Step Therapy Group Algorithm Steps
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- Kristopher Owens
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1 Step Therapy Group Algorithm Steps ACTONEL AMITIZA ANTICONVULSANT ANTIDEPRESSION Previous trial on alendronate Step 1: ALENDRONATE SODIUM Step 2: RISEDRONATE SODIUM, RISEDRONATE SODIUM DR Previous trial on Linzess OR Step 1: LINZESS, MOVANTIK Step 2: AMITIZA Movantik "Previous trial on at least TWO of the following: carbamezapine, divalproex, epitol, ethosuximide, felbamate, lamotrigine, levetiracetam, oxcarbazepine, phenytoin, tiagabine, topiramate, valproic acid, zonisamide" Step 2: APTIOM, BRIVIACT, POTIGA, SPRITAM "Previous trial on at least TWO of the following: bupropion, citalopram, escitalopram, fluoxetine, fluvoxamine, maprotiline, mirtazapine, paroxetine, sertraline, venlafaxine" Step 1: CARBAMAZEPINE, CARBAMAZEPINE ER, DILANTIN, DILANTIN-125, DIVALPROEX SODIUM, DIVALPROEX SODIUM ER, EPITOL, ETHOSUXIMIDE, FELBAMATE, LAMOTRIGINE, LAMOTRIGINE ER, LEVETIRACETAM, LEVETIRACETAM ER, LEVETIRACETAM-NACL, OXCARBAZEPINE, PHENYTEK, PHENYTOIN, PHENYTOIN SODIUM EXTENDED, TIAGABINE HCL, TOPIRAMATE, VALPROATE SODIUM, VALPROIC ACID, ZONISAMIDE Step 1: BUPROPION HCL, BUPROPION HCL SR, BUPROPION XL, CITALOPRAM HBR, ESCITALOPRAM OXALATE, FLUOXETINE DR, FLUOXETINE HCL, FLUVOXAMINE MALEATE, FLUVOXAMINE MALEATE ER, MAPROTILINE HCL, MIRTAZAPINE, PAROXETINE ER, PAROXETINE HCL, SERTRALINE HCL, VENLAFAXINE HCL, VENLAFAXINE HCL ER Step 2: FETZIMA, KHEDEZLA, TRINTELLIX 1
2 Step 1: CLOZAPINE, HALOPERIDOL, OLANZAPINE, OLANZAPINE ODT, Previous trial on at least ONE of the OLANZAPINE-FLUOXETINE HCL, QUETIAPINE FUMARATE, RISPERIDONE, following: clozapine, fluoxetineolanzapine, haloperidol, olanzapine, ANTIPSYCHOTIC RISPERIDONE ODT, ZIPRASIDONE HCL Step 2: ARIPIPRAZOLE, ARIPIPRAZOLE ODT, ARISTADA, FANAPT, LATUDA, PALIPERIDONE ER, quetiapine, risperidone, ziprasidone SAPHRIS ASTHMA Previous trial on Symbicort Step 1: SYMBICORT Step 2: ADVAIR DISKUS, ADVAIR HFA, BREO ELLIPTA CADUET CELEBREX the following: atorvastatin, lovastatin, pravastatin, simvastatin AND previous trial on amlodipine" previous trial on at least ONE NSAID Step 1: AMLODIPINE BESYLATE, ATORVASTATIN CALCIUM, LOVASTATIN, PRAVASTATIN SODIUM, SIMVASTATIN Step 2: AMLODIPINE- ATORVASTATIN Step 1: DICLOFENAC POTASSIUM, DICLOFENAC SODIUM, DICLOFENAC SODIUM ER, ETODOLAC, ETODOLAC ER, FENOPROFEN CALCIUM, FLURBIPROFEN, IBUPROFEN, KETOPROFEN, MELOXICAM, NABUMETONE, NAPRELAN, NAPROXEN, NAPROXEN SODIUM, NAPROXEN SODIUM CR, OXAPROZIN, PIROXICAM, SULINDAC Step 2: CELECOXIB 2
