FORMULARY November 2015

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1 FORUAR ovember 2015

2 July 2011 was the last printed publication of the ova Scotia Formulary onthly updates of the ova Scotia Formulary are published online and can be accessed at: Copyright 1996 ova Scotia Department of Health. All rights reserved. o part of this publication may be reproduced, photocopied, stored on a retrieval system, or transmitted without the express written consent of the publisher.

3 TAB OF COTTS ITRODUCTIO How to Use the Formulary egend ATC CASSIFICATIO OF DRUGS A - Alimentary Tract and etabolism 1-23 B - Blood and Blood Forming Organs C - Cardiovascular System D - Dermatologicals G - Genito-Urinary System & Sex Hormones H - Systemic Hormonal reparations, xcluding Sex Hormones J - General Antiinfectives, Systemic Antineoplastics and Immunomodulating Agents usculo-skeletal System ervous System Antiparasitic roducts, Insecticides and Repellents R - Respiratory System S - Sensory Organs V - Various ISCAOUS Diabetic Supplies Benefit ist Ostomy Supplies Benefit ist Compounds ADICS Appendix I - Abbreviations Appendix II - Abbreviations of anufacturers' ames Appendix III - Criteria for Coverage of xception Status Drugs RODUCT IDX

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5 ITRODUCTIO The ova Scotia Formulary details which drugs and supplies are benefits under the ova Scotia Seniors' harmacare rogram, Family harmacare rogram, Diabetes Assistance rogram, Community Services harmacare rograms and Drug Assistance for Cancer atients. The Formulary is provided on our website at in DF. The ATC Classification System All medications are classified according to the Anatomical Therapeutic Chemical (ATC) Classification System which is used by the World Health Organization for pharmacoepidemiological purposes and by the atented edicine rices Review Board for pricing purposes. The ATC Classification System groups chemically similar products according to their site of action and facilitates the comparison of new medicines with previously available medicines. There are fourteen main groups in the ATC system: A B C D G H J R S V Alimentary tract and metabolism Blood and blood forming organs Cardiovascular system Dermatologicals Genito-urinary system and sex hormones Systemic hormonal preparations, excluding sex hormones General antiinfectives, systemic Antineoplastic and immunomodulating agents usculo-skeletal system ervous system Antiparasitic products, insecticides and repellents Respiratory system Sensory organs Various ach group is subdivided into anatomical, therapeutic and chemical subgroups as shown in the egend. A drug may be given more than one ATC code. If it is available in two or more strengths or formulations with clearly different therapeutic uses, the drug would appear in various categories depending on its different forms. If a drug has more than one clinical indication, the main indication is chosen for the listing of the various brands and strengths of this drug. ovember 2015 age i

6 Interchangeability, aximum Reimbursable rice (R) and harmacare Reimbursement rice (R) The Formulary indicates those products which have been deemed interchangeable by the Drugs and Therapeutics Committee of the ova Scotia Department of Health and Wellness (see the egend). For generic products that meet the criteria for interchangeability a aximum Reimbursable rice (R) may be applied. R is the maximum price established by the harmacare rograms for an interchangeable generic drug. R is applied to those drugs which are harmacare benefits, and have been deemed interchangeable (e.g., brand name drugs and their generic equivalents) The R is the maximum amount that the harmacare rograms will reimburse providers for one unit (tablet, capsule, millilitre, etc.) of a drug. For each interchangeable, generic drug category, a maximum reimbursable price per unit (e.g., tablet, capsule, millilitre) is determined by calculating a percentage of the cost of the equivalent brand name drug. The percentage of the R is reimbursed at 25% of the cost of the manufacturer list price of the equivalent brand drug. Some generic drugs may have exceptions to the R formula, and their R will also be included in the Reimbursement ist. xemptions to the R are available for beneficiaries who have experienced a severe or life threatening reaction with lower cost alternatives. A request must be received from the prescriber detailing the reaction. roviders shall not charge any cost difference between the R of the drug and amount reimbursed by the harmacare rograms unless the beneficiary requests the higher priced drug. If the beneficiary requests the higher priced drug the extra cost is not counted toward their annual maximum copayment or annual maximum deductible. In addition, a harmacare Reimbursement rice (R) is the maximum cost assigned to: - certain groups of drugs that are similar in effect; - specific services for which coverage is established; - certain unit dose and special delivery formats that are also available in less expensive bulk formats; and - certain supplies that are used for the same function. The R is the maximum amount the harmacare rogram reimburses providers for one unit of a drug (tablet, capsule, millilitre, etc.) supply or service. roviders may charge the beneficiary the portion of their AAC that exceeds the R. The extra cost is not counted toward the beneficiary's annual maximum copayment or annual maximum deductible. In all pricing categories, except AAC, the harmacare rograms will reimburse pharmacies the lesser of the amount submitted, or as applicable,, R, or R. All anufacturer ist rices (s) will be updated on a quarterly basis unless otherwise notified directly by the manufacturer. rescriber The Formulary provides prescriber codes (see egend) associated with each benefit under the harmacare rograms. These codes indicate which benefits will be reimbursed when prescribed by a specific prescriber. ovember 2015 age ii

7 The ova Scotia Government harmacare rograms 1. Seniors' harmacare rogram - available to all ova Scotia seniors 65 years or older who have a valid ova Scotia Health Card, and do not have private drug coverage. 2. Community Services harmacare rograms - The Department of Community Services provides drug benefits as part of the Income Assistance rograms (including Special eeds harmacare and Transitional harmacare), the ow Income harmacare rogram for Children, Services for ersons with Disabilities and the Children in Care rograms. ligibility is determined by the Department of Community Services. 3. Drug Assistance for Cancer atients, an income based assistance program covering medication for the treatment of cancer. 4. Diabetes Assistance rogram, an income based assistance program covering medication and supplies needed for diabetes treatment. 5. Under 65-ong Term Care (TC) harmacare, provides drug coverage for long term care residents under 65 years of age who have no drug insurance. 6. Family harmacare rogram, an income based program available to all ova Scotians with a valid ova Scotia Health Card who are not currently receiving drug benefits through Seniors', Community Services, Diabetes Assistance or the Under 65-ong Term Care harmacare rograms. The benefit status of medications reimbursed under these programs are indicated, in the fourth column of the ATC classification, by the letters S (Seniors' harmacare), F (Community Services harmacare / Under 65-ong Term Care harmacare / Family harmacare), C (Drug Assistance for Cancer atients), D (Diabetes Assistance) or (xception Status Drug - see Appendix III). If this column is blank, the product is not a benefit under any of these programs. ovember 2015 age iii

