New Brunswick Drug Plans Formulary

New Brunswick Drug Plans Formulary September 2015 Administered by Medavie Blue Cross on Behalf of the Government of New Brunswick

TABLE OF CONTENTS Page Introduction... I New Brunswick Drug Plans... II Exclusions... IV Legend... V Anatomical Therapeutic Chemical (ATC) Classification of Drugs A Alimentary Tract and Metabolism... 1 B Blood and Blood Forming Organs... 24 C Cardiovascular System... 35 D Dermatologicals... 84 G Genito Urinary System and Sex Hormones... 97 H Systemic Hormonal Preparations, Excluding Sex Hormones... 109 J Antiinfectives for Systemic Use... 117 L Antineoplastic and Immunomodulating Agents... 144 M Musculo-Skeletal System... 163 N Nervous System... 174 P Antiparasitic Products, Insecticides and Repellants... 238 R Respiratory System... 241 S Sensory Organs... 252 V Various... 262 Appendices I-A Abbreviations of Dosage Forms... A - 1 I-B Abbreviations of Routes... A - 4 I-C Abbreviations of Units... A - 6 I-D Abbreviations of Manufacturers Names... A - 8 II Extemporaneous Preparations... A - 10 III Special Authorization... A - 11 III Special Authorization Drug Criteria... A - 13

New Brunswick Drug Plans Formulary Introduction The New Brunswick Drug Plans provides prescription drug coverage to eligible New Brunswick residents (see pages II and III). The New Brunswick Drug Plans Formulary is a list of the drugs which are eligible benefits under the drug plans. All drugs considered for listing as benefits must be reviewed according to the drug review process. Most drugs listed in the New Brunswick Drug Plans Formulary are regular benefits which are reimbursed with no criteria or prior approval requirements. Some drugs require special authorization in order to be reimbursed. Certain drug products are not eligible benefits and are identified on the exclusion list (see Formulary page IV). September 2015 v.1 I

New Brunswick Drug Plans Plans Fees Eligibility Authority A $9.05 per prescription up to an annual copay ceiling of $500 for GIS recipients. $15.00 per prescription with no annual copay ceiling for non-gis recipients Eligible residents of the province who are sixty-five years of age or older Prescription Drug Payment Act and Regulations B $50 per year registration fee; 20% of cost of prescription to a maximum of $20 per prescription up to an annual copay ceiling of $500 per family unit Persons with cystic fibrosis who are eligible residents and registered with the Department of Health Prescription Drug Payment Act and Regulations D Premiums and copays are based on income Uninsured New Brunswick residents Prescription and Catastrophic Drug Insurance Act and Regulation E $4 per prescription (1) ; up to an annual copay ceiling of $250 per person Persons in licensed residential facilities who hold a valid health card issued by the Department of Social Development Health Services Act and Regulations F $4 per prescription (1) for adults (18 years and over) $2 per prescription (1) for children (under 18 years); up to an annual copay ceiling of $250 per family unit Department of Social Development clients Regional Health Authorities Act and Regulations G None Children in care of the Minister of the Department of Social Development and special needs children Health Services Act and Regulations H $50 per year premium; copay ranges from zero to 100 per cent for each prescription Persons with multiple sclerosis who are eligible residents and registered with the Department of Health Prescription Drug Payment Act and Regulations I None Publicly Funded, Pharmacist Administered Seasonal Influenza Vacccine P None Publically funded drugs for the management of active or latent tuberculosis (TB) infection. Public Health Public Health September 2015 v.1 II

New Brunswick Drug Plans Plans Fees Eligibility Legislative Authority R $50 per year registration fee; 20% of cost of prescription to a maximum of $20 per prescription up to an annual ceiling of $500 per family unit Solid organ transplant recipients who are eligible residents and registered with the Department of Health Prescription Drug Payment Act and Regulations T $50 per year registration fee; 20% of cost of prescription to a maximum of $20 per prescription up to an annual ceiling of $500 per family unit Persons with growth hormone deficiency who are eligible residents and registered with the Department of Health Prescription Drug Payment Act and Regulations U $50 per year registration fee; 20% of cost of prescription to a maximum of $20 per prescription up to an annual ceiling of $500 per family unit HIV-infected persons who are eligible residents and registered with the Department of Health Prescription Drug Payment Act and Regulations V None Eligible residents of Nursing Homes as defined in the Nursing Home Act operated by a licensee under the Act Prescription Drug Payment Act and Regulations W $9.05 per prescription Extra Mural Program patients who are in possession of a Prescription Drug Authorization Form Regional Health Authorities Act (1) Does not apply to prescriptions for certain drugs (e.g. contraceptives, methadone for opioid dependence). September 2015 v.1 III

Exclusions The following classes of products, except those specifically listed on the Formulary, are excluded as benefits under the New Brunswick Drug Plans. Drugs not authorized for sale and use in Canada Over-the-counter (OTC) or non-prescription drugs, vitamins, and minerals Dietary or nutritional supplements and food products Weight loss products Products for the treatment of erectile/sexual dysfunction, or infertility Products for esthetic or cosmetic purposes Soaps, cleansers, shampoos, antiseptics, or disinfectants Drugs for the prevention of travel acquired diseases Diagnostic agents and point-of-care testing kits Medical supplies, devices and equipment (e.g. prostheses, first aid supplies, ostomy supplies, diabetes test strips and syringes, etc.) Vaccines September 2015 v.1 IV

Legend 1. ATC-Therapeutic subgroup 2. ATC- Pharmacological subgroups 3. ATC- Chemical Substance 4. Dosage form, route and strength. Strength represents the amount of ingredients present in a solid dose form (Tablet) or in one gram or one millilitre of a preparation (Cream, uid, etc.) 5. Brand or manufacturers' product name 6. Drug Identification Number (DIN) 7. Manufacturers' identification code. See Appendix I-D for details 8. Drug plans for which the product is considered to be a benefit 9. Manufacturer has discontinued this product it will be deleted from the list as a benefit on the date indicated September 2015 v.1 V

A01 A01A A01AA A01AA01 A01AC A01AC01 A01AD A02 A02A A01AD02 A02AD A02AD01 STOMATOLOGICAL PREPARATIONS PRODUITS STOMATOLOGIQUES STOMATOLOGICAL PREPARATIONS PRODUITS STOMATOLOGIQUES CARIES PROPHYLACTIC AGENTS AGENTS PROPHYLACTIQUES DES CARIES SODIUM FLUORIDE FLUORURE DE SODIUM Den 0.2% Fluorinse 00782882 MLA EF-18G CORTICOSTEROIDS FOR LOCAL ORAL TREATMENT CORTICOSTÉROÏDES POUR TRAITEMENT BUCCAL LOCALISÉ TRIAMCINOLONE TRIAMCINOLONE Pst Den 0.1% Oracort 01964054 TAR ADEFGVW Pst OTHER AGENTS FOR LOCAL ORAL TREATMENT AUTRES MÉDICAMENTS POUR TRAITEMENT BUCCAL LOCALISÉ BENZYDAMINE BENZYDAMINE Buc 0.15% Pharixia 02229777 PMS ADEFGVW DRUGS FOR ACID RELATED DISORDERS MÉDICAMENTS CONTRE LES TROUBLES DUS À L'HYPERACIDITÉ ANTACIDS ANTIACIDES COMBINATIONS AND COMPLEXES OF ALUMINIUM, CALCIUM AND MAGNESIUM COMPOUNDS COMBINAISON DE COMPOSÉS DE MAGNÉSIUM, D'ALUMINIUM ET DE CALCIUM ORDINARY SALT COMBINATIONS COMPOSES DE SEL ORDINAIRE ALUMINUM / MAGNESIUM ALUMINIUM / MAGNÉSIUM Sus Orl 45.6mg/40mg Diovol 01966529 CHU G Susp Sus Orl 120mg/60mg Diovol EX 00491217 CHU G Susp September 2015 v.1 1

A02B A02BA A02BA01 DRUGS FOR PEPTIC ULCER AND GASTRO-OESOPHAGEAL REFLUX DISEASE (GORD) MÉDICAMENTS CONTRE L'ULCÈRE GASTRODUODÉNAL ET LE REFLUX GASTRO OESOPHAGIEN H2-RECEPTOR ANTAGONISTS ANTAGONISTES DES RÉCEPTEURS H2 CIMETIDINE CIMÉTIDINE Tab Orl 200mg Apo-Cimetidine 00584215 APX ADEFGVW Tab Orl 300mg Apo-Cimetidine 00487872 APX ADEFGVW Mylan-Cimetidine 02227444 MYL ADEFGVW Tab Orl 400mg Apo-Cimetidine 00600059 APX ADEFGVW Mylan-Cimetidine 02227452 MYL ADEFGVW Tab Orl 600mg Apo-Cimetidine 00600067 APX ADEFGVW Mylan-Cimetidine 02227460 MYL ADEFGVW Tab Orl 800mg Apo-Cimetidine (Disc/non Disp Mar 7/16) 00749494 APX ADEFGVW A02BA02 RANITIDINE RANITIDINE Inj 25mg/mL Zantac 02212366 GSK W Orl 15mg/mL Apo-Ranitidine 02280833 APX DEFGVW Teva-Ranidine 02242940 TEV DEFGVW Tab Orl 150mg Zantac 02212331 GSK ABDEFGVW Act Ranitidine 02248570 ATV ABDEFGVW Apo-Ranitidine 00733059 APX ABDEFGVW Mylan-Ranitidine 02207761 MYL ABDEFGVW Myl-Ranitidine 02367378 MYL ABDEFGVW pms-ranitidine 02242453 PMS ABDEFGVW Ranitidine 02353016 SAS ABDEFGVW Ranitidine 02385953 SIV ABDEFGVW Ran-Ranitidine 02336480 RAN ABDEFGVW Sandoz Ranitidine 02243229 SDZ ABDEFGVW Teva-Ranidine 00828564 TEV ABDEFGVW September 2015 v.1 2

A02BA02 A02BA03 A02BB A02BB01 A02BC A02BC01 RANITIDINE RANITIDINE Tab Orl 300mg Zantac 02212358 GSK ABDEFGVW Act Ranitidine 02248571 ATV ABDEFGVW Apo-Ranitidine 00733067 APX ABDEFGVW Mylan-Ranitidine 02207788 MYL ABDEFGVW Myl-Ranitidine 02367386 MYL ABDEFGVW pms-ranitidine 02242454 PMS ABDEFGVW Ranitidine 02353024 SAS ABDEFGVW Ranitidine 02385961 SIV ABDEFGVW Ran-Ranitidine 02336502 RAN ABDEFGVW Sandoz Ranitidine 02243230 SDZ ABDEFGVW Teva-Ranidine 00828556 TEV ABDEFGVW FAMOTIDINE FAMOTIDINE Tab Orl 20mg Apo-Famotidine 01953842 APX ADEFGVW Famotidine 02351102 SAS ADEFGVW Mylan-Famotidine 02196018 MYL ADEFGVW Teva-Famotidine 02022133 TEV ADEFGVW Tab Orl 40mg Apo-Famotidine 01953834 APX ADEFGVW Famotidine 02351110 SAS ADEFGVW Mylan-Famotidine 02196026 MYL ADEFGVW Teva-Famotidine 02022141 TEV ADEFGVW PROSTAGLANDINS PROSTAGLANDINES MISOPROSTOL MISOPROSTOL Tab Orl 100mcg Misoprostol 02244022 AAP ADEFGVW Tab Orl 200mcg Misoprostol 02244023 AAP ADEFGVW PROTON PUMP INHIBITORS INHIBITEURS DE LA POMPE À PROTONS OMEPRAZOLE OMÉPRAZOLE SRC Orl 20mg Losec 00846503 AZE ABDEFGVW Caps.L.L. Apo-Omeprazole 02245058 APX ABDEFGVW Mylan-Omeprazole 02329433 MYL ABDEFGVW Omeprazole 02348691 SAS ABDEFGVW Omeprazole 02411857 SIV ABDEFGVW pms-omeprazole 02320851 PMS ABDEFGVW Ran-Omeprazole 02403617 RAN ABDEFGVW Sandoz Omeprazole 02296446 SDZ ABDEFGVW September 2015 v.1 3

A02BC01 A02BC02 OMEPRAZOLE OMÉPRAZOLE SRT Orl 20mg Losec 02190915 AZE ABDEFGVW L.L. Jamp-Omeprazole 02420198 JPC ABDEFGVW Omeprazole 02416549 AHI ABDEFGVW pms-omeprazole DR 02310260 PMS ABDEFGVW Ran-Omeprazole 02374870 RAN ABDEFGVW Teva-Omeprazole 02295415 TEV ABDEFGVW PANTOPRAZOLE PANTOPRAZOLE ECT Orl 20mg Pantoloc 02241804 TAK (SA) Ent Apo-Pantoprazole 02292912 APX (SA) Jamp-Pantoprazole 02408414 JPC (SA) Pantoprazole 02385740 SIV (SA) Ran-Pantoprazole 02305038 RAN (SA) Sandoz Pantoprazole 02301075 SDZ (SA) Teva-Pantoprazole 02285479 TEV (SA) ECT Orl 40mg Pantoloc 02229453 TAK (SA) Ent Abbott-Pantoprazole 02412969 ABB (SA) Act Pantoprazole 02300486 ATV (SA) Apo-Pantoprazole 02292920 APX (SA) Jamp-Pantoprazole 02357054 JPC (SA) Mar-Pantoprazole 02416565 MAR (SA) Mint-Pantoprazole 02417448 MNT (SA) Mylan-Pantoprazole 02299585 MYL (SA) Pantoprazole 02437945 PMS (SA) Pantoprazole 02370808 SAS (SA) Pantoprazole 02385759 SIC (SA) pms-pantoprazole 02307871 PMS (SA) Ran-Pantoprazole 02305046 RAN (SA) Sandoz Pantoprazole 02301083 SDZ (SA) Teva-Pantoprazole 02285487 TEV (SA) Tab Orl 40mg Tecta 02267233 TAK ABDEFGVW A02BC03 LANSOPRAZOLE LANSOPRAZOLE SRC Orl 15mg Prevacid 02165503 ABB (SA) Caps.L.L. Apo-Lansoprazole 02293811 APX (SA) Lansoprazole 02433001 PMS (SA) Lansoprazole 02357682 SAS (SA) Mylan-Lansoprazole 02353830 MYL (SA) pms-lansoprazole (Disc/Non-Disp Feb 25/17) 02395258 PMS (SA) Ran-Lansoprazole 02402610 RAN (SA) Sandoz Lansoprazole 02385643 SDZ (SA) Teva-Lansoprazole 02280515 TEV (SA) September 2015 v.1 4

A02BC03 LANSOPRAZOLE LANSOPRAZOLE SRC Orl 30mg Prevacid 02165511 ABB (SA) Caps.L.L. Apo-Lansoprazole 02293838 APX (SA) Lansoprazole 02357690 SAS (SA) Lansoprazole 02433028 PMS (SA) Lansoprazole 02410389 SIV (SA) Mylan-Lansoprazole 02353849 MYL (SA) pms-lansoprazole (Disc/Non-Disp Feb 25/17) 02395266 PMS (SA) Ran-Lansoprazole 02402629 RAN (SA) Sandoz Lansoprazole 02385651 SDZ (SA) Teva-Lansoprazole 02280523 TEV (SA) SRT Orl 15mg Prevacid FasTab 02249464 ABB (SA) L.L A02BC04 A02BD A02BD99 SRT Orl 30mg Prevacid FasTab 02249472 ABB (SA) L.L. RABEPRAZOLE RABÉPRAZOLE ECT Orl 10mg Pariet 02243796 JAN ABDEFGVW Ent Abbott-Rabeprazole 02422638 BGP ABDEFGVW Apo-Rabeprazole 02345579 APX ABDEFGVW Mylan-Rabeprazole 02408392 MYL ABDEFGVW pms-rabeprazole EC 02310805 PMS ABDEFGVW Rabeprazole 02385449 SIV ABDEFGVW Rabeprazole EC 02356511 SAS ABDEFGVW Ran-Rabeprazole 02298074 RAN ABDEFGVW Sandoz Rabeprazole 02314177 SDZ ABDEFGVW Teva-Rabeprazole EC 02296632 TEV ABDEFGVW ECT Orl 20mg Pariet 02243797 JAN ABDEFGVW Ent Abbott-Rabeprazole 02422646 BGP ABDEFGVW Apo-Rabeprazole 02345587 APX ABDEFGVW Mylan-Rabeprazole 02408406 MYL ABDEFGVW pms-rabeprazole EC 02310813 PMS ABDEFGVW Rabeprazole 02385457 SIV ABDEFGVW Rabeprazole EC 02356538 SAS ABDEFGVW Ran-Rabeprazole 02298082 RAN ABDEFGVW Sandoz Rabeprazole 02314185 SDZ ABDEFGVW Teva-Rabeprazole EC 02296640 TEV ABDEFGVW COMBINATIONS FOR ERADICATION OF HELICOBACTER PYLORI ASSOCIATIONS POUR L ÉRADICATION DU HELICOBACTER PYLORI LANSOPRAZOLE, CLARITHROMYCIN AND AMOXICILLIN LANSOPRAZOLE, L AMOXICILLINE ET CLARITHROMYCINE Kit Orl 30mg, 500mg, 500mg Hp-Pac Kit 7 blister cards 02238525 ABB (SA) Tro September 2015 v.1 5

A02BX A03 A03A A02BX02 A03AA A03AA05 OTHER DRUGS FOR PEPTIC ULCER AND GASTROESOPHAGEAL REFLUX DISEASE (GORD) AUTRES MÉDICAMENTS CONTRE L ULCÈRE GASTRODUODÉNAL ET LE REFLUX GASTRO OESOPHAGIEN SUCRALFATE SUCRALFATE Sus Orl 1g/5mL Sulcrate Suspension Plus 02103567 AXC ADEFGVW Susp Tab Orl 1g Sulcrate 02100622 AXC ADEFGVW Apo-Sucralfate 02125250 APX ADEFGVW Teva-Sulcralfate 02045702 TEV ADEFGVW DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS MÉDICAMENTS CONTRE LES TROUBLES GASTROINTESTINAUX FONCTIONNELS DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS MÉDICAMENTS CONTRE LES TROUBLES GASTROINTESTINAUX FONCTIONNELS SYNTHETIC ANTICHOLINERGICS, ESTERS WITH TERTIARY AMINO GROUP ANTICHOLINERGIQUES SYNTHÉTIQUES A ESTERS AVEC GROUPE AMINO TERTIAIRE TRIMEBUTINE TRIMÉBUTINE Tab Orl 100mg Trimebutine 02245663 AAP ADEFGVW Tab Orl 200mg Modulon 00803499 AXC ADEFGVW Trimebutine 02245664 AAP ADEFGVW A03AA07 DICYCLOVERINE (DICYCLOMINE) DICYCLOVERINE (DICYCLOMINE) Cap Orl 10mg Protylol 00287709 PDL ADEFGVW Caps Syr Orl 10mg/5mL Bentylol 02102978 AXC ADEFGVW Sir. Tab Orl 10mg Bentylol 02103087 AXC ADEFGVW Jamp-Dicyclomine 02391619 JPC ADEFGVW A03AB A03AB02 Tab Orl 20mg Bentylol 02103095 AXC ADEFGVW Protylol-20 (Disc/non disp Jul 24/16) 00513059 PDL ADEFGVW Jamp-Dicyclomine 02366088 JPC ADEFGVW SYNTHETIC ANTICHOLINERGICS, QUATERNARY AMMONIUM COMPOUNDS ANTICHOLINERGIQUES SYNTHÉTIQUES, ESTERS, COMPOSES D AMMONIUM QUATERNAIRE GLYCOPYRRONIUM (GLYCOPYRROLATE) GLYCOPYRRONIUM (GLYCOPYRROLATE) Inj 0.2mg/mL Glycopyrrolate 02039508 SDZ ADEFVW September 2015 v.1 6

A03AX A03C A03AX04 A03CA A03E A03CA02 A03ED A03F A03ED99 A03FA A03FA01 OTHER DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS AUTRES MÉDICAMENTS POUR LES TROUBLES FONCTIONNELS DE L INTESTIN PINAVERIUM PINAVÉRIUM Tab Orl 50mg Dicetel 01950592 ABB ADEFGVW Tab Orl 100mg Dicetel 02230684 ABB ADEFGVW ANTISPASMODICS IN COMBINATION WITH PSYCHOLEPTICS ANTISPASMODIQUES EN COMBINAISON AVEC DES PSYCHOLEPTIQUES SYNTHETIC ANTICHOLINERGIC AGENTS IN COMBINATION WITH PSYCHOLEPTICS AGENTS ANTICHOLINERGIQUES SYNTHÉTIQUES EN COMBINAISON AVEC DES PSYCHOLEPTIQUES CLIDINIUM AND PSYCHOLEPTICS CLIDINIUM ET PSYCHOLEPTIQUES CHLORDIAZEPOXIDE / CLIDINIUM CHLORDIAZÉPOXIDE / CLIDINIUM Cap Orl 5mg/2.5mg Librax 00115630 VLN ADEFGVW Caps Chlorax 00618454 AAP ADEFGVW ANTISPASMODICS AND ANTICHOLINERGICS IN COMBINATION WITH OTHER DRUGS ANTISPASMODIQUES ET ANTICHOLINERGIQUES EN COMBINAISON AVEC D AUTRES MÉDICAMENTS ANTISPASMODICS IN COMBINATION WITH OTHER DRUGS ANTISPASMODIQUES EN COMBINAISON AVEC D AUTRES MÉDICAMENTS ANTISPASMODICS, COMBINATIONS ANTISPASMODIQUES, COMBINAISONS PHENOBARBITAL / ERGOTAMINE / BELLADONNA PHÉNOBARBITAL / ERGOTAMINE / BELLADONE SRT Orl 40mg / 0.6mg / 0.2mg Bellergal spacetabs 00176141 PAL ADEFGVW L.L. PROPULSIVES PROPULSIFS PROPULSIVES PROPULSIVES METOCLOPRAMIDE MÉTOCLOPRAMIDE Inj 5mg/mL Metoclopramide 02185431 SDZ ADEFVW Syr Orl 1mg/mL Metonia 02230433 PDP ADEFGVW Sir. September 2015 v.1 7

A04 A04A A03FA01 A03FA03 A04AA A04AA01 METOCLOPRAMIDE MÉTOCLOPRAMIDE Tab Orl 5mg Metonia 02230431 PDP ADEFGVW Tab Orl 10mg Metonia 02230432 PDP ADEFGVW DOMPERIDONE DOMPÉRIDONE Tab Orl 10mg Domperidone 02238341 SIV ADEFGVW Domperidone 02350440 SAS ADEFGVW Apo-Domperidone 02103613 APX ADEFGVW Jamp-Domperidone 02369206 JPC ADEFGVW Mar-Domperidone 02403870 MAR ADEFGVW Mylan-Domperidone 02278669 MYL ADEFGVW pms-domperidone 02236466 PMS ADEFGVW Ran-Domperidone 02268078 RAN ADEFGVW ratio-domperidone 01912070 RPH ADEFGVW Teva-Domperidone 02157195 TEV ADEFGVW ANTIEMETICS AND ANTINAUSEANTS ANTIEMÉTIQUES ET ANTINAUSÉEUX ANTIEMETICS AND ANTINAUSEANTS ANTIEMÉTIQUES ET ANTINAUSÉEUX SEROTONIN (5HT3) ANTAGONISTS ANTAGONISTES DE LA SÉROTONINE (5HT3) ONDANSETRON ONDANSÉTRON Orl 4mg/5mL Zofran 02229639 GSK (SA) Ondansetron 02291967 AAP (SA) ODT Slg 4mg Zofran ODT 2239372 GSK (SA) D.O Ondissolve 02389983 TAK (SA) ODT Slg 8mg Zofran ODT 2239373 GSK (SA) D.O Ondissolve 02389991 TAK (SA) Inj 2mg/mL Zofran (PF) 02213745 GSK W Ondansetron (PF) 02390019 MYL W Ondansetron (PF) 02265524 TEV W Inj 2mg/mL Zofran 02213745 GSK W Jamp-Ondansetron with preservative 02420422 JPC W Ondansetron with preservative 02265532 TEV W September 2015 v.1 8

A04AA01 ONDANSETRON ONDANSÉTRON Tab Orl 4mg Zofran 02213567 GSK W (SA) Apo-Ondansetron 02288184 APX W (SA) Co Ondansetron 02296349 COB W (SA) Jamp-Ondansetron 02313685 JPC W (SA) Mar-Ondansetron 02371731 MAR W (SA) Mint-Ondansetron 02305259 MNT W (SA) Mylan-Ondansetron 02297868 MYL W (SA) Nat-Ondansetron 02417839 NAT W (SA) Ondansetron 02421402 SAS W (SA) Ondansetron-Odan 02306212 ODN W (SA) Phl-Ondansetron 02278618 PHL W (SA) pms-ondansetron 02258188 PMS W (SA) Ran-Ondansetron 02312247 RAN W (SA) Ratio-Ondansetron 02278529 RPH W (SA) Sandoz Ondansetron 02274310 SDZ W (SA) Septa-Ondansetron 02376091 SPT W (SA) Teva-Ondansetron 02264056 TEV W (SA) Tab Orl 8mg Zofran 02213575 GSK W (SA) Apo-Ondansetron 02288192 APX W (SA) Co Ondansetron 02296357 COB W (SA) Jamp-Ondansetron 02313693 JPC W (SA) Mar-Ondansetron 02371758 MAR W (SA) Mint-Ondansetron 02305267 MNT W (SA) Mylan-Ondansetron 02297876 MYL W (SA) Nat-Ondansetron 02417847 NAT W (SA) Ondansetron 02421410 SAS W (SA) Ondansetron-Odan 02306220 ODN W (SA) Phl-Ondansetron 02278626 PHL W (SA) pms-ondansetron 02258196 PMS W (SA) Ran-Ondansetron 02312255 RAN W (SA) ratio-ondansetron 02278537 RPH W (SA) Sandoz Ondansetron 02274329 SDZ W (SA) Septa-Ondansetron 02376105 SPT W (SA) Teva-Ondansetron 02264064 TEV W (SA) A04AA02 A04AD A04AD01 GRANISETRON GRANISÉTRON Tab Orl 1mg Kytril (Disc/non disp Jan 1/17) 02185881 HLR W (SA) Granisetron 02308894 AAP W (SA) OTHER ANTIEMETICS AUTRES ANTIEMÉTIQUES SCOPOLAMINE SCOPOLAMINE Inj 0.4mg/mL Scopolamine Hydrobromide 00541869 HOS ADEFVW September 2015 v.1 9

A04AD01 SCOPOLAMINE SCOPOLAMINE Inj 0.6mg/mL Scopolamine Hydrobromide 00541877 HOS ADEFVW Inj 20mg/mL Buscopan 00363839 BOE W Hyoscine Butylbromide 02229868 SDZ ADEFGVW Srd Trd 1.5mg Transderm-V 80024336 NVR AEFGVW Srd Tab Orl 10mg Buscopan 00363812 BOE ADEFGVW A04AD11 NABILONE NABILONE Cap Orl 0.25mg Cesamet 02312263 VLN (SA) Caps Ran-Nabilone 02358077 RAN (SA) Teva-Nabilone 02392925 TEV (SA) Cap Orl 0.5mg Cesamet 02256193 VLN (SA) Caps Act Nabilone 02393581 ATV (SA) pms-nabilone 02380900 PMS (SA) Ran-Nabilone 02358085 RAN (SA) Teva-Nabilone 02384884 TEV (SA) A04AD12 Cap Orl 1mg Cesamet 00548375 VLN (SA) Caps Act Nabilone 02393603 ATV (SA) pms-nabilone 02380919 PMS (SA) Ran-Nabilone 02358093 RAN (SA) Teva-Nabilone 02384892 TEV (SA) APREPITANT APRÉPITANT Cap Orl 80mg Emend 02298791 FRS W (SA) Caps Cap Orl 125mg Emend 02298805 FRS W (SA) Caps A04AD99 Kit Orl 80mg, 125mg Emend-Tri-Pack 02298813 FRS W (SA) Tro DIMENHYDRINATE DIMENHYDRINATE Inj 50mg/mL Gravol 00013579 CHU W Dimenhydrinate IM 00392537 SDZ W Syr Orl 15mg/5mL Gravol 00230197 CHU G Sir. September 2015 v.1 10

A05 A05A A04AD99 A05AA A06 A06A A05AA02 A06AD A07 A07A A06AD11 A07AA A07AA02 DIMENHYDRINATE DIMENHYDRINATE Tab Orl 15mg Gravol (Disc/non disp. Jun 26/16) 00511196 CHU G BILE AND LIVER THERAPY TRAITEMENT DU FOIE ET BILIAIRE BILE THERAPY TRAITEMENT BILIAIRE BILE ACID PREPERATIONS PREPARATIONS POUR L ACIDE BILIAIRE URSODEOXYCHOLIC ACID ACIDE URSODÉOXYCHOLIQUE Tab Orl 250mg Urso 02238984 AXC (SA) pms-ursodiol C 02273497 PMS (SA) Tab Orl 500mg Urso DS 02245894 AXC (SA) Co pms-ursodiol C 02273500 PMS (SA) LAXATIVES LAXATIFS LAXATIVES LAXATIFS OSMOTICALLY ACTING LAXATIVES LAXATIFS AGISSANT OSMOTIQUEMENT LACTULOSE LACTULOSE Syr Orl 667mg Apo-Lactulose 02242814 APX (SA) Sir Jamp-Lactulose 02295881 JPC (SA) Lactulose 02412268 SAS (SA) pms-lactulose 00703486 PMS (SA) ratio-lactulose 00854409 RPH (SA) Teva-Lactulose 02331551 TEV (SA) ANTIDIARRHEALS, INTESTINAL ANTIINFLAMMATORY/ANTIINFECTIVE AGENTS ANTIDIARRHÉIQUES, AGENTS ANTI-INFECTIEUX/ANTI-INFLAMMATOIRES POUR L INTESTIN INTESTINAL ANTIINFECTIVES ANTI-INFECTIEUX INTESTINAUX ANTIBIOTICS ANTIBIOTIQUES NYSTATIN NYSTATINE Susp Orl 100000IU/mL Jamp-Nystatin 02433443 JPC ABDEFGVW Susp. pms-nystatin Suspension 00792667 PMS ABDEFGVW ratio-nystatin 02194201 RPH ABDEFGVW September 2015 v.1 11

A07D A07AA12 A07DA A07E A07DA01 A07DA03 A07EA A07EA02 FIDAXOMICIN FIDAXOMICINE Tab Orl 200mg Dificid 02387174 CBP (SA) ANTIPROPULSIVES ANTIPROPULSIFS ANTIPROPULSIVES ANTIPROPULSIFS DIPHENOXYLATE DIPHÉNOXYLATE DIPHENOXYLATE / ATROPINE DIPHÉNOXYLATE / ATROPINE Tab Orl 2.5mg/0.025mg Lomotil 00036323 PFI ADEFGVW LOPERAMIDE LOPÉRAMIDE Orl 0.2mg/mL pms-loperamide Hydrochloride 02016095 PMS AEFGVW Tab Orl 2mg Apo-Loperamide 02212005 APX AEFGVW Loperamide 02256452 JPC AEFGVW Novo-Loperamide 02132591 TEV AEFGVW pms-loperamide 02228351 PMS AEFGVW Sandoz Loperamide (Disc/non disp Nov 15/15) 02257564 SDZ AEFGVW INTESTINAL ANTIINFLAMMATORY AGENTS AGENTS ANTI-INFLAMMATOIRES INTESTINAUX CORTICOSTEROIDS ACTING LOCALLY CORTICOSTÉROÏDES AGISSANT LOCALEMENT HYDROCORTISONE HYDROCORTISONE Aer Rt 10% Cortifoam 00579335 PAL ADEFGVW Aér. Enm Rt 100mg/60mL Cortenema 02112736 AXC ADEFGVW Lav. Hycort (Disc/non disp Apr 22/16) 00230316 VLN ADEFGVW A07EA04 BETAMETHASONE BÉTAMÉTHASONE Enm Rt 5mg/100mL Betnesol 02060884 PAL ADEFGVW Lav. September 2015 v.1 12

A07EA06 BUDESONIDE BUDÉSONIDE Cap Orl 3mg Entocort 02229293 AZE ADEFGVW Caps Enm Rt 2.3mg Entocort 02052431 AZE ADEFGVW Lav. A07EB A07EB01 A07EC A07EC01 A07EC02 ANTIALLERGIC AGENTS, EXCL. CORTICOSTEROIDS AGENTS ANTIALLERGIQUES, À L EXCLUSION DES CORTICOSTÉROÏDES CROMOGLICIC ACID CROMOGLYCATE DISODIQUE Cap Orl 100mg Nalcrom 00500895 SAV ADEFGVW Caps AMINOSALICYLIC ACID AND SIMILAR AGENTS ACIDE AMINOSALICYLIQUE ET AGENTS SEMBLABLES SULFASALAZINE SULFASALAZINE ECT Orl 500mg Salazopyrin EN 02064472 PFI ADEFGVW Ent pms-sulfasalazine EC 00598488 PMS ADEFGVW Tab Orl 500mg Salazopyrin 02064480 PFI ADEFGVW pms-sulfasalazine 00598461 PMS ADEFGVW MESALAZINE MÉSALAZINE ECT Orl 400mg Asacol 01997580 WNC ADEFGVW Ent ECT Orl 500mg Mesasal 01914030 GSK ADEFGVW Ent Salofalk 02112787 AXC ADEFGVW ECT Orl 800mg Asacol 02267217 WNC ADEFGVW Ent ERT Orl 500mg Pentasa 02099683 FEI ADEFGVW L.P. ERT Orl 1000mg Pentasa 02399466 FEI ADEFGVW L.P. Sup Rt 500mg Salofalk 02112760 AXC ADEFGVW Supp. Sup Rt 1g Pentasa 02153564 FEI ADEFGVW Supp. Salofalk 02242146 AXC ADEFGVW Sup Rt 1g/100mL Pentasa 02153521 FEI ADEFGVW Susp September 2015 v.1 13

A07EC02 MESALAZINE MÉSALAZINE Sup Rt 2g/60g Salofalk 02112795 AXC ADEFGVW Susp. Sup Rt 4g/60g Salofalk 02112809 AXC ADEFGVW Susp. Sup Rt 4g/100mL Pentasa 02153556 FEI ADEFGVW Susp. Tab Orl 1.2g Mezavant 02297558 SHI ADEFGVW A07EC03 OLSALAZINE OLSALAZINE Cap Orl 250mg Dipentum 02063808 UCB ADEFGVW Caps A07F A07FA ANTIDIARRHEAL MICROORGANISMS MICRO-ORGANISMES ANTIDIARRHÉIQUES ANTIDIARRHEAL MICROORGANISMS MICRO-ORGANISMES ANTIDIARRHÉIQUES A07FA01 LACTIC ACID PRODUCING ORGANISMS ORGANISMES PRODUISANT DE L ACIDE LACTIQUE Cap Orl 1B Bacid 80017987 ERF AEFGVW Caps A09 DIGESTIVES, INCLUDING ENZYMES AGENTS DIGESTIFS, Y COMPRIS LES ENZYMES A09A DIGESTIVES, INCLUDING ENZYMES AGENTS DIGESTIFS, Y COMPRIS LES ENZYMES A09AA ENZYME PREPARATIONS PRÉPARATIONS D ENZYMES A09AA02 MULTIENZYMES (LIPASE, PROTEASE ETC) MULTIENZYMES (LIPASE, PROTÉASE ETC) Cap Orl 4500U/ 20000U/20000U Ultrase MS 4 02203324 AXC ABDEFGV Caps. Cap Orl 8000U/30000U/30000U Cotazym 00263818 FRS ABDEFGV Caps. Cap Orl 12000U/39000U/39000U Ultrase MT 12 02045834 AXC ABDEFGV Caps. Cap Orl 20000U/ 65000U/65000U Ultrase MT 20 02045869 AXC ABDEFGV Caps. September 2015 v.1 14

A09AA02 MULTIENZYMES (LIPASE, PROTEASE ETC) MULTIENZYMES (LIPASE, PROTÉASE ETC) ECC Orl 4000U/12000U/12000U Pancrease MT 4 00789445 JAN ABDEFGV Caps.Ent ECC Orl 5000U/16600U/18750U Creon 5 Minimicrospheres 02239007 ABB ABDEFGV Caps.Ent (Disc/non disp Dec 31/15) ECC Orl 6000U/30000U/19000U Creon 6 Minimicrospheres 02415194 ABB ABDEFGV Caps.Ent ECC Orl 8000U/30000U/30000U Cotazym ECS 8 00502790 SCH ABDEFGV Caps.Ent ECC Orl 10000U/33200U/37500U Creon 10 Minimicrospheres 02200104 ABB ABDEFGV Caps.Ent ECC Orl 1000U/30000U/30000U Pancrease MT 10 00789437 JAN ABDEFGV Caps.Ent ECC Orl 16000U/48000U/48000U Pancrease MT 16 00789429 JAN ABDEFGV Caps.Ent ECC Orl 20000U/55000U/55000U Cotazym ECS 20 00821373 SCH ABDEFGV Caps.Ent ECC Orl 25000U/ 74000U/62500U Creon 25 Minimicrospheres 01985205 ABB ABDEFGV Caps.Ent A10 A10A A10AB Tab Orl 8000U/ 30000U/30000U Viokase 8 02230019 AXC ABDEFGV Tab Orl 16000U/ 60000U/60000U Viokase 16 02241933 AXC ABDEFGV DRUGS USED IN DIABETES MÉDICAMENTS UTILISÉS CHEZ LES DIABÉTIQUES INSULINS AND ANALOGUES INSULINES ET ANALOGUES INSULINS & ANALOGUES FOR INJECTION, FAST-ACTING INSULINES ET ANALOGUES POUR L INJECTION, À ACTION RAPIDE A10AB01 INSULIN (HUMAN); FAST-ACTING INSULINE (HUMAINE); ACTION RAPIDE Inj 100U/mL Humulin R 00586714 LIL ADEFGVW Humulin R (cartridge) 01959220 LIL ADEFGVW Novolin GE Toronto 02024233 NNO ADEFGVW Novolin GE Toronto(penfill) 02024284 NNO ADEFGVW Inj 100U/mL Humalog 02229704 LIL (SA) Humalog (cartridge) 02229705 LIL (SA) Humalog (kwikpen) 02403412 LIL (SA) September 2015 v.1 15

A10AB05 A10AB06 A10AC A10AC01 A10AD A10AD01 INSULIN ASPART INSULINE ASPARTE Inj 100U/mL Novorapid 02245397 NNO (SA) Novorapid (penfill) 02244353 NNO (SA) INSULIN GLULISINE INSULINE GLULISINE Inj 100U/mL Apidra (cartridge) 02279479 SAV DEFG-18 (SA) Apidra Solostar 02294346 SAV DEFG-18 (SA) Apidra 02279460 SAV DEFG-18 (SA) INSULINS & ANALOGUES FOR INJECTION, INTERMEDIATE-ACTING INSULINES ET ANALOGUES POUR INJECTION, ACTION INTERMÉDIAIRE INSULIN (HUMAN); INTERMEDIATE-ACTING INSULINE (HUMAINE); ACTION INTERMÉDIAIRE Sus Inj 100U/mL Humulin N 00587737 LIL ADEFGVW Susp Humulin N (cartridge) 01959239 LIL ADEFGVW Humulin N (kwikpen) 02403447 LIL ADEFGVW Novolin GE NPH 02024225 NNO ADEFGVW Novolin GE NPH (penfill) 02024268 NNO ADEFGVW INSULINS & ANALOGUES FOR INJECTION INTERMEDIATE-ACTING, FAST-ACTING INSULINES ET ANALOGUES POUR INJECTION, ACTION INTERMÉDIAIRE, À ACTION RAPIDE INSULIN (HUMAN), INTERMEDIATE-ACTING IN COMBINATION INSULINE (HUMAINE); ACTION INTERMÉDIAIRE, COMBINASON Sus Inj 30U/70U Humulin 30/70 00795879 LIL ADEFGVW Susp Humulin 30/70 (cartridge) 01959212 LIL ADEFGVW Novolin GE 30/70 02024217 NNO ADEFGVW Novolin GE 30/70 (penfill) 02025248 NNO ADEFGVW Sus Inj 40U/60U Novolin GE 40/60 (Penfill) 02024314 NNO ADEFGVW Susp A10AE A10AE04 A10AE05 Sus Inj 50U/50U Novolin GE 50/50 (Penfill) 02024322 NNO ADEFGVW Susp INSULINS & ANALOGUES, FOR INJECTION LONG ACTING INSULINES ET ANALOGUES POUR INJECTION, À ACTION LENTE INSULIN GLARGINE INSULINE GLARGINE Inj 100U/mL Lantus Cartridge 02251930 SAV (SA) Lantus SoloSTAR pre-filled pen 02294338 SAV (SA) Lantus Vial 02245689 SAV (SA) INSULIN DETEMIR INSULINE DÉTÉMIR Inj 100U/mL Levemir Penfill Cartridge 02271842 NNO (SA) September 2015 v.1 16

A10B A10BA A10BA02 A10BB A10BB01 BLOOD GLUCOSE LOWERING DRUGS, EXCLUDING INSULINS MÉDICAMENTS HYPOGLYCÉMIANTS, À L EXCLUSION DES INSULINES BIGUANIDES BIGUANIDES METFORMIN METFORMINE Tab Orl 500mg Glucophage 02099233 SAV ADEFGVW Act Metformin 02257726 ATV ADEFGVW Apo-Metformin 02167786 APX ADEFGVW Jamp-Metformin 02380196 JPC ADEFGVW Jamp-Metformin Blackberry 02380722 JPC ADEFGVW Mar-Metformin 02378620 MAR ADEFGVW Metformin 02353377 SAS ADEFGVW Metformin FC 02385341 SIV ADEFGVW Mylan-Metformin 02148765 MYL ADEFGVW pms-metformin 02223562 PMS ADEFGVW Ran-Metformin 02269031 RAN ADEFGVW ratio-metformin 02242974 RPH ADEFGVW Sandoz Metformin FC 02246820 SDZ ADEFGVW Septa-Metformin 02379767 SPT ADEFGVW Teva-Metformin 02045710 TEV ADEFGVW Tab Orl 850mg Glucophage 02162849 SAV ADEFGVW Act Metformin 02257734 ATV ADEFGVW Apo-Metformin 02229785 APX ADEFGVW Jamp-Metformin 02380218 JPC ADEFGVW Jamp-Metformin Blackberry 02380730 JPC ADEFGVW Mar-Metformin 02378639 MAR ADEFGVW Metformin 02353385 SAS ADEFGVW Metformin FC 02385368 SIV ADEFGVW Mylan-Metformin 02229656 MYL ADEFGVW pms-metformin 02242589 PMS ADEFGVW Ran-Metformin 02269058 RAN ADEFGVW ratio-metformin 02242931 RPH ADEFGVW Sandoz Metformin FC 02246821 SDZ ADEFGVW Septa-Metformin 02379775 SPT ADEFGVW Teva-Metformin 02230475 TEV ADEFGVW SULFONAMIDES, UREA DERIVATIVES SULFONAMIDES, DÉRIVÉS DE L URÉE GLIBENCLAMIDE (GLYBURIDE) GLIBENCLAMIDE (GLYBURIDE) Tab Orl 2.5mg Diabeta 02224550 SAV ADEFGVW Apo-Glyburide 01913654 APX ADEFGVW Glyburide 02350459 SAS ADEFGVW Mylan-Glybe 00808733 MYL ADEFGVW ratio-glyburide (Disc/non disp Sept 19/16) 01900927 RPH ADEFGVW Sandoz Glyburide 02248008 SDZ ADEFGVW Teva-Glyburide 01913670 TEV ADEFGVW September 2015 v.1 17

A10BB01 A10BB02 A10BB03 A10BB09 A10BB12 GLIBENCLAMIDE (GLYBURIDE) GLIBENCLAMIDE (GLYBURIDE) Tab Orl 5mg Diabeta 02224569 SAV ADEFGVW Apo-Glyburide 01913662 APX ADEFGVW Glyburide 02350467 SAS ADEFGVW Mylan-Glybe 00808741 MYL ADEFGVW ratio-glyburide (Disc/non disp Sept 19/16) 01900935 RPH ADEFGVW Sandoz Glyburide 02248009 SDZ ADEFGVW Teva-Glyburide 01913689 TEV ADEFGVW CHLORPROPAMIDE CHLORPROPAMIDE Tab Orl 100mg Apo-Chlorpropamide 00399302 APX ADEFGVW Tab Orl 250mg Apo-Chlorpropamide 00312711 APX ADEFGVW TOLBUTAMIDE TOLBUTAMIDE Tab Orl 500mg Tolbutamide 00312762 AAP ADEFGVW GLICLAZIDE GLICLAZIDE ERT Orl 30mg Diamicron MR 02242987 SEV ADEFGVW L.P. Act Gliclazide MR 02429764 ATV ADEFGVW Apo-Gliclazide MR 02297795 APX ADEFGVW Mint-Gliclazide MR 02423286 MNT ADEFGVW ERT Orl 60mg Diamicron MR 02356422 SEV ADEFGVW L.P. Apo-Gliclazide MR 02407124 APX ADEFGVW Tab Orl 80mg Diamicron 00765996 SEV ADEFGVW Apo-Gliclazide 02245247 APX ADEFGVW Gliclazide 02287072 SAS ADEFGVW Mylan-Gliclazide 02229519 MYL ADEFGVW Teva-Gliclazide 02238103 TEV ADEFGVW GLIMEPIRIDE GLIMÉPIRIDE Tab Orl 1mg Amaryl 02245272 SAV ADEFGVW Apo-Glimepiride 02295377 APX ADEFGVW Novo-Glimepiride 02273756 TEV ADEFGVW Ratio-Glimepiride 02273101 TEV ADEFGVW Sandoz Glimepiride 02269589 SDZ ADEFGVW September 2015 v.1 18

A10BB12 A10BD A10BD07 GLIMEPIRIDE GLIMÉPIRIDE Tab Orl 2mg Amaryl 02245273 SAV ADEFGVW Apo-Glimepiride 02295385 APX ADEFGVW Novo-Glimepiride 02273764 TEV ADEFGVW Ratio-Glimepiride 02273128 TEV ADEFGVW Sandoz Glimepiride 02269597 SDZ ADEFGVW Tab Orl 4mg Amaryl 02245274 SAV ADEFGVW Apo-Glimepiride 02295393 APX ADEFGVW Novo-Glimepiride 02273772 TEV ADEFGVW Ratio-Glimepiride 02273136 TEV ADEFGVW Sandoz Glimepiride 02269619 SDZ ADEFGVW COMBINATIONS OF ORAL BLOOD GLUCOSE LOWERING DRUGS ASSOCIATIONS DE MEDICAMENTS ORAUX METFORMIN AND SITAGLIPTIN METFORMINE ET SITAGLIPTINE Tab Orl 500mg/50mg Janumet 02333856 FRS (SA) Tab Orl 850mg/50mg Janumet 02333864 FRS (SA) Tab Orl 1000mg/50mg Janumet 02333872 FRS (SA) ERT Orl 1000mg/50mg Janumet XR 02416794 FRS (SA) L.P. A10BD10 METFORMIN AND SAXAGLIPTIN METFORMINE ET SAXAGLIPTINE Tab Orl 500mg/2.5mg Komboglyze 02389169 AZE (SA) Tab Orl 850mg/2.5mg Komboglyze 02389177 AZE (SA) A10BF A10BF01 Tab Orl 1000mg/2.5mg Komboglyze 02389185 AZE (SA) ALPHA GLUCOSIDASE INHIBITORS INHIBITIEURS D ALPHA-GLUCOSIDASE ACARBOSE ACARBOSE Tab Orl 50mg Glucobay 02190893 BAY ADEFGVW Tab Orl 100mg Glucobay 02190885 BAY ADEFGVW September 2015 v.1 19

