The following is a list of the most commonly prescribed drugs. It represents an abbreviatedversion of the drug list (formulary) that is at the core of your prescription-drug benefit plan. The list is not all-inclusive and does not guarantee coverage. In addition to using this list,you are encouraged to ask your doctor to prescribe generic drugs whenever appropriate. 2009 Express Scripts PLEASE NOTE: The symbol * next to a drug signifies that it is subject to nonformulary status when a generic is available throughout the year. Not all the drugs listed are covered by all High Performance Formulary prescription-drug benefit programs; check your benefit materials for the specific drugs covered and the copayments for your prescription-drug benefit program. For specific For Carolina Crescent questions about your coverage, please call the phone number printed on your ID card. ANTIINFECTIVES CARDIOVASCULAR Drugs to Treat Multiple ENDOCRINE MEDICATIONS MEDICATIONS Sclerosis Antivirals Amylin Analogues NOTE: All brand oral antiviral ACE Inhibitors + HCT Combos oxcarbazepine Sedative/Hypnotics Dipeptidyl Peptidase IV IMMUNOLOGICALS Inhibitors Antidementia Drugs Glucocorticoids Selective Serotonin Reuptake Inhibitors Growth Hormones Cephalosporins Antidepressants Angiotensin II Receptor Glucose Elevating Drugs Antagonists + HCT Combos Tertiary Amines Incretin Mimetics Beta-Adrenergic Antagonists venlafaxine Insulins Erythroid Stimulants Macrolides Antiparkinson Drugs DERMATOLOGICAL MEDICATIONS Interferons Oral Antifungals Antipsychotic Drugs Insulin Sensitizers Antiacne Drugs Pegylated Interferons/ Oral Ribavirin Agents Oral Hypoglycemics Calcium Antagonists Penicillins MUSCULOSKELETAL Antivertigo & Antiemetics Antipsoriasis & Antieczema metformin, er MEDICATIONS Quinolones HMG-CoA Reductase Drugs Inhibitors CNS Muscle Relaxants Thyroid Supplements Topical Antifungals Corticosteroid Drugs HMG-CoA Combinations Class II Narcotics Other Endocrine Drugs Hypolipoproteinemics Inj. Drugs for Arthritis Urinary Antiinfectives ANTINEOPLASTIC/IMMUNO- Class III Narcotics Miscellaneous GASTROINTESTINAL Non-Steroidal Anti- SUPPRESSANT DRUGS Dermatologicals MEDICATIONS Inflammatory Agents Antispasmodics/Drugs Nitrates Affecting GI Motility considered formulary, unless isosorbide mononitrate
CNS Stimulants EAR-NOSE MEDICATIONS Thiazide & Related Drugs Drugs Affecting The Ear Proton Pump Inhibitors Salicylates & Related Drugs Other Antihypertensives Other GI Drugs Other Drugs For ADHD AUTONOMIC & CNS Drugs Affecting The Nose NUTRITION & BLOOD MEDICATIONS MODIFIERS Drugs To Prevent & Treat Anticonvulsants Headaches Antiplatelet Drugs THIS DOCUMENT LIST IS EFFECTIVE JULY 1, 2009 THROUGH DECEMBER 31, 2009. THIS LIST IS SUBJECT TO CHANGE. You can get more information and updates to this document at our web site at www.express-scripts.com. 2009 Express Scripts, Inc. PRMTJQUHP-09 (07/01/09 Vs2) All Rights Reserved RESPIRATORY MEDICATIONS Examples of Nonformulary Medications With Selected Formulary Alternatives
The following is a list of some nonformulary brand-name medications with examples of selected alternatives that are on the formulary. Blood Detoxicants Antihistamines
Column 1 lists examples of nonformulary medications.
Column 2 lists some alternatives that can be prescribed. Antihistamine/Decongestants Oral and Inj. Anticoagulants promethazine w/codeine LOVENOX* [INJ] [PA] Nonformulary Formulary Alternative Nonformulary Formulary Alternative Therapeutic Vitamins & Minerals Antitussive & Expectorants OBSTETRICAL & Beta-2 Adrenergics GYNECOLOGICAL MEDICATIONS Androgen Drugs Contraceptives Leukotriene Modifiers Methyl Xanthines Other Drugs For Asthma Estrogen Drugs
flunisolide, fluticasone, Nasacort AQ [ST]
Estrogen/Progestin
flunisolide, fluticasone, Nasacort AQ [ST]
Combinations
ORTHO TRI-CYCLEN LO Generic oral contraceptive
flunisolide, fluticasone, Nasacort AQ [ST]
Prenatal Vitamins UROLOGICAL MEDICATIONS Progestin Drugs Anticholinergic
medroxyprogesterone acetate Antispasmodics
fluoxetine (daily), citalopram, paroxetine
Drugs Used For BPH Specialized OB/GYN Drugs
flunisolide, fluticasone, Nasacort AQ [ST]
OPHTHALMIC MEDICATIONS WEIGHT MANAGEMENT Antibacterial Drugs Appetite Suppressants Other Weight Loss Products DIABETIC SUPPLIES Antiglaucoma Drugs
flunisolide, fluticasone, Nasacort AQ [ST]
Meters & Strips Corticosteroid Drugs Miscellaneous Supplies Other Ophthalmic Drugs
The symbol [INJ] next to a drug name indicates that the drug is available in injectable form only.
The symbol [PA] next to a drug name indicates that Prior Authorization may apply to some or all strengths of the drug.
The symbol [SNRI] stands for Serotonin-Norepinephrine Reuptake Inhibitor.
The symbol [ST] next to a drug name indicates that Step Therapy may apply to some or all strengths of the drug. For the member: Generic medications contain the same active ingredients as their corresponding brand-name medications, although
they may look different in color or shape. They have been FDA-approved under strict standards. For the physician: Please prescribe preferred products and allow generic substitutions when medically appropriate. Thank you. Brand-name drugs are listed in CAPITAL letters. Generic drugs are listed in lower case letters. THIS DOCUMENT LIST IS EFFECTIVE JULY 1, 2009 THROUGH DECEMBER 31, 2009. THIS LIST IS SUBJECT TO CHANGE. You can get more information and updates to this document at our web site at www.express-scripts.com. 2009 Express Scripts, Inc. PRMTJQUHP-09 (07/01/09 Vs2) All Rights Reserved
Deepti Varma & Dr. Susan Jansen, Temple University,Philadelphia, PA and David J. Tognarelli, Jasco Inc., Easton, MD Rapid Profiling of Human Sex Hormones Rapid separation of human sex hormones in Biological Samples using the JASCO X-LC system Introduction: Hypertension is a serious problem among African breast cancer risk 3. Testosterone is a steroid hormoneAmerican po
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