3 CORLANOR DEPRESSION DERM DEXILANT the following: acebutolol, atenolol, bisoprolol, labetolol, metoprolol, nadolol, pindolol, propranolol, timolol" Previous trial on at least ONE of the following: buproban, bupropion, citalopram, escitalopram, fluoxetine, fluvoxamine, maprotiline, mirtazapine, paroxetine, sertraline, venlafaxine the following: betamethasone, clobetasol, hydrocortisone, triamcinolone" the following: lansoprazole, omeprazole, pantoprazole" Step 1: ACEBUTOLOL HCL, ATENOLOL, BISOPROLOL FUMARATE, LABETALOL HCL, METOPROLOL SUCCINATE, METOPROLOL TARTRATE, NADOLOL, PINDOLOL, PROPRANOLOL HCL, PROPRANOLOL HCL ER, TIMOLOL MALEATE Step 2: CORLANOR Step 1: BUPROPION HCL, BUPROPION HCL SR, BUPROPION XL, CITALOPRAM HBR, ESCITALOPRAM OXALATE, FLUOXETINE DR, FLUOXETINE HCL, FLUVOXAMINE MALEATE, FLUVOXAMINE MALEATE ER, MAPROTILINE HCL, MIRTAZAPINE, PAROXETINE ER, PAROXETINE HCL, SERTRALINE HCL, VENLAFAXINE HCL, VENLAFAXINE HCL ER Step 2: APLENZIN, EMSAM, FORFIVO XL, PEXEVA, PRISTIQ ER, VIIBRYD Step 1: BETAMETHASONE DIPROPIONATE, BETAMETHASONE VALERATE, CLOBETASOL EMOLLIENT, CLOBETASOL PROPIONATE, HYDROCORTISONE, HYDROCORTISONE BUTYRATE, HYDROCORTISONE VALERATE, TRIAMCINOLONE ACETONIDE Step 2: ELIDEL, TACROLIMUS Step 1: LANSOPRAZOLE, OMEPRAZOLE, PANTOPRAZOLE SODIUM Step 2: DEXILANT 3
4 DIABETES DPP IV ELLIPTA EPLERENONE "Previous trial on metformin AND at least ONE of the following: acarbose, Actoplus Met XR, Step 1: ACARBOSE, ACTOPLUS MET XR, ALOGLIPTIN, ALOGLIPTINalogliptin, alogliptin-metformin, METFORMIN, ALOGLIPTIN-PIOGLITAZONE, AVANDIA, GLIMEPIRIDE, alogliptin-pioglitasone, Avandia, GLIPIZIDE, GLIPIZIDE ER, GLIPIZIDE-METFORMIN, GLUMETZA, GLYSET, glimepiride, glimepiridepioglitazone, glipizide, glipizide- KAZANO, KOMBIGLYZE XR, METFORMIN HCL, METFORMIN HCL ER, JANUMET, JANUMET XR, JANUVIA, JENTADUETO, JENTADUETO XR, metformin, Glumetza, Glyset, MIGLITOL, NATEGLINIDE, NESINA, ONGLYZA, OSENI, PIOGLITAZONE HCL, Janumet, Januvia, Jentadueto, PIOGLITAZONE-GLIMEPIRIDE, PIOGLITAZONE-METFORMIN, Kazano, Kombiglyze, metformin, REPAGLINIDE, REPAGLINIDE-METFORMIN