8 iscellaneous Section Diabetes and ostomy supplies are listed in this section. These products are benefits under the Seniors' and Community Services harmacare rograms and are cross-referenced in the appropriate ATC classification. Diabetes supplies are also benefits under the Diabetes Assistance rogram. egend 1. Therapeutic ain Group 2. Therapeutic Subgroup 3. Chemical/Therapeutic Subgroup 4. Subgroup for Chemical Substance 5. Brand or anufacturer's ame of the Drug, including dosage form and/or route and strength 6. Interchangeable roduct Heading 7. rescriber Codes: D - hysician / Dentist - urse ractitioner - harmacist - idwife O - rescribing Optometrist 8. Unit rice 9. = aximum Reimbursement rice = harmacare Reimbursement rice = anufacturer's ist rice 10. Benefit Status (plans for which the product is a benefit): S - Seniors' harmacare F - Community Services harmacare - Under 65-ong Term Care harmacare - Family harmacare C - Drug Assistance for Cancer atients D - Diabetes Assistance rogram - xception status applies (see Appendix III) 11. Drug Identification umber (DI) 12. Abbreviation of anufacturer (see Appendix II) 13. Interchangeable roduct Indicator ovember 2015 age iv

9 CC A A01 A01A A01AB Alimentary Tract and etabolism STOATOOGICAS, OUTH RARATIOS STOATOOGICAS, OUTH RARATIOS ATIIFCTIVS FOR OCA ORA TRATT A01AB03 CHORHXIDI chlorhexidine 0.12% oral rinse erichlor 0.12% Oral Rinse S eridex 0.12% Oral Rinse ZIA A01AB22 DOXCCI eriostat 20mg Cap D A01AC CORTICOSTROIDS FOR OCA ORA TRATT A01AC01 TRIACIOO triamcinolone acetonide 0.1% oral paste Oracort 0.1% Oral aste TAR Kenalog 0.1% in Orabase (discontinued) BRI A01AD OTHR DRUGS FOR OCA ORA TRATT A01AD02 BZDAI benzydamine 0.15% oral rinse harixia 1.5mg/m Oral Rinse D Tantum Oral Rinse (discontinued) DS A02 A02A A02AB DRUGS FOR ACID RATD DISORDRS ATACIDS AUIIU COOUDS A02AB01 AUIIU HDROXID Basaljel 500mg Cap AUR A02AD COB OF AUIIU,CACIU AD AGSIU COOUDS A02AD01 ATACIDS, ORDIAR SAT COBIATIOS Diovol Regular O/ CHU A02AF ATACIDS WITH ATIFATUTS A02AF02 ATACIDS, ORDIAR SAT COBIATIOS AD ATIFATUTS Diovol lus O/ CHU Diovol lus Tab CHU ylanta Double St Tab JJ A02B A02BA DRUGS FOR TIC UCR AD GASTROSOHAGA RFUX DI(GRD) H2-RCTOR ATAGOISTS A02BA01 CITIDI cimetidine 200mg tab Apo-Cimetidine 200mg Tab ovember

10 A Alimentary Tract and etabolism Tagamet 200mg Tab (discontinued) SKR cimetidine 300mg tab Apo-Cimetidine 300mg Tab A-Cimetidine 300mg Tab Tagamet 300mg Tab (discontinued) GSK cimetidine 400mg tab Apo-Cimetidine 400mg Tab A-Cimetidine 400mg Tab Tagamet 400mg Tab (discontinued) GSK cimetidine 600mg tab Apo-Cimetidine 600mg Tab A-Cimetidine 600mg Tab Tagamet 600mg Tab (discontinued) GSK A02BA02 RAITIDI ranitidine 15mg/m o/l Apo-Ranitidine 15mg/m O/ ovo-ranitidine 15mg/m O/ C TV Zantac 15mg/m O/ (discontinued) GSK ranitidine 25mg/m inj Ranitidine 25mg/m Inj C Zantac 25mg/m Inj C GSK ranitidine 75mg tab Apo-Ranitidine 75mg Tab Zantac 75mg Tab (discontinued) JJ ranitidine 150mg tab Apo-Ranitidine 150mg Tab C CO Ranitidine 150mg Tab C yl-ranitidine 150mg Tab (discontinued) A-Ranitidine 150mg Tab C ovo-ranidine 150mg Tab C TV pms-ranitidine 150mg Tab C S RA-Ranitidine 150mg Tab C RA Ranitidine 150mg Tab C Ranitidine-150mg Tab C SIV Sandoz Ranitidine 150mg Tab C Zantac 150mg Tab C GSK ranitidine 300mg tab Apo-Ranitidine 300mg Tab C CO Ranitidine 300mg Tab C yl-ranitidine 300mg Tab (discontinued) A-Ranitidine 300mg Tab C ovo-ranidine 300mg Tab C TV pms-ranitidine 300mg Tab C S RA-Ranitidine 300mg Tab C RA Ranitidine 300mg Tab C Ranitidine-300mg Tab C SIV ovember

11 A Alimentary Tract and etabolism Sandoz Ranitidine 300mg Tab C Zantac 300mg Tab C GSK A02BA03 FAOTIDI famotidine 10mg/m inj Famotidine Omega 10mg/m Inj OG epcid 10mg/m Inj (discontinued) FRS famotidine 10mg/m inj (pf) Famotidine Omega (F) 10mg/m Inj OG epcid (F) 10mg/m Inj (discontinued) FRS famotidine 20mg tab Apo-Famotidine 20mg Tab Famotidine 20mg Tab A-Famotidine 20mg Tab ovo-famotidine 20mg Tab TV epcid 20mg Tab (discontinued) FRS famotidine 40mg tab Apo-Famotidine 40mg Tab Famotidine 40mg Tab A-Famotidine 40mg Tab ovo-famotidine 40mg Tab TV epcid 40mg Tab (discontinued) FRS A02BA04 IZATIDI nizatidine 150mg cap Apo-izatidine 150mg Cap (discontinued) Axid 150mg Cap D nizatidine 300mg cap Apo-izatidine 300mg Cap (discontinued) Axid 300mg Cap (discontinued) D A02BB ROSTAGADIS A02BB01 ISOROSTO misoprostol 100mcg tab isoprostol 100mcg Tab AA Cytotec 100mcg Tab (discontinued) misoprostol 200mcg tab isoprostol 200mcg Tab AA Cytotec 200mcg Tab (discontinued) A02BC ROTO U IHIBITORS A02BC01 ORAZO omeprazole 10mg cap A-Omeprazole 10mg Cap C* Sandoz Omeprazole 10mg Cap C* osec 10mg Cap (discontinued) AZ *exception status when daily dose exceeds once daily ovember

