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Microsoft word - wvpdl 01-01-07.doc

NEW Plan Year 2007
Preferred Drug List Goes Into Effect
January 1, 2007
Following is a list of the most commonly prescribed drugs on the West Virginia Preferred Drug List. It is an abbreviated version of
the drug list that is at the core of the PEIA pharmacy benefit plan. The list is not all-inclusive and does not guarantee coverage. In
addition to using this list, you're encouraged to ask your doctor to prescribe generic drugs whenever possible. THIS LIST WILL BE
EFFECTIVE January 1, 2007 and IS SUBJECT TO CHANGE.

KEY
Following is a list symbols used on this list, as well as the explanation for each:
[G] indicates that a generic is available for at least one or more strengths of the brand medication.
[PA] indicates Prior Authorization is required.
[PA*] indicates Step Therapy.
[PA**] indicates Prior Authorization is required for dependents for medical necessity.
[QLL] indicates Quantity Level Limits.
[SP] indicates specialty product with $50 copay per 30 days supply
[PA$] indicates that Step Therapy and $30 copay apply
For the member: Generic medications contain the same active ingredients as their corresponding brand name medications, although
they may look different in color or shape. They have been FDA-approved under strict standards.
For the physician: Please prescribe preferred products and allow generic substitutions when medically appropriate.
PLEASE NOTE: the * next to a drug signifies the drug is subject to non-preferred status when generic becomes available throughout
the year.
Brand name drugs are listed in CAPITAL letters.
ABILIFY ACTIVELLA ACTONEL ACTONEL W/CA ACTOS ACTOPLUS MET acyclovir ADDERALL XR* [G] ADVANCED NATALCARE ADVAIR DISKUS ADVICOR [PA*] ALDARA ALINIA ALKERAN allopurinol ALPHAGAN P ALORA alprazolam AMBIEN*[QLL] AMBIEN PAK [QLL] aminophylline amitriptyline amox tr/potassium clavulanate amoxicillin amphetamine salt ANDRODERM ANDROGEL ANTABUSE ARANESP [PA], [SP] ARICEPT ASACOL ASTELIN atenolol atenolol/chlorthalidone ATROVENT/ HFA AVANDAMET AVANDARYL AVANDIA AVELOX, ABC PACK
AVODART
azithromycin
B
BAYER ASCENSIA ELITE TEST STRIPS
BAYER ASCENSIA AUTODISC TEST STRIPS
BAYER MICROFILL TEST STRIPS
benazepril/ hctz
benzonatate
BENICAR/HCT [PA*]
BETASERON [SP]
bisoprolol fumarate/hctz
bimonidine tartrate
bromfenex,-PD
bumetanide
bupropion
bupropion sr
buspirone hcl
butalbital/apap/caffeine
BYETTA
C
CAPITAL W/CODEINE
captopril
CARAFATE SUSP
carbamazepine
CARBATROL
carisoprodol
cartia xt
CASODEX
cefaclor
cefuroxime
CELLCEPT
CELONTIN
CETROTIDE [SP]
choline mag trisalicylate
cimetidine
ciprofloxacin
CIPRODEX
CIPRO HC
citalopram
clarithromycin
clidinium/chlordiazepoxide
CLIMARA PRO
clindamycin phosphate
clobetasol proprionate
clonidine hcl
clotrimazole
clotrimazole/betamethasone
COLAZAL*
COMBIVENT
CONCERTA*
COREG* [PA*]
CREON [G]
CRESTOR [PA*]
cromolyn sodium
cyclobenzaprine
cyclosporine, modified
CYMBALTA[PA*]
D
dantrolene sodium
DAPSONE
DEPAKOTE
desmopressin acetate
desogestrel- ethinyl estradiol [PA**]
desoximetasone
DESOXYN
dextroampehtamine sulfate
DIAMOX SEQUELS
dicyclomine hcl
diclofenac sodium
diflunisal
diltiazem, er
DIOVAN/HCT [PA*]
DITROPAN XL* [G][PA*]
DOVONEX
E
EFFEXOR XR [PA*]
EMEND [QLL]
enalapril maleate, hctz
erythromycin
erythromycin/benzoyl perox
ESTINYL
estradiol
ESTRING
estropipate
ethinyl estradiol [PA**]
ethinyl estradiol-levonorgestrel [PA**]
EVISTA
EXELON

