Louisiana Healthy Blue
Lista de medicamentos preferidos aprobada por Medicaid En vigencia desde el 1 de mayo de 2018
Leyenda
En cada categoría, los medicamentos se listan en orden alfabético por marca o nombre genérico.
Medicamento de marca: letra mayúscula en negrita
Medicamento genérico: letra minúscula en texto sin formato
AL: restricción de límite de edad
DO: programa de optimización de dosis
GR: restricción de género
OTC: medicamento de venta libre disponible con receta. (Los recetadores deben incluir la sigla OTC en la
receta).
PA: requiere autorización previa. La autorización previa es el proceso mediante el cual se obtiene la aprobación
de los beneficios antes de que se puedan abastecer ciertas recetas.
QL: límites de cantidad. Ciertos medicamentos recetados tienen límites de cantidad específicos, por receta o por
mes.
SP: farmacia de medicamentos especiales ST: requiere terapia escalonada. Es posible que necesite utilizar un medicamento antes de que los beneficios
para el uso de otro medicamento puedan autorizarse.
Nombre del medicamento Referencia Notas
ADJUVANTES QUÍMICOS O FARMACÉUTICOS
ADJUVANTE FARMACÉUTICO (INHALADORES)
NEBUSAL INHALATION SOLUTION FOR NEBULIZATION
pulmosal inhalation solution for nebulization
sodium chloride inhalation solution for nebulization
NebuSal
AGENTES ANORRECTALES
AGENTES ANORRECTALES
hydrocortisone topical cream with perineal applicator
Anusol-HC QL
proctosol hc topical cream with perineal applicator
QL
proctozone-hc topical cream with perineal applicator
QL
AGENTES ANTI-INFECCIOSOS
AGENTES ANTIBACTERIANOS ANTIPROTOZOARIOS
metronidazole oral capsule Flagyl
metronidazole oral tablet Flagyl
tinidazole oral tablet QL
AGENTES ANTILEPROSOS, DAPSONA
dapsone oral tablet
AGENTES ANTIMICOBACTERIANOS
ethambutol oral tablet Myambutol
isoniazid oral solution
isoniazid oral tablet
PRIFTIN ORAL TABLET
pyrazinamide oral tablet
rifabutin oral capsule Mycobutin
rifampin oral capsule Rifadin
RIFATER ORAL TABLET
2
Nombre del medicamento Referencia Notas
AGENTES PARA EL TRATAMIENTO DE HEPATITIS B
adefovir oral tablet Hepsera PA; QL
BARACLUDE ORAL SOLUTION PA; QL
entecavir oral tablet Baraclude PA; QL
EPIVIR HBV ORAL SOLUTION PA; QL
lamivudine oral tablet Epivir HBV PA; QL
AGENTES PARA EL TRATAMIENTO DE HEPATITIS C
MAVYRET ORAL TABLET PA; QL
PEGASYS PROCLICK SUBCUTANEOUS PEN INJECTOR
PA
PEGASYS SUBCUTANEOUS SOLUTION
PA; QL
PEGASYS SUBCUTANEOUS SYRINGE PA
PEGINTRON REDIPEN SUBCUTANEOUS PEN INJECTOR KIT
PA
PEGINTRON SUBCUTANEOUS KIT PA
ribavirin oral capsule Ribasphere QL
ribavirin oral tablet Moderiba QL
ZEPATIER ORAL TABLET PA; QL
AMIBICIDAS
paromomycin oral capsule
AMINOGLICÓSIDOS
gentamicin in nacl (iso-osm) intravenous piggyback
gentamicin injection solution
gentamicin sulfate (ped) (pf) injection solution
gentamicin sulfate (pf) intravenous solution
neomycin oral tablet
AMINOPENICILINAS
amoxicillin oral capsule
amoxicillin oral suspension for reconstitution
QL
amoxicillin oral tablet
amoxicillin oral tablet,chewable
3
Nombre del medicamento Referencia Notas
amoxicillin-pot clavulanate oral suspension for reconstitution
Augmentin ES-600
amoxicillin-pot clavulanate oral tablet
amoxicillin-pot clavulanate oral tablet extended release 12 hr
Augmentin XR QL
amoxicillin-pot clavulanate oral tablet,chewable
ampicillin oral capsule
ampicillin oral suspension for reconstitution
ANTIBIÓTICO SULFONAMIDA
sulfadiazine oral tablet
ANTIBIÓTICOS ANTIMICÓTICOS
fluconazole oral suspension for reconstitution
Diflucan QL
fluconazole oral tablet Diflucan QL
flucytosine oral capsule Ancobon
griseofulvin microsize oral suspension
griseofulvin ultramicrosize oral tablet Gris-PEG (ultramicrosize)
itraconazole oral capsule Sporanox PA
ketoconazole oral tablet QL
nystatin oral powder
nystatin oral tablet
terbinafine hcl oral tablet QL
voriconazole intravenous solution Vfend IV PA
voriconazole oral suspension for reconstitution
Vfend PA
voriconazole oral tablet 200 mg Vfend PA; QL
voriconazole oral tablet 50 mg Vfend PA
ANTIHELMÍNTICOS
ALBENZA ORAL TABLET
ivermectin oral tablet Stromectol
praziquantel oral tablet Biltricide
ANTIRETROVIRAL - ANTI-CD4 DOMAIN 2 MONOCLONAL ANTIBODY
TROGARZO INTRAVENOUS SOLUTION
4
Nombre del medicamento Referencia Notas
ANTIRETROVIRAL COMBINATIONS - INTEGRASE INHIBITOR AND NNRTI
JULUCA ORAL TABLET
ANTIVIRALES, ESPECÍFICOS DE VIH
abacavir oral solution Ziagen
abacavir oral tablet Ziagen
abacavir-lamivudine oral tablet Epzicom
abacavir-lamivudine-zidovudine oral tablet Trizivir
APTIVUS ORAL CAPSULE
APTIVUS ORAL SOLUTION
atazanavir oral capsule Reyataz
BIKTARVY ORAL TABLET
CRIXIVAN ORAL CAPSULE
DESCOVY ORAL TABLET
didanosine oral capsule,delayed release(dr/ec)
Videx EC
EDURANT ORAL TABLET
EMTRIVA ORAL CAPSULE
EMTRIVA ORAL SOLUTION
EVOTAZ ORAL TABLET
FUZEON SUBCUTANEOUS RECON SOLN
GENVOYA ORAL TABLET
INTELENCE ORAL TABLET AL
ISENTRESS HD ORAL TABLET
ISENTRESS ORAL POWDER IN PACKET
ISENTRESS ORAL TABLET
ISENTRESS ORAL TABLET,CHEWABLE
KALETRA ORAL TABLET
lamivudine oral solution Epivir AL
lamivudine oral tablet Epivir
lamivudine-zidovudine oral tablet Combivir
lopinavir-ritonavir oral solution Kaletra
nevirapine oral suspension Viramune
5
Nombre del medicamento Referencia Notas
nevirapine oral tablet Viramune
nevirapine oral tablet extended release 24 hr
Viramune XR
NORVIR ORAL CAPSULE
NORVIR ORAL SOLUTION
PREZCOBIX ORAL TABLET
PREZISTA ORAL SUSPENSION
PREZISTA ORAL TABLET
RESCRIPTOR ORAL TABLET
RESCRIPTOR ORAL TABLET, DISPERSIBLE
RETROVIR INTRAVENOUS SOLUTION
REYATAZ ORAL POWDER IN PACKET
ritonavir oral tablet Norvir
SELZENTRY ORAL SOLUTION
SELZENTRY ORAL TABLET
stavudine oral capsule Zerit
stavudine oral recon soln Zerit
STRIBILD ORAL TABLET
SYMFI ORAL TABLET
tenofovir disoproxil fumarate oral tablet Viread PA; QL
TIVICAY ORAL TABLET
TRIUMEQ ORAL TABLET
TRUVADA ORAL TABLET
VIDEX 2 GRAM PEDIATRIC ORAL RECON SOLN
VIDEX 4 GRAM PEDIATRIC ORAL RECON SOLN
VIRACEPT ORAL TABLET
VIREAD ORAL POWDER PA; QL
VIREAD ORAL TABLET PA; QL
zidovudine oral capsule Retrovir
zidovudine oral syrup Retrovir
zidovudine oral tablet
ANTIVIRALES, GENERALES
acyclovir oral capsule Zovirax
acyclovir oral suspension Zovirax
acyclovir oral tablet Zovirax
6
Nombre del medicamento Referencia Notas
cidofovir intravenous solution
famciclovir oral tablet QL
oseltamivir oral capsule Tamiflu QL
oseltamivir oral suspension for reconstitution
Tamiflu QL
RELENZA DISKHALER INHALATION BLISTER WITH DEVICE
QL
rimantadine oral tablet Flumadine
TAMIFLU ORAL SUSPENSION FOR RECONSTITUTION
QL
valacyclovir oral tablet Valtrex QL
valganciclovir oral recon soln Valcyte
valganciclovir oral tablet Valcyte
CEFALOSPORINA, ANTIBIÓTICOS
cefaclor oral capsule
cefaclor oral suspension for reconstitution
cefaclor oral tablet extended release 12 hr
cefadroxil oral capsule
cefadroxil oral suspension for reconstitution
cefadroxil oral tablet
cefdinir oral capsule QL
cefdinir oral suspension for reconstitution QL
cefpodoxime oral suspension for reconstitution
cefpodoxime oral tablet
cefprozil oral suspension for reconstitution
cefprozil oral tablet
CEFTIN ORAL SUSPENSION FOR RECONSTITUTION
ceftriaxone injection recon soln 1 gram, 2 gram, 250 mg, 500 mg
QL
ceftriaxone injection recon soln 10 gram, 100 gram
ceftriaxone intravenous recon soln
cefuroxime axetil oral suspension for reconstitution
cefuroxime axetil oral tablet
cephalexin oral capsule Keflex
7
Nombre del medicamento Referencia Notas
cephalexin oral suspension for reconstitution
cephalexin oral tablet
COMBINACIONES DE PLASMOCIDAS
atovaquone-proguanil oral tablet Malarone Pediatric
LINCOSAMIDAS
clindamycin hcl oral capsule Cleocin HCl
clindamycin palmitate hcl oral recon soln Cleocin Pediatric
clindamycin pediatric oral recon soln
MACRÓLIDOS
azithromycin oral packet Zithromax QL
azithromycin oral suspension for reconstitution
Zithromax QL
azithromycin oral tablet Zithromax QL
clarithromycin oral suspension for reconstitution
clarithromycin oral tablet
clarithromycin oral tablet extended release 24 hr
e.e.s. 400 oral tablet
ery-tab oral tablet,delayed release (dr/ec)
erythrocin (as stearate) oral tablet
erythromycin ethylsuccinate oral tablet E.E.S. 400
erythromycin oral capsule,delayed release(dr/ec)
erythromycin oral tablet
erythromycin stearate oral tablet Erythrocin (as stearate)
PENICILINAS
BICILLIN L-A INTRAMUSCULAR SYRINGE
dicloxacillin oral capsule
penicillin v potassium oral recon soln
penicillin v potassium oral tablet
PLASMOCIDAS
chloroquine phosphate oral tablet
hydroxychloroquine oral tablet Plaquenil
mefloquine oral tablet QL
8
Nombre del medicamento Referencia Notas
PRIMAQUINE ORAL TABLET
QUINOLONES
ciprofloxacin hcl oral tablet QL
levofloxacin oral solution QL
levofloxacin oral tablet Levaquin QL
ofloxacin oral tablet QL
SULFONAMIDAS ABSORBIBLES
sulfamethoxazole-trimethoprim oral suspension
Sulfatrim
sulfamethoxazole-trimethoprim oral tablet Bactrim
sulfatrim oral suspension
trimethoprim oral tablet
TETRACICLINA
demeclocycline oral tablet
doxycycline monohydrate oral capsule 100 mg, 50 mg
Mondoxyne NL QL
doxycycline monohydrate oral capsule 150 mg
doxycycline monohydrate oral capsule 75 mg
Mondoxyne NL
doxycycline monohydrate oral suspension for reconstitution
Vibramycin
minocycline oral capsule Minocin
minocycline oral tablet
tetracycline oral capsule
VANCOMICINA Y DERIVADOS
linezolid oral suspension for reconstitution Zyvox PA; QL
linezolid oral tablet Zyvox PA; QL
vancomycin oral capsule Vancocin PA
AGENTES DE DIAGNÓSTICO
AGENTES DE DIAGNÓSTICO: COMPLEMENTO RADIOLÓGICO GASTROINTESTINAL
GLUCAGEN DIAGNOSTIC KIT INJECTION RECON SOLN
QL
AGENTES DE DIAGNÓSTICO: FUNCIÓN DE LA HIPÓFISIS
cosyntropin injection recon soln Cortrosyn QL
9
Nombre del medicamento Referencia Notas
cosyntropin intravenous solution
AGENTES DE TERAPIA CARDIOVASCULAR
AGENTES BLOQUEADORES ALFA ADRENÉRGICOS
doxazosin oral tablet Cardura QL
prazosin oral capsule Minipress
terazosin oral capsule QL
AGENTES BLOQUEADORES ALFA/BETA ADRENÉRGICOS
carvedilol oral tablet Coreg QL
labetalol oral tablet
AGENTES BLOQUEADORES BETA ADRENÉRGICOS
acebutolol oral capsule
atenolol oral tablet Tenormin
betaxolol oral tablet
bisoprolol fumarate oral tablet
metoprolol succinate oral tablet extended release 24 hr
Toprol XL
metoprolol tartrate oral tablet 100 mg, 50 mg
Lopressor QL
metoprolol tartrate oral tablet 25 mg, 37.5 mg, 75 mg
nadolol oral tablet 20 mg, 40 mg Corgard
nadolol oral tablet 80 mg Corgard PA
pindolol oral tablet
propranolol oral capsule,extended release 24 hr
Inderal LA
propranolol oral solution
propranolol oral tablet
sorine oral tablet QL
sotalol af oral tablet QL
sotalol oral tablet Betapace QL
timolol maleate oral tablet
AGENTES BLOQUEADORES DEL CANAL DE CALCIO
afeditab cr oral tablet extended release 30 mg
DO; QL
10
Nombre del medicamento Referencia Notas
afeditab cr oral tablet extended release 60 mg
QL
amlodipine oral tablet 10 mg Norvasc QL
amlodipine oral tablet 2.5 mg, 5 mg Norvasc DO; QL
cartia xt oral capsule,extended release 24hr 120 mg, 180 mg, 240 mg
DO; QL
cartia xt oral capsule,extended release 24hr 300 mg
QL
diltiazem hcl oral capsule,ext.rel 24h degradable 120 mg, 180 mg
DILT-XR DO; QL
diltiazem hcl oral capsule,ext.rel 24h degradable 240 mg
DILT-XR QL
diltiazem hcl oral capsule,extended release 12 hr
QL
diltiazem hcl oral capsule,extended release 24 hr 120 mg, 180 mg
Taztia XT DO; QL
diltiazem hcl oral capsule,extended release 24 hr 240 mg, 300 mg, 360 mg
Taztia XT QL
diltiazem hcl oral capsule,extended release 24 hr 420 mg
Tiazac QL
diltiazem hcl oral capsule,extended release 24hr 120 mg, 180 mg, 240 mg
Cardizem CD DO; QL
diltiazem hcl oral capsule,extended release 24hr 300 mg, 360 mg