12 A Alimentary Tract and etabolism omeprazole 10mg cap/tab A-Omeprazole 10mg Cap C* Teva-Omeprazole 10mg Tab C* TV osec 10mg Tab C* AZ *exception status when daily dose exceeds once daily. omeprazole 20mg cap Apo-Omeprazole 20mg Cap C* A-Omeprazole 20mg Cap C* Omeprazole 20mg Cap C* Omeprazole-20mg Cap C* SIV pms-omeprazole 20mg Cap C* S RA-Omeprazole 20mg Cap C* RA Sandoz Omeprazole 20mg Cap C* osec 20mg Cap C* AZ *exception status when daily dose exceeds once daily. omeprazole 20mg cap/tab Apo-Omeprazole 20mg Cap C* Jamp-Omeprazole DR 20mg Tab C* JC A-Omeprazole 20mg Cap C* ovo-omeprazole Delayed-Release 20mg Tab C* TV Omeprazole 20mg Cap C* Omeprazole DR 20mg Tab C* AHI pms-omeprazole DR 20mg Tab C* S RA-Omeprazole 20mg tab C* RA osec 20mg Tab C* AZ *exception status when daily dose exceeds once daily. A02BC02 ATORAZO pantoprazole 20mg C tab Apo-antoprazole 20mg DR Tab C* Jamp-antoprazole 20mg Tab C* JC antoprazole-20mg Tab C* SIV pms-antoprazole 20mg DR Tab S RA-antoprazole 20mg Tab C* RA Sandoz antoprazole 20mg DR Tab C* Teva-antoprazole 20mg DR Tab C* TV antoloc 20mg Tab C* TAK *exception status when daily dose exceeds once daily. pantoprazole 40mg C tab Abbott-antoprazole 40mg Tab C* ABB Apo-antoprazole 40mg DR Tab C* CO antoprazole 40mg DR Tab C* Jamp-antoprazole 40mg Tab C* JC ar-antoprazole 40mg DR Tab C* AR IT-antoprazole 40mg DR Tab C* T A-antoprazole 40mg DR Tab C* antoprazole 40mg DR Tab C* S antoprazole 40mg Tab C* antoprazole-40mg Tab C* SIV ovember

13 A Alimentary Tract and etabolism pms-antoprazole 40mg DR Tab C* S RA-antoprazole 40mg Tab C* RA Sandoz antoprazole 40mg DR Tab C* Teva-antoprazole 40mg DR Tab C* TV antoloc 40mg Tab C* TAK *exception status when daily dose exceeds once daily. Tecta 40mg Tab TAK A02BC03 ASORAZO lansoprazole 15mg cap Apo-ansoprazole 15mg DR Cap ansoprazole 15mg Cap S ansoprazole 15mg Cap SIV ansoprazole 15mg DR Cap A-ansoprazole 15mg DR Cap ovo-ansoprazole 15mg DR Cap TV pms-ansoprazole 15mg Cap (discontinued) S RA-ansoprazole 15mg Cap RA Sandoz ansoprazole 15mg DR Cap revacid 15mg Cap ABB revacid FasTab 15mg Tab ABB lansoprazole 30mg cap Apo-ansoprazole 30mg DR Cap ansoprazole 30mg Cap S ansoprazole 30mg DR Cap ansoprazole-30mg Cap SIV A-ansoprazole 30mg DR Cap ovo-ansoprazole 30mg DR Cap TV pms-ansoprazole 30mg DR Cap (discontinued) S RA-ansoprazole 30mg Cap RA Sandoz ansoprazole 30mg DR Cap revacid 30mg Cap ABB revacid FasTab 30mg Tab ABB A02BC04 RABRAZO rabeprazole 10mg C tab Abbott-Rabeprazole 10mg DR Tab C ABB Apo-Rabeprazole 10mg C Tab C A-Rabeprazole 10mg Tab C pms-rabeprazole 10mg C Tab C S Rabeprazole C 10mg Tab C Rabeprazole-10mg Tab C SIV RA-Rabeprazole 10mg Tab C RA Sandoz Rabeprazole 10mg C Tab C Teva-Rabeprazole-C 10mg Tab C TV ariet 10mg Tab C JA rabeprazole 20mg C tab Abbott-Rabeprazole 20mg DR Tab C ABB ovember

14 A Alimentary Tract and etabolism Apo-Rabeprazole 20mg C Tab C A-Rabeprazole 20mg Tab C pms-rabeprazole 20mg C Tab C S Rabeprazole C 20mg Tab C Rabeprazole-20mg Tab C SIV RA-Rabeprazole 20mg Tab C RA Sandoz Rabeprazole 20mg C Tab C Teva-Rabeprazole-C 20mg Tab C TV ariet 20mg Tab C JA A02BC05 SORAZO esomeprazole 20mg tab Apo-someprazole 20mg DR Tab A-someprazole 20mg DR Tab RA-someprazole 20mg Tab RA exium 20mg Tab AZ esomeprazole 40mg cap/tab Apo-someprazole 40mg DR Tab someprazole 40mg DR Tab A-someprazole 40mg DR Tab pms-someprazole DR 40mg Cap S RA-someprazole 40mg Tab RA exium 40mg Tab AZ A02BD COBIATIOS FOR RADICATIO OF HICOBACTR ORI A02BD07 ASORAZO, CARITHROCI AD AOXICII Hp-AC * ABB *quantity limit of one pack per year A02BX DRUGS FOR TIC UCR AD GASTROSOHAGA RFUX DI(GRD) A02BX02 SUCRAFAT sucralfate 1g tab Apo-Sucralfate 1g Tab ovo-sucralate 1g Tab TV Sulcrate 1g Tab AXC Sulcrate 1g/5m lus Susp AXC A03 A03A A03AA DRUGS FOR FUCTIOA GASTROITSTIA DISORDRS DRUGS FOR FUCTIOA BOW DISORDRS ST ATICHOI STRS WITH TRTIAR AIO GROU A03AA05 TRIBUTI Trimebutine 100mg Tab C AA trimebutine 200mg tab Trimebutine 200mg Tab C AA odulon 200mg Tab C AXC A03AA07 DICCOVRI (DICCOI) ovember

15 A Alimentary Tract and etabolism Jamp-Dicyclomine 10mg Tab C JC Bentylol 10mg Tab C AXC Dicyclomine 10mg/m Inj Bentylol 10mg/5m Syr C AXC Jamp-Dicyclomine 20mg Tab C JC Bentylol 20mg Tab C AXC A03AB ST ATICHOIRGICS,STRS,QUATR AOIU CO A03AB02 GCORROAT (GCORROIU) Glycopyrrolate 0.2mg/m Inj C A03AD AAVRI AD DRIVATIVS A03AD01 AAVRI apaverine HCl 32.5mg/m Inj A03AX OTHR DRUGS FOR FUCTIOA BOW DISORDRS A03AX04 IAVRIU Dicetel 50mg Tab C ABB Dicetel 100mg Tab C ABB A03AX13 SIICOS Ovol 80 (80mg) Tab CHU A03B A03BA BADOA AD DRIVATIVS, AI BADOA AKAOIDS, TRTIAR AIS A03BA01 ATROI Atropine Sulfate 0.4mg/m Inj C Atropine Sulfate 0.6mg/m Inj C A03BA03 HOSCAI evsin 0.125mg S Tab C AXS A03C A03CA ATISASODICS I COBIATIO WITH SCHOTICS STHTICS,SCHOTICS COBIATIOS A03CA02 CIDIIU AD SCHOTICS chlordiazepoxide HCl 5mg & clidinium Br 2.5mg cap Apo-Chlorax 5/2.5mg Cap D C AA ibrax Cap D C V A03 A03D ATISASODICS,ATICHOIRGICS WITH AAGSICS ATISASODICS I COBIATIO WITH OTHR DRUGS A03D99 ATISASODICS, COBIATIOS Bellergal Spacetabs D C A ovember

