference Price (MRP) This price represents the reasonable price in the market place for a particular

More information

YES = formulary NO = non-formulary NO BENEFIT = excluded. Beat4 Beat1 Beat 3 Pace2 Beat2 Pace1 Pace3 Pace4 A NO BENEFIT SANDOZ AMITRIPTYLINE 25

YES = formulary NO = non-formulary NO BENEFIT = excluded. Beat4 Beat1 Beat 3 Pace2 Beat2 Pace1 Pace3 Pace4 A NO BENEFIT SANDOZ AMITRIPTYLINE 25 Benefits are subject to the following: Pre-authorisation Bestmed guidelines Bestmed protocols Mediscor Reference Price (MRP) This price represents the reasonable price in the market place for a particular

More information

BONITAS STANDARD FORMULARY September 2018

BONITAS STANDARD FORMULARY September 2018 BONITAS STANDARD FORMULARY September 2018 Reimbursement of all formulary items is subject to the Chronic Medicine Management clinical guidelines and protocols and the Medicine Price List (MPL). Nappi code

More information

Restrictive Formulary. RESTRICTIVE PMB FORMULARY Effective 1 June 2010

Restrictive Formulary. RESTRICTIVE PMB FORMULARY Effective 1 June 2010 RESTRICTIVE PMB FORMULARY Effective 1 June 2010 Products included on this chronic medicines formulary will not attract a co-payment if authorised by Chronic Medicine Management (Medi-Serve) for a disease

More information

REGISTRATION CRITERIA : SPECIALIST INITIATION OF TREATMENT AND FOR ANY SIGNIFICANT INCREASES IN DOSAGES OR ADDITION OF MEDICATION.

REGISTRATION CRITERIA : SPECIALIST INITIATION OF TREATMENT AND FOR ANY SIGNIFICANT INCREASES IN DOSAGES OR ADDITION OF MEDICATION. CARDIOMYOPATHY REGISTRATION CRITERIA : SPECIALIST INITIATION OF TREATMENT AND FOR ANY SIGNIFICANT INCREASES IN DOSAGES OR ADDITION OF MEDICATION. * REQUEST FOR ANGIO-TENSIN RECEPTOR BLOCKER WILL REQUIRE

More information

Chronic Illness Benefit medicine list (formulary) 2017

Chronic Illness Benefit medicine list (formulary) 2017 Chronic Illness Benefit medicine list (formulary) 2017 Who we are The Malcor Medical Aid Scheme (referred to as the Scheme ), registration number 1547, is the medical scheme that you a member of. This

More information

ADCO-CAPTOPRIL 25MG BIO-CAPTOPRIL 25MG MERCK-CAPTOPRIL 25MG SANDOZ CAPTOPRIL 25MG ZAPTO 25MG TAB

ADCO-CAPTOPRIL 25MG BIO-CAPTOPRIL 25MG MERCK-CAPTOPRIL 25MG SANDOZ CAPTOPRIL 25MG ZAPTO 25MG TAB CHRONIC RENAL FAILURE REGISTRATION CRITERIA: Diagnosis confirmed by a GP or Specialist Faxed copy of lab results required : serum creatinine clearance value

More information

YES = formulary NO = non-formulary NO BENEFIT = excluded. Beat4 Beat1 Beat 3 Pace2 Beat2 Pace1 Pace3 Pace4 B BECLOMETHASONE BECEZE 50MCG INHALER

YES = formulary NO = non-formulary NO BENEFIT = excluded. Beat4 Beat1 Beat 3 Pace2 Beat2 Pace1 Pace3 Pace4 B BECLOMETHASONE BECEZE 50MCG INHALER Benefits are subject to the following: Pre-authorisation Bestmed guidelines Bestmed protocols Mediscor Reference Price (MRP) This price represents the reasonable price in the market place for a particular

More information

REGISTRATION CRITERIA : SPECIALIST INITIATION OF TREATMENT AND FOR ANY SIGNIFICANT INCREASES IN DOSAGES OR ADDITION OF MEDICATION.

REGISTRATION CRITERIA : SPECIALIST INITIATION OF TREATMENT AND FOR ANY SIGNIFICANT INCREASES IN DOSAGES OR ADDITION OF MEDICATION. CORONARY ARTERY DISEASE REGISTRATION CRITERIA : SPECIALIST INITIATION OF TREATMENT AND FOR ANY SIGNIFICANT INCREASES IN DOSAGES OR ADDITION OF MEDICATION. * REQUEST FOR ANGIO-TENSIN RECEPTOR BLOCKER WILL

More information

Chronic Illness Benefit medicine list (formulary) 2016

Chronic Illness Benefit medicine list (formulary) 2016 Chronic Illness Benefit medicine list (formulary) 2016 Who we are The Anglovaal Group Medical Scheme (referred to as the Scheme ), registration number 1571. This is a non-profit organisation, registered