F
FEMARA
fentanyl citrate [PA]
FINACEA
finasteride
FLOMAX
FLOVENT*, ROTADISK
FLOVENT HFA
fluocinonide
fluconazole [PA]
fluorouracil
fluoxetine hcl
flurazepam [QLL]
flutamide
fluticasone
fluvoxamine
FOLTX
FORADIL
FORTEO [PA],[SP]
FOSAMAX/Plus D
G
gabapentin
GABITRIL
GANTRISIN SUSP.
gemfibrozil
gentamicin sulfate
glipizide
glyburide
GRIFULVIN V TAB
guaifenesin la
H
haloperidol
homatropine hydrobromide
HUMALOG (vials
only)
HUMATROPE
[PA],[SP]
HUMULIN (vials
only)
hydrochlorothiazide
hydrocodone
w/guaifenesin
hydrocodone/
acetaminophen
hydrocortisone
acetate
hyoscyamine sulfate
I
ibuprofen
IMITREX* [QLL]
INDERAL LA [PA*]
indomethacin
INNOPRAN XL [PA*]
INTAL
ipratropium bromide

K
ketoconazole
KEPPRA
L
lactulose
LAMICTAL
LAMISIL* [PA]
LANTUS (vials only)
leucovorin
levothyroxine sodium
LEVAQUIN
LEVEMIR
LEXAPRO[PA*]
LEVOXYL]
lidocaine hcl viscous
LIDODERM
lisinopril/ hctz
lithium carbonate, er
LIVOSTIN*
LOTREL [PA*]
lovastatin
LUMIGAN
M
MALARONE
MATULANE
medroxyprogesterone
megestrol
MENEST
MEPHYTON
mephobarbital
MEPRON
mercaptopurine
MESTINON SA
METANX
metformin,
extended release
methocarbamol
methotrexate
methylphenidate hcl
methylprednisolone
metolazone
metoprolol
metronidazole
microgestin fe [PA**]
migergot
MIRAPEX
mirtazapine soltab
misoprostol
MOBAN
MONUROL
morphine sulfate sa tab
MSIR [G]
mupirocin
MYCOBUTIN
N
nabumetone
nadolol
naproxen
NARDIL
NASCOBAL
NASONEX [PA*]
NATALCARE
NEBUPENT
NEXIUM [PA$]
NIASPAN *[G]
nifedipine, er
NIMOTOPnitrofurantoin
macrocrystal
nizatidine
norethindrone-
ethinyl estradiol
[PA**]
norethindrone-
mestranol [PA**]
norgestrel ethinyl
estradiol [PA**]
NOVOFINE 30
NOVOLIN (vials only)
NOVOLOG (vials only)
NUTROPIN , AQ
excluding Depot [PA],
[SP]
nystatin
nystatin w/triamcinolone
O
omeprazole
OMNICEF*
ORTHO EVRA[PA**]
ORTHO TRI-CYCLEN
LO [PA**]
OXSORALEN/ULTRA
oxybutynin chloride
o
OXYCONTIN [PA]
oxycodone/
acetaminophen
OXYTROL [PA*]
P
PANCREASE MT 4
paroxetine hcl
PEGANONE
PEGASYS [SP]
penicillin v potassium
PENTASA
perphenazine
PHOSLO
PLAVIX
podofilox solution
potassium chloride
potassium citrate er
PRANDIN
PRECOSE
PRED G
PRED MILD
prednisolone acetate
prednisone
PREMARIN
PREMARIN LOW
DOSE
PREMPHASE
PREMPRO
PREMPRO LOW DOSE
PRENATE
ADVANCE [G]
PREVACID [PA$]
PRIMSOL
prochlorperazine
PROCRIT [PA], [SP]
proctozone – HC
PROGRAF
promethazine
promethazine/codeine
promethazine vc
PROMETRIUM
propranolol
PROTOPIC
PULMICORT
Q
quetiapine fumarate
QVAR

