Report ADDITIONS: Product Brand Agents: Indication. Subcategory. Generic Agents: Gastrointestinal/ Antiemetics
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1 This report highlights all changes (additions and deletions) to the CVS Caremark Performance Drug List. ADDITIONS: Brand Agents: Diclegis (doxylamine/ pyridoxine delayed release) Gastrointestinal/ Antiemetics Diclegis is indicated for the treatment of nausea and vomiting of pregnancy in women who do not respond to conservative management. To providee the only therapy option that is U.S. Food and Drug Administration (FDA)-approved for treatment of nausea and vomiting of pregnancy. Generic Agents: lactulose Gastrointestinal/ Laxatives Lactulose is indicated: For the treatment of constipation. Solution only: For the prevention and treatment of portal-systemic encephalopathy, including the stages of hepatic precoma and coma. To providee an additional generic therapy option. niacin extended release Cardiovascular/ Antilipemics/ Niacins/Combinations Niacin extended-release is indicated: To reduce elevated total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), The A -rated generic niacin extended release will replace the branded agent Niaspan (niacin extended release) on the Performance Drug List. Pg. 1 of 6
2 apolipoprotein B (Apo B) and triglycerides (TG), and to increase high-density lipoprotein cholesterol (HDL-C) in patients with primary hyperlipidemia and mixed dyslipidemia. In combination with simvastatin or lovastatin: to treat primary hyperlipidemia and mixed dyslipidemia when treatment with Niaspan, simvastatin or lovastatin monotherapy is considered inadequate. To reduce the risk of recurrent nonfatal myocardial infarction in myocardial infarction and In combination with a bile acid binding resin: o Slows progression or promotes regression of atherosclerotic disease in coronary artery disease and o As an adjunct to diet to reduce elevated TC and Pg. 2 of 6
3 LDL-C in adult patients with primary To reduce TG in adult patients with severe hypertriglyceridemia. travoprost 0.004% Topical/ Ophthalmic/Prostaglandins Travoprost is indicated for the reduction of elevated intraocular pressure in patients with open angle glaucoma or ocular hypertension. To providee an additional generic therapy option. DELETIONS: Brand Agents: Loestrin 24 Fe (norethindrone acetate/ethinyl estradiol 1/20 and iron) Endocrine and Metabolic/ Contraceptives/Monophasic Loestrin 24 Fe is indicated for the prevention of pregnancy in women who elect to use oral contraceptives as a method of contraception. Loestrin 24 Fe has been discontinued by the manufacturer. Alternatives on the Performance Drug List include Lo Loestrin Fe (norethindronee acetate/ethinyl estradiol 1/10 and ethinyl estradiol 10) and Minastrin 24 Fe (norethindrone acetate/ethinyl estradiol 1/20 and iron) Pg. 3 of 6
4 Niaspan (niacin extended release Cardiovascular/ Antilipemics/ Niacins/Combinations Niaspan is indicated: To reduce elevated TC, LDL-C, Apo B and TG, and to increasee HDL-C in patients with primary hyperlipidemia and mixed dyslipidemia. In combination with simvastatin or lovastatin: to treat primary hyperlipidemia and mixed dyslipidemia when treatment with Niaspan, simvastatin or lovastatin monotherapy is considered inadequate. To reduce the risk of recurrent nonfatal myocardial infarction in myocardial infarction and In combination with a bile acid binding resin: o Slows progression or promotes regression of atherosclerotic disease in coronary artery disease and o As an adjunct to diet to chewable. Niaspan (niacin extended release) will be replaced on the Performance Drug List by the A -rated generic niacin extended release. Pg. 4 of 6
5 reduce elevated TC and LDL-C in adult patients with primary To reduce TG in adult patients with severe hypertriglyceridemia. Oxistat (oxiconazole) Topical/ Dermatology/ Antifungals Oxistat Cream and Lotion are indicated for the topical treatment of the following dermal infections: tinea pedis, tinea cruris and tinea corporis due to susceptible organisms. Availabilityy of other therapy options that are indicated for topical treatment of fungal dermal infections. Alternatives on the Performance Drug List include topical formulations of ciclopirox, clotrimazole, econazole, ketoconazole, nystatin and Mentax (butenafine). Oxistat Cream is indicated for the topical treatment of tinea (pityriasis) versicolor due to susceptible organism. Tobradex suspension (tobramycin/ dexamethasone) 0.3%/0.1% suspension Topical/ Ophthalmic/ Anti-infective/Anti- inflammatory Combinations Tobradex suspension is indicated for steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where superficial bacterial ocular infection or a risk of bacterial ocular infection exists. Tobradex (tobramycin/dexamethasone) 0.3%/0.1% suspension is being removed from the Performance Drug List due too the availability of an A -rated generic, tobramycin/dexamethasone. The listingg for Tobradex will change to Tobradex ointment. Tobradex (tobramycin/dexamethasone) 0.3%/0.1% % ointment remains on the Performance Drug Pg. 5 of 6
6 List. Pg. 6 of 6
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