More information

Chronic Illness Benefit medicine list (formulary)

Chronic Illness Benefit medicine list (formulary) Chronic Illness Benefit medicine list (formulary) 2015 Chronic Illness Benefit 2015 Contents Page Explanation of terms 3 The Prescribed Minimum Benefits medicine list 4 Important information you need to

More information

Chronic Illness Benefit medicine list (formulary) 2016

Chronic Illness Benefit medicine list (formulary) 2016 Chronic Illness Benefit medicine list (formulary) 2016 Who we are TFG Medical Aid Scheme (referred to as 'the Scheme"), registration number 1578, is a non-profit organisation, registered with the Council

More information

Chronic Illness Benefit medicine list (formulary) 2017

Chronic Illness Benefit medicine list (formulary) 2017 Chronic Illness Benefit medicine list (formulary) 2017 Who we are LA Health Medical Scheme (referred to as 'the Scheme ), registration number 1145, is a non-profit organisation, registered with the Council

More information

BONCAP Chronic Formulary 1-Jan-15

BONCAP Chronic Formulary 1-Jan-15 BONCAP Chronic Formulary 1-Jan-15 KEY to Chronic Medicine Management Reimbursement Criteria: Quantity/dosage and duration of authorisation may vary - depending on the requested drug. Accepted Treatment

More information

Chronic Illness Benefit 2018

Chronic Illness Benefit 2018 Chronic Illness Benefit 2018 Who we are TFG Medical Aid Scheme (referred to as 'the Scheme"), registration number 1578, is a non-profit organisation, registered with the Council for Medical Schemes. Discovery

More information

Chronic Illness Benefit medicine list (formulary)

Chronic Illness Benefit medicine list (formulary) Chronic Illness Benefit medicine list (formulary) - 2018 Who we are Remedi Medical Aid Scheme (referred to as 'the Scheme"), registration number 1430, is a non-profit organisation, registered with the

More information

Chronic Illness Benefit medicine list (formulary) 2018

Chronic Illness Benefit medicine list (formulary) 2018 Chronic Illness Benefit medicine list (formulary) 2018 Who we are The Anglovaal Group Medical Scheme (referred to as the Scheme ), registration number 1571, is a nonprofit organisation, registered with

More information

Chronic Illness Benefit medicine list (formulary) 2018

Chronic Illness Benefit medicine list (formulary) 2018 Chronic Illness Benefit medicine list (formulary) 2018 Who we are Glencore Medical Scheme (referred to as 'the Scheme"), registration number 1253, is a non-profit organisation, registered with the Council

More information

Chronic Illness Benefit medicine list (formulary)

Chronic Illness Benefit medicine list (formulary) Chronic Illness Benefit medicine list (formulary) - 2018 Who we are The BMW Employee Medical Aid Society (referred to as BEMAS ), registration number 1526, is the medical scheme that you are a member of.

More information

Chronic Illness Benefit medicine list (formulary)

Chronic Illness Benefit medicine list (formulary) Chronic Illness Benefit medicine list (formulary) 2014 Chronic Illness Benefit 2014 Contents Page Explanation of terms 3 The Prescribed Minimum Benefits medicine list (for all plan types) 4 Important information

More information

As a result of these reviews, Discovery Health has updated its Chronic Medicine Formulary and CDA.

As a result of these reviews, Discovery Health has updated its Chronic Medicine Formulary and CDA. Dear Pharmacist Update on the CDL formulary and Chronic Drug Amount for 2017 Discovery Health reviews the Chronic Medicine Formulary and Chronic Drug Amounts (CDAs) twice a year. We do this to make sure

More information

Chronic Illness Benefit medicine list (formulary)

Chronic Illness Benefit medicine list (formulary) Chronic Illness Benefit medicine list (formulary) 2014 Page 1 of 22 01/2014 Chronic Illness Benefit 2014 Contents Page Explanation of terms 3 The Prescribed Minimum Benefits medicine list 4 Important information

More information

Chronic Illness Benefit medicine list (formulary)

Chronic Illness Benefit medicine list (formulary) Chronic Illness Benefit medicine list (formulary) 2013 Anglovaal Chronic Illness Benefit 2013 Contents Page Explanation of terms 3 The Prescribed Minimum Benefits medicine formulary 4 Important information

More information

Chronic Illness Benefit medicine list (formulary)

Chronic Illness Benefit medicine list (formulary) Chronic Illness Benefit medicine list (formulary) 2017 Chronic Illness Benefit 2017 Important information you need to know The Discovery Health Medical Scheme Rules set out the requirements for the Chronic

