A
Adapalene (DIFFERIN) (Ages > 35)
Alglucerase (CEREDASE)
Alpha1-proteinase inhibitor (PROLASTIN)
Amlexanox (APHTHASOL)
Anakinera (KINERET)
Atorvastatin (LIPITOR)
Azelaic acid (AZELEX) (Ages > 35)
B
Becaplermin (REGRANEX gel)
C
Calcipotriene (DOVONEX)
Ciclopirox solution (PENLAC)
D
Darbepoetin (ARANESP)
Desmopressin (STIMATE)
Diazepam rectal gel (DIASTAT)
Dofetilide (TIKOSYN)
Donepezil (ARICEPT)
Dornase alfa (PULMOZYME)
E
Entacapone (COMTAN)
Epoetin alfa (EPOGEN, PROCRIT)
Epoprostenol (FLOLAN)
ESKALITH
Etanercept (ENBREL)
F
Fenofibrate (TRICOR brand only)
Filgrastim (NEUPOGEN)
Finasteride (PROSCAR)
Fluconazole (DIFLUCAN)
Fluticasone propionate/salmeterol inhalation powder (ADVAIR DISKUS)
Follitropin alfa (GONAL-F)
Fomivirsen (VITRAVENE)
G
Galantamine (REMINYL)
Ganciclovir (oral CYTOVENE)
Glatiramer (COPAXONE)
Goserelin (ZOLADEX)
H
Human growth hormone (Humatrope brand – all other brands excluded)
Hyaluronan injections (SYNVISC)
I
Imatinib mesylate (GLEEVEC)
Imiglucerase (CEREZYME)
Infliximab (REMICADE)
Insulin infusion pumps (NOVOPEN or equivalent)
Interferon (all types, including BETASERON, AVONEX, REBIF)
Itraconazole (SPORANOX)
L
Lansoprazole (PREVACID)
Leflunomide (ARAVA)
Leuprolide (LUPRON)
Levetiracetam (KEPPRA)
Losartan (COZAAR)
Losartan/hydrochlorothiazide (HYZAAR)
| M
Menotropins (HUMEGON, PERGONAL)
Modafinil (PROVIGIL)
N
Nafarelin (SYNAREL)
Naltrexone (REVIA)
Naratriptan tablets (AMERGE)
Nateglinide (STARLIX)
Norethindrone acetate/ethinyl estradiol (LOESTRIN, LOESTRIN FE)
Norethindrone/ethinyl estradiol (ESTROSTEP, ORTHO-NOVUM 7-7-7)
Norgestimate ethinyl estradiol
(ORTHO-CYCLEN, ORTHO TRI-CYCLEN)
O
Ofloxacin (FLOXIN)
Oprelvekin (NEUMEGA)
Oseltamivir (TAMIFLU)
Oxcarbazepine (TRILEPTAL)
P
Palivizumab (SYNAGIS)
Peginterferon alfa-2b (PEG-INTRON)
Pimecrolimus topical (ELIDEL)
Pioglitazone (ACTOS)
Progesterone gel (CRINONE)
R
Raloxifene (EVISTA)
Repaglinide (PRANDIN)
Rimantadine (FLUMADINE)
Rivastigmine (EXELON)
Rizatriptan (MAXALT, MAXALT MLT)
Rofecoxib (VIOXX)
Rosiglitazone (AVANDIA)
S
Sargramostim (all types)
Sumatriptan tablets (IMITREX)
T
Tacrolimus topical (PROTOPIC)
Tamsulosin (FLOMAX)
Tazarotene (TAZORAC)
Terbinafine oral (LAMISIL)
Testosterone 1% gel (ANDROGEL)
Thyrotropin alfa (THYROGEN)
Tizanidine (ZANAFLEX)
Tolcapone (TASMAR)
Topiramate (TOPAMAX)
Trastuzumab (HERCEPTIN)
Tretinoin (AVITA, RETIN-A) (Ages > 35)
U
Urofollitropin (FERTINEX, METRODIN)
V
Valsartan (DIOVAN)
Valsartan/hydrochlorothiazide (DIOVAN HCT)
Verteporfin (VISUDYNE)
Voriconazole (VFEND)
Z
Zolpidem (AMBIEN)
Zonisamide (ZONEGRAN)
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