Cardizem CD QL
diltiazem hcl oral tablet Cardizem QL
diltiazem hcl oral tablet extended release 24 hr 180 mg, 240 mg
Cardizem LA DO; QL
diltiazem hcl oral tablet extended release 24 hr 300 mg, 360 mg, 420 mg
Cardizem LA QL
dilt-xr oral capsule,ext.rel 24h degradable 120 mg, 180 mg
DO; QL
dilt-xr oral capsule,ext.rel 24h degradable 240 mg
QL
felodipine oral tablet extended release 24 hr 10 mg
QL
felodipine oral tablet extended release 24 hr 2.5 mg, 5 mg
DO; QL
isradipine oral capsule QL
matzim la oral tablet extended release 24 hr 180 mg, 240 mg
DO; QL
matzim la oral tablet extended release 24 hr 300 mg, 360 mg, 420 mg
QL
11
Nombre del medicamento Referencia Notas
nicardipine oral capsule QL
nifedipine oral capsule QL
nifedipine oral tablet extended release 24hr 30 mg
Procardia XL DO; QL
nifedipine oral tablet extended release 24hr 60 mg, 90 mg
Procardia XL QL
nifedipine oral tablet extended release 30 mg
Adalat CC DO; QL
nifedipine oral tablet extended release 60 mg, 90 mg
Adalat CC QL
taztia xt oral capsule,extended release 24 hr 120 mg, 180 mg
DO; QL
taztia xt oral capsule,extended release 24 hr 240 mg, 300 mg, 360 mg
QL
verapamil oral capsule, 24 hr er pellet ct Verelan PM DO; QL
verapamil oral capsule,ext rel. pellets 24 hr 120 mg, 180 mg
Verelan DO; QL
verapamil oral capsule,ext rel. pellets 24 hr 240 mg, 360 mg
Verelan QL
verapamil oral tablet QL
verapamil oral tablet extended release Calan SR QL
AGENTES DE TERAPIA ANAFILAXIA
epinephrine injection auto-injector EpiPen Jr QL
epinephrine injection solution Adrenalin
AGENTES DIURÉTICOS, OTROS
acetazolamide oral capsule, extended release
acetazolamide oral tablet
methazolamide oral tablet
spironolactone oral tablet Aldactone
ANTAGONISTAS DEL RECEPTOR DE LA ALDOSTERONA
spironolactone oral tablet Aldactone
ANTIARRÍTMICOS
amiodarone oral tablet 200 mg Pacerone QL
amiodarone oral tablet 400 mg Pacerone
disopyramide phosphate oral capsule Norpace
flecainide oral tablet QL
12
Nombre del medicamento Referencia Notas
mexiletine oral capsule
pacerone oral tablet 200 mg QL
pacerone oral tablet 400 mg
propafenone oral capsule,extended release 12 hr
Rythmol SR
propafenone oral tablet
quinidine gluconate oral tablet extended release
quinidine sulfate oral tablet
sorine oral tablet QL
sotalol af oral tablet QL
sotalol oral tablet Betapace QL
DIURÉTICOS AHORRADORES DE POTASIO
amiloride oral tablet
amiloride-hydrochlorothiazide oral tablet
spironolacton-hydrochlorothiaz oral tablet Aldactazide
triamterene-hydrochlorothiazid oral capsule
triamterene-hydrochlorothiazid oral tablet Maxzide-25mg
DIURÉTICOS DE ASA
bumetanide oral tablet
furosemide oral solution
furosemide oral tablet Lasix
torsemide oral tablet Demadex
GLUCÓSIDOS DIGITÁLICOS
digitek oral tablet
digox oral tablet
digoxin oral solution
digoxin oral tablet Digitek
HIPERTENSIÓN ARTERIAL PULMONAR
ADCIRCA ORAL TABLET PA; QL
LETAIRIS ORAL TABLET PA; QL
sildenafil (antihypertensive) oral tablet Revatio PA; QL
13
Nombre del medicamento Referencia Notas
HIPOTENSIVOS, ANTAGONISTA DE LOS RECEPTORES DE LA ANGIOTENSINA
candesartan oral tablet Atacand
candesartan-hydrochlorothiazid oral tablet Atacand HCT
irbesartan oral tablet 150 mg, 75 mg Avapro DO; QL
irbesartan oral tablet 300 mg Avapro QL
irbesartan-hydrochlorothiazide oral tablet Avalide QL
losartan oral tablet Cozaar QL
losartan-hydrochlorothiazide oral tablet 100-12.5 mg, 100-25 mg
Hyzaar QL
losartan-hydrochlorothiazide oral tablet 50-12.5 mg
Hyzaar DO; QL
valsartan oral tablet Diovan QL
valsartan-hydrochlorothiazide oral tablet Diovan HCT QL
HIPOTENSIVOS, INHIBIDORES DE LA ECA, COMBINACIONES
benazepril oral tablet QL
benazepril-hydrochlorothiazide oral tablet QL
captopril oral tablet QL
captopril-hydrochlorothiazide oral tablet QL
enalapril maleate oral tablet Vasotec QL
enalapril-hydrochlorothiazide oral tablet QL
fosinopril oral tablet QL
fosinopril-hydrochlorothiazide oral tablet QL
lisinopril oral tablet 10 mg, 20 mg, 5 mg Prinivil DO; QL
lisinopril oral tablet 2.5 mg Zestril DO; QL
lisinopril oral tablet 30 mg, 40 mg Zestril QL
lisinopril-hydrochlorothiazide oral tablet 10-12.5 mg
Zestoretic DO; QL
lisinopril-hydrochlorothiazide oral tablet 20-12.5 mg, 20-25 mg
Zestoretic QL
moexipril oral tablet
moexipril-hydrochlorothiazide oral tablet
perindopril erbumine oral tablet QL
quinapril oral tablet Accupril QL
quinapril-hydrochlorothiazide oral tablet Accuretic QL
ramipril oral capsule Altace QL
14
Nombre del medicamento Referencia Notas
trandolapril oral tablet
HIPOTENSIVOS, SIMPATOLÍTICOS
clonidine hcl oral tablet Catapres
guanfacine oral tablet
methyldopa oral tablet
reserpine oral tablet
HIPOTENSIVOS, VARIOS
atenolol-chlorthalidone oral tablet Tenoretic 100
bisoprolol-hydrochlorothiazide oral tablet Ziac
methyldopa-hydrochlorothiazide oral tablet
metoprolol ta-hydrochlorothiaz oral tablet Lopressor HCT QL
nadolol-bendroflumethiazide oral tablet Corzide QL
propranolol-hydrochlorothiazid oral tablet
HIPOTENSIVOS, VASODILATADORES
hydralazine oral tablet
minoxidil oral tablet
INHIBIDOR DE LA ECA/COMBINACIÓN DEL BLOQUEADOR DEL CANAL DE CALCIO
amlodipine-benazepril oral capsule QL
INHIBIDORES DE LA PCSK-9
REPATHA PUSHTRONEX SUBCUTANEOUS WEARABLE INJECTOR
PA; QL
REPATHA SURECLICK SUBCUTANEOUS PEN INJECTOR
PA; QL
REPATHA SYRINGE SUBCUTANEOUS SYRINGE
PA; QL
LIPOTRÓPICOS
atorvastatin oral tablet 10 mg, 20 mg, 40 mg
Lipitor DO; QL
atorvastatin oral tablet 80 mg Lipitor QL
cholestyramine (with sugar) oral powder Questran
cholestyramine (with sugar) oral powder in packet
Questran
cholestyramine light oral powder
15
Nombre del medicamento Referencia Notas
cholestyramine light oral powder in packet
colestipol oral granules Colestid
colestipol oral packet Colestid
colestipol oral tablet Colestid
fenofibrate micronized oral capsule 130 mg, 200 mg, 43 mg
QL
fenofibrate micronized oral capsule 134 mg
fenofibrate micronized oral capsule 67 mg PA; QL
fenofibrate nanocrystallized oral tablet Tricor QL
fenofibrate oral tablet QL
fenofibric acid (choline) oral capsule,delayed release(dr/ec) 135 mg
Trilipix QL
fenofibric acid (choline) oral capsule,delayed release(dr/ec) 45 mg
Trilipix PA; QL
fenofibric acid oral tablet Fibricor PA; QL
fish oil oral capsule,delayed release(dr/ec) OTC
gemfibrozil oral tablet Lopid
lovastatin oral tablet QL
pravastatin oral tablet Pravachol QL
prevalite oral powder
prevalite oral powder in packet
simvastatin oral tablet 10 mg, 20 mg, 40 mg, 5 mg
Zocor DO; QL
simvastatin oral tablet 80 mg Zocor PA; QL
TIAZIDA Y DIURÉTICOS RELACIONADOS
chlorothiazide oral tablet
chlorthalidone oral tablet
hydrochlorothiazide oral capsule Microzide QL
hydrochlorothiazide oral tablet 12.5 mg QL
hydrochlorothiazide oral tablet 25 mg, 50 mg
indapamide oral tablet
metolazone oral tablet
VASODILATADORES, CORONARIA
isosorbide dinitrate oral tablet
isosorbide dinitrate oral tablet extended release
ISOCHRON
16
Nombre del medicamento Referencia Notas
isosorbide mononitrate oral tablet
isosorbide mononitrate oral tablet extended release 24 hr
nitro-bid transdermal ointment
NITRO-DUR TRANSDERMAL PATCH 24 HOUR
nitroglycerin oral capsule, extended release
Nitro-Time
nitroglycerin sublingual tablet Nitrostat
nitroglycerin transdermal patch 24 hour Minitran
nitro-time oral capsule, extended release
VASOPRESOR ADRENÉRGICO
midodrine oral tablet
AGENTES DE TERAPIA GASTROINTESTINAL
AGENTES ANTIEMÉTICOS/ANTIVÉRTIGOS
compro rectal suppository
meclizine oral tablet Dramamine Less Drowsy OTC
ondansetron oral tablet,disintegrating Zofran ODT QL
phenadoz rectal suppository
prochlorperazine edisylate injection solution
prochlorperazine maleate oral tablet Compazine
prochlorperazine rectal suppository Compazine
promethazine rectal suppository Phenadoz AL
promethegan rectal suppository AL
trimethobenzamide oral capsule Tigan
AGENTES PARA LA ENFERMEDAD INFLAMATORIA INTESTINAL
budesonide oral capsule,delayed,extend.release
Entocort EC QL
colocort rectal enema
HUMIRA PEDIATRIC CROHN'S START SUBCUTANEOUS SYRINGE KIT
PA; QL
HUMIRA PEN CROHN'S-UC-HS START SUBCUTANEOUS PEN INJECTOR KIT
PA; QL
HUMIRA PEN PSORIASIS-UVEITIS SUBCUTANEOUS PEN INJECTOR KIT
PA; QL
17
Nombre del medicamento Referencia Notas
HUMIRA PEN SUBCUTANEOUS PEN INJECTOR KIT
PA; QL
HUMIRA SUBCUTANEOUS SYRINGE KIT
PA; QL
hydrocortisone rectal enema Colocort
ANTIDIARREICOS
diphenoxylate-atropine oral liquid
diphenoxylate-atropine oral tablet Lomotil
loperamide oral capsule Anti-Diarrheal (loperamide) OTC; QL
ANTIESPASMÓDICOS
dicyclomine oral capsule
dicyclomine oral solution
dicyclomine oral tablet
glycopyrrolate oral tablet Robinul
hyoscyamine sulfate oral drops Hyosyne
hyoscyamine sulfate oral elixir Hyosyne
hyoscyamine sulfate oral tablet Levsin
hyoscyamine sulfate oral tablet extended release 12 hr
Levbid
hyoscyamine sulfate oral tablet,disintegrating
Anaspaz
hyoscyamine sulfate sublingual tablet Levsin/SL
hyosyne oral drops
hyosyne oral elixir
oscimin oral tablet
oscimin oral tablet,disintegrating
oscimin sl sublingual tablet
oscimin sr oral tablet extended release 12 hr
propantheline oral tablet
symax fastabs oral tablet,disintegrating
symax-sr oral tablet extended release 12 hr
ENZIMAS PANCREÁTICAS
CREON ORAL CAPSULE,DELAYED RELEASE(DR/EC) 12,000-38,000 -60,000 UNIT, 24,000-76,000 -120,000 UNIT, 6,000-19,000 -30,000 UNIT
QL
18
Nombre del medicamento Referencia Notas
CREON ORAL CAPSULE,DELAYED RELEASE(DR/EC) 3,000-9,500- 15,000 UNIT, 36,000-114,000- 180,000 UNIT
ESTIMULANTES DE MOTILIDAD INTESTINAL
metoclopramide hcl oral solution
metoclopramide hcl oral tablet Reglan
INFLAMACIÓN CRÓNICA, ENFERMEDAD DE COLON, 5 AMINOSALICILATOS
APRISO ORAL CAPSULE,EXTENDED RELEASE 24HR
QL
balsalazide oral capsule Colazal QL
mesalamine rectal enema Rowasa QL
mesalamine with cleansing wipe rectal enema kit
Rowasa QL
sulfasalazine oral tablet Azulfidine QL
sulfasalazine oral tablet,delayed release (dr/ec)
Azulfidine EN-tabs QL
LAXANTES Y CATÁRTICOS
constulose oral solution QL
enulose oral solution
gavilyte-c oral recon soln QL
gavilyte-g oral recon soln QL
gavilyte-n oral recon soln QL
generlac oral solution
lactulose oral solution Constulose QL
peg 3350-electrolytes oral recon soln GaviLyte-G QL
peg-3350 with flavor packs oral recon soln QL
peg-electrolyte soln oral recon soln GaviLyte-N QL
polyethylene glycol 3350 oral powder ClearLax OTC
polyethylene glycol 3350 oral powder in packet
ClearLax OTC; QL
trilyte with flavor packets oral recon soln QL
REDUCTORES DE SECRECIÓN ÁCIDA GÁSTRICA
CARAFATE ORAL SUSPENSION
famotidine (pf) intravenous solution
famotidine 20 mg tablet (rx) Acid Controller OTC; QL
19
Nombre del medicamento Referencia Notas
famotidine 20 mg tablet f/c (rx) Acid Controller OTC; QL
famotidine 20 mg tablet u-d,10x10,inner (rx)
Acid Controller OTC; QL
famotidine 20 mg tablet u-d,10x10,outer (rx)
Acid Controller OTC; QL
famotidine 20 mg tablet u-d,robot ready,innr (rx)
Acid Controller OTC; QL
famotidine 20 mg tablet u-d,robot ready,outr (rx)
Acid Controller OTC; QL
famotidine oral suspension Pepcid AL
famotidine oral tablet 40 mg Pepcid QL
misoprostol oral tablet Cytotec
nizatidine oral capsule
nizatidine oral solution
pantoprazole oral tablet,delayed release (dr/ec)
Protonix QL
ranitidine 150 mg tablet (rx) Acid Control (ranitidine) OTC; QL
ranitidine 150 mg tablet f/c (rx) Acid Control (ranitidine) OTC; QL
ranitidine 150 mg tablet federal supply (rx) Acid Control (ranitidine) OTC; QL
ranitidine 150 mg tablet inner (rx) Acid Control (ranitidine) OTC; QL
ranitidine 150 mg tablet outer (rx) Acid Control (ranitidine) OTC; QL
ranitidine 150 mg tablet u-d,10x10,inner (rx)