16 A Alimentary Tract and etabolism A03F A03FA ROUSIVS ROUSIVS A03FA01 TOCORAID metoclopramide HCl 1mg o/l etonia 1mg/m iq C D axeran 1mg/m O/ (discontinued) RD metoclopramide HCl 5mg tab etonia 5mg Tab C D axeran 5mg Tab (discontinued) RR etoclopramide 5mg/m Inj C metoclopramide HCl 10mg tab etonia 10mg Tab C D axeran 10mg Tab (discontinued) RR A03FA03 DORIDO domperidone maleate 10mg tab Apo-Domperidone 10mg Tab C Domperidone 10mg Tab C Domperidone-10mg Tab C SIV Jamp-Domperidone 10mg Tab C JC ar-domperidone 10mg Tab C AR A-Domperidone 10mg Tab (discontinued) pms-domperidone 10mg Tab C S RA-Domperidone 10mg Tab C RA ratio-domperidone 10mg Tab C TV Teva-Domperidone 10mg Tab C TV otilium 10mg Tab (discontinued) JA A04 A04A A04AA ATITICS AD ATIAUSATS ATITICS AD ATIAUSATS SROTOI (5HT3) ATAGOISTS A04AA01 ODASTRO ondansetron 4mg tab Apo-Ondansetron 4mg Tab CO Ondansetron 4mg Tab Jamp-Ondansetron 4mg Tab JC ar-ondansetron 4mg Tab AR IT-Ondansetron 4mg Tab T A-Ondansetron 4mg Tab AT-Ondansetron 4mg Tab AT ovo-ondansetron 4mg Tab TV Ondansetron 4mg Tab Ondansetron-Odan 4mg Tab OD pms-ondansetron 4mg Tab S RA-Ondansetron 4mg Tab RA ratio-ondansetron 4mg Tab (discontinued) TV ovember

17 A Alimentary Tract and etabolism Sandoz Ondansetron 4mg Tab Septa-Ondansetron 4mg Tab ST Zofran 4mg Tab VR ondansetron 4mg/5m o/l Ondansetron 4mg/5m O/ AA Zofran 4mg/5m O/ VR ondansetron OD 4mg tab/film Ondissolve ODF 4mg Film TAK Zofran 4mg ODT Tab VR ondansetron 8mg tab Apo-Ondansetron 8mg Tab CO Ondansetron 8mg Tab Jamp-Ondansetron 8mg Tab JC ar-ondansetron 8mg Tab AR IT-Ondansetron 8mg Tab T A-Ondansetron 8mg Tab AT-Ondansetron 8mg Tab AT Ondansetron 8mg Tab pms-ondansetron 8mg Tab S RA-Ondansetron 8mg Tab RA ratio-ondansetron 8mg Tab (discontinued) TV Sandoz Ondansetron 8mg Tab Septa-Ondansetron 8mg Tab ST Teva-Ondansetron 8mg Tab TV Zofran 8mg Tab VR ondansetron OD 8mg tab/film Ondissolve ODF 8mg Film TAK Zofran 8mg ODT Tab VR A04AA02 GRAISTRO granisetron 1mg tab Granisetron 1mg Tab AA Kytril 1mg Tab (discontinued) HR A04AA05 AOOSTRO Aloxi 0.25/5m Inj IS Aloxi 0.5mg Cap IS A04AD OTHR ATITICS A04AD01 SCOOAI Scopolamine 0.4mg/m Inj C HOS Scopolamine 0.6mg/m Inj C HOS Transderm-V 1.5mg atch VR Buscopan 10mg Tab BO hyoscine butylbromide 20mg/m inj Hyoscine Butylbromide 20mg/m Inj Buscopan 20mg/m Inj (discontinued) BO ovember

18 A Alimentary Tract and etabolism A04AD11 ABIO (CAABIOID (THC) DRIVATIVS) nabilone 0.25mg cap RA-abilone 0.25mg Cap D RA Teva-abilone 0.25mg Cap D TV Cesamet 0.25mg Cap D V nabilone 0.5mg cap CO abilone 0.5mg Cap D pms-abilone 0.5mg Cap D S RA-abilone 0.5mg Cap D RA Teva-abilone 0.5mg Cap D TV Cesamet 0.5mg Cap D V nabilone 1mg cap CO abilone 1mg Cap D pms-abilone 1mg Cap D S RA-abilone 1mg Cap D RA Teva-abilone 1mg Cap D TV Cesamet 1mg Cap D V A04AD12 ARITAT mend Tri-ack Cap FRS mend 80mg Cap FRS mend 125mg Cap FRS A04AD99 DIHDRIAT dimenhydrinate 10mg/m IV inj Dimenhydrinate 10mg/m IV Amp Gravol 10mg/m IV Amp (discontinued) CHU Gravol 15mg/5m O/ CHU Gravol 25mg Supp CHU dimenhydrinate 50mg/m I inj Dimenhydrinate 50mg/m I Inj C Gravol l 50mg/m I Inj C CHU Dimenhydrinate 50mg Supp Gravol 50mg Tab CHU Dimenhydrinate 100mg (Adult) Supp Gravol 100mg Supp CHU A05 A05A A05AA BI AD IVR THRA BI THRA BI ACID RARATIOS A05AA02 URSODIO (URSODOXCHOIC ACID) ursodiol 250mg tab pms-ursodiol C 250mg Tab D S Urso 250mg Tab D AXC ovember

19 A Alimentary Tract and etabolism ursodiol 500mg tab pms-ursodiol C 500mg Tab D S Urso DS 500mg Tab D AXC A05AA99 DHDROCHOIC ACID Dycholium 300mg Tab D C A06 A06A A06AA AXATIVS AXATIVS SOFTRS, OITS A06AA02 DOCUSAT SODIU pms-docusate Sodium 4mg/m Syr C S pms-docusate Sodium 10mg Drp C S Colace 10mg/m Drp C WS Colace 20mg/5m Syrup C WS ratio-docusate Sodium 20mg/5m Syr C TV Selax 20mg/5m US Syr C OD docusate sodium 100mg cap Docusate Sodium 100mg Cap C pms-docusate Sodium 100mg Cap C S Docusate Sodium 100mg Cap C TAR Jamp-Docusate Sodium 100mg Cap C JC ovo-docusate 100mg Cap TV ratio-docusate Sodium 100mg Cap C TV Colace 100mg Cap C WS Selax 100mg Cap C OD A06AB COTACT AXATIVS A06AB02 BISACOD Apo-Bisacodyl 5mg Tab C Jamp-Bisacodyl 5mg Tab C JC Bisacodyl-ODA 5mg Tab C OD Dulcolax CT 5mg Tab C BO Jamp-Bisacodyl 5mg Supp C JC pms-bisacodyl 10mg Supp C S Dulcolax 10mg Supp C BO Jamp-Bisacodyl 10mg Supp C JC A06AB06 SA GCOSIDS Senokot 1.7mg/m Syr C FR Jamp-Sennosides 8.6mg Tab C JC Senokot 8.6mg Tab C FR A06AB56 SA GCOSIDS, COBIATIOS Senokot S 8.6mg/50mg Tab C FR ovember