More information

YES = formulary NO = non-formulary NO BENEFIT = excluded

YES = formulary NO = non-formulary NO BENEFIT = excluded Benefits are subject to the following: Pre-authorisation Bestmed guidelines Bestmed protocols Mediscor Reference Price (MRP) This price represents the reasonable price in the market place for a particular

More information

Chronic Illness Benefit medicine list (formulary)

Chronic Illness Benefit medicine list (formulary) Chronic Illness Benefit medicine list (formulary) - 2019 Who we are Remedi Medical Aid Scheme (referred to as 'the Scheme"), registration number 1430, is a non-profit organisation, registered with the

More information

ACE inhibitors Captopril Tab 12.5 MG CAPTOHEXAL 12.5MG

ACE inhibitors Captopril Tab 12.5 MG CAPTOHEXAL 12.5MG CHRONIC RENAL FAILURE REGISTRATION CRITERIA: Diagnosis confirmed by a GP or Specialist Faxed copy of lab results required : serum creatinine clearance value

More information

Chronic Illness Benefit medicine list (formulary)

Chronic Illness Benefit medicine list (formulary) Chronic Illness Benefit medicine list (formulary) 2013 Altron Medical Aid Chronic Illness Benefit 2013 Contents Page Explanation of terms 3 The Prescribed s medicine formulary (for all plan types) 4 Important

More information

Chronic Illness Benefit medicine list (formulary)

Chronic Illness Benefit medicine list (formulary) Chronic Illness Benefit medicine list (formulary) 2018 Chronic Illness Benefit 2018 Important information you need to know The Discovery Health Medical Scheme Rules set out the requirements for the Chronic

More information

Chronic Illness Benefit medicine list (formulary)

Chronic Illness Benefit medicine list (formulary) Chronic Illness Benefit medicine list (formulary) 2018 Chronic Illness Benefit 2018 Important information you need to know The Discovery Health Medical Scheme Rules set out the requirements for the Chronic

More information

Discovery Health PBR formulary and benchmark pricing

Discovery Health PBR formulary and benchmark pricing Discovery Health PBR formulary and benchmark pricing Period: 2018 Q1 & Q2 Implementation date: 01 January 2018 Performance-based remuneration (PBR) is a voluntarily programme designed to provide additional

More information

Chronic Illness Benefit medicine list (formulary)

Chronic Illness Benefit medicine list (formulary) Chronic Illness Benefit medicine list (formulary) 2012 Discovery Health Chronic Illness Benefit 2012 Contents Page Explanation of terms 2 The Prescribed s medicine formulary (for all plan types) 3 Important

More information

Chronic Illness Benefit medicine list (formulary)

Chronic Illness Benefit medicine list (formulary) Chronic Illness Benefit medicine list (formulary) 2016 Chronic Illness Benefit 2016 Important information you need to know We may change the information contained in this document from time to time. We

More information

Anglovaal Group Medical Scheme Chronic Illness Benefit medicine list

Anglovaal Group Medical Scheme Chronic Illness Benefit medicine list Anglovaal Group Medical Scheme Chronic Illness Benefit medicine list 2012 AVGMS Chronic Illness Benefit 2012 Contents Page Explanation of terms 3 The Prescribed Minimum Benefits medicine formulary 4 Important

More information

Chronic Illness Benefit medicine list (formulary) 2012

Chronic Illness Benefit medicine list (formulary) 2012 Chronic Illness Benefit medicine list (formulary) 2012 Discovery Health Chronic Illness Benefit 2012 Contents Page Explanation of terms 2 The Prescribed s medicine formulary (for all plan types) 3 Important

More information

For long term corticosteriod use

For long term corticosteriod use NEDGROUP TRADITIONAL, COMPREHENSIVE AND PLATINUM PLANS A clinically relevant motivation is when prescribing any product which does not appear on this list. Chronic application forms must accompany all

More information

FOR LONG TERM CORTICOSTEROIDS ONLY FOR SEVERE PERSISTENT ASTHMA (MOTIVATION REQUIRED FROM SPECIALIST)

FOR LONG TERM CORTICOSTEROIDS ONLY FOR SEVERE PERSISTENT ASTHMA (MOTIVATION REQUIRED FROM SPECIALIST) NEDGROUP TRADITIONAL, COMPREHENSIVE AND PLATINUM PLANS A clinically relevant motivation is required when prescribing any product which does not appear on this list. Chronic application forms must accompany

More information

For long term corticosteriod use. Only for severe persistent asthma (motivation required from specialist)

For long term corticosteriod use. Only for severe persistent asthma (motivation required from specialist) NEDGROUP TRADITIONAL, COMPREHENSIVE AND PLATINUM PLANS A clinically relevant motivation is when prescribing any product which does not appear on this list. Chronic application forms must accompany all

More information

Chronic Illness Benefit medicine list (formulary)