Acid Control (ranitidine) OTC; QL
ranitidine 150 mg tablet u-d,10x10,outer (rx)
Acid Control (ranitidine) OTC; QL
ranitidine hcl oral capsule 150 mg
ranitidine hcl oral capsule 300 mg QL
ranitidine hcl oral syrup
ranitidine hcl oral tablet 300 mg Zantac QL
sucralfate oral suspension Carafate
sucralfate oral tablet Carafate
SALES BILIARES
ursodiol oral capsule Actigall
ursodiol oral tablet URSO 250
AGENTES DE TERAPIA RESPIRATORIA
AGENTES ALFA/BETA ADRENÉRGICOS
epinephrine injection solution Adrenalin
20
Nombre del medicamento Referencia Notas
epinephrine injection syringe
AGENTES BETA ADRENÉRGICOS
albuterol sulfate inhalation solution for nebulization
QL
albuterol sulfate oral syrup
albuterol sulfate oral tablet
albuterol sulfate oral tablet extended release 12 hr
metaproterenol oral syrup
metaproterenol oral tablet
PROVENTIL HFA INHALATION HFA AEROSOL INHALER
PA; QL
SEREVENT DISKUS INHALATION BLISTER WITH DEVICE
QL
terbutaline oral tablet
VENTOLIN HFA INHALATION HFA AEROSOL INHALER
QL
AGENTES BRONCODILATADORES GENERALES
ATROVENT HFA INHALATION HFA AEROSOL INHALER
QL
ipratropium bromide inhalation solution QL
SPIRIVA RESPIMAT INHALATION MIST QL
AGENTES PARA EL TRATAMIENTO DE LA FIBROSIS QUÍSTICA
tobramycin in 0.225 % nacl inhalation solution for nebulization
Tobi QL
AGENTES PARA EL TRATAMIENTO DEL ASMA
ARNUITY ELLIPTA INHALATION BLISTER WITH DEVICE
QL
budesonide inhalation suspension for nebulization
Pulmicort PA; AL; QL
cromolyn inhalation solution for nebulization
FLOVENT DISKUS INHALATION BLISTER WITH DEVICE
QL
FLOVENT HFA INHALATION HFA AEROSOL INHALER
QL
montelukast oral granules in packet Singulair QL
21
Nombre del medicamento Referencia Notas
montelukast oral tablet Singulair
montelukast oral tablet,chewable Singulair
PULMICORT FLEXHALER INHALATION AEROSOL POWDR BREATH ACTIVATED
PA; QL
zafirlukast oral tablet Accolate QL
ANTIBIÓTICOS NASALES
BACTROBAN NASAL NASAL OINTMENT
QL
ANTICOLINÉRGICOS NASALES
ipratropium bromide nasal spray,non-aerosol
ANTICUERPOS DE INMUNOGLOBULINA
XOLAIR SUBCUTANEOUS RECON SOLN
PA
ANTIHISTAMÍNICOS NASALES
azelastine nasal aerosol,spray QL
azelastine nasal spray,non-aerosol Astepro QL
ANTIHISTAMÍNICOS
carbinoxamine maleate oral liquid
carbinoxamine maleate oral tablet
clemastine oral tablet Allergy Relief (clemastine)
cyproheptadine oral tablet
diphenhydramine hcl oral capsule Banophen OTC
diphenhydramine hcl oral elixirChildren's Allergy (diphenhyd)
OTC; QL
fexofenadine oral tablet Allegra Allergy OTC; QL
promethazine oral syrup AL
promethazine oral tablet 12.5 mg, 50 mg AL
promethazine oral tablet 25 mg AL; QL
UNISOM (DIPHENHYDRAMINE) ORAL LIQUID
OTC
COMBINACIÓN DE AGENTES BETA ADRENÉRGICOS
ANORO ELLIPTA INHALATION BLISTER WITH DEVICE
COMBIVENT RESPIMAT INHALATION MIST
QL
22
Nombre del medicamento Referencia Notas
ipratropium-albuterol inhalation solution for nebulization
COMBINACIONES ANTITUSIVAS NO NARCÓTICAS
benzonatate oral capsule
chlorpheniramine-phenyleph-dm oral liquid
OTC
promethazine-dm oral syrup AL; QL
COMBINACIONES DE ANTIHISTAMÍNICOS Y DESCONGESTIVOS
fexofenadine-pseudoephedrine oral tablet extended release 12 hr
Allegra-D 12 Hour OTC; QL
hist-pse oral liquid OTC
promethazine vc oral syrup AL; QL
promethazine-phenylephrine oral syrup Promethazine VC AL; QL
r-tanna oral tablet
COMBINACIONES DE ANTITUSIVOS NARCÓTICOS
cheratussin ac oral liquid AL; OTC; QL
guaiatussin ac oral liquid AL; OTC; QL
guaifenesin ac oral liquid AL; OTC; QL
guaifenesin dac oral syrup AL; OTC
hydrocodone compound oral syrup
hydrocodone-homatropine oral syrup Hydrocodone Compound
hydrocodone-homatropine oral tablet Tussigon
hydromet oral syrup
m-clear wc oral liquid AL; OTC
promethazine vc-codeine oral syrup AL; QL
promethazine-codeine oral syrup AL; QL
promethazine-phenyleph-codeine oral syrup
Promethazine VC-Codeine AL; QL
relcof c oral liquid AL; OTC
REZIRA ORAL SOLUTION
tusnel c oral syrup AL; OTC
virtussin ac oral liquid AL; OTC; QL
23
Nombre del medicamento Referencia Notas
COMBINACIONES DE DESCONGESTIVOS Y EXPECTORANTES
TRIAMINIC CHEST-NASAL CONGEST ORAL LIQUID
OTC
COMBINACIONES DE GLUCOCORTICOIDES Y BETA-ADRENÉRGICOS
BREO ELLIPTA INHALATION BLISTER WITH DEVICE 100-25 MCG/DOSE
PA; QL
BREO ELLIPTA INHALATION BLISTER WITH DEVICE 200-25 MCG/DOSE
PA
DULERA INHALATION HFA AEROSOL INHALER
PA; QL
COMBINACIONES DESCONGESTIVAS
pain reliever pm oral tablet OTC
DESCONGESTIVOS SIMPATICOMIMÉTICOS SISTÉMICOS
pseudoephedrine hcl oral tablet Sudogest AL; OTC
MUCOLÍTICOS
acetylcysteine solution
PULMOZYME INHALATION SOLUTION PA; QL
XANTINAS
THEO-24 ORAL CAPSULE,EXTENDED RELEASE 24HR
QL
theochron oral tablet extended release 12 hr
theophylline oral elixir Elixophyllin
theophylline oral solution
theophylline oral tablet extended release 12 hr
Theochron
theophylline oral tablet extended release 24 hr
AGENTES DEL SISTEMA NERVIOSO CENTRAL
ANSIOLÍTICOS
alprazolam intensol oral concentrate
alprazolam oral tablet Xanax
24
Nombre del medicamento Referencia Notas
alprazolam oral tablet,disintegrating
buspirone oral tablet
chlordiazepoxide hcl oral capsule
clonazepam oral tablet Klonopin
clonazepam oral tablet,disintegrating
clorazepate dipotassium oral tablet
diazepam intensol oral concentrate
diazepam oral concentrate Diazepam Intensol
diazepam oral solution
diazepam oral tablet Valium
hydroxyzine hcl oral solution
hydroxyzine hcl oral tablet
hydroxyzine pamoate oral capsule
lorazepam oral tablet Ativan
oxazepam oral capsule
ANTICONVULSIVOS
carbamazepine oral capsule, er multiphase 12 hr
Carbatrol QL
carbamazepine oral suspension Tegretol
carbamazepine oral tablet Epitol
carbamazepine oral tablet extended release 12 hr
Tegretol XR
carbamazepine oral tablet,chewable
clonazepam oral tablet Klonopin
clonazepam oral tablet,disintegrating
diazepam rectal kit Diastat QL
divalproex oral capsule, delayed rel sprinkle
Depakote Sprinkles QL
divalproex oral tablet extended release 24 hr
Depakote ER QL
divalproex oral tablet,delayed release (dr/ec) 125 mg, 250 mg
Depakote QL
divalproex oral tablet,delayed release (dr/ec) 500 mg
Depakote
epitol oral tablet
ethosuximide oral capsule Zarontin
ethosuximide oral solution Zarontin
felbamate oral suspension Felbatol
25
Nombre del medicamento Referencia Notas
felbamate oral tablet Felbatol
gabapentin oral capsule Neurontin QL
gabapentin oral solution Neurontin QL
gabapentin oral tablet Neurontin QL
lamotrigine oral tablet Lamictal
lamotrigine oral tablet disintegrating, dose pk
Lamictal ODT Starter (Orange)
lamotrigine oral tablet extended release 24hr
Lamictal XR
lamotrigine oral tablet, chewable dispersible
Lamictal
lamotrigine oral tablet,disintegrating 100 mg, 50 mg
Lamictal ODT QL
lamotrigine oral tablet,disintegrating 200 mg, 25 mg
Lamictal ODT
lamotrigine oral tablets,dose pack Lamictal Starter (Blue) Kit
levetiracetam oral solution Keppra
levetiracetam oral tablet Keppra QL
levetiracetam oral tablet extended release 24 hr
Keppra XR QL
oxcarbazepine oral suspension Trileptal
oxcarbazepine oral tablet Trileptal
phenobarbital oral elixir
phenobarbital oral tablet 100 mg, 15 mg, 16.2 mg, 30 mg, 60 mg, 64.8 mg, 97.2 mg
phenobarbital oral tablet 32.4 mg QL
phenytoin oral suspension Dilantin-125
phenytoin oral tablet,chewable Dilantin Infatabs
phenytoin sodium extended oral capsule Phenytek
primidone oral tablet Mysoline
ROWEEPRA ORAL TABLET QL
roweepra xr oral tablet extended release 24 hr
QL
tiagabine oral tablet Gabitril
topiramate oral capsule, sprinkle Topamax
topiramate oral tablet Topamax
valproic acid (as sodium salt) oral solution Depakene
valproic acid oral capsule Depakene QL
zonisamide oral capsule 100 mg Zonegran
26
Nombre del medicamento Referencia Notas
zonisamide oral capsule 25 mg Zonegran QL
zonisamide oral capsule 50 mg QL
ANTIDEPRESIVOS ANTAGONISTAS DE RECEPTORES ALFA-2
mirtazapine oral tablet Remeron
mirtazapine oral tablet,disintegrating Remeron SolTab
ANTIDEPRESIVOS TRICÍCLICOS E INHIBIDORES DE RECAPTACIÓN NO SELECCIONADOS RELACIONADOS
amitriptyline oral tablet
amoxapine oral tablet
clomipramine oral capsule Anafranil
desipramine oral tablet Norpramin
doxepin oral capsule
doxepin oral concentrate
imipramine hcl oral tablet Tofranil
imipramine pamoate oral capsule
maprotiline oral tablet
nortriptyline oral capsule Pamelor
nortriptyline oral solution
protriptyline oral tablet
trimipramine oral capsule Surmontil
ANTIDEPRESIVOS, OTROS
perphenazine-amitriptyline oral tablet
ANTIPSICÓTICOS, DOPAMINA ATÍPICA Y ANTAGONISTAS DE SEROTONINA
ABILIFY MAINTENA INTRAMUSCULAR SUSPENSION,EXTENDED REL RECON
AL; QL
ABILIFY MAINTENA INTRAMUSCULAR SUSPENSION,EXTENDED REL SYRING
AL
aripiprazole oral tablet Abilify AL; QL
ARISTADA INTRAMUSCULAR SUSPENSION,EXTENDED REL SYRING
PA; AL
clozapine oral tablet Clozaril AL; QL
INVEGA SUSTENNA INTRAMUSCULAR SYRINGE
PA; AL; QL
27
Nombre del medicamento Referencia Notas
INVEGA TRINZA INTRAMUSCULAR SYRINGE
PA; AL; QL
olanzapine intramuscular recon soln Zyprexa AL
olanzapine oral tablet Zyprexa AL; QL
paliperidone oral tablet extended release 24hr
Invega AL
quetiapine oral tablet Seroquel AL; QL
RISPERDAL CONSTA INTRAMUSCULAR SYRINGE
PA; AL; QL
risperidone oral solution Risperdal AL; QL
risperidone oral tablet Risperdal AL; QL
ziprasidone hcl oral capsule Geodon AL; QL
ZYPREXA RELPREVV INTRAMUSCULAR SUSPENSION FOR RECONSTITUTION
PA; AL
ANTIPSICÓTICOS, TÍPICOS
chlorpromazine oral tablet AL
fluphenazine decanoate injection solution AL
fluphenazine hcl injection solution AL
fluphenazine hcl oral concentrate AL
fluphenazine hcl oral elixir AL
fluphenazine hcl oral tablet AL
haloperidol decanoate intramuscular solution 100 mg/ml
Haldol Decanoate AL; QL
haloperidol decanoate intramuscular solution 50 mg/ml
Haldol Decanoate AL
haloperidol lactate injection solution Haldol AL
haloperidol lactate intramuscular syringe AL
haloperidol lactate oral concentrate AL
haloperidol oral tablet AL
loxapine succinate oral capsule AL
perphenazine oral tablet AL
pimozide oral tablet Orap PA
prochlorperazine maleate oral tablet Compazine
thioridazine oral tablet
thiothixene oral capsule AL
trifluoperazine oral tablet AL
BENZODIACEPINAS
alprazolam intensol oral concentrate
28
Nombre del medicamento Referencia Notas
alprazolam oral tablet Xanax
alprazolam oral tablet,disintegrating
chlordiazepoxide hcl oral capsule
clonazepam oral tablet Klonopin
clonazepam oral tablet,disintegrating
clorazepate dipotassium oral tablet
estazolam oral tablet
flurazepam oral capsule QL
oxazepam oral capsule
temazepam oral capsule Restoril QL
triazolam oral tablet Halcion QL
COMBINACIONES DE BENZODIACEPINA/ANTIDEPRESIVOS TRICÍCLICOS
amitriptyline-chlordiazepoxide oral tablet
DÉFICIT DE ATENCIÓN, HIPERACTIVIDAD (TDAH)/NARCOLEPSIA
atomoxetine oral capsule Strattera DO; AL; QL
caffeine citrate intravenous solution Cafcit
caffeine citrate oral solution
clonidine hcl oral tablet extended release 12 hr
Kapvay AL; QL
dexmethylphenidate oral capsule,er biphasic 50-50
Focalin XR AL; QL
dexmethylphenidate oral tablet 10 mg, 2.5 mg
Focalin AL
dexmethylphenidate oral tablet 5 mg Focalin PA; QL
dextroamphetamine oral capsule, extended release
Dexedrine Spansule AL; QL
dextroamphetamine oral tablet Zenzedi AL; QL
dextroamphetamine-amphetamine oral capsule,extended release 24hr
Adderall XR AL; QL
dextroamphetamine-amphetamine oral tablet
Adderall AL
metadate er oral tablet extended release AL; QL
methylphenidate hcl oral capsule, er biphasic 30-70
AL; QL
29
Nombre del medicamento Referencia Notas
methylphenidate hcl oral capsule,er biphasic 50-50
Ritalin LA AL; QL
methylphenidate hcl oral solution Methylin AL
methylphenidate hcl oral tablet Ritalin AL