20 A Alimentary Tract and etabolism A06AD OSOTICA ACTIG AXATIVS A06AD10 IRA SATS I COBIATIO Coyte owder for Solution C D eglyte owder for Solution C D A06AD11 ACTUOS lactulose 667mg/m o/l Apo-actulose 667mg/m O/ Jamp-actulose 667mg/m O/ JC ratio-actulose 667mg/m O/ TV Teva-actulose 667mg/m O/ TV Chronulac 667mg/m O/ (discontinued) R lactulose 667mg/m syrup actulose 667mg/5m Syr pms-actulose 667mg/m Syr S A06AD15 ACROGO G 3350 wd Sol SC A06AD19 AGSIU CITRAT Citro ag 50mg/m O/ C ROG Citrodan 50mg/m O/ C OD A06AH RIHRA OIOID RCTOR ATAGOISTS A06AH01 THATRXO BROID Relistor 20mg/m Inj A06AX OTHR DRUGS FOR COSTIATIO A06AX05 RUCAORID Resotran 1mg Tab JA Resotran 2mg Tab JA A07 A07A A07AA ATIDIARRHAS, ITSTIA ATIIFAATOR/ATIIFCTIV AGTS ITSTIA ATIIFCTIVS ATIBIOTICS A07AA02 STATI nystatin 100,000iu o/l ratio-ystatin 100,000iu/m Oral Drops C TV ycostatin 100,000iu/m Oral Susp (discontinued) BRI pms-ystatin 100,000iu/m Oral Susp C S A07AA06 AROOCI Humatin 250mg Cap RF A07B A07BB ITSTIA ADSORBTS BISUTH RARATIOS ovember

21 A Alimentary Tract and etabolism A07BB99 BISUTH SUBSAICAT eptobismol 17.6mg/m O/ GA A07D A07DA ATIROUSIVS ATIROUSIVS A07DA01 DIHOXAT omotil 2.5mg Tab D C A07DA02 OIU Sandoz Opium & Belladonna 65mg/15mg Supp D C A07DA03 ORAID loperamide HCl 0.2mg/m o/l pms-operamide 0.2mg/m O/ C S Imodium 0.2mg/m O/ (discontinued) JJ loperamide 2mg caplet Apo-operamide 2mg Caplet C ovo-operamide 2mg Caplet C TV pms-operamide 2mg Caplet C S Diarr-eze 2mg Caplet (discontinued) D Imodium 2mg Caplet (discontinued) JJ Jamp-operamide 2mg Tab C JC A07 A07A ITSTIA ATIIFAATOR AGTS CORTICOSTROIDS ACTIG OCA A07A02 HDROCORTISO Cortifoam A Cortenema 100mg/60m Susp AXC A07A04 BTATHASO Betnesol 5mg/100m Retention nema A A07A06 BUDSOID ntocort 0.02mg/m nema AZ ntocort 3mg Cap AZ A07B ATIARGIC AGTS, XC CORTICOSTROIDS A07B01 CROOGCAT SODIU alcrom 100mg Cap SAV A07C AIOSAICIC ACID AD SIIAR AGTS A07C01 SUFASAAZI pms-sulfasalazine 500mg Tab S pms-sulfasalazine C 500mg Tab S Salazopyrin 500mg ntabs ovember

22 A Alimentary Tract and etabolism Salazopyrin 500mg Tab A07C02 5-AIOSAICIC ACID (SAAI) entasa 1g Supp FI Salofalk 1g Supp AXC entasa 1g/100m Rectal Susp FI ezavant 1.2g Tab SHI Salofalk 2g/60g Rectal Susp AXC Salofalk 4g/60g Rectal Susp AXC entasa 4g/100m Rectal Susp FI 5-aminosalicylic acid 400mg tab ovo-5-asa 400mg C Tab TV Asacol 400mg Tab esasal 500mg Tab GSK entasa 500mg Tab FI Salofalk 500mg Supp AXC Salofalk 500mg Tab AXC Asacol 800 (800mg) Tab A07C03 OSAAZI (5-ASA) Dipentum 250mg Cap S A07F A07FA ATIDIARRHOA ICROORGAISS ATIDIARRHOA ICROORGAISS A07FA01 ACTIC ACID RODUCIG ORGAISS Bacid Cap RF A08 A08A A08AB ATIOBSIT RARATIOS, XC DIT RODUCTS ATIOBSIT RARATIOS, XC DIT RODUCTS RIHRA ACTIG ATIOBSIT RODUCTS A08AB01 ORISTAT Xenical 120mg Cap HR A09 A09A A09AA DIGSTIVS, IC ZS DIGSTIVS, IC ZS Z RARATIOS A09AA02 UTIZS (IAS, ROTAS, TC) Cotazym Cap FRS Ultrase T20 Cap AXC Viokase Tab AXC Cotazym CS 4 Cap (discontinued) SCH ancrease T 4 Cap JA ovember

23 A Alimentary Tract and etabolism Ultrase S4 Cap AXC Creon 6 inimicrospheres ABB Cotazym CS 8 Cap SCH Creon 10 inimicrospheres ABB ancrease T 10 Cap JA Ultrase T12 Cap AXC ancrease T 16 Cap JA Viokase 16 Tab AXC Cotazym CS 20 Cap SCH Creon 25 inimicrospheres ABB Cotazym-65B Cap (discontinued) SCH A09AA03 SI Fermentol 100mg/30m iq CHU A10 A10A A10AB DRUGS USD I DIABTS ISUIS AD AAOGUS ISUIS & AAOGUS FOR IJCTIO, FAST-ACTIG A10AB01 ISUI (HUA) Humulin R Cartridges D I Humulin R Insulin D I ovolin G Toronto Insulin D O ovolin G Toronto enfill D O A10AB04 ISUI ISRO Humalog Cartridges * I Humalog Insulin * I Humalog Kwiken * I *full benefit for children 18 years and younger. A10AB05 ISUI ASART ovoix 30 enfill O ovorapid 100iu/m enfill Ins * O ovorapid 100iu/m Vial Ins * O *full benefit for children 18 years and younger. A10AB06 ISUI GUISI Apidra 3m Cartridges * SAV Apidra 3m refilled en * SAV Apidra 10m Vial * SAV *full benefit for children 18 years and younger. A10AC ISUIS & AAOGUS FOR IJCTIO, ITRDIAT-ACTIG A10AC01 ISUI (HUA) ovember

