Asthma, COPD and Diabetes Preferred Drug List Medications
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1 GPI Name Dexamethasone Tab 0.5 MG Dexamethasone Tab 0.75 MG Dexamethasone Tab 1 MG Dexamethasone Tab 1.5 MG Dexamethasone Tab 2 MG Dexamethasone Tab 4 MG Dexamethasone Tab 6 MG Dexamethasone Elixir 0.5 MG/5ML Dexamethasone Soln 0.5 MG/5ML Hydrocortisone Tab 5 MG Hydrocortisone Tab 10 MG Hydrocortisone Tab 20 MG Methylprednisolone Tab 4 MG Methylprednisolone Tab 8 MG Methylprednisolone Tab 4 MG Dose Pack Prednisolone Tab 5 MG Prednisolone Syrup 15 MG/5ML (USP Solution Equivalent) Prednisolone Sod Phosphate Oral Soln 15 MG/5ML (Base Equiv) Prednisolone Sod Phosph Oral Soln 6.7 MG/5ML (5 MG/5ML Base) Prednisolone Sod Phosphate Oral Soln 20 MG/5ML (Base Equiv) Prednisone Tab 1 MG Prednisone Tab 2.5 MG Prednisone Tab 5 MG Prednisone Tab 10 MG Prednisone Tab 20 MG Prednisone Tab 50 MG Prednisone Conc 5 MG/ML Prednisone Oral Soln 5 MG/5ML Prednisone Tab 5 MG Dose Pack Prednisone Tab 10 MG Dose Pack Fludrocortisone Acetate Tab 0.1 MG Cromolyn Sodium Soln Nebu 20 MG/2ML Albuterol Sulfate Tab 2 MG Albuterol Sulfate Tab 4 MG Albuterol Sulfate Syrup 2 MG/5ML
2 Albuterol Sulfate Soln Nebu 0.083% (2.5 MG/3ML) Albuterol Sulfate Soln Nebu 0.5% (5 MG/ML) Albuterol Sulfate Soln Nebu 0.63 MG/3ML (Base Equiv) Albuterol Sulfate Soln Nebu 1.25 MG/3ML (Base Equiv) Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) Formoterol Fumarate Inhal Cap 12 MCG Salmeterol Xinafoate Aer Pow BA 50 MCG/DOSE (Base Equiv) Terbutaline Sulfate Tab 2.5 MG Terbutaline Sulfate Tab 5 MG Budesonide-Formoterol Fumarate Dihyd Aerosol MCG/ACT Budesonide-Formoterol Fumarate Dihyd Aerosol MCG/ACT Fluticasone-Salmeterol Inhal Aerosol MCG/ACT Fluticasone-Salmeterol Inhal Aerosol MCG/ACT Fluticasone-Salmeterol Inhal Aerosol MCG/ACT Fluticasone-Salmeterol Aer Powder BA MCG/DOSE Fluticasone-Salmeterol Aer Powder BA MCG/DOSE Fluticasone-Salmeterol Aer Powder BA MCG/DOSE Mometasone Furoate-Formoterol Fumarate Aerosol MCG/ACT Mometasone Furoate-Formoterol Fumarate Aerosol MCG/ACT Theophylline Cap SR 24HR 200 MG Theophylline Cap SR 24HR 300 MG Theophylline Tab SR 12HR 100 MG Theophylline Tab SR 12HR 200 MG Theophylline Tab SR 12HR 300 MG Theophylline Tab SR 24HR 400 MG Budesonide Inhalation Susp 0.25 MG/2ML Budesonide Inhalation Susp 0.5 MG/2ML Budesonide Inhalation Susp 1 MG/2ML Budesonide Inhal Aero Powd 90 MCG/ACT (Breath Activated) Budesonide Inhal Aero Powd 180 MCG/ACT (Breath Activated) Flunisolide HFA Inhal Aerosol 80 MCG/ACT Fluticasone Propionate Aer Pow BA 50 MCG/BLISTER Fluticasone Propionate Aer Pow BA 100 MCG/BLISTER Fluticasone Propionate Aer Pow BA 250 MCG/BLISTER Fluticasone Propionate HFA Inhal Aero 44 MCG/ACT (50/Valve) Fluticasone Propionate HFA Inhal Aer 110 MCG/ACT (125/Valve)