methylphenidate hcl oral tablet extended release 10 mg
AL
methylphenidate hcl oral tablet extended release 20 mg
Metadate ER AL; QL
methylphenidate hcl oral tablet extended release 24hr
Concerta AL; QL
ESTIMULANTES DEL SNC
dextroamphetamine oral capsule, extended release
Dexedrine Spansule AL; QL
dextroamphetamine oral tablet Zenzedi AL; QL
dextroamphetamine-amphetamine oral capsule,extended release 24hr
Adderall XR AL; QL
dextroamphetamine-amphetamine oral tablet
Adderall AL
INHIBIDOR SELECTIVO DE RECAPTACIÓN DE SEROTONINA (ISRS)
citalopram oral solution QL
citalopram oral tablet 10 mg, 40 mg Celexa
citalopram oral tablet 20 mg Celexa QL
escitalopram oxalate oral solution
escitalopram oxalate oral tablet Lexapro QL
fluoxetine oral capsule Prozac QL
fluoxetine oral capsule,delayed release(dr/ec)
fluoxetine oral solution
fluoxetine oral tablet Sarafem QL
fluvoxamine oral tablet
paroxetine hcl oral tablet Paxil QL
paroxetine hcl oral tablet extended release 24 hr 12.5 mg, 37.5 mg
Paxil CR
paroxetine hcl oral tablet extended release 24 hr 25 mg
Paxil CR QL
sertraline oral concentrate Zoloft QL
sertraline oral tablet Zoloft QL
30
Nombre del medicamento Referencia Notas
INHIBIDORES DE RECAPTACIÓN DE ANTAGONISTAS DE SEROTONINA-2 (SARIS)
nefazodone oral tablet
trazodone oral tablet
INHIBIDORES DE RECAPTACIÓN DE DOPAMINA Y NOREPINEFRINA (IRND)
bupropion hcl oral tablet
bupropion hcl oral tablet extended release 12 hr
Wellbutrin SR
bupropion hcl oral tablet extended release 24 hr
Wellbutrin XL QL
INHIBIDORES DE RECAPTACIÓN DE SEROTONINA-NOREPINEFRINA (IRSN)
venlafaxine oral capsule,extended release 24hr
Effexor XR QL
venlafaxine oral tablet QL
venlafaxine oral tablet extended release 24hr
QL
INHIBIDORES MAO
phenelzine oral tablet Nardil
tranylcypromine oral tablet Parnate
MEDICAMENTOS ANTIMANÍACOS
lithium carbonate oral capsule
lithium carbonate oral tablet
lithium carbonate oral tablet extended release
Lithobid
lithium citrate oral solution 8 meq/5 ml AL
lithium citrate oral solution 8 meq/5 ml (5 ml)
MEDICAMENTOS PARA EL PARKINSON, ANTICOLINÉRGICO
benztropine oral tablet
trihexyphenidyl oral elixir
trihexyphenidyl oral tablet
31
Nombre del medicamento Referencia Notas
MEDICAMENTOS PARA EL PARKINSON, OTROS
amantadine hcl oral capsule QL
amantadine hcl oral solution
amantadine hcl oral tablet
bromocriptine oral capsule Parlodel
bromocriptine oral tablet Parlodel
carbidopa-levodopa oral tablet Sinemet
carbidopa-levodopa oral tablet extended release
Sinemet CR
carbidopa-levodopa oral tablet,disintegrating
carbidopa-levodopa-entacapone oral tablet
Stalevo 50 QL
entacapone oral tablet Comtan
pramipexole oral tablet Mirapex QL
ropinirole oral tablet Requip
selegiline hcl oral capsule
selegiline hcl oral tablet
PREPARADOS PARA LA MIGRAÑA
divalproex oral tablet extended release 24 hr
Depakote ER QL
ergotamine-caffeine oral tablet Cafergot
isometh-dichloral-acetaminophn oral capsule
migergot rectal suppository
naratriptan oral tablet Amerge QL
nodolor oral capsule
sumatriptan nasal spray,non-aerosol Imitrex PA; QL
sumatriptan succinate oral tablet Imitrex QL
sumatriptan succinate subcutaneous cartridge
Imitrex STATdose Kit Refill PA; QL
sumatriptan succinate subcutaneous pen injector
Imitrex STATdose Pen PA; QL
sumatriptan succinate subcutaneous solution
Imitrex PA; QL
sumatriptan succinate subcutaneous syringe
PA; QL
32
Nombre del medicamento Referencia Notas
SEDANTE HIPNÓTICO, BARBITÚRICOS
phenobarbital oral elixir
phenobarbital oral tablet 100 mg, 15 mg, 16.2 mg, 30 mg, 60 mg, 64.8 mg, 97.2 mg
phenobarbital oral tablet 32.4 mg QL
SEDANTE HIPNÓTICO, NO BARBITÚRICOS
diphenhydramine hcl oral capsule Banophen OTC
estazolam oral tablet
flurazepam oral capsule QL
temazepam oral capsule Restoril QL
triazolam oral tablet Halcion QL
UNISOM (DIPHENHYDRAMINE) ORAL LIQUID
OTC
zaleplon oral capsule Sonata QL
zolpidem oral tablet Ambien QL
AGENTES HEMATOLÓGICOS
AGENTES ANTIFIBRINOLÍTICOS
tranexamic acid oral tablet Lysteda QL
AGENTES HEMORREOLÓGICOS
pentoxifylline oral tablet extended release
AGENTES INHIBIDORES DE C1 ESTERASA
BERINERT INTRAVENOUS RECON SOLN
PA
AGENTES PARA LA ANEMIA FALCIFORME
DROXIA ORAL CAPSULE
ANTICOAGULANTES ORALES
ELIQUIS ORAL TABLET
ELIQUIS ORAL TABLETS,DOSE PACK QL
jantoven oral tablet
warfarin oral tablet Coumadin
FORMULACIONES DE COLORACIÓN CON HEPARINA
heparin lock flush (porcine) intravenous syringe
33
Nombre del medicamento Referencia Notas
HEMATÍNICOS, OTRO
ARANESP (IN POLYSORBATE) INJECTION SOLUTION
PA; QL
ARANESP (IN POLYSORBATE) INJECTION SYRINGE 10 MCG/0.4 ML, 100 MCG/0.5 ML, 200 MCG/0.4 ML, 25 MCG/0.42 ML, 300 MCG/0.6 ML, 40 MCG/0.4 ML, 60 MCG/0.3 ML
PA
ARANESP (IN POLYSORBATE) INJECTION SYRINGE 150 MCG/0.3 ML, 500 MCG/ML
PA; QL
EPOGEN INJECTION SOLUTION PA
PROCRIT INJECTION SOLUTION PA
HEPARINA Y PREPARADOS RELACIONADOS
enoxaparin subcutaneous solution Lovenox QL
enoxaparin subcutaneous syringe Lovenox QL
heparin (porcine) injection cartridge
heparin (porcine) injection solution
heparin (porcine) injection syringe
heparin lock flush (porcine) intravenous syringe
heparin, porcine (pf) injection solution
heparin, porcine (pf) injection syringe
INHIBIDORES DE AGREGACIÓN PLAQUETARIA
anagrelide oral capsule Agrylin
cilostazol oral tablet
clopidogrel oral tablet 300 mg Plavix
clopidogrel oral tablet 75 mg Plavix QL
dipyridamole oral tablet
ticlopidine oral tablet
AGENTES INMUNOSUPRESORES
INMUNOSUPRESORES
azathioprine oral tablet Imuran
cyclosporine modified oral capsule Gengraf
cyclosporine modified oral solution Gengraf
cyclosporine oral capsule Sandimmune
gengraf oral capsule
34
Nombre del medicamento Referencia Notas
gengraf oral solution
mycophenolate mofetil oral capsule CellCept
mycophenolate mofetil oral suspension for reconstitution
CellCept
mycophenolate mofetil oral tablet CellCept
mycophenolate sodium oral tablet,delayed release (dr/ec)
Myfortic
RAPAMUNE ORAL SOLUTION
SANDIMMUNE ORAL SOLUTION
sirolimus oral tablet Rapamune
tacrolimus oral capsule Prograf
AGENTES OFTÁLMICOS
AGENTES ANTINFLAMATORIOS OFTÁLMICOS
dexamethasone sodium phosphate ophthalmic (eye) drops
diclofenac sodium ophthalmic (eye) drops
fluorometholone ophthalmic (eye) drops,suspension
FML Liquifilm
flurbiprofen sodium ophthalmic (eye) drops
prednisolone acetate ophthalmic (eye) drops,suspension
Omnipred
prednisolone sodium phosphate ophthalmic (eye) drops
XIIDRA OPHTHALMIC (EYE) DROPPERETTE
PA; QL
ANTIBIÓTICO OFTÁLMICO, COMBINACIONES DE CORTICOESTEROIDES
neomycin-bacitracin-poly-hc ophthalmic (eye) ointment
Neo-Polycin HC
neomycin-polymyxin b-dexameth ophthalmic (eye) drops,suspension
Maxitrol
neomycin-polymyxin b-dexameth ophthalmic (eye) ointment
Maxitrol
neomycin-polymyxin-hc ophthalmic (eye) drops,suspension
neo-polycin hc ophthalmic (eye) ointment
35
Nombre del medicamento Referencia Notas
sulfacetamide-prednisolone ophthalmic (eye) drops
QL
tobramycin-dexamethasone ophthalmic (eye) drops,suspension
TobraDex QL
ANTIBIÓTICOS OFTÁLMICOS
bacitracin ophthalmic (eye) ointment QL
bacitracin-polymyxin b ophthalmic (eye) ointment
Polycin
ciprofloxacin hcl ophthalmic (eye) drops Ciloxan
erythromycin ophthalmic (eye) ointment
gatifloxacin ophthalmic (eye) drops Zymaxid
gentak ophthalmic (eye) ointment QL
gentamicin ophthalmic (eye) drops QL
gentamicin ophthalmic (eye) ointment Gentak QL
levofloxacin ophthalmic (eye) drops
moxifloxacin ophthalmic (eye) drops Vigamox QL
neomycin-bacitracin-polymyxin ophthalmic (eye) ointment
Neo-Polycin QL
neomycin-polymyxin-gramicidin ophthalmic (eye) drops
QL
neo-polycin ophthalmic (eye) ointment QL
ofloxacin ophthalmic (eye) drops Ocuflox QL
polycin ophthalmic (eye) ointment
polymyxin b sulf-trimethoprim ophthalmic (eye) drops
Polytrim QL
sulfacetamide sodium ophthalmic (eye) drops
Bleph-10 QL
sulfacetamide sodium ophthalmic (eye) ointment
QL
tobramycin ophthalmic (eye) drops Tobrex QL
ANTIHISTAMÍNICOS OFTÁLMICOS
azelastine ophthalmic (eye) drops QL
epinastine ophthalmic (eye) drops Elestat QL
ANTIVIRALES OFTÁLMICOS
trifluridine ophthalmic (eye) drops Viroptic QL
DESCONGESTIVOS OFTÁLMICOS
phenylephrine hcl ophthalmic (eye) drops
36
Nombre del medicamento Referencia Notas
ESTABILIZADORES DE MASTOCITOS OFTÁLMICOS
cromolyn ophthalmic (eye) drops QL
LÁGRIMAS ARTIFICIALES
hypotears ophthalmic (eye) drops OTC
lubricant eye(dextran70-hypml) ophthalmic (eye) dropperette
OTC
MIDRIÁTRICOS
atropine ophthalmic (eye) drops QL
atropine ophthalmic (eye) ointment QL
MIÓTICOS/OTROS REDUCTORES DE PRESIÓN INTRAOCULAR
apraclonidine ophthalmic (eye) drops Iopidine
betaxolol ophthalmic (eye) drops
brimonidine ophthalmic (eye) drops QL
carteolol ophthalmic (eye) drops QL
dorzolamide ophthalmic (eye) drops Trusopt QL
dorzolamide-timolol ophthalmic (eye) drops
Cosopt QL
latanoprost ophthalmic (eye) drops Xalatan QL
levobunolol ophthalmic (eye) drops Betagan
metipranolol ophthalmic (eye) drops QL
pilocarpine hcl ophthalmic (eye) drops Isopto Carpine
timolol maleate ophthalmic (eye) drops Timoptic QL
timolol maleate ophthalmic (eye) gel forming solution
Timoptic-XE QL
ANALGÉSICO, ANTINFLAMATORIO O ANTIPIRÉTICO
ANALGÉSICO/ANTIPIRÉTICOS, SALICILATOS
butalbital-aspirin-caffeine oral capsule Fiorinal QL
butalbital-aspirin-caffeine oral tablet
choline,magnesium salicylate oral liquid
diflunisal oral tablet
salsalate oral tablet Disalcid
ANALGÉSICOS, NARCÓTICOS
acetaminophen-codeine oral solution 120 mg-12 mg /5 ml (5 ml), 120-12 mg/5 ml
PA; AL; QL
37
Nombre del medicamento Referencia Notas
acetaminophen-codeine oral solution 240 mg-24 mg /10 ml (10 ml), 300 mg-30 mg /12.5 ml
PA; AL
acetaminophen-codeine oral tablet PA; AL; QL
ascomp with codeine oral capsule AL
aspirin-caffeine-dihydrocodein oral capsule
QL
butalbital compound w/codeine oral capsule
AL
butalbital compound-codeine oral capsule AL
butalbital-acetaminop-caf-cod oral capsule AL; QL
butorphanol tartrate nasal spray,non-aerosol
PA; QL
codeine sulfate oral tablet 15 mg, 30 mg AL
codeine sulfate oral tablet 60 mg AL; QL
codeine-butalbital-asa-caff oral capsule Ascomp with Codeine AL
diskets oral tablet,soluble QL
endocet oral tablet 10-325 mg, 5-325 mg
endocet oral tablet 7.5-325 mg QL
fentanyl citrate buccal lozenge on a handle
Actiq PA; QL
fentanyl transdermal patch 72 hour Duragesic PA; QL
hydrocodone-acetaminophen oral solution Hycet PA; QL
hydrocodone-acetaminophen oral tablet Lorcet (hydrocodone) PA; QL
hydrocodone-ibuprofen oral tablet PA; QL
hydromorphone oral liquid Dilaudid QL
hydromorphone oral tablet 2 mg, 4 mg Dilaudid
hydromorphone oral tablet 8 mg Dilaudid QL
hydromorphone rectal suppository QL
meperidine oral solution QL
meperidine oral tablet 100 mg Demerol QL
meperidine oral tablet 50 mg
methadone intensol oral concentrate PA; QL
methadone oral concentrate Methadone Intensol PA; QL
methadone oral solution PA; QL
methadone oral tablet Dolophine PA; QL
methadone oral tablet,soluble Diskets PA; QL
methadose oral concentrate PA; QL
38
Nombre del medicamento Referencia Notas
methadose oral tablet,soluble PA; QL
morphine concentrate oral solution QL
morphine oral solution QL
morphine oral tablet QL
morphine oral tablet extended release MS Contin PA; QL
morphine rectal suppository QL
oxycodone oral capsule QL
oxycodone oral concentrate QL
oxycodone oral solution QL
oxycodone oral tablet Roxicodone QL
oxycodone-acetaminophen oral tablet 10-325 mg, 2.5-325 mg, 5-325 mg
Endocet
oxycodone-acetaminophen oral tablet 7.5-325 mg
Endocet QL
oxycodone-aspirin oral tablet QL
pentazocine-naloxone oral tablet QL
tramadol oral tablet Ultram PA; AL; QL
tramadol-acetaminophen oral tablet Ultracet PA; AL; QL
vicodin es oral tablet PA; QL
vicodin hp oral tablet PA; QL