24 A Alimentary Tract and etabolism Humulin Cartridges D I Humulin Insulin D I Humulin Kwiken D I ovolin G H Insulin D O ovolin G H enfill D O A10AD ISUIS & AAOGUS FOR IJC. ITRDIAT-ACTIG + FAST-ACTIG A10AD01 ISUI (HUA) Humulin 30/70 Cartridges D I Humulin 30/70 Insulin D I ovolin G 30/70 Insulin D O ovolin G 30/70 enfill D O ovolin G 40/60 enfill D O ovolin G 50/50 enfill D O A10AD04 ISUI ISRO Humalog ix25 Cartridges I Humalog ix25 Kwiken I Humalog ix25 Vial I Humalog ix50 Cartridges I Humalog ix50 Kwiken I A10A ISUIS & AAOGUS, FOR IJCTIO OG-ACTIG A10A04 ISUI GARGI antus 100iu/m Cartridge SAV antus 100iu/m Solostar re-filled en SAV antus 100iu/m Vial SAV A10A05 ISUI DTIR evemir 100iu/m enfill O evemir FlexTouch 100iu/m re-filled en O A10B A10BA BOOD GUCOS OWRIG DRUGS, XC. ISUIS BIGUAIDS A10BA02 TFORI metformin HCl 500mg tab Apo-etformin 500mg Tab D CO etformin 500mg Tab D Jamp-etformin 500mg Tab D JC Jamp-etformin Blackberry 500mg Tab D JC ar-etformin 500mg Tab D AR etformin 500mg Tab (AR) D AR etformin 500mg Tab () D etformin FC 500mg Tab D SIV IT-etformin 500mg Tab D T A-etformin 500mg Tab D pms-etformin 500mg Tab D S ovember

25 A Alimentary Tract and etabolism RA-etformin 500mg Tab Tab D RA ratio-etformin 500mg Tab D TV Sandoz etformin FC 500mg Tab D Septa-etformin 500mg Tab D ST Teva-etformin 500mg Tab D TV Glucophage 500mg Tab D SAV metformin HCl 850mg tab Apo-etformin 850mg Tab D CO etformin 850mg Tab D Jamp-etformin 850mg Tab D JC Jamp-etformin Blackberry 850mg Tab D JC ar-etformin 850mg Tab D AR etformin 850mg Tab (AR) D AR etformin 850mg Tab () D etformin FC 850mg Tab D SIV IT-etformin 850mg Tab D T A-etformin 850mg Tab D pms-etformin 850mg Tab D S RA-etformin 850mg Tab D RA ratio-etformin 850mg Tab D TV Sandoz etformin FC 850mg Tab D Septa-etformin 850mg Tab D ST Teva-etformin 850mg Tab D TV Glucophage 850mg Tab D SAV A10BB SUFOAIDS, URA DRIVATIVS A10BB01 GBURID (GIBCAID) glyburide 2.5mg tab Apo-Glyburide 2.5mg Tab D Glyburide 2.5mg Tab D A-Glybe 2.5mg Tab (discontinued) Sandoz Glyburide 2.5mg Tab D Teva-Glyburide 2.5mg Tab D TV Diabeta 2.5mg Tab D SAV uglucon 2.5mg Tab (discontinued) S glyburide 5mg tab Apo-Glyburide 5mg Tab D Glyburide 5mg Tab D A-Glybe 5mg Tab (discontinued) pms-glyburide 5mg Tab D S Sandoz Glyburide 5mg Tab D Teva-Glyburide 5mg Tab D TV Diabeta 5mg Tab D SAV uglucon 5mg Tab (discontinued) S A10BB02 CHORROAID Apo-Chlorpropamide 100mg Tab chlorpropamide 250mg tab ovember

26 A Alimentary Tract and etabolism Apo-Chlorpropamide 250mg Tab Diabinese 250mg Tab (discontinued) A10BB03 TOBUTAID tolbutamide 500mg tab Tolbutamide 500mg Tab D AA obenol 500mg Tab (discontinued) HOR A10BB09 GICAZID gliclazide 30mg R tab ACT Gliclazide R 30mg Tab D Apo-Gliclazide R 30mg Tab D AO IT-Gliclazide R 30mg Tab D T Diamicron R 30mg Tab D SV gliclazide 60mg R tab Apo-Gliclazide R 60mg Tab D Diamicron R 60mg Tab D SV gliclazide 80mg tab Apo-Gliclazide 80mg Tab D Gliclazide 80mg Tab D A-Gliclazide 80mg Tab D ovo-gliclazide 80mg Tab D TV Diamicron 80mg Tab D SV A10BB12 GIIRID glimepiride 1mg tab Apo-Glimepiride 1mg Tab ovo-glimepiride 1mg Tab (discontinued) TV ratio-glimepiride 1mg Tab TV Sandoz Glimepiride 1mg Tab Amaryl 1mg Tab SAV glimepiride 2mg tab Apo-Glimepiride 2mg Tab ovo-glimepiride 2mg Tab (discontinued) TV ratio-glimepiride 2mg Tab TV Sandoz Glimepiride 2mg Tab Amaryl 2mg Tab SAV glimepiride 4mg tab Apo-Glimepiride 4mg Tab ovo-glimepiride 4mg Tab (discontinued) TV ratio-glimepiride 4mg Tab TV Sandoz Glimepiride 4mg Tab Amaryl 4mg Tab SAV A10BD COBIATIOS OF ORA BOOD GUCOS OWRIG DRUGS A10BD03 TFORI AD ROSIGITAZO Avandamet 2/500mg Tab GSK Avandamet 2/1000mg Tab GSK ovember

27 A Alimentary Tract and etabolism Avandamet 4/500mg Tab GSK Avandamet 4/1000mg Tab GSK A10BD07 TFORI AD SITAGITI Janumet 50/500mg Tab FRS Janumet 50/850mg Tab FRS Janumet 50/1000mg Tab FRS Janumet 50/1000mg XR Tab FRS A10BD10 TFORI AD SAXAGITI Komboglyze 2.5mg/500mg Tab AZ Komboglyze 2.5mg/850mg Tab AZ Komboglyze 2.5mg/1000mg Tab AZ A10BD13 TFORI AD AOGITI Kazano 500/12.5mg Tab TAK Kazano 850/12.5mg Tab TAK Kazano 1000/12.5mg Tab TAK A10BF AHA GUCOSIDAS IHIBITORS A10BF01 ACARBOS Glucobay 50mg Tab D BA Glucobay 100mg Tab D BA A10BG THIAZOIDIOS A10BG02 ROSIGITAZO Avandia 2mg Tab GSK Avandia 4mg Tab GSK Avandia 8mg Tab GSK A10BG03 IOGITAZO pioglitazone 15mg tab Accel ioglitazone 15mg Tab ACC Apo-ioglitazone 15mg Tab Auro-ioglitiazone 15mg Tab ARO CO ioglitazone 15mg Tab Jamp-ioglitazone 15mg Tab JC IT-ioglitazone 15mg Tab T A-ioglitazone 15mg Tab ovo-ioglitazone 15mg Tab TV ioglitazone 15mg Tab AHI pms-ioglitazone 15mg Tab S RA-ioglitazone 15mg Tab RA Sandoz ioglitazone 15mg Tab Actos 15mg Tab TAK ovember