A10BG A10BG03 THIAZOLINEDIONES THIAZOLINEDIONES PIOGLITAZONE PIOGLITAZONE Tab Orl 15mg Actos 02242572 TAK (SA) Accel Pioglitazone 02303442 ACC (SA) Apo-Pioglitazone 02302942 APX (SA) Auro-Pioglitazone 02384906 ARO (SA) Co Pioglitazone 02302861 COB (SA) Jamp-Pioglitazone 02397307 JPC (SA) Mint-Pioglitazone 02326477 MNT (SA) Mylan-Pioglitazone 02298279 MYL (SA) Phl-Pioglitazone 02307669 PHL (SA) Pioglitazone Hydrochloride 02391600 AHI (SA) pms-pioglitazone 02303124 PMS (SA) Ran-Pioglitazone 02375850 RAN (SA) Sandoz Pioglitazone 02297906 SDZ (SA) Teva-Pioglitazone 02274914 TEV (SA) Zym-Pioglitazone (Disc/non disp Jun 16/16) 02320754 ZYM (SA) Tab Orl 30mg Actos 02242573 TAK (SA) Accel Pioglitazone 02303450 ACC (SA) Apo-Pioglitazone 02302950 APX (SA) Auro-Pioglitazone 02384914 ARO (SA) Co Pioglitazone 02302888 COB (SA) Jamp-Pioglitazone 02365529 JPC (SA) Mint-Pioglitazone 02326485 MNT (SA) Mylan-Pioglitazone 02298287 MYL (SA) Phl-Pioglitazone 02307677 PHL (SA) Pioglitazone HCL 02339587 AHI (SA) pms-pioglitazone 02303132 PMS (SA) Ran-Pioglitazone 02375869 RAN (SA) Sandoz Pioglitazone 02297914 SDZ (SA) Teva-Pioglitazone 02274922 TEV (SA) Zym-Pioglitazone (Disc/non disp Jun 16/16) 02320762 ZYM (SA) Tab Orl 45mg Actos 02242574 TAK (SA) Accel Pioglitazone 02303469 ACC (SA) Apo-Pioglitazone 02302977 APX (SA) Auro-Pioglitazone 02384922 ARO (SA) Co Pioglitazone 02302896 COB (SA) Jamp-Pioglitazone 02365537 JPC (SA) Mint-Pioglitazone 02326493 MNT (SA) Mylan-Pioglitazone 02298295 MYL (SA) Phl-Pioglitazone 02307723 PHL (SA) Pioglitazone HCL 02339595 AHI (SA) pms-pioglitazone 02303140 PMS (SA) Ran-Pioglitazone 02375877 RAN (SA) Sandoz Pioglitazone 02297922 SDZ (SA) Teva-Pioglitazone 02274930 TEV (SA) Zym-Pioglitazone (Disc/non disp Jun 16/16) 02320770 ZYM (SA) September 2015 v.1 20

A10BH A10BH01 DIPEPTIDYL PEPTIDASE 4 (DPP-4) INHIBITORS INHIBITEURS DE LA DIPEPTIDYL PEPTIDASE-4 (DPP-4) SITAGLIPTIN SITAGLIPTINE Tab Orl 25mg Januvia 02388839 FRS (SA) Tab Orl 50mg Januvia 02388847 FRS (SA) A10BH03 A10BH05 A10BX A10BX02 Tab Orl 100mg Januvia 02303922 FRS (SA) SAXAGLIPTIN SAXAGLIPTINE Tab Orl 2.5mg Onglyza 02375842 AZE (SA) Tab Orl 5mg Onglyza 02333554 AZE (SA) LINAGLIPTIN LINAGLIPTINE Tab Orl 5mg Trajenta 02370921 BOE (SA) OTHER BLOOD GLUCOSE LOWERING DRUGS, EXCL INSULINS AUTRES MEDICAMENTS HYPOGLYCEMIANTS, EXCL INSULINES REPAGLINIDE REPAGLINIDE Tab Orl 0.5mg Gluconorm 02239924 MNO (SA) Act Repaglinide 02321475 ATV (SA) Apo-Repaglinide 02355663 APX (SA) pms-repaglinide 02354926 PMS (SA) Sandoz Repaglinide 02357453 SDZ (SA) Tab Orl 1mg Gluconorm 02239925 MNO (SA) Act Repaglinide 02321483 ATV (SA) Apo-Repaglinide 02355671 APX (SA) pms-repaglinide 02354934 PMS (SA) Sandoz Repaglinide 02357461 SDZ (SA) Tab Orl 2mg Gluconorm 02239926 MNO (SA) Act Repaglinide 02321491 ATV (SA) Apo-Repaglinide 02355698 APX (SA) pms-repaglinide 02354942 PMS (SA) Sandoz Repaglinide 02357488 SDZ (SA) September 2015 v.1 21

A11 A11A A11AA A11C A11AA03 A11CC A11CC01 VITAMINS VITAMINES MULTIVITAMINS, COMBINATIONS MULTIVITAMINES, EN COMBINAISON MULTIVITAMINS WITH MINERALS MULTIVITAMINES ET MINÉRAUX MULTIVITAMIN AND OTHER MINERALS, INCLUDING COMBINATIONS MULTIVITAMINE ET AUTRES MINÉRAUX, Y COMPRIS LES COMBINAISONS Tab Orl Centrum Junior 02246236 WCH G VITAMIN A AND D, INCLUDING COMBINATIONS OF THE TWO VITAMINE A ET D, Y COMPRIS LES COMBINAISONS DES DEUX VITAMIN D AND ANALOGUES VITAMINE D ET ANALOGUES ERGOCALCIFEROL ERGOCALCIFÉROL Cap Orl 50000IU D-Forte 02237450 EUR ADEFGVW Caps Osto-D2 02301911 PAL ADEFGVW Dps Orl 8288IU Erdol (Drisodan) 80003615 ODN ADEFGVW Gttes A11CC03 ALFACALCIDOL ALFACALCIDOL Cap Orl 0.25mcg One-Alpha 00474517 LEO ADEFGVW Caps Cap Orl 1mcg One-Alpha 00474525 LEO ADEFGVW Caps A11CC04 A11CC05 CALCITRIOL CALCITRIOL Cap Orl 0.25mcg Rocaltrol 00481823 HLR ADEFGVW Caps Cap Orl 0.5mcg Rocaltrol 00481815 HLR ADEFGVW Caps CHOLECALCIFEROL CHOLÉCALCIFÉROL Tab Orl 1000IU Vitamin D 80000436 JAM EF-18G September 2015 v.1 22

A11H A11HA OTHER PLAIN VITAMIN PREPARATIONS AUTRES PRÉPARATIONS VITAMINIQUES ORDINAIRES OTHER PLAIN VITAMIN PREPARATIONS AUTRES PRÉPARATIONS VITAMINIQUES ORDINAIRES A11HA03 TOCOPHEROL (VIT E) TOCOPHÉROL (VIT E) Cap Orl 100IU Vitamin E 00189227 JAM BEF-18G Caps Vitamin E Natural 00122823 JAM BEF-18G Cap Orl 200IU Vitamin E 00189235 SWS BEF-18G Caps Vitamin E Natural 00122831 JAM BEF-18G Cap Orl 400IU Vitamin E 00266108 PMT BEF-18G Caps Vitamin E 02040816 PMT BEF-18G Vitamin E (Disc/non disp Apr 28/16) 02247190 HHC BEF-18G Vitamin E Natural 00122858 JAM BEF-18G Vitamin E Natural 00201995 WAM BEF-18G Vitamin E Synthetic 00274259 WAM BEF-18G Dps Orl 50IU Aquasol E 02162075 CLC BEF-18G Gttes A11J A11JA OTHER VITAMIN PRODUCTS, COMBINATIONS AUTRES PRODUITS VITAMINIQUES, EN COMBINAISON COMBINATIONS OF VITAMINS COMBINAISONS DE VITAMINES Orl Infantol 00558079 CHU BEFG A12 A12B A12BA MINERAL SUPPLEMENTS SUPPLÉMENTS DE MINÉRAUX POTASSIUM POTASSIUM POTASSIUM POTASSIUM A12BA01 POTASSIUM CHLORIDE CHLORURE DE POTASSIUM Orl 100mg/mL K-10 80024360 GSK ADEFGVW pms-potassium 02238604 PMS ADEFGVW SRC Orl 600mg Micro-K 02042304 PAL ADEFGVW Caps.L.L. SRT Orl 600mg Slow-K 80040226 NVR ADEFGVW L.L. Apo-K 00602884 APX ADEFGVW Jamp-K8 80013005 JPC ADEFGVW SRT Orl 1500mg Odan K-20 80004415 ODN ADEFGVW L.L. Jamp-K20 80013007 JPC ADEFGVW September 2015 v.1 23

A12C A12CD A16 A16A A12CD01 A16AA A16AA01 A16AB B01 B01A A16AB07 B01AA B01AA03 OTHER MINERAL SUPPLEMENTS AUTRES SUPPLÉMENTS MINÉRAUX FLUORIDE FLUORURE SODIUM FLUORIDE FLUORURE DE SODIUM Dps Orl 5.56mg/mL Fluor-a-Day 00610100 PDP EF-18G Gttes Tab Orl 2.21mg Fluor-a-Day 00575569 PDP EF-18G OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS AUTRE PRODUITS LIÉS AU TRACTUS DIGESTIF ET AU MÉTABOLISME OTHER ALIMENTARY TRACT AND METABOLISM PRODUTS AUTRE PRODUITS LIÉS AU TRACTUS DIGESTIF ET AU MÉTABOLISME AMINO ACIDS AND DERIVATIVES DÉRIVÉS ACIDES AMINÉS LEVOCARNITINE LÉVOCARNITINE Orl 100mg/mL Carnitor 02144336 QGT (SA) Tab Orl 330mg Carnitor 02144328 QGT (SA) ENZYMES ENZYMES ALGLUCOSIDASE ALFA ALGLUCOSIDASE ALFA Pws IV 50mg Myozyme 02284863 GZM (SA) Pds. ANTITHROMBOTIC AGENTS AGENTS ANTITHROMBOTIQUES ANTITHROMBOTIC AGENTS AGENTS ANTITHROMBOTIQUES VITAMIN K ANTAGONISTS ANTAGONISTES DE LA VITAMINE K WARFARIN WARFARINE Tab Orl 1mg Coumadin 01918311 BRI ADEFGVW Apo-Warfarin 02242924 APX ADEFGVW Mylan-Warfarin 02244462 MYL ADEFGVW Taro-Warfarin 02242680 TAR ADEFGVW Warfarin (Disc/non disp Aug 1/16) 02344025 SAS ADEFGVW September 2015 v.1 24

B01AA03 WARFARIN WARFARINE Tab Orl 2mg Coumadin 01918338 BRI ADEFGVW Apo-Warfarin 02242925 APX ADEFGVW Mylan-Warfarin 02244463 MYL ADEFGVW Novo-Warfarin 02265281 TEV ADEFGVW Taro-Warfarin 02242681 TAR ADEFGVW Warfarin (Disc/non dip Aug 1/16) 02344033 SAS ADEFGVW Tab Orl 2.5mg Coumadin 01918346 BRI ADEFGVW Apo-Warfarin 02242926 APX ADEFGVW Mylan-Warfarin 02244464 MYL ADEFGVW Novo-Warfarin 02265303 TEV ADEFGVW Taro-Warfarin 02242682 TAR ADEFGVW Warfarin (Disc/non disp Aug 1/16) 02344041 SAS ADEFGVW Tab Orl 3mg Coumadin 02240205 BRI ADEFGVW Apo-Warfarin 02245618 APX ADEFGVW Mylan-Warfarin 02287498 MYL ADEFGVW Taro-Warfarin 02242683 TAR ADEFGVW Warfarin (Disc/non disp Aug 1/16) 02344068 SAS ADEFGVW Tab Orl 4mg Coumadin 02007959 BRI ADEFGVW Apo-Warfarin 02242927 APX ADEFGVW Mylan-Warfarin 02244465 MYL ADEFGVW Taro-Warfarin 02242684 TAR ADEFGVW Warfarin (Disc/non disp Aug 1/16) 02344076 SAS ADEFGVW Tab Orl 5mg Coumadin 01918354 BRI ADEFGVW Apo-Warfarin 02242928 APX ADEFGVW Mylan-Warfarin 02244466 MYL ADEFGVW Novo-Warfarin 02265346 TEV ADEFGVW Taro-Warfarin 02242685 TAR ADEFGVW Warfarin (Disc/non disp Aug 1/16) 02344084 SAS ADEFGVW Tab Orl 6mg Coumadin 02240206 BRI ADEFGVW Mylan-Warfarin 02287501 MYL ADEFGVW Taro-Warfarin 02242686 TAR ADEFGVW B01AA07 Tab Orl 10mg Coumadin 01918362 BRI ADEFGVW Apo-Warfarin 02242929 APX ADEFGVW Mylan-Warfarin 02244467 MYL ADEFGVW Taro-Warfarin 02242687 TAR ADEFGVW Warfarin (Disc/non disp Aug 1/16) 02344114 SAS ADEFGVW ACENOCOUMAROL (NICOUMALONE) ACENOCOUMAROL (NICOUMALONE) Tab Orl 1mg Sintrom 00010383 PAL ADEFGVW Tab Orl 4mg Sintrom 00010391 PAL ADEFGVW September 2015 v.1 25

B01AB B01AB01 B01AB04 HEPARIN GROUP GROUPE DE L HÉPARINE HEPARIN HÉPARINE Inj 100IU/mL Heparin 00727520 LEO W Inj 10,000IU/mL Heparin (Disc/non disp July 2 /17) 00579718 LEO ADEFGV DALTEPARIN DALTÉPARINE Inj 2,500IU/0.2mL Fragmin (pre-filled syringe) 02132621 PFI W (SA) Inj 5,000IU/0.2mL Fragmin (pre-filled syringe) 02132648 PFI W (SA) Inj 7,500IU/0.3mL Fragmin (pre-filled syringe) 02352648 PFI W (SA) Inj 10,000IU/0.4mL Fragmin (pre-filled syringe) 02352656 PFI W (SA) Inj 12,500IU/0.5mL Fragmin (pre-filled syringe) 02352664 PFI W (SA) Inj 15,000IU/0.6mL Fragmin (pre-filled syringe) 02352672 PFI W (SA) Inj 18,000IU/0.72mL Fragmin (pre-filled syringe) 02352680 PFI W (SA) Inj 10,000IU/mL Fragmin (ampoule) 02132664 PFI W (SA) Inj 2,500IU/mL Fragmin (single-dose vial) 02377454 PFI W (SA) Inj 25,000IU/mL Fragmin(multi-dose vial) 02231171 PFI W (SA) B01AB05 ENOXAPARIN ÉNOXAPARINE Inj 30mg/0.3mL Lovenox (pre-filled syringe) 02012472 SAV W (SA) Inj 40mg/0.4mL Lovenox (pre-filled syringe) 02236883 SAV W (SA) September 2015 v.1 26

B01AB05 ENOXAPARIN ÉNOXAPARINE Inj 60mg/0.6mL Lovenox (pre-filled syringe) 02378426 SAV W (SA) Inj 80mg/0.8mL Lovenox (pre-filled syringe) 02378434 SAV W (SA) Inj 100mg/mL Lovenox (pre-filled syringe) 02378442 SAV W (SA) Inj 300mg/3mL Lovenox 02236564 SAV W (SA) Inj 120mg/0.8mL Lovenox HP (pre-filled syringe) 02242692 SAV W (SA) B01AB06 B01AB10 Inj 150mg/mL Lovenox HP (pre-filled syringe) 02378469 SAV W (SA) NADROPARIN NADROPARINE Inj 9500IU/mL Fraxiparin (pre-filled syringes) 02236913 APR W (SA) Inj 19000IU/mL Fraxiparin Forte (pre-filled syringes) 02240114 APR W (SA) TINZAPARIN TINZAPARINE Inj 2500IU/0.25mL Innohep (pre-filled syringe) 02229755 LEO W (SA) Inj 3500IU/0.35mL Innohep (pre-filled syringe) 02358158 LEO W (SA) Inj 4500IU/0.45mL Innohep (pre-filled syringe) 02358166 LEO W (SA) Inj 8000IU/0.4mL Innohep (pre-filled syringe) 02429462 LEO W (SA) Inj 10000IU/0.5mL Innohep (pre-filled syringe) 02231478 LEO W (SA) Inj 12000IU/0.6mL Innohep (pre-filled syringe) 02429470 LEO W (SA) Inj 14000IU/0.7mL Innohep (pre-filled syringe) 02358174 LEO W (SA) September 2015 v.1 27

B01AB10 TINZAPARIN TINZAPARINE Inj 16000IU/0.8mL Innohep (pre-filled syringe) 02429489 LEO W (SA) Inj 18000IU/0.9mL Innohep (pre-filled syringe) 02358182 LEO W (SA) Inj 10000IU/mL Innohep 02167840 LEO W (SA) Inj 20000IU/mL Innohep 02229515 LEO W (SA) B01AC PLATELET AGGREGATION INHIBITORS EXCLUDING HEPARIN INHIBITEURS D AGRÉGATION PLAQUETTAIRE, À L EXCLUSION DE HÉPARINE B01AC04 CLOPIDOGREL CLOPIDOGREL Tab Orl 75mg Plavix 02238682 SAV W (SA) Abbott-Clopidogrel 02412942 ABB W (SA) Apo-Clopidogrel 02252767 APX W (SA) Auro-Clopidogrel 02416387 ARO W (SA) Clopidogrel 02400553 SAS W (SA) Clopidogrel 02385813 SIV W (SA) Co Clopidogrel 02303027 COB W (SA) Jamp-Clopidogrel 02415550 JPC W (SA) Mar-Clopidogrel 02422255 MAR W (SA) Mint-Clopidogrel 02408910 MNT W (SA) Mylan-Clopidogrel 02351536 MYL W (SA) pms-clopidogrel 02348004 PMS W (SA) Ran-Clopidogrel 02379813 RAN W (SA) Sandoz Clopidogrel 02359316 SDZ W (SA) Teva-Clopidogrel 02293161 TEV W (SA) B01AC05 TICLOPIDINE TICLOPIDINE Tab Orl 250mg Apo-Ticlopidine 02237701 APX ADEFVW Mylan-Ticlopidine (Disc/non disp Jun 05/16) 02239744 MYL ADEFVW Teva-Ticlopidine 02236848 TEV ADEFVW Ticlopidine (Disc/non dips Aug 1/16) 02343045 SAS ADEFVW B01AC07 DIPYRIDAMOLE DIPYRIDAMOLE Tab Orl 25mg Apo-Dipyridamole FC/FE 00895644 APX ADEFGVW Tab Orl 50mg Apo-Dipyridamole FC/FE 00895652 APX ADEFGVW Tab Orl 75mg Apo-Dipyridamole FC/FE 00895660 APX ADEFGVW September 2015 v.1 28

B01AC09 EPOPROSTENOL ÉPOPROSTÉNOL Pws IV 0.5mg Caripul 02397447 ACT (SA) Pds. Pws IV 1.5mg Caripul 02397455 ACT (SA) Pds. Pws IV 0.5mg Flolan 02230845 GSK (SA) Pds. Pws IV 1.5mg Flolan 02230848 GSK (SA) Pds. B01AC21 TREPROSTINIL TREPROSTINIL SC 1mg/mL Remodulin 02246552 UTC (SA) SC 2.5mg/mL Remodulin 02246553 UTC (SA) SC 5mg/mL Remodulin 02246554 UTC (SA) B01AC22 B01AC24 B01AC30 SC 10mg/mL Remodulin 02246555 UTC (SA) PRASUGREL PRASUGREL Tab Orl 10mg Effient 02349124 LIL (SA) TICAGRELOR TICAGRÉLOR Tab Orl 90mg Brilinta 02368544 AZE (SA) COMBINATIONS COMBINAISONS DIPYRIDAMOLE / ACETYLSALICYLIC ACID DIPYRIDAMOLE / ACIDE ACÉTYLSALICYLIQUE Cap Orl 200mg/25mg Aggrenox 02242119 BOE (SA) Caps September 2015 v.1 29

B01AE DIRECT THROMBIN INHIBITORS LES INHIBITEURS DIRECTS DE LA THROMBINE B01AE07 DABIGATRAN DABIGATRAN Cap Orl 110mg Pradaxa 02312441 BOE (SA) Caps Cap Orl 150mg Pradaxa 02358808 BOE (SA) Caps B01AF DIRECT FACTOR XA INHIBITORS INHIBITEURS DU FACTEUR XA DIRECTE B01AF01 RIVAROXABAN RIVAROXABAN Tab Orl 10mg Xarelto 02316986 BAY W (SA) Tab Orl 15mg Xarelto 02378604 BAY (SA) Tab Orl 20mg Xarelto 02378612 BAY (SA) B01AF02 APIXABAN APIXABAN Tab Orl 2.5mg Eliquis 02377233 BRI (SA) Tab Orl 5mg Eliquis 02397714 BRI (SA) B02 B02A B02AA ANTIHAEMORRHAGICS ANTIHÉMORRAGIQUES ANTIFIBRINOLYTICS ANTIFIBRINOLYTIQUES AMINO ACIDS ACIDES AMINÉS B02AA02 TRANEXAMIC ACID ACIDE TRANEXAMIQUE Tab Orl 500mg Cyklokapron 02064405 PFI ADEFGVW Tranexamic Acid 02401231 STR ADEFGVW B02AA03 AMINOMETHYLBENZOIC ACID ACIDE AMINOMETHYLBENZOIQUE Cap Orl 500mg Potaba (Disc/non disp Jun 18/17) 00611271 GLE ADEFGVW Caps Tab Orl 500mg Potaba (Disc/non disp Jul 31/16) 00550175 GLE ADEFGVW September 2015 v.1 30

B02B B02BA VITAMIN K AND OTHER HEMOSTATICS VITAMINE K ET AUTRES PRODUITS HÉMOSTATIQUES VITAMIN K VITAMINE K B02BA01 PHYTOMENADIONE PHYTOMÉNADIONE IM 1mg/0.5mL Vitamin K 00781878 SDZ ADEFGVW IM 10mg/mL Vitamin K 00804312 SDZ ADEFGVW B03 B03A B03AA ANTIANAEMIC PREPARATIONS PRÉPARATIONS ANTIANÉMIQUES IRON PREPARATIONS PRÉPARATIONS DE FER IRON BIVALENT, ORAL PREPARATIONS FER BIVALENT, PRÉPARATIONS ORALES B03AA02 FERROUS FUMARATE FUMARATE FERREUX Sus Orl 60mg/mL Palafer 01923439 MVL AEFGVW Susp Cap Orl 300mg Palafer 01923420 MVL AEFGVW Caps Jamp-Fer 80024232 JPC AEFGVW Tab Orl 300mg Ferrous Fumarate 00031089 JPC AEFGVW B03AA03 FERROUS GLUCONATE GLUCONATE FERREUX Tab Orl 300mg Apo-Ferrous Gluconate 00545031 APX AEFGVW Ferrous Gluconate 00031097 JPC AEFGVW Ferrous Gluconate 00582727 VTH AEFGVW Novo-Ferrogluc 80000435 TEV AEFGVW B03AA07 FERROUS SULPHATE SULFATE FERREUX Dps Orl 75mg pms-ferrous Sulfate 02222574 PMS AEFGVW Gttes Dps Orl 125mg/mL pms-ferrous Sulfate 00816035 PMS AEFGVW Gttes ECT Orl 300mg Apo-Ferrous Sulfate-FC (Disc/non disp 01912518 APX AEFGVW Ent Dec 12/16) Orl 15mg Fer-In-Sol 00762954 MJO AEFGVW Ferodan 02237385 ODN AEFGVW Jamp Ferrous Sulfate 80008309 JPC AEFGVW September 2015 v.1 31

B03AA07 FERROUS SULPHATE SULFATE FERREUX Orl 30mg Jamp Ferrous Sulfate 80008295 JPC AEFGVW SRT Orl 160mg Slow-Fe 00623520 NNC G L.L. Syr Orl 150mg/5mL Fer-In-Sol 00017884 MJO AEFGVW Sir. Ferodan 00758469 ODN AEFGVW pms-ferrous Sulfate 00792675 PMS AEFGVW B03AC B03B B03AC01 B03AC02 B03AC07 B03AC99 B03BA B03BA01 Tab Orl 300mg Ferrous Sulfate 00031100 JPC AEFGVW Ferrous Sulfate SC 00346918 PMT AEFGVW pms-ferrous Sulfate 00586323 PMS AEFGVW IRON TRIVALENT, PARENTERAL PREPARATIONS FER TRIVALENT, PRÉPARATIONS PARENTÉRALES FERRIC OXIDE POLYMALTOSE COMPLEXES COMPLEXES D OXYDE FERRIQUE POLYMALTOSE Inj 50mg/mL DexIron 02205963 LUI (SA) SACCHARATED IRON OXIDE SACCHARURE D OXYDE DE FER Inj 20mg/mL Venofer 02243716 LUI (SA) FERRIC SODIUM GLUCONATE COMPLEX COMPLEXE DE GLUCONATE DE SODIUM FERRIQUE Inj 12.5mg/mL Ferrlecit 02243333 SAV (SA) FERUMOXYTOL FERUMOXYTOL Inj 30mg/mL Feraheme 02377217 TAK (SA) VITAMIN B12 AND FOLIC ACID VITAMINE B12 ET ACIDE FOLIQUE VITAMIN B12 (CYANOCOBALAMIN AND DERIVATIVES) VITAMINE B12 (CYANOCOBALAMINE ET DÉRIVÉS) CYANOCOBALAMIN CYANOCOBALAMINE Inj 1000mcg/mL Vitamin B12 00521515 SDZ ADEFGVW Cyanocobalamin 01987003 CYI ADEFGVW Cyanocobalamin Injection USP 02413795 MYL ADEFGVW Jamp-Cyanocobalamin 02420147 JPC ADEFGVW September 2015 v.1 32

B03BB B03X B03BB01 B03XA B03XA01 FOLIC ACID AND DERIVATIVES ACIDE FOLIQUE ET DÉRIVÉS FOLIC ACID ACIDE FOLIQUE Tab Orl 5mg Apo-Folic Acid 00426849 APX ADEFGVW Euro-Folic 02285673 EUR ADEFGVW Jamp-Folic 02366061 JPC ADEFGVW OTHER ANTIANEMIC PREPARATIONS AUTRES PRÉPARATIONS ANTIANÉMIQUES OTHER ANTIANEMIC PREPARATIONS AUTRES PRÉPARATIONS ANTIANÉMIQUES EPOETIN ALFA ÉPOÉTINE ALFA Inj 1000IU/0.5mL Eprex 02231583 JAN W (SA) Inj 2000IU/0.5mL Eprex 02231584 JAN W (SA) Inj 3000IU/0.3mL Eprex 02231585 JAN W (SA) Inj 4000IU/0.4mL Eprex 02231586 JAN W (SA) Inj 5000IU/0.5mL Eprex 02243400 JAN (SA) Inj 6000IU/0.6mL Eprex 02243401 JAN W (SA) Inj 8000IU80.8mL Eprex 02243403 JAN W (SA) Inj 10000IU/mL Eprex 02231587 JAN W (SA) Inj 20000IU/0.5mL Eprex 02243239 JAN (SA) Inj 30000IU0.75mL Eprex 02288680 JAN (SA) Inj 40000IU/mL Eprex 02240722 JAN W (SA) September 2015 v.1 33

B03XA02 DARBEPOETIN ALFA DARBÉPOÉTINE ALFA Inj 10mcg/0.4mL Aranesp 02392313 AGA W (SA) Inj 20mcg/0.5mL Aranesp 02392321 AGA W (SA) Inj 30mcg/0.3mL Aranesp 02392348 AGA W (SA) Inj 40mcg/0.4mL Aranesp 02391740 AGA W (SA) Inj 50mcg/0.5mL Aranesp 02391759 AGA W (SA) Inj 60mcg/0.3mL Aranesp 02392356 AGA W (SA) Inj 80mcg/0.4mL Aranesp 02391767 AGA W (SA) Inj 100mcg/0.5mL Aranesp 02391775 AGA W (SA) Inj 130mcg/0.65mL Aranesp 02391783 AGA W (SA) Inj 150mcg/0.3mL Aranesp 02391791 AGA W (SA) Inj 200mcg/0.4mL Aranesp 02391805 AGA W (SA) Inj 300mcg/0.6mL Aranesp 02391821 AGA W (SA) Inj 500mcg/1mL Aranesp 02392364 AGA W (SA) September 2015 v.1 34

B05 B05C B05CA C01 C01A B05CA10 C01AA C01AA05 BLOOD SUBSTITUTES AND PERFUSION SOLUTIONS PRODUITS DE REMPLACEMENT DU SANG ET SOLUTIONS POUR PERFUSION IRRIGATING SOLUTIONS SOLUTIONS POUR IRRIGATION ANTIINFECTIVES ANTI-INFECTIEUX COMBINATIONS COMBINAISONS POLYMYXIN B / NEOMYCIN POLYMYXINE B / NÉOMYCINE Urh 200000IU/40mg Neosporin Irrigating Sol 00666157 GSK ADEFGVW (Disc/Non Disp Jan 5/17) CARDIAC THERAPY CARDIOTHÉRAPIE CARDIAC GLYCOSIDES GLUCOSIDES CARDIOTONIQUES DIGITALIS GLYCOSIDES GLUCOSIDES DIGITALIQUE DIGOXIN DIGOXINE Orl 0.05mg/mL Toloxin 02242320 PDP ADEFGVW Tab Orl 0.0625mg Toloxin 02335700 PDP ADEFGVW Tab Orl 0.125mg Toloxin 02335719 PDP ADEFGVW C01B C01BA C01BA02 Tab Orl 0.25mg Toloxin 02335727 PDP ADEFGVW ANTIARRHYTHMICS, CLASS I AND III ANTIARHYTHMIQUES, CATÉGORIES I ET III ANTIARRHYTHMICS, CLASS IA ANTIARHYTHMIQUES, CATÉGORIE IA PROCAINAMIDE PROCAINAMIDE SRT Orl 250mg Procan SR 00638692 ERF ADEFGVW L.L. SRT Orl 500mg Procan SR (Disc/non disp Jun 5/17) 00638676 ERF ADEFGVW L.L. SRT Orl 750mg Procan SR (Disc/non disp Jun 5/17) 00638684 ERF ADEFGVW L.L. September 2015 v.1 35

C01BA03 C01BB C01BB02 C01BC C01BC03 DISOPYRAMIDE DISOPYRAMIDE Cap Orl 100mg Rythmodan 02224801 SAV ADEFGVW Caps ANTIARRHYTHMICS, CLASS IB ANTIARHYTHMIQUES, CATÉGORIE IB MEXILETINE MEXILÉTINE Cap Orl 100mg Novo-Mexiletine 02230359 TEV ADEFGVW Caps Cap Orl 200mg Novo-Mexiletine 02230360 TEV ADEFGVW Caps ANTIARRHYTHMICS, CLASS IC ANTIARHYTHMIQUES, CATÉGORIE IC PROPAFENONE PROPAFÉNONE Tab Orl 150mg Rythmol 00603708 BGP ADEFGVW Apo-Propafenone 02243324 APX ADEFGVW Mylan-Propafenone 02245372 MYL ADEFGVW pms-propafenone 02294559 PMS ADEFGVW Propafenone 02343053 SAS ADEFGVW Tab Orl 300mg Rythmol 00603716 BGP ADEFGVW Apo-Propafenone 02243325 APX ADEFGVW Mylan-Propafenone 02245373 MYL ADEFGVW pms-propafenone 02294575 PMS ADEFGVW Propafenone 02343061 SAS ADEFGVW C01BC04 C01BD C01BD01 FLECAINIDE FLÉCAÏNIDE Tab Orl 50mg Flecainide 02275538 AAP ADEFGVW Tab Orl 100mg Flecainide 02275546 AAP ADEFGVW ANTIARRHYTHMICS, CLASS III ANTIARHYTHMIQUES, CATÉGORIE III AMIODARONE AMIODARONE Tab Orl 100mg pms-amiodarone 02292173 PMS ADEFGVW September 2015 v.1 36

C01BD01 AMIODARONE AMIODARONE Tab Orl 200mg Cordarone 02036282 PFI ADEFGVW Amiodarone 02364336 SAS ADEFGVW Amiodarone 02385465 SIV ADEFGVW Apo-Amiodarone 02246194 APX ADEFGVW Mylan-Amiodarone 02240604 MYL ADEFGVW Phl-Amiodarone 02245781 PHL ADEFGVW pms-amiodarone 02242472 PMS ADEFGVW Sandoz Amiodarone 02243836 SDZ ADEFGVW Teva-Amiodarone 02239835 TEV ADEFGVW C01C C01CA CARDIAC STIMULANTS EXCLUDING CARDIAC GLYCOSIDES CARDIOTONIQUES À L EXCLUSION DES GLYCOSIDES CARDIOTONIQUES ADRENERGIC AND DOPAMINERGIC AGENTS AGENTS ADRÉNERGIQUES ET DOPAMINERGIQUES C01CA17 MIDODRINE MIDODRINE Tab Orl 2.5mg Midodrine 02278677 AAP ADEFGVW C01CA24 Tab Orl 5mg Midodrine 02278685 AAP ADEFGVW EPINEPHRINE (CARDIAC STIMULANTS) ÉPINEPHRINE (STIMULANTS CARDIAQUES) Inj 0.15mg Allerject 02382059 SAV ADEFGVW Twinject 02268205 PAL ADEFGVW Inj 0.3mg Allerject 02382067 SAV ADEFGVW Twinject 02247310 PAL ADEFGVW Inj 0.5mg Epi Pen Jr 00578657 KNG ADEFGVW Inj 1mg Epi Pen 00509558 KNG ADEFGVW Inj 1mg Adrenalin 00155357 ERF ADEFGVW C01D C01DA VASODILATORS USED IN CARDIAC DISEASES VASODILATATEURS UTILISÉS POUR LES MALADIES CARDIAQUES ORGANIC NITRATES NITRATES ORGANIQUES C01DA02 NITROGLYCERIN (GLYCERYL TRINITRATE) NITROGLYCERINE (TRINITRATE DE GLYCERYLE) Aem Slg 0.4mg Nitrolingual 02231441 SAV ADEFGVW Aém. Apo-Nitroglycerin 02393433 APX ADEFGVW Mylan-Nitro SL 02243588 MYL ADEFGVW Rho-Nitro 02238998 SDZ ADEFGVW September 2015 v.1 37

C01DA02 NITROGLYCERIN (GLYCERYL TRINITRATE) NITROGLYCERINE (TRINITRATE DE GLYCERYLE) Ont Top 2% Nitrol 01926454 PAL ADEFGVW Ont Pth Trd 0.2mg/hr Nitro-Dur 01911910 FRS ADEFVW Pth Minitran 02162806 VLN ADEFVW Mylan-Nitro Patch 02407442 MYL ADEFVW Trinipatch 02230732 PAL ADEFV Pth Trd 0.4mg/hr Nitro-Dur 01911902 FRS ADEFVW Pth Minitran 02163527 VLN ADEFVW Mylan-Nitro Patch 02407450 MYL ADEFVW Trinipatch 02230733 PAL ADEFV Pth Trd 0.6mg/hr Nitro-Dur 01911929 FRS ADEFVW Pth Minitran 02163535 VLN ADEFVW Mylan-Nitro Patch 02407469 MYL ADEFVW Trinipatch 02230734 PAL ADEFV Pth Trd 0.8mg/hr Nitro-Dur 02011271 FRS ADEFVW Pth Mylan-Nitro Patch 02407477 MYL ADEFVW Slt Slg 0.3mg Nitrostat 00037613 PFI ADEFGVW S.L. Slt Slg 0.6mg Nitrostat 00037621 PFI ADEFGVW S.L. Srd Trd 0.2mg Transderm-Nitro 00584223 NVR ADEFVW Srd Srd Trd 0.4mg Transderm-Nitro 00852384 NVR ADEFVW Srd Srd Trd 0.6mg Transderm-Nitro 02046156 NVR ADEFVW Srd C01DA08 ISOSORBIDE DINITRATE DINITRATE D ISOSORBIDE Slt Slg 5mg ISDN S/L 00670944 AAP ADEFGVW S.L. Tab Orl 10mg ISDN 00441686 AAP ADEFGVW Tab Orl 30mg ISDN 00441694 AAP ADEFGVW September 2015 v.1 38

C01DA14 ISOSORBIDE MONONITRATE MONONITRATE D ISOSORBIDE SRT Orl 60mg Imdur 02126559 AZE ADEFGVW L.L. Apo-ISMN 02272830 APX ADEFGVW pms-ismn 02301288 PMS ADEFGVW C02 C02A C02AB ANTIHYPERTENSIVES ANTIHYPERTENSEURS ANTIADRENERGIC AGENTS, CENTRALLY ACTING AGENTS ANTIADRÉNERGIQUES, AGISSANT CENTRALEMENT METHYLDOPA MÉTHYLDOPA C02AB02 METHYLDOPA (RACEMIC) MÉTHYLDOPA (RACEMIQUE) Tab Orl 125mg Methyldopa 00360252 AAP ADEFGVW Tab Orl 250mg Methyldopa 00360260 AAP ADEFGVW Tab Orl 500mg Methyldopa 00426830 AAP ADEFGVW C02AC IMIDAZOLINE RECEPTOR AGONISTS AGONISTES DU RÉCEPTEUR IMIDAZOLINE C02AC01 CLONIDINE CLONIDINE Tab Orl 0.025mg Dixarit 00519251 BOE ADEFGVW Novo-Clonidine 02304163 TEV ADEFGVW Tab Orl 0.1mg Catapres 00259527 BOE ADEFGVW Novo-Clonidine 02046121 TEV ADEFGVW Tab Orl 0.2mg Catapres (Disc/non disp Mar 30/17) 00291889 BOE ADEFGVW Novo-Clonidine 02046148 TEV ADEFGVW C02C C02CA ANTIADRENERGIC AGENTS, PERIPHERALLY ACTING AGENTS ANTIADRÉNERGIQUES, AGISSANT EN PÉRIPHÉRIE ALPHA-ADRENOCEPTOR ANTAGONISTS ALPHABLOQUANT DE L ADRÉNOCEPTEUR C02CA01 PRAZOSIN PRAZOSINE Tab Orl 1mg Apo-Prazo 00882801 APX ADEFGVW Teva-Prazin 01934198 TEV ADEFGVW Tab Orl 2mg Apo-Prazo 00882828 APX ADEFGVW Teva-Prazin 01934201 TEV ADEFGVW Tab Orl 5mg Apo-Prazo 00882836 APX ADEFGVW Teva-Prazin 01934228 TEV ADEFGVW September 2015 v.1 39

C02CA04 DOXAZOSIN DOXAZOSINE Tab Orl 1mg Cardura-1 01958100 PFI ADEF18+V Apo-Doxazosin 02240588 APX ADEF18+V Mylan-Doxazosin 02240498 MYL ADEF18+V pms-doxazosin 02244527 PMS ADEF18+V Teva-Doxazosin 02242728 TEV ADEF18+V Tab Orl 2mg Cardura-2 01958097 PFI ADEF18+V Apo-Doxazosin 02240589 APX ADEF18+V Mylan-Doxazosin 02240499 MYL ADEF18+V pms-doxazosin 02244528 PMS ADEF18+V Teva-Doxazosin 02242729 TEV ADEF18+V C02D C02DB C02DB02 Tab Orl 4mg Cardura-4 01958119 PFI ADEF18+V Apo-Doxazosin 02240590 APX ADEF18+V Mylan-Doxazosin 02240500 MYL ADEF18+V pms-doxazosin 02244529 PMS ADEF18+V Teva-Doxazosin 02242730 TEV ADEF18+V ARTERIOLAR SMOOTH MUSCLE, AGENTS ACTING ON MUSCLES LISSES ARTÉRIOLAIRES, AGENTS AGISSANT SUR LES HYDRAZINOPHTHALAZINE DERIVATIVES DÉRIVÉS DU HYDRAZINOPHTHALAZINE HYDRALAZINE HYDRALAZINE Tab Orl 10mg Hydralazine 00441619 AAP ADEFGVW Tab Orl 25mg Hydralazine 00441627 AAP ADEFGVW C02DC C02DC01 Tab Orl 50mg Hydralazine 00441635 AAP ADEFGVW PYRIMIDINE DERIVATIVES DÉRIVÉS DU PYRIMIDINE MINOXIDIL MINOXIDIL Tab Orl 2.5mg Loniten 00514497 PFI ADEFGVW Tab Orl 10mg Loniten 00514500 PFI ADEFGVW September 2015 v.1 40

C02K C02KX C02KX01 OTHER ANTIHYPERTENSIVES AUTRES ANTIHYPERTENSEURS OTER ANTIHYPERTENSIVES AUTRES ANTIHYPERTENSEURS BOSENTAN BOSENTAN Tab Orl 62.5mg Tracleer 02244981 ACT (SA) Act Bosentan 02386194 ATV (SA) Mylan-Bosentan 02383497 MYL (SA) pms-bosentan 02383012 PMS (SA) Sandoz Bosentan 02386275 SDZ (SA) Teva-Bosentan 02398400 TEV (SA) Tab Orl 125mg Tracleer 02244982 ACT (SA) Act Bosentan 02386208 ATV (SA) Mylan-Bosentan 02383500 MYL (SA) pms-bosentan 02383020 PMS (SA) Sandoz Bosentan 02386283 SDZ (SA) Teva-Bosentan 02398419 TEV (SA) C02KX02 AMBRISENTAN AMBRISENTAN Tab Orl 5mg Volibris 02307065 GSK (SA) Tab Orl 10mg Volibris 02307073 GSK (SA) C02KX05 RIOCIGUAT RIOCIGUAT Tab Orl 0.5mg Adempas 02412764 BAY (SA) Tab Orl 1mg Adempas 02412772 BAY (SA) Tab Orl 1.5mg Adempas 02412799 BAY (SA) Tab Orl 2mg Adempas 02412802 BAY (SA) Tab Orl 2.5mg Adempas 02412810 BAY (SA) September 2015 v.1 41

C03 C03A C03AA DIURETICS DIURÉTIQUES LOW-CEILING DIURETICS, THIAZIDES DIURÉTIQUES DE PLAFOND BAS, THIAZIDES THIAZIDES, PLAIN THIAZIDES, ORDINAIRE C03AA03 HYDROCHLOROTHIAZIDE HYDROCHLOROTHIAZIDE Tab Orl 12.5mg Apo-Hydro 02327856 APX ADEFGVW pms-hydrochlorothiazide 02274086 PMS ADEFGVW Tab Orl 25mg Apo-Hydro 00326844 APX ADEFGVW pms-hydrochlorothiazide 02247386 PMS ADEFGVW Teva-Hydrochlorothiazide 00021474 TEV ADEFGVW Tab Orl 50mg Apo-Hydro 00312800 APX ADEFGVW Hydrochlorothiazide 02360608 SAS ADEFGVW pms-hydrochlorothiazide 02247387 PMS ADEFGVW Teva-Hydrazide 00021482 TEV ADEFGVW Tab Orl 100mg Apo-Hydro 00644552 APX ADEFGVW C03B C03BA LOW-CEILING DIURETICS, EXCLUDING THIAZIDES DIURÉTIQUES DE PLAFOND BAS, À L EXCLUSION DES THIAZIDES SULFONAMIDES, PLAIN SULFONAMIDES, ORDINAIRES C03BA04 C03BA08 C03BA11 CHLORTHALIDONE CHLORTHALIDONE Tab Orl 50mg Chlorthalidone 00360279 AAP ADEFGVW METOLAZONE MÉTOLAZONE Tab Orl 2.5mg Zaroxolyn 00888400 SAV ADEFGVW INDAPAMIDE INDAPAMIDE Tab Orl 1.25mg Lozide 02179709 SEV ADEFGVW Apo-Indapamide 02245246 APX ADEFGVW Jamp-Indapamide 02373904 JPC ADEFGVW Mylan-Indapamide 02240067 MYL ADEFGVW pms-indapamide 02239619 PMS ADEFGVW Tab Orl 2.5mg Lozide 00564966 SEV ADEFGVW Apo-Indapamide 02223678 APX ADEFGVW Jamp-Indapamide 02373912 JPC ADEFGVW Mylan-Indapamide 02153483 MYL ADEFGVW Teva-Indapamide 02231184 TEV ADEFGVW pms-indapamide 02239620 PMS ADEFGVW September 2015 v.1 42

C03C C03CA HIGH-CEILING DIURETICS DIURÉTIQUES À PLAFOND ÉLEVÉ SULFONAMIDES, PLAIN SULFONAMIDES, ORDINAIRES C03CA01 FUROSEMIDE FUROSÉMIDE Inj 10mg/mL Furosemide 00527033 SDZ VW Furosemide 02382539 SDZ VW Orl 10mg/mL Lasix 02224720 SAV ADEFGVW Tab Orl 20mg Apo-Furosemide 00396788 APX ADEFGVW Furosemide 02351420 SAS ADEFGVW pms-furosemide 02247493 PMS ADEFGVW Teva-Furosemide 00337730 TEV ADEFGVW Tab Orl 40mg Furosemide 02351439 SAS ADEFGVW pms-furosemide 02247494 PMS ADEFGVW Tab Orl 80mg Apo-Furosemide 00707570 APX ADEFGVW Furosemide 02351447 SAS ADEFGVW Teva-Furosemide 00765953 TEV ADEFGVW Tab Orl 500mg Lasix Special 02224755 SAV ADEFGVW C03CA02 BUMETANIDE BUMÉTANIDE Tab Orl 1mg Burinex 00728284 LEO ADEFVW Tab Orl 5mg Burinex 00728276 LEO ADEFVW C03CC ARYLOXYACETIC ACID DERIVATIVES DÉRIVÉS DE L ACIDE ARYLOXYACÉTIQUE C03CC01 ETHACRYNIC ACID ACIDE ÉTHACRYNIQUE Tab Orl 25mg Edecrin 02258528 VLN ADEFGVW C03D C03DA POTASSIUM-SPARING DRUGS MÉDICAMENTS D ÉPARGNE DE POTASSIUM ALDOSTERONE ANTAGONISTS ANTAGONISTES DE L ALDOSTÉRONE C03DA01 SPIRONOLACTONE SPIRONOLACTONE Tab Orl 25mg Aldactone 00028606 PFI ADEFGVW Teva-Spiroton 00613215 TEV ADEFGVW September 2015 v.1 43

C03DA01 C03DB C03E C03DB01 C03EA C03EA01 SPIRONOLACTONE SPIRONOLACTONE Tab Orl 100mg Aldactone 00285455 PFI ADEFGVW Teva-Spiroton 00613223 TEV ADEFGVW OTHER POTASSIUM-SPARING AGENTS AUTRES MÉDICAMENTS D ÉPARGNE DE POTASSIUM AMILORIDE AMILORIDE Tab Orl 5mg Midamor 02249510 AAP ADEFGVW DIURETICS AND POTASSIUM-SPARING AGENTS IN COMBINATION DIURÉTIQUES ET MÉDICAMENTS D ÉPARGNE DE POTASSIUM EN COMBINAISON LOW-CEILING DIURETICS AND POTASSIUM-SPARING AGENTS DIURÉTIQUES DE PLAFOND BAS ET MÉDICAMENTS D ÉPARGNE DE POTASSIUM EN COMBINAISON HYDROCHLOROTHIAZIDE AND POTASSIUM-SPARING DRUGS HYDROCHLOROTHIAZIDE ET MÉDICAMENTS D ÉPARGNE DE POTASSIUM HYDROCHLOROTHIAZIDE / AMILORIDE HYDROCHLOROTHIAZIDE / AMILORIDE Tab Orl 50mg/5mg Novamilor 01937219 TEV ADEFGVW Apo-Amilzide 00784400 APX ADEFGVW Tab Orl 25mg/25mg Aldactazide-25 00180408 PFI ADEFGVW Teva-Spirozine-25 00613231 TEV ADEFGVW C04 C04A C04AA C04AA02 Tab Orl 50mg/50mg Aldactazide-50 00594377 PFI ADEFGVW Teva-Spirozine-50 00657182 TEV ADEFGVW TRIAMTERENE / HYDROCHLOROTHIAZIDE TRIAMTÉRÈNE / HYDROCHLOROTHIAZIDE Tab Orl 50mg/25mg Apo-Triazide 00441775 APX ADEFGVW Teva-Triamterene/HCTZ 00532657 TEV ADEFGVW PERIPHERAL VASODILATORS VASODILATATEURS PÉRIPHÉRIQUES PERIPHERAL VASODILATORS VASODILATATEURS PÉRIPHÉRIQUES 2-AMINO-1-PHENYLETHANOL DERIVATIVES DÉRIVÉS DU 2-AMINO-1 PHÉNYLÉTHANOL BUPHENINE (HYLIDRIN) BUPHENINE (HYLIDRINE) Tab Orl 6mg Arlidin 01926713 ERF ADEFGVW September 2015 v.1 44