vicodin oral tablet PA; QL
zamicet oral solution QL
ANALGÉSICOS, NO NARCÓTICOS
acetaminophen oral liquid OTC
acetaminophen oral tablet,disintegrating Children's Pain-Fever Relief OTC
butalbital-acetaminophen oral tablet Tencon QL
butalbital-acetaminophen-caff oral capsule Capacet QL
butalbital-acetaminophen-caff oral tablet Esgic QL
capacet oral capsule QL
marten-tab oral tablet QL
non-aspirin pain relief oral tablet OTC
tencon oral tablet QL
ANTINFLAMATORIO, INHIBIDOR DE LA SÍNTESIS DE PIRIMIDINA
leflunomide oral tablet Arava
RIDAURA ORAL CAPSULE
39
Nombre del medicamento Referencia Notas
FÁRMACOS ANTIRREUMÁTICOS MODIFICADORES DE LA ENFERMEDAD (FARME)
DEPEN TITRATABS ORAL TABLET PA
minocycline oral capsule Minocin
minocycline oral tablet
sulfasalazine oral tablet Azulfidine QL
sulfasalazine oral tablet,delayed release (dr/ec)
Azulfidine EN-tabs QL
INHIBIDOR DEL FACTOR DE LA NECROSIS TUMORAL ANTINFLAMATORIA
ENBREL MINI SUBCUTANEOUS CARTRIDGE
PA; QL
ENBREL SUBCUTANEOUS RECON SOLN
PA; QL
ENBREL SUBCUTANEOUS SYRINGE PA; QL
ENBREL SURECLICK SUBCUTANEOUS PEN INJECTOR
PA; QL
HUMIRA PEDIATRIC CROHN'S START SUBCUTANEOUS SYRINGE KIT
PA; QL
HUMIRA PEN CROHN'S-UC-HS START SUBCUTANEOUS PEN INJECTOR KIT
PA; QL
HUMIRA PEN PSORIASIS-UVEITIS SUBCUTANEOUS PEN INJECTOR KIT
PA; QL
HUMIRA PEN SUBCUTANEOUS PEN INJECTOR KIT
PA; QL
HUMIRA SUBCUTANEOUS SYRINGE KIT
PA; QL
INHIBIDOR DEL FACTOR DE NECROSIS TUMORAL ANTINFLAMATORIO
ENBREL MINI SUBCUTANEOUS CARTRIDGE
PA; QL
ENBREL SUBCUTANEOUS RECON SOLN
PA; QL
ENBREL SUBCUTANEOUS SYRINGE PA; QL
ENBREL SURECLICK SUBCUTANEOUS PEN INJECTOR
PA; QL
HUMIRA PEDIATRIC CROHN'S START SUBCUTANEOUS SYRINGE KIT
PA; QL
40
Nombre del medicamento Referencia Notas
HUMIRA PEN CROHN'S-UC-HS START SUBCUTANEOUS PEN INJECTOR KIT
PA; QL
HUMIRA PEN PSORIASIS-UVEITIS SUBCUTANEOUS PEN INJECTOR KIT
PA; QL
HUMIRA PEN SUBCUTANEOUS PEN INJECTOR KIT
PA; QL
HUMIRA SUBCUTANEOUS SYRINGE KIT
PA; QL
INMUNOSUPRESORES
cyclosporine modified oral capsule Gengraf
cyclosporine modified oral solution Gengraf
cyclosporine oral capsule Sandimmune
gengraf oral capsule
gengraf oral solution
mycophenolate mofetil oral suspension for reconstitution
CellCept
SANDIMMUNE ORAL SOLUTION
NSAIDS
diclofenac potassium oral tablet
diclofenac sodium oral tablet extended release 24 hr
Voltaren-XR PA
diclofenac sodium oral tablet,delayed release (dr/ec)
etodolac oral capsule
etodolac oral tablet Lodine
etodolac oral tablet extended release 24 hr
fenoprofen oral tablet ProFeno QL
flurbiprofen oral tablet
ibu oral tablet
ibuprofen oral suspension Child Ibuprofen OTC; QL
ibuprofen oral tablet IBU
indomethacin oral capsule
indomethacin oral capsule, extended release
ketoprofen oral capsule
ketoprofen oral capsule,ext rel. pellets 24 hr
QL
ketorolac oral tablet QL
41
Nombre del medicamento Referencia Notas
meclofenamate oral capsule QL
meloxicam oral suspension
meloxicam oral tablet 15 mg Mobic
meloxicam oral tablet 7.5 mg Mobic PA
nabumetone oral tablet
naproxen oral suspension Naprosyn PA
naproxen oral tablet
naproxen oral tablet,delayed release (dr/ec)
EC-Naprosyn PA
naproxen sodium oral tablet Anaprox DS
oxaprozin oral tablet Daypro
piroxicam oral capsule Feldene PA
profeno oral tablet QL
sulindac oral tablet
tolmetin oral capsule
tolmetin oral tablet
ANESTÉSICOS
ANESTÉSICOS LOCALES
lidocaine hcl laryngotracheal solution LTA Pre-Attached QL
lidocaine topical ointment QL
ANTICONCEPTIVOS
ANTICONCEPTIVOS DE EMERGENCIA
ELLA ORAL TABLET
ANTICONCEPTIVOS
altavera (28) oral tablet AL; QL
alyacen 1/35 (28) oral tablet AL
alyacen 7/7/7 (28) oral tablet AL
amethia lo oral tablets,dose pack,3 month AL; QL
amethia oral tablets,dose pack,3 month AL; QL
amethyst oral tablet AL
apri oral tablet AL
aranelle (28) oral tablet AL
ashlyna oral tablets,dose pack,3 month AL; QL
aubra oral tablet AL
aviane oral tablet AL
azurette (28) oral tablet AL
42
Nombre del medicamento Referencia Notas
balziva (28) oral tablet AL
bekyree (28) oral tablet AL
blisovi 24 fe oral tablet AL
blisovi fe 1.5/30 (28) oral tablet AL
blisovi fe 1/20 (28) oral tablet AL
briellyn oral tablet AL
camila oral tablet AL
camrese lo oral tablets,dose pack,3 month AL; QL
camrese oral tablets,dose pack,3 month AL; QL
caziant (28) oral tablet AL
chateal oral tablet AL; QL
cryselle (28) oral tablet AL
cyclafem 1/35 (28) oral tablet AL
cyclafem 7/7/7 (28) oral tablet AL
cyred oral tablet AL
dasetta 1/35 (28) oral tablet AL
dasetta 7/7/7 (28) oral tablet AL
daysee oral tablets,dose pack,3 month AL; QL
deblitane oral tablet AL
delyla (28) oral tablet AL
desog-e.estradiol/e.estradiol oral tablet Azurette (28) AL
desogestrel-ethinyl estradiol oral tablet Apri AL
drospirenone-e.estradiol-lm.fa oral tablet Beyaz AL
drospirenone-ethinyl estradiol oral tablet Ocella AL
elinest oral tablet AL
emoquette oral tablet AL
enpresse oral tablet AL
enskyce oral tablet AL
errin oral tablet AL
estarylla oral tablet AL
ethynodiol diac-eth estradiol oral tablet Kelnor 1/35 (28) AL
falmina (28) oral tablet AL
fayosim oral tablets,dose pack,3 month AL; QL
femynor oral tablet AL
gianvi (28) oral tablet AL
gildagia oral tablet AL
heather oral tablet AL
43
Nombre del medicamento Referencia Notas
introvale oral tablets,dose pack,3 month AL; QL
isibloom oral tablet AL
jencycla oral tablet AL
jolessa oral tablets,dose pack,3 month AL; QL
jolivette oral tablet AL
juleber oral tablet AL
junel 1.5/30 (21) oral tablet AL
junel 1/20 (21) oral tablet AL
junel fe 1.5/30 (28) oral tablet AL
junel fe 1/20 (28) oral tablet AL
junel fe 24 oral tablet AL
kaitlib fe oral tablet,chewable AL
kariva (28) oral tablet AL
kelnor 1/35 (28) oral tablet AL
kelnor 1-50 oral tablet
kimidess (28) oral tablet AL
kurvelo oral tablet AL; QL
KYLEENA INTRAUTERINE INTRAUTERINE DEVICE
l norgest/e.estradiol-e.estrad oral tablets,dose pack,3 month
Amethia AL; QL
larin 1.5/30 (21) oral tablet AL
larin 1/20 (21) oral tablet AL
larin 24 fe oral tablet AL
larin fe 1.5/30 (28) oral tablet AL
larin fe 1/20 (28) oral tablet AL
larissia oral tablet AL
layolis fe oral tablet,chewable AL
leena 28 oral tablet AL
lessina oral tablet AL
levonest (28) oral tablet AL
levonorgestrel-ethinyl estrad oral tablet 0.1-20 mg-mcg
Aubra AL
levonorgestrel-ethinyl estrad oral tablet 0.15-0.03 mg
Altavera (28) AL; QL
levonorgestrel-ethinyl estrad oral tablet 90-20 mcg
Amethyst AL
44
Nombre del medicamento Referencia Notas
levonorgestrel-ethinyl estrad oral tablets,dose pack,3 month
Introvale AL; QL
levonorg-eth estrad triphasic oral tablet Enpresse AL
levora 0.15/30 (28) oral tablet AL; QL
levora-28 oral tablet AL; QL
LILETTA INTRAUTERINE INTRAUTERINE DEVICE
lillow oral tablet AL; QL
lomedia 24 fe oral tablet AL
loryna (28) oral tablet AL
low-ogestrel (28) oral tablet AL
lutera (28) oral tablet AL
lyza oral tablet AL
marlissa oral tablet AL; QL
medroxyprogesterone intramuscular suspension
Depo-Provera AL; QL
medroxyprogesterone intramuscular syringe
Depo-Provera AL; QL
melodetta 24 fe oral tablet,chewable AL
mibelas 24 fe oral tablet,chewable AL
microgestin 1.5/30 (21) oral tablet AL
microgestin 1/20 (21) oral tablet AL
microgestin fe 1.5/30 (28) oral tablet AL
microgestin fe 1/20 (28) oral tablet AL
MIRENA INTRAUTERINE INTRAUTERINE DEVICE
mono-linyah oral tablet AL
mononessa (28) oral tablet AL
myzilra oral tablet AL
necon 0.5/35 (28) oral tablet AL
necon 1/50 (28) oral tablet AL
necon 10/11 (28) oral tablet AL
necon 7/7/7 (28) oral tablet AL
NEXPLANON SUBDERMAL IMPLANT
nikki (28) oral tablet AL
nora-be oral tablet AL
noreth-ethinyl estradiol-iron oral tablet,chewable
Wymzya Fe AL
45
Nombre del medicamento Referencia Notas
norethindrone (contraceptive) oral tablet Camila AL
norethindrone ac-eth estradiol oral tablet Junel 1/20 (21) AL
norethindrone-e.estradiol-iron oral tablet Blisovi Fe 1/20 (28) AL
norethindrone-e.estradiol-iron oral tablet,chewable
Melodetta 24 Fe AL
norgestimate-ethinyl estradiol oral tablet 0.18/0.215/0.25 mg-25 mcg
Ortho Tri-Cyclen LO (28) AL; QL
norgestimate-ethinyl estradiol oral tablet 0.18/0.215/0.25 mg-35 mcg (28)
Ortho Tri-Cyclen (28) AL
norgestimate-ethinyl estradiol oral tablet 0.25-35 mg-mcg
Estarylla AL
norgestrel-ethinyl estradiol oral tablet Ogestrel (28) AL
norlyda oral tablet AL
norlyroc oral tablet AL
nortrel 0.5/35 (28) oral tablet AL
nortrel 1/35 (21) oral tablet AL
nortrel 1/35 (28) oral tablet AL
nortrel 7/7/7 (28) oral tablet AL
NUVARING VAGINAL RING AL; QL
ocella oral tablet AL
ogestrel (28) oral tablet AL
orsythia oral tablet AL
PARAGARD T 380A INTRAUTERINE INTRAUTERINE DEVICE
philith oral tablet AL
pimtrea (28) oral tablet AL
pirmella oral tablet AL
portia oral tablet AL; QL
previfem oral tablet AL
quasense oral tablets,dose pack,3 month AL; QL
rajani oral tablet AL
reclipsen (28) oral tablet AL
RIVELSA ORAL TABLETS,DOSE PACK,3 MONTH
AL; QL
setlakin oral tablets,dose pack,3 month AL; QL
sharobel oral tablet AL
SKYLA INTRAUTERINE INTRAUTERINE DEVICE
sprintec (28) oral tablet AL
46
Nombre del medicamento Referencia Notas
sronyx oral tablet AL
syeda oral tablet AL
tarina fe 1/20 (28) oral tablet AL
tilia fe oral tablet AL; QL
tri femynor oral tablet AL
tri-estarylla oral tablet AL
tri-legest fe oral tablet AL; QL
tri-linyah oral tablet AL
tri-lo-estarylla oral tablet AL; QL
tri-lo-marzia oral tablet AL; QL
tri-lo-sprintec oral tablet AL; QL
trinessa (28) oral tablet AL
trinessa lo oral tablet AL; QL
tri-previfem (28) oral tablet AL
tri-sprintec (28) oral tablet AL
trivora (28) oral tablet AL
tri-vylibra oral tablet AL
tydemy oral tablet AL
velivet triphasic regimen (28) oral tablet AL
vestura (28) oral tablet AL
vienva oral tablet AL
viorele (28) oral tablet AL
vyfemla (28) oral tablet AL
vylibra oral tablet AL
wera (28) oral tablet AL
wymzya fe oral tablet,chewable AL
xulane transdermal patch weekly AL; QL
zarah oral tablet AL
zenchent (28) oral tablet AL
zenchent fe oral tablet,chewable AL
zovia 1/35e (28) oral tablet AL
zovia 1/50e (28) oral tablet AL
ANTÍDOTOS Y OTROS AGENTES DE REVERSIÓN
AGENTES QUELANTES
deferoxamine injection recon soln Desferal
DEPEN TITRATABS ORAL TABLET PA
47
Nombre del medicamento Referencia Notas
trientine oral capsule Syprine PA; QL
ANTAGONISTAS DE NARCÓTICOS
naloxone injection solution QL
naloxone injection syringe QL
naltrexone oral tablet
NARCAN NASAL SPRAY,NON-AEROSOL
QL
ANTÍDOTOS
acetylcysteine solution
ANTINEOPLÁSICOS
MEDICAMENTOS ANTINEOPLÁSICOS/INMUNOSUPRESORES
anastrozole oral tablet Arimidex QL
bicalutamide oral tablet Casodex
EMCYT ORAL CAPSULE PA
exemestane oral tablet Aromasin QL
flutamide oral capsule
HEXALEN ORAL CAPSULE PA
hydroxyurea oral capsule Hydrea
imatinib oral tablet Gleevec PA; QL
IRESSA ORAL TABLET PA; QL
letrozole oral tablet Femara QL
leucovorin calcium injection recon soln
leucovorin calcium oral tablet
megestrol oral tablet
melphalan oral tablet Alkeran
MESNEX ORAL TABLET PA
MYLERAN ORAL TABLET
PROLEUKIN INTRAVENOUS RECON SOLN
tamoxifen oral tablet
tretinoin (chemotherapy) oral capsule
VANTAS IMPLANT KIT PA
VELCADE INJECTION RECON SOLN PA
48
Nombre del medicamento Referencia Notas
BIOLÓGICOS
INMUNOGLOBULINAS
GAMUNEX-C INJECTION SOLUTION PA
OCTAGAM INTRAVENOUS SOLUTION PA
VACUNAS INMUNOLÓGICAS
AFLURIA 2016-2017 (PF) INTRAMUSCULAR SYRINGE
AFLURIA 2016-2017 INTRAMUSCULAR SUSPENSION
AFLURIA 2017-2018 (PF) INTRAMUSCULAR SYRINGE
QL
AFLURIA 2017-2018 INTRAMUSCULAR SUSPENSION
QL
AFLURIA QUAD 2016-2017 (PF) INTRAMUSCULAR SYRINGE
AFLURIA QUAD 2017-2018 (PF) INTRAMUSCULAR SYRINGE
QL
AFLURIA QUAD 2017-2018 INTRAMUSCULAR SUSPENSION
QL
CERVARIX VACCINE (PF) INTRAMUSCULAR SYRINGE
EZ FLU 2016-17 (AFLURIA) (PF) INTRAMUSCULAR SYRINGE KIT
EZ FLU 2016-17 (FLUVIRIN) (PF) INTRAMUSCULAR SYRINGE KIT