3 Fluticasone Propionate HFA Inhal Aerosol 220 MCG/ACT Montelukast Sodium Tab 10 MG (Base Equiv) Montelukast Sodium Chew Tab 4 MG (Base Equiv) Montelukast Sodium Chew Tab 5 MG (Base Equiv) Montelukast Sodium Oral Granules Packet 4 MG (Base Equiv) Insulin Aspart Inj 100 Unit/ML Insulin Aspart Soln Pen-injector 100 Unit/ML Insulin Aspart Soln Cartridge 100 Unit/ML Insulin Glargine Inj 100 Unit/ML Insulin Glargine Soln Pen-Injector 100 Unit/ML Insulin Glulisine Inj 100 Unit/ML Insulin Glulisine Soln Pen-Injector Inj 100 Unit/ML Insulin Lispro (Human) Inj 100 Unit/ML Insulin Lispro (Human) Soln Pen-injector 100 Unit/ML Insulin Lispro (Human) Soln Cartridge 100 Unit/ML Insulin Regular (Human) Inj 100 Unit/ML Insulin Isophane (Human) Inj 100 Unit/ML Insulin Isophane (Human) Susp Pen-injector 100 Unit/ML Insulin Aspart Prot & Aspart (Human) Inj 100 Unit/ML (70-30) Insulin Aspart Prot & Aspart Sus Pen-inj 100 Unit/ML (70-30) Insulin Lispro Prot & Lispro (Human) Inj 100 Unit/ML (75-25) Insulin Lispro Prot & Lispro (Human) Inj 100 Unit/ML (50-50) Insulin Lispro Prot & Lispro Sus Pen-inj 100 Unit/ML (75-25) Insulin Isophane & Regular (Human) Inj 100 Unit/ML (70-30) Glimepiride Tab 1 MG Glimepiride Tab 2 MG Glimepiride Tab 4 MG Glipizide Tab 5 MG Glipizide Tab 10 MG Glipizide Tab SR 24HR 2.5 MG Glipizide Tab SR 24HR 5 MG Glipizide Tab SR 24HR 10 MG Glyburide Tab 1.25 MG Glyburide Tab 2.5 MG Glyburide Tab 5 MG Metformin HCl Tab 500 MG
4 Metformin HCl Tab 850 MG Metformin HCl Tab 1000 MG Metformin HCl Tab SR 24HR 500 MG Metformin HCl Tab SR 24HR 750 MG Linagliptin Tab 5 MG Saxagliptin HCl Tab 2.5 MG (Base Equiv) Saxagliptin HCl Tab 5 MG (Base Equiv) Pioglitazone HCl Tab 15 MG (Base Equiv) Pioglitazone HCl Tab 30 MG (Base Equiv) Pioglitazone HCl Tab 45 MG (Base Equiv) Linagliptin-Metformin HCl Tab MG Linagliptin-Metformin HCl Tab MG Linagliptin-Metformin HCl Tab MG Saxagliptin-Metformin HCl Tab SR 24HR MG Saxagliptin-Metformin HCl Tab SR 24HR MG Saxagliptin-Metformin HCl Tab SR 24HR MG Glipizide-Metformin HCl Tab MG Glipizide-Metformin HCl Tab MG Glipizide-Metformin HCl Tab MG Glyburide-Metformin Tab MG Glyburide-Metformin Tab MG Pioglitazone HCl-Metformin HCl Tab MG Pioglitazone HCl-Metformin HCl Tab MG Ipratropium Bromide Inhal Soln 0.02% Ipratropium Bromide HFA Inhal Aerosol 17 MCG/ACT Tiotropium Bromide Monohydrate Inhal Cap 18 MCG (Base Equiv) Formoterol Fumarate Inhal Cap 12 MCG Salmeterol Xinafoate Aer Pow BA 50 MCG/DOSE (Base Equiv) Ipratropium-Albuterol Nebu Soln (3) MG/3ML Ipratropium-Albuterol Aerosol MCG/ACT (20-120MCG/ACT) Ipratropium-Albuterol Inhal Aerosol Soln MCG/ACT Budesonide-Formoterol Fumarate Dihyd Aerosol MCG/ACT Budesonide-Formoterol Fumarate Dihyd Aerosol MCG/ACT Fluticasone-Salmeterol Inhal Aerosol MCG/ACT Fluticasone-Salmeterol Inhal Aerosol MCG/ACT Fluticasone-Salmeterol Inhal Aerosol MCG/ACT
5 Fluticasone-Salmeterol Aer Powder BA MCG/DOSE Fluticasone-Salmeterol Aer Powder BA MCG/DOSE Fluticasone-Salmeterol Aer Powder BA MCG/DOSE Theophylline Cap SR 24HR 200 MG Theophylline Cap SR 24HR 300 MG Theophylline Tab SR 12HR 100 MG Theophylline Tab SR 12HR 200 MG Theophylline Tab SR 12HR 300 MG Theophylline Tab SR 24HR 400 MG Budesonide Inhalation Susp 1 MG/2ML Budesonide Inhal Aero Powd 90 MCG/ACT (Breath Activated) Budesonide Inhal Aero Powd 180 MCG/ACT (Breath Activated) Ipratropium Bromide Inhal Soln 0.02% Ipratropium Bromide HFA Inhal Aerosol 17 MCG/ACT Tiotropium Bromide Monohydrate Inhal Cap 18 MCG (Base Equiv) Ipratropium-Albuterol Nebu Soln (3) MG/3ML Ipratropium-Albuterol Aerosol MCG/ACT (20-120MCG/ACT) Ipratropium-Albuterol Inhal Aerosol Soln MCG/ACT
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