R
RAZADYNE (not
ER)
REBIF [SP]
REGRANEX [PA]
RENACIDIN
RENAGEL
REQUIP*
RESTASIS
ribasphere [SP]
ribavirin [SP]
RIDAURA
RILUTEK
RISPERDAL
(excluding M-tabs)
ROZEREM[PA*][QLL]
S
SAIZEN [PA],[SP]
salsalate
selenium sulfide
SEREVENT,
DISKUS
SEROQUEL
simvastatin
SINGULAIR [PA*]
SKELAXIN*
SPIRIVA
STALEVO
STARLIX
STIMATE
STRATTERA
[ PA*]
STROMECTOL
SUBUXONE
SUBUTEX
SULAR [PA*]
SYNAREL
T
TAMIFLU [QLL]
tamoxifen
TARGRETIN
TASMAR
TAZORAC [PA]
TEGRETOL XR
temazepam [QLL]
theophylline
anhydrous
thioguanine
thioridazine hcl
thyroid
ticlopidine hcl
TIKOSYN
TILADE
timolol hcl
tobramcyin sulfate
TOPAMAX [PA]
TOPROL XL* [G] [PA*]
TRACLEER
tretinoin
TREXALL
TRICOR
trazodone hcl
triamcinolone
acetonide
triamterene/hctz
triazolam [QLL]
trifluoperazine hcl
TRILEPTAL
TRUSOPT
U
UNIPHYL [G]
UNITHROID
URSO/FORTE
V
VAGIFEM
VALCYTE
VANCOCIN HCL
venlafaxine
VENTAVIS
VENTOLIN HFA
verapamil hcl
VESANOID
VFEND [PA]
VIGAMOX
VINATE II
VOLTAREN OPHTH.
VYTORIN [PA*]
W
WELLBUTRIN XL*
[PA*]
X
XALATAN
XYREM
Y

Z
ZADITOR
ZETIA [PA*]
ZELNORM
ZEMPLAR
ZOFRAN, ODT* [QLL]
ZOMIG/ ZMT [QLL]
zonisamide
ZOVIRAX OINT
ZYLET
ZYMAR
ZYPREXA (excluding
Zydis)
ZYVOX

Source: http://www.wvagriculture.org/images/Admin/07_PDL.pdf

Microsoft word - wukpresse09_09.doc

Kartenvorverkauf/Reservierungen: T 40121-70 ZOOT WOMAN JULI ZEH & SLUT Beginn 20:00 ’Corpus Delicti - Eine Schallnovelle’ SARAH KUTTNER Beginn 20:00 Lesung: ‘Mängelexemplar’ SHANTEL & BUCOVINA CLUB ORKESTAR 20/18 Pressekontakt: Emanuel Rudas, emanuel.rudas@wuk.at , Tel 40121-43 SAISONERÖFFNUNG mit GOD´S ENTERTAINMENT THIS IS NOT 9/11 Vorgrup

nuvocare.us

Effects of a natural extract of (–)-hydroxycitric acid (HCA-SX) anda combination of HCA-SX plus niacin-bound chromium andGymnema sylvestre extract on weight lossH. G. Preuss,1 D. Bagchi,2 M. Bagchi,2 C. V. S. Rao,3 D. K. Dey4 and S. Satyanarayana51Department of Physiology and Biophysics, Georgetown University Medical Center, Georgetown, Washington, DC, USA2Department of Pharmacy Sciences, Creig

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