EZ FLU16-17(FLUZON QD PED)(PF) INTRAMUSCULAR SYRINGE KIT
FLUAD 2016-2017 (65 YR UP)(PF) INTRAMUSCULAR SYRINGE
FLUAD 2017-2018 (65 YR UP)(PF) INTRAMUSCULAR SYRINGE
QL
FLUARIX QUAD 2016-2017 (PF) INTRAMUSCULAR SYRINGE
FLUARIX QUAD 2017-2018 (PF) INTRAMUSCULAR SYRINGE
QL
FLUBLOK 2016-2017 (PF) INTRAMUSCULAR SOLUTION
FLUBLOK 2017-2018 (PF) INTRAMUSCULAR SOLUTION
QL
FLUBLOK QUAD 2017-2018 (PF) INTRAMUSCULAR SYRINGE
QL
49
Nombre del medicamento Referencia Notas
FLUCELVAX QUAD 2016-2017 (PF) INTRAMUSCULAR SYRINGE
FLUCELVAX QUAD 2017-2018 (PF) INTRAMUSCULAR SYRINGE
QL
FLUCELVAX QUAD 2017-2018 INTRAMUSCULAR SUSPENSION
QL
FLULAVAL QUAD 2016-2017 (PF) INTRAMUSCULAR SYRINGE
FLULAVAL QUAD 2016-2017 INTRAMUSCULAR SUSPENSION
FLULAVAL QUAD 2017-2018 (PF) INTRAMUSCULAR SYRINGE
QL
FLULAVAL QUAD 2017-2018 INTRAMUSCULAR SUSPENSION
QL
FLUVIRIN 2016-2017 (PF) INTRAMUSCULAR SYRINGE
FLUVIRIN 2016-2017 INTRAMUSCULAR SUSPENSION
FLUVIRIN 2017-2018 (PF) INTRAMUSCULAR SYRINGE
QL
FLUVIRIN 2017-2018 INTRAMUSCULAR SUSPENSION
QL
FLUZONE HIGH-DOSE 2016-17 (PF) INTRAMUSCULAR SYRINGE
FLUZONE HIGH-DOSE 2017-18 (PF) INTRAMUSCULAR SYRINGE
QL
FLUZONE INTRADERM QUAD 2016-17 INTRADERMAL SYRINGE
FLUZONE INTRADERM QUAD 2017-18 INTRADERMAL SYRINGE
QL
FLUZONE QUAD 2016-2017 (PF) INTRAMUSCULAR SUSPENSION
FLUZONE QUAD 2016-2017 (PF) INTRAMUSCULAR SYRINGE
FLUZONE QUAD 2016-2017 INTRAMUSCULAR SUSPENSION
FLUZONE QUAD 2017-2018 (PF) INTRAMUSCULAR SUSPENSION
QL
FLUZONE QUAD 2017-2018 (PF) INTRAMUSCULAR SYRINGE
QL
FLUZONE QUAD 2017-2018 INTRAMUSCULAR SUSPENSION
QL
50
Nombre del medicamento Referencia Notas
FLUZONE QUAD PEDI 2016-17 (PF) INTRAMUSCULAR SYRINGE
FLUZONE QUAD PEDI 2017-18 (PF) INTRAMUSCULAR SYRINGE
QL
GARDASIL (PF) INTRAMUSCULAR SUSPENSION
GARDASIL 9 (PF) INTRAMUSCULAR SUSPENSION
GARDASIL 9 (PF) INTRAMUSCULAR SYRINGE
PREVNAR 13 (PF) INTRAMUSCULAR SYRINGE
SYNAGIS INTRAMUSCULAR SOLUTION
PA
DEPENDENCIA QUÍMICA, AGENTES PARA TRATAMIENTO
AGENTES PARA DEJAR DE FUMAR
bupropion hcl (smoking deter) oral tablet extended release 12 hr
Zyban QL
bupropion hcl oral tablet extended release 12 hr
Wellbutrin SR
ANTAGONISTA DEL ALCOHOL
acamprosate oral tablet,delayed release (dr/ec)
QL
disulfiram oral tablet Antabuse
ANTAGONISTAS DE NARCÓTICOS
buprenorphine hcl sublingual tablet QL
buprenorphine-naloxone sublingual tablet PA; QL
SUBOXONE SUBLINGUAL FILM PA; QL
DERMATOLÓGICO
AGENTES ANTIACNÉ, TÓPICOS
benzoyl peroxide topical cleanser OTC; QL
clindamycin phosphate topical gel Cleocin T
clindamycin phosphate topical solution Cleocin T QL
clindamycin phosphate topical swab Cleocin T QL
clindamycin-benzoyl peroxide topical gel Duac QL
ery pads topical swab QL
erygel topical gel QL
erythromycin with ethanol topical solution QL
51
Nombre del medicamento Referencia Notas
erythromycin with ethanol topical swab Ery Pads QL
metronidazole topical cream MetroCream QL
metronidazole topical lotion MetroLotion
rosadan topical cream QL
AGENTES ANTINFLAMATORIOS ESTEROIDES TÓPICOS
amcinonide topical lotion
amcinonide topical ointment QL
betamethasone dipropionate topical lotion QL
betamethasone valerate topical cream QL
betamethasone valerate topical ointment QL
betamethasone, augmented topical cream
clobetasol scalp solution Cormax QL
clobetasol topical cream Temovate QL
clobetasol topical gel
clobetasol topical ointment Temovate QL
clobetasol-emollient topical cream QL
cormax scalp solution QL
CORTAID TOPICAL CREAM OTC; QL
diflorasone topical cream Psorcon QL
fluocinonide-e topical cream
fluocinonide-emollient topical cream Fluocinonide-E
fluticasone topical cream Cutivate QL
fluticasone topical ointment QL
halobetasol propionate topical cream Ultravate QL
halobetasol propionate topical ointment Ultravate QL
hydrocortisone 1% ointment (rx) Anti-Itch (HC) OTC
hydrocortisone topical cream 1 % Ala-Cort PA; OTC; QL
hydrocortisone topical cream 2.5 % Ala-Cort QL
hydrocortisone topical cream with perineal applicator
Anusol-HC QL
hydrocortisone topical ointment 2.5 % QL
hydrocortisone-pramoxine topical cream Pramosone
mometasone topical cream Elocon QL
mometasone topical ointment Elocon QL
mometasone topical solution QL
prednicarbate topical ointment Dermatop QL
52
Nombre del medicamento Referencia Notas
proctosol hc topical cream with perineal applicator
QL
proctozone-hc topical cream with perineal applicator
QL
TEXACORT TOPICAL SOLUTION
triamcinolone acetonide topical cream Triderm QL
triamcinolone acetonide topical ointment QL
trianex topical ointment QL
triderm topical cream QL
AGENTES ANTIPSORIÁSICOS
calcipotriene scalp solution QL
calcipotriene topical cream Dovonex QL
calcipotriene topical ointment Calcitrene
calcitrene topical ointment
AGENTES PARA ROSÁCEA, TÓPICOS
metronidazole topical gel 0.75 % Rosadan
metronidazole topical gel 1 % Metrogel QL
metronidazole topical gel with pump Metrogel QL
rosadan topical gel
AGENTES SISTÉMICOS CONTRA EL ACNÉ
claravis oral capsule PA
myorisan oral capsule PA
zenatane oral capsule PA
AGENTES TÓPICOS, VARIOS
aluminum chloride topical solution Drysol
ammonium lactate topical cream Geri-Hydrolac OTC; QL
ammonium lactate topical lotion AmLactin OTC
diclofenac sodium topical drops PA; QL
lidocaine hcl mucous membrane jelly
lidocaine topical adhesive patch,medicated
Lidoderm PA; QL
lidocaine topical ointment QL
nivatopic plus topical cream
podofilox topical solution PA
prumyx topical cream
remeven topical cream
53
Nombre del medicamento Referencia Notas
salacyn topical cream
salacyn topical lotion
salicylic acid topical cream Salimez
salicylic acid topical cream,extended release
salicylic acid topical film forming liquid w/appl
Virasal
salicylic acid topical film-forming soln er w/ appl
UltraSal-ER
salicylic acid topical foam Salvax
salicylic acid topical gel Keralyt Rx
salicylic acid topical liquid
salicylic acid topical lotion
salicylic acid topical lotion,extended release
salicylic acid topical shampoo Salex
salvax topical foam
selenium sulfide topical lotion QL
selenium sulfide topical shampoo
silver sulfadiazine topical cream Silvadene
ssd topical cream
thermazene topical cream
urea topical cream 40 % QL
urea topical cream 45 % Uramaxin QL
urea topical cream 50 % Ure-K
urea topical gel 40 % QL
urea topical gel 45 % CEM-Urea
urea topical lotion Uramaxin
ANESTÉSICOS TÓPICOS
hydrocortisone-pramoxine topical cream Pramosone
lidocaine-prilocaine topical cream QL
ANTIBIÓTICOS TÓPICOS
gentamicin topical cream
gentamicin topical ointment
mupirocin topical ointment Centany QL
sss 10-5 topical cream
sulfacetamide sodium-sulfur topical cream Avar-E
54
Nombre del medicamento Referencia Notas
ANTIMICÓTICOS TÓPICOS
ciclopirox topical cream Ciclodan PA; QL
ciclopirox topical solution Ciclodan PA; QL
ciclopirox topical suspension Loprox (as olamine) QL
clotrimazole topical cream Antifungal (clotrimazole) OTC; QL
clotrimazole topical solution OTC
clotrimazole-betamethasone topical cream Lotrisone QL
clotrimazole-betamethasone topical lotion QL
FUNGI-NAIL TOPICAL TINCTURE OTC
ketoconazole topical cream QL
ketoconazole topical shampoo Nizoral QL
nyamyc topical powder QL
nyata topical powder QL
nystatin topical cream QL
nystatin topical ointment QL
nystatin topical powder Nyamyc QL
nystop topical powder QL
ANTIVIRALES TÓPICOS
acyclovir topical ointment Zovirax PA; QL
DERIVADOS DE LA VITAMINA A
adapalene topical cream Differin PA; QL
adapalene topical gel Differin PA; QL
tretinoin (emollient) topical cream Refissa PA; AL
tretinoin microspheres topical gel Retin-A Micro PA; AL; QL
tretinoin topical cream Retin-A PA
tretinoin topical gel Retin-A PA; QL
ESCABICIDAS Y PEDICULICIDAS
permethrin topical cream Elimite QL
spinosad topical suspension Natroba
INMUNOMODULADORES TÓPICOS
imiquimod topical cream in packet Aldara PA; QL
tacrolimus topical ointment Protopic PA; QL
TÓPICO ANTINEOPLÁSICO Y PREMALIGNO
fluorouracil topical cream Efudex QL
fluorouracil topical solution QL
55
Nombre del medicamento Referencia Notas
DISPOSITIVOS CON Y SIN AGUJAS, JERINGAS Y ACCESORIOS
AGUJAS, DISPOSITIVOS SIN AGUJAS, JERINGAS Y ACCESORIOS
ADVOCATE SYRINGES SYRINGE OTC; QL
ASSURE ID INSULIN SAFETY SYRINGE OTC; QL
BD ECLIPSE LUER-LOK SYRINGE OTC; QL
BD INSULIN SYRINGE HALF UNIT SYRINGE
OTC; QL
BD INSULIN SYRINGE MICRO-FINE SYRINGE
OTC; QL
BD INSULIN SYRINGE SAFETY-LOK SYRINGE
OTC; QL
BD INSULIN SYRINGE SYRINGE OTC; QL
BD INSULIN SYRINGE ULTRA-FINE SYRINGE
OTC; QL
BD LO-DOSE MICRO-FINE IV SYRINGE OTC; QL
BD LO-DOSE ULTRA-FINE SYRINGE OTC; QL
BD SAFETYGLIDE INSULIN SYRINGE SYRINGE
OTC; QL
BD SAFETYGLIDE SYRINGE SYRINGE OTC; QL
BD ULTRA-FINE SHORT PEN NEEDLE NEEDLE
OTC; QL
BD VEO INSULIN SYR HALF UNIT SYRINGE
OTC
BD VEO INSULIN SYRINGE UF SYRINGE
OTC
COMFORT EZ SYRINGE SYRINGE OTC; QL
EASY COMFORT INSULIN SYRINGE SYRINGE
OTC; QL
EASY TOUCH INSULIN SAFETY SYR SYRINGE
OTC; QL
EASY TOUCH INSULIN SYRINGE SYRINGE
OTC; QL
EXEL INSULIN SYRINGE OTC; QL
FREESTYLE PRECISION SYRINGE OTC; QL
insulin syringe microfine syringe OTC; QL
insulin syringe needleless syringe BD Insulin Syringe Slip Tip OTC; QL
insulin syringe syringe OTC; QL
56
Nombre del medicamento Referencia Notas
insulin syringe-needle u-100 syringe Advocate Syringes OTC; QL
insulin syringes (disposable) syringe Monoject Insulin Syringe OTC; QL
LITE TOUCH INSULIN SYRINGE SYRINGE
OTC; QL
MAXI-COMFORT INSULIN SYRINGE SYRINGE
OTC; QL
MONOJECT INSULIN SAFETY SYRING SYRINGE 0.3 ML 29 GAUGE X 1/2"
OTC; QL
MONOJECT INSULIN SAFETY SYRING SYRINGE 0.3 ML 30 GAUGE X 5/16, 0.5 ML 29 GAUGE X 1/2", 1/2 ML 30 GAUGE X 5/16
QL
MONOJECT INSULIN SYRINGE SYRINGE
OTC; QL
MONOJECT SAFETY SYRINGES SYRINGE
OTC
MONOJECT SYRINGE SYRINGE QL
pen needle 31g x 3/16" (rx) OTC; QL
PEN NEEDLE 31G X 5/16" (RX) OTC; QL
pen needle needle 30 gauge x 5/16" QL
PRODIGY INSULIN SYRINGE SYRINGE OTC; QL
SURE COMFORT INS. SYR. U-100 SYRINGE
OTC; QL
SURE COMFORT INSULIN SYRINGE SYRINGE
OTC; QL
SURE-JECT INSULIN SYRINGE SYRINGE
OTC; QL
TERUMO INSULIN SYRINGE SYRINGE OTC; QL
THINPRO INSULIN SYRINGE SYRINGE OTC; QL
TOPCARE ULTRA COMFORT SYRINGE OTC; QL
TRUEPLUS INSULIN SYRINGE OTC; QL
ULTICARE SYRINGE OTC; QL
ULTILET INSULIN SYRINGE SYRINGE OTC; QL
ULTRA CMFT INS SYR HALF UNIT SYRINGE
OTC; QL
ULTRA COMFORT INSULIN SYRINGE SYRINGE
OTC; QL
ULTRA-THIN II (SHORT) INS SYR SYRINGE
OTC; QL
ULTRA-THIN II INSULIN SYRINGE SYRINGE
OTC; QL
57
Nombre del medicamento Referencia Notas
VANISHPOINT SYRINGE SYRINGE OTC; QL
DIAFRAGMAS/CAPUCHÓN CERVICAL
WIDE-SEAL DIAPHRAGM 60 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 65 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 70 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 75 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 80 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 85 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 90 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 95 VAGINAL DIAPHRAGM
DISPOSITIVOS CON Y SIN AGUJAS, JERINGAS Y ACCESORIOS
ACE AEROSOL CLOUD ENHANCER SPACER
QL
ADVOCATE SYRINGES SYRINGE OTC; QL
AEROTRACH PLUS SPACER QL
AEROVENT PLUS SPACER QL
ASSURE ID INSULIN SAFETY SYRINGE OTC; QL
BD ECLIPSE LUER-LOK SYRINGE OTC; QL
BD INSULIN SYRINGE HALF UNIT SYRINGE
OTC; QL
BD INSULIN SYRINGE MICRO-FINE SYRINGE
OTC; QL
BD INSULIN SYRINGE SAFETY-LOK SYRINGE
OTC; QL
BD INSULIN SYRINGE SYRINGE OTC; QL
BD INSULIN SYRINGE ULTRA-FINE SYRINGE
OTC; QL
BD LO-DOSE MICRO-FINE IV SYRINGE OTC; QL
BD LO-DOSE ULTRA-FINE SYRINGE OTC; QL
BD SAFETYGLIDE INSULIN SYRINGE SYRINGE
OTC; QL
58
Nombre del medicamento Referencia Notas
BD SAFETYGLIDE SYRINGE SYRINGE OTC; QL
BD ULTRA-FINE SHORT PEN NEEDLE NEEDLE
OTC; QL
BD VEO INSULIN SYR HALF UNIT SYRINGE
OTC