Chronic Illness Benefit medicine list (formulary) Chronic Illness Benefit medicine list (formulary) 2019 Chronic Illness Benefit 2019 Important information you need to know The Discovery Health Medical Scheme Rules set out the requirements for the Chronic

More information

Chronic Illness Benefit medicine list (formulary)

Chronic Illness Benefit medicine list (formulary) Chronic Illness Benefit medicine list (formulary) 2012 Discovery Health Chronic Illness Benefit 2012 Contents Page Explanation of terms 2 The Prescribed s medicine formulary (for all plan types) 3 s for

More information

Chronic Illness Benefit medicine list (formulary)

Chronic Illness Benefit medicine list (formulary) Chronic Illness Benefit medicine list (formulary) 2015 Chronic Illness Benefit 2015 Contents Page Explanation of terms 3 The Prescribed Minimum Benefits medicine list (for all plan types) 4 Frequently

More information

Motohealth Custom Chronic Medicine Formulary

Motohealth Custom Chronic Medicine Formulary Motohealth Custom Chronic Medicine Formulary 2018 Chronic application forms must accompany all first-time applications. All applications MUST include valid ICD10 codes. Risk Equalisation Fund criteria

More information

Chronic Illness Benefit medicine list (formulary)

Chronic Illness Benefit medicine list (formulary) Chronic Illness Benefit medicine list (formulary) 2013 Chronic Illness Benefit 2013 Contents Page Explanation of terms 3 The Prescribed Minimum Benefits medicine list (for all plan types) 4 Important information

More information

Chronic Illness Benefit medicine list (formulary)

Chronic Illness Benefit medicine list (formulary) Chronic Illness Benefit medicine list (formulary) 2014 Chronic Illness Benefit 2014 Contents Page Explanation of terms 3 The Prescribed Minimum Benefits medicine list (for all plan types) 4 Important information

More information

CareCross Chronic Medicine Formulary

CareCross Chronic Medicine Formulary CareCross Chronic Medicine Formulary 2013 Chronic application forms must accompany all first-time applications. All applications MUST include valid ICD10 codes. Risk Equalisation Fund criteria must be

More information

NEDGROUP HOSPITAL AND SAVINGS PLAN

NEDGROUP HOSPITAL AND SAVINGS PLAN NEDGROUP HOSPITAL AND SAVINGS PLAN A clinically relevant motivation is required when prescribing any product which does not appear on this list. Chronic application forms must accompany all first-time

More information

ACEBUTOLOL HCL 100MG TABLET GENERIC BETA BLOCKERS ALISKIREN 150MG TABLET RASILAZ RENIN INHIBITOR

ACEBUTOLOL HCL 100MG TABLET GENERIC BETA BLOCKERS ALISKIREN 150MG TABLET RASILAZ RENIN INHIBITOR S/N ME OF MEDICATIONS BRANDED/GENERIC DRUG CLASS * UNIT PRICE RANGE (SGD$) 1 ACEBUTOLOL HCL 100MG CAPSULE SECTRAL BETA BLOCKERS 0.50 2 ACEBUTOLOL HCL 100MG TABLET GENERIC BETA BLOCKERS 0.33 3 ALISKIREN

More information

Chronic drug clinical request codes payable

Chronic drug clinical request codes payable We re about you Chronic drug clinical request codes payable NHRPL code Description NHRPL code Description tel 061 285 5400 fax 061 230 465 email members@nhp.com.na website www.nhp.com.na Unit 2, Demushuwa

More information

CYSTIC FIBROSIS. Pace4 Pace3 Pace2 A AMOXYCILLIN ADCO-AMOX 125MG SUSP YES ADCO-AMOX 500MG CAP ADCO-AMOX 250MG SUSP A-LENNON AMOXYCILLIN 250M

CYSTIC FIBROSIS. Pace4 Pace3 Pace2 A AMOXYCILLIN ADCO-AMOX 125MG SUSP YES ADCO-AMOX 500MG CAP ADCO-AMOX 250MG SUSP A-LENNON AMOXYCILLIN 250M Benefits are subject to the following: Pre-authorisation Bestmed guidelines Bestmed protocols Mediscor Reference Price (MRP) This price represents the reasonable price in the market place for a particular

More information

$0 Preferred Generics List

$0 Preferred Generics List 2017 HMO/POS/Select $0 Preferred Generics List Members enrolled in one of the listed HMO/POS/Select plans beginning on or after January 1, 2016 will have a zero-dollar copayment for the following Preferred

More information

Oncology supportive medicine list (formulary) 2016

Oncology supportive medicine list (formulary) 2016 Oncology supportive medicine list (formulary) 2016 Who we are Glencore Medical Scheme (referred to as 'the Scheme"), registration number 1253, is a non-profit organisation, registered with the Council

More information

Professor David Castle. Ms. Nga Tran. St. Vincent s Mental Health Level 2, 46 Nicholson Street, Fitzroy Vic 3065