C04AD C05 C05A C04AD03 C05AA C05AA01 PURINE DERIVATIVES DÉRIVÉS DE LA PURINE PENTOXIFYLLINE PENTOXIFYLLINE SRT Orl 400mg Pentoxifylline SR 02230090 AAP ADEFGVW L.L. VASOPROTECTIVES VASOPROTECTEURS AGENTS FOR TREATMENT OF HEMORRHOIDS & ANAL FISSURES FOR TOPICAL USE AGENTS POUR LE TRAITEMENT DES HÉMORROÏDES ET FISSURES ANALES / USAGE TOPIQUE CORTICOSTEROIDS CORTICOSTÉROÏDES HYDROCORTISONE HYDROCORTISONE HYDROCORTISONE / ZINC HYDROCORTISONE / ZINC Aer Rt 1% / 1% Proctofoam HC 00363014 DUI ADEFGVW Aér. Ont Rt 0.5% / 0.5% Anusol-HC 00505773 JNJ ADEFGVW Ont Anodan HC 02128446 ODN ADEFGVW Ratio-Hemcort HC 00607789 RPH ADEFGVW Sandoz Anuzinc HC 02247691 SDZ ADEFGVW Jamp-Zinc-HC 02387239 JPC ADEFGVW Sup Rt 0.5% / 0.5% Anusol-HC 00476285 JNJ ADEFGVW Supp. Anodan HC 02236399 ODN ADEFGVW Ratio-Hemcort HC 00607797 RPH ADEFGVW Sab-Anuzinc HC 02242798 SDZ ADEFGVW FRAMYCETIN / ESCULIN / DIBUCAINE / HYDROCORTISONE FRAMYCÉTINE / ESCULINE / DIBUCAINE / HYDROCORTISONE Ont Rt 10mg/10mg/5mg/5mg Proctol Ointment 02247322 ODN ADEFGVW Ont. Proctosedyl 02223252 AXC ADEFGVW Sandoz Proctomyxin HC 02242527 SDZ ADEFGVW Sup Rt 10mg/10mg/5mg/5mg Proctol Suppositories 02247882 ODN ADEFGVW Supp. Proctosedyl 02223260 AXC ADEFGVW Sandoz Proctomyxin HC Supp 02242528 SDZ ADEFGVW HYDROCORTISONE / PRAMOXINE / ZINC HYDROCORTISONE / PRAMOXINE / ZINC Ont Rt 0.5% / 1% / 0.5% Anugesic-HC 00505781 JNJ ADEFGVW Ont Proctodan-HC Suppositories 02234466 ODN ADEFGVW Sup Rt 10mg/20mg/10mg Anugesic-HC 00476242 JNJ ADEFGVW Supp. Proctodan-HC Suppositories 02240851 ODN ADEFGVW Sab-Anuzinc HC Plus 02242797 SDZ ADEFGVW September 2015 v.1 45

C05B C05BA C07 C07A C05BA04 C07AA C07AA03 ANTIVARICOSE THERAPY TRAITEMENT ANTIVARICES HEPARINS OR HEPARINOIDS FOR TOPICAL USE HÉPARINES OU HÉPARINOÏDS POUR USAGE TOPIQUE PENTOSAN POLYSULFATE SODIUM POLYSULFATE DE PENTOSANE Cap Orl 100mg Elmiron 02029448 JAN ADEFGVW Caps. BETA BLOCKING AGENTS BETA-BLOQUANTS BETA BLOCKING AGENTS, PLAIN BETA-BLOQUANTS, ORDINAIRES BETA BLOCKING AGENTS, NON-SELECTIVE BETA-BLOQUANTS, NON SÉLECTIFS PINDOLOL PINDOLOL Tab Orl 5mg Visken 00417270 NVR ADEFGVW Apo-Pindol 00755877 APX ADEFGVW pms-pindolol (Disc/non disp Nov 17/16) 02231536 PMS ADEFGVW Sandoz Pindolol (Disc/non disp Apr 27/17) 02261782 SDZ ADEFGVW Teva-Pindol 00869007 TEV ADEFGVW Tab Orl 10mg Visken 00443174 NVR ADEFGVW Apo-Pindol 00755885 APX ADEFGVW pms-pindolol (Disc/non disp Nov 17/16) 02231537 PMS ADEFGVW Sandoz Pindolol (Disc/non disp Apr 27/17) 02261790 SDZ ADEFGVW Teva-Pindol 00869015 TEV ADEFGVW C07AA05 Tab Orl 15mg Visken 00417289 NVR ADEFGVW Apo-Pindol 00755893 APX ADEFGVW pms-pindolol (Disc/non disp Nov 17/16) 02231539 PMS ADEFGVW Sandoz Pindolol 02261804 SDZ ADEFGVW Teva-Pindol 00869023 TEV ADEFGVW PROPRANOLOL PROPRANOLOL SRC Orl 60mg Inderal LA 02042231 PFI ADEFGVW Caps.L.L. SRC Orl 80mg Inderal LA 02042258 PFI ADEFGVW Caps.L.L. SRC Orl 120mg Inderal LA 02042266 PFI ADEFGVW Caps.L.L. SRC Orl 160mg Inderal LA 02042274 PFI ADEFGVW Caps.L.L. September 2015 v.1 46

C07AA05 PROPRANOLOL PROPRANOLOL Tab Orl 10mg Novo-Pranol 00496480 TEV ADEFGVW Tab Orl 20mg Apo-Propranolol (Disc/non disp Oct 22/15) 00663719 APX ADEFGVW Novo-Pranol 00740675 TEV ADEFGVW Tab Orl 40mg Novo-Pranol 00496499 TEV ADEFGVW Tab Orl 80mg Novo-Pranol 00496502 TEV ADEFGVW C07AA06 Tab Orl 120mg Apo-Propranolol (Disc/non disp May 6/17) 00504335 APX ADEFGVW TIMOLOL TIMOLOL Tab Orl 5mg Apo-Timol 00755842 APX ADEFGVW Teva-Timol (Disc/non disp Oct 27/16) 01947796 TEV ADEFGVW Tab Orl 10mg Apo-Timol 00755850 APX ADEFGVW Teva-Timol 01947818 TEV ADEFGVW Tab Orl 20mg Apo-Timol 00755869 APX ADEFGVW Teva-Timol 01947826 TEV ADEFGVW C07AA07 SOTALOL SOTALOL Tab Orl 80mg Apo-Sotalol 02210428 APX ADEFGVW Jamp-Sotalol 02368617 JPC ADEFGVW Mylan-Sotalol 02229778 MYL ADEFGVW Novo-Sotalol 02231181 TEV ADEFGVW pms-sotalol 02238326 PMS ADEFGVW ratio-sotalol 02084228 TEV ADEFGVW Sandoz Sotalol 02257831 SDZ ADEFGVW Sotalol 02385988 SIV ADEFGVW Tab Orl 160mg Apo-Sotalol 02167794 APX ADEFGVW Jamp-Sotalol 02368625 JPC ADEFGVW Mylan-Sotalol 02229779 MYL ADEFGVW Novo-Sotalol 02231182 TEV ADEFGVW pms-sotalol 02238327 PMS ADEFGVW ratio-sotalol 02084236 TEV ADEFGVW Sandoz Sotalol 02257858 SDZ ADEFGVW Sotalol 02385996 SIV ADEFGVW September 2015 v.1 47

C07AA12 NADOLOL NADOLOL Tab Orl 40mg Apo-Nadol 00782505 APX ADEFGVW Tab Orl 80mg Apo-Nadol 00782467 APX ADEFGVW C07AB C07AB02 Tab Orl 160mg Apo-Nadol 00782475 APX ADEFGVW BETA BLOCKING AGENTS, SELECTIVE BETA-BLOQUANTS, SÉLECTIFS METOPROLOL MÉTOPROLOL SRT Orl 100mg Lopresor SR 00658855 NVR ADEFGVW L.L. Apo-Metoprolol SR 02285169 APX ADEFGVW Sandoz Metoprolol SR 02303396 SDZ ADEFGVW SRT Orl 200mg Lopresor SR 00534560 NVR ADEFGVW L.L. Apo-Metoprolol SR 02285177 APX ADEFGVW Sandoz Metoprolol SR 02303418 SDZ ADEFGVW Tab Orl 25mg Apo-Metoprolol 02246010 APX ADEFGVW Jamp-Metoprolol-L 02356813 JPC ADEFGVW Mylan-Metoprolol (type L) 02302055 MYL ADEFGVW pms-metoprolol-l 02248855 PMS ADEFGVW Tab Orl 50mg Lopresor (coated) 00397423 NVR ADEFGVW Apo-Metoprolol type L 00749354 APX ADEFGVW Apo-Metoprolol (uncoated) 00618632 APX ADEFGVW Jamp-Metoprolol-L 02356821 JPC ADEFGVW Metoprolol 02350394 SAS ADEFGVW Mylan-Metoprolol (type L) 02174545 MYL ADEFGVW pms-metoprolol-l 02230803 PMS ADEFGVW Sandoz Metoprolol 02354187 SDZ ADEFGVW Teva-Metoprolol (coated) 00648035 TEV ADEFGVW Teva-Metoprolol (uncoated) 00842648 TEV ADEFGVW Tab Orl 100mg Lopresor (coated) 00397431 NVR ADEFGVW Apo-Metoprolol type L 00751170 APX ADEFGVW Apo-Metoprolol (uncoated) 00618640 APX ADEFGVW Jamp-Metoprolol-L 02356848 JPC ADEFGVW Metoprolol 02350408 SAS ADEFGVW Mylan-Metoprolol (type L) 02174553 MYL ADEFGVW pms-metoprolol-l 02230804 PMS ADEFGVW Sandoz Metoprolol 02354195 SDZ ADEFGVW Teva-Metoprolol (coated) 00648043 TEV ADEFGVW Teva-Metoprolol (uncoated) 00842656 TEV ADEFGVW September 2015 v.1 48

C07AB03 ATENOLOL ATÉNOLOL Tab Orl 25mg Atenolol 02247182 SIV ADEFGVW Jamp-Atenolol 02367556 JPC ADEFGVW Mar-Atenolol 02371979 MAR ADEFGVW Mint-Atenolol 02368013 MNT ADEFGVW Mylan-Atenolol 02303647 MYL ADEFGVW pms-atenolol 02246581 PMS ADEFGVW Ran-Atenolol 02373963 RAN ADEFGVW Teva-Atenolol 02266660 TEV ADEFGVW Tab Orl 50mg Tenormin 02039532 AZE ADEFGVW Act Atenolol 02255545 ATV ADEFGVW Apo-Atenol 00773689 APX ADEFGVW Atenolol 02238316 SIV ADEFGVW Jamp-Atenolol 02367564 JPC ADEFGVW Mar-Atenolol 02371987 MAR ADEFGVW Mint-Atenolol 02368021 MNT ADEFGVW Mylan-Atenolol-50 02146894 MYL ADEFGVW Ran-Atenolol 02267985 RAN ADEFGVW ratio-atenolol 02171791 TEV ADEFGVW Sandoz Atenolol 02231731 SDZ ADEFGVW Septa-Atenolol 02368641 SPT ADEFGVW pms-atenolol 02237600 PMS ADEFGVW C07AB04 Tab Orl 100mg Tenormin 02039540 AZE ADEFGVW Act Atenolol 02255553 ATV ADEFGVW Apo-Atenol 00773697 APX ADEFGVW Atenolol 02238318 SIV ADEFGVW Jamp-Atenolol 02367572 JPC ADEFGVW Mar-Atenolol 02371995 MAR ADEFGVW Mint-Atenolol 02368048 MNT ADEFGVW Mylan-Atenolol-100 02147432 MYL ADEFGVW pms-atenolol 02237601 PMS ADEFGVW Ran-Atenolol 02267993 RAN ADEFGVW ratio-atenolol 02171805 TEV ADEFGVW Sandoz Atenolol 02231733 SDZ ADEFGVW Septa-Atenolol 02368668 SPT ADEFGVW Teva-Atenolol (Disc/non disp July 24/17) 01912054 TEV ADEFGVW ACEBUTOLOL ACÉBUTOLOL Tab Orl 100mg Sectral 01926543 SAV ADEFGVW Acebutolol 02286246 SAS ADEFGVW Apo-Acebutolol 02147602 APX ADEFGVW Mylan-Acebutolol 02237721 MYL ADEFGVW Mylan-Acebutolol Type S 02237885 MYL ADEFGVW Teva-Acebutolol 02204517 TEV ADEFGVW September 2015 v.1 49

C07AB04 ACEBUTOLOL ACÉBUTOLOL Tab Orl 200mg Sectral 01926551 SAV ADEFGVW Acebutolol 02286254 SAS ADEFGVW Apo-Acebutolol 02147610 APX ADEFGVW Mylan-Acebutolol 02237722 MYL ADEFGVW Mylan-Acebutolol Type S 02237886 MYL ADEFGVW Teva-Acebutolol 02204525 TEV ADEFGVW Tab Orl 400mg Sectral 01926578 SAV ADEFGVW Acebutolol 02286262 SAS ADEFGVW Apo-Acebutolol 02147629 APX ADEFGVW Mylan-Acebutolol 02237723 MYL ADEFGVW Mylan-Acebutolol Type S 02237887 MYL ADEFGVW Teva-Acebutolol 02204533 TEV ADEFGVW C07AB07 C07AG C07AG01 BISOPROLOL BISOPROLOL Tab Orl 5mg Apo-Bisoprolol 02256134 APX ADEFVW Bisoprolol 02391589 SAS ADEFVW Bisoprolol 02383055 SIV ADEFVW Mylan-Bisoprolol 02384418 MYL ADEFVW pms-bisoprolol 02302632 PMS ADEFVW Sandoz Bisoprolol 02247439 SDZ ADEFVW Teva-Bisoprolol 02267470 TEV ADEFVW Tab Orl 10mg Apo-Bisoprolol 02256177 APX ADEFVW Bisoprolol 02391597 SAS ADEFVW Bisoprolol 02383063 SIV ADEFVW Mylan-Bisoprolol 02384426 MYL ADEFVW pms-bisoprolol 02302640 PMS ADEFVW Sandoz Bisoprolol 02247440 SDZ ADEFVW Teva-Bisoprolol 02267489 TEV ADEFVW ALPHA AND BETA BLOCKING AGENTS ALPHA-BLOQUANTS ET BETA-BLOQUANTS LABETALOL LABÉTALOL Tab Orl 100mg Trandate 02106272 PAL ADEFGVW Tab Orl 200mg Trandate 02106280 PAL ADEFGVW September 2015 v.1 50

C07AG02 CARVEDILOL CARVÉDILOL Tab Orl 3.125mg Apo-Carvedilol 02247933 APX (SA) Auro-Carvedilol 02418495 ARO (SA) Carvedilol 02364913 SAS (SA) Carvedilol 02248752 SIV (SA) Jamp-Carvedilol 02368897 JPC (SA) Mylan-Carvedilol 02347512 MYL (SA) pms-carvedilol 02245914 PMS (SA) Ran-Carvedilol 02268027 RAN (SA) ratio-carvedilol 02252309 TEV (SA) Zym-Carvedilol (Disc/non disp Jun 16/16) 02338068 ZYM (SA) Tab Orl 6.25mg Apo-Carvedilol 02247934 APX (SA) Auro-Carvedilol 02418509 ARO (SA) Carvedilol 02364921 SAS (SA) Carvedilol 02248753 SIV (SA) Jamp-Carvedilol 02368900 JPC (SA) Mylan-Carvedilol 02347520 MYL (SA) pms-carvedilol 02245915 PMS (SA) Ran-Carvedilol 02268035 RAN (SA) ratio-carvedilol 02252317 TEV (SA) Zym-Carvedilol (Disc/non disp Jun 16/16) 02338092 ZYM (SA) Tab Orl 12.5mg Apo-Carvedilol 02247935 APX (SA) Auro-Carvedilol 02418517 ARO (SA) Carvedilol 02364948 SAS (SA) Carvedilol 02248754 SIV (SA) Jamp-Carvedilol 02368919 JPC (SA) Mylan-Carvedilol 02347555 MYL (SA) pms-carvedilol 02245916 PMS (SA) Ran-Carvedilol 02268043 RAN (SA) ratio-carvedilol 02252325 TEV (SA) Zym-Carvedilol (Disc/non disp Jun 16/16) 02338106 ZYM (SA) Tab Orl 25mg Apo-Carvedilol 02247936 APX (SA) Auro-Carvedilol 02418525 ARO (SA) Carvedilol 02364956 SAS (SA) Carvedilol 02248755 SIV (SA) Jamp-Carvedilol 02368927 JPC (SA) Mylan-Carvedilol 02347571 MYL (SA) pms-carvedilol 02245917 PMS (SA) Ran-Carvedilol 02268051 RAN (SA) ratio-carvedilol 02252333 TEV (SA) Zym-Carvedilol (Disc/non disp Jun 16/16) 02338114 ZYM (SA) September 2015 v.1 51

C07C C07CA BETA BLOCKING AGENTS AND OTHER DIURETICS BETA-BLOQUANTS ET AUTRES DIURÉTIQUES BETA BLOCKING AGENTS, NON-SELECTIVE, OTHER DIURETICS BETA-BLOQUANTS, NON SÉLECTIFS, AUTRES DIURÉTIQUES C07CA03 PINDOLOL AND OTHER DIURETICS PINDOLOL ET AUTRE DIURÉTIQUES PINDOLOL / HYDROCHLOROTHIAZIDE PINDOLOL / HYDROCHLOROTHIAZIDE Tab Orl 10mg/25mg Viskazide 00568627 NVR ADEFGVW Tab Orl 10mg/50mg Viskazide 00568635 NVR ADEFGVW C07CB C07CB03 BETA BLOCKING AGENTS, SELECTIVE, AND OTHER DIURETICS BETA-BLOQUANTS, SÉLECTIFS, ET AUTRES DIURÉTIQUES ATENOLOL AND OTHER DIURETICS ATÉNOLOL ET AU DIURÉTIQUES ATENOLOL / CHLORTHALIDONE ATÉNOLOL / CHLORTHALIDONE Tab Orl 50mg/25mg Tenoretic 02049961 AZE ADEFGVW Apo-Atenidone 02248763 APX ADEFGVW Teva-Atenolol/Chlorthalidone 02302918 TEV ADEFGVW Tab Orl 100mg/25mg Tenoretic 02049988 AZE ADEFGVW Apo-Atenidone 02248764 APX ADEFGVW Teva-Atenolol/Chlorthalidone 02302926 TEV ADEFGVW C08 C08C C08CA CALCIUM CHANNEL BLOCKERS ANTAGONISTES DU CALCIUM SELECTIVE CALCIUM CHANNEL BLOCKERS WITH MAINLY VASCULAR EFFECTS ANTAGONISTES DU CALCIUM SÉLECTIFS AVEC PRINCIPALEMENT DES EFFETS VASCULAIRES DIHYDROPYRIDINE DERIVATIVES DÉRIVÉS DU DIHYDROPYRIDINE C08CA01 AMLODIPINE AMLODIPINE Tab Orl 2.5mg Act Amlodipine 02297477 ATV ADEFVW Amlodipine 02385783 SIV ADEFVW Jamp-Amlodipine 02357186 JPC ADEFVW Mar-Amlodipine 02371707 MAR ADEFVW pms-amlodipine 02295148 PMS ADEFVW Ran-Amlodipine 02398877 RAN ADEFVW Sandoz Amlodipine 02330474 SDZ ADEFVW September 2015 v.1 52

C08CA01 AMLODIPINE AMLODIPINE Tab Orl 5mg Norvasc 00878928 PFI ADEFVW Act Amlodipine 02297485 ATV ADEFVW Amlodipine 02331284 SAS ADEFVW Amlodipine 02385791 SIV ADEFVW Apo-Amlodipine 02273373 APX ADEFVW Auro-Amlodipine 02397072 ARO ADEFVW GD-Amlodipine 02280132 GMD ADEFVW Jamp-Amlodipine (new formulation) 02357194 JPC ADEFVW Mar-Amlodipine 02371715 MAR ADEFVW Mint-Amlodipine 02362651 MNT ADEFVW Mylan-Amlodipine 02272113 MYL ADEFVW pms-amlodipine 02284065 PMS ADEFVW Ran-Amlodipine 02321858 RAN ADEFVW ratio-amlodipine (Disc/non disp Sept 19/16) 02259605 RPH ADEFVW Sandoz Amlodipine 02284383 SDZ ADEFVW Septa-Amlodipine 02357712 SPT ADEFVW Teva-Amlodipine 02250497 TEV ADEFVW Tab Orl 10mg Norvasc 00878936 PFI ADEFVW Act Amlodipine 02297493 ATV ADEFVW Amlodipine 02331292 SAS ADEFVW Amlodipine 02385805 SIV ADEFVW Apo-Amlodipine 02273381 APX ADEFVW Auro-Amlodipine 02397080 ARO ADEFVW GD-Amlodipine 02280140 GMD ADEFVW Jamp-Amlodipine (new formulation) 02357208 JPC ADEFVW Mar-Amlodipine 02371723 MAR ADEFVW Mint-Amlodipine 02362678 MNT ADEFVW Mylan-Amlodipine 02272121 MYL ADEFVW pms-amlodipine 02284073 PMS ADEFVW Ran-Amlodipine 02321866 RAN ADEFVW ratio-amlodipine (Disc/non disp Sept 19/16) 02259613 RPH ADEFVW Sandoz Amlodipine 02284391 SDZ ADEFVW Septa-Amlodipine 02357720 SPT ADEFVW Teva-Amlodipine 02250500 TEV ADEFVW C08CA02 FELODIPINE FÉLODIPINE SRT Orl 2.5mg Plendil 02057778 AZE ADEFVW L.L. Renedil (Disc/non disp Sep 18/15) 02221985 SAV ADEFVW SRT Orl 5mg Plendil 00851779 AZE ADEFVW L.L. Sandoz Felodipine 02280264 SDZ ADEFVW SRT Orl 10mg Plendil 00851787 AZE ADEFVW L.L. Sandoz Felodipine 02280272 SDZ ADEFVW September 2015 v.1 53

C08CA05 NIFEDIPINE NIFÉDIPINE Cap Orl 5mg Nifedipine 00725110 AAP ADEFGVW Caps Cap Orl 10mg Nifedipine 00755907 AAP ADEFGVW Caps ERT Orl 20mg Adalat XL 02237618 BAY ADEFGVW L.P. ERT Orl 30mg Adalat XL 02155907 BAY ADEFGVW L.P. Mylan-Nifedipine Extended Release 02349167 MYL ADEFGVW C08D C08DA C08DA01 ERT Orl 60mg Adalat XL 02155990 BAY ADEFGVW L.P. Mylan-Nifedipine Extended Release 02321149 MYL ADEFGVW SELECTIVE CALCIUM CHANNEL BLOCKERS WITH DIRECT CARDIAC EFFECTS ANTAGONISTES DU CALCIUM SÉLECTIFS AVEC EFFETS CARDIAQUES DIRECTS PHENYLALKYLAMINE DERIVATIVES DÉRIVÉS DU PHÉNYLALKYLAMINE VERAPAMIL VÉRAPAMIL SRT Orl 120mg Isoptin SR 01907123 BGP ADEFGVW L.L. Apo-Verapamil SR 02246893 APX ADEFGVW Mylan-Verapamil SR 02210347 MYL ADEFGVW SRT Orl 180mg Isoptin SR 01934317 BGP ADEFGVW L.L. Apo-Verap SR 02246894 APX ADEFGVW Mylan-Verapamil 02210355 MYL ADEFGVW SRT Orl 240mg Isoptin SR 00742554 BGP ADEFGVW L.L. Apo-Verap SR 02246895 APX ADEFGVW Mylan-Verapamil 02210363 MYL ADEFGVW Novo-Veramil SR (Disc/non disp Sept 29/16) 02211920 TEV ADEFGVW pms-verapamil SR 02237791 PMS ADEFGVW Tab Orl 80mg Apo-Verap 00782483 APX ADEFGVW Mylan-Verapamil 02237921 MYL ADEFGVW Tab Orl 120mg Apo-Verap 00782491 APX ADEFGVW Mylan-Verapamil 02237922 MYL ADEFGVW September 2015 v.1 54

C08DB C08DB01 BENZOTHIAZEPINE DERIVATIVES DÉRIVÉS DU BENZOTHIAZÉPINE DILTIAZEM DILTIAZEM CDC Orl 120mg Cardizem CD 02097249 VLN ADEFGVW Caps.L.C. Act Diltiazem CD 02370611 ATV ADEFGVW Apo-Diltiaz CD 02230997 APX ADEFGVW Diltiazem CD 02400421 SAS ADEFGVW pms-diltiazem CD 02355752 PMS ADEFGVW Sandoz Diltiazem CD 02243338 SDZ ADEFGVW Teva-Diltazem CD 02242538 TEV ADEFGVW CDC Orl 180mg Cardizem CD 02097257 VLN ADEFGVW Caps.L.C. Act Diltiazem CD 02370638 ATV ADEFGVW Apo-Diltiaz CD 02230998 APX ADEFGVW Diltiazem CD 02400448 SAS ADEFGVW pms-diltiazem CD 02355760 PMS ADEFGVW Sandoz Diltiazem CD 02243339 SDZ ADEFGVW Teva-Diltazem CD 02242539 TEV ADEFGVW CDC Orl 240mg Cardizem CD 02097265 VLN ADEFGVW Caps.L.C. Act Diltiazem CD 02370646 ATV ADEFGVW Apo-Diltiaz CD 02230999 APX ADEFGVW Diltiazem CD 02400456 SAS ADEFGVW pms-diltiazem CD 02355779 PMS ADEFGVW Sandoz Diltiazem CD 02243340 SDZ ADEFGVW Teva-Diltazem CD 02242540 TEV ADEFGVW CDC Orl 300mg Cardizem CD 02097273 VLN ADEFGVW Caps.L.C. Act Diltiazem CD 02370654 ATV ADEFGVW Apo-Diltiaz CD 02229526 APX ADEFGVW Diltiazem CD 02400464 SAS ADEFGVW pms-diltiazem CD 02355787 PMS ADEFGVW Sandoz Diltiazem CD 02243341 SDZ ADEFGVW Teva-Diltazem CD 02242541 TEV ADEFGVW ERC Orl 120mg Tiazac 02231150 VLN ADEFVW Caps.L.P. Apo-Diltiaz TZ (Disc/non disp Dec 12/16) 02291037 APX ADEFVW Co Diltiazem T 02370441 COB ADEFVW Sandoz Diltiazem T 02245918 SDZ ADEFVW Teva-Diltiazem ER 02271605 TEV ADEFVW ERC Orl 180mg Tiazac 02231151 VLN ADEFVW Caps.L.P. Apo-Diltiaz TZ (Disc/non disp Dec 12/16) 02291045 APX ADEFVW Co Diltiazem T 02370492 COB ADEFVW Sandoz Diltiazem T 02245919 SDZ ADEFVW Teva-Diltiazem ER 02271613 TEV ADEFVW September 2015 v.1 55

C08DB01 DILTIAZEM DILTIAZEM ERC Orl 240mg Tiazac 02231152 VLN ADEFVW Caps.L.P. Apo-Diltiaz TZ (Disc/non disp Dec 12/16) 02291053 APX ADEFVW Co Diltiazem T 02370506 COB ADEFVW Sandoz Diltiazem T 02245920 SDZ ADEFVW Teva-Diltiazem ER 02271621 TEV ADEFVW ERC Orl 300mg Tiazac 02231154 VLN ADEFVW Caps.L.P. Apo-Diltiaz TZ (Disc/non disp Dec 12/16) 02291061 APX ADEFVW Co Diltiazem T 02370514 COB ADEFVW Sandoz Diltiazem T 02245921 SDZ ADEFVW Teva-Diltiazem ER 02271648 TEV ADEFVW ERC Orl 360mg Tiazac 02231155 VLN ADEFVW Caps.L.P. Apo-Diltiaz TZ (Disc/non disp Dec 12/16) 02291088 APX ADEFVW Co Diltiazem T 02370522 COB ADEFVW Sandoz Diltiazem T 02245922 SDZ ADEFVW Teva-Diltiazem ER 02271656 TEV ADEFVW ERT Orl 120mg Tiazac XC 02256738 VLN ADEFGVW L.P. ERT Orl 180mg Tiazac XC 02256746 VLN ADEFGVW L.P. ERT Orl 240mg Tiazac XC 02256754 VLN ADEFGVW L.P. ERT Orl 300mg Tiazac XC 02256762 VLN ADEFGVW L.P. ERT Orl 360mg Tiazac XC 02256770 VLN ADEFGVW L.P. Tab Orl 30mg Apo-Diltiaz 00771376 APX ADEFGVW Teva-Diltiazem 00862924 TEV ADEFGVW Tab Orl 60mg Apo-Diltiaz 00771384 APX ADEFGVW Teva-Diltiazem 00862932 TEV ADEFGVW C09 AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM AGENTS AGISSANT SUR LE SYSTÈME RÉNINE-ANGIOTENSINE C09A C09AA C09AA01 ACE INHIBITORS, PLAIN INHIBITEUR DE L ENZYME CONVERTISSANT L ANGIOTENSINE, ORDINAIRE ACE INHIBITORS, PLAIN INHIBITEUR DE L ENZYME CONVERTISSANT L ANGIOTENSINE, ORDINAIRE CAPTOPRIL CAPTOPRIL Tab Orl 12.5mg Apo-Capto 00893595 APX ADEFGVW Mylan-Captopril (Disc/non disp. Jun 5/16) 02163551 MYL ADEFGVW Teva-Captoril 01942964 TEV ADEFGVW September 2015 v.1 56

C09AA01 CAPTOPRIL CAPTOPRIL Tab Orl 25mg Apo-Capto 00893609 APX ADEFGVW Mylan-Captopril (Disc/non disp. Jun 5/16) 02163578 MYL ADEFGVW Teva-Captoril 01942972 TEV ADEFGVW Tab Orl 50mg Apo-Capto 00893617 APX ADEFGVW Mylan-Captopril (Disc/non disp. Jun 5/16) 02163586 MYL ADEFGVW Teva-Captoril 01942980 TEV ADEFGVW Tab Orl 100mg Apo-Capto 00893625 APX ADEFGVW Mylan-Captopril (Disc/non disp. Jun 5/16) 02163594 MYL ADEFGVW Teva-Captoril 01942999 TEV ADEFGVW C09AA02 ENALAPRIL ÉNALAPRIL Tab Orl 2.5mg Vasotec 00851795 FRS ADEFGVW Act Enalapril 02291878 ATV ADEFGVW Apo-Enalapril 02020025 APX ADEFGVW Enalapril 02400650 SAS ADEFGVW Mylan-Enalapril 02300036 MYL ADEFGVW pms-enalapril 02300079 PMS ADEFGVW Ran-Enalapril 02352230 RAN ADEFGVW Sandoz Enalapril 02299933 SDZ ADEFGVW Teva-Enalapril (Disc/Non-Disp June 5/17) 02300680 TEV ADEFGVW Tab Orl 5mg Vasotec 00708879 FRS ADEFGVW Act Enalapril 02291886 ATV ADEFGVW Apo-Enalapril 02019884 APX ADEFGVW Enalapril 02400669 SAS ADEFGVW Mylan-Enalapril 02300044 MYL ADEFGVW pms-enalapril 02300087 PMS ADEFGVW Ran-Enalapril 02352249 RAN ADEFGVW Sandoz Enalapril 02299941 SDZ ADEFGVW Teva-Enalapril 02233005 TEV ADEFGVW Tab Orl 10mg Vasotec 00670901 FRS ADEFGVW Act Enalapril 02291894 ATV ADEFGVW Apo-Enalapril 02019892 APX ADEFGVW Enalapril 02400677 SAS ADEFGVW Mylan-Enalapril 02300052 MYL ADEFGVW pms-enalapril 02300095 PMS ADEFGVW Ran-Enalapril 02352257 RAN ADEFGVW Sandoz Enalapril 02299968 SDZ ADEFGVW Teva-Enalapril 02233006 TEV ADEFGVW September 2015 v.1 57

C09AA02 C09AA03 ENALAPRIL ÉNALAPRIL Tab Orl 20mg Vasotec 00670928 FRS ADEFGVW Act Enalapril 02291908 ATV ADEFGVW Apo-Enalapril 02019906 APX ADEFGVW Enalapril 02400685 SAS ADEFGVW Mylan-Enalapril 02300060 MYL ADEFGVW pms-enalapril 02300109 PMS ADEFGVW Ran-Enalapril 02352265 RAN ADEFGVW Sandoz Enalapril 02299976 SDZ ADEFGVW Teva-Enalapril 02233007 TEV ADEFGVW LISINOPRIL LISINOPRIL Tab Orl 5mg Prinivil 00839388 FRS ADEFGVW Zestril 02049333 AZE ADEFGVW Apo-Lisinopril 02217481 APX ADEFGVW Auro-Lisinopril 02394472 ARO ADEFGVW Act Lisinopril 02271443 ATV ADEFGVW Jamp-Lisinopril 02361531 JPC ADEFGVW Lisinopril 02386232 SIV ADEFGVW Mylan-Lisinopril 02274833 MYL ADEFGVW pms-lisinopril 02292203 PMS ADEFGVW Ran-Lisinopril 02294230 RAN ADEFGVW Sandoz Lisinopril 02289199 SDZ ADEFGVW Teva-Lisinopril P 02285061 TEV ADEFGVW Teva-Lisinopril Z 02285118 TEV ADEFGVW Tab Orl 10mg Prinivil 00839396 FRS ADEFGVW Zestril 02049376 AZE ADEFGVW Apo-Lisinopril 02217503 APX ADEFGVW Auro-Lisinopril 02394480 ARO ADEFGVW Act Lisinopril 02271451 ATV ADEFGVW Jamp-Lisinopril 02361558 JPC ADEFGVW Lisinopril 02386240 SIV ADEFGVW Mylan-Lisinopril 02274841 MYL ADEFGVW pms-lisinopril 02292211 PMS ADEFGVW Ran-Lisinopril 02294249 RAN ADEFGVW Sandoz Lisinopril 02289202 SDZ ADEFGVW Teva-Lisinopril P 02285088 TEV ADEFGVW Teva-Lisinopril Z 02285126 TEV ADEFGVW September 2015 v.1 58

C09AA03 C09AA04 LISINOPRIL LISINOPRIL Tab Orl 20mg Prinivil 00839418 FRS ADEFGVW Zestril 02049384 AZE ADEFGVW Apo-Lisinopril 02217511 APX ADEFGVW Auro-Lisinopril 02394499 ARO ADEFGVW Act Lisinopril 02271478 ATV ADEFGVW Jamp-Lisinopril 02361566 JPC ADEFGVW Lisinopril 02386259 SIV ADEFGVW Mylan-Lisinopril 02274868 MYL ADEFGVW pms-lisinopril 02292238 PMS ADEFGVW Ran-Lisinopril 02294257 RAN ADEFGVW Sandoz Lisinopril 02289229 SDZ ADEFGVW Teva-Lisinopril P 02285096 TEV ADEFGVW Teva-Lisinopril Z 02285134 TEV ADEFGVW PERINDOPRIL PERINDOPRIL Tab Orl 2mg Coversyl 02123274 SEV ADEFGVW Tab Orl 4mg Coversyl 02123282 SEV ADEFGVW Tab Orl 8mg Coversyl 02246624 SEV ADEFGVW C09AA05 RAMIPRIL RAMIPRIL Cap Orl 1.25mg Altace 02221829 SAV ADEFGVW Caps Act Ramipril 02295482 ATV ADEFGVW Apo-Ramipril 02251515 APX ADEFGVW Auro-Ramipril 02387387 ARO ADEFGVW Jamp-Ramipril 02331101 JPC ADEFGVW Mar-Ramipril 02420457 MAR ADEFGVW Mylan-Ramipril 02301148 MYL ADEFGVW pms-ramipril 02295369 PMS ADEFGVW Ran-Ramipril 02310503 RAN ADEFGVW ratio-ramipril (Disc/non disp Sept 19/16) 02287692 RPH ADEFGVW September 2015 v.1 59

C09AA05 RAMIPRIL RAMIPRIL Cap Orl 2.5mg Altace 02221837 SAV ADEFGVW Caps Act Ramipril 02295490 ATV ADEFGVW Apo-Ramipril 02251531 APX ADEFGVW Auro-Ramipril 02387395 ARO ADEFGVW Jamp-Ramipril 02331128 JPC ADEFGVW Mar-Ramipril 02420465 MAR ADEFGVW Mint-Ramipril 02421305 MNT ADEFGVW Mylan-Ramipril 02301156 MYL ADEFGVW pms-ramipril 02247917 PMS ADEFGVW Ramipril 02374846 SAS ADEFGVW Ramipril 02411563 SIV ADEFGVW Ran-Ramipril 02310511 RAN ADEFGVW ratio-ramipril (Disc/non disp Sept 19/16) 02287706 RPH ADEFGVW Teva-Ramipril 02247945 TEV ADEFGVW Cap Orl 5mg Altace 02221845 SAV ADEFGVW Caps Act Ramipril 02295504 ATV ADEFGVW Apo-Ramipril 02251574 APX ADEFGVW Auro-Ramipril 02387409 ARO ADEFGVW Jamp-Ramipril 02331136 JPC ADEFGVW Mar-Ramipril 02420473 MAR ADEFGVW Mint-Ramipril 02421313 MNT ADEFGVW Mylan-Ramipril 02301164 MYL ADEFGVW pms-ramipril 02247918 PMS ADEFGVW Ramipril 02374854 SAS ADEFGVW Ramipril 02411571 SIV ADEFGVW Ran-Ramipril 02310538 RAN ADEFGVW Teva-Ramipril 02247946 TEV ADEFGVW Cap Orl 10mg Altace 02221853 SAV ADEFGVW Caps Act Ramipril 02295512 ATV ADEFGVW Apo-Ramipril 02251582 APX ADEFGVW Auro-Ramipril 02387417 ARO ADEFGVW Jamp-Ramipril 02331144 JPC ADEFGVW Mar-Ramipril 02420481 MAR ADEFGVW Mint-Ramipril 02421321 MNT ADEFGVW Mylan-Ramipril 02301172 MYL ADEFGVW pms-ramipril 02247919 PMS ADEFGVW Ramipril 02374862 SAS ADEFGVW Ramipril 02411598 SIV ADEFGVW Ran-Ramipril 02310546 RAN ADEFGVW Teva-Ramipril 02247947 TEV ADEFGVW Cap Orl 15mg Altace 02281112 SAV ADEFGVW Caps Apo-Ramipril 02325381 APX ADEFGVW Tab Orl 1.25mg Sandoz Ramipril 02291398 SDZ ADEFGVW September 2015 v.1 60

C09AA05 RAMIPRIL RAMIPRIL Tab Orl 2.5mg Sandoz Ramipril 02291401 SDZ ADEFGVW Tab Orl 5mg Sandoz Ramipril 02291428 SDZ ADEFGVW C09AA06 Tab Orl 10mg Sandoz Ramipril 02291436 SDZ ADEFGVW QUINAPRIL QUINAPRIL Tab Orl 5mg Accupril 01947664 PFI ADEFGVW Apo-Quinapril 02248499 APX ADEFGVW Tab Orl 10mg Accupril 01947672 PFI ADEFGVW Apo-Quinapril 02248500 APX ADEFGVW C09AA07 Tab Orl 20mg Accupril 01947680 PFI ADEFGVW Apo-Quinapril 02248501 APX ADEFGVW Tab Orl 40mg Accupril 01947699 PFI ADEFGVW Apo-Quinapril 02248502 APX ADEFGVW BENAZEPRIL BÉNAZÉPRIL Tab Orl 5mg Lotensin 00885835 NVR ADEFGVW Benazapril 02290332 AAP ADEFGVW Tab Orl 10mg Benazapril 02290340 AAP ADEFGVW C09AA08 Tab Orl 20mg Lotensin 00885851 NVR ADEFGVW Benazapril 02273918 AAP ADEFGVW CILAZAPRIL CILAZAPRIL Tab Orl 1mg Apo-Cilazapril 02291134 APX ADEFGVW Mylan-Cilazapril 02283778 MYL ADEFGVW Novo-Cilazapril 02266350 TEV ADEFGVW pms-cilazapril 02280442 PMS ADEFGVW Tab Orl 2.5mg Inhibace 01911473 HLR ADEFGVW Apo-Cilazapril 02291142 APX ADEFGVW Cilazapril 02350971 SAS ADEFGVW Co Cilazapril 02285215 COB ADEFGVW Mylan-Cilazapril 02283786 MYL ADEFGVW Novo-Cilazapril 02266369 TEV ADEFGVW pms-cilazapril 02280450 PMS ADEFGVW September 2015 v.1 61

C09AA08 C09AA09 CILAZAPRIL CILAZAPRIL Tab Orl 5mg Inhibace 01911481 HLR ADEFGVW Apo-Cilazapril 02291150 APX ADEFGVW Cilazapril (Disc/non dip Aug 1/16) 02350998 SAS ADEFGVW Co Cilazapril 02285223 COB ADEFGVW Mylan-Cilazapril 02283794 MYL ADEFGVW Novo-Cilazapril 02266377 TEV ADEFGVW pms-cilazapril 02280469 PMS ADEFGVW FOSINOPRIL FOSINOPRIL Tab Orl 10mg Apo-Fosinopril 02266008 APX ADEFGVW Jamp-Fosinopril 02331004 JPC ADEFGVW Mylan-Fosinopril 02262401 MYL ADEFGVW Ran-Fosinopril 02294524 RAN ADEFGVW Teva-Fosinopril 02247802 TEV ADEFGVW Tab Orl 20mg Apo-Fosinopril 02266016 APX ADEFGVW Jamp-Fosinopril 02331012 JPC ADEFGVW Mylan-Fosinopril 02262428 MYL ADEFGVW Ran-Fosinopril 02294532 RAN ADEFGVW Teva-Fosinopril 02247803 TEV ADEFGVW C09AA10 TRANDOLAPRIL TRANDOLAPRIL Cap Orl 1mg Mavik 02231459 BGP ADEFGVW Caps Cap Orl 2mg Mavik 02231460 BGP ADEFGVW Caps C09B C09BA C09BA02 Cap Orl 4mg Mavik 02239267 BGP ADEFGVW Caps ACE-INHIBITORS, COMBINATIONS INHIBITEUR DE L ENZYME CONVERTISSANT L ANGIOTENSINE, COMBINAISONS ACE-INHIBITORS AND DIURETICS INHIBITEUR DE L ENZYME CONVERTISSANT L ANGIOTENSINE, ET DIURÉTIQUES ENALAPRIL AND DIURETICS ÉNALAPRIL ET DIURÉTIQUES ENALAPRIL / HYDROCHLOROTHIAZIDE ÉNALAPRIL / HYDROCHLOROTHIAZIDE Tab Orl 5mg/12.5mg Novo-Enalapril/HCTZ 02300222 TEV ADEFGVW Apo-Enalapril/HCTZ 02352923 APX ADEFGVW Tab Orl 10mg/25mg Vaseretic 00657298 FRS ADEFGVW Novo-Enalapril/HCTZ (Disc/non disp Jul 14/17) 02300230 TEV ADEFGVW Apo-Enalapril/HCTZ 02352931 APX ADEFGVW September 2015 v.1 62

C09BA03 LISINOPRIL AND DIURETICS LISINOPRIL ET DIURÉTIQUES LISINOPRIL / HYDROCHLOROTHIAZIDE LISINOPRIL / HYDROCHLOROTHIAZIDE Tab Orl 10mg/12.5mg Zestoretic 02103729 AZE ADEFGVW Apo-Lisinopril/HCTZ (Disc/non disp Dec 12/16) 02261979 APX ADEFGVW Lisinopril HCTZ (Type Z) 02362945 SAS ADEFGVW Mylan-Lisinopril HCTZ 02297736 MYL ADEFGVW Sandoz Lisinopril HCT 02302365 SDZ ADEFGVW Teva-Lisinopril HCTZ (Type P) 02302136 TEV ADEFGVW Teva-Lisinopril HCTZ (Type Z) 02301768 TEV ADEFGVW Tab Orl 20mg/12.5mg Zestoretic 02045737 AZE ADEFGVW Prinzide (Disc/non disp Oct 10/16) 00884413 FRS ADEFGVW Apo-Lisinopril/HCTZ (Disc/non disp Dec 12/16) 02261987 APX ADEFGVW Lisinopril HCTZ (Type Z) 02362953 SAS ADEFGVW Mylan-Lisinopril HCTZ 02297744 MYL ADEFGVW Sandoz Lisinopril HCT 02302373 SDZ ADEFGVW Teva-Lisinopril HCTZ (Type P) 02302144 TEV ADEFGVW Teva-Lisinopril HCTZ (Type Z) 02301776 TEV ADEFGVW Tab Orl 20mg/25mg Zestoretic 02045729 AZE ADEFGVW Apo-Lisinopril/HCTZ (Disc/non disp Dec 12/16) 02261995 APX ADEFGVW Lisinopril HCTZ (Type Z) 02362961 SAS ADEFGVW Mylan-Lisinopril HCTZ 02297752 MYL ADEFGVW Sandoz Lisinopril HCT 02302381 SDZ ADEFGVW Teva-Lisinopril HCTZ (Type P) 02302152 TEV ADEFGVW Teva-Lisinopril HCTZ (Type Z) 02301784 TEV ADEFGVW C09BA04 PERINDOPRIL AND DIURETICS PERINDOPRIL ET DIURÉTIQUES PERINDOPRIL / INDAPAMIDE PERINDOPRIL / INDAPAMIDE Tab Orl 4mg/1.25mg Coversyl Plus 02246569 SEV ADEFGVW Tab Orl 8mg/2.5mg Coversyl Plus HD 02321653 SEV ADEFGVW C09BA05 RAMIPRIL AND DIURETICS RAMIPRIL ET DIURÉTIQUES RAMIPRIL / HYDROCHLOROTHIAZIDE RAMIPRIL / HYDROCHLOROTHIAZIDE Tab Orl 2.5mg/12.5mg Altace HCT 02283131 SAV ADEFGVW pms Ramipril-HCTZ 02342138 PMS ADEFGVW Teva-Ramipril/HCTZ (Disc/non disp Nov 18/16) 02388332 TEV ADEFGVW Tab Orl 5mg/12.5mg Altace HCT 02283158 SAV ADEFGVW pms Ramipril-HCTZ 02342146 PMS ADEFGVW Ramipril-HCTZ 02412640 SNS ADEFGVW Teva-Ramipril/HCTZ (Disc/non disp Nov 18/16) 02388340 TEV ADEFGVW September 2015 v.1 63