28 A Alimentary Tract and etabolism pioglitazone 30mg tab Accel ioglitazone 30mg Tab ACC Apo-ioglitazone 30mg Tab Auro-ioglitazone 30mg Tab ARO CO ioglitazone 30mg Tab Jamp-ioglitazone 30mg Tab JC IT-ioglitazone 30mg Tab T A-ioglitazone 30mg Tab ovo-ioglitazone 30mg Tab TV ioglitazone 30mg Tab AHI pms-ioglitazone 30mg Tab S RA-ioglitazone 30mg Tab RA Sandoz ioglitazone 30mg Tab Actos 30mg Tab TAK pioglitazone 45mg tab Accel ioglitazone 45mg Tab ACC Apo-ioglitazone 45mg Tab Auro-ioglitazone 45mg Tab ARO CO ioglitazone 45mg Tab Jamp-ioglitazone 45mg Tab JC IT-ioglitazone 45mg Tab T A-ioglitazone 45mg Tab ovo-ioglitazone 45mg Tab TV ioglitazone 45mg Tab AHI pms-ioglitazone 45mg Tab S RA-ioglitazone 45mg Tab RA Sandoz ioglitazone 45mg Tab Actos 45mg Tab TAK A10BH DITID TIDAS 4 (D-4) IHIBITORS A10BH01 SITAGITI Januvia 25mg Tab FRS Januvia 50mg Tab FRS Januvia 100mg Tab FRS A10BH03 SAXAGITI Onglyza 2.5mg Tab AZ Onglyza 5mg Tab AZ A10BH04 AOGITI esina 6.25mg Tab TAK esina 12.5mg Tab TAK esina 25mg Tab TAK A10BH05 IAGITI Trajenta 5mg Tab BO A10BX OTHR BOOD GUCOS OWRIG DRUGS, XC ISUIS ovember

29 A Alimentary Tract and etabolism A10BX02 RAGIID repaglinide 0.5mg tab Apo-Repaglinide 0.5mg Tab Auro-Repaglinide 0.5mg Tab ARO CO Repaglinide 0.5mg Tab pms-repaglinide 0.5mg Tab S Sandoz Repaglinide 0.5mg Tab Glucoorm 0.5mg Tab O repaglinide 1mg tab Apo-Repaglinide 1mg Tab Auro-Repaglinide 1mg Tab ARO CO Repaglinide 1mg Tab pms-repaglinide 1mg Tab S Sandoz Repaglinide 1mg Tab Glucoorm 1mg Tab O repaglinide 2mg tab Apo-Repaglinide 2mg Tab CO Repaglinide 2mg Tab pms-repaglinide 2mg Tab S Sandoz Repaglinide 2mg Tab Glucoorm 2mg Tab O A10BX03 ATGIID Starlix 60mg Tab (discontinued) VR Starlix 120mg Tab (discontinued) VR A10BX04 XATID Byetta 1.2m refilled en AZ Byetta 2.4m refilled en AZ A10BX07 IRAGUTID Victoza 6mg/m Inj O A10BX11 CAAGIFOZI Invokana 100mg Tab JA Invokana 300mg Tab JA A11 A11C A11CC VITAIS VIT A AD D, IC COBIATIOS OF TH TWO VITAI D AD AAOGUS A11CC01 RGOCACIFRO rdol 8,288iu/m Sol OD A11CC03 AFACACIDO One-Alpha 0.25mcg Cap O One-Alpha 1mcg Cap O ovember

30 A Alimentary Tract and etabolism One-Alpha 2mcg O/ O A11CC04 CACITRIO Rocaltrol 0.25mcg Cap HR Rocaltrol 0.5mcg Cap HR A11D A11DA VIT B1,AI AD I COB WITH VITAI B6 AD B12 THIAI (VIT B1), AI A11DA01 THIAI (VIT B1) thiamine (vit B1) 100mg/m inj Thiamine 100mg/m Inj CI Vitamin B1 100mg/m Inj Betaxin 100mg/m Inj (discontinued) HOS Thiamiject 100mg/m Inj (Omega) OG A12 A12B A12BA IRA SUTS OTASSIU OTASSIU A12BA01 OTASSIU CHORID potassium chloride 1.33mq/m o/l pms-otassium Chloride 20mq/15m C S K-10 Sol 20mq/15m C GSK Apo-K 8mq Tab C icro-k 8mq xtencap C A Slow-K 8mq Tab C VR Jamp-K8 600mg Tab C JC Jamp-K mg SR Tab C JC Odan-K mg SR Tab C OD A12BA02 OTASSIU CITRAT K-yte 25mq ff Tab C WS A12C A12CC OTHR IRA SUTS AGSIU A12CC99 AGSIU GUCOHTOAT Jamp-agnesium 5mg/m O/ JC agnesium-odan 5mg/m O/ OD Rougier-agnesium 5mg/m O/ ROG A12CX VARIOUS IRA RODUCTS A12CX99 SODIU HOSHAT hosphate-ovartis 500mg ff Tab VR A16 OTHR AITAR TRACT AD TABOIS RODUCTS ovember

31 A Alimentary Tract and etabolism A16A A16AA OTHR AITAR TRACT AD TABOIS RODUCTS AIO ACIDS AD DRIVATIVS A16AA01 VOCARITI Carnitor 1g/5m Inj QGT Carnitor 100mg/m O/ QGT Carnitor 330mg Tab QGT A16AA06 BTAI A16AB ZS Cystadane 1g owder for Oral Sol OR A16AB05 AROIDAS Aldurazyme 0.58mg/m Inj GZ A16AB07 AGUCOSIDAS AFA yozyme 50mg dr for Inj GZ A16AB09 IDURSUFAS A16AX laprase 2mg/m Inj VARIOUS AITAR TRACT & TABOIS RODUCTS A A16AX06 IGUSTAT Zavesca 100mg Cap ACT ovember

32 B B01 B01A B01AA Blood and Blood Forming Organs ATICOAGUATS ATICOAGUATS VITAI K ATAGOISTS B01AA03 WARFARI warfarin 1mg tab Apo-Warfarin 1mg Tab C A-Warfarin 1mg Tab C Taro-Warfarin 1mg Tab C TAR Coumadin 1mg Tab C BRI warfarin 2mg tab Apo-Warfarin 2mg Tab C A-Warfarin 2mg Tab C ovo-warfarin 2mg Tab (discontinued) TV Taro-Warfarin 2mg Tab C TAR Coumadin 2mg Tab C BRI warfarin 2.5mg tab Apo-Warfarin 2.5mg Tab C A-Warfarin 2.5mg Tab C ovo-warfarin 2.5mg Tab (discontinued) TV Taro-Warfarin 2.5mg Tab C TAR Coumadin 2.5mg Tab C BRI warfarin 3mg tab Apo-Warfarin 3mg Tab C A-Warfarin 3mg Tab C Taro-Warfarin 3mg Tab C TAR Coumadin 3mg Tab C BRI warfarin 4mg tab Apo-Warfarin 4mg Tab C A-Warfarin 4mg Tab C Taro-Warfarin 4mg Tab C TAR Coumadin 4mg Tab C BRI warfarin 5mg tab Apo-Warfarin 5mg Tab C A-Warfarin 5mg Tab C ovo-warfarin 5mg Tab (discontinued) TV Taro-Warfarin 5mg Tab C TAR Coumadin 5mg Tab C BRI warfarin 6mg tab A-Warfarin 6mg Tab C Taro-Warfarin 6mg Tab TAR Coumadin 6mg Tab C BRI warfarin 7.5mg tab A-Warfarin 7.5 Tab C Taro-Warfarin 7.5mg Tab C TAR warfarin 10mg tab Apo-Warfarin 10mg Tab C ovember