HCL, RIOMET, TOLAZAMIDE, metformin-pioglitazone, miglitol, TOLBUTAMIDE, TRADJENTA Step 2: BYDUREON, BYDUREON PEN, nateglinide, Nesina, Onglyza, BYETTA, FARXIGA, GLYXAMBI, INVOKAMET, INVOKANA, JARDIANCE, Oseni, pioglitazone, repaglinide, SYNJARDY, TANZEUM, TRULICITY, VICTOZA 3-PAK repaglinide-metformin, Riomet, tolazamide, tolbutamide, Tradjenta" the following: alogliptin, alogliptinmetformin, alogliptin-pioglitasone, Kasano, Nesina, Osenia AND at least ONE of the following: Jentadueto, Tradjenta" Previous trial on Spiriva OR Tudorza the following: spironolactone, spironolactone-hctz" Step 1: ALOGLIPTIN, ALOGLIPTIN-METFORMIN, ALOGLIPTIN- PIOGLITAZONE, JENTADUETO, JENTADUETO XR, KAZANO, NESINA, OSENI, TRADJENTA Step 2: JANUMET, JANUMET XR, JANUVIA, KOMBIGLYZE XR, ONGLYZA Step 1: SPIRIVA, SPIRIVA RESPIMAT, TUDORZA PRESSAIR Step 2: ANORO ELLIPTA, INCRUSE ELLIPTA Step 1: SPIRONOLACTONE, SPIRONOLACTONE-HCTZ Step 2: EPLERENONE 4
5 EXALGO GABAPENTIN GASTRO KADIAN "Previous trial on at least TWO of the following: buprenorphine tablets, fentanyl patches, Kadian, levorphanol, methadone, morphine ER, oxycodone er, oxymorphone ER, Zohydro" Step 1: BUPRENORPHINE HCL, FENTANYL, HYDROMORPHONE ER, KADIAN, LEVORPHANOL TARTRATE, METHADONE HCL, MORPHINE SULFATE ER, OXYCODONE HCL ER, OXYMORPHONE HCL ER, ZOHYDRO ER Step 2: HYDROMORPHONE ER Previous trial on generic gabapentin Step 1: GABAPENTIN, PRAMIPEXOLE DIHYDROCHLORIDE Step 2: GRALISE, OR pramipexole HORIZANT Step 1: APRISO, BALSALAZIDE DISODIUM, CANASA, PENTASA, the following: Apriso, balsalazide, SULFASALAZINE, SULFASALAZINE DR Step 2: ASACOL HD, DELZICOL Canasa, Pentasa, sulfasalazine" "Previous trial on at least TWO of the following: buprenorphine tablets, fentanyl patches, hydromorphone er, levorphanol, methadone, morphine ER, oxycodone er, oxymorphone ER, Zohydro" Step 1: BUPRENORPHINE HCL, FENTANYL, HYDROMORPHONE ER, LEVORPHANOL TARTRATE, METHADONE HCL, MORPHINE SULFATE ER, OXYCODONE HCL ER, OXYMORPHONE HCL ER, ZOHYDRO ER Step 2: KADIAN 5
