A
Adapalene (DIFFERIN)
(Ages > 35)
Alglucerase (CEREDASE)
Alpha1-proteinase inhibitor (PROLASTIN)
Amlexanox (APHTHASOL)
Atorvastatin (LIPITOR)
Azelaic acid (AZELEX)
(Ages > 35)
B
Becaplermin (REGRANEX gel)
C
Calcipotriene (DOVONEX)
Ciclopirox solution (PENLAC)
CONCETA
D
Desmopressin (STIMATE)
Diazepam rectal gel (DIASTAT)
Dofetilide (TIKOSYN)
Donepezil (ARICEPT)
Dornase alfa (PULMOZYME)
E
Entacapone (COMTAN)
Epoetin alpha (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 (all types)
Hyaluronan injections (SYNVISC)
I
Imatinib mesylate (GLEEVAC)
Imiglucerase (CEREZYME)
Infliximab (REMICADE)
Insulin infusion pumps (NOVOPEN or equivalent)
Interferon (all types, including ETASERON, AVONEX)
Intraconazole (SPORANOX)
L
Lansoprazole (PREVACID)
Leflunomide (ARAVA)
Leuprolide (LUPRON)
Levetiractam (KEPPRA)
Losartan (COZAAR)
Losartan/hydrochlorothiazide (HYZAAR)
M
Menotropins (HUMEGON, ERGONAL)
Modafanil (PROVIGIL)
N
Nafarelin (SYNAREL)
Naltrexone (REVIA)
Naratriptan tablets (AMERGE)
Nateglinide (STARLIX)
Norethindrone/ethinyl estradiol (ESTROSTEP, RTHO-NOVUM 7-7-7)
Norgestimate ethinyl estradiol (ORTHO-CYCLEN, ORTHO TRI-CYCLEN)
O
Ofloxacin (FLOXIN)
Oprelvekin (NEUEMEGA)
Oseltamivir (TAMIFLU)
Oxcarbazine (TRILEPTAL)
P
Palivizumab (SYNAGIS)
Peginterferon alfa 2b (PEG-INTRON)
Pioglitazone (ACTOS)
Progesterone—gel (CRINONE)—oral (PROMETRIUM),
all other oral excluded
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)
Thyrotropin alfa (THYROGEN)
Tizanidine (ZANAFLEX)
Tolcapone (TASMAR)
Tramadol (ULTRAM)
Trastuzumab (HERCEPTIN)
Tretinoin (AVITA, RETIN-A)
(Ages > 35)
U
Urofollitropin (FERTINEX, METRODIN)
V
Valsartan (DIOVAN)
Valsartan/hydrochlorothiazide (DIOVAN HCT)
Verteporfin (VISUDYNE)
Z
Zolpidem (AMBIEN)
Zonisamide (ZONEGRAN)