BD VEO INSULIN SYRINGE UF SYRINGE
OTC
BREATHERITE MDI SPACER SPACER QL
BREATHERITE SPACER-MASK, NEO. SPACER
QL
BREATHERITE SPACER-MASK,ADULT SPACER
QL
BREATHERITE SPACER-MASK,CHILD SPACER
QL
BREATHERITE SPACER-MASK,INFANT SPACER
QL
BREATHERITE SPACER-MASK,S.CHLD SPACER
QL
BREATHERITE VALVED MDI CHAMBER SPACER
QL
BREATHERITE VALVED MDI SPACER SPACER
QL
BREATHERITE WITH MASK, LARGE SPACER
QL
BREATHERITE WITH MASK, MEDIUM SPACER
QL
BREATHERITE WITH MASK, SMALL SPACER
QL
COMFORT EZ SYRINGE SYRINGE OTC; QL
COMPACT SPACE CHAMBER SPACER QL
COMPACT SPACE CHAMBER-LRG MASK SPACER
QL
COMPACT SPACE CHAMBER-MED MASK SPACER
QL
COMPACT SPACE CHAMBER-SM MASK SPACER
QL
EASIVENT MASK LARGE DEVICE QL
EASIVENT MASK MEDIUM DEVICE QL
EASIVENT MASK SMALL DEVICE QL
EASY COMFORT INSULIN SYRINGE SYRINGE
OTC; QL
59
Nombre del medicamento Referencia Notas
EASY TOUCH INSULIN SAFETY SYR SYRINGE
OTC; QL
EASY TOUCH INSULIN SYRINGE SYRINGE
OTC; QL
EXEL INSULIN SYRINGE OTC; QL
FREESTYLE PRECISION SYRINGE OTC; QL
insulin syringe microfine syringe OTC; QL
insulin syringe needleless syringe BD Insulin Syringe Slip Tip OTC; QL
insulin syringe syringe OTC; QL
insulin syringe-needle u-100 syringe Advocate Syringes OTC; QL
insulin syringes (disposable) syringe Monoject Insulin Syringe OTC; QL
LITE TOUCH INSULIN SYRINGE SYRINGE
OTC; QL
LITEAIRE MDI CHAMBER SPACER QL
MAXI-COMFORT INSULIN SYRINGE SYRINGE
OTC; QL
MICROCHAMBER SPACER QL
MICROSPACER SPACER QL
MINI WRIGHT PEAK FLOW METER DEVICE
MONOJECT INSULIN SAFETY SYRING SYRINGE 0.3 ML 29 GAUGE X 1/2"
OTC; QL
MONOJECT INSULIN SAFETY SYRING SYRINGE 0.3 ML 30 GAUGE X 5/16, 0.5 ML 29 GAUGE X 1/2", 1/2 ML 30 GAUGE X 5/16
QL
MONOJECT INSULIN SYRINGE SYRINGE
OTC; QL
MONOJECT SAFETY SYRINGES SYRINGE
OTC
MONOJECT SYRINGE SYRINGE QL
OPTICHAMBER ADULT MASK-LARGE DEVICE
QL
OPTICHAMBER DIAMOND LG MASK SPACER
QL
OPTICHAMBER DIAMOND VHC SPACER
QL
OPTICHAMBER DIAMOND-MED MSK SPACER
QL
OPTICHAMBER DIAMOND-SML MASK SPACER
QL
60
Nombre del medicamento Referencia Notas
pen needle 31g x 3/16" (rx) OTC; QL
PEN NEEDLE 31G X 5/16" (RX) OTC; QL
pen needle needle 30 gauge x 5/16" QL
POCKET CHAMBER SPACER QL
PRIMEAIRE SPACER QL
PROCHAMBER SPACER QL
PRODIGY INSULIN SYRINGE SYRINGE OTC; QL
RITEFLO AEROCHAMBER SPACER QL
SURE COMFORT INS. SYR. U-100 SYRINGE
OTC; QL
SURE COMFORT INSULIN SYRINGE SYRINGE
OTC; QL
SURE-JECT INSULIN SYRINGE SYRINGE
OTC; QL
TERUMO INSULIN SYRINGE SYRINGE OTC; QL
THINPRO INSULIN SYRINGE SYRINGE OTC; QL
TOPCARE ULTRA COMFORT SYRINGE OTC; QL
TRUEPLUS INSULIN SYRINGE OTC; QL
TRUZONE PEAK FLOW METER DEVICE
ULTICARE SYRINGE OTC; QL
ULTILET INSULIN SYRINGE SYRINGE OTC; QL
ULTRA CMFT INS SYR HALF UNIT SYRINGE
OTC; QL
ULTRA COMFORT INSULIN SYRINGE SYRINGE
OTC; QL
ULTRA-THIN II (SHORT) INS SYR SYRINGE
OTC; QL
ULTRA-THIN II INSULIN SYRINGE SYRINGE
OTC; QL
UNISTIK 2 EXTRA KIT OTC; QL
VANISHPOINT SYRINGE SYRINGE OTC; QL
VORTEX HOLDING CHAMBER CHILD SPACER
QL
VORTEX HOLDING CHAMBER SPACER
QL
VORTEX HOLDING CHAMBER TODDLER SPACER
QL
VORTEX VHC FROG MASK-CHILD SPACER
QL
61
Nombre del medicamento Referencia Notas
VORTEX VHC LADYBUG MASK-TODDLR SPACER
QL
WIDE-SEAL DIAPHRAGM 60 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 65 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 70 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 75 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 80 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 85 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 90 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 95 VAGINAL DIAPHRAGM
EQUIPOS, DISPOSITIVOS, ESPACIADORES Y AUXILIARES RESPIRATORIOS
ACE AEROSOL CLOUD ENHANCER SPACER
QL
AEROTRACH PLUS SPACER QL
AEROVENT PLUS SPACER QL
BREATHERITE MDI SPACER SPACER QL
BREATHERITE SPACER-MASK, NEO. SPACER
QL
BREATHERITE SPACER-MASK,ADULT SPACER
QL
BREATHERITE SPACER-MASK,CHILD SPACER
QL
BREATHERITE SPACER-MASK,INFANT SPACER
QL
BREATHERITE SPACER-MASK,S.CHLD SPACER
QL
BREATHERITE VALVED MDI CHAMBER SPACER
QL
BREATHERITE VALVED MDI SPACER SPACER
QL
BREATHERITE WITH MASK, LARGE SPACER
QL
62
Nombre del medicamento Referencia Notas
BREATHERITE WITH MASK, MEDIUM SPACER
QL
BREATHERITE WITH MASK, SMALL SPACER
QL
COMPACT SPACE CHAMBER SPACER QL
COMPACT SPACE CHAMBER-LRG MASK SPACER
QL
COMPACT SPACE CHAMBER-MED MASK SPACER
QL
COMPACT SPACE CHAMBER-SM MASK SPACER
QL
EASIVENT MASK LARGE DEVICE QL
EASIVENT MASK MEDIUM DEVICE QL
EASIVENT MASK SMALL DEVICE QL
LITEAIRE MDI CHAMBER SPACER QL
MICROCHAMBER SPACER QL
MICROSPACER SPACER QL
OPTICHAMBER ADULT MASK-LARGE DEVICE
QL
OPTICHAMBER DIAMOND LG MASK SPACER
QL
OPTICHAMBER DIAMOND VHC SPACER
QL
OPTICHAMBER DIAMOND-MED MSK SPACER
QL
OPTICHAMBER DIAMOND-SML MASK SPACER
QL
POCKET CHAMBER SPACER QL
PRIMEAIRE SPACER QL
PROCHAMBER SPACER QL
RITEFLO AEROCHAMBER SPACER QL
VORTEX HOLDING CHAMBER CHILD SPACER
QL
VORTEX HOLDING CHAMBER SPACER
QL
VORTEX HOLDING CHAMBER TODDLER SPACER
QL
VORTEX VHC FROG MASK-CHILD SPACER
QL
VORTEX VHC LADYBUG MASK-TODDLR SPACER
QL
63
Nombre del medicamento Referencia Notas
SUMINISTROS MÉDICOS Y DME PARA EL ANÁLISIS Y MONITOREO DE LA GLUCOSA EN SANGRE
UNISTIK 2 EXTRA KIT OTC; QL
SUMINISTROS MÉDICOS Y DME: ESPIRÓMETRO
MINI WRIGHT PEAK FLOW METER DEVICE
TRUZONE PEAK FLOW METER DEVICE
ENDOCRINO
AGENTES ANDRÓGENOS
testosterone cypionate intramuscular oil Depo-Testosterone PA
testosterone enanthate intramuscular oil PA
testosterone transdermal gel Testim PA; QL
testosterone transdermal gel in metered-dose pump
Vogelxo PA; QL
testosterone transdermal gel in packet AndroGel PA; QL
AGENTES DE PROGESTERONA PARA LA FERTILIDAD: PREVENCIÓN DE NACIMIENTOS PREMATUROS
MAKENA (PF) SUBCUTANEOUS AUTO-INJECTOR
MAKENA INTRAMUSCULAR OIL QL
AGENTES ESTROGÉNICOS
amabelz oral tablet
estradiol oral tablet Estrace
estradiol transdermal patch transdermal patch weekly
QL
estradiol transdermal patch weekly Climara QL
estradiol-norethindrone acet oral tablet Activella
estropipate oral tablet
fyavolv oral tablet
jevantique lo oral tablet
jinteli oral tablet
lopreeza oral tablet
mimvey lo oral tablet
mimvey oral tablet
64
Nombre del medicamento Referencia Notas
norethindrone ac-eth estradiol oral tablet Fyavolv
PREMARIN ORAL TABLET QL
PREMPHASE ORAL TABLET
PREMPRO ORAL TABLET
AGENTES PROGESTACIONALES
hydroxyprogesterone caproate intramuscular oil
QL
MAKENA (PF) SUBCUTANEOUS AUTO-INJECTOR
MAKENA INTRAMUSCULAR OIL QL
medroxyprogesterone oral tablet Provera QL
norethindrone acetate oral tablet Aygestin
progesterone micronized oral capsule Prometrium QL
AGENTES SUPRESORES HIPOFISARIOS
cabergoline oral tablet QL
ANTIHIPERGLICÉMICO, MIMÉTICO DE INCRETINA (AGONISTA DEL RECEPTOR GLP-1)
OZEMPIC SUBCUTANEOUS PEN INJECTOR
PA; QL
TANZEUM SUBCUTANEOUS PEN INJECTOR
PA; QL
VICTOZA 2-PAK SUBCUTANEOUS PEN INJECTOR
QL
VICTOZA 3-PAK SUBCUTANEOUS PEN INJECTOR
QL
ANTIHIPERGLUCÉMICOS, TIPO ANÁLOGO DE AMILINA
SYMLINPEN 120 SUBCUTANEOUS PEN INJECTOR
PA; QL
SYMLINPEN 60 SUBCUTANEOUS PEN INJECTOR
PA; QL
CALCITONINAS
calcitonin (salmon) nasal spray,non-aerosol
GLUCOCORTICOIDES
cortisone oral tablet
dexamethasone intensol oral drops
65
Nombre del medicamento Referencia Notas
dexamethasone oral elixir Decadron
dexamethasone oral solution
dexamethasone oral tablet Decadron
dexamethasone sodium phosphate injection solution
DEXPAK 10 DAY ORAL TABLETS,DOSE PACK
DEXPAK 13 DAY ORAL TABLETS,DOSE PACK
DEXPAK 6 DAY ORAL TABLETS,DOSE PACK
hydrocortisone oral tablet Cortef
MEDROL ORAL TABLET
methylprednisolone acetate injection suspension
Depo-Medrol
methylprednisolone oral tablet Medrol
methylprednisolone oral tablets,dose pack Medrol (Pak)
millipred oral tablet
prednisolone oral solution
prednisolone sodium phosphate oral solution
prednisone intensol oral concentrate
prednisone oral solution
prednisone oral tablet
prednisone oral tablets,dose pack
HIPERGLUCEMIA
GLUCAGEN HYPOKIT INJECTION RECON SOLN
QL
GLUCAGON EMERGENCY KIT (HUMAN) INJECTION KIT
QL
glucose oral tablet,chewable OTC
HIPOGLUCEMIA, INSULINA, INTENSIFICADOR DE RESPUESTA
pioglitazone oral tablet Actos PA; QL
pioglitazone-glimepiride oral tablet DUETACT PA
pioglitazone-metformin oral tablet Actoplus MET PA
HIPOGLUCEMIA, INSULINA, TIPO ESTIMULANTE LIBERADOR
glimepiride oral tablet Amaryl
66
Nombre del medicamento Referencia Notas
glipizide oral tablet Glucotrol
glipizide oral tablet extended release 24hr Glucotrol XL
glipizide-metformin oral tablet
glyburide micronized oral tablet Glynase
glyburide oral tablet
glyburide-metformin oral tablet
nateglinide oral tablet Starlix PA; QL
repaglinide oral tablet Prandin PA
HIPOGLUCEMIA, TIPO BIGUANIDA
metformin oral tablet Glucophage
metformin oral tablet extended release 24 hr
Glucophage XR
HIPOGLUCEMIA, TIPO INHIBIDOR DE LA ALFA GLUCOSIDASA
acarbose oral tablet 100 mg Precose
acarbose oral tablet 25 mg, 50 mg Precose QL
HORMONAS ANTIDIURÉTICAS Y VASOPRESORAS
DDAVP NASAL SOLUTION
desmopressin nasal solution DDAVP
desmopressin nasal spray with pump DDAVP
desmopressin nasal spray,non-aerosol
desmopressin oral tablet DDAVP QL
HORMONAS DEL CRECIMIENTO
ZOMACTON SUBCUTANEOUS RECON SOLN
PA; QL
HORMONAS TIROIDEAS
levothyroxine oral tablet Levo-T
levoxyl oral tablet
liothyronine oral tablet Cytomel
nature-throid oral tablet QL
np thyroid oral tablet QL
thyroid (pork) oral tablet Armour Thyroid QL
unithroid oral tablet
westhroid oral tablet QL
INHIBIDOR DE LA DIPEPTIDIL PEPTIDASA IV Y COMBINACIONES
JANUMET ORAL TABLET PA; QL
67
Nombre del medicamento Referencia Notas
JANUMET XR ORAL TABLET, ER MULTIPHASE 24 HR
PA; QL
JANUVIA ORAL TABLET PA; QL
JENTADUETO ORAL TABLET PA; QL
JENTADUETO XR ORAL TABLET, IR - ER, BIPHASIC 24HR
PA; QL
TRADJENTA ORAL TABLET PA; QL
INHIBIDORES DE RESORCIÓN ÓSEA
alendronate oral solution QL
alendronate oral tablet QL
raloxifene oral tablet Evista
INHIBIDORES DE SODIO-GLUCOSA (SGLT2)
JARDIANCE ORAL TABLET PA; QL
SYNJARDY ORAL TABLET PA; QL
SYNJARDY XR ORAL TABLET, IR - ER, BIPHASIC 24HR
PA; QL
INSULINAS
APIDRA SOLOSTAR U-100 INSULIN SUBCUTANEOUS INSULIN PEN
QL
APIDRA U-100 INSULIN SUBCUTANEOUS SOLUTION
QL
BASAGLAR KWIKPEN U-100 INSULIN SUBCUTANEOUS INSULIN PEN
QL
HUMALOG MIX 50-50 INSULN U-100 SUBCUTANEOUS SUSPENSION
QL
HUMALOG MIX 50-50 KWIKPEN SUBCUTANEOUS INSULIN PEN
QL
HUMALOG MIX 75-25 KWIKPEN SUBCUTANEOUS INSULIN PEN
QL
HUMALOG MIX 75-25(U-100)INSULN SUBCUTANEOUS SUSPENSION
QL
HUMULIN 70/30 U-100 KWIKPEN SUBCUTANEOUS INSULIN PEN
OTC; QL
HUMULIN N NPH INSULIN KWIKPEN SUBCUTANEOUS INSULIN PEN
OTC; QL
HUMULIN N NPH U-100 INSULIN SUBCUTANEOUS SUSPENSION
OTC; QL
68
Nombre del medicamento Referencia Notas
HUMULIN R REGULAR U-100 INSULN INJECTION SOLUTION
OTC; QL
HUMULIN R U-500 (CONC) INSULIN SUBCUTANEOUS SOLUTION
QL
HUMULIN R U-500 (CONC) KWIKPEN SUBCUTANEOUS INSULIN PEN
QL
LANTUS SOLOSTAR U-100 INSULIN SUBCUTANEOUS INSULIN PEN
PA; AL; QL
LANTUS U-100 INSULIN SUBCUTANEOUS SOLUTION
PA; QL
NOVOLIN R REGULAR U-100 INSULN INJECTION SOLUTION
OTC; QL
NOVOLOG MIX 70-30 U-100 INSULN SUBCUTANEOUS SOLUTION
QL
NOVOLOG MIX 70-30FLEXPEN U-100 SUBCUTANEOUS INSULIN PEN
QL
MINERALOCORTICOIDES
fludrocortisone oral tablet
OXITÓCICOS
methylergonovine injection solution
PREPARADOS ANTITIROIDEOS
methimazole oral tablet Tapazole
propylthiouracil oral tablet
EQUILIBRIO ELECTROLÍTICO, PRODUCTOS NUTRICIONALES
AGENTES CON MINERALES Y ELECTROLITOS
av-phos 250 neutral oral tablet
k-phos-neutral oral tablet
phospha 250 neutral oral tablet
virt-phos 250 neutral oral tablet
MULTIVITAMÍNICOS
central vite with lutein oral tablet OTC
central-vite cardio oral tablet OTC; QL
corvita oral tablet
ICAPS PLUS ORAL TABLET OTC; QL
m.v.i. adult intravenous solution
multi-vite (with folic acid) oral tablet OTC; QL
multi-vite 50 and over oral tablet OTC; QL
