| 5-Aminosalicylates - PA, ST |
Apriso (mesalamine extended-release) capsules, Asacol HD (mesalamine delayed-release), Delzicol (mesalamine delayed-release), Lialda (mesalamine 1.2g) delayed-release tablet, Pentasa |
| 5HT-1 Receptor Agonists (Triptans) |
Onzetra Xsail (sumatriptan), Tosymra (sumatriptan), Treximet (sumatriptan/naproxen), Zembrace SymTouch (sumatriptan) injection solution, Zomig (zolmitriptan) nasal spray |
| Actimmune (interferon gamma-1b) |
Actimmune (interferon gamma-1b) |
| Adakveo (crizanlizumab-tmca) |
Adakveo (crizanlizumab-tmca) |
| Adasuve (loxapine) |
Adasuve (loxapine) |
| Adbry (tralokinumab-ldrm) |
Adbry (tralokinumab-ldrm) |
| Addyi (flibanserin) |
Addyi (flibanserin) |
| ADHD |
Adderall (amphetamine-dextroamphetamine mixed salts), Adderall XR (amphetamine-dextroamphetamine mixed salts extended-release), Adzenys XR-ODT (amphetamine extended-release, orally disintegrating tablet), Aptensio XR (methylphenidate HCl extended-release), Azstarys (serdexmethylphenidate and dexmethylphenidate), CNS Stimulants, Concerta (methylphenidate extended-release), Cotempla XR-ODT (methylphenidate extended-release), Daytrana (methylphenidate transdermal system), Desoxyn (methamphetamine), Dexedrine (dextroamphetamine sulfate), Dyanavel XR (amphetamine extended-release), Evekeo (amphetamine sulfate), Evekeo ODT (amphetamine sulfate) orally disintegrating tablets, Focalin (dexmethylphenidate), Focalin XR (dexmethylphenidate extended-release), Jornay PM (methylphenidate extended-release capsule), Metadate CD (methylphenidate hydrochloride), Methylin (methylphenidate oral solution), Mydayis (mixed amphetamine salts), ProCentra (dextroamphetamine oral solution), Quillichew ER (methylphenidate extended-release, chewable), Quillivant XR (methylphenidate extended-release oral suspension), Relexxi, Brand Methylphenidate ER, Ritalin (methylphenidate), Ritalin LA (methylphenidate extended-release), Vyvanse (lisdexamfetamine dimesylate) capsules, Vyvanse (lisdexamfetamine dimesylate) chewable tablets, Xelstrym (dextroamphetamine) transdermal system, Zenzedi (dextroamphetamine) |
| Administrative Non-Formulary & Excluded Drug Exceptions Process |
contraception, contraceptive, contraceptives, Excluded drug, Exclusion, non, non-form, non-formulary, Non-formulary drug |
| Adstiladrin (nadofaragene firadenovec-vncg) |
Adstiladrin (nadofaragene firadenovec-vncg) |
| Adzynma (ADAMTS13, recombinant-krhn) |
Adzynma (ADAMTS13, recombinant-krhn) |
| Aemcolo (rifamycin) |
Aemcolo (rifamycin) |
| Afinitor, Afinitor Disperz (everolimus) - PA, NF |
Afinitor (everolimus tablet), Afinitor Disperz (everolimus tablet for oral suspension), Torpenz (everolimus tablet) |
| Afrezza (insulin human, inhalation powder) - PA, NF |
Afrezza (insulin human, inhalation powder) |
| Agamree (vamorolone) |
Agamree (vamorolone) |
| Akeega (niraparib and abiraterone) - PA, NF |
Akeega (niraparib and abiraterone) |
| Aldurazyme (laronidase) |
Aldurazyme (laronidase) |
| Alecensa (alectinib) |
Alecensa (alectinib) |
| Alfa Interferons |
Intron A (interferon alfa-2b), Pegasys (peginterferon alfa-2a) |
| Alpha-1 Proteinase Inhibitors |
Aralast NP (alpha-1-proteinase inhibitor [human]), Glassia (alpha-1-proteinase inhibitor [human]), Prolastin-C (alpha-1-proteinase inhibitor [human]), Prolastin-C liquid (alpha-1-proteinase inhibitor [human]), Zemaira (alpha-1-proteinase inhibitor [human]) |
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