6 LUNESTA OXYCONTIN PPI RANEXA Previous trial of Zolpidem or Step 1: ZALEPLON, ZOLPIDEM TARTRATE Step 2: ESZOPICLONE Zaleplon "Previous trial on at least TWO of the following: buprenorphine Step 1: BUPRENORPHINE HCL, FENTANYL, HYDROMORPHONE ER, KADIAN, tablets, fentanyl patches, LEVORPHANOL TARTRATE, METHADONE HCL, MORPHINE SULFATE ER, hydromorphone er, Kadian, OXYMORPHONE HCL ER, ZOHYDRO ER Step 2: OXYCODONE HCL ER levorphanol, methadone, morphine ER, oxymorphone ER, Zohydro" "Previous trial on at least TWO of Step 1: LANSOPRAZOLE, MISOPROSTOL, OMEPRAZOLE, PANTOPRAZOLE the following: lansoprazole, SODIUM Step 2: ESOMEPRAZOLE MAGNESIUM, NEXIUM, PREVACID, misoprostol, omeprazole, ZEGERID pantoprazole" Step 1: AMLODIPINE BESYLATE, ATENOLOL, DILTIAZEM 12HR ER, DILTIAZEM 24HR CD, DILTIAZEM 24HR ER, DILTIAZEM ER, DILTIAZEM the following: amlodipine, atenolol, HCL, ISORDIL, ISOSORBIDE DINITRATE, ISOSORBIDE MONONITRATE, diltiazem, isosorbide dinitrate, ISOSORBIDE MONONITRATE ER, METOPROLOL SUCCINATE, METOPROLOL isosorbide mononitrate, metoprolol, TARTRATE, PROPRANOLOL HCL, PROPRANOLOL HCL ER, VERAPAMIL ER, propranolol, verapamil" VERAPAMIL ER PM, VERAPAMIL HCL Step 2: RANEXA 6
7 RASUVO Previous trial on generic methotrexate Step 1: METHOTREXATE, METHOTREXATE SODIUM Step 2: RASUVO REXULTI Previous therapy on aripiprazole Step 1: ARIPIPRAZOLE, ARIPIPRAZOLE ODT Step 2: REXULTI RYTARY Previous trial on Step 1: CARBIDOPA-LEVODOPA, CARBIDOPA-LEVODOPA ER Step 2: carbidopa/levodopa RYTARY Previous trial on at least TWO of SA OPIOID the following: APAP/codeine, Step 1: ACETAMINOPHEN-CODEINE, CODEINE SULFATE, HYDROCODONEcodiene sulfate, ACETAMINOPHEN, HYDROCODONE-IBUPROFEN, HYDROMORPHONE HCL, hydrocodone/apap, MORPHINE SULFATE, OXYCODONE HCL, OXYCODONE HCL-ASPIRIN, hydrocodone/ibu, hydromorphone, OXYCODONE HCL-IBUPROFEN, OXYCODONE-ACETAMINOPHEN Step 2: morphine IR, oxycodone, OXYMORPHONE HCL oxycodone/apap, oxycodone/asa, oxycodone/ibu 7
8 SEEBRI STATIN SYMLIN TEKTURNA Previous trial on Spiriva AND Tudorza the following: atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin" Previous trial on insulin the following: benazepril, benazepril-hctz, captopril, captopril-hctz, enalapril, enalapril-hctz, fosinopril, fosinopril-hctz, lisinopril, lisinopril-hctz, quinapril, quinapril-hctz, ramipril AND previous trial on at least ONE of the following: Benicar, Benicar HCT, candesartan, candesartan-hctz, Edarbi, eprosartan, irbesartan, irbesartan-hctz, losartan, losartan- HCTZ, telmisartan, telmisartan- HCTZ, valsartan, valsartan-hctz" Step 1: SPIRIVA, SPIRIVA RESPIMAT, TUDORZA PRESSAIR Step 2: SEEBRI NEOHALER Step 1: ATORVASTATIN CALCIUM, FLUVASTATIN