Professor David Castle. Ms. Nga Tran. St. Vincent s Mental Health Level 2, 46 Nicholson Street, Fitzroy Vic 3065 ARABIIC Professor David Castle Ms. Nga Tran St. Vincent s Mental Health Level 2, 46 Nicholson Street, Fitzroy Vic 3065 (03) 9288 4147 (03) 9288 4751 Psychiatric Medication Information / Arabic 1 Psychiatric

More information

Alaska Medicaid 90 Day** Generic Prescription Medication List

Alaska Medicaid 90 Day** Generic Prescription Medication List 1 ACYCLOVIR 200 MG CAPSULE BUPROPION HCL 150 MG TAB ER 24H ACYCLOVIR 200 MG/5ML BUPROPION HCL 150 MG TABLET ER ACYCLOVIR 400 MG TABLET BUPROPION HCL 150 MG TABLET ER ACYCLOVIR 800 MG TABLET BUPROPION HCL

More information

Cardiac Medications At A Glance

Cardiac Medications At A Glance Cardiac Medications At A Glance 1) Anticoagulants (Also known as Blood Thinners.) Dalteparin (Fragmin), Danaparoid (Orgaran) Enoxaparin (Lovenox) Heparin (various) Tinzaparin (Innohep) Warfarin (Coumadin)

More information

Inhalers containing CFCs. CFC-free inhalers

Inhalers containing CFCs. CFC-free inhalers Propellants used in medical metered dose inhalers and aerosol-based breath activated devices in New Zealand August to October 2002 (most recent period for which data is available) (February 2003) Inhalers

More information

Have You Ever Wondered

Have You Ever Wondered Have You Ever Wondered A few facts about medication use and related falls The Number of Medications You Take & The Connection to Falls CONCERN: As you increase the number of medications that you take,

More information

A Visual Approach to Simplifying Respiratory Drug Regimens

A Visual Approach to Simplifying Respiratory Drug Regimens A Visual Approach to Simplifying Respiratory Drug Regimens Stephanie Cheng, PharmD, MPH, BCGP 3 Main Categories Inhaled Respiratory Drugs Binds to beta-2 receptors Relaxation of smooth muscles in the lung

More information

Cardiovascular Risk Reduction in Diabetic Mellitus. Presenter: Dr. Martin N. Wanyoike MB.CHB., M. Med.(internal med) Physician / Cardiologist

Cardiovascular Risk Reduction in Diabetic Mellitus. Presenter: Dr. Martin N. Wanyoike MB.CHB., M. Med.(internal med) Physician / Cardiologist Cardiovascular Risk Reduction in Diabetic Mellitus Presenter: Dr. Martin N. Wanyoike MB.CHB., M. Med.(internal med) Physician / Cardiologist Cardiovascular Risk Reduction in Diabetic Mellitus Disclosures

More information

Commissioner for the Department for Medicaid Services Selections for Preferred Products

Commissioner for the Department for Medicaid Services Selections for Preferred Products Commissioner for the Department for Medicaid Services Selections for Preferred Products This is a summary of the final Preferred Drug List (PDL) selections made by the Commissioner for the Department for

More information

LONG TERM CARE MEDICATIONS MANAGEMENT INITIATIVE JULY Prepared by the Long-Term Care Medications Management Working Group

LONG TERM CARE MEDICATIONS MANAGEMENT INITIATIVE JULY Prepared by the Long-Term Care Medications Management Working Group LONG TERM CARE MEDICATIONS MANAGEMENT INITIATIVE JULY 2016 (last updated July 28, 2016) Prepared by the Long-Term Care Medications Management Working Group Drug Classes for Consideration Angiotensin Converting

More information

An overview of fixed-dose combinations of antihypertensive drugs in South Africa

An overview of fixed-dose combinations of antihypertensive drugs in South Africa South African Family Practice 2014; 56(4):206-211 56(4):1 6 http://dx.doi.org/10.1080/20786190.2014.953860 http://dx.doi.org/10.1080/20786204.2014.953868 Open Access article distributed under the terms

More information

Medicine Related Falls Risk Assessment Tool (MRFRAT)

Medicine Related Falls Risk Assessment Tool (MRFRAT) Medicine Related Falls Risk Assessment Tool (MRFRAT) The Medicine Related Falls Risk Assessment tool (MRFRAT) in Appendix 1 is designed to help identify patients at risk of falls due to their current medicine

More information

Pharmacy Benefit Management (PBM) Program FORMULARY/PRODUCT RESTRICTIONS

Pharmacy Benefit Management (PBM) Program FORMULARY/PRODUCT RESTRICTIONS Workforce Safety & Insurance Revised Document Date: 07/21/2015 1600 E Century Ave Ste 1 PO Box 5585 Bismarck, ND 58506-5585 701.328.3800 1.800.777.5033 www.workforcesafety.com Pharmacy Benefit Management