69
Nombre del medicamento Referencia Notas
one daily mens 50 plus(ginkgo) oral tablet OTC
purevit dualfe plus oral capsule
se-tan plus oral capsule
v-c forte oral capsule
vic-forte oral capsule
vit 3 oral capsule
VITAMAX ORAL TABLET,CHEWABLE
women's daily multivitamin oral tablet OTC; QL
PREPARADOS DE VITAMINA B
b complex 100 injection solution
cyanocobalamin (vitamin b-12) injection solution
Vitamin B-12
DIALYVITE ORAL TABLET
folbee oral tablet
folbee plus oral tablet
folbic oral tablet QL
folic acid-vit b6-vit b12 oral tablet Folplex 2.2
folplex 2.2 oral tablet
hydroxocobalamin intramuscular solution
mynephrocaps oral capsule
mynephron oral capsule
nephplex rx oral tablet
NEPHRO-VITE RX ORAL TABLET OTC
pyridoxine (vitamin b6) injection solution
renal caps oral capsule
rena-vite rx oral tablet
reno caps oral capsule OTC
thiamine hcl (vitamin b1) injection solution
tl gard rx oral tablet
triphrocaps oral capsule
virt-gard oral tablet
virt-vite forte oral tablet QL
virt-vite oral tablet
vitamin b-12 injection solution
vol-care rx oral tablet
vp-vite rx oral tablet
70
Nombre del medicamento Referencia Notas
PREPARADOS DE VITAMINA C
ascorbic acid (vitamin c) injection solution
vitamin c oral lozenge OTC
PREPARADOS DE VITAMINA D
calcitriol oral capsule Rocaltrol PA
calcitriol oral solution Rocaltrol PA
ergocalciferol (vitamin d2) oral capsule Drisdol
vitamin d2 oral capsule
PREPARADOS DE VITAMINA K
MEPHYTON ORAL TABLET
vitamin k injection solution
vitamin k1 injection solution
PREPARADOS DE VITAMINAS PRENATALES
dothelle dha oral capsule AL; QL
elite-ob oral tablet AL; QL
mynatal advance oral tablet AL; QL
mynatal oral capsule AL; QL
mynatal oral tablet AL; QL
mynatal plus oral tablet AL; QL
mynatal-z oral tablet AL; QL
mynate 90 plus oral tablet extended release
AL; QL
prena1 true oral combo pack AL; QL
prenatal vitamin plus low iron oral tablet AL; QL
thrivite-19 oral tablet AL; QL
virt-nate dha oral capsule AL; QL
vol-plus oral tablet AL; QL
RESINAS LIBERADORAS DE POTASIO
sodium polystyrene (sorb free) oral suspension
sodium polystyrene sulfonate oral suspension
sodium polystyrene (sorb free)
sodium polystyrene sulfonate rectal enema
sps (with sorbitol) oral suspension
sps (with sorbitol) rectal enema
71
Nombre del medicamento Referencia Notas
SOLUCIONES DE IRRIGACIÓN
sodium chloride irrigation solution Sterile Saline
SUSTITUTO DEL CALCIO
calcium 500 oral tablet OTC; QL
calcium acetate oral tablet Calphron PA
calcium-folic acid-vitamin d oral wafer
tl g-fol os oral tablet
SUSTITUTO DEL HIERRO
centratex oral capsule
corvita 150 oral tablet
elite-ob oral tablet AL; QL
ferocon oral capsule QL
ferraplus 90 oral tablet
ferrex 150 forte oral capsule
ferrex 150 forte plus oral capsule
ferrex 28 oral tablet
ferrocite plus oral tablet
folivane-f oral capsule
folivane-plus oral capsule
hematinic plus vit/minerals oral tablet
hematinic/folic acid oral tablet
hematogen fa oral capsule
hematogen forte oral capsule
hematogen oral capsule
hemetab oral tablet QL
iferex 150 forte oral capsule
infed injection solution
multigen folic oral tablet
multigen plus oral tablet
myferon 150 forte oral capsule
poly-iron 150 forte oral capsule
sodium ferric gluconat-sucrose intravenous solution
Ferrlecit
taron forte oral capsule
tl icon oral capsule QL
tl-hem 150 oral tablet extended release 24 hr
72
Nombre del medicamento Referencia Notas
tricon oral capsule QL
trigels-f forte oral capsule
SUSTITUTO DEL POTASIO
effer-k oral tablet, effervescent
k-effervescent oral tablet, effervescent
klor-con 10 oral tablet extended release
klor-con 8 oral tablet extended release
klor-con m10 oral tablet,er particles/crystals
klor-con m15 oral tablet,er particles/crystals
klor-con m20 oral tablet,er particles/crystals
klor-con oral packet
klor-con/ef oral tablet, effervescent
k-tab oral tablet extended release
potassium bicarb and chloride oral tablet, effervescent
potassium bicarb-citric acid oral tablet, effervescent
Effer-K
potassium chloride oral capsule, extended release
Klor-Con Sprinkle
potassium chloride oral liquid
potassium chloride oral packet Klor-Con
potassium chloride oral tablet extended release
K-Tab
potassium chloride oral tablet,er particles/crystals
Klor-Con M20
VITAMINAS PEDIÁTRICAS CON FLÚOR
multi-vit with fluoride-iron oral drops OTC
multi-vitamin with fluoride oral drops OTC
multivitamin with fluoride oral tablet,chewable
multi-vitamin with fluoride oral tablet,chewable
multivitamins with fluoride oral tablet,chewable
multivit-fluor (vit e acetate) oral drops
mvc-fluoride oral tablet,chewable
73
Nombre del medicamento Referencia Notas
triple vitamin with fluoride oral drops
tri-vit with fluoride and iron oral drops
tri-vitamin with fluoride oral drops
vitamins a,c,d and fluoride oral drops
VITAMINAS PEDIÁTRICAS
children's chewable oral tablet,chewable OTC
VITAMINAS
folbee oral tablet
folbic oral tablet QL
folic acid injection solution
folic acid oral tablet OTC
folic acid-vit b6-vit b12 oral tablet Folplex 2.2
folplex 2.2 oral tablet
tl gard rx oral tablet
virt-gard oral tablet
virt-vite forte oral tablet QL
virt-vite oral tablet
ESCLEROSIS MÚLTIPLE
MEDICAMENTOS PARA TRATAR LA ESCLEROSIS MÚLTIPLE
AVONEX (WITH ALBUMIN) INTRAMUSCULAR KIT
PA; QL
AVONEX INTRAMUSCULAR PEN INJECTOR KIT
PA; QL
AVONEX INTRAMUSCULAR SYRINGE KIT
PA; QL
BETASERON SUBCUTANEOUS KIT PA; QL
EXTAVIA SUBCUTANEOUS KIT PA; QL
EXTAVIA SUBCUTANEOUS RECON SOLN
PA
GILENYA ORAL CAPSULE PA; QL
glatiramer subcutaneous syringe Copaxone PA; QL
glatopa subcutaneous syringe PA; QL
REBIF (WITH ALBUMIN) SUBCUTANEOUS SYRINGE
PA
REBIF REBIDOSE SUBCUTANEOUS PEN INJECTOR
PA
REBIF TITRATION PACK SUBCUTANEOUS SYRINGE
PA
74
Nombre del medicamento Referencia Notas
TECFIDERA ORAL CAPSULE,DELAYED RELEASE(DR/EC)
PA; QL
INSUMOS Y PREPARADOS DENTALES
AGENTES PARA LA BOCA Y GARGANTA
clotrimazole mucous membrane troche QL
lidocaine hcl mucous membrane jelly
lidocaine hcl mucous membrane solution QL
lidocaine viscous mucous membrane solution
QL
nystatin oral suspension
oralone dental paste
pilocarpine hcl oral tablet Salagen (pilocarpine) QL
triamcinolone acetonide dental paste Oralone
ANTISÉPTICOS, OTROS
chlorhexidine gluconate mucous membrane mouthwash
Paroex Oral Rinse QL
paroex oral rinse mucous membrane mouthwash
QL
periogard mucous membrane mouthwash QL
PREPARACIONES DE FLUORUROS
dentagel dental gel
fluor-a-day (with xylitol) oral tablet,chewable
FLUOR-A-DAY ORAL DROPS
fluoride (sodium) dental solution PreviDent
fluoride (sodium) oral drops QL
fluoride (sodium) oral tablet,chewable Fluoritab
fluoritab oral tablet,chewable
FLURA-DROPS ORAL DROPS
ludent fluoride oral tablet,chewable
sf dental gel
MODIFICADORES METABÓLICOS
AGENTES DE DEFICIENCIA METABÓLICA
calcitriol oral capsule Rocaltrol PA
calcitriol oral solution Rocaltrol PA
75
Nombre del medicamento Referencia Notas
levocarnitine oral tablet Carnitor OTC
sodium phenylbutyrate oral powder Buphenyl PA
sodium phenylbutyrate oral tablet Buphenyl PA
PHARMACOENHANCER - INHIBIDORES DEL CITOCROMO P450
TYBOST ORAL TABLET
ÓTICO
PREPARADOS ÓTICOS, MISCELÁNEOS, ANTINFECCIOSOS
acetic acid otic (ear) solution
acetic acid-aluminum acetate otic (ear) drops
ciprofloxacin hcl otic (ear) dropperette Cetraxal QL
floxin otic (ear) drops QL
neomycin-polymyxin-hc otic (ear) drops,suspension
neomycin-polymyxin-hc otic (ear) solution
ofloxacin otic (ear) drops QL
PRODUCTOS VAGINALES
ANTIBIÓTICOS VAGINALES
CLEOCIN VAGINAL SUPPOSITORY
clindamycin phosphate vaginal cream Cleocin
metronidazole vaginal gel Metrogel Vaginal
vandazole vaginal gel
ANTIMICÓTICOS VAGINALES
miconazole-3 vaginal suppository PA
terconazole vaginal cream Terazol 7 QL
terconazole vaginal suppository QL
PREPARADOS DE ESTRÓGENO VAGINALES
estradiol vaginal tablet Vagifem
yuvafem vaginal tablet
76
Nombre del medicamento Referencia Notas
SISTEMA LOCOMOTOR
AGENTES PARA EL TRATAMIENTO DE TRASTORNOS MUSCULOESQUELÉTICOS
EUFLEXXA INTRA-ARTICULAR SYRINGE
PA; QL
GELSYN-3 INTRA-ARTICULAR SYRINGE
PA; QL
SUPARTZ FX INTRA-ARTICULAR SYRINGE
PA; QL
OTROS MEDICAMENTOS AUTÓNOMOS/DEL SNC
MESTINON ORAL SYRUP
pyridostigmine bromide oral tablet Mestinon
pyridostigmine bromide oral tablet extended release
Mestinon Timespan
RELAJANTES DEL MÚSCULO ESQUELÉTICO
baclofen oral tablet
carisoprodol oral tablet Soma QL
carisoprodol-asa-codeine oral tablet AL; QL
carisoprodol-aspirin oral tablet QL
chlorzoxazone oral tablet
cyclobenzaprine oral tablet 10 mg QL
cyclobenzaprine oral tablet 5 mg
dantrolene oral capsule Dantrium
methocarbamol oral tablet Robaxin QL
orphenadrine citrate oral tablet extended release
QL
riluzole oral tablet Rilutek PA
tizanidine oral tablet QL
TERAPIA ALTERNATIVA
TERAPIA ALTERNATIVA
SYSTANE VITAMIN ORAL CAPSULE OTC
TERAPIA DE LA GOTA Y LA HIPERURICEMIA
AGENTES URICOSÚRICOS
probenecid oral tablet
77
Nombre del medicamento Referencia Notas
COMBINADOS DE COLQUICINA
probenecid-colchicine oral tablet
TERAPIA PARA HIPERURICEMIA, INHIBIDORES DE PURINA
allopurinol oral tablet Zyloprim
TERAPIA DEL TRASTORNO COGNITIVO
INHIBIDORES DE LA COLINESTERASA
donepezil oral tablet 10 mg, 5 mg Aricept QL
donepezil oral tablet 23 mg Aricept PA; QL
donepezil oral tablet,disintegrating QL
galantamine oral capsule,ext rel. pellets 24 hr
Razadyne ER
galantamine oral solution
galantamine oral tablet Razadyne QL
memantine oral solution
memantine oral tablet Namenda QL
memantine oral tablets,dose pack Namenda Titration Pak QL
NAMENDA TITRATION PAK ORAL TABLETS,DOSE PACK
QL
rivastigmine tartrate oral capsule
TERAPIA GENITOURINARIA
ACIDULANTES URINARIOS
av-phos 250 neutral oral tablet
k-phos-neutral oral tablet
phospha 250 neutral oral tablet
virt-phos 250 neutral oral tablet
AGENTE PARA LA INCONTINENCIA/ANTIESPASMÓDICO PARA TRACTO URINARIO
darifenacin oral tablet extended release 24 hr
Enablex
flavoxate oral tablet QL
oxybutynin chloride oral syrup QL
oxybutynin chloride oral tablet
oxybutynin chloride oral tablet extended release 24hr
Ditropan XL QL
78
Nombre del medicamento Referencia Notas
tolterodine oral capsule,extended release 24hr
Detrol LA
tolterodine oral tablet Detrol
trospium oral capsule,extended release 24hr
trospium oral tablet
AGENTES ANALGÉSICOS/ANESTÉSICOS PARA TRACTO URINARIO
phenazopyridine oral tablet Pyridium
urinary tract oral tablet OTC; QL
AGENTES ANTIBACTERIANOS URINARIOS
ciprofloxacin (mixture) oral tablet, er multiphase 24 hr
Cipro XR
methenamine hippurate oral tablet Hiprex
methenamine mandelate oral tablet
nitrofurantoin macrocrystal oral capsule Macrodantin
nitrofurantoin monohyd/m-cryst oral capsule
Macrobid
nitrofurantoin oral suspension Furadantin
AGENTES PARASIMPÁTICOS
bethanechol chloride oral tablet Urecholine QL
DESINTOXICANTES DE SANGRE
calcium acetate oral capsule PA
calcium acetate oral tablet Calphron PA
eliphos oral tablet PA
VELPHORO ORAL TABLET,CHEWABLE
PA
HIPERTROFIA PROSTÁTICA BENIGNA/AGENTES MICCIONALES
alfuzosin oral tablet extended release 24 hr
Uroxatral QL
finasteride oral tablet Proscar QL
tamsulosin oral capsule,extended release 24hr
Flomax QL
MODIFICADORES DEL PH URINARIO
cytra k crystals oral packet
79
Nombre del medicamento Referencia Notas
cytra-2 oral solution
cytra-3 oral solution
cytra-k oral solution
potassium citrate oral tablet extended release
Urocit-K 10
potassium citrate-citric acid oral packet Cytra K Crystals
potassium citrate-citric acid oral solution Cytra-K
sodium citrate-citric acid oral solution Cytra-2
tricitrates oral solution
virtrate-k oral solution
TERAPIA PARA TRASTORNOS DE LA ALIMENTACIÓN
AGENTES ESTIMULANTES DEL APETITO
megestrol oral suspension
80
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