SODIUM, LOVASTATIN, PRAVASTATIN SODIUM, SIMVASTATIN Step 2: LIVALO Step 1: LANTUS, LANTUS SOLOSTAR, LEVEMIR, LEVEMIR FLEXTOUCH, NOVOLIN 70-30, NOVOLIN N, NOVOLIN R, NOVOLOG, NOVOLOG FLEXPEN, NOVOLOG MIX 70-30, NOVOLOG MIX FLEXPEN, TOUJEO SOLOSTAR Step 2: SYMLINPEN 120, SYMLINPEN 60 Step 1: BENAZEPRIL HCL, BENAZEPRIL-HYDROCHLOROTHIAZIDE, BENICAR, BENICAR HCT, CANDESARTAN CILEXETIL, CANDESARTAN- HYDROCHLOROTHIAZID, CAPTOPRIL, CAPTOPRIL- HYDROCHLOROTHIAZIDE, EDARBI, ENALAPRIL MALEATE, ENALAPRIL- HYDROCHLOROTHIAZIDE, EPROSARTAN MESYLATE, FOSINOPRIL SODIUM, FOSINOPRIL-HYDROCHLOROTHIAZIDE, IRBESARTAN, IRBESARTAN-HYDROCHLOROTHIAZIDE, LISINOPRIL, LISINOPRIL- HYDROCHLOROTHIAZIDE, LOSARTAN POTASSIUM, LOSARTAN- HYDROCHLOROTHIAZIDE, QUINAPRIL HCL, QUINAPRIL- HYDROCHLOROTHIAZIDE, RAMIPRIL, TELMISARTAN, TELMISARTAN- HYDROCHLOROTHIAZID, VALSARTAN, VALSARTAN- HYDROCHLOROTHIAZIDE Step 2: TEKTURNA, TEKTURNA HCT 8
9 UCERIS FOAM the following: colocort enema, hydrocortisone enema, or Step 1: COLOCORT, HYDROCORTISONE, MESALAMINE Step 2: UCERIS mesalamine enema" UCERIS TAB Previous trial on budesonide Step 1: BUDESONIDE EC Step 2: UCERIS ULORIC Previous trial on allopurinol Step 1: ALLOPURINOL Step 2: ULORIC UTIBRON Previous trial on Spiriva OR Tudorza AND Stiolto Step 1: SPIRIVA, SPIRIVA RESPIMAT, STIOLTO RESPIMAT, TUDORZA PRESSAIR Step 2: UTIBRON NEOHALER 9
10 VELPHORO VELTASSA VIMOVO VRAYLAR ZOHYDRO Previous trial on Renagel OR Renvela Previous trial on sodium polystyrene sulfonate the following: Dexilant, esomeprazole, lansoprazole, Nexium, omeprazole, pantoprazole, Prevacid Solutabs, rabeprazole AND previous trial on at least ONE of the following: celecoxib, diclofenac, etodolac, fenoprofen, flurbiprofen, ibuprofen, ketoprofen, meloxicam, nabumetone, naprelan, naproxen, oxaprozin, piroxicam, sulindac" "Previous trial on aripiprazole AND at least ONE of the following: clozapine, fluoxetine-olanzapine, haloperidol, olanzapine, quetiapine, risperidone, ziprasidone" "Previous trial on at least TWO of the following: buprenorphine tablets, fentanyl patches, hydromorphone er, levorphanol, methadone, morphine ER, oxycodone er, oxymorphone ER" Step 1: RENAGEL, RENVELA Step 2: AURYXIA, VELPHORO Step 1: SODIUM POLYSTYRENE SULFONATE Step 2: VELTASSA Step 1: CELECOXIB, DEXILANT, DICLOFENAC POTASSIUM, DICLOFENAC SODIUM, DICLOFENAC