C09BA05 RAMIPRIL AND DIURETICS RAMIPRIL ET DIURÉTIQUES RAMIPRIL / HYDROCHLOROTHIAZIDE RAMIPRIL / HYDROCHLOROTHIAZIDE Tab Orl 5mg/25mg Altace HCT 02283174 SAV ADEFGVW pms Ramipril-HCTZ 02342162 PMS ADEFGVW Ramipril-HCTZ 02412667 SNS ADEFGVW Teva-Ramipril/HCTZ (Disc/non disp Nov 18/16) 02388367 TEV ADEFGVW Tab Orl 10mg/12.5mg Altace HCT 02283166 SAV ADEFGVW pms Ramipril-HCTZ 02342154 PMS ADEFGVW Ramipril-HCTZ 02412659 SNS ADEFGVW Teva-Ramipril/HCTZ (Disc/non disp Nov 18/16) 02388359 TEV ADEFGVW Tab Orl 10mg/25mg Altace HCT 02283182 SAV ADEFGVW pms Ramipril-HCTZ 02342170 PMS ADEFGVW Ramipril-HCTZ 02412675 SNS ADEFGVW Teva-Ramipril/HCTZ (Disc/non disp Nov 19/16) 02388375 TEV ADEFGVW C09BA06 QUINAPRIL AND DIURETICS QUINAPRIL ET DIURÉTIQUES QUINAPRIL / HYDROCHLOROTHIAZIDE QUINAPRIL / HYDROCHLOROTHIAZIDE Tab Orl 10mg/12.5mg Accuretic 02237367 PFI ADEFGVW Apo-Quinapril/HCTZ 02408767 APX ADEFGVW Tab Orl 20mg/12.5mg Accuretic 02237368 PFI ADEFGVW Apo-Quinapril/HCTZ 02408775 APX ADEFGVW Tab Orl 20mg/25mg Accuretic 02237369 PFI ADEFGVW Apo-Quinapril/HCTZ 02408783 APX ADEFGVW C09BA08 CILAZAPRIL AND DIURETICS CILAZAPRIL ET DIURÉTIQUES CILAZAPRIL / HYDROCHLOROTHIAZIDE CILAZAPRIL / HYDROCHLOROTHIAZIDE Tab Orl 5mg/12.5mg Inhibace Plus 02181479 HLR ADEFGVW Apo-Cilazapril/HCTZ 02284987 APX ADEFGVW Novo-Cilazapril/HCTZ 02313731 TEV ADEFGVW September 2015 v.1 64

C09C C09CA C09CA01 ANGIOTENSIN II ANTAGONISTS, PLAIN ANTAGONISTES DE L ANGIOTENSINE II, ORDINAIRE ANGIOTENSIN II ANTAGONISTS, PLAIN ANTAGONISTES DE L ANGIOTENSINE II, ORDINAIRE LOSARTAN LOSARTAN Tab Orl 25mg Cozaar 02182815 FRS ADEFGVW Act Losartan 02354829 ATV ADEFGVW Apo-Losartan 02379058 APX ADEFGVW Auro-Losartan 02403323 ARO ADEFGVW Jamp-Losartan 02398834 JPC ADEFGVW Losartan 02388863 SAS ADEFGVW Losartan 02388790 SIV ADEFGVW Mint-Losartan 02405733 MNT ADEFGVW Mylan-Losartan 02368277 MYL ADEFGVW pms-losartan 02309750 PMS ADEFGVW Ran-Losartan (Disc/Non-Disp Jan 19/17) 02404451 RAN ADEFGVW Sandoz Losartan 02313332 SDZ ADEFGVW Teva-Losartan 02380838 TEV ADEFGVW Tab Orl 50mg Cozaar 02182874 FRS ADEFGVW Act Losartan 02354837 ATV ADEFGVW Apo-Losartan 02353504 APX ADEFGVW Auro-Losartan 02403331 ARO ADEFGVW Jamp-Losartan 02398842 JPC ADEFGVW Losartan 02388871 SAS ADEFGVW Losartan 02388804 SIV ADEFGVW Mint-Losartan 02405741 MNT ADEFGVW Mylan-Losartan 02368285 MYL ADEFGVW pms-losartan 02309769 PMS ADEFGVW Ran-Losartan (Disc/Non-Disp Jan 19/17) 02404478 RAN ADEFGVW Sandoz Losartan 02313340 SDZ ADEFGVW Teva-Losartan 02357968 TEV ADEFGVW Tab Orl 100mg Cozaar 02182882 FRS ADEFGVW Act Losartan 02354845 ATV ADEFGVW Apo-Losartan 02353512 APX ADEFGVW Auro-Losartan 02403358 ARO ADEFGVW Jamp-Losartan 02398850 JPC ADEFGVW Losartan 02388898 SAS ADEFGVW Losartan 02388812 SIV ADEFGVW Mint-Losartan 02405768 MNT ADEFGVW Mylan-Losartan 02368293 MYL ADEFGVW pms-losartan 02309777 PMS ADEFGVW Ran-Losartan (Disc/Non-Disp Jan 19/17) 02404486 RAN ADEFGVW Sandoz Losartan 02313359 SDZ ADEFGVW Teva-Losartan 02357976 TEV ADEFGVW September 2015 v.1 65

C09CA02 C09CA03 EPROSARTAN ÉPROSARTAN Tab Orl 400mg Teveten 02240432 BGP ADEFGVW Tab Orl 600mg Teveten 02243942 BGP ADEFGVW VALSARTAN VALSARTAN Tab Orl 40mg Diovan 02270528 NVR ADEFGVW Act Valsartan 02337487 ATV ADEFGVW Apo-Valsartan 02371510 APX ADEFGVW Auro-Valsartan 02414201 ARO ADEFGVW Mylan- Valsartan 02383527 MYL ADEFGVW pms-valsartan 02312999 PMS ADEFGVW Ran-Valsartan 02363062 RAN ADEFGVW Sandoz Valsartan 02356740 SDZ ADEFGVW Teva-Valsartan 02356643 TEV ADEFGVW Valsartan 02366940 SAS ADEFGVW Valsartan 02384523 SIV ADEFGVW Tab Orl 80mg Diovan 02244781 NVR ADEFGVW Act Valsartan 02337495 ATV ADEFGVW Apo-Valsartan 02371529 APX ADEFGVW Auro-Valsartan 02414228 ARO ADEFGVW Mylan-Valsartan 02383535 MYL ADEFGVW pms-valsartan 02313006 PMS ADEFGVW Ran-Valsartan 02363100 RAN ADEFGVW Sandoz Valsartan 02356759 SDZ ADEFGVW Teva-Valsartan 02356651 TEV ADEFGVW Valsartan 02366959 SAS ADEFGVW Valsartan 02384531 SIV ADEFGVW Tab Orl 160mg Diovan 02244782 NVR ADEFGVW Act Valsartan 02337509 ATV ADEFGVW Apo-Valsartan 02371537 APX ADEFGVW Auro-Valsartan 02414236 ARO ADEFGVW Mylan- Valsartan 02383543 MYL ADEFGVW pms-valsartan 02313014 PMS ADEFGVW Ran-Valsartan 02363119 RAN ADEFGVW Sandoz Valsartan 02356767 SDZ ADEFGVW Teva-Valsartan 02356678 TEV ADEFGVW Valsartan 02366967 SAS ADEFGVW Valsartan 02384558 SIV ADEFGVW September 2015 v.1 66

C09CA03 C09CA04 VALSARTAN VALSARTAN Tab Orl 320mg Diovan 02289504 NVR ADEFGVW Act Valsartan 02337517 ATV ADEFGVW Apo-Valsartan 02371545 APX ADEFGVW Mylan- Valsartan 02383551 MYL ADEFGVW pms-valsartan 02344564 PMS ADEFGVW Sandoz Valsartan 02356775 SDZ ADEFGVW Teva-Valsartan 02356686 TEV ADEFGVW Valsartan 02366975 SAS ADEFGVW Valsartan 02384566 SIV ADEFGVW IRBESARTAN IRBESARTAN Tab Orl 75mg Avapro 02237923 SAV ADEFGVW Act Irbesartan 02328070 ATV ADEFGVW Apo-Irbesartan 02386968 APX ADEFGVW Auro-Irbesartan 02406098 ARO ADEFGVW Irbesartan 02372347 SAS ADEFGVW Irbesartan 02385287 SIV ADEFGVW Jamp-Irbesartan 02418193 JPC ADEFGVW Mint-Irbesartan 02422980 MNT ADEFGVW Mylan-Irbesartan 02347296 MYL ADEFGVW pms-irbesartan 02317060 PMS ADEFGVW Ran-Irbesartan 02406810 RAN ADEFGVW ratio-irbesartan 02316390 TEV ADEFGVW Sandoz Irbesartan 02328461 SDZ ADEFGVW Teva-Irbesartan (Disc/non disp Oct 3/16) 02315971 TEV ADEFGVW Tab Orl 150mg Avapro 02237924 SAV ADEFGVW Act Irbesartan 02328089 ATV ADEFGVW Apo-Irbesartan 02386976 APX ADEFGVW Auro-Irbesartan 02406101 ARO ADEFGVW Irbesartan 02372371 SAS ADEFGVW Irbesartan 02385295 SIV ADEFGVW Jamp-Irbesartan 02418207 JPC ADEFGVW Mint-Irbesartan 02422999 MNT ADEFGVW Mylan-Irbesartan 02347318 MYL ADEFGVW pms-irbesartan 02317079 PMS ADEFGVW Ran-Irbesartan 02406829 RAN ADEFGVW ratio-irbesartan 02316404 TEV ADEFGVW Sandoz Irbesartan 02328488 SDZ ADEFGVW Teva-Irbesartan 02315998 TEV ADEFGVW September 2015 v.1 67

C09CA04 C09CA06 IRBESARTAN IRBESARTAN Tab Orl 300mg Avapro 02237925 SAV ADEFGVW Apo-Irbesartan 02386984 APX ADEFGVW Auro-Irbesartan 02406128 ARO ADEFGVW Co Irbesartan 02328100 COB ADEFGVW Irbesartan 02372398 SAS ADEFGVW Irbesartan 02385309 SIV ADEFGVW Jamp-Irbesartan 02418215 JPC ADEFGVW Mint-Irbesartan 02423006 MNT ADEFGVW Mylan-Irbesartan 02347326 MYL ADEFGVW pms-irbesartan 02317087 PMS ADEFGVW Ran-Irbesartan 02406837 RAN ADEFGVW ratio-irbesartan 02316412 TEV ADEFGVW Sandoz Irbesartan 02328496 SDZ ADEFGVW Teva-Irbesartan (Disc/non disp Sept 25/16) 02316005 TEV ADEFGVW CANDESARTAN CANDÉSARTAN Tab Orl 4mg Atacand 02239090 AZE ADEFGVW Apo-Candesartan 02365340 APX ADEFGVW Candesartan 02388901 SAS ADEFGVW Candesartan 02388693 SIV ADEFGVW Candesartan Cilexetil 02379260 AHI ADEFGVW Co Candesartan 02376520 COB ADEFGVW Jamp-Candesartan 02386496 JPC ADEFGVW Mylan-Candesartan 02379120 MYL ADEFGVW pms-candesartan 02391171 PMS ADEFGVW Ran-Candesartan 02380684 RAN ADEFGVW Sandoz Candesartan 02326957 SDZ ADEFGVW Tab Orl 8mg Atacand 02239091 AZE ADEFGVW Apo-Candesartan 02365359 APX ADEFGVW Candesartan 02388928 SAS ADEFGVW Candesartan 02388707 SIV ADEFGVW Candesartan Cilexetil 02379279 AHI ADEFGVW Co Candesartan 02376539 COB ADEFGVW Jamp-Candesartan 02386518 JPC ADEFGVW Mylan-Candesartan 02379139 MYL ADEFGVW pms-candesartan 02391198 PMS ADEFGVW Ran-Candesartan 02380692 RAN ADEFGVW Sandoz Candesartan 02326965 SDZ ADEFGVW Teva-Candesartan 02366312 TEV ADEFGVW September 2015 v.1 68

C09CA06 C09CA07 CANDESARTAN CANDÉSARTAN Tab Orl 16mg Atacand 02239092 AZE ADEFGVW Apo-Candesartan 02365367 APX ADEFGVW Candesartan 02388936 SAS ADEFGVW Candesartan 02388715 SIV ADEFGVW Candesartan Cilexetil 02379287 AHI ADEFGVW Co Candesartan 02376547 COB ADEFGVW Jamp-Candesartan 02386526 JPC ADEFGVW Mylan-Candesartan 02379147 MYL ADEFGVW pms-candesartan 02391201 PMS ADEFGVW Ran-Candesartan 02380706 RAN ADEFGVW Sandoz Candesartan 02326973 SDZ ADEFGVW Teva-Candesartan 02366320 TEV ADEFGVW Tab Orl 32mg Atacand 02311658 AZE ADEFGVW Apo-Candesartan 02399105 APX ADEFGVW Candesartan 02435845 SAS ADEFGVW Candesartan Cilexetil 02379295 AHI ADEFGVW Co Candesartan 02376555 COB ADEFGVW Jamp-Candesartan 02386534 JPC ADEFGVW Mylan-Candesartan 02379155 MYL ADEFGVW pms-candesartan 02391228 PMS ADEFGVW Ran-Candesartan 02380714 RAN ADEFGVW Sandoz Candesartan 02392267 SDZ ADEFGVW Sandoz Candesartan 02417340 SDZ ADEFGVW Teva-Candesartan 02366339 TEV ADEFGVW TELMISARTAN TELMISARTAN Tab Orl 40mg Micardis 02240769 BOE ADEFGVW Act Telmisartan 02393247 ATV ADEFGVW Apo-Telmisartan 02420082 APX ADEFGVW Mylan-Telmisartan 02376717 MYL ADEFGVW pms-telmisartan (Disc/Non-Disp Feb 25/17) 02391236 PMS ADEFGVW Sandoz Telmisartan 02375958 SDZ ADEFGVW Telmisartan 02407485 AHI ADEFGVW Telmisartan 02432897 PMS ADEFGVW Telmisartan 02388944 SAS ADEFGVW Telmisartan 02390345 SIV ADEFGVW Teva-Telmisartan 02320177 TEV ADEFGVW September 2015 v.1 69

C09CA07 C09CA08 TELMISARTAN TELMISARTAN Tab Orl 80mg Micardis 02240770 BOE ADEFGVW Act Telmisartan 02393255 ATV ADEFGVW Apo-Telmisartan 02420090 APX ADEFGVW Mylan-Telmisartan 02376725 MYL ADEFGVW pms-telmisartan(disc/non-disp Feb 25/17) 02391244 PMS ADEFGVW Sandoz Telmisartan 02375966 SDZ ADEFGVW Telmisartan 02407493 AHI ADEFGVW Telmisartan 02432900 PMS ADEFGVW Telmisartan 02388952 SAS ADEFGVW Telmisartan 02390353 SIV ADEFGVW Teva-Telmisartan 02320185 TEV ADEFGVW OLMESARTAN MEDOXOMIL OLMÉSARTAN MÉDOXOMIL Tab Orl 20mg Olmetec 02318660 FRS ADEFGVW Tab Orl 40mg Olmetec 02318679 FRS ADEFGVW C09D C09DA ANGIOTENSIN II ANTAGONISTS, COMBINATIONS ANTAGONISTES DE L ANGIOTENSINE II, EN COMBINAISON ANGIOTENSIN II ANTAGONISTS AND DIURETICS ANTAGONISTES DE L ANGIOTENSINE II ET DIURÉTIQUES C09DA01 LOSARTAN AND DIURETICS LOSARTAN ET DIURÉTIQUES LOSARTAN / HYDROCHLOROTHIAZIDE LOSARTAN / HYDROCHLOROTHIAZIDE Tab Orl 50mg/12.5mg Hyzaar 02230047 FRS ADEFGVW Act Losartan/HCT 02388251 ATV ADEFGVW Apo-Losartan HCTZ 02371235 APX ADEFGVW Jamp-Losartan HCTZ 02408244 JPC ADEFGVW Losartan HCT 02388960 SIV ADEFGVW Losartan/HCTZ 02427648 SAS ADEFGVW Mint-Losartan/HCTZ 02389657 MNT ADEFGVW Mylan-Losartan HCTZ 02378078 MYL ADEFGVW pms-losartan-hctz 02392224 PMS ADEFGVW Sandoz Losartan HCT 02313375 SDZ ADEFGVW Teva-Losartan HCTZ 02358263 TEV ADEFGVW Tab Orl 100mg/12.5mg Hyzaar 02297841 FRS ADEFGVW Act Losartan/HCT 02388278 ATV ADEFGVW Apo-Losartan HCTZ 02371243 APX ADEFGVW Losartan HCT 02388979 SIV ADEFGVW Losartan/HCTZ 02427656 SAS ADEFGVW Mint-Losartan/HCTZ 02389665 MNT ADEFGVW Mylan-Losartan HCTZ 02378086 MYL ADEFGVW pms-losartan-hctz 02392232 PMS ADEFGVW Sandoz Losartan HCT 02362449 SDZ ADEFGVW Teva-Losartan HCTZ 02377144 TEV ADEFGVW September 2015 v.1 70

C09DA01 C09DA02 C09DA03 LOSARTAN AND DIURETICS LOSARTAN ET DIURÉTIQUES LOSARTAN / HYDROCHLOROTHIAZIDE LOSARTAN / HYDROCHLOROTHIAZIDE Tab Orl 100mg/25mg Hyzaar DS 02241007 FRS ADEFGVW Act Losartan/HCT 02388286 ATV ADEFGVW Apo-Losartan HCTZ 02371251 APX ADEFGVW Jamp-Losartan HCTZ 02408252 JPC ADEFGVW Losartan HCT 02388987 SIV ADEFGVW Losartan/HCTZ 02427664 SAS ADEFGVW Mint-Losartan/HCTZ DS 02389673 MNT ADEFGVW Mylan-Losartan HCTZ 02378094 MYL ADEFGVW pms-losartan-hctz 02392240 PMS ADEFGVW Sandoz Losartan HCT 02313383 SDZ ADEFGVW Teva-Losartan HCTZ 02377152 TEV ADEFGVW EPROSARTAN AND DIURETICS ÉPROSARTAN ET DIURÉTIQUES EPROSARTAN / HYDROCHLOROTHIAZIDE ÉPROSARTAN / HYDROCHLOROTHIAZIDE Tab Orl 600mg/12.5mg Teveten Plus 02253631 BGP ADEFGVW VALSARTAN AND DIURETICS VALSARTAN ET DIURÉTIQUES VALSARTAN / HYDROCHLOROTHIAZIDE VALSARTAN / HYDROCHLOROTHIAZIDE Tab Orl 80mg/12.5mg Diovan HCT 02241900 NVR ADEFGVW Apo-Valsartan/HCTZ 02382547 APX ADEFGVW Auro-Valsartan HCT 02408112 ARO ADEFGVW Mylan-Valsartan HCTZ 02373734 MYL ADEFGVW Sandoz Valsartan HCT 02356694 SDZ ADEFGVW Teva-Valsartan/ HCTZ 02356996 TEV ADEFGVW Valsartan/HCTZ 02367009 SAS ADEFGVW Valsartan HCT 02384736 SIV ADEFGVW Tab Orl 160mg/12.5mg Diovan HCT 02241901 NVR ADEFGVW Apo-Valsartan/HCTZ 02382555 APX ADEFGVW Auro-Valsartan HCT 02408120 ARO ADEFGVW Mylan-Valsartan HCTZ 02373742 MYL ADEFGVW Sandoz Valsartan HCT 02356708 SDZ ADEFGVW Teva-Valsartan/ HCTZ 02357003 TEV ADEFGVW Valsartan/HCTZ 02367017 SAS ADEFGVW Valsartan HCT 02384744 SIV ADEFGVW September 2015 v.1 71

C09DA03 VALSARTAN AND DIURETICS VALSARTAN ET DIURÉTIQUES VALSARTAN / HYDROCHLOROTHIAZIDE VALSARTAN / HYDROCHLOROTHIAZIDE Tab Orl 160mg/25mg Diovan HCT 02246955 NVR ADEFGVW Apo-Valsartan/HCTZ 02382563 APX ADEFGVW Auro-Valsartan HCT 02408139 ARO ADEFGVW Mylan-Valsartan HCTZ 02373750 MYL ADEFGVW Sandoz Valsartan HCT 02356716 SDZ ADEFGVW Teva-Valsartan/ HCTZ 02357011 TEV ADEFGVW Valsartan/HCTZ 02367025 SAS ADEFGVW Valsartan HCT 02384752 SIV ADEFGVW Tab Orl 320mg/12.5mg Diovan HCT 02308908 NVR ADEFGVW Apo-Valsartan/HCTZ 02382571 APX ADEFGVW Auro-Valsartan HCT 02408147 ARO ADEFGVW Mylan-Valsartan HCTZ 02373769 MYL ADEFGVW Sandoz Valsartan HCT 02356724 SDZ ADEFGVW Teva-Valsartan/ HCTZ 02357038 TEV ADEFGVW Valsartan/HCTZ 02367033 SAS ADEFGVW Tab Orl 320mg/25mg Diovan HCT 02308916 NVR ADEFGVW Apo-Valsartan/HCTZ 02382598 APX ADEFGVW Auro-Valsartan HCT 02408155 ARO ADEFGVW Mylan-Valsartan HCTZ 02373777 MYL ADEFGVW Sandoz Valsartan HCT 02356732 SDZ ADEFGVW Teva-Valsartan/ HCTZ 02357046 TEV ADEFGVW Valsartan/HCTZ 02367041 SAS ADEFGVW C09DA04 IRBESARTAN AND DIURETICS IRBESARTAN ET DIURÉTIQUES IRBESARTAN / HYDROCHLOROTHIAZIDE IRBESARTAN / HYDROCHLOROTHIAZIDE Tab Orl 150mg/12.5mg Avalide 02241818 SAV ADEFGVW Act Irbesartan HCT 02357399 ATV ADEFGVW Apo-Irbesartan/HCTZ 02387646 APX ADEFGVW Irbesartan/HCTZ 02372886 SAS ADEFGVW Irbesartan HCT 02385317 SIV ADEFGVW Jamp-Irbesartan/Hydrochlorothiazide 02418223 JPC ADEFGVW Mint-Irbesartan/HCTZ 02392992 MNT ADEFGVW pms-irbesartan HCTZ 02328518 PMS ADEFGVW Ran-Irbesartan HCTZ 02363208 RAN ADEFGVW ratio-irbesartan HCTZ 02330512 TEV ADEFGVW Sandoz Irbesartan HCT 02337428 SDZ ADEFGVW Teva-Irbesartan HCTZ 02316013 TEV ADEFGVW September 2015 v.1 72

C09DA04 C09DA06 IRBESARTAN AND DIURETICS IRBESARTAN ET DIURÉTIQUES IRBESARTAN / HYDROCHLOROTHIAZIDE IRBESARTAN / HYDROCHLOROTHIAZIDE Tab Orl 300mg/12.5mg Avalide 02241819 SAV ADEFGVW Act Irbesartan HCT 02357402 ATV ADEFGVW Apo-Irbesartan/HCTZ 02387654 APX ADEFGVW Irbesartan/HCTZ 02372894 SAS ADEFGVW Irbesartan HCT 02385325 SIV ADEFGVW Jamp-Irbesartan/Hydrochlorothiazide 02418231 JPC ADEFGVW Mint-Irbesartan/HCTZ 02393018 MNT ADEFGVW pms-irbesartan HCTZ 02328526 PMS ADEFGVW Ran-Irbesartan HCTZ 02363216 RAN ADEFGVW ratio-irbesartan HCTZ 02330520 TEV ADEFGVW Sandoz Irbesartan HCT 02337436 SDZ ADEFGVW Teva-Irbesartan HCTZ 02316021 TEV ADEFGVW Tab Orl 300mg/25mg Act Irbesartan HCT 02357410 ATV ADEFGVW Apo-Irbesartan/HCTZ 02387662 APX ADEFGVW Irbesartan/HCTZ 02372908 SAS ADEFGVW Irbesartan HCT 02385333 SIV ADEFGVW Jamp-Irbesartan/Hydrochlorothiazide 02418258 JPC ADEFGVW Mint-Irbesartan/HCTZ 02393026 MNT ADEFGVW pms-irbesartan HCTZ 02328534 PMS ADEFGVW Ran-Irbesartan HCTZ 02363224 RAN ADEFGVW ratio-irbesartan HCTZ 02330539 TEV ADEFGVW Sandoz Irbesartan HCT 02337444 SDZ ADEFGVW Teva-Irbesartan HCTZ 02316048 TEV ADEFGVW CANDESARTAN AND DIURETICS CANDÉSARTAN ET DIURÉTIQUES CANDESARTAN / HYDROCHLOROTHIAZIDE CANDÉSARTAN / HYDROCHLOROTHIAZIDE Tab Orl 16mg/12.5mg Atacand Plus 02244021 AZE ADEFGVW Act Candesartan/HCT 02388650 ATV ADEFGVW Apo-Candesartan/HCTZ 02367866 APX ADEFGVW Candesartan HCT 02394812 SIV ADEFGVW Candesartan/HCTZ 02394804 SAS ADEFGVW Mylan-Candesartan HCTZ 02374897 MYL ADEFGVW pms-candesartan-hctz 02391295 PMS ADEFGVW Sandoz Candesartan Plus 02327902 SDZ ADEFGVW Teva-Candesartan/HCTZ 02395541 TEV ADEFGVW Tab Orl 32mg/12.5mg Atacand Plus 02332922 AZE ADEFGVW Apo-Candesartan/HCTZ 02395126 APX ADEFGVW Sandoz Candesartan Plus 02420732 SDZ ADEFGVW Teva-Candesartan/HCTZ 02395568 TEV ADEFGVW Tab Orl 32mg/25mg Atacand Plus 02332957 AZE ADEFGVW Apo-Candesartan/HCTZ 02395134 APX ADEFGVW Sandoz Candesartan Plus 02420740 SDZ ADEFGVW September 2015 v.1 73

C09DA07 C09DA08 TELMISARTAN AND DIURETICS TELMISARTAN ET DIURÉTIQUES TELMISARTAN / HYDROCHLOROTHIAZIDE TELMISARTAN / HYDROCHLOROTHIAZIDE Tab Orl 80mg/12.5mg Micardis Plus 02244344 BOE ADEFGVW Act Telmisartan/HCT 02393263 ATV ADEFGVW Mylan-telmisartan HCTZ 02373564 MYL ADEFGVW pms-telmisartan/hctz 02401665 PMS ADEFGVW Sandoz Telmisartan HCT 02393557 SDZ ADEFGVW Telmisartan/HCTZ 02395355 SAS ADEFGVW Telmisartan HCTZ 02390302 SIV ADEFGVW Telmisartan-HCTZ 02433214 PMS ADEFGVW Teva-telmisartan HCTZ 02330288 TEV ADEFGVW Tab Orl 80mg/25mg Micardis Plus 02318709 BOE ADEFGVW Act Telmisartan/HCT 02393271 ATV ADEFGVW Mylan-telmisartan HCTZ 02373572 MYL ADEFGVW pms-telmisartan/hctz 02401673 PMS ADEFGVW Sandoz Telmisartan HCT 02393565 SDZ ADEFGVW Telmisartan/HCTZ 02395363 SAS ADEFGVW Telmisartan HCTZ 02390310 SIV ADEFGVW Telmisartan-HCTZ 02433222 PMS ADEFGVW Teva-telmisartan HCTZ 02379252 TEV ADEFGVW OLMESARTAN AND DIURETICS OLMÉSARTAN ET DIURÉTIQUES OLMESARTAN / HYDROCHLOROTHIAZIDE OLMÉSARTAN / HYDROCHLOROTHIAZIDE Tab Orl 20mg/12.5mg Olmetec Plus 02319616 FRS ADEFGVW Tab Orl 40mg/12.5mg Olmetec Plus 02319624 FRS ADEFGVW C09DB C09DB04 Tab Orl 40mg/25mg Olmetec Plus 02319632 FRS ADEFGVW ANGIOTENSIN II ANTAGONISTS AND CALCIUM CHANNEL BLOCKERS ANTAGONISTES DE L ANGIOTENSINE II ET ANTAGONISTES DU CALCIUM TELMISARTAN AND AMLODIPINE TELMISARTAN ET AMLODIPINE Tab Orl 40mg/5mg Twynsta 02371022 BOE ADEFGVW Tab Orl 40mg/10mg Twynsta 02371030 BOE ADEFGVW Tab Orl 80mg/5mg Twynsta 02371049 BOE ADEFGVW September 2015 v.1 74

C10 C10A C09DB04 C10AA C10AA01 TELMISARTAN AND AMLODIPINE TELMISARTAN ET AMLODIPINE Tab Orl 80mg/10mg Twynsta 02371057 BOE ADEFGVW LIPID MODIFYING AGENTS AGENTS RÉDUISANT LES LIPIDES SÉRIQUES LIPID MODIFYING AGENTS, PLAIN AGENTS RÉDUISANT LES LIPIDES SÉRIQUES, ORDINAIRES HMG COA REDUCTASE INHIBITORS INHIBITEURS DU HMG COA-REDUCTASE SIMVASTATIN SIMVASTATINE Tab Orl 5mg Zocor 00884324 FRS ADEFGVW Act Simvastatin 02248103 ATV ADEFGVW Apo-Simvastatin 02247011 APX ADEFGVW Auro-Simvastatin 02405148 ARO ADEFGVW Jamp-Simvastatin 02375591 JPC ADEFGVW Mar-Simvastatin 02375036 MAR ADEFGVW Mint-Simvastatin 02372932 MNT ADEFGVW Mylan-Simvastatin 02246582 MYL ADEFGVW pms-simvastatin 02269252 PMS ADEFGVW Ran-Simvastatin 02329131 RAN ADEFGVW Simvastatin 02284723 SAS ADEFGVW Simvastatin 02386291 SIV ADEFGVW Teva-Simvastatin 02250144 TEV ADEFGVW Tab Orl 10mg Zocor 00884332 FRS ADEFGVW Act Simvastatin 02248104 ATV ADEFGVW Apo-Simvastatin 02247012 APX ADEFGVW Auro-Simvastatin 02405156 ARO ADEFGVW Jamp-Simvastatin 02375605 JPC ADEFGVW Mar-Simvastatin 02375044 MAR ADEFGVW Mint-Simvastatin 02372940 MNT ADEFGVW Mylan-Simvastatin 02246583 MYL ADEFGVW pms-simvastatin 02269260 PMS ADEFGVW Ran-Simvastatin 02329158 RAN ADEFGVW Simvastatin 02284731 SAS ADEFGVW Simvastatin 02386305 SIV ADEFGVW Teva-Simvastatin 02250152 TEV ADEFGVW September 2015 v.1 75

C10AA01 SIMVASTATIN SIMVASTATINE Tab Orl 20mg Zocor 00884340 FRS ADEFGVW Act Simvastatin 02248105 ATV ADEFGVW Apo-Simvastatin 02247013 APX ADEFGVW Auro-Simvastatin 02405164 ARO ADEFGVW Jamp-Simvastatin 02375613 JPC ADEFGVW Mar-Simvastatin 02375052 MAR ADEFGVW Mint-Simvastatin 02372959 MNT ADEFGVW Mylan-Simvastatin 02246737 MYL ADEFGVW pms-simvastatin 02269279 PMS ADEFGVW Ran-Simvastatin 02329166 RAN ADEFGVW Simvastatin 02284758 SAS ADEFGVW Simvastatin 02386313 SIV ADEFGVW Teva-Simvastatin 02250160 TEV ADEFGVW Tab Orl 40mg Zocor 00884359 FRS ADEFGVW Act Simvastatin 02248106 ATV ADEFGVW Apo-Simvastatin 02247014 APX ADEFGVW Auro-Simvastatin 02405172 ARO ADEFGVW Jamp-Simvastatin 02375621 JPC ADEFGVW Mar-Simvastatin 02375060 MAR ADEFGVW Mint-Simvastatin 02372967 MNT ADEFGVW Mylan-Simvastatin 02246584 MYL ADEFGVW pms-simvastatin 02269287 PMS ADEFGVW Ran-Simvastatin 02329174 RAN ADEFGVW Simvastatin 02284766 SAS ADEFGVW Simvastatin 02386321 SIV ADEFGVW Teva-Simvastatin 02250179 TEV ADEFGVW Tab Orl 80mg Zocor (Disc/non disp May 06/16) 02240332 FRS ADEFGVW Act Simvastatin 02248107 ATV ADEFGVW Apo-Simvastatin 02247015 APX ADEFGVW Auro-Simvastatin 02405180 ARO ADEFGVW Jamp-Simvastatin 02375648 JPC ADEFGVW Mar-Simvastatin 02375079 MAR ADEFGVW Mint-Simvastatin 02372975 MNT ADEFGVW Mylan-Simvastatin 02246585 MYL ADEFGVW pms-simvastatin 02269295 PMS ADEFGVW Ran-Simvastatin 02329182 RAN ADEFGVW Simvastatin 02284774 SAS ADEFGVW Simvastatin 02386348 SIV ADEFGVW Teva-Simvastatin 02250187 TEV ADEFGVW September 2015 v.1 76

C10AA02 LOVASTATIN LOVASTATINE Tab Orl 20mg Mevacor (Disc/non disp. Jun 06/16) 00795860 FRS ADEFGVW Apo-Lovastatin 02220172 APX ADEFGVW Act Lovastatin 02248572 ATV ADEFGVW Lovastatin 02353229 SAS ADEFGVW Mylan-Lovastatin 02243127 MYL ADEFGVW pms-lovastatin 02246013 PMS ADEFGVW Sandoz Lovastatin (Disc/non disp Nov 15/15) 02247056 SDZ ADEFGVW Teva-Lovastatin 02246542 TEV ADEFGVW Tab Orl 40mg Mevacor (Disc/non disp. Jun 06/16) 00795852 FRS ADEFGVW Apo-Lovastatin 02220180 APX ADEFGVW Act Lovastatin 02248573 ATV ADEFGVW Lovastatin 02353237 SAS ADEFGVW Mylan-Lovastatin 02243129 MYL ADEFGVW pms-lovastatin 02246014 PMS ADEFGVW Sandoz Lovastatin (Disc/non disp Nov 15/15) 02247057 SDZ ADEFGVW Teva-Lovastatin 02246543 TEV ADEFGVW C10AA03 PRAVASTATIN PRAVASTATINE Tab Orl 10mg Apo-Pravastatin 02243506 APX ADEFGVW Co Pravastatin 02248182 COB ADEFGVW Jamp-Pravastatin 02330954 JPC ADEFGVW Mint-Pravastatin 02317451 MNT ADEFGVW Mylan-Pravastatin 02257092 MYL ADEFGVW pms-pravastatin 02247655 PMS ADEFGVW Pravastatin 02356546 SAS ADEFGVW Pravastatin 02389703 SIV ADEFGVW Ran-Pravastatin 02284421 RAN ADEFGVW Sandoz Pravastatin (Disc/non disp Dec 31/16) 02247856 SDZ ADEFGVW Teva-Pravastatin 02247008 TEV ADEFGVW Tab Orl 20mg Pravachol 00893757 BRI ADEFGVW Apo-Pravastatin 02243507 APX ADEFGVW Co Pravastatin 02248183 COB ADEFGVW Jamp-Pravastatin 02330962 JPC ADEFGVW Mint-Pravastatin 02317478 MNT ADEFGVW Mylan-Pravastatin 02257106 MYL ADEFGVW pms-pravastatin 02247656 PMS ADEFGVW Pravastatin 02356554 SAS ADEFGVW Pravastatin 02389738 SIV ADEFGVW Ran-Pravastatin 02284448 RAN ADEFGVW Sandoz Pravastatin (Disc/non disp Dec 31/16) 02247857 SDZ ADEFGVW Teva-Pravastatin 02247009 TEV ADEFGVW September 2015 v.1 77

C10AA03 C10AA04 PRAVASTATIN PRAVASTATINE Tab Orl 40mg Pravachol 02222051 BRI ADEFGVW Apo-Pravastatin 02243508 APX ADEFGVW Co Pravastatin 02248184 COB ADEFGVW Jamp-Pravastatin 02330970 JPC ADEFGVW Mint-Pravastatin 02317486 MNT ADEFGVW Mylan-Pravastatin 02257114 MYL ADEFGVW pms-pravastatin 02247657 PMS ADEFGVW Pravastatin 02356562 SAS ADEFGVW Pravastatin 02389746 SIV ADEFGVW Ran-Pravastatin 02284456 RAN ADEFGVW Sandoz Pravastatin 02247858 SDZ ADEFGVW Teva-Pravastatin 02247010 TEV ADEFGVW FLUVASTATIN FLUVASTATINE Cap Orl 20mg Lescol 02061562 NVR ADEFGVW Caps Sandoz Fluvastatin 02400235 SDZ ADEFGVW Teva-Fluvastatin 02299224 TEV ADEFGVW Cap Orl 40mg Lescol 02061570 NVR ADEFGVW Caps Sandoz Fluvastatin 02400243 SDZ ADEFGVW Teva-Fluvastatin 02299232 TEV ADEFGVW C10AA05 SRT Orl 80mg Lescol XL 02250527 NVR ADEFGVW L.L ATORVASTATIN ATORVASTATINE Tab Orl 10mg Lipitor 02230711 PFI ADEFGVW Act Atorvastatin 02310899 ATV ADEFGVW Apo-Atorvastatin 02295261 APX ADEFGVW Atorvastatin 02348705 SAS ADEFGVW Atorvastatin 02411350 SIV ADEFGVW Auro-Atorvastatin 02407256 ARO ADEFGVW GD-Atorvastatin 02288346 GMD ADEFGVW Jamp-Atorvastatin 02391058 JPC ADEFGVW Mylan-Atorvastatin 02392933 MYL ADEFGVW Novo-Atorvastatin 02302675 TEV ADEFGVW pms-atorvastatin 02399377 PMS ADEFGVW Ran-Atorvastatin 02313707 RAN ADEFGVW ratio-atorvastatin 02350297 TEV ADEFGVW Sandoz Atorvastatin 02324946 SDZ ADEFGVW September 2015 v.1 78

C10AA05 ATORVASTATIN ATORVASTATINE Tab Orl 20mg Lipitor 02230713 PFI ADEFGVW Act Atorvastatin 02310902 ATV ADEFGVW Apo-Atorvastatin 02295288 APX ADEFGVW Atorvastatin 02348713 SAS ADEFGVW Atorvastatin 02411369 SIV ADEFGVW Auro-Atorvastatin 02407264 ARO ADEFGVW GD-Atorvastatin 02288354 GMD ADEFGVW Jamp-Atorvastatin 02391066 JPC ADEFGVW Mylan-Atorvastatin 02392941 MYL ADEFGVW Novo-Atorvastatin 02302683 TEV ADEFGVW pms-atorvastatin 02399385 PMS ADEFGVW Ran-Atorvastatin 02313715 RAN ADEFGVW ratio-atorvastatin 02350319 TEV ADEFGVW Sandoz Atorvastatin 02324954 SDZ ADEFGVW Tab Orl 40mg Lipitor 02230714 PFI ADEFGVW Act Atorvastatin 02310910 ATV ADEFGVW Apo-Atorvastatin 02295296 APX ADEFGVW Atorvastatin 02348721 SAS ADEFGVW Atorvastatin 02411377 SIV ADEFGVW Auro-Atorvastatin 02407272 ARO ADEFGVW GD-Atorvastatin 02288362 GMD ADEFGVW Jamp-Atorvastatin 02391074 JPC ADEFGVW Mylan-Atorvastatin 02392968 MYL ADEFGVW Novo-Atorvastatin 02302691 TEV ADEFGVW pms-atorvastatin 02399393 PMS ADEFGVW Ran-Atorvastatin 02313723 RAN ADEFGVW ratio-atorvastatin 02350327 TEV ADEFGVW Sandoz Atorvastatin 02324962 SDZ ADEFGVW Tab Orl 80mg Lipitor 02243097 PFI ADEFGVW Apo-Atorvastatin 02295318 APX ADEFGVW Act Atorvastatin 02310929 ATV ADEFGVW Atorvastatin 02348748 SAS ADEFGVW Atorvastatin 02411385 SIV ADEFGVW Auro-Atorvastatin 02407280 ARO ADEFGVW GD-Atorvastatin 02288370 GMD ADEFGVW Jamp-Atorvastatin 02391082 JPC ADEFGVW Mylan-Atorvastatin 02392976 MYL ADEFGVW Novo-Atorvastatin 02302713 TEV ADEFGVW pms-atorvastatin 02399407 PMS ADEFGVW Ran-Atorvastatin 02313758 RAN ADEFGVW ratio-atorvastatin 02350335 TEV ADEFGVW Sandoz Atorvastatin 02324970 SDZ ADEFGVW Auro-Atorvastatin 02407280 ARO ADEFGVW September 2015 v.1 79

C10AA07 ROSUVASTATIN ROSUVASTATINE Tab Orl 5mg Crestor 02265540 AZE ADEFGVW Apo-Rosuvastatin 02337975 APX ADEFGVW Co Rosuvastatin 02339765 COB ADEFGVW Jamp-Rosuvastatin 02391252 JPC ADEFGVW Mar-Rosuvastatin 02413051 MAR ADEFGVW Mint-Rosuvastatin 02397781 MNT ADEFGVW Mylan-Rosuvastatin 02381265 MYL ADEFGVW pms-rosuvastatin 02378523 PMS ADEFGVW Ran-Rosuvastatin 02382644 RAN ADEFGVW Rosuvastatin 02405628 SAS ADEFGVW Rosuvastatin 02411628 SIV ADEFGVW Sandoz Rosuvastatin 02338726 SDZ ADEFGVW Teva-Rosuvastatin 02354608 TEV ADEFGVW Tab Orl 10mg Crestor 02247162 AZE ADEFGVW Apo-Rosuvastatin 02337983 APX ADEFGVW Co Rosuvastatin 02339773 COB ADEFGVW Jamp-Rosuvastatin 02391260 JPC ADEFGVW Mar-Rosuvastatin 02413078 MAR ADEFGVW Mint-Rosuvastatin 02397803 MNT ADEFGVW Mylan-Rosuvastatin 02381273 MYL ADEFGVW pms-rosuvastatin 02378531 PMS ADEFGVW Ran-Rosuvastatin 02382652 RAN ADEFGVW Rosuvastatin 02405636 SAS ADEFGVW Rosuvastatin 02411636 SIV ADEFGVW Sandoz Rosuvastatin 02338734 SDZ ADEFGVW Teva-Rosuvastatin 02354616 TEV ADEFGVW Tab Orl 20mg Crestor 02247163 AZE ADEFGVW Apo-Rosuvastatin 02337991 APX ADEFGVW Co Rosuvastatin 02339781 COB ADEFGVW Jamp-Rosuvastatin 02391279 JPC ADEFGVW Mar-Rosuvastatin 02413086 MAR ADEFGVW Mint-Rosuvastatin 02397811 MNT ADEFGVW Mylan-Rosuvastatin 02381281 MYL ADEFGVW pms-rosuvastatin 02378558 PMS ADEFGVW Ran-Rosuvastatin 02382660 RAN ADEFGVW Rosuvastatin 02405644 SAS ADEFGVW Rosuvastatin 02411644 SIV ADEFGVW Sandoz Rosuvastatin 02338742 SDZ ADEFGVW Teva-Rosuvastatin 02354624 TEV ADEFGVW September 2015 v.1 80

C10AA07 C10AB C10AB04 ROSUVASTATIN ROSUVASTATINE Tab Orl 40mg Crestor 02247164 AZE ADEFGVW Apo-Rosuvastatin 02338009 APX ADEFGVW Co Rosuvastatin 02339803 COB ADEFGVW Jamp-Rosuvastatin 02391287 JPC ADEFGVW Mar-Rosuvastatin 02413108 MAR ADEFGVW Mint-Rosuvastatin 02397838 MNT ADEFGVW Mylan-Rosuvastatin 02381303 MYL ADEFGVW pms-rosuvastatin 02378566 PMS ADEFGVW Ran-Rosuvastatin 02382679 RAN ADEFGVW Rosuvastatin 02405652 SAS ADEFGVW Rosuvastatin 02411652 SIV ADEFGVW Sandoz Rosuvastatin 02338750 SDZ ADEFGVW Teva-Rosuvastatin 02354632 TEV ADEFGVW FIBRATES FIBRATES GEMFIBROZIL GEMFIBROZIL Tab Orl 300mg Apo-Gemfibrozil 01979574 APX ADEFGVW Mylan-Gemfibrozil 02185407 MYL ADEFGVW Teva-Gemfibrozil 02241704 TEV ADEFGVW pms-gemfibrozil 02239951 PMS ADEFGVW Tab Orl 600mg Apo-Gemfibrozil 01979582 APX ADEFGVW Mylan-Gemfibrozil 02230476 MYL ADEFGVW Teva-Gemfibrozil 02142074 TEV ADEFGVW pms-gemfibrozil (Disc/non disp Jan 31/16) 02230183 PMS ADEFGVW C10AB05 FENOFIBRATE FÉNOFIBRATE Cap Orl 100mg Apo-Fenofibrate 02225980 APX ADEFGVW Caps Cap Orl 200mg Lipidil Micro (Disc/non disp May 31/17) 02146959 ABB ADEFGVW Caps Apo-Feno-Micro 02239864 APX ADEFGVW Fenofibrate Micro(Disc/non disp Feb 27/17) 02286092 SAS ADEFGVW Mylan-Fenofibrate Micro 02240210 MYL ADEFGVW Novo-Fenofibrate Micro 02243552 TEV ADEFGVW pms-fenofibrate Micro (Disc/non disp Apr 1/16) 02273551 PMS ADEFGVW ratio-fenofibrate MC 02250039 TEV ADEFGVW Tab Orl 100mg Lipidil Supra (Disc/non disp Jan 29/16) 02241601 ABB ADEFGVW Apo-Feno-Super 02246859 APX ADEFGVW Fenofibrate S 02356570 SAS ADEFGVW Sandoz Fenofibrate S 02288044 SDZ ADEFGVW Teva-Fenofibrate-S 02289083 TEV ADEFGVW September 2015 v.1 81

C10AB05 FENOFIBRATE FÉNOFIBRATE Tab Orl 160mg Lipidil Supra 02241602 ABB ADEFGVW Apo-Feno-Super 02246860 APX ADEFGVW Fenofibrate S 02356589 SAS ADEFGVW Sandoz Fenofibrate S 02288052 SDZ ADEFGVW Teva-Fenofibrate-S 02289091 TEV ADEFGVW C10AC BILE ACID SEQUESTRANTS SEQUESTRANTS DE L ACIDE BILIAIRE C10AC01 CHOLESTYRAMINE CHOLESTYRAMINE Pws Orl 4g Packets/sachets Olestyr 00890960 PDP ADEFGVW Pds. Pws Orl 4g Packets/sachets Olestyr 02210320 PDP ADEFGVW Pds. C10AC02 COLESTIPOL COLESTIPOL Tab Orl 1g Colestid 02132680 PFI ADEFGVW Pws Orl 5g Colestid 00642975 PFI ADEFGVW Pds. Pws Orl 7.5g Colestid (Orange) 02132699 PFI ADEFGVW Pds. C10AC04 COLESEVELAM HYDROCHLORIDE COLÉSÉVÉLAM, CHLORHYDRATE DE Tab Orl 625mg Lodalis 02373955 VLN ADEFGVW C10AX OTHER LIPID MODIFYING AGENTS AUTRE AGENTS RÉDUISANT LES LIPIDES SÉRIQUES C10AX09 EZETIMIBE ÉZÉTIMIBE Tab Orl 10mg Ezetrol 02247521 FRS (SA) Act Ezetimibe 02414716 ATV (SA) Apo-Ezetimibe 02427826 APX (SA) Ezetimibe 02431300 SAS (SA) Ezetimibe 02429659 SIV (SA) Jamp- Ezetimibe 02423235 JPC (SA) Mar- Ezetimibe 02422662 MAR (SA) Mint- Ezetimibe 02423243 MNT (SA) Mylan- Ezetimibe 02378035 MYL (SA) pms- Ezetimibe 02416409 PMS (SA) Ran- Ezetimibe 02419548 RAN (SA) Sandoz- Ezetimibe 02416778 SDZ (SA) Teva- Ezetimibe 02354101 TEV (SA) September 2015 v.1 82