33 B Blood and Blood Forming Organs A-Warfarin 10mg Tab C Taro-Warfarin 10mg Tab C TAR Coumadin 10mg Tab C BRI B01AA07 ACOCOUARO Sintrom 1mg Tab C A Sintrom 4mg Tab C A B01AB HARI GROU B01AB01 HARI Heparin 100iu/m Inj C O Heparin 1,000iu/m Inj C O Heparin 10,000iu/m Inj (discontinued) O B01AB04 DATARI Fragmin 2,500iu [anti-xa] 0.2/m Syringe Inj C Fragmin 5,000iu [anti-xa] 0.2/m Syringe Inj C Fragmin 7,500iu [anti-xa] 0.3/m Syringe Inj C Fragmin 10,000iu [anti-xa]/m Amp Inj C Fragmin 10,000iu [anti-xa] 0.4/m Syringe Inj C Fragmin 12,500iu [anti-xa] 0.5/m Syringe Inj C Fragmin 15,000iu [anti-xa] 0.6/m Syringe Inj C Fragmin 18,000iu [anti-xa] 0.72/m Syringe Inj C Fragmin 25,000iu [anti-xa]/m Vial Inj C B01AB05 OXAARI ovenox 30mg/0.3m Syringe Inj C SAV ovenox 40mg/0.4m Syringe Inj C SAV ovenox 60mg/0.6m Syringe Inj C SAV ovenox 80mg/0.8m Syringe Inj C SAV ovenox 100mg/m refilled Syringe Inj C SAV ovenox 100mg/m Vial Inj C SAV ovenox 120mg/0.8m Syringe Inj C SAV ovenox H 150mg/m Syringe Inj C SAV B01AB10 TIZAARI Innohep 2,500iu/0.25m Inj C O Innohep 3,500iu/0.35m Inj C O Innohep 4,500iu/0.45m Inj C O Innohep 8,000iu/0.4m Inj C O Innohep 10,000iu/0.5m Inj C O Innohep 10,000iu/m Inj C O ovember

34 B Blood and Blood Forming Organs Innohep 12,000iu/0.6m Inj C O Innohep 14,000iu/0.7m Inj C O Innohep 16,000iu/0.8m Inj C O Innohep 18,000iu/0.9m Inj C O Innohep 20,000iu/m Inj C O B01AC ATT AGGRGATIO IHIBITORS XC. HARI B01AC04 COIDOGR clopidogrel 75mg tab Abbott-Clopidogrel 75mg Tab ABB Apo-Clopidogrel 75mg Tab Auro-Clopidogrel 75mg Tab ARO Clopidogrel 75mg Tab Clopidogrel-75mg Tab SIV CO Clopidogrel 75mg Tab Jamp-Clopidogrel 75mg Tab JC ar-clopidogrel 75mg Tab AR IT-Clopidogrel 75mg Tab T A-Clopidogrel 75mg Tab pms-clopidogrel 75mg Tab S RA-Clopidogrel 75mg Tab RA Sandoz Clopidogrel 75mg Tab Teva-Clopidogrel 75mg Tab TV lavix 75mg Tab SAV clopidogrel 300mg tab Apo-Clopidogrel 300mg Tab Teva-Clopidogrel 300mg Tab TV lavix 300mg Tab SAV B01AC05 TICOIDI ticlopidine 250mg tab Apo-Ticlopidine 250mg Tab Teva-Ticlopidine 250mg Tab TV Ticlid 250mg Tab (discontinued) S B01AC07 DIRIDAO dipyridamole 25mg tab Apo-Dipyridamole-FC 25mg Tab ersantine 25mg Tab (discontinued) BO dipyridamole 50mg tab Apo-Dipyridamole-FC 50mg Tab ersantine 50mg Tab (discontinued) BO dipyridamole 75mg tab Apo-Dipyridamole-FC 75mg Tab ersantine 75mg Tab (discontinued) BO B01AC21 TRROSTII ovember

35 B Blood and Blood Forming Organs Remodulin 1mg/m Inj UTC Remodulin 2.5mg/m Inj UTC Remodulin 5mg/m Inj UTC Remodulin 10mg/m Inj UTC B01AC22 RASUGR ffient 10mg Tab I B01AC24 TICAGROR Brilinta 90mg Tab AZ B01AC30 ATT AGGRGATIO IHIBITORS, COBIATIOS Aggrenox 200/25mg Cap BO B01A DIRCT THROBI IHIBITORS B01A07 DABIGATRA TXIAT radaxa 75mg Cap BO radaxa 110mg Cap BO radaxa 150mg Cap BO B01AF DIRCT FACTOR XA IHIBITORS B01AF01 RIVAROXABA Xarelto 10mg Tab BA B01AF02 AIXABA liquis 2.5mg Tab BRI liquis 5mg Tab BRI B01AX OTHR ATITHROBOTIC AGTS B01AX05 FODAARIUX fondaparinux sodium 2.5mg/0.5m Inj Fondaparinux Sodium 2.5mg/0.5m Inj RCH Arixtra 2.5mg/0.5m Inj AR fondapariunux sodium 12.5mg/m Inj Fondaparinux Sodium 12.5mg/m Inj RCH Arixtra 12.5mg/m AR B01AX06 RIVAROXABA Xarelto 15mg Tab BA Xarelto 20mg Tab BA B02 B02A B02AA ATIHAORRHAGICS ATIFIBRIOTICS AIO ACIDS B02AA02 TRAXAIC ACID ovember

36 B Blood and Blood Forming Organs tranexamic acid 100mg/m inj Tranexamic Acid 100mg/m Inj Cyklokapron 100mg/m Inj tranexamic acid 500mg tab GD-Tranexamic Acid 500mg Tab GD Tranexamic Acid 500mg Tab STR Cyklokapron 500mg Tab B02B B02BA VITAI K AD OTHR HOSTATICS VITAI K B02BA01 HTOADIO Vitamin K1 10mg/m Inj Vitamin K1 2mg/m Inj B02BX OTHR SSTIC HAOSTATICS B02BX04 ROIOSTI plate 250mcg/0.5m Inj AGA plate 500mcg/m Inj AGA B02BX05 TROBOAG Revolade 25mg Tab GSK Revolade 50mg Tab GSK B03 B03A B03AA ATIAAIC RARATIOS IRO RARATIOS IRO BIVAT, ORA RARATIOS B03AA02 FRROUS FUARAT alafer 300mg Cap V alafer 300mg/5m Susp V B03AA03 FRROUS GUCOAT ferrous gluconate 300mg tab AC-Ferrous Gluconate 300mg Tab Apo-Ferrous Gluconate 300mg Tab ovo-ferrogluc 300mg Tab TV B03AA07 FRROUS SUFAT Ferodan 75mg/m Infant Drops OD pms-ferrous Sulfate 75mg/0.6m Drops S Ferodan 150mg5/m Syrup OD B03AC IRO TRIVAT, ARTRA RARATIOS B03AC01 DXTRIFRRO (IRO DXTRA) DexIron 50mg/m Inj BHC ovember

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