SODIUM ER, ESOMEPRAZOLE MAGNESIUM, ETODOLAC, ETODOLAC ER, FENOPROFEN CALCIUM, FLURBIPROFEN, IBUPROFEN, KETOPROFEN, LANSOPRAZOLE, MELOXICAM, NABUMETONE, NAPRELAN, NAPROXEN, NAPROXEN SODIUM, NAPROXEN SODIUM CR, NEXIUM, OMEPRAZOLE, OXAPROZIN, PANTOPRAZOLE SODIUM, PIROXICAM, PREVACID, RABEPRAZOLE SODIUM, SULINDAC Step 2: VIMOVO Step 1: ARIPIPRAZOLE, ARIPIPRAZOLE ODT, CLOZAPINE, HALOPERIDOL, OLANZAPINE, OLANZAPINE ODT, OLANZAPINE-FLUOXETINE HCL, QUETIAPINE FUMARATE, RISPERIDONE, RISPERIDONE ODT, ZIPRASIDONE HCL Step 2: VRAYLAR Step 1: BUPRENORPHINE HCL, FENTANYL, HYDROMORPHONE ER, KADIAN, LEVORPHANOL TARTRATE, METHADONE HCL, MORPHINE SULFATE ER, OXYCODONE HCL ER, OXYMORPHONE HCL ER Step 2: ZOHYDRO ER 10
11 Index ACARBOSE... 4 ACEBUTOLOL HCL... 3 ACETAMINOPHEN-CODEINE... 7 ACTOPLUS MET XR... 4 ADVAIR DISKUS... 2 ADVAIR HFA... 2 ALENDRONATE SODIUM... 1 ALLOPURINOL... 9 ALOGLIPTIN... 4 ALOGLIPTIN-METFORMIN... 4 ALOGLIPTIN-PIOGLITAZONE... 4 AMITIZA... 1 AMLODIPINE BESYLATE... 2,6 AMLODIPINE-ATORVASTATIN... 2 ANORO ELLIPTA... 4 APLENZIN... 3 APRISO... 5 APTIOM... 1 ARIPIPRAZOLE... 2,7,10 ARIPIPRAZOLE ODT... 2,7,10 ARISTADA... 2 ASACOL HD... 5 ATENOLOL... 3,6 ATORVASTATIN CALCIUM... 2,8 AURYXIA AVANDIA... 4 BALSALAZIDE DISODIUM... 5 BENAZEPRIL HCL... 8 BENAZEPRIL-HYDROCHLOROTHIAZIDE... 8 BENICAR... 8 BENICAR HCT... 8 BETAMETHASONE DIPROPIONATE... 3 BETAMETHASONE VALERATE... 3 BISOPROLOL FUMARATE... 3 BREO ELLIPTA... 2 BRIVIACT... 1 BUDESONIDE EC... 9 BUPRENORPHINE HCL... 5,6,11 BUPROPION HCL... 1,3 BUPROPION HCL SR... 1,3 BUPROPION XL... 1,3 BYDUREON... 4 BYDUREON PEN... 4 BYETTA... 4 CANASA... 5 CANDESARTAN CILEXETIL... 8 CANDESARTAN-HYDROCHLOROTHIAZID... 8 CAPTOPRIL... 8 CAPTOPRIL-HYDROCHLOROTHIAZIDE... 8 CARBAMAZEPINE... 1 CARBAMAZEPINE ER... 1 CARBIDOPA-LEVODOPA... 7 CARBIDOPA-LEVODOPA ER... 7 CELECOXIB... 2,10 11
12 CITALOPRAM HBR... 1,3 CLOBETASOL EMOLLIENT... 3 CLOBETASOL PROPIONATE... 3 CLOZAPINE... 2,10 CODEINE SULFATE... 7 COLOCORT... 9 CORLANOR... 3 DELZICOL... 5 DEXILANT... 3,10 DICLOFENAC POTASSIUM... 2,10 DICLOFENAC SODIUM... 2,10 DICLOFENAC SODIUM ER... 2,10 DILANTIN... 1 DILANTIN DILTIAZEM 12HR ER... 6 DILTIAZEM 24HR CD... 6 DILTIAZEM 24HR ER... 6 DILTIAZEM ER... 6 DILTIAZEM HCL... 6 DIVALPROEX SODIUM... 1 DIVALPROEX SODIUM ER... 1 EDARBI... 8 ELIDEL... 3 EMSAM... 3 ENALAPRIL MALEATE... 