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 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
(Humatrope brand – all
other brands excluded)
Hyaluronan injections
(SYNVISC)
I
Imatinib mesylate
(GLEEVAC)
Imiglucerase (CEREZYME)
Infliximab (REMICADE)
Insulin infusion pumps
(NOVOPEN or equivalent)
Interferon (all types,
including BETASERON,
AVONEX)
Itraconazole (SPORANOX)
L
Lansoprazole (PREVACID)
Leflunomide (ARAVA)
Leuprolide (LUPRON)
Levetiractam (KEPPRA)
Losartan (COZAAR)
Losartan/hydrochlorothiazide
(HYZAAR)
|
M
Menotropins (HUMEGON,
PERGONAL)
Modafanil (PROVIGIL)
N
Nafarelin (SYNAREL)
Naltrexone (REVIA)
Naratriptan tablets
(AMERGE)
Nateglinide (STARLIX)
Norethindrone/ethinyl
estradiol (ESTROSTEP,
ORTHO-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)
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)
| 