C10B C10BX C10BX03 LIPID MODIFYING AGENTS, COMBINATIONS AGENTS RÉDUISANT LES LIPIDES SÉRIQUES, EN COMBINAISON HMG COA REDUCTASE INHIBITORS, OTHER COMBINATIONS INHIBITEURS DE LA HMG COA RÉDUCTASE, AUTRES COMBINAISONS ATORVASTATIN AND AMLODIPINE ATORVASTATINE ET AMLODIPINE Tab Orl 5mg/10mg Caduet 02273233 PFI ADEFGVW Apo-Amlodipine-Atorvastatin 02411253 APX ADEFGVW GD-Amlodipine/Atorvastatin 02362759 GMD ADEFGVW pms-amlodipine/atorvastatin 02404222 PMS ADEFGVW Tab Orl 5mg/20mg Caduet 02273241 PFI ADEFGVW Apo-Amlodipine-Atorvastatin 02411261 APX ADEFGVW GD-Amlodipine/Atorvastatin 02362767 GMD ADEFGVW pms-amlodipine/atorvastatin 02404230 PMS ADEFGVW Tab Orl 5mg/40mg Caduet 02273268 PFI ADEFGVW Apo-Amlodipine-Atorvastatin 02411288 APX ADEFGVW GD-Amlodipine/Atorvastatin 02362775 GMD ADEFGVW Tab Orl 5mg/80mg Caduet 02273276 PFI ADEFGVW Apo-Amlodipine-Atorvastatin 02411296 APX ADEFGVW GD-Amlodipine/Atorvastatin 02362783 GMD ADEFGVW Tab Orl 10mg/10mg Caduet 02273284 PFI ADEFGVW Apo-Amlodipine-Atorvastatin 02411318 APX ADEFGVW GD-Amlodipine/Atorvastatin 02362791 GMD ADEFGVW pms-amlodipine/atorvastatin 02404249 PMS ADEFGVW Tab Orl 10mg/20mg Caduet 02273292 PFI ADEFGVW Apo-Amlodipine-Atorvastatin 02411326 APX ADEFGVW GD-Amlodipine/Atorvastatin 02362805 GMD ADEFGVW pms-amlodipine/atorvastatin 02404257 PMS ADEFGVW Tab Orl 10mg/40mg Caduet 02273306 PFI ADEFGVW Apo-Amlodipine-Atorvastatin 02411334 APX ADEFGVW GD-Amlodipine/Atorvastatin 02362813 GMD ADEFGVW Tab Orl 10mg/80mg Caduet 02273314 PFI ADEFGVW Apo-Amlodipine-Atorvastatin 02411342 APX ADEFGVW GD-Amlodipine/Atorvastatin 02362821 GMD ADEFGVW September 2015 v.1 83

D01 D01A D01AA D01AA01 D01AC D01AC01 D01AC02 D01AC08 D01AC20 D01AE D01AE14 ANTIFUNGALS FOR DERMATOLOGICAL USE ANTIFONGIQUES À USAGE DERMATOLOGIQUE ANTIFUNGALS FOR TOPICAL USE ANTIFONGIQUES POUR USAGE TOPIQUE ANTIBIOTICS ANTIBIOTIQUES NYSTATIN NYSTATINE Crm Top 100000IU Nyaderm 00716871 TAR ADEFGVW Cr. Ratio-Nystatin 02194236 RPH ADEFGVW Ont Top 100000IU Ratio-Nystatin 02194228 RPH ADEFGVW Ont IMIDAZOLE AND TRIAZOLE DERIVATIVES DÉRIVÉS DE L IMIDAZOLE ET TRIAZOLE CLOTRIMAZOLE CLOTRIMAZOLE Crm Top 1% Canesten 02150867 YNO ADEFGVW Cr. Clotrimaderm 00812382 TAR ADEFGVW MICONAZOLE MICONAZOLE Crm Top 2% Micatin 02085852 WLS ADEFGVW Cr. Monistat Derm 02126567 JNJ ADEFGVW KETOCONAZOLE KÉTOCONAZOLE Crm Top 2% Ketoderm 02245662 TPH ADEFGVW Cr. COMBINATION, TOPICAL ANTIFUNGALS (IMIDAZOLE DERVATIVES) COMBINAISON, ANTIFONGIQUES TOPIQUES (DÉRIVÉS DE L IMIDAZOLE) CLOTRIMAZOLE / BETAMETHASONE CLOTRIMAZOLE / BÉTAMÉTHASONE Crm Top 1%/0.05% Lotriderm 00611174 FRS ADEFGVW Cr. OTHER ANTIFUNGALS FOR TOPICAL USE AUTRES ANTIFONGIQUES POUR USAGE TOPIQUE CICLOPIROX CICLOPIROX Crm Top 1% Loprox 02221802 VLN ADEFGVW Cr. Lot Top 1% Loprox 02221810 VLN ADEFGVW Lot September 2015 v.1 84

D01B D01AE15 D01BA D05 D05A D01BA02 D05AA D05AA99 D05AX D05AX02 TERBINAFINE TERBINAFINE Crm Top 1% Lamisil 02031094 NVR ADEFGVW Cr. ANTIFUNGALS, SYSTEMIC PREPARATIONS ANTIFONGIQUES, PREPARATIONS SYSTEMIQUES ANTIFUNGALS FOR SYSTEMIC USE ANTIFONGIQUES POUR USAGE SYSTEMIQUE TERBINAFINE TERBINAFINE Tab Orl 250mg Lamisil 02031116 NVR (SA) Act Terbinafine 02254727 ATV (SA) Apo-Terbinafine 02239893 APX (SA) Auro-Terbinafine 02320134 ARO (SA) GD-Terbinafine (Disc/non disp Nov 30/15) 02352818 GMD (SA) Jamp-Terbinafine 02357070 JPC (SA) Mylan-Terbinafine 02242503 MYL (SA) pms-terbinafine 02294273 PMS (SA) Sandoz Terbinafine (Disc/non disp Dec 31/16) 02262177 SDZ (SA) Terbinafine 02353121 SAS (SA) Terbinafine 02385279 SIV (SA) Teva-Terbinafine 02240346 TEV (SA) ANTIPSORIATICS TRAITEMENT DU PSORIASIS ANTIPSORIATICS FOR TOPICAL USE TRAITEMENT DU PSORIASIS, POUR USAGE TOPIQUE TARS GOUDRONS TARS GOUDRONS Top 20% Odans LCD 00358495 ODN ADEFGV OTHER ANTISPORIATICS FOR TOPICAL USE AUTRES TRAITEMENTS DU PSORIASIS POUR USAGE TOPIQUE CALCIPOTRIOL CALCIPOTRIOL Crm Top 50mcg Dovonex 02150956 LEO ADEFV Cr. Ont Top 50mcg Dovonex 01976133 LEO ADEFV Ont Top 50mcg Dovonex Scalp Solution 02194341 LEO ADEFV September 2015 v.1 85

D05B D05BA D05BA02 D05BB D06 D06A D05BB02 D05AX D06AX01 D06AX07 D06AX09 ANTIPSORIATICS FOR SYSTEMIC USE TRAITEMENT DU PSORIASIS, POUR USAGE SYSTÉMIQUE PSORALENS FOR SYSTEMIC USE PSORALENES, POUR USAGE SYSTÉMIQUE METHOXSALEN MÉTHOXSALENE Cap Orl 10mg Oxsoralen 01946374 VLN ADEFGVW Caps RETINOIDS FOR TREATMENT OF PSORIASIS RÉTINOÏDES POUR LE TRAITEMENT DU PSORIASIS ACITRETIN ACITRÉTINE Cap Orl 10mg Soriatane 02070847 TRB ADEFGVW Caps Cap Orl 25mg Soriatane 02070863 TRB ADEFGVW Caps ANTIBIOTICS AND CHEMOTHERAPEUTICS FOR DERMATOLOGICAL USE ANTIBIOTIQUES ET AGENTS CHIMIOTHÉRAPEUTIQUES ET DERMATOLOGIQUES ANTIBIOTICS FOR TOPICAL USE ANTIBIOTIQUES POUR USAGE TOPIQUE OTHER ANTIBIOTICS FOR TOPICAL USE AUTRES ANTIBIOTIQUES POUR USAGE TOPIQUE FUSIDIC ACID ACIDE FUSIDIQUE Ont Top 2% Fucidin 00586676 LEO ADEFGVW Ont Crm Top 2% Fucidin 00586668 LEO ADEFGVW Cr. GENTAMICIN GENTAMICINE Crm Top 0.1% ratio-gentamicin Sulfate 00805386 RPH ADEFGVW Cr. Ont Top 0.1% ratio-gentamicin Sulfate 00805025 RPH ADEFGVW Ont MUPIROCIN MUPIROCINE Crm Top 2% Bactroban 02239757 GCH ADEFGVW Cr. Ont Top 2% Bactroban 01916947 GCH ADEFGVW Ont Taro-Mupirocin 02279983 TAR ADEFGVW September 2015 v.1 86

D06B D06BA D06BA01 D06BB D06BB03 D06BB04 D06BB10 D06BX D06BX01 CHEMOTHERAPEUTICS FOR TOPICAL USE AGENTS CHIMIOTHÉRAPEUTIQUES POUR USAGE TOPIQUE SULFONAMIDES SULFONAMIDES SILVER SULFADIAZINE SULFADIAZINE D ARGENT Crm Top 1% Flamazine 00323098 SNE ADEFGVW Cr. ANTIVIRALS ANTIVIRAUX ACYCLOVIR ACYCLOVIR Ont Top 5% Zovirax 00569771 VLN ADEFGVW Ont PODOPHYLLOTOXIN PODOPHYLLOTOXINE Top 250mg/mL Podofilm 00598208 PAL ADEFGV IMIQUIMOD IMIQUIMOD Crm Top 5% Aldara 02239505 VLN (SA) Cr. Apo-Imiquimod 02407825 APX (SA) OTHER CHEMOTHERAPEUTICS AUTRES AGENTS DE CHIMOTHÉRAPIE METRONIDAZOLE MÉTRONIDAZOLE Crm Top 0.75% Metrocream 02226839 GAC ADEFV Cr. Crm Top 1% Noritate 02156091 VLN ADEFV Cr. Rosasol cream (Disc/non disp Mar 3/16) 02242919 GSK ADEFV Gel Top 1% Metrogel 02297809 GAC ADEFGVW Gel Lot Top 0.75% Metrolotion 02248206 GAC ADEFGVW Lot September 2015 v.1 87

D07 D07A CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS CORTICOSTÉROÏDES, PRÉPARATIONS DERMATOLOGIQUES CORTICOSTEROIDS, PLAIN CORTICOSTÉROÏDES, ORDINAIRES D07AA CORTICOSTEROIDS, WEAK (GROUP I) CORTICOSTÉROÏDES, FAIBLES (GROUPE I) D07AA02 HYDROCORTISONE HYDROCORTISONE Crm Top 0.5% Cortate 80021088 SCO AEFGVW Cr. Hyderm 00716820 TAR AEFGVW Hydrosone 00564281 ROG AEFGVW Crm Top 1% Emo-Cort 00192597 STI ADEFGVW Cr. Hyderm 00716839 TAR ADEFGVW Prevex HC (Disc/non disp Dec 24/16) 00804533 GSK ADEFGVW Crm Top 2.5% Emo-Cort 00595799 STI ADEFGVW Cr. Lot Top 1% Emo-Cort 00192600 STI ADEFGVW Lot Sarna HC (Disc/non disp Dec 24/16) 00578541 GSK ADEFGVW Lot Top 2.5% Emo-Cort 00595802 STI ADEFGVW Lot Sarna HC (Disc/non disp. Jun 6/16) 00856711 GSK ADEFGVW Ont Top 1% Cortoderm 00716693 TAR ADEFGVW Ont Crm Top 0.2% Hydroval 02242984 TPH ADEFGVW Cr. D07AB D07AB01 D07AB08 Ont Top 0.2% Hydroval 02242985 TPH ADEFGVW Ont CORTICOSTEROIDS, MODERATELY POTENT (GROUP II) CORTICOSTÉROÏDES, MOYENNEMENT PUISSANT (GROUPE II) CLOBETASONE CLOBÉTASONE Crm Top 0.05% Spectro Eczemacare 02214415 GCH AEFGVW Cr. DESONIDE DÉSONIDE Crm Top 0.05% pdp-desonide 02229315 PDP ADEFGVW Cr. Ont Top 0.05% pdp-desonide 02229323 PDP ADEFGVW Ont September 2015 v.1 88

D07AB09 TRIAMCINOLONE TRIAMCINOLONE Crm Top 0.1% Aristocort R 02194058 VLN ADEFGVW Cr. Crm Top 0.5% Aristocort C 02194066 VLN ADEFGVW Cr. D07AC D07AC01 Ont Top 0.1% Aristocort R 02194031 VLN ADEFGVW Ont CORTICOSTEROIDS, POTENT (GROUP III) CORTICOSTÉROÏDES, PUISSANT (GROUPE III) BETAMETHASONE BÉTAMÉTHASONE BETAMETHASONE DIPROPIONATE DIPROPIONATE DE BÉTAMÉTHASONE Crm Top 0.05% Diprosone 00323071 FRS ADEFGVW Cr. ratio-topisone 00804991 RPH ADEFGVW Lot Top 0.05% Diprosone 00417246 FRS ADEFGVW Lot ratio-topisone 00809187 RPH ADEFGVW Ont Top 0.05% Diprosone 00344923 FRS ADEFGVW Ont ratio-topisone 00805009 RPH ADEFGVW Crm Top 0.05% Diprolene Glycol 00688622 FRS ADEFGVW Cr. ratio-topilene Glycol 00849650 RPH ADEFGVW Lot Top 0.05% Diprolene Glycol 00862975 FRS ADEFGVW Lot ratio-topilene Glycol 01927914 RPH ADEFGVW Ont Top 0.05% Diprolene Glycol 00629367 FRS ADEFGVW Ont ratio-topilene Glycol 00849669 RPH ADEFGVW BETAMETHASONE VALERATE VALÉRATE DE BÉTAMÉTHASONE Crm Top 0.05% Betaderm 00716618 TAR ADEFGVW Cr. Celestoderm V/2 02357860 VLN ADEFGVW ratio-ectosone Mild 00535427 RPH ADEFGVW Crm Top 0.1% Betaderm 00716626 TAR ADEFGVW Cr. Celestoderm V 02357844 VLN ADEFGVW ratio-ectosone 00535435 RPH ADEFGVW Prevex B 00804541 GSK ADEFGVW Lot Top 0.05% ratio-ectosone Mild 00653209 RPH ADEFGVW Lot September 2015 v.1 89

D07AC01 BETAMETHASONE BÉTAMÉTHASONE BETAMETHASONE VALERATE VALÉRATE DE BÉTAMÉTHASONE Lot Top 0.1% Betaderm 00716634 TAR ADEFGVW Lot Valisone 00027944 VLN ADEFGVW ratio-ectosone 00750050 RPH ADEFGVW ratio-ectosone Scalp 00653217 RPH ADEFGVW Ont Top 0.05% Betaderm 00716642 TAR ADEFGVW Ont Celestoderm V/2 02357879 VLN ADEFGVW Ont Top 0.1% Betaderm 00716650 TAR ADEFGVW Ont Celestoderm V 02357852 VLN ADEFGVW D07AC03 DESOXIMETASONE DÉSOXIMÉTASONE Crm Top 0.05% Topicort Mild 02221918 VLN ADEFGVW Cr. Crm Top 0.25% Topicort 02221896 VLN ADEFGVW Cr. Gel Top 0.05% Topicort 02221926 VLN ADEFGVW Gel Ont Top 0.25% Topicort 02221934 VLN ADEFGVW Ont D07AC04 FLUOCINOLONE FLUOCINOLONE Top 0.01% Derma Smooth 00873292 HLZ DEFG D07AC06 DIFLUCORTOLONE DIFLUCORTOLONE Crm Top 0.1% Nerisone (Disc/non disp Mar 3/16) 00587826 GSK ADEFGVW Cr. Nerisone Oily 00587818 GSK ADEFGVW D07AC08 FLUOCINONIDE FLUOCINONIDE Crm Top 0.05% Lidex 02161923 VLN ADEFGVW Cr. Lidemol 02163152 VLN ADEFGVW Lyderm 00716863 TPH ADEFGVW Gel Top 0.05% Lidex Gel 02161974 VLN ADEFGVW Gel Lyderm 02236997 TPH ADEFGVW Ont Top 0.05% Lidex 02161966 VLN ADEFGVW Ont Lyderm 02236996 TPH ADEFGVW September 2015 v.1 90

D07AC11 AMCINONIDE AMCINONIDE Crm Top 0.1% Cyclocort 02192284 GSK ADEFGVW Cr. ratio-amcinonide 02247098 TEV ADEFGVW Taro-Amcinonide 02246714 TAR ADEFGVW Lot Top 0.1% Cyclocort 02192276 GSK ADEFGVW Lot ratio-amcinonide 02247097 TEV ADEFGVW Ont Top 0.1% Cyclocort 02192268 GSK ADEFGVW Ont ratio-amcinonide 02247096 TEV ADEFGVW D07AC13 MOMETASONE MOMÉTASONE Crm Top 0.1% Elocom 00851744 FRS ADEFGVW Cr. Taro-Mometasone 02367157 TAR ADEFGVW Lot Top 0.1% Elocom 00871095 FRS ADEFGVW Lot Taro-Mometasone 02266385 TAR ADEFGVW D07AD D07AD01 Ont Top 0.1% Elocom 00851736 FRS ADEFGVW Ont ratio-mometasone 02248130 TEV ADEFGVW CORTICOSTEROIDS, VERY POTENT (GROUP IV) CORTICOSTÉROÏDES, TRÈS PUISSANT (GROUPE IV) CLOBETASOL CLOBÉTASOL Crm Top 0.05% Dermovate 02213265 TPH ADEFGVW Cr. Mylan-Clobetasol 02024187 MYL ADEFGVW Novo-Clobetasol 02093162 TEV ADEFGVW pms-clobetasol 02309521 PMS ADEFGVW ratio-clobetasol 01910272 TEV ADEFGVW Taro-Clobetasol Cream 02245523 TAR ADEFGVW Lot Top 0.05% Dermovate 02213281 TPH ADEFGVW Lot Mylan-Clobetasol Propionate 02216213 MYL ADEFGVW ratio-clobetasol 01910299 TEV ADEFGVW Taro-Clobetasol Topical Sol n 02245522 TAR ADEFGVW Ont Top 0.05% Dermovate 02213273 TPH ADEFGVW Ont Mylan-Clobetasol 02026767 MYL ADEFGVW Novo-Clobetasol 02126192 TEV ADEFGVW pms-clobetasol 02309548 PMS ADEFGVW ratio-clobetasol 01910280 TEV ADEFGVW Taro-Clobetasol Ointment 02245524 TAR ADEFGVW September 2015 v.1 91

D07C D07CA D07CA02 D07CB D07CB01 D07CB05 CORTICOSTEROIDS, COMBINATIONS WITH ANTIBIOTICS CORTICOSTÉROÏDES, EN COMBINAISON AVEC DES ANTIBIOTIQUES CORTICOSTEROIDS, WEAK, COMBINATIONS WITH ANTIBIOTICS CORTICOSTÉROÏDES, FAIBLES, EN COMBINAISON AVEC DES ANTIBIOTIQUES HYDROCORTISONE AND ANTIBIOTICS HYDROCORTISONE ET ANTIBIOTIQUES IODOCHLORHYDROXYQUINE / HYDROCORTISONE IODOCHLORHYDROXYQUINE / HYDROCORTISONE Crm Top 3% / 1% Vioform HC 00074500 PAL ADEFGVW Cr. POLYMYXIN B SULFATE / BACITRACIN ZINC / HYDROCORTISONE / NEOMYCIN POLYMYXINE B (SULFATE DE) / BACITRACINE / HYDROCORTISONE / NÉOMYCINE Ont Top 5000IU/400IU/10mg/5mg Cortisporin (Disc/non 00666246 GSK ADEFGVW Ont disp Nov 3/16) FUSIDIC ACID / HYDROCORTISONE ACIDE FUSIDIQUE / HYDROCORTISONE Crm Top 2% / 1% Fucidin H 02238578 LEO ADEFGVW Cr. CORTICOSTEROIDS, MODERATELY POTENT, COMBINATIONS WITH ANTIBIOTICS CORTICOSTÉROÏDES, MOYENNEMENT PUISSANTS, EN COMBINAISON AVEC DES ANTIBIOTIQUES TRIAMCINOLONE AND ANTIBIOTICS TRIAMCINOLONE ET ANTIBIOTIQUES TRIAMCINOLONE / NEOMYCIN / NYSTATIN / GRAMICIDIN TRIAMCINOLONE / NÉOMYCINE / NYSTATINE / GRAMICIDINE Crm Top 100000IU/2.5mg/1mg/0.25mg Viaderm K-C 00717002 TAR ADEFGVW Cr. Ont Top 100000IU/2.5mg/1mg/0.25mg Viaderm K-C 00717029 TAR ADEFGVW Ont FLUMETASONE AND ANTIBIOTICS FLUMETASONE ET ANTIBIOTIQUES CLIOQUINO / FLUMETHASONE CLIOQUINO / FLUMÉTHASONE Crm Top 3% / 0.02% Locacorten-Vioform 00074462 PAL ADEFGVW Cr. September 2015 v.1 92

D07CC D07X D07CC01 D07XA D07XA01 D07XC D07XC01 CORTICOSTEROIDS, POTENT, COMBINATIONS WITH ANTIBIOTICS CORTICOSTÉROÏDES, PUISSANT, EN COMBINAISON AVEC DES ANTIBIOTIQUES BETAMETHASONE AND ANTIBIOTICS BÉTAMETHASONE ET ANTIBIOTIQUES BETAMETHASONE / GENTAMICIN BÉTAMETHASONE / GENTAMICINE Ont Top 0.1% / 0.1% Valisone G 00232351 VLN ADEFGVW Ont Crm Top 0.1% / 0.1% Valisone G 00177016 VLN ADEFGVW Cr. CORTICOSTEROIDS, OTHER COMBINATIONS CORTICOSTÉROÏDES, AUTRES COMBINAISONS CORTICOSTEROIDS, WEAK, OTHER COMBINATIONS CORTICOSTÉROÏDES, FAIBLES, AUTRES COMBINAISONS HYDROCORTISONE, OTHER COMBINATIONS HYDROCORTISONE, AUTRES COMBINAISONS HYDROCORTISONE / PRAMOXINE HYDROCORTISONE / PRAMOXINE Crm Top 1% / 1% Pramox HC 00770957 DPT ADEFGVW Cr. HYDROCORTISONE / UREA HYDROCORTISONE / URÉA Crm Top 10% / 1% Uremol HC (Disc/non disp Jun 23/16) 00503134 GSK ADEFGVW Cr. Lot Top 10% / 1% Uremol HC (Disc/non disp Jun 23/16) 00560022 GSK ADEFGVW Lot CORTICOSTEROIDS, POTENT, OTHER COMBINATIONS CORTICOSTÉROÏDES, PUISSANTS, AUTRES COMBINAISONS BETAMETHASONE, OTHER COMBINATIONS BÉTAMÉTHASONE, AUTRES COMBINAISONS BETAMETHASONE / SALICYLIC ACID BÉTAMÉTHASONE / ACIDE SALICYLIQUE Lot Top 20mg/0.5mg Diprosalic 00578428 FRS ADEFGVW Lot ratio-topisalic 02245688 TEV ADEFGVW Ont Top 30mg/0.5mg Diprosalic 00578436 FRS ADEFGVW Ont BETAMETHASONE / CALCIPOTRIOL BÉTAMÉTHASONE / CALCIPOTRIOL Gel Top 0.5mg/50mcg Dovobet 02319012 LEO ADEFGVW Gel September 2015 v.1 93

D08 D08A D08AJ D09 D09A D08AJ58 D09AA D10 D10A D09AA01 D10AA D10AA02 D10AB D10AB02 ANTISEPTICS AND DISINFECTANTS ANTISEPTIQUES ET AGENTS STÉRILISANTS ANTISEPTICS AND DISINFECTANTS ANTISEPTIQUES ET AGENTS STÉRILISANTS QUATERNARY AMMONIUM COMPOUNDS COMPOSÉS D AMMONIUM QUATERNAIRE BENZETHONIUM CHLORIDE, COMBINATIONS COMBINATION DE BENZETHONIUM CHLORIDE ALUMINUM ACETATE / BENZETHONIUM CHLORIDE ACÉTATE D ALUMINIUM / CHLORURE DE BENZÉTHONIUM Pwr Top 0.35% Buro Sol 00579947 TCD ADEFGVW Pds. MEDICATED DRESSINGS PANSEMENTS MÉDICAMENTEUX MEDICATED DRESSINGS PANSEMENTS MÉDICAMENTEUX MEDICATED DRESSINGS WITH ANTIINFECTIVES PANSEMENTS MÉDICAMENTEUX ET ANTI-INFECTIEUX FRAMYCETIN FRAMYCÉTINE Dre Top 1% Sofra-Tulle (10cm x 30cm) 01987682 ERF ADEFGVW Dre Sofra-Tulle (10cm x 10cm) 01988840 ERF ADEFGVW ANTI-ACNE PREPARATIONS PRÉPARATIONS CONTRE L ACNÉ ANTI-ACNE PREPARATIONS FOR TOPICAL USE PRÉPARATIONS TOPIQUES CONTRE L ACNÉ CORTICOSTEROIDS, COMBINATIONS FOR TREATMENT OF ACNE CORTICOSTÉROÏDES, COMBINAISON CONTRE L ACNÉ METHYLPREDNISONE, COMBINATION METHYLPREDNISONE, COMBINAISON ALUMINUM CHLORHYDROXIDE / SULPHUR / METHYLPREDNISOLONE / NEOMYCIN ALUMINUM (CHLORHYDROXIDE D ) / SOUFRE / MÉTHYLPREDNISOLONE / NÉOMYCINE Lot Top 100mg/50mg/2.5mg/2.5mg Neo-Medrol Acne 00195057 PFI EDFGW Lot PREPARATIONS CONTAINING SULPHUR PRÉPARATIONS CONTENANT DU SOUFRE SULPHUR SOUFRE SULFACETAMIDE SODIUM / SULPHUR SULFACÉTAMIDE SODIQUE / SOUFRE Lot Top 10% / 5% Sulfacet R 02220407 VLN ADEFGVW Lot September 2015 v.1 94

D10AD RETINOIDS FOR TOPICAL USE IN ACNE RÉTINOÏDES POUR USAGE TOPIQUE CONTRE L ACNÉ D10AD01 TRETINOIN TRÉTINOINE Crm Top 0.01% Stieva-A 00657204 GSK DEFG Cr. Crm Top 0.025% Stieva-A 00578576 GSK DEFG Cr. Crm Top 0.05% Retin-A 00443794 VLN DEFG Cr. Stieva-A 00518182 GSK DEFG Crm Top 0.1% Stieva-A Forte 00662348 GSK DEFG Cr. Gel Top 0.01% Vitamin A Acid 01926462 VLN DEFG Gel Gel Top 0.025% Vitamin A Acid 01926470 VLN DEFG Gel Gel Top 0.05% Vitamin A Acid 01926489 VLN DEFG Gel D10AE PEROXIDES PEROXIDES D10AE01 BENZOYL PEROXIDE PEROXYDE DE BENZOYLE BENZOYL PEROXIDE / POLYOXYETHYLENE LAURYL ETHER PEROXYDE DE BENZOYLE / LAURYL ETHER DE POLYOXYÉTHYLÈNE Gel Top 10% / 6% Panoxyl (Disc/non disp Oct 1/16) 00263699 GSK ADEFGVW Gel Gel Top 20% / 6% Panoxyl (Disc/non disp Apr 1/16) 00373036 GSK ADEFGVW Gel D10AF ANTIINFECTIVES FOR TREATMENT OF ACNE ANTI-INFECTIEUX POUR LE TRAITEMENT DE L ACNÉE D10AF01 CLINDAMYCIN CLINDAMYCINE Top 1% Dalacin T 00582301 PFI ADEFGV Taro-Clindamycin 02266938 TAR ADEFGV September 2015 v.1 95

D10AF52 D10AX D10B D10AX03 D10BA D10BA01 ERYTHROMYCIN COMBINATIONS ÉRYTHROMYCINE, EN COMBINAISON ERYTHROMYCIN BASE / TRETINOIN ÉRYTHROMYCINE BASE / TRÉTINOÏNE Gel Top 4% / 0.025% Stievamycin 01905112 GSK DEFG Gel Gel Top 4% / 0.01% Stievamycin Mild 02015994 GSK DEFG Gel OTHER ANTI ACNE PREPARATIONS FOR TOPICAL USE AUTRES PRÉPARATIONS CONTRE L ACNÉ POUR USAGE TOPIQUE AZELAIC ACID ACIDE AZÉLAÏQUE Gel Top 15% Finacea 02270811 BAY ADEFGVW Gel ANTI ACNE PREPARATIONS FOR SYSTEMIC USE PRÉPARATIONS CONTRE L ACNÉ POUR USAGE SYSTÉMIQUE RETINOIDS FOR TREATMENT OF ACNE RÉTINOÏDES POUR LE TRAITEMENT DE L ACNÉ ISOTRETINOIN ISOTRÉTINOINE Cap Orl 10mg Accutane Roche 00582344 HLR DEFG Caps Clarus 02257955 MYL DEFG Epuris 02396971 CIP EFG Cap Orl 20mg Epuris 02396998 CIP EFG Caps Cap Orl 30mg Epuris 02397005 CIP EFG Caps D11 D11A D11AH D11AH01 Cap Orl 40mg Accutane Roche 00582352 HLR DEFG Caps Clarus 02257963 MYL DEFG Epuris 02397013 CIP EFG OTHER DERMATOLOGICAL PREPARATIONS AUTRES PRÉPARATIONS DERMATOLOGIQUES OTHER DERMATOLOGICAL PREPARATIONS AUTRES PRÉPARATIONS DERMATOLOGIQUES AGENTS FOR DERMATITIS, EXCLUDING CORTICOSTEROIDS AUTRES PREPARATIONS DERMATOLOGIQUES TACROLIMUS TACROLIMUS Ont Top 0.03% Protopic 02244149 ASL (SA) Ont September 2015 v.1 96

G01 G01A D11AH01 G01AA G01AA01 G01AA51 G01AC G01AC01 G01AF G01AF01 TACROLIMUS TACROLIMUS Ont Top 0.1% Protopic 02244148 ASL (SA) Ont GYNECOLOGICAL ANTIINFECTIVES AND ANTISEPTICS ANTI-INFECTIEUX ET ANTISEPTIQUES GYNÉCOLOGIQUES ANTIINFECTIVES AND ANTISEPTICS, EXCLUDING COMBINATIONS WITH CORTICOSTEROIDS ANTI-INFECTIEUX ET ANTISEPTIQUES, SAUF LES ASSOCIATIONS AVEC DES CORTICOSTÉROÏDES ANTIBIOTICS ANTIBIOTIQUES NYSTATIN NYSTATINE Crm Vag 25000IU Nyaderm 00716901 TAR ADEFGVW Cr. Crm Vag 100000IU Ratio-Nystatin 02194163 RPH ADEFGVW Cr. NYSTATIN, COMBINATIONS COMBINATION NYSTATINE NYSTATIN / METRONIDAZOLE NYSTATINE / MÉTRONIDAZOLE Sup Vag 100000IU/500mg Flagystatin 01926829 SAV ADEFGVW Supp. Crm Vag 100000IU/500mg Flagystatin 01926845 SAV ADEFGVW Cr. QUINOLINE DERIVATIVES DÉRIVÉS DE LA QUINOLEINE DIIODOHYDROXYQUINOLINE QUINOLEINE DIIODOHYDROXYLE Tab Orl 650mg Diodoquin (Disc/non disp Jul 30/16) 01997750 GLE ADEFGVW IMIDAZOLE DERIVATIVES DÉRIVÉS DE L IMIDAZOLE METRONIDAZOLE MÉTRONIDAZOLE Crm Vag 10% Flagyl 01926861 AVE ADEFGVW Cr. September 2015 v.1 97

G01AF02 CLOTRIMAZOLE CLOTRIMAZOLE Crm Vag 1% Canesten 02150891 YNO ADEFGVW Cr. Crm Vag 2% Canesten 3 02150905 YNO ADEFGVW Cr. G01AF04 Crm Vag 500mg/1% Canesten 1 Comfortab 02264102 YNO ADEFGVW Cr. Canesten 3 Comfortab Combi-Pak 02264099 YNO ADEFGVW MICONAZOLE MICONAZOLE Crm Vag 2% Monistat 7 02084309 JNJ ADEFGVW Cr. Micozole Vaginal 2% 02231106 TAR ADEFGVW Crm Vag 1200mg / 2% Monistat 3 Dual Pak 02126249 JNJ ADEFGVW Cr. G01AG G02 G02B Sup Vag 400mg Monistat-3 02126605 JNJ ADEFGVW Supp. TRIAZOLE DERIVATIVES DÉRIVÉS DU TRIAZOLE G01AG02 TERCONAZOLE TERCONAZOLE Crm Vag 0.4% Terazol 7 00894729 JAN ADEFGVW Cr. Taro-Terconazole 02247651 TAR ADEFGVW G02BA OTHER GYNECOLOGICALS AUTRES AGENTS GYNÉCOLOGIQUES CONTRACEPTIVES FOR TOPICAL USE CONTRACEPTIFS TOPIQUES INTRAUTERINE CONTRACEPTIVES CONTRACEPTIFS INTRA-UTÉRINS G02BA03 PLASTIC IUD WITH PROGESTERONE AND LEVONORGESTREL DIU EN PLASTIQUE AVEC LA PROGESTÉRONE ET DE LÉVONORGESTREL Ins Vag 13.5mg Jaydess 02408295 BAY DEFG Ins G02BB Ins Vag 52mg Mirena 02243005 BAY DEFG Ins INTRAVAGINAL CONTRACEPTIVES CONTRACEPTIFS INTRAVAGINAUX G02BB01 ETHINYL ESTRADIOL AND ETONOGESTREL ÉTHINYLOESTRADIOL ET ÉTONOGESTREL Ins Vag 2.6mg/11.4mg Nuvaring 02253186 FRS (SA) Ins September 2015 v.1 98

G02C G02CB G02CB01 OTHER GYNECOLOGICALS AUTRES AGENTS GYNÉCOLOGIQUES PROLACTINE INHIBITORS INHIBITEURS DE LA PROLACTINE BROMOCRIPTINE BROMOCRIPTINE Tab Orl 2.5mg Bromocriptine 02087324 AAP ADEFGVW Cap Orl 5mg Bromocriptine 02230454 AAP ADEFGVW Caps G03 G03A G02CB03 G02CB04 G03AA G03AA01 G03AA05 CABERGOLINE CABERGOLINE Tab Orl 0.5mg Dostinex 02242471 PAL (SA) Co Cabergoline 02301407 COB (SA) QUINAGOLIDE QUINAGOLIDE Tab Orl 0.075mg Norprolac 02223767 FEI (SA) Tab Orl 0.15mg Norprolac 02223775 FEI (SA) SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM HORMONES SEXUELLES ET MODULATEURS DE L APPAREIL GÉNITAL HORMONAL CONTRACEPTIVES FOR SYSTEMIC USE CONTRACEPTIFS HORMONAUX, SYSTÉMIQUES PROGESTOGENS AND ESTROGENS, FIXED COMBINATIONS PROGESTOGÈNES ET OESTROGÈNES, COMBINAISONS FIXES ETYNODIOL AND ETHINYL ESTRADIOL ÉTYNODIOL ET ÉTHINYLOESTRADIOL Tab Orl 0.03mg/2mg Demulen 30 (21) 00469327 PFI DEFGV Demulen 30 (28) 00471526 PFI DEFGV NORETHISTERONE AND ETHINYL ESTRADIOL NORÉTHISTERONE ET ÉTHINYLOESTRADIOL Tab Orl 0.020mg/1mg Minestrin 1/20 (21) 00315966 WNC DEFGV Minestrin 1/20 (28) 00343838 WNC DEFGV Tab Orl 1.5mg/0.03mg Loestrin 1.5/30 (21) 00297143 WNC DEFGV Loestrin 1.5/30 (28) 00353027 WNC DEFGV Tab Orl 0.5mg/0.035mg Brevicon (21) 02187086 PFI DEFGV Brevicon (28) 02187094 PFI DEFGV Ortho 0.5/35 (21) 00317047 JAN DEFGV Ortho 0.5/35 (28) 00340731 JAN DEFGV September 2015 v.1 99

G03AA05 G03AA07 G03AA09 NORETHISTERONE AND ETHINYL ESTRADIOL NORÉTHISTERONE ET ÉTHINYLOESTRADIOL Tab Orl 1mg/0.035mg Brevicon 1/35 (21) 02189054 PFI DEFGV Brevicon 1/35 (28) 02189062 PFI DEFGV Ortho 1/35 (21) 00372846 JAN DEFGV Ortho 1/35 (28) 00372838 JAN DEFGV Select 1/35 (21) 02197502 PFI DEFGV Select 1/35 (28) 02199297 PFI DEFGV LEVONORGESTREL AND ETHINYL ESTRADIOL LÉVONORGESTREL ET ÉTHINYLOESTRADIOL Tab Orl 0.15mg/0.03mg Min-Ovral (21) 02042320 PFI DEFGV Min-Ovral (28) 02042339 PFI DEFGV Ovima (21) 02387085 APX DEFGV Ovima (28) 02387093 APX DEFGV Portia (21) 02295946 TEV DEFGV Portia (28) 02295954 TEV DEFGV Tab Orl 0.1mg/0.02mg Alesse (21) 02236974 PFI DEFGV Alesse (28) 02236975 PFI DEFGV Alysena (21) 02387875 APX DEFGV Alysena (28) 02387883 APX DEFGV Aviane (21) 02298538 TEV DEFGV Aviane (28) 02298546 TEV DEFGV Esme (21) 02388138 MYL DEFGV Esme (28) 02388146 MYL DEFGV Lutera (21) 02401185 COB DEFGV Lutera (28) 02401207 COB DEFGV DESOGESTREL AND ETHINYL ESTRADIOL DÉSOGESTREL ET ÉTHINYLOESTRADIOL Tab Orl 0.15mg/0.03mg Marvelon (21) 02042487 FRS DEFGV Marvelon (28) 02042479 FRS DEFGV Apri (21) 02317192 TEV DEFGV Apri (28) 02317206 TEV DEFGV Freya (21) 02396491 TEV DEFGV Freya (28) 02396610 TEV DEFGV Mirvala (21) 02410249 APX DEFGV Mirvala (28) 02410257 APX DEFGV Reclipsen (21) 02420813 ATV DEFGV Reclipsen (28) 02417464 ATV DEFGV Tab Orl 0.15mg/0.03mg Linessa (21) 02272903 APR DEFGV Linessa (28) 02257238 APR DEFGV Tab Orl 0.15mg/0.03mg Ortho-cept 02042533 JAN DEFGV (Disc/non disp Mar 26/17) September 2015 v.1 100

G03AA11 G03AA12 G03AB G03AB03 G03AB04 NORGESTIMATE AND ETHINYLESTRADIOL NORGESTIMATE ET ÉTHINYLOESTRADIOL Tab Orl 0.25mg/0.035mg Cyclen (21) 01968440 JAN DEFGV Cyclen (28) 01992872 JAN DEFGV DROSPIRENONE AND ETHINYLESTRADIOL DROSPIRÉNONE ET ÉTHINYLOESTRADIOL Tab Orl 3mg/0.03mg Yasmin (21) 02261723 BAY DEFGV Yasmin (28) 02261731 BAY DEFGV Zamine (21) 02410788 APX DEFGV Zamine (28) 02410796 APX DEFGV Zarah (21) 02385058 COB DEFGV Zarah (28) 02385066 COB DEFGV PROGESTOGENS AND ESTROGENS, SEQUENTIAL PREPARATIONS PROGESTOGÈNES ET OESTROGÈNES, PRÉPARATION SÉQUENTIELLE LEVONORGESTREL AND ETHINYLESTRADIOL LÉVONORGESTREL ET ÉTHINYLOESTRADIOL Tab Orl 0.05mg/0.075mg/0.125mg/0.03mg/0.040mg/0.03mg Triquilar (21) 00707600 BAY DEFGV Triquilar (28) 00707503 BAY DEFGV NORETHISTERONE AND ETHINYLESTRADIOL NORÉTHISTERONE ET ÉTHINYLOESTRADIOL Tab Orl 1mg/0.5mg/0.035mg Synphasic (21) 02187108 PFI DEFGV Synphasic (28) 02187116 PFI DEFGV Tab Orl 1mg/0.75mg/0.5mg/0.035mg Ortho 7/7/7 (21) 00602957 JAN DEFGV Ortho 7/7/7 (28) 00602965 JAN DEFGV G03AB11 G03AC G03AC01 NORGESTIMATE AND ETHINYLESTRADIOL NORGÉSTIMATE ET ÉTHINYLOESTRADIOL Tab Orl 0.215mg/0.18mg/0.025mg/0.025mg Tri-Cyclen LO (21) 02258560 JAN DEFGV Tri-Cyclen LO (28) 02258587 JAN DEFGV Tricira LO (21) 02401967 APX DEFGV Tricira LO (28) 02401975 APX DEFGV Tab Orl 0.25mg/0.215mg/0.18mg/0.035mg Tri-Cyclen (21) 02028700 JAN DEFGV Tri-Cyclen (28) 02029421 JAN DEFGV PROGESTOGENS PROGESTOGÈNES NORGESTIMATE NORGÉSTIMATE Tab Orl 0.35mg Micronor (28) 00037605 JAN DEFGV Movisse 02410303 MYL DEFGV September 2015 v.1 101

G03AC06 G03AD G03B G03AD01 G03BA G03BA03 MEDROXYPROGESTERONE MÉDROXYPROGESTÉRONE Sus Inj 50mg/mL Depo-Provera 00030848 PFI W Susp Sus Inj 150mg/mL Depo-Provera 00585092 PFI DEFGV Susp Medroxyprogesterone Acetate 02322250 SDZ DEFGV EMERGENCY CONTRACEPTIVES CONTRACEPTIFS D URGENCE LEVONORGESTREL (EMERGENCY CONTRACEPTIVE) LÉVONORGESTREL (CONTRACEPTIF D URGENCE) Tab Orl 0.75mg Next Choice 02364905 COB DEFG Plan B 02241674 PAL DEFG ANDROGENS ANDROGÈNES 3-OXOANDROSTEN (4) DERIVATIVES DÉRIVÉS DU 3-OXOANDROSTENE (4) TESTOSTERONE TESTOSTÉRONE Cap Orl 40mg Andriol 00782327 FRS (SA) Caps pms-testosterone 02322498 PMS (SA) Tarp-Testosterone 02421186 TAR (SA) Gel Top 25mg AndroGel Packets 02245345 BGP (SA) Gel Gel Top 50mg AndroGel Packets 02245346 BGP (SA) Gel Gel Top 1% Testim 02280248 PAL (SA) Gel Inj 100mg/mL Depo-Testosterone 00030783 PFI ADEFGVW Sandoz Testosterone 02246063 SDZ ADEFGVW Inj 200mg/mL Delatestryl 00029246 VLN ADEFGVW Pad Trd 2.5mg Androderm 02239653 ASP (SA) Gaze Pad Trd 5mg Androderm 02245972 ASP (SA) Gaze September 2015 v.1 102

G03C G03CA G03CA03 ESTROGENS OESTROGÈNES NATURAL AND SEMISYNTHETIC ESTROGENS, PLAIN OESTROGÈNES NATURELS ET SEMI-SYNTHÉTIQUES, ORDINAIRES ESTRADIOL ESTRADIOL Tab Vag 10mcg Vagifem 10 02325462 NNO ADEFGVW Gel Trd 0.06% Estrogel 02238704 FRS ADEFV Gel Ins Vag 2mg Estring 02168898 PAL ADEFV Ins Pth Trd 25mcg Climara 25 02247499 BAY ADEFVW Pth Pth Trd 50mcg Climara 50 02231509 BAY ADEFV Pth Pth Trd 75mcg Climara 75 02247500 BAY ADEFVW Pth Pth Trd 100mcg Climara 100 02231510 BAY ADEFV Pth Pth Trd 0.39mg Estradot 02245676 NVR (SA) Pth Pth Trd 0.585mg Estradot 02243999 NVR (SA) Pth Pth Trd 50mcg Estradot 02244000 NVR (SA) Pth Sandoz Estradiol Derm Srd 02246967 SDZ (SA) Pth Trd 75mcg Estradot 02244001 NVR (SA) Pth Sandoz Estradiol Derm Srd 02246968 SDZ (SA) Pth Trd 100mcg Estradot 02244002 NVR (SA) Pth Sandoz Estradiol Derm Srd 02246969 SDZ (SA) Tab Orl 0.5mg Estrace 02225190 TML ADEFGVW Tab Orl 1mg Estrace 02148587 TML ADEFGVW Tab Orl 2mg Estrace 02148595 TML ADEFGVW September 2015 v.1 103

G03CA57 CONJUGATED ESTROGENS OESTROGÈNES CONJUGUÉS Crm Vag 0.625mg Premarin 02043440 PFI ADEFGVW Cr. Tab Orl 0.3mg Premarin 02414678 PFI ADEFGVW Tab Orl 0.625mg Premarin 02414686 PFI ADEFGVW Tab Orl 1.25mg Premarin 02414694 PFI ADEFGVW G03D G03DA PROGESTOGENS PROGESTOGÈNES PREGNEN (4) DERIVATIVES DÉRIVÉS DU PREGNEN (4) G03DA02 MEDROXYPROGESTERONE MÉDROXYPROGESTÉRONE Tab Orl 2.5mg Provera 00708917 PFI ADEFGVW Apo-Medroxy 02244726 APX ADEFGVW Teva-Medrone 02221284 TEV ADEFGVW Tab Orl 5mg Provera 00030937 PFI ADEFGVW Apo-Medroxy 02244727 APX ADEFGVW Teva-Medrone 02221292 TEV ADEFGVW Tab Orl 10mg Provera 00729973 PFI ADEFGVW Apo-Medroxy 02277298 APX ADEFGVW Teva-Medrone 02221306 TEV ADEFGVW Tab Orl 100mg Apo-Medroxy 02267640 APX ADEFGVW G03DB PREGNADIEN DERIVATIVES DÉRIVATIFS DE LA PREGNADIENE G03DB08 DIENOGEST DIENOGEST Tab Orl 2mg Visanne 02374900 BAY (SA) G03FA PROGESTOGENS AND ESTROGENS IN COMBINATION PROGESTOGÈNES EN COMBINAISON G03FA01 NORETHINDRONE AND ESTROGEN NORÉTHINDRONE ET ESTRADIOL Pad Trd 140mcg/50mcg Estalis 02241835 NVR (SA) Gaze Pad Trd 250mcg/50mcg Estalis 02241837 NVR (SA) Gaze September 2015 v.1 104