8 ENALAPRIL-HYDROCHLOROTHIAZIDE... 8 EPITOL... 1 EPLERENONE... 4 EPROSARTAN MESYLATE... 8 ESCITALOPRAM OXALATE... 1,3 ESOMEPRAZOLE MAGNESIUM... 6,10 ESZOPICLONE... 6 ETHOSUXIMIDE... 1 ETODOLAC... 2,10 ETODOLAC ER... 2,10 FANAPT... 2 FARXIGA... 4 FELBAMATE... 1 FENOPROFEN CALCIUM... 2,10 FENTANYL... 5,6,11 FETZIMA... 1 FLUOXETINE DR... 1,3 FLUOXETINE HCL... 1,3 FLURBIPROFEN... 2,10 FLUVASTATIN SODIUM... 8 FLUVOXAMINE MALEATE... 1,3 FLUVOXAMINE MALEATE ER... 1,3 FORFIVO XL... 3 FOSINOPRIL SODIUM... 8 FOSINOPRIL-HYDROCHLOROTHIAZIDE... 8 GABAPENTIN... 5 GLIMEPIRIDE... 4 GLIPIZIDE... 4 GLIPIZIDE ER
13 GLIPIZIDE-METFORMIN... 4 GLUMETZA... 4 GLYSET... 4 GLYXAMBI... 4 GRALISE... 5 HALOPERIDOL... 2,10 HORIZANT... 5 HYDROCODONE-ACETAMINOPHEN... 7 HYDROCODONE-IBUPROFEN... 7 HYDROCORTISONE... 3,9 HYDROCORTISONE BUTYRATE... 3 HYDROCORTISONE VALERATE... 3 HYDROMORPHONE ER... 5,6,11 HYDROMORPHONE HCL... 7 IBUPROFEN... 2,10 INCRUSE ELLIPTA... 4 INVOKAMET... 4 INVOKANA... 4 IRBESARTAN... 8 IRBESARTAN-HYDROCHLOROTHIAZIDE... 8 ISORDIL... 6 ISOSORBIDE DINITRATE... 6 ISOSORBIDE MONONITRATE... 6 ISOSORBIDE MONONITRATE ER... 6 JANUMET... 4 JANUMET XR... 4 JANUVIA... 4 JARDIANCE... 4 JENTADUETO... 4 JENTADUETO XR... 4 KADIAN... 5,6,11 KAZANO... 4 KETOPROFEN... 2,10 KHEDEZLA... 1 KOMBIGLYZE XR... 4 LABETALOL HCL... 3 LAMOTRIGINE... 1 LAMOTRIGINE ER... 1 LANSOPRAZOLE... 3,6,10 LANTUS... 8 LANTUS SOLOSTAR... 8 LATUDA... 2 LEVEMIR... 8 LEVEMIR FLEXTOUCH... 8 LEVETIRACETAM... 1 LEVETIRACETAM ER... 1 LEVETIRACETAM-NACL... 1 LEVORPHANOL TARTRATE... 5,6,11 LINZESS... 1 LISINOPRIL... 8 LISINOPRIL-HYDROCHLOROTHIAZIDE... 8 LIVALO... 8 LOSARTAN POTASSIUM... 8 LOSARTAN-HYDROCHLOROTHIAZIDE
14 LOVASTATIN... 2,8 MAPROTILINE HCL... 1,3 MELOXICAM... 2,10 MESALAMINE... 9 METFORMIN HCL... 4 METFORMIN HCL ER... 4 METHADONE HCL... 5,6,11 METHOTREXATE... 7 METHOTREXATE SODIUM... 7 METOPROLOL SUCCINATE... 3,6 METOPROLOL TARTRATE... 3,6 MIGLITOL... 4 MIRTAZAPINE... 1,3 MISOPROSTOL... 6 MORPHINE SULFATE... 7 MORPHINE SULFATE ER... 5,6,11 MOVANTIK... 1 NABUMETONE... 2,10 NADOLOL... 3 NAPRELAN... 2,10 NAPROXEN... 2,10 NAPROXEN SODIUM... 2,10 NAPROXEN SODIUM CR... 2,10 NATEGLINIDE... 4 NESINA... 4 NEXIUM... 6,10 NOVOLIN NOVOLIN N... 8 NOVOLIN R... 8 NOVOLOG... 8 NOVOLOG FLEXPEN... 8 NOVOLOG MIX NOVOLOG MIX FLEXPEN... 8 OLANZAPINE... 