More information

Oncology supportive medicine list formulary

Oncology supportive medicine list formulary Oncology supportive medicine list formulary Disclaimer The Bankmed Special Care Oncology Programme is governed by the Bankmed Medical Scheme Rules. The use of the benefits and programmes associated with

More information

12.5mg, 25mg, 50mg. 25mg, 50mg. 2.5mg, 5mg, 10mg. 5mg, 10mg, 20mg, 100mg. 25mg. -- $2.81 Acetazolamide (IR, 125mg, 250mg, 500mg (ER)

12.5mg, 25mg, 50mg. 25mg, 50mg. 2.5mg, 5mg, 10mg. 5mg, 10mg, 20mg, 100mg. 25mg. -- $2.81 Acetazolamide (IR, 125mg, 250mg, 500mg (ER) MEDICATION COVERAGE POLICY PHARMACY AND THERAPEUTICS ADVISORY COMMITTEE POLICY: Blood Pressure P&T DATE: 5/9/2017 THERAPEUTIC CLASS: Cardiovascular Disorders REVIEW HISTORY: 9/15, 2/13, 2/08, 5/07 LOB

More information

2019 STEP THERAPY CRITERIA UCare Individual & Family Plans UCare Individual & Family Plans with Fairview

2019 STEP THERAPY CRITERIA UCare Individual & Family Plans UCare Individual & Family Plans with Fairview 2019 STEP THERAPY CRITERIA UCare Individual & Family Plans UCare Individual & Family Plans with Fairview In some cases, UCare requires you to first try certain drugs to treat your medical condition before

More information

A Visual Approach to Simplifying Respiratory Drug Regimens

A Visual Approach to Simplifying Respiratory Drug Regimens Adverse Effects of Inhaled Medications A Visual Approach to Simplifying Respiratory Drug Regimens Stephanie Cheng, PharmD, MPH, BCGP June 28, 2017 Drug Category Beta 2 agonists antagonists Adverse Effects

More information

A Visual Approach to Simplifying Respiratory Drug Regimens

A Visual Approach to Simplifying Respiratory Drug Regimens A Visual Approach to Simplifying Respiratory Drug Regimens Stephanie Cheng, PharmD, MPH, BCGP October 23, 2017 Learning Objectives Be able to list at least 3 major adverse effects of inhaled medications

More information

Chapter 2 ~ Cardiovascular system

Chapter 2 ~ Cardiovascular system Chapter 2 ~ Cardiovascular System: General Section 1 of 6 Chapter 2 ~ Cardiovascular system 2.1 Positive inotropic drugs 2.1.1 Cardiac glycosides DIGOXIN 2.2 Diuretics Elixir 50micrograms in 1ml Injection

More information

Lisinopril 20 converting to losartan

Lisinopril 20 converting to losartan Search Lisinopril 20 converting to losartan Stop wasting your time with unanswered searches. lisinopril 40 mg to losartan conversion,cannot Find low price Best. Winds SSW at 10 to 20. Lisinopril 20 to

More information

ASEBP and ARTA TARP Drugs and Reference Price by Categories

ASEBP and ARTA TARP Drugs and Reference Price by Categories ASEBP Pantoprazole Sodium 40 mg (generic) $0.2016 ASEBP Dexlansoprazole 30 mg Dexlansoprazole 60 mg Esomeprazole 10 mg Esomeprazole 20 mg Esomeprazole 40 mg Lansoprazole 15 mg Lansoprazole 30 mg Omeprazole

More information

Formulary Item Restrictions and/or Advice Site availability

Formulary Item Restrictions and/or Advice Site availability Formulary Item Restrictions and/or Advice Site availability C&W CNWL Typical Antipsychotic drugs Chlorpromazine 25mg Chlorpromazine 50mg Chlorpromazine 100mg Chlorpromazine 25mg/5ml syrup Chlorpromazine

More information

APPENDIX 1 Printable point-of-care tables Asthma Action Plan Yellow Zone Formulation Table Region: Europe

APPENDIX 1 Printable point-of-care tables Asthma Action Plan Yellow Zone Formulation Table Region: Europe APPENDIX 1 Printable point-of-care tables Asthma Action Plan Yellow Zone Formulation Table Region: Europe Instructions: Print on 8.5 x14 (216 x 279 mm) paper (Legal size) Medication in Green Zone Change

More information

TREATMENT OF HYPERTENSION

TREATMENT OF HYPERTENSION TREATMENT OF HYPERTENSION Aim of treatment BP Goals Main items of treatment Lifestyle modification When to start drug Rx Pharmacological therapy 1. Relief of symptoms 2. Prevention of complications and