G03H G03HA G03X G03HA01 G03XA G03XA01 G03XC G04 G04B G03XC01 G04BD G04BD04 ANTIANDROGENS ANTIANDROGÈNES ANTIANDROGENS, PLAIN ANTIANDROGÈNES, ORDINAIRES CYPROTERONE CYPROTÉRONE Tab Orl 50mg Androcur 00704431 PMS ADEFVW Cyproterone 02245898 AAP ADEFVW Med-Cyproterone 02390760 GMP ADEFVW OTHER SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM AUTRES HORMONES SEXUELLES ET MODULATEURS DE L APPAREIL GÉNITAL ANTIGONADOTROPHINS AND SIMILAR AGENTS ANTIGONADOTROPHINES ET AGENTS SIMILAIRES DANAZOL DANAZOL Cap Orl 100mg Cyclomen 02018152 SAV ADEFVW Caps Cap Orl 200mg Cyclomen 02018160 SAV ADEFVW Caps OTHER SEX HORMONES AUTRES HORMONES SEXUELS RALOXIFENE RALOXIFÈNE Tab Orl 60mg Evista 02239028 LIL (SA) Act Raloxifene 02358840 ATV (SA) Apo-Raloxifene 02279215 APX (SA) pms-raloxifene 02358921 PMS (SA) Teva-Raloxifene 02312298 TEV (SA) UROLOGICALS MÉDICAMENTS UROLOGIQUES UROLOGICALS MÉDICAMENTS UROLOGIQUES DRUGS FOR URINARY FREQUENCY AND INCONTINENCE MÉDICAMENTS POUR LA FRÉQUENCE URINAIRE ET INCONTINENCE OXYBUTYNIN OXYBUTYNINE ERT Orl 5mg Ditropan XL 02243960 JAN (SA) L.P. ERT Orl 10mg Ditropan XL 02243961 JAN (SA) L.P. Syr Orl 1mg pms-oxybutynin 02223376 PMS ADEFGVW Sir. September 2015 v.1 105

G04BD04 G04BD07 OXYBUTYNIN OXYBUTYNINE Tab Orl 2.5mg pms-oxybutynin 02240549 PMS ADEFGVW Tab Orl 5mg Apo-Oxybutynin 02163543 APX ADEFGVW Mylan-Oxybutynin 02230800 MYL ADEFGVW Novo-Oxybutynin 02230394 TEV ADEFGVW Oxybutynin 02350238 SAS ADEFGVW pms-oxybutynin 02240550 PMS ADEFGVW TOLTERODINE TOLTÉRODINE SRC Orl 2mg Detrol LA 02244612 PFI (SA) Caps.L.L. SRC Orl 4mg Detrol LA 02244613 PFI (SA) Caps.L.L. Tab Orl 1mg Detrol 02239064 PFI (SA) Tab Orl 2mg Detrol 02239065 PFI (SA) G04BD08 G04BD09 G04BD10 SOLIFENACIN SOLIFÉNCINE Tab Orl 5mg Vesicare 02277263 ASL (SA) Tab Orl 10mg Vesicare 02277271 ASL (SA) TROSPIUM TROSPIUM Tab Orl 20mg Trosec 02275066 SNV (SA) DARIFENACIN DARIFÉNACINE ERT Orl 7.5mg Enablex 02273217 MRS (SA) L.P. ERT Orl 15mg Enablex 02273225 MRS (SA) L.P. September 2015 v.1 106

G04BD11 G04BE G04BE03 G04BX G04C G04BX13 G04CA G04CA02 FESOTERODINE FÉSOTÉRODINE ERT Orl 4mg Toviaz 02380021 PFI (SA) L.P. ERT Orl 8mg Toviaz 02380048 PFI (SA) L.P. DRUGS USED IN ERECTILE DYSFUNCTION MÉDICAMENT POUR LE TRAITEMENT DU DYSFONCTIONNEMENT ÉRECTILE SILDENAFIL SILDÉNAFIL Tab Orl 20mg Revatio 02279401 PFI (SA) Apo-Sildenafil R 02418118 APX (SA) ratio-sildenafil R 02319500 TEV (SA) OTHER UROLOGICAL AUTRES MÉDICAMENTS UROLOGIQUES DIMETHYL SULFOXIDE SULFOXYDE DE DIMÉTHYLE ITV 500mg/g Rimso-50 00493392 BCH ADEFGVW DRUGS USED IN BENIGN PROSTATIC HYPERTROPHY MÉDICAMENTS UTILISÉS POUR LE TRAITEMENT DE L HYPERTROPHIE BÉNIGNE DE LA PROSTATE ALPHA-ADRENORECEPTOR ANTAGONISTS ANTAGONISTES DE L ALPHA-ADRÉNORÉCEPTEUR TAMSULOSIN TAMSULOSINE ERT Orl 0.4mg Flomax CR 02270102 BOE ADEFVW L.P. Apo-Tamsulosin CR 02362406 APX ADEFVW Sandoz Tamsulosin CR 02340208 SDZ ADEFVW Tamsulosin CR 02427117 SAS ADEFVW Tamsulosin CR 02429667 SIV ADEFVW Teva-Tamsulosin CR 02368242 TEV ADEFVW SRC Orl 0.4mg Mylan-Tamsulosin 02298570 MYL ADEFVW Caps.L.L. ratio-tamsulosin 02294265 TEV ADEFVW Sandoz Tamsulosin 02295121 SDZ ADEFVW Sandoz Tamsulosin 02319217 SDZ ADEFVW Teva-Tamsulosin 02281392 TEV ADEFVW September 2015 v.1 107

G04CA03 TERAZOSIN TÉRAZOSINE Tab Orl 1mg Hytrin 00818658 BGP ADEF18+VW Apo-Terazosin 02234502 APX ADEF18+VW Mylan-Terazosin 02396289 MYL ADEF18+VW pms-terazosin 02243518 PMS ADEF18+VW ratio-terazosin (Disc/non disp Sept 19/16) 02218941 RPH ADEF18+VW Terazosin 02350475 SAS ADEF18+VW Teva-Terazosin 02230805 TEV ADEF18+VW Tab Orl 2mg Hytrin 00818682 BGP ADEF18+VW Apo-Terazosin 02234503 APX ADEF18+VW Mylan-Terazosin 02396297 MYL ADEF18+VW pms-terazosin 02243519 PMS ADEF18+VW ratio-terazosin (Disc/non disp Sept 19/16) 02218968 RPH ADEF18+VW Terazosin 02350483 SAS ADEF18+VW Teva-Terazosin 02230806 TEV ADEF18+VW Tab Orl 5mg Hytrin 00818666 BGP ADEF18+VW Apo-Terazosin 02234504 APX ADEF18+VW Mylan-Terazosin 02396300 MYL ADEF18+VW pms-terazosin 02243520 PMS ADEF18+VW ratio-terazosin (Disc/non disp Sept 19/16) 02218976 RPH ADEF18+VW Terazosin 02350491 SAS ADEF18+VW Teva-Terazosin 02230807 TEV ADEF18+VW G04CB G04CB01 Tab Orl 10mg Hytrin 00818674 BGP ADEF18+VW Apo-Terazosin 02234505 APX ADEF18+VW Mylan-Terazosin 02396319 MYL ADEF18+VW pms-terazosin 02243521 PMS ADEF18+VW ratio-terazosin (Disc/non disp Sept 19/16) 02218984 RPH ADEF18+VW Terazosin 02350505 SAS ADEF18+VW Teva-Terazosin 02230808 TEV ADEF18+VW TESTOSTERONE-5-ALPHA REDUCTASE INHIBITORS INHIBITEURS DE LA TESTOSTÉRONE-5-ALPHA RÉDUCTASE FINASTERIDE FINASTÉRIDE Tab Orl 5mg Proscar 02010909 FRS ADEFGVW Act Finasteride 02354462 ATV ADEFGVW Apo-Finasteride 02365383 APX ADEFGVW Auro-Finasteride 02405814 ARO ADEFGVW Finasteride 02355043 AHI ADEFGVW Jamp-Finasteride 02357224 JPC ADEFGVW Mint-Finasteride 02389878 MNT ADEFGVW Mylan-Finasteride 02356058 MYL ADEFGVW pms-finasteride 02310112 PMS ADEFGVW Ran-Finasteride 02371820 RAN ADEFGVW ratio-finasteride (Disc/non disp Jul 8/17) 02306905 TEV ADEFGVW Sandoz Finasteride 02322579 SDZ ADEFGVW Teva-Finasteride 02348500 TEV ADEFGVW September 2015 v.1 108

H01 H01A G04CB02 H01AC H01AC01 DUTASTERIDE DUTASTÉRIDE Cap Orl 0.5mg Avodart 02247813 GSK ADEFGVW Caps Act Dutasteride 02412691 ATV ADEFGVW Apo-Dutasteride 02404206 APX ADEFGVW Dutasteride 02429012 SIV ADEFGVW Med-Dutasteride 02416298 GMP ADEFGVW Mint-Dutasteride 02428873 MNT ADEFGVW pms-dutasteride 02393220 PMS ADEFGVW Sandoz Dutasteride 02424444 SDZ ADEFGVW Teva-Dutasteride 02408287 TEV ADEFGVW PITUITARY AND HYPOTHALAMIC HORMONES AND ANALOGUES HORMONES HYPOPHYSAIRES ET HYPOTHALAMIQUES ANTERIOR PITUITARY LOBE HORMONES AND ANALOGUES HORMONES DU LOBE ANTEHYPOPHYSAIRE SOMATROPIN AND SOMATROPIN AGONISTS SOMATROPINE ET AGONISTES DE LA SOMATROPINE SOMATROPIN SOMATROPINE Pwd SC 5.3mg Genotropin GoQuick 02401703 PFI T (SA) Pws. Pwd SC 12mg Genotropin GoQuick 02401711 PFI T (SA) Pws. Pwd SC 0.6mg Genotropin MiniQuick 02401762 PFI T (SA) Pws. Pwd SC 0.8mg Genotropin MiniQuick 02401770 PFI T (SA) Pws. Pwd SC 1mg Genotropin MiniQuick 02401789 PFI T (SA) Pws. Pwd SC 1.2mg Genotropin MiniQuick 02401797 PFI T (SA) Pws. Pwd SC 1.4mg Genotropin MiniQuick 02401800 PFI T (SA) Pws. Pwd SC 1.6mg Genotropin MiniQuick 02401819 PFI T (SA) Pws. Pwd SC 1.8mg Genotropin MiniQuick 02401827 PFI T (SA) Pws. Pwd SC 2mg Genotropin MiniQuick 02401835 PFI T (SA) Pws. September 2015 v.1 109

H01AC01 SOMATROPIN SOMATROPINE Ctg Inj 6mg Humatrope 02243077 LIL T (SA) Cart Ctg Inj 12mg Humatrope 02243078 LIL T (SA) Cart Ctg Inj 24mg Humatrope 02243079 LIL T (SA) Cart Inj 5mg/1.5mL Omnitrope 02325063 SDZ T (SA) Inj 10mg/1.5mL Omnitrope 02325071 SDZ T (SA) Inj 5mg/2mL Nutropin AQ NuSpin 02399091 HLR T (SA) Inj 10mg/2mL Nutropin AQ NuSpin 02376393 HLR T (SA) Inj 20mg/2mL Nutropin AQ NuSpin 02399083 HLR T (SA) Inj 10mg/2mL Nutropin AQ Pen 02249002 HLR T (SA) Inj 6mg Saizen 02350122 EMD T (SA) Inj 12mg Saizen 02350130 EMD T (SA) Inj 20mg Saizen 02350149 EMD T (SA) Pws Inj 1mg Humatrope 00745626 LIL T (SA) Pds. Nutropin (Disc/non disp Dec 02/15) 02216191 HLR T (SA) Pws Inj 3.33mg Saizen 02215136 EMD T (SA) Pds. Pws Inj 5mg Saizen 02237971 EMD T (SA) Pds. Pws Inj 8.8mg Saizen 02272083 EMD T (SA) Pds. September 2015 v.1 110

H01B H01BA POSTERIOR PITUITARY LOBE HORMONES HORMONES DU LOBE POSTHYPOPHYSAIRE VASOPRESSIN AND ANALOGUES VASOPRESSINE ET ANALOGUES H01BA02 DESMOPRESSIN DESMOPRESSINE Aem Nas 10mcg DDAVP Intranasal 00836362 FEI (SA) Aém. Desmopressin 02242465 AAP (SA) Inj 4mcg/mL DDAVP 00873993 FEI ADEFGVW Nas 10mcg DDAVP 00402516 FEI (SA) ODT Slg 60mg DDAVP Melt 02284995 FEI DEFG-18 (SA) D.O. ODT Slg 120mg DDAVP Melt 02285002 FEI DEFG-18 (SA) D.O. ODT Slg 240mg DDAVP Melt 02285010 FEI DEFG-18 (SA) D.O. Tab Orl 0.1mg DDAVP 00824305 FEI DEFG-18 (SA) Apo-Desmopressin 02284030 APX DEFG-18 (SA) Novo-Desmopressin 02287730 TEV DEFG-18 (SA) pms-desmopressin 02304368 PMS DEFG-18 (SA) Tab Orl 0.2mg DDAVP 00824143 FEI DEFG-18 (SA) Apo-Desmopressin 02284049 APX DEFG-18 (SA) Novo-Desmopressin 02287749 TEV DEFG-18 (SA) pms-desmopressin 02304376 PMS DEFG-18 (SA) H01C H01CA HYPOTHALAMIC HORMONES HORMONES HYPOTHALAMIQUES GONADOTROPIN-RELEASING HORMONES HORMONES DE LIBÉRATION DES GONADOTROPHINES HYPOPHYSAIRES H01CA02 NAFARELIN NAFARÉLINE Nas 2mg/mL Synarel 02188783 PFI (SA) H01CB SOMATOSTATIN AND ANALOGUES SOMATOSTATINE ET ANALOGUES H01CB02 OCTREOTIDE OCTRÉOTIDE Inj 0.05mg/mL Sandostatin 00839191 NVR ADEFGVW Ocphyl 02413191 PDP ADEFGVW Octreotide Acetate Omega 02248639 OMG ADEFGVW September 2015 v.1 111

H01CB02 OCTREOTIDE OCTRÉOTIDE Inj 0.1mg/mL Sandostatin 00839205 NVR ADEFGVW Ocphyl 02413205 PDP ADEFGVW Octreotide Acetate Omega 02248640 OMG ADEFGVW Inj 0.2mg/mL Sandostatin 02049392 NVR ADEFGVW Octreotide Acetate Omega 02248642 OMG ADEFGVW Inj 0.5mg/mL Sandostatin 00839213 NVR ADEFGVW Ocphyl 02413213 PDP ADEFGVW Octreotide Acetate Omega 02248641 OMG ADEFGVW Pws Inj 10mg Sandostatin LAR 02239323 NVR ADEFGVW Pds. Pws Inj 20mg Sandostatin LAR 02239324 NVR ADEFGVW Pds. Pws Inj 30mg Sandostatin LAR 02239325 NVR ADEFGVW Pds. H01CB03 LANREOTIDE LANRÉOTIDE SC 60mg/0.3mL Somatuline Autogel (pre-filled Syringe) 02283395 EMD (SA) SC 90mg/0.3mL Somatuline Autogel (pre-filled Syringe) 02283409 EMD (SA) H02 H02A H02AA SC 120mg/0.5mL Somatuline Autogel (pre-filled Syringe) 02283417 EMD (SA) CORTICOSTEROIDS FOR SYSTEMIC USE CORTICOSTÉROÏDES SYSTÉMIQUES CORTICOSTEROIDS FOR SYSTEMIC USE, PLAIN CORTICOSTÉROÏDES SYSTÉMIQUES, ORDINAIRES MINERALOCORTICOIDS MINÉRALOCORTICOÏDES H02AA02 FLUDROCORTISONE FLUDROCORTISONE Tab Orl 0.1mg Florinef 02086026 PAL ADEFGVW H02AB GLUCOCORTICOIDS GLUCOCORTICOÏDES H02AB01 BETAMETHASONE BÉTAMÉTHASONE Sus IA 3mg/3mg Celestone Soluspan (Disc/non disp Dec 00028096 FRS ADEFGVW Susp 15/16) September 2015 v.1 112

H02AB02 DEXAMETHASONE DEXAMÉTHASONE Tab Orl 0.5mg Apo-Dexamethasone 02261081 APX ADEFGVW pms-dexamethasone 01964976 PMS ADEFGVW ratio-dexamethasone 02240684 RPH ADEFGVW Tab Orl 2mg pms-dexamethasone 02279363 PMS ADEFGVW Tab Orl 4mg Dexasone 00489158 VLN ADEFGVW Apo-Dexamethasone 02250055 APX ADEFGVW pms-dexamethasone 01964070 PMS ADEFGVW ratio-dexamethasone 02240687 RPH ADEFGVW H02AB04 Inj 4mg/mL Dexamethasone-Omega 02204266 OMG ADEFGVW Dexamethasone sodium phosphate 00664227 SDZ ADEFGVW Dexamethasone sodium phosphate 01977547 CYI ADEFGVW METHYLPREDNISOLONE MÉTHYLPREDNISOLONE Tab Orl 4mg Medrol 00030988 PFI ADEFGVW Tab Orl 16mg Medrol 00036129 PFI ADEFGVW Sus IA 20mg/mL Depo-Medrol 01934325 PFI ADEFGVW Susp Sus IA 80mg/mL Depo-Medrol 00030767 PFI ADEFGVW Susp Depo-Medrol 01934341 PFI ADEFGVW Sus IBU 40mg/mL Depo-Medrol 00030759 PFI ADEFGVW Susp Depo-Medrol 01934333 PFI ADEFGVW Pws Inj 125mg Solu-Medrol 02367955 PFI W Pds. H02AB06 Pws Inj 500mg Solu-Medrol 02367963 PFI W Pds. PREDNISOLONE PREDNISOLONE Orl 5mg/5mL Pediapred 02230619 SAV ADEFGVW pms-prednisolone 02245532 PMS ADEFGVW September 2015 v.1 113

H02AB07 PREDNISONE PREDNISONE Tab Orl 1mg Winpred 00271373 AAP ADEFGRVW Apo-Prednisone (Disc/non disp Jan 9/16) 00598194 APX ADEFGRVW Tab Orl 5mg Apo-Prednisone 00312770 APX ABDEFGRVW Novo-Prednisone 00021695 TEV ABDEFGRVW Tab Orl 50mg Apo-Prednisone 00550957 APX ADEFGRVW Novo-Prednisone 00232378 TEV ADEFGRVW H02AB09 HYDROCORTISONE HYDROCORTISONE Tab Orl 10mg Cortef 00030910 PFI ADEFGVW Tab Orl 20mg Cortef 00030929 PFI ADEFGVW Pws Inj 100mg Solu-Cortef 00030600 PFI ADEFGVW Pds. H02B H02AB10 H02BX H03 H03A H02BX01 H03AA H03AA01 CORTISONE CORTISONE Tab Orl 25mg Cortisone 00280437 VLN ADEFGVW CORTICOSTEROIDS FOR SYSTEMIC USE, COMBINATIONS CORTICOSTÉROÏDES SYSTÉMIQUES, EN COMBINAISON CORTICOSTEROIDS FOR SYSTEMIC USE, COMBINATIONS CORTICOSTÉROÏDES SYSTEMIQUES, EN COMBINAISON METHYLPREDNISOLONE, COMBINATIONS MÉTHYLPREDNISOLONE, EN COMBINAISON METHYLPREDNISOLONE / LIDOCAINE MÉTHYLPREDNISOLONE / LIDOCAÏNE Sus IA 40mg/10mg Depo-Medrol 00260428 PFI ADEFGVW Susp THYROID THERAPY TRAITEMENT DE LA THYROÏDE THYROID PREPARATIONS PRÉPARATIONS POUR LA THYROÏDE THYROID HORMONES HORMONES POUR LA THYROÏDE LEVOTHYROXINE SODIUM LÉVOTHYROXINE SODIQUE Tab Orl 0.025mg Synthroid 02172062 BGP ADEFGVW September 2015 v.1 114

H03AA01 LEVOTHYROXINE SODIUM LÉVOTHYROXINE SODIQUE Tab Orl 0.05mg Synthroid 02172070 BGP ADEFGVW Eltroxin 02213192 APR ADEFGVW Tab Orl 0.075mg Synthroid 02172089 BGP ADEFGVW Tab Orl 0.088mg Synthroid 02172097 BGP ADEFGVW Tab Orl 0.1mg Synthroid 02172100 BGP ADEFGVW Eltroxin 02213206 APR ADEFGVW Tab Orl 0.112mg Synthroid 02171228 BGP ADEFGVW Tab Orl 0.125mg Synthroid 02172119 BGP ADEFGVW Tab Orl 0.137mg Synthroid 02233852 BGP ADEFGVW Tab Orl 0.15mg Synthroid 02172127 BGP ADEFGVW Eltroxin 02213214 APR ADEFGVW Tab Orl 0.175mg Synthroid 02172135 BGP ADEFGVW Tab Orl 0.2mg Synthroid 02172143 BGP ADEFGVW Eltroxin 02213222 APR ADEFGVW Tab Orl 0.3mg Synthroid 02172151 BGP ADEFGVW Eltroxin 02213230 APR ADEFGVW H03AA02 H03AA05 LIOTHYRONINE SODIUM LIOTHYRONINE SODIQUE Tab Orl 5mcg Cytomel 01919458 PFI ADEFGVW Tab Orl 25mcg Cytomel 01919466 PFI ADEFGVW THYROID GLAND PREPARATIONS PRÉPARATIONS POUR LA GLANDE THYROÏDE DESICCATED THYROID EXTRAIT THYROÏDIEN LYOPHILISÉ Tab Orl 30mg Thyroid 00023949 ERF ADEFGVW September 2015 v.1 115

H03B H03AA05 H03BA H03BA02 H03BB H04 H04A H03BB02 H04AA H04AA01 THYROID GLAND PREPARATIONS PRÉPARATIONS POUR LA GLANDE THYROÏDE DESICCATED THYROID EXTRAIT THYROÏDIEN LYOPHILISÉ Tab Orl 60mg Thyroid 00023957 ERF ADEFGVW Tab Orl 125mg Thyroid 00023965 ERF ADEFGVW ANTITHYROID PREPARATIONS PRÉPARATIONS ANTI-THYROÏDIENNES THIOURACILS THIOURACILES PROPYLTHIOURACIL PROPYLTHIOURACILE Tab Orl 50mg Propyl-Thyracil 00010200 PAL ADEFGVW Tab Orl 100mg Propyl-Thyracil 00010219 PAL ADEFGVW SULPHUR-CONTAINING IMIDAZOLE DERIVATIVES DÉRIVÉS DE L IMIDAZOLE CONTENANT DU SOUFRE THIAMAZOLE THIAMAZOLE Tab Orl 5mg Tapazole 00015741 PAL ADEFGVW Tab Orl 10mg Tapazole 02296039 PAL ADEFGVW PANCREATIC HORMONES HORMONES PANCRÉATIQUES GLYCOGENOLYTIC HORMONES HORMONES GLYCOGÉNOLYTIQUES GLYCOGENOLYTIC HORMONES HORMONES GLYCOGENOLYTIQUES GLUCAGON GLUCAGON Pws Inj 1mg Glucagen 02333619 NNO ADEFGVW Pds. Glucagen Hypokit 02333627 NNO ADEFGVW Glucagon 02243297 LIL ADEFGVW September 2015 v.1 116

H05 H05B H05BA J01 J01A J01AA H05BA01 J01AA02 CALCIUM HOMEOSTASIS HOMÉOSTASIE DU CALCIUM ANTI-PARATHYROID AGENTS AGENTS ANTI-PARATHYROÏDES CALCITONIN PREPARATIONS PRÉPARATIONS DU CALCITONINE CALCITONIN (SALMON SYNTHETIC) CALCITONINE (SAUMON, SYNTHETIQUE) Inj 100U/mL Caltine (Disc/non disp Jul 25/16) 02007134 FEI ADEFGVW Inj 200U/mL Calcimar 01926691 SAV ADEFGVW ANTIBACTERIALS FOR SYSTEMIC USE ANTIBACTÉRIENS POUR USAGE SYSTÉMIQUE TETRACYCLINES TÉTRACYCLINES TETRACYCLINES TÉTRACYCLINES DOXYCYCLINE DOXYCYCLINE Cap Orl 100mg Vibramycin 00024368 PFI ABDEFGVW Caps Apo-Doxy 00740713 APX ABDEFGVW Doxycycline 02351234 SAS ABDEFGVW Teva-Doxycycline 00725250 TEV ABDEFGVW Tab Orl 100mg Apo-Doxy 00874256 APX ABDEFGVW Doxycycline 02351242 SAS ABDEFGVW Teva-Doxycycline 02158574 TEV ABDEFGVW J01AA07 J01AA08 TETRACYCLINE TÉTRACYCLINE Cap Orl 250mg Tetra 00580929 AAP ADEFGVW Caps MINOCYCLINE MINOCYCLINE Cap Orl 50mg Apo-Minocycline 02084090 APX ABDEFGVW Caps Minocycline 02287226 SAS ABDEFGVW Mylan-Minocycline 02230735 MYL ABDEFGVW Teva-Minocycline 02108143 TEV ABDEFGVW pms-minocycline 02294419 PMS ABDEFGVW Sandoz Minocycline 02237313 SDZ ABDEFGVW September 2015 v.1 117

J01C J01CA J01AA08 J01CA01 MINOCYCLINE MINOCYCLINE Cap Orl 100mg Apo-Minocycline 02084104 APX ABDEFGVW Caps Minocycline 02239982 IVX ABDEFGVW Minocycline 02287234 SAS ABDEFGVW Mylan-Minocycline 02230736 MYL ABDEFGVW Teva-Minocycline 02108151 TEV ABDEFGVW pms-minocycline 02294427 PMS ABDEFGVW Sandoz Minocycline 02237314 SDZ ABDEFGVW BETA LACTAM ANTIBACTERIALS, PENICILLINS ANTIBACTÉRIEN BETA-LACTAME, PÉNICILLINES PENICILLIN WITH EXTENDED SPECTRUMS PÉNICILLINE AVEC SPECTRUMS ÉTENDUS AMPICILLIN AMPICILLINE Cap Orl 250mg Teva-Ampicillin 00020877 TEV ADEFGVW Caps Cap Orl 500mg Teva-Ampicillin 00020885 TEV ADEFGVW Caps Pws Inj 500mg Teva-Ampicillin 00872652 TEV ADEFGW Pds. Pws Inj 1g Teva-Ampicillin 01933345 TEV ADEFGW Pds. Pws Inj 2g Ampicillin Sodium 01933353 TEV ADEFGW Pds. J01CA04 AMOXICILLIN AMOXICILLINE Cap Orl 250mg Amoxicillin 02241826 NUM ABDEFGVW Caps Amoxicillin 02352710 SAS ABDEFGVW Amoxicillin 02401495 SIV ABDEFGVW Apo-Amoxi 00628115 APX ABDEFGVW Auro-Amoxicillin 02388073 ARO ABDEFGVW Mylan-Amoxicillin 02238171 MYL ABDEFGVW Novamoxin 00406724 TEV ABDEFGVW pms-amoxicillin 02230243 PMS ABDEFGVW Cap Orl 500mg Amoxicillin 02241827 NUM ABDEFGVW Caps Amoxicillin 02352729 SAS ABDEFGVW Amoxicillin 02401509 SIV ABDEFGVW Apo-Amoxi 00628123 APX ABDEFGVW Auro-Amoxicillin 02388081 ARO ABDEFGVW Mylan-Amoxicillin 02238172 MYL ABDEFGVW Novamoxin 00406716 TEV ABDEFGVW pms-amoxicillin 02230244 PMS ABDEFGVW September 2015 v.1 118

J01CA04 AMOXICILLIN AMOXICILLINE Pws Orl 25mg Amoxicillin 02352745 SAS ABDEFGVW Pds. Amoxicillin (sugar-reduced) 02352761 SAS ABDEFGVW Apo-Amoxi 00628131 APX ABDEFGVW Novamoxin 00452149 TEV ABDEFGVW Novamoxin 125 (sugar-reduced) 01934171 TEV ABDEFGVW pms-amoxicillin 02230245 PMS ABDEFGVW Pws Orl 50mg Amoxicillin 02352753 SAS ABDEFGVW Pds. Amoxicillin 02401541 SIV ABDEFGVW Amoxicillin (sugar-reduced) 02352788 SAS ABDEFGVW Apo-Amoxi 00628158 APX ABDEFGVW Novamoxin 00452130 TEV ABDEFGVW Novamoxin 125 (sugar-reduced) 01934163 TEV ABDEFGVW pms-amoxicillin 02230246 PMS ABDEFGVW TabC Orl 125mg Novamoxin chew 02036347 TEV ABDEFGVW C. TabC Orl 250mg Novamoxin chew 02036355 TEV ABDEFGVW C. J01CE J01CA12 PIPERACILLIN PIPÉRACILLINE Pws Inj 3g Piperacillin 02246641 HOS ADEFGW Pds. BETA-LACTAMASE SENSITIVE PENICILLINS PÉNICILLINES SENSIBLES AUX BETA-LACTAMASES J01CE01 BENZYLPENICILLIN (PENICILLIN G) BENZYLPÉNICILLINE (PÉNICILLINE G) Inj 1000000U Penicillin G Sodium 01930672 TEV ADEFGW Inj 5000000U Penicillin G Sodium 00883751 TEV ADEFGW Inj 10000000U Penicillin G Sodium 01930680 TEV ADEFGW Pws Inj 1000000U Crystapen (Disc/non disp Nov 24/16) 02060086 BCH W Pds. Pws Inj 10000000U Crystapen (Disc/non disp Nov 24/16) 02060108 BCH W Pds. September 2015 v.1 119

J01CE02 PHENOXYMETHYLPENICILLIN (PENICILLIN V) PHENOXYMETHYLPÉNICILLINE (PÉNICILLINE V) Pws Orl 25mg Apo-Pen VK 00642223 APX ADEFGVW Pds. Pws Orl 60mg Apo-Pen VK 00642231 APX ADEFGVW Pds. J01CF J01CE08 J01CF02 Tab Orl 300mg Pen VK 00642215 AAP ADEFGVW BENZATHINE BENZYLPENICILLIN (PENICILLIN G BENZATHINE) BENZATHINE BENZYLPÉNICILLINE (PÉNICILLINE G BENZATHINE) Sus Inj 1200000unit/2mL Bicillin L-A 02291924 KNG ADEFGVW Susp BETA-LACTAMASE RESISTANT PENICILLINS PÉNICILLINES RÉSISTANT AUX BETA-LACTAMASE CLOXACILLIN CLOXACILLINE Cap Orl 250mg Novo-Cloxin 00337765 TEV ABDEFGVW Caps Cap Orl 500mg Novo-Cloxin 00337773 TEV ABDEFGVW Caps Pws Inj 500mg Cloxacillin Sodium 01912429 TEV ADEFGW Pds. Pws Inj 1g Cloxacillin Sodium 01975447 TEV ADEFGW Pds. Pws Inj 2g Cloxacillin Sodium 01912410 TEV ADEFGW Pds. Cloxacillin 02367424 STR W J01CR J01CR02 Pws Orl 25mg Novo-Cloxin 00337757 TEV ABDEFGVW Pds. COMBINATIONS PENICILLINS INCLUDING BETA LACTAMASE INHIBITORS COMBINAISON DE PÉNICILLINES, Y COMPRIS LES INHIBITEURS DE BETA-LACTAMASE AMOXICILLIN AND ENZYME INHIBITOR AMOXICILLINE ET INHIBITEURS D ENZYMES AMOXICILLIN / CLAVULANIC ACID AMOXICILLINE / ACIDE CLAVULANIQUE Pws Orl 25mg/6.25mg Clavulin 01916882 GSK ABDEFGVW Pds. Apo-Amoxi Clav 02243986 APX ABDEFGVW Ratio-Aclavulanate 125 F 02244646 TEV ABDEFGVW September 2015 v.1 120

J01CR02 AMOXICILLIN AND ENZYME INHIBITOR AMOXICILLINE ET INHIBITEURS D ENZYMES AMOXICILLIN / CLAVULANIC ACID AMOXICILLINE / ACIDE CLAVULANIQUE Pws Orl 50mg/12.5mg Clavulin-250 F 01916874 GSK ABDEFGVW Pds. Apo-Amoxi Clav 02243987 APX ABDEFGVW Ratio-Aclavulanate 250 F 02244647 TEV ABDEFGVW Pws Orl 200mg/28.5mg/5mL Clavulin 200 02238831 GSK ABDEFGVW Pds. Pws Orl 400mg/57mg/5mL Clavulin 400 02238830 GSK ABDEFGVW Pds. Apo-Amoxi Clav 02288559 APX ABDEFGVW Tab Orl 250mg/125mg Apo-Amoxi Clav 02243350 APX ABDEFGVW Tab Orl 500mg/125mg Clavulin-500 F 01916858 GSK ABDEFGVW Apo-Amoxi Clav 02243351 APX ABDEFGVW ratio-aclavulanate 02243771 TEV ABDEFGVW Tab Orl 875mg/125mg Clavulin 02238829 GSK ABDEFGVW Apo-Amoxi Clav 02245623 APX ABDEFGVW ratio-aclavulanate 02247021 TEV ABDEFGVW Novo-Clavamoxin 02248138 TEV ABDEFGVW J01CR03 TICARICILLIN AND ENZYME INHIBITOR TICARICILLINE ET INHIBITEURS D ENZYMES TICARICILLIN / POTASSIUM CLAVULANATE TICARICILLINE / CLAVULANATE DE POTASSIUM Pws Inj 3g Timentin (Disc/non disp Mar 23/17) 01916939 GSK W Pds. J01CR05 PIPERACILLIN AND ENZYME INHIBITOR PIPÉRACILLINE ET INHIBITEURS D ENZYMES PIPERACILLIN / TAZOBACTAM PIPÉRACILLINE / TAZOBACTAM Pws Inj 2g/0.25g Tazocin (Disc/non disp Apr 24/17) 02170817 PFI ABDEFGW Pds. Piperacillin & Tazobactam 02308444 APX ABDEFGW Piperacillin & Tazobactam 02299623 SDZ ABDEFGW Pws Inj 3g/0.375g Tazocin (Disc/non disp Feb 26/17) 02170795 PFI ABDEFGW Pds. Piperacillin & Tazobactam 02308452 APX ABDEFGW Piperacillin & Tazobactam 02299631 SDZ ABDEFGW Piperacillin/Tazobactam 02370166 TEV ABDEFGW Pws Inj 4g/0.5g Tazocin (Disc/non disp Apr 24/17) 02170809 PFI ABDEFGW Pds. Piperacillin & Tazobactam 02308460 APX ABDEFGW Piperacillin & Tazobactam 02299658 SDZ ABDEFGW Piperacillin/Tazobactam 02370174 TEV ABDEFGW Piperacillin and Tazobactam 02391546 MYL ABDEFGW September 2015 v.1 121

J01D J01DB J01DB01 OTHER BETA LACTAM ANTIBACTERIALS AUTRES ANTIBACTERIEN BETA-LACTAM FIRST GENERATION CEPHALOSPORINS CÉPHALOSPORINES DE PREMIÈRE GÉNÉRATION CEPHALEXIN CÉPHALEXINE Cap Orl 250mg Novo-Lexin 00342084 TEV ABDEFGVW Caps Cap Orl 500mg Novo-Lexin 00342114 TEV ABDEFGVW Caps Pws Orl 25mg Novo-Lexin 00342106 TEV ABDEFGVW Pds. Pws Orl 50mg Novo-Lexin 00342092 TEV ABDEFGVW Pds. Tab Orl 250mg Apo-Cephalex 00768723 APX ABDEFGVW Novo-Lexin 00583413 TEV ABDEFGVW J01DC J01DB04 J01DB05 J01DC01 Tab Orl 500mg Apo-Cephalex 00768715 APX ABDEFGVW Novo-Lexin 00583421 TEV ABDEFGVW CEFAZOLIN CÉFAZOLINE Pws Inj 500mg Cefazolin Sodium 02108119 TEV ABDEFGW Pds. Cefazolin Sodium 02308932 SDZ ABDEFGW Pws Inj 1g Cefazolin 02297205 HOS ABDEFGW Pds. Cefazolin Sodium 02108127 TEV ABDEFGW Cefazolin Sodium 02308959 SDZ ABDEFGW CEFADROXIL CÉFADROXIL Cap Orl 500mg Apo-Cefadroxil 02240774 APX ADEFGVW Caps Teva-Cefadroxil 02235134 TEV ADEFGVW SECOND GENERATION CEPHALOSPORINS CÉPHALOSPORINES DE DEUXIÈME GÉNÉRATION CEFOXITIN CÉFOXITINE Pws Inj 1g Cefoxitin for Injection 02291711 APX W Pds. Cefoxitin Sodium 02128187 TEV W Pws Inj 2g Cefoxitin for Injection 02291738 APX W Pds. Cefoxitin Sodium 02128195 TEV W Pws Inj 10g Cefoxitin 02240773 TEV W Pds. September 2015 v.1 122

J01DC02 CEFUROXIME CÉFUROXIME Orl 125mg/mL Ceftin 02212307 GSK ABDEFGVW Pws Inj 750mg Cefuroxime 02241638 FKB ADEFGW Pds. Pws Inj 1.5g Cefuroxime 02241639 FKB ADEFGW Pds. Tab Orl 250mg Ceftin 02212277 GSK ABDEFGVW Apo-Cefuroxime 02244393 APX ABDEFGVW Auro-Cefuroxime 02344823 ARO ABDEFGVW ratio-cefuroxime 02242656 TEV ABDEFGVW J01DC04 Tab Orl 500mg Ceftin 02212285 GSK ABDEFGVW Apo-Cefuroxime 02244394 APX ABDEFGVW Auro-Cefuroxime 02344831 ARO ABDEFGVW ratio-cefuroxime 02242657 TEV ABDEFGVW CEFACLOR CÉFACLOR Cap Orl 250mg Ceclor 00465186 PDP ABDEFGVW Caps Cap Orl 500mg Ceclor 00465194 PDP ABDEFGVW Caps Pws Orl 25mg Ceclor 00465208 PDP ABDEFGVW Pds. Pws Orl 50mg Ceclor 00465216 PDP ABDEFGVW Pds. Pws Orl 75mg Ceclor B.I.D. 00832804 PDP ABDEFGVW Pds. J01DC10 CEFPROZIL CEFPROZIL Tab Orl 250mg Cefzil 02163659 BRI ADEFGVW Apo-Cefprozil 02292998 APX ADEFGVW Auro-Cefprozil 02347245 ARO ADEFGVW Ran-Cefprozil 02293528 RAN ADEFGVW Sandoz Cefprozil 02302179 SDZ ADEFGVW Tab Orl 500mg Cefzil 02163667 BRI ADEFGVW Apo-Cefprozil 02293005 APX ADEFGVW Auro-Cefprozil 02347253 ARO ADEFGVW Ran-Cefprozil 02293536 RAN ADEFGVW Sandoz Cefprozil 02302187 SDZ ADEFGVW September 2015 v.1 123

J01DC10 CEFPROZIL CEFPROZIL Pws Orl 25mg Cefzil 02163675 BRI ADEFGVW Pds. Apo-Cefprozil 02293943 APX ADEFGVW Auro-Cefprozil (Disc/non disp Nov 3/16) 02347261 ARO ADEFGVW Ran-Cefprozil 02329204 RAN ADEFGVW Pws Orl 50mg Cefzil 02163683 BRI ADEFGVW Pds. Apo-Cefprozil 02293951 APX ADEFGVW Auro-Cefprozil (Disc/non disp Nov 3/16) 02347288 ARO ADEFGVW Ran-Cefprozil 02293579 RAN ADEFGVW J01DD THIRD GENERATION CEPHALOSPORINS CÉPHALOSPORINES DE TROISIÈME GÉNÉRATION J01DD01 CEFOTAXIME CÉFOTAXIME Pws Inj 1g Claforan 02225093 SAV ADEFGW Pds. Cefotaxime Sodium 02434091 STR ADEFGW Pws Inj 2g Claforan 02225107 SAV ADEFGW Pds. Cefotaxime Sodium 02434105 STR ADEFGW J01DD02 CEFTAZIDIME CEFTAZIDIME Pws Inj 1g Fortaz 02212218 GSK ABDEFGW Pds. Ceftazidime 00886971 FKB ABDEFGW Pws Inj 2g Fortaz 02212226 GSK ABDEFGW Pds. Ceftazidime 00886955 FKB ABDEFGW J01DD04 CEFTRIAXONE CEFTRIAXONE Pws Inj 250mg Ceftriaxone 02292866 APX ADEFGVW Pds. Ceftriaxone Sodium 02325594 STR ADEFGVW Pws Inj 1g Ceftriaxone 02292270 SDZ ADEFGVW Pds. Ceftriaxone 02292874 APX ADEFGVW Ceftriaxone Sodium 02325616 STR ADEFGVW Ceftriaxone Sodium 02287633 TEV ADEFGVW Pws Inj 2g Ceftriaxone 02292289 SDZ ADEFGVW Pds. Ceftriaxone 02292882 APX ADEFGVW Ceftriaxone Sodium 02325624 STR ADEFGVW J01DD08 CEFIXIME CÉFIXIME Pws Orl 20mg Suprax 00868965 SAV ABDEFGVW Pds. Tab Orl 400mg Suprax 00868981 SAV ABDEFGVW Auro-Cefixime 02432773 ARO ABDEFGVW September 2015 v.1 124

J01DE J01DH J01DE01 J01DH02 FOURTH GENERATION CEPHALOSPORINS CÉPHALOSPORINES DE QUATRIÈME GÉNÉRATION CEFEPIME CÉFEPIME Pws Inj 1g Maxipime (Disc/Non-Disp Jan 28/17) 02163632 BRI W Pds. Pws Inj 2g Maxipime (Disc/Non-Disp Jan 28/17) 02163640 BRI W Pds. Cefepime 02319039 APX W CARBAPENEMS CARBAPENEMS MEROPENEM MÉROPÉNEM Pws Inj 500mg Merrem 02218488 AZE W Pds. Pws Inj 1g Merrem 02218496 AZE W Pds. J01E J01EA J01DH03 J01DH51 J01EA01 ERTAPENEM ERTAPÉNEM Pws Inj 1g Invanz 02247437 FRS W Pds. IMIPENEM AND ENZYME INHIBITOR IMIPENEM ET INHIBITEURS D ENZYMES IMIPENEM / CILASTATIN IMIPÉNEM / CILASTATINE Pws Inj 250mg Ran-Imipenem-Cilastatin 02351692 RAN W Pds. Pws Inj 500mg Primaxin 00717282 FRS W Pds. Ran-Imipenem-Cilastatin 02351706 RAN W SULFONAMIDES AND TRIMETHOPRIM SULFONAMIDES ET TRIMÉTHOPRIME TRIMETHOPRIM AND DERIVATIVES TRIMÉTHOPRIME ET DÉRIVÉS TRIMETHOPRIM TRIMÉTHOPRIME Tab Orl 100mg Trimethoprim 02243116 AAP ADEFGVW Tab Orl 200mg Trimethoprim 02243117 AAP ADEFGVW September 2015 v.1 125

J01EE J01EE01 COMBINATIONS OF SULFONAMIDES AND TRIMETHOPRIM, INCLUDING DERIVATIVES COMBINAISON DE SULFONAMIDES ET DE TRIMÉTHOPRIME, INCLUANT LES DÉRIVÉS SULFAMETHOXASOLE AND TRIMETHOPRIM SULFAMÉTHOXASOLE ET TRIMÉTHOPRIME Sus Orl 8mg/40mg Teva-Trimel 00726540 TEV ABDEFGVW Susp Tab Orl 20mg/100mg Apo-Sulfatrim 00445266 APX ABDEFGVW Tab Orl 80mg/400mg Apo-Sulfatrim 00445274 APX ABDEFGVW Teva-Trimel 00510637 TEV ABDEFGVW J01F J01FA J01FA01 Tab Orl 160mg/800mg Apo-Sulfatrim DS 00445282 APX ABDEFGVW Teva-Trimel DS 00510645 TEV ABDEFGVW MACROLIDES, LINCOSAMIDES AND STREPTOGRAMINS MACROLIDES, LINCOSAMIDES ET STREPTOGRAMINES MACROLIDES MACROLIDES ERYTHROMYCIN ÉRYTHROMYCINE ECC Orl 250mg Eryc 00607142 PFI ABDEFGVW Caps.Ent Erythro E-C (Disc/non disp Nov 7/16) 00726672 AAP ABDEFGVW ECC Orl 333mg Eryc 00873454 PFI ABDEFGVW Caps.Ent Erythro E-C (Disc/non disp Nov 7/16) 01925938 AAP ABDEFGVW Tab Orl 250mg Erythro 00682020 AAP ABDEFGVW Orl 250mg/5mL Novo-Rythro Estolate 00262595 TEV ABDEFGVW Pws Orl 40mg Novo-Rythro 00605859 TEV ABDEFGVW Pds. Pws Orl 80mg Novo-Rythro 00652318 TEV ABDEFGVW Pds. Tab Orl 600mg Erythro-ES 00637416 AAP ABDEFGVW Tab Orl 250mg Erythro-S 00545678 AAP ABDEFGVW Tab Orl 500mg Erythro-S 00688568 AAP ABDEFGVW September 2015 v.1 126

J01FA02 J01FA09 SPIRAMYCIN SPIRAMYCINE Cap Orl 750000IU Rovamycine 250 01927825 ODN ADEFGVW Caps Cap Orl 1500000IU Rovamycine 500 01927817 ODN ADEFGVW Caps CLARITHROMYCIN CLARITHROMYCINE ERT Orl 500mg Biaxin XL 02244756 ABB ABDEFGVW L.P. Act Clarithromycin XL 02403196 ATV ABDEFGVW Apo-Clarithromycin XL 02413345 APX ABDEFGVW Pws Orl 125mg/5mL Biaxin 02146908 ABB ABDEFGVW Pds. Accel-Clarithromycin 02390442 ACC ABDEFGVW Clarithromycin 02408988 SAS ABDEFGVW Pws Orl 250mg/5mL Biaxin 02244641 ABB ABDEFGVW Pds. Accel-Clarithromycin 02390450 ACC ABDEFGVW Clarithromycin 02408996 SAS ABDEFGVW Tab Orl 250mg Biaxin BID 01984853 ABB ABDEFGVW Apo-Clarithromycin 02274744 APX ABDEFGVW Mylan-Clarithromycin 02248856 MYL ABDEFGVW pms-clarithromycin 02247573 PMS ABDEFGVW Ran-Clarithromycin 02361426 RAN ABDEFGVW Sandoz Clarithromycin 02266539 SDZ ABDEFGVW Teva-Clarithromycin 02248804 TEV ABDEFGVW J01FA10 Tab Orl 500mg Biaxin BID 02126710 ABB ABDEFGVW Apo-Clarithromycin 02274752 APX ABDEFGVW Mylan-Clarithromycin 02248857 MYL ABDEFGVW pms-clarithromycin 02247574 PMS ABDEFGVW Ran-Clarithromycin 02361434 RAN ABDEFGVW Sandoz Clarithromycin 02266547 SDZ ABDEFGVW Teva-Clarithromycin 02248805 TEV ABDEFGVW AZITHROMYCIN AZITHROMYCINE Pws Inj 500mg Zithromax 02239952 PFI ADEFGVW Pds. Azithromycin 02385473 MYL ADEFGVW Pws Orl 100mg/5mL Zithromax 02223716 PFI ABDEFGVW Pds. Azithromycin 02274388 PMS ABDEFGVW GD-Azithromycin 02274566 GMD ABDEFGVW Novo-Azithromycin pediatric 02315157 TEV ABDEFGVW Phl-Azithromycin 02282380 PHL ABDEFGVW pms-azithromycin 02418452 PMS ABDEFGVW Sandoz Azithromycin 02332388 SDZ ABDEFGVW September 2015 v.1 127