2,10 OLANZAPINE ODT... 2,10 OLANZAPINE-FLUOXETINE HCL... 2,10 OMEPRAZOLE... 3,6,10 ONGLYZA... 4 OSENI... 4 OXAPROZIN... 2,10 OXCARBAZEPINE... 1 OXYCODONE HCL... 7 OXYCODONE HCL ER... 5,6,11 OXYCODONE HCL-ASPIRIN... 7 OXYCODONE HCL-IBUPROFEN... 7 OXYCODONE-ACETAMINOPHEN... 7 OXYMORPHONE HCL... 7 OXYMORPHONE HCL ER... 5,6,11 PALIPERIDONE ER... 2 PANTOPRAZOLE SODIUM... 3,6,10 PAROXETINE ER... 1,3 PAROXETINE HCL... 1,3 PENTASA... 5 PEXEVA
15 PHENYTEK... 1 PHENYTOIN... 1 PHENYTOIN SODIUM EXTENDED... 1 PINDOLOL... 3 PIOGLITAZONE HCL... 4 PIOGLITAZONE-GLIMEPIRIDE... 4 PIOGLITAZONE-METFORMIN... 4 PIROXICAM... 2,10 POTIGA... 1 PRAMIPEXOLE DIHYDROCHLORIDE... 5 PRAVASTATIN SODIUM... 2,8 PREVACID... 6,10 PRISTIQ ER... 3 PROPRANOLOL HCL... 3,6 PROPRANOLOL HCL ER... 3,6 QUETIAPINE FUMARATE... 2,10 QUINAPRIL HCL... 8 QUINAPRIL-HYDROCHLOROTHIAZIDE... 8 RABEPRAZOLE SODIUM RAMIPRIL... 8 RANEXA... 6 RASUVO... 7 RENAGEL RENVELA REPAGLINIDE... 4 REPAGLINIDE-METFORMIN HCL... 4 REXULTI... 7 RIOMET... 4 RISEDRONATE SODIUM... 1 RISEDRONATE SODIUM DR... 1 RISPERIDONE... 2,10 RISPERIDONE ODT... 2,10 RYTARY... 7 SAPHRIS... 2 SEEBRI NEOHALER... 8 SERTRALINE HCL... 1,3 SIMVASTATIN... 2,8 SODIUM POLYSTYRENE SULFONATE SPIRIVA... 4,8,9 SPIRIVA RESPIMAT... 4,8,9 SPIRONOLACTONE... 4 SPIRONOLACTONE-HCTZ... 4 SPRITAM... 1 STIOLTO RESPIMAT... 9 SULFASALAZINE... 5 SULFASALAZINE DR... 5 SULINDAC... 2,10 SYMBICORT... 2 SYMLINPEN SYMLINPEN SYNJARDY... 4 TACROLIMUS... 3 TANZEUM... 4 TEKTURNA
16 TEKTURNA HCT... 8 TELMISARTAN... 8 TELMISARTAN-HYDROCHLOROTHIAZID... 8 TIAGABINE HCL... 1 TIMOLOL MALEATE... 3 TOLAZAMIDE... 4 TOLBUTAMIDE... 4 TOPIRAMATE... 1 TOUJEO SOLOSTAR... 8 TRADJENTA... 4 TRIAMCINOLONE ACETONIDE... 3 TRINTELLIX... 1 TRULICITY... 4 TUDORZA PRESSAIR... 4,8,9 UCERIS... 9 ULORIC... 9 UTIBRON NEOHALER... 9 VALPROATE SODIUM... 1 VALPROIC ACID... 1 VALSARTAN... 8 VALSARTAN-HYDROCHLOROTHIAZIDE... 8 VELPHORO VELTASSA VENLAFAXINE HCL... 1,3 VENLAFAXINE HCL ER... 1,3 VERAPAMIL ER... 6 VERAPAMIL ER PM... 6 VERAPAMIL HCL... 6 VICTOZA 3-PAK... 4 VIIBRYD... 3 VIMOVO VRAYLAR ZALEPLON... 6 ZEGERID... 6 ZIPRASIDONE HCL... 2,10 ZOHYDRO ER... 5,6,10 ZOLPIDEM TARTRATE... 6 ZONISAMIDE
SelectHealth Advantage 2018 Step Therapy Criteria. Previous trial on at least ONE: Generic topical acne treatment. Previous trial on: alendronate
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