Step Therapy 2014 2 Tier-Alameda Last Updated: 10/10/2014 ANGIOTENSIN RECEPTOR BLOCKERS Benicar Benicar Hct Diovan Valsartan Step 1: First line therapy should be irbesartan, irbesartan/hctz, losartan, losartan/hctz, or valsartan/hctz. Step 2: Second line therapy should be Benicar or Benicar HCT. Step 3: Once irbesartan or irbesartan/hctz or losartan or losartan/hctz or valsartan/hctz and Benicar or Benicar HCT have been tried, patients can receive therapy with Diovan or Valsartan. 1
AZILECT Azilect Step 1: First line therapy should be selegiline tablets or capsules. Step 2: Once selegiline tablets or capsules have been tried, patients can receive therapy with Azilect. 2
CALCIUM CHANNEL BLOCKERS Afeditab Cr Isradipine Nifedical XL Nifedipine Er Step 1: First line therapy should be felodipine or amlodipine. Step 2: Once felodipine or amlodipine have been tried, patients can receive therapy with nifedipine ER or isradipine. 3
CRESTOR Crestor TABS 10MG, 20MG, 5MG Step 1: First line therapy should be atorvastatin. Step 2: Once atorvastatin has been tried, patients can receive therapy with Crestor. 4
EPLERENONE Eplerenone Step 1: First line therapy should be spironolactone or spironolactone/hctz. Step 2: Once spironolactone or spironolactone/hctz have been tried, patients can receive therapy with eplerenone. 5
HYPOGLYCEMICS Acarbose Actoplus Met Xr Avandamet Avandaryl Avandia Janumet Janumet Xr Januvia Jentadueto Kombiglyze Xr Nateglinide Onglyza Pioglitazone Hcl Pioglitazone Hcl/metformin Hcl Pioglitazone Hcl-glimepiride Prandin Repaglinide Tradjenta Step 1: First line therapy should be a formulary sulfonylurea, metformin, or formulary insulin (if appropriate). Step 2: Once one of these agents has been tried, patients can receive therapy with other formulary hypoglycemics such as Actoplus Met XR, Avandamet, Avandaryl, Avandia, Acarbose, Januvia, Janumet, Janumet XR, Onglyza, Prandin, repaglinide, nateglinide, Kombiglyze XR, pioglitazone, pioglitazone/metformin, pioglitazone/glimepiride, Tradjenta, and Jentadueto. 6
OPHTHALMIC ANTIHISTAMINES Azelastine Hcl OPHTHALMIC SOLN 0.05% Epinastine Hcl Pataday Patanol Step 1: First line therapy should be Zaditor OTC, ketotifen OTC or Alaway OTC. Step 2: Second line therapy should be Patanol or Pataday. Step 3: Once Patanol or Pataday has been tried, patients can receive therapy with other formulary prescription ophthalmic antihistamines such as azelastine and epinastine. 7
PROTON PUMP INHIBITORS Dexilant Lansoprazole CPDR Step 1: First line therapy should be Omeprazole or pantoprazole. Step 2: Second line should be lansoprazole or Dexilant. 8
TOPICAL IMMUNOMODULATORS Elidel Protopic Step 1: First line therapy should be trial of 2 formulary topical corticosteroids. Step 2: Once two of these agents have been tried, patients can receive therapy with Elidel or Protopic. 9
INDEX A Acarbose... 6 Actoplus Met Xr... 6 Afeditab Cr... 3 Angiotensin Receptor Blockers... 1 Avandamet... 6 Avandaryl... 6 Avandia... 6 Azelastine Hcl... 7 Azilect... 2 B Benicar... 1 Benicar Hct... 1 C Calcium Channel Blockers... 3 Crestor... 4 D Dexilant... 8 Diovan... 1 E Elidel... 9 Epinastine Hcl... 7 Eplerenone... 5 H Hypoglycemics... 6 I Isradipine... 3 J Janumet... 6 Janumet Xr... 6 Januvia... 6 Jentadueto...6 K Kombiglyze Xr...6 L Lansoprazole...8 N Nateglinide...6 Nifedical XL...3 Nifedipine Er...3 O Onglyza...6 Ophthalmic Antihistamines...7 P Pataday...7 Patanol...7 Pioglitazone Hcl...6 Pioglitazone Hcl/metformin Hcl...6 Pioglitazone Hcl-glimepiride...6 Prandin...6 Proton Pump Inhibitors...8 Protopic...9 R Repaglinide...6 T Topical Immunomodulators...9 Tradjenta...6 V Valsartan...1 10