J01FA10 AZITHROMYCIN AZITHROMYCINE Pws Orl 200mg/5mL Zithromax 02223724 PFI ABDEFGVW Pds. Azithromycin 02274396 PMS ABDEFGVW GD-Azithromycin 02274574 GMD ABDEFGVW Novo-Azithromycin pediatric 02315165 TEV ABDEFGVW Phl-Azithromycin 02282410 PHL ABDEFGVW pms-azithromycin 02418460 PMS ABDEFGVW Sandoz Azithromycin 02332396 SDZ ABDEFGVW Tab Orl 250mg Zithromax 02212021 PFI ABDEFGVW Act Azithromycin 02255340 ATV ABDEFGVW Apo-Azithromycin 02247423 APX ABDEFGVW Apo-Azithromycin Z 02415542 APX ABDEFGVW Azithromycin 02330881 SAS ABDEFGVW GD-Azithromycin 02274531 GMD ABDEFGVW Mylan-Azithromycin 02278359 MYL ABDEFGVW Novo-Azithromycin 02267845 TEV ABDEFGVW pms-azithromycin 02261634 PMS ABDEFGVW ratio-azithromycin (Disc/non disp Sept 19/16) 02275287 RPH ABDEFGVW Sandoz Azithromycin 02265826 SDZ ABDEFGVW J01FF J01FF01 Tab Orl 600mg Zithromax (Disc/non disp Feb 4/16) 02231143 PFI W (SA) Act Azithromycin 02256088 ATV W (SA) Azithromycin (Disc/non disp Aug 1/16) 02330911 SAS W (SA) pms-azithromycin 02261642 PMS W (SA) LINCOSAMIDES LINCOSAMIDES CLINDAMYCIN CLINDAMYCINE Cap Orl 150mg Dalacin C 00030570 PFI ABDEFGVW Caps Apo-Clindamycin 02245232 APX ABDEFGVW Mylan-Clindamycin 02258331 MYL ABDEFGVW Teva-Clindamycin 02241709 TEV ABDEFGVW Cap Orl 300mg Dalacin C 02182866 PFI ABDEFGVW Caps Apo-Clindamycin 02245233 APX ABDEFGVW Mylan-Clindamycin 02258358 MYL ABDEFGVW Teva-Clindamycin 02241710 TEV ABDEFGVW Inj 150mg/mL Dalacin C Phosphate 00260436 PFI ADEFGW Clindamycin (bulk vials) 02230535 SDZ ADEFGW Clindamycin (2mL, 4mL, 6mL vials) 02230540 SDZ ADEFGW Pws Orl 75mg/5mL Dalacin C 00225851 PFI ABDEFGVW Pds. September 2015 v.1 128

J01G J01GB J01GB01 AMINOGLYCOSIDE ANTIBACTERIALS ANTIBACTÉRIENS AMINOGLYCOSIDES OTHER AMINOGLYCOSIDES AUTRES AMINOGLYCOSIDES TOBRAMYCIN TOBRAMYCINE Inh 300mg/5mL Tobi 02239630 NVR (SA) Inj 40mg/mL Tobramycin (PF) 02241210 SDZ ABDEFGVW Inj 40mg/mL Tobramycin 02241210 SDZ ABDEFGVW Tobramycin 02382814 MYL ABDEFGVW J01GB03 GENTAMICIN GENTAMICINE Inj 40mg/mL Gentamicin 02242652 SDZ ADEFGVW J01GB06 AMIKACIN AMIKACINE Inj 250mg/mL Amikacin 02242971 SDZ W J01M J01MA J01MA01 QUINOLONE ANTIBACTERIALS ANTIBACTÉRIENS QUINOLONES FLUOROQUINOLONES FLUOROQUINOLONES OFLOXACIN OFLOXACINE Tab Orl 200mg Ofloxacin 02231529 AAP ADEFGVW Tab Orl 300mg Ofloxacin 02231531 AAP ADEFGVW Tab Orl 400mg Ofloxacin 02231532 AAP ADEFGVW J01MA02 CIPROFLOXACIN CIPROFLOXACINE ERT Orl 1000mg Cipro XL 02251787 BAY (SA) L.P. Inj 2mg/mL Ciprofloxacin I.V. 02267462 TEV W September 2015 v.1 129

J01MA02 CIPROFLOXACIN CIPROFLOXACINE Orl 10g/100mL Cipro Oral Suspension 02237514 BAY (SA) Tab Orl 250mg Cipro 02155958 BAY BW (SA) Act Ciprofloxacin 02247339 ATV BW (SA) Apo-Ciproflox 02229521 APX BW (SA) Auro-Ciprofloxacin 02381907 ARO BW (SA) Ciprofloxacin 02353318 SAS BW (SA) Ciprofloxacin 02386119 SIV BW (SA) Jamp-Ciprofloxacin 02380358 JPC BW (SA) Mar-Ciprofloxacin 02379686 MAR BW (SA) Mint-Ciprofloxacin 02317427 MNT BW (SA) Mint-Ciproflox 02423553 MNT BW (SA) Mylan-Ciprofloxacin 02245647 MYL BW (SA) Teva-Ciprofloxacin 02161737 TEV BW (SA) pms-ciprofloxacin 02248437 PMS BW (SA) Ran-Ciproflox 02303728 RAN BW (SA) ratio-ciprofloxacin (Disc/non disp Nov 29/15) 02246825 TEV BW (SA) Sandoz Ciprofloxacin 02248756 SDZ BW (SA) Septa-Ciprofloxacin 02379627 SPT BW (SA) Tab Orl 500mg Cipro 02155966 BAY BW (SA) Act Ciprofloxacin 02247340 ATV BW (SA) Apo-Ciproflox 02229522 APX BW (SA) Auro-Ciprofloxacin 02381923 ARO BW (SA) Ciprofloxacin 02353326 SAS BW (SA) Ciprofloxacin 02386127 SIV BW (SA) Jamp-Ciprofloxacin 02380366 JPC BW (SA) Mar-Ciprofloxacin 02379694 MAR BW (SA) Mint-Ciprofloxacin 02317435 MNT BW (SA) Mint-Ciproflox 02423561 MNT BW (SA) Mylan-Ciprofloxacin 02245648 MYL BW (SA) Teva-Ciprofloxacin 02161745 TEV BW (SA) pms-ciprofloxacin 02248438 PMS BW (SA) Ran-Ciproflox 02303736 RAN BW (SA) Sandoz Ciprofloxacin 02248757 SDZ BW (SA) Septa-Ciprofloxacin 02379635 SPT BW (SA) September 2015 v.1 130

J01MA02 J01MA06 J01MA12 CIPROFLOXACIN CIPROFLOXACINE Tab Orl 750mg Cipro 02155974 BAY BW (SA) Act Ciprofloxacin 02247341 ATV BW (SA) Apo-Ciproflox 02229523 APX BW (SA) Auro-Ciprofloxacin 02381931 ARO BW (SA) Ciprofloxacin 02353334 SAS BW (SA) Jamp-Ciprofloxacin 02380374 JPC BW (SA) Mar-Ciprofloxacin 02379708 MAR BW (SA) Mint-Ciprofloxacin 02317443 MNT BW (SA) Mylan-Ciprofloxacin 02245649 MYL BW (SA) Novo-Ciprofloxacin 02161753 TEV BW (SA) pms-ciprofloxacin 02248439 PMS BW (SA) Ran-Ciproflox 02303744 RAN BW (SA) ratio-ciprofloxacin (Disc/non disp Nov 29/15) 02246827 TEV BW (SA) Septa-Ciprofloxacin 02379643 SPT BW (SA) Sandoz Ciprofloxacin 02248758 SDZ BW (SA) NORFLOXACIN NORFLOXACINE Tab Orl 400mg Apo-Norflox 02229524 APX ADEFVW Co Norfloxacin 02269627 COB ADEFVW Teva-Norfloxacin 02237682 TEV ADEFVW pms-norfloxacin (Disc/non disp Oct 29/15) 02246596 PMS ADEFVW LEVOFLOXACIN LÉVOFLOXACINE Inj 5mg/mL Levaquin (Disc/non disp Mar 19/16) 02236839 JAN W Levofloxacin 02314932 HOS W Tab Orl 250mg Levaquin (Disc/non disp Oct 27/16) 02236841 JAN VW (SA) Act Levofloxacin 02315424 ATV VW (SA) Apo-Levofloxacin 02284707 APX VW (SA) Mylan-Levofloxacin 02313979 MYL VW (SA) Teva-Levofloxacin 02248262 TEV VW (SA) pms-levofloxacin 02284677 PMS VW (SA) Sandoz Levofloxacin 02298635 SDZ VW (SA) Tab Orl 500mg Levaquin (Disc/non disp Apr 1/17) 02236842 JAN VW (SA) Act Levofloxacin 02315432 ATV VW (SA) Apo-Levofloxacin 02284715 APX VW (SA) Mylan-Levofloxacin 02313987 MYL VW (SA) Teva-Levofloxacin 02248263 TEV VW (SA) pms-levofloxacin 02284685 PMS VW (SA) Sandoz Levofloxacin 02298643 SDZ VW (SA) September 2015 v.1 131

J01X J01XA J01MA12 J01MA14 J01XA01 LEVOFLOXACIN LÉVOFLOXACINE Tab Orl 750mg Levaquin (Disc/non disp Apr 1/17) 02246804 JAN W Act Levofloxacin 02315440 ATV W Apo-Levofloxacin 02325942 APX W Teva-Levofloxacin 02285649 TEV W pms-levofloxacin 02305585 PMS W Sandoz Levofloxacin 02298651 SDZ W MOXIFLOXACIN MOXIFLOXACINE Inj 400mg/250mL Avelox I.V. 02246414 BAY W Tab Orl 400mg Avelox 02242965 BAY VW (SA) OTHER ANTIBACTERIALS AUTRES ANTIBACTÉRIENS GLYCOPEPTIDE ANTIBACTERIALS ANTIBACTÉRIENS GLYCOPEPTIDES VANCOMYCIN VANCOMYCINE Cap Orl 125mg Vancocin 00800430 MRS ADEFGVW Caps Jamp-Vancomycin 02407744 JPC ADEFGVW Vancomycin Hydrochloride 02377470 FKB ADEFGVW Cap Orl 250mg Vancocin 00788716 MRS ADEFGVW Caps Jamp-Vancomycin 02407752 JPC ADEFGVW Vancomycin Hydrochloride 02377489 FKB ADEFGVW Pws Inj 500mg pms-vancomycin (Disc/non disp Mar 23/17) 02241820 PMS ABDEFGVW Pds. Sterile Vancomycin 02230191 HOS ABDEFGVW Sterile Vancomycin HCL 02139375 FKB ABDEFGVW Val-Vancomycin 02342855 VLN ABDEFGVW Vancomycin 02394626 SDZ ABDEFGVW Vancomycin 02407914 MYL ABDEFGVW Pws Inj 1g pms-vancomycin(disc/non disp Mar 23/17) 02241821 PMS ABDEFGVW Pds. Val-Vancomycin 02342863 VLN ABDEFGVW Vancomycin 02394634 SDZ ABDEFGVW Vancomycin HCL 02139383 FKB ABDEFGVW Vancomycin 02407922 MYL ABDEFGVW September 2015 v.1 132

J01XD J01XE J01XD01 J01XE01 IMIDAZOLE DERIVATIVES DÉRIVÉS DE L IMIDAZOLE METRONIDAZOLE MÉTRONIDAZOLE Inj 5mg/mL Metronidazole 00649074 HOS W Metronidazole 00870420 BAX W Tab Orl 250mg Metronidazole 00545066 AAP ADEFGVW NITROFURAN DERIVATIVES DÉRIVÉS DU NITROFURANE NITROFURANTOIN NITROFURANTOÏNE Cap Orl 50mg Teva-Furantoin 02231015 TEV ADEFGVW Caps Cap Orl 100mg Macrobid 02063662 WNC ADEFGVW Caps Tab Orl 50mg Nitrofurantoin 00319511 AAP ADEFGVW J01XX J01XX01 J01XX05 J01XX08 Tab Orl 100mg Nitrofurantoin 00312738 AAP ADEFGVW OTHER ANTIBACTERIALS AUTRES ANTIBACTÉRIENS FOSFOMYCIN FOSFOMYCINE Pws Orl 3g Monurol 02240335 PAL (SA) Pds. METHENAMINE MÉTHÉNAMINE Tab Orl 500mg Mandelamine 00499013 ERF ADEFGVW LINEZOLID LINÉZOLIDE Tab Orl 600mg Zyvoxam 02243684 PFI (SA) Apo-Linezolid 02426552 APX (SA) Sandoz Linezolid 02422689 SDZ (SA) September 2015 v.1 133

J02 J02A J02AA J02AB J02AC J02AA01 J02AB02 J02AC01 ANTIMYCOTICS FOR SYSTEMIC USE ANTIMYCOTIQUES POUR USAGE SYSTÉMIQUE ANTIMYCOTICS FOR SYSTEMIC USE ANTIMYCOTIQUES POUR USAGE SYSTÉMIQUE ANTIBIOTICS ANTIBIOTIQUES AMPHOTERICIN B AMPHOTÉRICINE B Pws Inj 50mg Fungizone IV 00029149 BRI W Pds. IMIDAZOLE DERIVATIVES DÉRIVÉS DE L IMIDAZOLE KETOCONAZOLE KÉTOCONAZOLE Tab Orl 200mg Apo-Ketoconazole 02237235 APX ADEFGVW Novo-Ketoconazole 02231061 TEV ADEFGVW TRIAZOLE DERIVATIVES DÉRIVÉS DE TRIAZOLE FLUCONAZOLE FLUCONAZOLE Cap Orl 150mg Apo-Fluconazole 02241895 APX ADEFGVW Caps Jamp-Fluconazole 02432471 JPC ADEFGVW pms-fluconazole 02282348 PMS ADEFGVW Inj 2mg/mL Diflucan 00891835 PFI W Tab Orl 50mg Act Fluconazole 02281260 ATV ADEFGVW Apo-Fluconazole 02237370 APX ADEFGVW Mylan-Fluconazole 02245292 MYL ADEFGVW Novo-Fluconazole 02236978 TEV ADEFGVW pms-fluconazole 02245643 PMS ADEFGVW Tab Orl 100mg Act Fluconazole 02281279 ATV ADEFGVW Apo-Fluconazole 02237371 APX ADEFGVW Mylan-Fluconazole 02245293 MYL ADEFGVW Novo-Fluconazole 02236979 TEV ADEFGVW pms-fluconazole 02245644 PMS ADEFGVW J02AC02 ITRACONAZOLE ITRACONAZOLE Cap Orl 100mg Sporanox 02047454 JAN (SA) Caps September 2015 v.1 134

J02AX J04 J04A J04AB J02AC03 J02AX04 J04AB02 VORICONAZOLE VORICONAZOLE Tab Orl 50mg Vfend 02256460 PFI (SA) Apo-Voriconazole 02409674 APX (SA) Sandoz Voriconazole 02399245 SDZ (SA) Teva-Voriconazole 02396866 TEV (SA) Tab Orl 200mg Vfend 02256479 PFI (SA) Apo-Voriconazole 02409682 APX (SA) Sandoz Voriconazole 02399253 SDZ (SA) Teva-Voriconazole 02396874 TEV (SA) ANTIMYCOTICS FOR SYSTEMIC USE ANTIMYCOTIQUES POUR USAGE SYSTÉMIQUE CASPOFUNGIN CASPOFUNGIN Pwd Inj 50mg Cancidas IV 02244265 FRS W Pws. ANTIMYCOBACTERIALS ANTIFONGIQUES BACTÉRIENS DRUGS FOR TREATMENT OF TUBERCULOSIS MÉDICAMENTS POUR LE TRAITEMENT DE LA TUBERCULOSE ANTIBIOTICS ANTIBIOTIQUES RIFAMPICIN RIFAMPICINE Cap Orl 150mg Rifadin 02091887 SAV ADEFGPVW Caps Rofact 00393444 VLN ADEFGPVW Cap Orl 300mg Rifadin 02092808 SAV ADEFGPVW Caps Rofact 00343617 VLN ADEFGPVW J04AC J04AB04 J04AC01 RIFABUTIN RIFABUTINE Cap Orl 150mg Mycobutin 02063786 PFI (SA) Caps HYDRAZIDES HYDRAZIDES ISONIAZID ISONIAZIDE Tab Orl 300mg pdp-isoniazid 00577804 PDP P Syr Orl 10mg/mL pdp-isoniazid 00577812 PDP P Sir. September 2015 v.1 135

J04AK J04AK01 J04AK02 J04AM J04B J04BA J05 J05A J05AB J04AM02 J04BA02 J05AB01 OTHER DRUGS FOR TREATMENT OF TUBERCULOSIS AUTRE MÉDICAMENTS POUR LE TRAITEMENT DE LA TUBERCULOSE PYRAZINAMIDE PYRAZINAMIDE Tab Orl 500mg pdp-pyrazinamde 00618810 PDP P ETHAMBUTOL ÉTHAMBUTOL Tab Orl 100mg Etibi 00247960 VLN P Tab Orl 400mg Etibi 00247979 VLN P COMBINATIONS OF DRUGS FOR TREATMENT OF TUBERCULOSIS COMBINAISON DE MÉDICAMENTS POUR LE TRAITEMENT DE LA TUBERCULOSE RIFAMPICIN AND ISONIAZID RIFAMPICINE ET ISONIAZIDE RIFAMPIN / ISONIAZID / PYRAZINAMIDE RIFAMPINE / ISONIAZIDE / PYRAZINAMIDE Tab Orl 120mg/50mg/300mg Rifater 02148625 SAV P DRUGS FOR TREATMENT OF LEPRA MÉDICAMENTS POUR LE TRAITEMENT DE LA LÈPRE DRUGS FOR TREATMENT OF LEPRA MÉDICAMENTS POUR LE TRAITEMENT DE LA LEPRE DAPSONE DAPSONE Tab Orl 100mg Dapsone 02041510 JCB ADEFGVW ANTIVIRALS FOR SYSTEMIC USE ANTIVIRAUX SYSTÉMIQUES DIRECT ACTING ANTIVIRALS AGENTS AGISSANT DIRECTEMENT SUR LE VIRUS NUCLEOSIDES AND NUCLEOTIDES EXCLUDING REVERSE TRANSCRIPTASE INHIBITORS NUCLÉOSIDES ET NUCLÉOTIDES, À L EXCLUSION DES INHIBITEURS LA TRANSCRIPTASE INVERSÉE ACYCLOVIR ACYCLOVIR Tab Orl 200mg Zovirax 00634506 GSK ADEFGVW Acyclovir (Disc/non dips Aug 1/16) 02286556 SAS ADEFGVW Apo-Acyclovir 02207621 APX ADEFGVW Mylan-Acyclovir 02242784 MYL ADEFGVW ratio-acyclovir 02078627 TEV ADEFGVW Teva-Acyclovir 02285959 TEV ADEFGVW September 2015 v.1 136

J05AB01 ACYCLOVIR ACYCLOVIR Tab Orl 400mg Zovirax (Disc/non disp Feb 20/16) 01911627 GSK ADEFGVW Acyclovir 02286564 SAS ADEFGVW Apo-Acyclovir 02207648 APX ADEFGVW Mylan-Acyclovir 02242463 MYL ADEFGVW ratio-acyclovir (Disc/non disp Nov.29/15) 02078635 TEV ADEFGVW Teva-Acyclovir 02285967 TEV ADEFGVW Tab Orl 800mg Acyclovir (Disc/non disp Aug 1/16) 02286572 SAS ADEFGVW Apo-Acyclovir 02207656 APX ADEFGVW Mylan-Acyclovir 02242464 MYL ADEFGVW Teva-Acyclovir 02285975 TEV ADEFGVW Inj 25mg/mL Acyclovir Sodium 02236916 HOS ADEFGW J05AB04 J05AB06 J05AB09 Inj 50mg/mL Acyclovir Sodium 02236926 FKB ADEFGW RIBAVIRIN RIBAVIRINE Tab Orl 400mg Ibavyr 02425890 PDP (SA) Tab Orl 600mg Ibavyr 02425904 PDP (SA) GANCICLOVIR GANCICLOVIR Pws Inj 500mg Cytovene 02162695 HLR ADEFGVW Pds. FAMCICLOVIR FAMCICLOVIR Tab Orl 125mg Famvir 02229110 NVR ADEFGVW Act Famciclovir 02305682 ATV ADEFGVW Apo-Famciclovir 02292025 APX ADEFGVW pms-famciclovir 02278081 PMS ADEFGVW Sandoz Famciclovir 02278634 SDZ ADEFGVW Tab Orl 250mg Famvir 02229129 NVR ADEFGVW Act Famciclovir 02305690 ATV ADEFGVW Apo-Famciclovir 02292041 APX ADEFGVW pms-famciclovir 02278103 PMS ADEFGVW Sandoz Famciclovir 02278642 SDZ ADEFGVW September 2015 v.1 137

J05AE J05AB09 J05AB11 J05AB14 J05AE01 FAMCICLOVIR FAMCICLOVIR Tab Orl 500mg Famvir 02177102 NVR ADEFGVW Act Famciclovir 02305704 ATV ADEFGVW Apo-Famciclovir 02292068 APX ADEFGVW pms-famciclovir 02278111 PMS ADEFGVW Sandoz Famciclovir 02278650 SDZ ADEFGVW VALACYCLOVIR VALACYCLOVIR Tab Orl 500mg Valtrex 02219492 GSK ADEFGVW Apo-Valacyclovir (Disc/non disp Jun 01/16) 02295822 APX ADEFGVW Auro-Valacyclovir (Disc/non disp Jun 20/16) 02405040 ARO ADEFGVW Co Valacyclovir (Disc/non disp Jun 1/16) 02331748 COB ADEFGVW Mylan-Valacyclovir (Disc/non disp May 16/16) 02351579 MYL ADEFGVW pms-valacyclovir (Disc/non disp Jun 1/16) 02298457 PMS ADEFGVW Teva-Valacyclovir (Disc/non disp May 31/16) 02357534 TEV ADEFGVW VALGANCICLOVIR VALGANCYCLOVIR Pws Orl 50mg/mL Valcyte 02306085 HLR (SA) Pds. Tab Orl 450mg Valcyte 02245777 HLR (SA) Apo-Valganciclovir 02393824 APX (SA) Teva-Valganciclovir 02413825 TEV (SA) PROTEASE INHIBITORS INHIBITEURS DE PROTÉASE SAQUINAVIR SAQUINAVIR Cap Orl 200mg Invirase 02216965 HLR DU Caps Tab Orl 500mg Invirase 02279320 HLR DU J05AE02 J05AE03 INDINAVIR INDINAVIR Cap Orl 200mg Crixivan (Disc/non disp Sep 19/16) 02229161 FRS DU Caps Cap Orl 400mg Crixivan 02229196 FRS DU Caps RITONAVIR RITONAVIR Tab Orl 100mg Norvir 02357593 ABV DU September 2015 v.1 138

J05AE04 J05AE07 J05AE08 NELFINAVIR NELFINAVIR Tab Orl 250mg Viracept 02238617 VIV DU Tab Orl 625mg Viracept 02248761 VIV DU FOSAMPRENAVIR FOSAMPRÉNAVIR Sus Orl 50mg/mL Telzir 02261553 VIV DU Susp Tab Orl 700mg Telzir 02261545 VIV DU ATAZANAVIR ATAZANAVIR Cap Orl 150mg Reyataz 02248610 BRI DU Caps Cap Orl 200mg Reyataz 02248611 BRI DU Caps J05AE09 J05AE10 Cap Orl 300mg Reyataz 02294176 BRI DU Caps TIPRANAVIR TIPRANAVIR Cap Orl 250mg Aptivus 02273322 BOE (SA) Caps DARUNAVIR DARUNAVIR Tab Orl 75mg Prezista 02338432 JAN DU Tab Orl 150mg Prezista 02369753 JAN DU Tab Orl 400mg Prezista (Disc/non disp Mar 26/17) 02324016 JAN DU Tab Orl 600mg Prezista 02324024 JAN DU Tab Orl 800mg Prezista 02393050 JAN DU September 2015 v.1 139

J05AF J05AE11 J05AE12 J05AE14 J05AE30 J05AF01 TELAPREVIR TÉLAPRÉVIR Tab Orl 375mg Incivek (Disc/non disp Jan 1/17) 02371553 VTX (SA) BOCEPREVIR BOCÉPRÉVIR Cap Orl 200mg Victrelis (Disc/non disp Mar 31/18) 02370816 FRS (SA) Caps SIMEPREVIR SIMÉPRÉVIR Cap Orl 150mg Galexos 02416441 JAN (SA) Caps COMBINATIONS OF PROTEASE INHIBITORS COMBINAISONS D INHIBITEURS DE PROTÉASE LOPINAVIR / RITONAVIR LOPINAVIR / RITONAVIR Orl 80mg/20mg/mL Kaletra Oral Solution 02243644 ABV DU Tab Orl 100mg/25mg Kaletra 02312301 ABV DU Tab Orl 200mg/50mg Kaletra Tab 02285533 ABB DU NUCLEOSIDE AND NUCLEOTIDE REVERSE TRANSCRIPTASE INHIBITORS INHIBITEURS NUCLÉOSIDIQUES ET NUCLÉOTIDIQUES DE LA TRANSCRIPTASE ZIDOVUDINE ZIDOVUDINE Cap Orl 100mg Retrovir 01902660 VIV DU Caps Apo-Zidovudine 01946323 APX DU Inj 10mg/mL Retrovir 01902644 VIV DU Syr Orl 50mg/5mL Retrovir 01902652 VIV DU Sir. J05AF02 DIDANOSINE DIDANOSINE ECC Orl 125mg Videx EC 02244596 BRI DU Caps.Ent. ECC Orl 200mg Videx EC 02244597 BRI DU Caps.Ent September 2015 v.1 140

J05AF02 J05AF04 DIDANOSINE DIDANOSINE ECC Orl 250mg Videx EC 02244598 BRI DU Caps.Ent ECC Orl 400mg Videx EC 02244599 BRI DU Caps.Ent STAVUDINE STAVUDINE Cap Orl 15mg Zerit 02216086 BRI DU Caps Cap Orl 20mg Zerit 02216094 BRI DU Caps Cap Orl 30mg Zerit 02216108 BRI DU Caps J05AF05 Cap Orl 40mg Zerit 02216116 BRI DU Caps LAMIVUDINE LAMIVUDINE Orl 5mg/mL Heptovir 02239194 GSK ADEFGVW Orl 10mg/mL 3TC 02192691 VIV DU Tab Orl 100mg Heptovir 02239193 GSK ADEFGVW Apo-Lamivudine HBV 02393239 APX ADEFGVW Tab Orl 150mg 3TC 02192683 VIV DU Apo-Lamivudine 02369052 APX DU J05AF06 Tab Orl 300mg 3TC 02247825 VIV DU Apo-Lamivudine 02369060 APX DU ABACAVIR ABACAVIR Orl 20mg/mL Ziagen 02240358 VIV DU Tab Orl 300mg Ziagen 02240357 VIV DU J05AF07 TENOFOVIR TÉNOFOVIR Tab Orl 300mg Viread 02247128 GIL (SA) September 2015 v.1 141

J05AF08 J05AF10 J05AG J05AG01 J05AG03 ADEFOVIR DIPIVOXIL ADÉFOVIR DIPIVOXIL Tab Orl 10mg Hepsera 02247823 GIL (SA) Apo-Adefovir 02420333 APX (SA) ENTECAVIR ENTÉCAVIR Tab Orl 0.5mg Baraclude 02282224 BRI (SA) Apo-Entecavir 02396955 APX (SA) Pms-Entecavir 02430576 PMS (SA) NON-NUCLEOSIDES REVERSE TRANSCRIPTASE INHIBITORS INHIBITEURS NON NUCLÉOSIDIQUES DE LA TRANSCRIPTASE INVERSÉE NEVIRAPINE NÉVIRAPINE ERT Orl 400mg Viramune XR 02367289 BOE DU L.P. Tab Orl 200mg Viramune 02238748 BOE DU Auro-Nevirapine 02318601 ARO DU Mylan-Nevirapine 02387727 MYL DU pms-nevirapine 02405776 PMS DU Teva-Nevirapine 02352893 TEV DU EFAVIRENZ ÉFAVIRENZ Cap Orl 50mg Sustiva 02239886 BRI DU Caps Cap Orl 200mg Sustiva 02239888 BRI DU Caps J05AG04 Tab Orl 600mg Sustiva 02246045 BRI DU Auro-Efavirenz 02418428 ARO DU Mylan-Efavirenz 02381524 MYL DU Teva-Efavirenz 02389762 TEV DU ETRAVIRINE ÉTRAVIRINE Tab Orl 100mg Intelence 02306778 JAN (SA) Tab Orl 200mg Intelence 02375931 JAN (SA) J05AG05 RILPIVIRINE RILPIVIRINE Tab Orl 25mg Edurant 02370603 JAN DU September 2015 v.1 142

J05AH J05AH01 J05AH02 NEURAMINIDASE INHIBITORS INHIBITEURS DE LA NEURAMINIDASE ZANAMIVIR ZANAMIVIR Pwr Inh 5mg Relenza 02240863 GSK (SA) Pd. OSELTAMIVIR OSELTAMIVIR Cap Orl 30mg Tamiflu 02304848 HLR (SA) Caps Cap Orl 45mg Tamiflu 02304856 HLR (SA) Caps J05AR J05AR01 J05AR02 J05AR03 J05AR04 J05AR06 Cap Orl 75mg Tamiflu 02241472 HLR (SA) Caps ANTIVIRALS FOR TREATMENT OF HIV INFECTIONS, COMBINATIONS ANTIVIRAUX POUR LE TRAITEMENT DES INFECTIONS AU VIH, COMBINAISONS LAMIVUDINE AND ZIDOVUDINE LAMIVUDINE ET ZIDOVUDINE Tab Orl 300mg/150mg Combivir 02239213 VIV DU Apo-Lamivudine/Zidovudine 02375540 APX DU Teva-Lamivudine/Zidovudine 02387247 TEV DU LAMIVUDINE AND ABACAVIR LAMIVUDINE ET ABACAVIR Tab Orl 600mg/300mg Kivexa 02269341 VIV DU TENOFOVIR DISOPROXIL AND EMTRICITABINE TÉNOFOVIR DISOPROXIL ET EMTRICITABINE Tab Orl 300mg/200mg Truvada 02274906 GIL DU ZIDOVUDINE, LAMIVUDINE AND ABACAVIR ZIDOVUDINE, LAMIVUDINE ET ABACAVIR Tab Orl 300mg/150mg/300mg Trizivir 02244757 VIV DU EMTRICITABINE, TENOFOVIR DISOPROXIL AND EFAVIRENZ EMTRICITABINE, TÉNOFOVIR DISOPROXIL ET ÉFAVIRENZ Tab Orl 600mg/300mg/200mg Atripla 02300699 GIL DU September 2015 v.1 143

J05AR08 EMTRICITABINE, TENOFOVIR DISOPROXIL AND RILPIVIRINE EMTRICITABINE, TÉNOFOVIR DISOPROXIL ET RILPIVIRINE Tab Orl 25mg/200mg/300mg Complera 02374129 GIL DU J05AR09 EMTRICITABINE, TENOFOVIR DISOPROXIL, ELVITEGRAVIR AND COBICSTAT EMTRICITABINE, TÉNOFOVIR DISOPROXIL, ELVITEGRAVIR ET COBICISTAT Tab Orl 150mg/150mg/200mg/300mg Stribild 02397137 GIL (SA) J05AR13 LAMIVUDINE, ABACAVIR AND DOLUTEGRAVIR LAMIVUDINE, ABACAVIR ET DOLUTÉGRAVIR Tab Orl 300mg/600mg0mg Triumeq 02430932 VIV DU J05AX J05AX08 OTHER ANTIVIRALS AUTRES ANTIVIRAUX RALTEGRAVIR RALTÉGRAVIR Tab Orl 400mg Isentress 02301881 FRS DU J05AX09 MARAVIROC MARAVIROC Tab Orl 150mg Celsentri 02299844 VIV (SA) Tab Orl 300mg Celsentri 02299852 VIV (SA) J05AX12 DOLUTEGRAVIR DOLUTÉGRAVIR Tab Orl 50mg Tivicay 02414945 VIV DU J05AX15 SOFOSBUVIR SOFOSBUVIR Tab Orl 400mg Sovaldi 02418355 GIL (SA) J05AX65 SOFOSBUVIR AND LEDIPASVIR SOFOSBUVIR ET LÉDIPASVIR Tab Orl 400mg/90mg Harvoni 02432226 GIL (SA) September 2015 v.1 144

L01 L01A L01AA L01AA01 ANTINEOPLASTIC AGENTS AGENTS ANTINÉOPLASIQUES ALKYLATING AGENTS AGENTS ALKYLANTS NITROGEN MUSTARD ANALOGUES ANALOGUES, MOUTARDE AZOTÉE CYCLOPHOSPHAMIDE CYCLOPHOSPHAMIDE Tab Orl 25mg Procytox 02241795 BAX ADEFGVW Tab Orl 50mg Procytox 02241796 BAX ADEFGVW L01AA02 L01AA03 L01AB L01AB01 L01AD L01AD02 CHLORAMBUCIL CHLORAMBUCIL Tab Orl 2mg Leukeran 00004626 APR ADEFGVW MELPHALAN MELPHALAN Tab Orl 2mg Alkeran 00004715 APR ADEFGVW ALKYL SULPHONATES SULFONATES D ALKYLE BUSULFAN BUSULFAN Tab Orl 2mg Myleran 00004618 APR ADEFGVW NITROSOUREAS NITROSURÉES LOMUSTINE LOMUSTINE Cap Orl 10mg CeeNU 00360430 BRI ADEFGVW Caps. Cap Orl 40mg CeeNU 00360422 BRI ADEFGVW Caps. Cap Orl 100mg CeeNU 00360414 BRI ADEFGVW Caps. September 2015 v.1 145

L01AX L01AX03 OTHER ALKYLATING AGENTS AUTRES AGENTS ALKYLANTS TEMOZOLOMIDE TÉMOZOLOMIDE Cap Orl 5mg Temodal 02241093 FRS (SA) Caps Cap Orl 20mg Temodal 02241094 FRS (SA) Caps Co Temozolomide 02395274 COB (SA) Cap Orl 100mg Temodal 02241095 FRS (SA) Caps Co Temozolomide 02395282 COB (SA) Cap Orl 140mg Temodal 02312794 FRS (SA) Caps Co Temozolomide 02395290 COB (SA) L01B L01BA L01BA01 Cap Orl 250mg Temodal 02241096 FRS (SA) Caps Co Temozolomide 02395312 COB (SA) ANTIMETABOLITES ANTIMÉTABOLITES FOLIC ACID ANALOGUES ANALOGUES DE L ACIDE FOLIQUE METHOTREXATE MÉTHOTREXATE IM 7.5mg/0.75mL Metoject 02320029 MDX ADEFGVW IM 10mg/mL Metoject 02320037 MDX ADEFGVW IM 15mg/1.5mL Metoject 02320045 MDX ADEFGVW IM 20mg/2mL Metoject 02304767 MDX ADEFGVW IM 25mg/2.5mL Metoject 02320053 MDX ADEFGVW Inj 10mg/mL Methotrexate Inj USP 02182947 HOS ADEFGVW Inj 25mg/mL Methotrexate Inj USP 02099705 TEV ADEFGVW Methotrexate Inj USP 02182777 HOS ADEFGVW Methotrexate Inj USP 02182955 HOS ADEFGVW Tab Orl 2.5mg Methotrexate 02170698 PFI ADEFGVW Methotrexate 02182963 APX ADEFGVW Ratio-Methotrexate 02244798 TEV ADEFGVW September 2015 v.1 146

L01BA01 METHOTREXATE MÉTHOTREXATE Tab Orl 10mg Methotrexate 02182750 HOS ADEFGVW L01BB PURINE ANALOGUES ANALOGUES PURINE L01BB02 MERCAPTOPURINE MERCAPTOPURINE Tab Orl 50mg Purinethol 00004723 TEV ADEFGVW Mercaptopurine 02415275 STR ADEFGVW L01BB03 TIOGUANINE TIOGUANINE Tab Orl 40mg Lanvis 00282081 APR ADEFGVW L01BB05 FLUDARABINE FLUDARABINE Tab Orl 10mg Fludara 02246226 SAV (SA) L01BC PYRIMIDINE ANALOGUES ANALOGUES PYRIMIDIQUES L01BC02 FLUOROURACIL FLUOROURACILE Crm Top 5% Efudex 00330582 VLN ADEFGVW Cr. L01BC06 CAPECITABINE CAPÉCITABINE Tab Orl 150mg Xeloda 02238453 HLR (SA) Ach-Capecitabine 02426757 AHI (SA) Sandoz Capecitabine 02421917 SDZ (SA) Teva-Capecitabine 02400022 TEV (SA) Tab Orl 500mg Xeloda 02238454 HLR (SA) Ach-Capecitabine 02426765 AHI (SA) Sandoz Capecitabine 02421925 SDZ (SA) Teva-Capecitabine 02400030 TEV (SA) L01C L01CB PLANT ALKALOIDS AND OTHER NATURAL PRODUCTS ALCALOIDES DE PLANTES ET AUTRES PRODUITS NATURELS PODOPHYLLOTOXIN DERIVATIVES DÉRIVÉS DE LA PODOPHYLLOTOXINE L01CB01 ETOPOSIDE ÉTOPOSIDE Cap Orl 50mg Vepesid 00616192 BRI ADEFGVW Caps September 2015 v.1 147

L01X L01XB OTHER ANTINEOPLASTIC AGENTS AUTRES AGENTS ANTINÉOPLASIQUES METHYLHYDRAZINES MÉTHYLHYDRAZINES L01XB01 PROCARBAZINE PROCARBAZINE Cap Orl 50mg Matulane 00012750 QGT ADEFGVW Caps L01XC MONOCLONAL ANTIBODIES ANTICORPS MONOCLONAUX L01XC02 RITUXIMAB RITUXIMAB IV 10mg/mL Rituxan 02241927 HLR (SA) L01XE PROTEIN KINASE INHIBITORS INHIBITEURS DE PROTÉINE KINASE L01XE01 IMATINIB IMATINIB Cap Orl 100mg Gleevec 02253275 NVR (SA) Caps Act Imatinib 02397285 ATV (SA) Apo-Imatinib 02355337 APX (SA) pms-imatinib 02431114 PMS (SA) Teva-Imatinib 02399806 TEV (SA) Tab Orl 400mg Gleevec 02253283 NVR (SA) Act Imatinib 02397293 ATV (SA) Apo-Imatinib 02355345 APX (SA) pms-imatinib 02431122 PMS (SA) Teva-Imatinib 02399814 TEV (SA) L01XE03 ERLOTINIB ERLOTINIB Tab Orl 25mg Tarceva 02269007 HLR (SA) Teva-Erlotinib 02377691 TEV (SA) Tab Orl 100mg Tarceva 02269015 HLR (SA) Teva-Erlotinib 02377705 TEV (SA) Tab Orl 150mg Tarceva 02269023 HLR (SA) Teva-Erlotinib 02377713 TEV (SA) L01XE04 SUNITINIB SUNITINIB Cap Orl 12.5mg Sutent 02280795 PFI (SA) Caps Cap Orl 25mg Sutent 02280809 PFI (SA) Caps September 2015 v.1 148

L01XE04 L01XE05 L01XE06 SUNITINIB SUNITINIB Cap Orl 50mg Sutent 02280817 PFI (SA) Caps SORAFENIB SORAFENIB Tab Orl 200mg Nexavar 02284227 BAY (SA) DASATINIB DASATINIB Tab Orl 20mg Sprycel 02293129 BRI (SA) Tab Orl 50mg Sprycel 02293137 BRI (SA) Tab Orl 70mg Sprycel 02293145 BRI (SA) Tab Orl 80mg Sprycel 02360810 BRI (SA) Tab Orl 100mg Sprycel 02320193 BRI (SA) L01XE07 L01XE08 L01XE11 Tab Orl 140mg Sprycel 02360829 BRI (SA) LAPATINIB LAPATINIB Tab Orl 250mg Tykerb 02326442 NVR (SA) NILOTINIB NILOTINIB Cap Orl 150mg Tasigna 02368250 NVR (SA) Caps Cap Orl 200mg Tasigna 02315874 NVR (SA) Caps PAZOPANIB PAZOPANIB Tab Orl 200mg Votrient 02352303 GSK (SA) September 2015 v.1 149

L01XE13 L01XE15 L01XE16 L01XE17 AFATINIB AFATINIB Tab Orl 20mg Giotrif 02415666 BOE (SA) Tab Orl 30mg Giotrif 02415674 BOE (SA) Tab Orl 40mg Giotrif 02415682 BOE (SA) VEMURAFENIB VÉMURAFENIB Tab Orl 240mg Zelboraf 02380242 HLR (SA) CRIZOTINIB CRIZOTINIB Cap Orl 200mg Xalkori 02384256 PFI (SA) Caps Cap Orl 250mg Xalkori 02384264 PFI (SA) Caps AXITINIB AXITINIB Tab Orl 1mg Inlyta 02389630 PFI (SA) Tab Orl 5mg Inlyta 02389649 PFI (SA) L01XE18 RUXOLITINIB RUXOLITINIB Tab Orl 5mg Jakavi 02388006 NVR (SA) Tab Orl 15mg Jakavi 02388014 NVR (SA) Tab Orl 20mg Jakavi 02388022 NVR (SA) L01XE21 REGORAFENIB RÉGORAFENIB Tab Orl 150mg Stivarga 02403390 BAY (SA) September 2015 v.1 150

L01XX L01XE23 L01XE25 L01XX05 L01XX11 L01XX14 L01XX35 L01XX43 DABRAFENIB DABRAFÉNIB Cap Orl 50mg Tafinlar 02409607 NVR (SA) Caps Cap Orl 75mg Tafinlar 02409615 NVR (SA) Caps TRAMETINIB TRAMÉTINIB Tab Orl 0.5mg Mekinist 02409623 NVR (SA) Tab Orl 2mg Mekinist 02409658 NVR (SA) OTHER ANTINEOPLASTIC AGENTS AUTRES AGENTS ANTINÉOPLASIQUES HYDROXYCARBAMIDE (HYDROXYUREA) HYDROXYCARBAMIDE (HYDROXYURÉE) Cap Orl 500mg Hydrea 00465283 BRI ADEFGVW Caps Hydroxyurea 02343096 SAS ADEFGVW Mylan-Hydroxyurea 02242920 MYL ADEFGVW ESTRAMUSTINE ESTRAMUSTINE Cap Orl 140mg Emcyt 02063794 PFI ADEFGVW Caps TRETINOIN TRÉTINOÏNE Cap Orl 10mg Vesanoid 02145839 XPI (SA) Caps ANAGRELIDE ANAGRÉLIDE Cap Orl 0.5mg Agrylin 02236859 SHB ADEFGVW Caps Mylan-Anagrelide(Disc/non disp Nov 12/16) 02253054 MYL ADEFGVW pms-anagrelide 02274949 PMS ADEFGVW Sandoz Anagrelide 02260107 SDZ ADEFGVW VISMODEGIB VISMODEGIB Cap Orl 150mg Erivedge 02409267 HLR (SA) Caps September 2015 v.1 151

L02 L02A L02AB L02AB01 ENDOCRINE THERAPY TRAITEMENT ENDOCRINIEN HORMONES AND RELATED AGENTS HORMONES ET AGENTS APPARENTÉS PROGESTOGENS PROGESTOGÉNES MEGESTROL MÉGESTROL Sus Orl 40mg/mL Megace OS 02168979 BRI ADEFGVW Susp Tab Orl 40mg Megestrol 02195917 AAP ADEFGVW L02AE L02AE01 Tab Orl 160mg Megestrol 02195925 AAP ADEFGVW GONADOTROPHIN RELEASING HORMONE ANALOGUES ANALOGUES DE L HORMONE LIBÉRANT DE LA GONADOTROPHINE BUSERELIN BUSÉRÉLINE Asp Nas 1mg Suprefact 02225158 SAV AVW (SA) Asp Imp Inj 6.3mg Suprefact Depot 02228955 SAV ADEFVW Imp Imp Inj 9.45mg Suprefact Depot 02240749 SAV ADEFVW Imp L02AE02 LEUPRORELIN LEUPRORÉLINE Inj 5mg Lupron 00727695 ABB AVW (SA) Pws Inj 3.75mg Lupron Depot 00884502 ABB ADEFVW Pds. Pws Inj 7.5mg Lupron Depot 00836273 ABB ADEFVW Pds. Pws Inj 11.25mg Lupron Depot 02239834 ABB ADEFVW Pds. Pws Inj 22.5mg Lupron Depot 02230248 ABB ADEFVW Pds. Pws Inj 30mg Lupron Depot 02239833 ABB ADEFVW Pds. September 2015 v.1 152

L02AE02 LEUPRORELIN LEUPRORÉLINE Sus Inj 22.5mg Eligard 02248240 SAV ADEFVW Susp Sus Inj 45mg Eligard 02268892 SAV ADEFVW Susp L02AE03 GOSERELIN GOSÉRÉLINE Imp Inj 3.6mg Zoladex 02049325 AZE ADEFVW Imp Imp Inj 10.8mg Zoladex LA 02225905 AZE ADEFVW Imp L02AE04 TRIPTORELIN TRIPTORÉLINE Pws Inj 3.75mg Trelstar 02240000 ASP ADEFVW Pds. Pws Inj 11.25mg Trelstar 02243856 ASP ADEFVW Pds. L02B L02BA Pws Inj 22.5mg Trelstar 02412322 ASP ADEFVW Pds. HORMONE ANTAGONISTS AND RELATED AGENTS ANTAGONISTES D HORMONES ET AGENTS CONNEXES ANTI-ESTROGENS ANTI-OESTROGÈNES L02BA01 TAMOXIFEN TAMOXIFÈNE Tab Orl 10mg Apo-Tamox 00812404 APX ADEFGVW Mylan-Tamoxifen 02088428 MYL ADEFGVW Teva-Tamoxifen 00851965 TEV ADEFGVW L02BB Tab Orl 20mg Nolvadex-d 02048485 AZE ADEFGVW Apo-Tamox 00812390 APX ADEFGVW Mylan-Tamoxifen 02089858 MYL ADEFGVW Teva-Tamoxifen 00851973 TEV ADEFGVW ANTI-ANDROGENS ANTI-ANDROGÉNES L02BB01 FLUTAMIDE FLUTAMIDE Tab Orl 250mg Euflex (Disc/non disp Jun 1/17) 00637726 FRS ADEFVW Apo-Flutamide 02238560 APX ADEFVW pms-flutamide 02230104 PMS ADEFVW Teva-Flutamide (Disc/non disp Oct 27/16) 02230089 TEV ADEFVW September 2015 v.1 153

L02BB02 L02BB03 L02BB04 L02BG L02BG03 NILUTAMIDE NILUTAMIDE Tab Orl 50mg Anandron 02221861 SAV ADEFVW BICALUTAMIDE BICALUTAMIDE Tab Orl 50mg Casodex 02184478 AZE ADEFVW Act Bicalutamide 02274337 ATV ADEFVW Apo-Bicalutamide 02296063 APX ADEFVW Bicalutamide 02325985 AHI ADEFVW Bicalutamide 02382423 SIV ADEFVW Jamp-Bicalutamide 02357216 JPC ADEFVW Mylan-Bicalutamide 02302403 MYL ADEFVW Teva-Bicalutamide 02270226 TEV ADEFVW pms-bicalutamide 02275589 PMS ADEFVW Ran-Bicalutamide 02371324 RAN ADEFVW Sandoz Bicalutamide 02276089 SDZ ADEFVW ENZALUTAMIDE ENZALUTAMIDE Cap Orl 40mg Xtandi 02407329 ASL (SA) Caps AROMATASE INHIBITORS INHIBITEURS AROMATASES ANASTROZOLE ANASTROZOLE Tab Orl 1mg Arimidex 02224135 AZE ADEFVW Act Anastrozole 02394898 ATV ADEFVW Anastrozole 02351218 AHI ADEFVW Apo-Anastrozole 02374420 APX ADEFVW Auro-Anastrozole 02404990 ARO ADEFVW Jamp-Anastrozole 02339080 JPC ADEFVW Mar-Anastrozole 02379562 MAR ADEFVW Med-Anastrozole 02379104 GMP ADEFVW Mint-Anastrozole 02393573 MNT ADEFVW Mylan-Anastrozole 02361418 MYL ADEFVW Nat-Anastrozole 02417855 NAT ADEFVW pms-anastrozole 02320738 PMS ADEFVW Ran-Anastrozole 02328690 RAN ADEFVW Taro-Anastrozole 02365650 TAR ADEFVW Teva-Anastrozole (Disc/non disp Sept 19/16) 02313049 TEV ADEFVW Sandoz Anastrozole 02338467 SDZ ADEFVW Zinda-Anastrozole 02326035 MCK ADEFVW September 2015 v.1 154