More information

ALAMEDA COUNTY BEHAVIORAL HEALTH CARE SERVICES MEDICATION FORMULARY

ALAMEDA COUNTY BEHAVIORAL HEALTH CARE SERVICES MEDICATION FORMULARY ANTIDEPRESSANTS Serotonin Selective Reuptake Inhibitors citalopram 10, 20, 40 mg, 10 mg/5cc $ 0.40 No escitalopram 10, 20 mg $ 2.60 Yes fluoxetine 10, 20 mg, 20 mg/5 ml $ 0.40 Yes fluvoxamine 25, 50, 100

More information

THERAPEUTIC AREA NAME STRENGTH DOSAGE FORM

THERAPEUTIC AREA NAME STRENGTH DOSAGE FORM Value Based Tier Drugs are selected for the management of Asthma, Diabetes, Hypertension and Hyperlipidemia. These drugs are covered at no charge or at a reduced cost share. Medications are under continual

More information

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) TREATMENT GUIDELINES

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) TREATMENT GUIDELINES CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) TREATMENT GUIDELINES Document Description Document Type Service Application Version Guidelines All healthcare professionals(hcps) caring for patients with asthma

More information

Relative Cost/Month. Less than $10. Loratadine Liquid* $10-$15 Cetirizine liquid 1mg/mL*

Relative Cost/Month. Less than $10. Loratadine Liquid* $10-$15 Cetirizine liquid 1mg/mL* Allergy Chlorpheniramine Tablet* Diphenhydramine Tablet* Diphenhydramine Liquid* Loratadine Tablet* Cetirizine Tablet* Loratadine 10mg ODT* Less than $10 Loratadine Liquid* $10-$15 Cetirizine liquid 1mg/mL*

More information

Prescription Drug List Effective January 1, 2017 Oxford Connecticut Four-Tier

Prescription Drug List Effective January 1, 2017 Oxford Connecticut Four-Tier Your 2017 Prescription Drug List Effective January 1, 2017 Oxford Connecticut Four-Tier Please read: This document contains information about commonly prescribed medications. This Prescription Drug List

More information

THERAPEUTIC AREA NAME STRENGTH DOSAGE FORM

THERAPEUTIC AREA NAME STRENGTH DOSAGE FORM Value Based Tier Drugs are selected for the management of Asthma, Diabetes, Hypertension and Hyperlipidemia. These drugs are covered at no charge or at a reduced cost share. Medications are under continual

More information

Blue Cross KeyRx TK Preventive RX Pack Drug List Large Group Effective January 1, 2019

Blue Cross KeyRx TK Preventive RX Pack Drug List Large Group Effective January 1, 2019 Blue Cross KeyRx TK Preventive RX Pack Drug List Large Group Effective January 1, 2019 Your employer may have elected to include the KeyRx Turn-Key Preventive Pack Drug List in your benefit plan. Below

More information

Medicine Related Falls Risk Assessment Tool (MrFRAT) User Guide for Age Related Residential Care Facility Staff in Hawke s Bay

Medicine Related Falls Risk Assessment Tool (MrFRAT) User Guide for Age Related Residential Care Facility Staff in Hawke s Bay Medicine Related Falls Risk Assessment Tool (MrFRAT) User Guide for Age Related Residential Care Facility Staff in Hawke s Bay (Revised edition November 2015) The Medicine Related Falls Risk Assessment

More information

Guide to Inhaled Treatment Choices

Guide to Inhaled Treatment Choices Guide to Inhaled Treatment Choices Note: this is guidance only, it is important to consider which device is best suited to the patient. This may NOT be the first line choice (but should be on the joint

More information

Better Living with Obstructive Pulmonary Disease A Patient Guide

Better Living with Obstructive Pulmonary Disease A Patient Guide Better Living with Obstructive Pulmonary Disease A Patient Guide Second Edition November 2012 Queensland Health a Better Living with Chronic Obstructive Pulmonary Disease A Patient Guide is a joint project

More information

Guide to Inhaled Treatment Choices

Guide to Inhaled Treatment Choices Guide to Inhaled Treatment Choices Note: this is guidance only, it is important to consider which device is best suited to the patient. This may NOT be the first line choice (but should be on the joint

More information

DT Description Price Category Price change Percentage BNF 1.2 Mebeverine 135mg tablets (100) 759 M %

DT Description Price Category Price change Percentage BNF 1.2 Mebeverine 135mg tablets (100) 759 M % June 2016 On 13th May, the DH announced that there would be reductions to Category M prices from June until September. http://psnc.org.uk/our-news/contractor-notice-category-m-price-reduction/ This has

More information

ATYPICAL ANTIPSYCHOTICS

ATYPICAL ANTIPSYCHOTICS Step Therapy CareOregon 2018 Last Updated: 07/27/2018 ATYPICAL ANTIPSYCHOTICS Fanapt Fanapt Titration Pack Paliperidone Er Vraylar The following criteria applies to members who newly start on the drug:

More information

Living with Congestive Heart Failure: A Guide to a Healthy Heart

Living with Congestive Heart Failure: A Guide to a Healthy Heart Living with Congestive Heart Failure: A Guide to a Healthy Heart Things to Know, Before You Go Dear Patient/Caregiver These are the things you NEED TO KNOW, BEFORE YOU GO. It is very important that you

More information

12.5mg, 25mg, 50mg. 25mg, 50mg. 250mg, 500mg, 250mg/5ml. 2.5mg, 5mg, 10mg. 5mg, 10mg, 20mg, 100mg. 25mg

12.5mg, 25mg, 50mg. 25mg, 50mg. 250mg, 500mg, 250mg/5ml. 2.5mg, 5mg, 10mg. 5mg, 10mg, 20mg, 100mg. 25mg MEDICATION COVERAGE POLICY PHARMACY AND THERAPEUTICS ADVISORY COMMITTEE POLICY: Blood Pressure P&T DATE: 9/11/2018 THERAPEUTIC CLASS: Cardiovascular Disorders REVIEW HISTORY: 5/17, 9/15, 2/13, 2/08, LOB

More information

Information in these slides is used with permission from St. Mary s Cardiac Rehab

Information in these slides is used with permission from St. Mary s Cardiac Rehab Information in these slides is used with permission from St. Mary s Cardiac Rehab Prescription Pointers Heart Medications Questions!! 2-4% of patients who visit ER s have experienced a medication misadventure

More information

12:00 Autonomic Drugs 12:00. Autonomic Drugs

12:00 Autonomic Drugs 12:00. Autonomic Drugs Autonomic Drugs Autonomic Drugs 12:04 PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS PILOCARPINE HCL 5 MG ORAL TABLET 00002216345 SALAGEN 1.4298 PYRIDOSTIGMINE BROMIDE 60 MG ORAL TABLET 00000869961 MESTINON

More information

Diagnosis and Management of Asthma

Diagnosis and Management of Asthma Supporting Evidence: Diagnosis and Management of Asthma The subdivision of this section is: Appendix B Tables Copyright 2016 by 1 Eleventh Edition/December 2016 Appendix B Asthma Summary Tables Class:

More information

Value-Based Drug List for ABCs of Diabetes

Value-Based Drug List for ABCs of Diabetes Effective January 1, 2019 Value-Based Drug List for ABCs of Diabetes PCPS provides a Value-Based Benefit Design (VBD) to qualified participants in the ABCs of Diabetes. This means you will have lower out-of-pocket

More information

ASTHMA PRESCRIBING GUIDELINES FOR ADULTS AND CHILDREN OVER 12

ASTHMA PRESCRIBING GUIDELINES FOR ADULTS AND CHILDREN OVER 12 North Hampshire CCG Asthma Prescribing Guidelines June 2015 ASTHMA PRESCRIBING GUIDELINES FOR ADULTS AND CHILDREN OVER 12 These guidelines are based on the British Thoracic Society (BTS) and Scottish Intercollegiate

More information

Annual Review of Antihypertensives - Fiscal Year 2009

Annual Review of Antihypertensives - Fiscal Year 2009 Annual Review of Antihypertensives - Fiscal Year 2009 Oklahoma HealthCare Authority April 2010 Current Prior Authorization Criteria There are 7 categories of antihypertensive medications currently included

More information

Medications and Children Disorders

Medications and Children Disorders Mental Health Comprehensive Services Providing Family Stability and Developing Life Coping Skills Medications and Children Disorders Psychiatric medications can be an effective part of the treatment for

More information

Dose. Route. Units. Given. Dose. Route. Units. Given

Dose. Route. Units. Given. Dose. Route. Units. Given Chapter 4 Respiratory Andrew Stanton SALBUTAMOL (in acute asthma) 5 in acute asthma Nebulised (driven by oxygen not air) 4 6 hourly In acute severe asthma not responding to initial treatment or in life-threatening

More information

Respiratory Inhalers. Identification Guide Version 3

Respiratory Inhalers. Identification Guide Version 3 Respiratory Inhalers Identification Guide Version 3 This booklet has been prepared by NHSGGC Medicines Information. Endorsed by NHSGGC Respiratory Managed Clinical Network, February 2017. Designed by Medical

More information

Strategies to improve blood pressure control and cardiovascular outcomes in hypertensive patients

Strategies to improve blood pressure control and cardiovascular outcomes in hypertensive patients Strategies to improve blood pressure control and cardiovascular outcomes in hypertensive patients Alexia Carboni, BPharm Elsabé van der Merwe, BPharm; MSc (Pharmacology) Abstract Hypertension is a major

More information