L02BX L02BG04 L02BG06 L02BX02 L02BX03 LETROZOLE LÉTROZOLE Tab Orl 2.5mg Femara 02231384 NVR ADEFVW Apo-Letrozole 02358514 APX ADEFVW Auro-Letrozole 02404400 ARO ADEFVW Jamp-Letrozole 02373009 JPC ADEFVW Letrozole 02348969 COB ADEFVW Letrozole tablets usp 02338459 AHI ADEFVW Mar-Letrozole 02373424 MAR ADEFVW Med-Letrozole 02322315 GMP ADEFVW Myl-Letrozole 02372169 MYL ADEFVW Nat-Letrozole 02421585 NAT ADEFVW pms-letrozole 02309114 PMS ADEFVW Ran-Letrozole 02372282 RAN ADEFVW Sandoz Letrozole 02344815 SDZ ADEFVW Teva-Letrozole 02343657 TEV ADEFVW Zinda-Letrozole 02378213 MCK ADEFVW EXEMESTANE EXÉMESTANE Tab Orl 25mg Aromasin 02242705 PFI ADEFVW Act Exemestane 02390183 ATV ADEFVW Apo-Exemestane 02419726 APX ADEFVW Med-Exemestane 02407841 GMP ADEFVW Teva-Exemestane 02408473 TEV ADEFVW OTHER HORMONE ANTAGONISTS AND RELATED AGENTS AUTRES ANTAGONISTES D HORMONES ET AGENTS CONNEXES DEGARELIX DEGARELIX Pws Inj 80mg/vial Firmagon 02337029 FEI ADEF+18VW Pds. Pws Inj 120mg/vial Firmagon 02337037 FEI ADEF+18VW Pds. ABIRATERONE ABIRATERONE Tab Orl 250mg Zytiga 02371065 JAN (SA) September 2015 v.1 155

L03 L03A L03AA L03AA02 L03AA13 L03AB L03AB05 IMMUNOSTIMULANTS IMMUNOSTIMULANTS IMMUNOSTIMULANTS IMMUNOSTIMULANTS COLONY STIMULATING FACTORS FACTEURS DE CROISSANCE DES GLOBULES BLANCS FILGRASTIM FILGRASTIM Inj 300mcg/mL Neupogen 01968017 AGA W (SA) Neupogen (1.6 ml size only) 00999001 AGA W (SA) PEGFILGRASTIM PEGFILGRASTIM Inj 6mg Neulasta pre-filled syringe 02249790 AGA (SA) INTERFERONS INTERFÉRONS INTERFERON ALFA-2B INTERFÉRON ALFA-2B Inj 6000000IU/mL Intron A 02238674 SCH ADEFGVW Inj 10000000IU/mL Intron A 02223406 SCH ADEFGVW Intron A 02238675 SCH ADEFGVW Inj 15000000IU/mL Intron A 02240693 SCH ADEFGVW Inj 25000000IU/mL Intron A 02240694 FRS ADEFGVW L03AB07 Inj 50000000IU/mL Intron A 02240695 SCH ADEFGVW INTERFERON BETA-1A INTERFÉRON BÊTA-1A Inj 22mcg/0.5mL Rebif 02237319 EMD H (SA) Inj 44mcg/0.5mL Rebif 02237320 EMD H (SA) Inj 66mcg/1.5mL Rebif Cartridge 02318253 EMD H (SA) Inj 132mcg/1.5mL Rebif Cartridge 02318261 EMD H (SA) September 2015 v.1 156

L03AB07 L03AB08 L03AB11 L03AB60 INTERFERON BETA-1A INTERFÉRON BÊTA-1A Inj 30mcg/0.5mL Avonex PS 02269201 BIG H (SA) INTERFERON BETA-1B INTERFÉRON BÊTA-1B Inj 0.3mg Betaseron 02169649 BAY H (SA) Extavia 02337819 NVR H (SA) PEGINTERFERON ALFA-2A PEGINTERFÉRON ALFA-2A SC 180mcg/0.5mL Pegasys pre-filled syringe 02248077 HLR (SA) Pegasys ProClick (Autoinjector) 02248077 HLR (SA) PEGINTERFERON ALFA-2B, COMBINATIONS PEGINTERFÉRON ALFA-2B, COMBINAISONS PEGINTERFERON ALFA-2B / RIBAVIRIN PEGINTERFÉRON ALFA-2B / RIBAVIRINE Kit SC 50mcg/0.5mL + 200mg Pegetron Clearclick 02254573 SCH (SA) Tro Pegetron (Disc/non disp Apr 29/17) 02246026 SCH (SA) Kit SC 80mcg/0.5mL + 200mg Pegetron Clearclick 02254581 SCH (SA) Tro Kit SC 100mcg/0.5mL + 200mg Pegetron Clearclick 02254603 SCH (SA) Tro Kit SC 120mcg/0.5mL + 200mg Pegetron Clearclick 02254638 SCH (SA) Tro Kit SC 150mcg/0.5mL + 200mg Pegetron 02246030 SCH (SA) Tro Pegetron Clearclick 02254646 SCH (SA) PEGINTERFERON ALFA-2B / RIBAVIRIN / BOCEPREVIR PEGINTERFÉRON ALFA-2B / RIBAVIRINE / BOCÉPRÉVIR Kit Inj 80mcg/0.5mg + 200mg + 200mg Victrelis Triple 02371448 FRS (SA) Tro (Disc/non disp Mar 31/18) Kit Inj 100mcg/0.5mg + 200mg +200mg Victrelis Triple 02371456 FRS (SA) Tro (Disc/non disp Mar 31/18) Kit Inj 120mcg/0.5mg + 200mg + 200mg Victrelis Triple 02371464 FRS (SA) Tro (Disc/non disp Mar 31/18) Kit Inj 150mcg/0.5mg + 200mg + 200mg Victrelis Triple 02371472 FRS (SA) Tro (Disc/non disp Mar 31/18) September 2015 v.1 157

L03AX L04 L04A L03AB61 L03AX13 L03AX16 L04AA L04AA06 PEGINTERFERON ALFA-2A, COMBINATIONS PEGINTERFÉRON ALFA-2A, COMBINAISONS PEGINTERFERON ALFA-2A / RIBAVIRIN PEGINTERFÉRON ALFA-2A / RIBAVIRINE Kit SC 180mcg/0.5mL + 200mg Pegasys RBV 02253429 HLR (SA) Tro Pegasys RBV (ProClick Autoinjector) 02253429 HLR (SA) OTHER IMMUNOSTIMULANTS AUTRES IMMUNOSTIMULANTS GLATIRAMER ACETATE GLATIRAMÈRE ACÉTATE Inj 20mg/mL Copaxone 02245619 SAV H (SA) PLERIXAFOR PLÉRIXAFOR Inj 24mg/1.2mL Mozobil 02377225 SAV (SA) IMMUNOSUPPRESSANTS AGENTS IMMUNOSUPPRESSEURS IMMUNOSUPPRESSANTS AGENTS IMMUNOSUPPRESSEURS SELECTIVE IMMUNOSUPPRESSANTS IMMUNOSUPPRESSEURS SÉLECTIFS MYCOPHENOLIC ACID ACIDE MYCOPHÉNOLIQUE Cap Orl 250mg Cellcept 02192748 HLR ADEFGRV Caps Apo-Mycophenolate 02352559 APX ADEFGRV Jamp-Mycophenolate 02386399 JPC ADEFGRV Mycophenolate Mofetil 02383780 AHI ADEFGRV Mylan-Mycophenolate 02371154 MYL ADEFGRV Novo-Mycophenolate 02364883 TEV ADEFGRV Sandoz Mycophenolate 02320630 SDZ ADEFGRV Tab Orl 500mg Cellcept 02237484 HLR ADEFGRV Apo-Mycophenolate 02348675 APX ADEFGRV Co Mycophenolate (Disc/non disp Jan 31/16) 02379996 COB ADEFGRV Jamp-Mycophenolate 02380382 JPC ADEFGRV Mycophenolate Mofetil 02378574 AHI ADEFGRV Mylan-Mycophenolate 02370549 MYL ADEFGRV Novo-Mycophenolate 02352567 TEV ADEFGRV Sandoz Mycophenolate 02313855 SDZ ADEFGRV ECT Orl 180mg Myfortic 02264560 NVR ADEFGRV Ent Apo-Mycophenolic Acid 02372738 APX ADEFGRV ECT Orl 360mg Myfortic 02264579 NVR ADEFGRV Ent Apo-Mycophenolic Acid 02372746 APX ADEFGRV September 2015 v.1 158

L04AA10 L04AA13 SIROLIMUS SIROLIMUS Orl 1mg/mL Rapamune 02243237 PFI ADEFGRV Tab Orl 1mg Rapamune 02247111 PFI ADEFGRV LEFLUNOMIDE LÉFLUNOMIDE Tab Orl 10mg Arava 02241888 SAV ADEFGVW Apo-Leflunomide 02256495 APX ADEFGVW Leflunomide 02351668 SAS ADEFGVW Mylan-Leflunomide 02319225 MYL ADEFGVW Novo-Leflunomide 02261251 TEV ADEFGVW pms-leflunomide 02288265 PMS ADEFGVW Sandoz Leflunomide 02283964 SDZ ADEFGVW Tab Orl 20mg Arava 02241889 SAV ADEFGVW Apo-Leflunomide 02256509 APX ADEFGVW Leflunomide 02351676 SAS ADEFGVW Mylan-Leflunomide 02319233 MYL ADEFGVW Novo-Leflunomide 02261278 TEV ADEFGVW pms-leflunomide 02288273 PMS ADEFGVW Sandoz Leflunomide 02283972 SDZ ADEFGVW L04AA18 EVEROLIMUS ÉVÉROLIMUS Tab Orl 2.5mg Afinitor 02369257 NVR (SA) Tab Orl 5mg Afinitor 02339501 NVR (SA) Tab Orl 10mg Afinitor 02339528 NVR (SA) L04AA23 L04AA24 NATALIZUMAB NATALIZUMAB IV 300mg/15mL Tysabri 02286386 BIG (SA) ABATACEPT ABATACEPT SC 125mg Orencia 02402475 BRI (SA) Pws IV 250mg Orencia 02282097 BRI (SA) Pds. September 2015 v.1 159

L04AA25 L04AA27 L04AA31 L04AB L04AB01 ECULIZUMAB ÉCULIZUMAB IV 10mg/mL Soliris 02322285 ALX (SA) FINGOLIMOD FINGOLIMOD Cap Orl 0.5mg Gilenya 02365480 NVR (SA) Caps TERIFLUNOMIDE TÉRIFLUNOMIDE Tab Orl 14mg Aubagio 02416328 GZM (SA) TUMOR NECROSIS FACTOR ALPHA (TNF-A) INHIBITORS INHIBITEURS DU FACTEUR DE NÉCROSE TUMORALE ALPHA (TNF-A) ETANERCEPT ÉTANERCEPT Pws SC 25mg/mL Enbrel 02242903 AGA W (SA) Pds. SC 50mg/mL Enbrel 02274728 AGA (SA) L04AB02 INFLIXIMAB INFLIXIMAB Pws IV 100mg Remicade 02244016 JAN (SA) Pds. L04AB04 ADALIMUMAB ADALIMUMAB SC 40mg/0.8mL Humira pre-filled syringe 02258595 ABV (SA) L04AB06 GOLIMUMAB GOLIMUMAB SC 50mg/0.5mL Simponi autoinjector 02324784 JAN (SA) Simponi pre-filled syringe 02324776 JAN (SA) L04AC INTERLEUKIN INHIBITORS INHIBITEURS DES INTERLEUKINES L04AC05 USTEKINUMAB USTEKINUMAB SC 45mg/0.5mL Stelara 02320673 JAN (SA) SC 90mg/mL Stelara 02320681 JAN (SA) September 2015 v.1 160

L04AC07 TOCILIZUMAB TOCILIZUMAB IV 80mg/4mL Actemra 02350092 HLR (SA) IV 200mg/10mL Actemra 02350106 HLR (SA) IV 400mg/20mL Actemra 02350114 HLR (SA) L04AD CALCINEURIN INHIBITORS INHIBITEURS DE LA CALCINEURINE L04AD01 CYCLOSPORINE CYCLOSPORINE Cap Orl 10mg Neoral 02237671 NVR AEFGRVW Caps Cap Orl 25mg Neoral 02150689 NVR AEFGRVW Caps Sandoz Cyclosporine 02247073 SDZ ADEFGRVW Cap Orl 50mg Neoral 02150662 NVR AEFGRVW Caps Sandoz Cyclosporine 02247074 SDZ ADEFGRVW Cap Orl 100mg Neoral 02150670 NVR AEFGRVW Caps Sandoz Cyclosporine 02242821 SDZ ADEFGRVW L04AD02 Orl 100mg/mL Neoral 02150697 NVR AEFGRVW Apo-Cyclosporine 02244324 APX ADEFGRVW TACROLIMUS TACROLIMUS Cap Orl 0.5mg Prograf 02243144 ASL ADEFGRV Caps Sandoz Tacrolimus 02416816 SDZ ADEFGRV Cap Orl 1mg Prograf 02175991 ASL ADEFGRV Caps Sandoz Tacrolimus 02416824 SDZ ADEFGRV Cap Orl 5mg Prograf 02175983 ASL ADEFGRV Caps Sandoz Tacrolimus 02416832 SDZ ADEFGRV ERC Orl 0.5mg Advagraf 02296462 ASL ADEFGRV Caps.L.P. ERC Orl 1mg Advagraf 02296470 ASL ADEFGRV Caps.L.P. ERC Orl 3mg Advagraf 02331667 ASL ADEFGRV Caps.L.P. ERC Orl 5mg Advagraf 02296489 ASL ADEFGRV Caps.L.P. September 2015 v.1 161

L04AX L04AX01 L04AX04 OTHER IMMUNOSUPPRESSANTS AUTRES AGENTS IMMUNOSUPPRESSEURS AZATHIOPRINE AZATHIOPRINE Tab Orl 50mg Imuran 00004596 APR ADEFGVW Apo-Azathioprine 02242907 APX ADEFGVW Azathioprine 02343002 SAS ADEFGVW Mylan-Azathioprine 02231491 MYL ADEFGVW Teva-Azathioprine 02236819 TEV ADEFGVW LENALIDOMIDE LÉNALIDOMIDE Cap Orl 5mg Revlimid 02304899 CEL (SA) Caps Cap Orl 10mg Revlimid 02304902 CEL (SA) Caps Cap Orl 15mg Revlimid 02317699 CEL (SA) Caps L04AX05 L04AX06 Cap Orl 25mg Revlimid 02317710 CEL (SA) Caps PIRFENIDONE PIRFÉNIDONE Cap Orl 267mg Esbriet 02393751 HLR (SA) Caps POMALIDOMIDE POMALIDOMIDE Cap Orl 1mg Pomalyst 02419580 CEL (SA) Caps Cap Orl 2mg Pomalyst 02419599 CEL (SA) Caps Cap Orl 3mg Pomalyst 02419602 CEL (SA) Caps Cap Orl 4mg Pomalyst 02419610 CEL (SA) Caps September 2015 v.1 162

M01 M01A M01AB M01AB01 ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS ANTI-INFLAMMATOIRES ET ANTIRHUMATISMAUX ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS, NON-STEROIDS ANTI-INFLAMMATOIRES ET ANTIRHUMATISMAUX, NON STÉROIDÏENS ACETIC ACID DERIVATIVES AND RELATED SUBSTANCES ACIDE ACÉTIQUE ET SUBSTANCES APPARENTÉES INDOMETHACIN INDOMÉTHACINE Cap Orl 25mg Teva-Indomethacin 00337420 TEV ADEFGVW Caps Cap Orl 50mg Teva-Indomethacin 00337439 TEV ADEFGVW Caps Sup Rt 50mg Sab-Indomethacin 02231799 SDZ ADEFGVW Supp. M01AB02 M01AB05 Sup Rt 100mg Ratio-Indomethacin 01934139 TEV ADEFGVW Supp. Sab-Indomethacin 02231800 SDZ ADEFGVW SULINDAC SULINDAC Tab Orl 150mg Apo-Sulin (Disc/non disp Oct 9/16) 00778354 APX ADEFGVW Teva-Sundac 00745588 TEV ADEFGVW Tab Orl 200mg Apo-Sulin (Disc/non disp Oct 9/16) 00778362 APX ADEFGVW Teva-Sundac 00745596 TEV ADEFGVW DICLOFENAC DICLOFÉNAC ECT Orl 25mg Teva-Difenac 00808539 TEV ADEFGVW Ent Apo-Diclo 00839175 APX ADEFGVW pms-diclofenac 02302616 PMS ADEFGVW Sandoz Diclofenac 02261952 SDZ ADEFGVW ECT Orl 50mg Voltaren 00514012 NVR ADEFGVW Ent Apo-Diclo 00839183 APX ADEFGVW Diclofenac EC 02352397 SAS ADEFGVW pms-diclofenac 02302624 PMS ADEFGVW Sandoz Diclofenac 02261960 SDZ ADEFGVW Teva-Difenac 00808547 TEV ADEFGVW SRT Orl 75mg Voltaren SR 00782459 NVR ADEFGVW L.L. Apo-Diclo SR 02162814 APX ADEFGVW Diclofenac SR 02352400 SAS ADEFGVW pms-diclofenac SR 02231504 PMS ADEFGVW Sandoz Diclofenac SR 02261901 SDZ ADEFGVW Teva-Difenac SR 02158582 TEV ADEFGVW September 2015 v.1 163

M01AB05 DICLOFENAC DICLOFÉNAC SRT Orl 100mg Voltaren SR 00590827 NVR ADEFGVW L.L. Apo-Diclo SR 02091194 APX ADEFGVW pms-diclofenac SR 02231505 PMS ADEFGVW Sandoz Diclofenac SR 02261944 SDZ ADEFGVW Teva-Difenac SR 02048698 TEV ADEFGVW Sup Rt 50mg Voltaren 00632724 NVR ADEFGVW Supp. Pms-Difenac 02231506 PMS ADEFGVW Sandoz Diclofenac 02261928 SDZ ADEFGVW Sup Rt 100mg Voltaren 00632732 NVR ADEFGVW Supp. Pms-Difenac 02231508 PMS ADEFGVW Sandoz Diclofenac 02261936 SDZ ADEFGVW M01AB15 KETOROLAC KÉTOROLAC Inj 10mg Toradol 02162644 HLR W Tab Orl 10mg Toradol 02162660 HLR W Ketorolac 02229080 AAP W M01AB55 M01AC M01AC01 DICLOFENAC COMBINATIONS DICLOFÉNAC, EN COMBINAISON DICLOFENAC / MISOPROSTOL DICLOFÉNAC / MISOPROSTOL Tab Orl 50mg/200mcg Arthrotec 01917056 PFI ADEFGVW Act Diclo-Miso 02397145 ATV ADEFGVW GD-Diclofenac/Misoprostol 02341689 GMD ADEFGVW Tab Orl 75mg/200mcg Arthrotec 02229837 PFI ADEFGVW Act Diclo-Miso 02397153 ATV ADEFGVW GD-Diclofenac/Misoprostol 02341697 GMD ADEFGVW OXICAMS OXICAMS PIROXICAM PIROXICAM Cap Orl 10mg Apo-Piroxicam 00642886 APX ADEFGVW Caps Novo-Pirocam 00695718 TEV ADEFGVW Cap Orl 20mg Apo-Piroxicam 00642894 APX ADEFGVW Caps Novo-Pirocam 00695696 TEV ADEFGVW Sup Rt 20mg pms-piroxicam (Disc/non disp Jul 4/16) 02154463 PMS ADEFGVW Supp. September 2015 v.1 164

M01AC06 M01AE M01AE01 MELOXICAM MELOXICAM Tab Orl 7.5mg Mobicox 02242785 BOE ADEFGVW Act Meloxicam 02250012 ATV ADEFGVW Apo-Meloxicam 02248973 APX ADEFGVW Auro-Meloxicam 02390884 ARO ADEFGVW Meloxicam 02353148 SAS ADEFGVW Mylan-Meloxicam 02255987 MYL ADEFGVW Phl-Meloxicam 02248607 PHL ADEFGVW pms-meloxicam 02248267 PMS ADEFGVW Teva-Meloxicam 02258315 TEV ADEFGVW Tab Orl 15mg Mobicox 02242786 BOE ADEFGVW Act Meloxicam 02250020 ATV ADEFGVW Apo-Meloxicam 02248974 APX ADEFGVW Auro-Meloxicam 02390892 ARO ADEFGVW Meloxicam 02353156 SAS ADEFGVW Mylan-Meloxicam 02255995 MYL ADEFGVW Phl-Meloxicam 02248608 PHL ADEFGVW pms-meloxicam 02248268 PMS ADEFGVW Teva-Meloxicam 02258323 TEV ADEFGVW PROPIONIC ACID DERIVATIVES DÉRIVÉS DE L ACIDE PROPIONIQUE IBUPROFEN IBUPROFÈNE Tab Orl 300mg Apo-Ibuprofen 00441651 APX AEFGVW Tab Orl 400mg Motrin IB 02242658 JNJ AEFGVW Apo-Ibuprofen 00506052 APX AEFGVW Jamp-Ibuprofen 02401290 JPC AEFGVW Novo-Profen 00629340 TEV AEFGVW pms-ibuprofen 00836133 PMS AEFGVW Tab Orl 600mg Apo-Ibuprofen 00585114 APX ADEFGVW Novo-Profen 00629359 TEV ADEFGVW M01AE02 NAPROXEN NAPROXÈNE ECT Orl 250mg Naprosyn E (Disc/non disp Feb 5/16) 02162792 HLR ADEFGVW Ent Apo-Naproxen EC 02246699 APX ADEFGVW Naproxen EC 02350785 SAS ADEFGVW Teva-Naprox EC 02243312 TEV ADEFGVW ECT Orl 375mg Naprosyn E 02162415 HLR ADEFGVW Ent Apo-Naproxen EC 02246700 APX ADEFGVW Naproxen EC 02350793 SAS ADEFGVW Mylan-Naproxen EC 02243432 MYL ADEFGVW pms-naproxen EC 02294702 PMS ADEFGVW Teva-Naprox EC 02243313 TEV ADEFGVW September 2015 v.1 165

M01AE02 NAPROXEN NAPROXÈNE ECT Orl 500mg Naprosyn E 02162423 HLR ADEFGVW Ent Apo-Naproxen EC 02246701 APX ADEFGVW Mylan-Naproxen EC 02241024 MYL ADEFGVW Naproxen EC 02350807 SAS ADEFGVW pms-naproxen EC 02294710 PMS ADEFGVW Teva-Naprox EC 02243314 TEV ADEFGVW Sup Rt 500mg pms-naproxen 02017237 PMS ADEFGVW Supp. Sus Orl 25mg/mL Pediapharm Naproxen 02162431 PED ADEFGVW Susp Tab Orl 125mg Apo-Naproxen 00522678 APX ADEFGVW Tab Orl 250mg Apo-Naproxen 00522651 APX ADEFGVW Naproxen 02350750 SAS ADEFGVW Teva-Naproxen 00565350 TEV ADEFGVW Tab Orl 275mg Anaprox 02162725 HLR ADEFGVW Apo-Napro-Na 00784354 APX ADEFGVW Naproxen Sodium 02351013 SAS ADEFGVW Teva-Naproxen Sodium 00778389 TEV ADEFGVW Tab Orl 375mg Apo-Naproxen 00600806 APX ADEFGVW Naproxen 02350769 SAS ADEFGVW Teva-Naproxen 00627097 TEV ADEFGVW Tab Orl 500mg Apo-Naproxen 00589861 APX ADEFGVW Naproxen 02350777 SAS ADEFGVW Teva-Naproxen 00592277 TEV ADEFGVW M01AE03 Tab Orl 550mg Anaprox DS 02162717 HLR ADEFGVW Apo-Napro-Na DS 01940309 APX ADEFGVW Naproxen Sodium DS 02351021 SAS ADEFGVW Teva-Naproxen Sodium DS 02026600 TEV ADEFGVW KETOPROFEN KÉTOPROFÈNE Cap Orl 50mg Keto 00790427 AAP ADEFGVW Caps ECT Orl 50mg Keto-E 00790435 AAP ADEFGVW Ent ECT Orl 100mg Keto-E 00842664 AAP ADEFGVW Ent September 2015 v.1 166

M01AE03 KETOPROFEN KÉTOPROFÈNE SRT Orl 200mg Keto SR 02172577 AAP ADEFGVW L.L. Sup Rt 100mg pms-ketoprofen 02015951 PMS ADEFGW Supp. M01AE09 FLURBIPROFEN FLURBIPROFÈNE Tab Orl 50mg Apo-Flurbiprofen 01912046 APX ADEFGVW Novo-Flurprofen 02100509 TEV ADEFGVW Tab Orl 100mg Apo-Flurbiprofen 01912038 APX ADEFGVW Novo-Flurprofen 02100517 TEV ADEFGVW M01AE11 M01AG TIAPROFENIC ACID ACIDE TIAPROFÉNIQUE Tab Orl 200mg Teva-Tiaprofenic 02179679 TEV ADEFGVW Tab Orl 300mg Teva-Tiaprofenic 02179687 TEV ADEFGVW FENEMATES FENEMATES M01AG01 MEFENAMIC ACID ACIDE MÉFÉNAMIQUE M01AH M01AH01 Cap Orl 250mg Mefenamic 02229452 AAP ADEFGVW Caps COXIBS COXIBS CELECOXIB CÉLÉCOXIB Cap Orl 100mg Celebrex 02239941 PFI W (SA) Caps Apo-Celecoxib 02418932 APX W (SA) Celecoxib 02429675 SIV W (SA) Celecoxib 02436299 SAS W (SA) Act-Celecoxib 02420155 ATV W (SA) GD-Celecoxib 02291975 GMD W (SA) Jamp-Celecoxib 02424533 JPC W (SA) Mar-Celecoxib 02420058 MAR W (SA) Mint-Celecoxib 02412497 MNT W (SA) Mylan-Celecoxib 02423278 MYL W (SA) pms-celecoxib 02355442 PMS W (SA) Ran-Celecoxib 02412373 RAN W (SA) Sandoz Celecoxib 02321246 SDZ W (SA) Teva-Celecoxib 02288915 TEV W (SA) September 2015 v.1 167

M01AH01 CELECOXIB CÉLÉCOXIB Cap Orl 200mg Celebrex 02239942 PFI W (SA) Caps Apo-Celecoxib 02418940 APX W (SA) Celecoxib 02429683 SIV W (SA) Celecoxib 02436302 SAS W (SA) Act-Celecoxib 02420163 ATV W (SA) GD-Celecoxib 02291983 GMD W (SA) Jamp-Celecoxib 02424541 JPC W (SA) Mar-Celecoxib 02420066 MAR W (SA) Mint-Celecoxib 02412500 MNT W (SA) Mylan-Celecoxib 02399881 MYL W (SA) pms-celecoxib 02355450 PMS W (SA) Ran-Celecoxib 02412381 RAN W (SA) Sandoz Celecoxib 02321254 SDZ W (SA) Teva-Celecoxib 02288923 TEV W (SA) M01AX M01C M01AX01 M01CB M01CB01 OTHER ANTIINFLAMMATORY AND ANTIRHEUMATIC AGENTS, NON STEROIDS AUTRES AGENTS ANTI-INFLAMMATOIRES ET ANTIRHUMATISMAUX, NON STÉROIDÏENS NABUMETONE NABUMÉTONE Tab Orl 500mg Apo-Nabumetone 02238639 APX ADEFGVW Novo-Nabumetone 02240867 TEV ADEFGVW Tab Orl 750mg Novo-Nabumetone 02240868 TEV ADEFGVW SPECIFIC ANTIRHEUMATIC AGENTS AGENTS ANTIRHUMATISMAUX SPÉCIFIQUES GOLD PREPARATIONS PRÉPARATIONS D OR SODIUM AUROTHIOMALATE AUROTHIOMALATE SODIQUE Inj 10mg/mL Myochrysine 01927620 SAV ADEFGVW Sodium Aurothiomalate 02245456 SDZ ADEFGVW Inj 25mg/mL Myochrysine 01927612 SAV ADEFGVW Sodium Aurothiomalate 02245457 SDZ ADEFGVW M01CB03 Inj 50mg/mL Myochrysine 01927604 SAV ADEFGVW Sodium Aurothiomalate 02245458 SDZ ADEFGVW AURANOFIN AURANOFINE Cap Orl 3mg Ridaura 01916823 XPI ADEFGVW Caps September 2015 v.1 168

M01CC M03 M03A PENICILLAMINE AND SIMILAR AGENTS PÉNICILLAMINE ET AGENTS SEMBLABLES M01CC01 PENICILLAMINE PÉNICILLAMINE M03AX M03AX01 Cap Orl 250mg Cuprimine 00016055 VLN ADEFGVW Caps MUSCLE RELAXANTS MYORELAXANTS PERIPHERALLY ACTING AGENTS, MUSCLE RELAXANTS MYORELAXANTS À L ACTION PÉRIPHÉRIQUE OTHER MUSCLE RELAXANTS, PERIPHERALLY ACTING AUTRES MYORELAXANTS À L ACTION PÉRIPHÉRIQUE BOTULINUM TOXIN BOTULINUM TOXINE Pws IM 50 Unit Botox 00903741 ALL (SA) Pds. Pws IM 50Unit Xeomin 02371081 MRZ (SA) Pds. Pws IM 100Unit Botox 01981501 ALL (SA) Pds. Pws IM 100Unit Xeomin 02324032 MRZ (SA) Pds. M03B M03BA M03BA03 Pws IM 200Unit Botox 00999505 ALL (SA) Pds. MUSCLE RELAXANTS, CENTRALLY ACTING AGENTS MYORELAXANTS, AGENTS AGISSANT CENTRALEMENT CARBAMIC ACID ESTERS ESTERS DE L ACIDE CARBAMIQUE METHOCARBAMOL MÉTHOCARBAMOL Tab Orl 500mg Robaxin 01930990 WCH AEFGVW Tab Orl 750mg Robaxin 01932187 WCH AEFGVW September 2015 v.1 169

M03BA53 M03BC M03BC01 M03BX M03BX01 METHOCARBAMOL, COMBINATIONS EXCLUDING PSYCHOLEPTICS MÉTHOCARBAMOL, EN COMBINAISON, A L EXCLUSION DES PSYCHOLEPTIQUES METHOCARBAMOL / ACETYLSALICYLIC ACID / CODEINE PHOSPHATE MÉTHOCARBAMOL / ACIDE ACETYLSALICYLIC / PHOSPHATE DE CODÉINE Tab Orl 400mg/325mg/16.2mg Robaxisal C-1/4 01934783 WCH W Tab Orl 400mg/325mg/32.4mg Robaxisal C-1/2 01934791 WCH W ETHERS, CHEMICALLY CLOSE TO ANTIHISTAMINES ÉTHERS, CHIMIQUEMENT PRÈS DES ANTIHISTAMINES ORPHENADRINE ORPHÉNADRINE SRT Orl 100mg Sandoz Orphenadrine Citrate 02243559 SDZ AEFGVW L.L. OTHER CENTRALLY ACTING AGENTS AUTRES AGENTS AGISSANT CENTRALEMENT BACLOFEN BACLOFÈNE Tab Orl 10mg Lioresal 00455881 NVR ADEFGVW Apo-Baclofen 02139332 APX ADEFGVW Baclofen 02287021 SAS ADEFGVW Mylan-Baclofen 02088398 MYL ADEFGVW Phl-Baclofen 02236963 PHL ADEFGVW pms-baclofen 02063735 PMS ADEFGVW ratio-baclofen 02236507 TEV ADEFGVW Tab Orl 20mg Lioresal D.S. 00636576 NVR ADEFGVW Apo-Baclofen 02139391 APX ADEFGVW Baclofen 02287048 SAS ADEFGVW Mylan-Baclofen 02088401 MYL ADEFGVW Phl-Baclofen 02236964 PHL ADEFGVW pms-baclofen 02063743 PMS ADEFGVW ratio-baclofen 02236508 TEV ADEFGVW M03BX02 TIZANIDINE TIZANIDINE Tab Orl 4mg Zanaflex 02239170 PAL (SA) Mylan-Tizanidine (Disc/non disp Nov 12/16) 02272059 MYL (SA) Pal-Tizanidine 02239170 PAL (SA) Tizanidine 02259893 AAP (SA) September 2015 v.1 170

M03C M03BX08 M03CA M04 M04A M03CA01 M04AA M04AA01 CYCLOBENZAPRINE CYCLOBENZAPRINE Tab Orl 10mg Apo-Cycloprine 02177145 APX ADEFGVW Auro-Cyclobenzaprine 02348853 ARO ADEFGVW Cyclobenzaprine 02287064 SAS ADEFGVW Jamp-Cyclobenzaprine 02357127 JPC ADEFGVW Mylan-Cyclobenzaprine 02231353 MYL ADEFGVW Novo-Cycloprine 02080052 TEV ADEFGVW pms-cyclobenzaprine 02212048 PMS ADEFGVW MUSCLE RELAXANTS, DIRECTLY ACTING AGENTS MYORELAXANTS, AGENTS AGISSANT DIRECTEMENT DANTROLENE AND DERIVATIVES DANTROLENE ET DÉRIVÉS DANTROLENE DANTROLÈNE Cap Orl 25mg Dantrium 01997602 MTP ADEFGVW Caps Cap Orl 100mg Dantrium 01997653 MTP ADEFGVW Caps ANTIGOUT PREPARATIONS PRÉPARATIONS ANTI-GOUTTE ANTIGOUT PREPARATIONS PRÉPARATIONS ANTI-GOUTTE PREPARATIONS INHIBITING URIC ACID PRODUCTION PRÉPARATIONS INHIBANT LA PRODUCTION D ACIDE URIQUE ALLOPURINOL ALLOPURINOL Tab Orl 100mg Zyloprim 00402818 AAP ADEFGVW Apo-Allopurinol 02402769 APX ADEFGVW Mar-Allopurinol 02396327 MAR ADEFGVW Tab Orl 200mg Zyloprim 00479799 AAP ADEFGVW Apo-Allopurinol 02402777 APX ADEFGVW Mar-Allopurinol 02396335 MAR ADEFGVW Tab Orl 300mg Zyloprim 00402796 AAP ADEFGVW Apo-Allopurinol 02402785 APX ADEFGVW Mar-Allopurinol 02396343 MAR ADEFGVW M04AA03 FEBUXOSTAT FÉBUXOSTAT Tab Orl 80mg Uloric 02357380 TAK (SA) Tab September 2015 v.1 171

M04AB M04AB02 M04AC M05 M05B M04AC01 M05BA M05BA01 M05BA02 M05BA04 PREPARATIONS INCREASING URIC ACID EXCRETION PRÉPARATIONS AUGMENTANT L EXCRÉTION D ACIDE URIQUE SULFINPYRAZONE SULFINPYRAZONE Tab Orl 200mg Sulfinpyrazone 00441767 AAP ADEFGVW PREPARATION WITH NO EFFECT ON URIC ACID METABOLISM PRÉPARATION SANS EFFET SUR LE MÉTABOLISME DE L ACIDE URIQUE COLCHICINE COLCHICINE Tab Orl 0.6mg Colchicine 00287873 EUR ADEFGVW Colchicine 00572349 ODN ADEFGVW Jamp-Colchicine 02373823 JPC ADEFGVW DRUGS FOR TREATMENT OF BONE DISEASES MÉDICAMENTS POUR LE TRAITEMENT DES MALADIES OSSEUSES DRUGS AFFECTING BONE STRUCTURE AND MINERALIZATION MÉDICAMENTS AGISSANT SUR LA STRUCTURE OSSEUSE ET LA MINÉRALISATION BISPHOSPHONATES BISPHOSPHONATES ETIDRONIC ACID ACIDE ÉTIDRONIQUE Tab Orl 200mg Didronel 01997629 PGA (SA) Act Etidronate 02248686 ATV (SA) Mylan-Etidronate 02245330 MYL (SA) CLODRONIC ACID ACIDE CLODRONIQUE Cap Orl 400mg Bonefos 01984845 BAY ADEFGVW Caps Clasteon 02245828 SNV ADEFGVW ALENDRONIC ACID ACIDE ALENDRONIQUE Tab Orl 10mg Alendronate Sodium 02381486 AHI ADEFGVW Apo-Alendronate 02248728 APX ADEFGVW Auro-Alendronate 02388545 ARO ADEFGVW Mint-Alendronate 02394863 MNT ADEFGVW Mylan-Alendronate 02270129 MYL ADEFGVW Ran-Alendronate 02384701 RAN ADEFGVW Sandoz Alendronate 02288087 SDZ ADEFGVW Teva-Alendronate 02247373 TEV ADEFGVW Tab Orl 40mg Co Alendronate 02258102 COB W (SA) September 2015 v.1 172

M05BA04 M05BA07 ALENDRONIC ACID ACIDE ALENDRONIQUE Tab Orl 70mg Fosamax 02245329 FRS ADEFGVW Alendronate 02352966 SAS ADEFGVW Alendronate FC 02299712 SIV ADEFGVW Alendronate Sodium 02381494 AHI ADEFGVW Apo-Alendronate 02248730 APX ADEFGVW Auro-Alendronate 02388553 ARO ADEFGVW Co Alendronate 02258110 COB ADEFGVW Jamp-Alendronate 02385031 JPC ADEFGVW Mint-Alendronate 02394871 MNT ADEFGVW Mylan-Alendronate 02286335 MYL ADEFGVW pms-alendronate FC 02284006 PMS ADEFGVW Ran-Alendronate 02384728 RAN ADEFGVW Sandoz Alendronate 02288109 SDZ ADEFGVW Teva-Alendronate 02261715 TEV ADEFGVW RISEDRONIC ACID ACIDE RISEDRONIC Tab Orl 5mg Actonel 02242518 WNC ADEFGVW Teva-Risedronate 02298376 TEV ADEFGVW Tab Orl 30mg Actonel 02239146 WNC (SA) Teva-Risedronate 02298384 TEV (SA) Tab Orl 35mg Actonel 02246896 WNC ADEFGVW Apo-Risedronate 02353687 APX ADEFGVW Auro-Risedronate 02406306 ARO ADEFGVW Jamp-Risedronate 02368552 JPC ADEFGVW Mylan-Risedronate 02357984 MYL ADEFGVW pms-risedronate 02302209 PMS ADEFGVW ratio-risedronate 02319861 RPH ADEFGVW Risedronate 02370255 SAS ADEFGVW Risedronate 02411407 SIV ADEFGVW Sandoz Risedronate 02327295 SDZ ADEFGVW Teva-Risedronate 02298392 TV ADEFGVW M05BA08 ZOLEDRONIC ACID ACIDE ZOLÉDRONIQUE IV 5mg/100mL Aclasta 02269198 NVR (SA) Taro-Zoledronic Acid 02415100 TAR (SA) Zoledronic Acid 02422433 RCH (SA) Zoledronic Acid 02408082 TEV (SA) September 2015 v.1 173

M05BB M05BB01 M05BB03 M05BX M05BX04 BISPHOSPHONATES, COMBINATIONS BISPHOSPHONATES EN COMBINAISON ETIDRONIC ACID AND CALCIUM, SEQUENTIAL ACIDE ETIDRONIQUE ET CALCIUM, SEQUENTIELLE Tab Orl 400mg, 500mg Didrocal (Disc/non disp Oct 31/15) 02176017 WNC (SA) Act Etidrocal (Kit) 02263866 ATV (SA) Etidrocal (Disc/non disp Feb 27/17) 02353210 SAS (SA) Mylan-Eti-Cal Carepac (Kit) (Disc/non disp Jun 5/16) 02247323 MYL (SA) Novo-EtidronateCAL (Kit) (Disc/non disp Dec 11/15) 02324199 TEV (SA) ALENDRONIC ACID AND COLECALCIFEROL ACIDE ALENDRONIQUE ET COLÉCALCIFÉROL Tab Orl 70mg/5600IU Fosavance 02314940 FRS ADEFGVW Teva-Alendronate/Cholecalciferol 02403641 TEV ADEFGVW Sandoz Alendronate/Cholecalciferol 02429160 SDZ ADEFGVW OTHER DRUGS AFFECTING MINERALIZATION AUTRES MÉDICAMENTS AGISSANT SUR LA MINÉRALISATION DENOSUMAB DENOSUMAB SC 60mg/mL Prolia 02343541 AGA (SA) N01 N01B N01BX N01BX04 SC 120mg/1.7mL Xgeva 02368153 AGA (SA) ANAESTHETICS ANESTHÉSIQUES LOCAL ANAESTHETICS ANESTHÉSIQUES LOCAUX OTHER LOCAL ANAESTHETICS AUTRES ANESTHÉSIQUES LOCAUX CAPSAICIN CAPSAÏCINE Crm Top 0.025% Zostrix 00740306 MDS AEFGVW Cr. Capsaicin 02157101 VLN AEFGVW Crm Top 0.075% Zostrix H.P. 02004240 MDS AEFGVW Cr. Capsaicin Crm 02157128 VLN AEFGVW September 2015 v.1 174

N02 N02A N02AA N02AA01 ANALGESICS ANALGÉSIQUES OPIOIDS OPIOÏDES NATURAL OPIUM ALKALOIDS ALKALOÏDES D OPIUM NATUREL MORPHINE MORPHINE SRT Orl 30mg M.O.S.SR 00776181 VLN ADEFGVW L.L. SRT Orl 60mg M.O.S.SR (Disc/non disp May 31/17) 00776203 VLN ADEFGVW L.L. Syr Orl 1mg/mL ratio-morphine 00607762 RPH ADEFGVW Sir. Syr Orl 5mg/mL ratio-morphine 00607770 RPH ADEFGVW Sir. Syr Orl 10mg/mL ratio-morphine 00690783 RPH ADEFGVW Sir. Syr Orl 20mg/mL ratio-morphine 00690791 RPH ADEFGVW Sir. Dps Orl 20mg/mL Statex 00621935 PAL ADEFGVW Gtts Dps Orl 50mg/mL Statex 00705799 PAL ADEFGVW Gtts Inj 10mg/mL Morphine Sulfate 00392588 SDZ ADEFGVW Inj 15mg/mL Morphine Sulfate 00392561 SDZ ADEFGVW Inj 25mg/mL Morphine HP 25 00676411 SDZ ADEFGVW Inj 50mg/mL Morphine HP 50 00617288 SDZ ADEFGVW SRC Orl 10mg Kadian 02242163 ABB ADEFGVW Caps.L.L. M-Eslon 02019930 SAV ADEFGVW SRC Orl 15mg M-Eslon 15 02177749 SAV ADEFGVW Caps.L.L. September 2015 v.1 175

N02AA01 MORPHINE MORPHINE SRC Orl 20mg Kadian 02184435 ABB ADEFGVW Caps.L.L. SRC Orl 30mg M-Eslon 02019949 SAV ADEFGVW Caps.L.L. SRC Orl 50mg Kadian 02184443 ABB ADEFGVW Caps.L.L. SRC Orl 60mg M-Eslon 02019957 SAV ADEFGVW Caps.L.L. SRC Orl 100mg Kadian 02184451 ABB ADEFGVW Caps.L.L. M-Eslon 02019965 SAV ADEFGVW SRC Orl 200mg Kadian 02177757 ABB ADEFGVW Caps.L.L. SRT Orl 15mg MS Contin 02015439 PFR ADEFGVW L.L. Morphine SR 02350815 SAS ADEFGVW Sandoz Morphine SR 02244790 SDZ ADEFGVW Teva-Morphine SR 02302764 TEV ADEFGVW SRT Orl 30mg MS Contin 02014297 PFR ADEFGVW L.L. Morphine SR 02350890 SAS ADEFGVW Sandoz Morphine SR 02244791 SDZ ADEFGVW Teva-Morphine SR 02302772 TEV ADEFGVW SRT Orl 60mg MS Contin 02014300 PFR ADEFGVW L.L. Morphine SR 02350912 SAS ADEFGVW Sandoz Morphine SR 02244792 SDZ ADEFGVW Teva-Morphine SR 02302780 TEV ADEFGVW SRT Orl 100mg MS Contin 02014319 PFR ADEFGVW L.L. Teva-Morphine SR 02302799 TEV ADEFGVW SRT Orl 200mg MS Contin 02014327 PFR ADEFGVW L.L. Teva-Morphine SR 02302802 TEV ADEFGVW Sup Rt 5mg Statex 00632228 PAL ADEFGVW Supp. Sup Rt 10mg Statex 00632201 PAL ADEFGVW Supp. Sup Rt 20mg Statex 00596965 PAL ADEFGVW Supp. September 2015 v.1 176

N02AA01 MORPHINE MORPHINE Sup Rt 30mg Statex 00639389 PAL ADEFGVW Supp. Syr Orl 1mg/mL Statex 00591467 PAL ADEFGVW Sir. Syr Orl 5mg/mL Statex 00591475 PAL ADEFGVW Sir. Tab Orl 5mg MS IR 02014203 PFR ADEFGVW Statex 00594652 PAL ADEFGVW Tab Orl 10mg MS IR 02014211 PFR ADEFGVW Statex 00594644 PAL ADEFGVW Tab Orl 20mg MS IR 02014238 PFR ADEFGVW Tab Orl 25mg Statex 00594636 PAL ADEFGVW Tab Orl 30mg MS IR 02014254 PFR ADEFGVW N02AA03 Tab Orl 50mg Statex 00675962 PAL ADEFGVW HYDROMORPHONE HYDROMORPHONE Inj 2mg/mL Dilaudid 00627100 PFR ADEFGVW Hydromorphone Hydrochloride 02145901 SDZ ADEFGVW Inj 10mg/mL Dilaudid HP 00622133 PFR ADEFGVW Hydromorphone HP 10 02145928 SDZ ADEFGVW Inj 20mg/mL Hydromorphone HP 20 02145936 SDZ ADEFGVW Inj 50mg/mL Hydromorphone HP 50 02146126 SDZ ADEFGVW Cap Orl 4.5mg Hydromorph Contin 02359502 PFR ADEFGVW Caps. Cap Orl 9mg Hydromorph Contin 02359510 PFR ADEFGVW Caps. SRC Orl 3mg Hydromorph Contin 02125323 PFR ADEFGVW Caps.L.L. September 2015 v.1 177

N02AA03 HYDROMORPHONE HYDROMORPHONE SRC Orl 6mg Hydromorph Contin 02125331 PFR ADEFGVW Caps.L.L. SRC Orl 12mg Hydromorph Contin 02125366 PFR ADEFGVW Caps.L.L. SRC Orl 18mg Hydromorph Contin 02243562 PFR ADEFGVW Caps.L.L. SRC Orl 24mg Hydromorph Contin 02125382 PFR ADEFGVW Caps.L.L. SRC Orl 30mg Hydromorph Contin 02125390 PFR ADEFGVW Caps.L.L. Syr Orl 1mg/mL Dilaudid 00786535 PFR ADEFGVW Sir. Pms-Hydromorphone 01916386 PMS ADEFGVW Tab Orl 1mg Dilaudid 00705438 PFR ADEFGVW Apo-Hydromorphone 02364115 APX ADEFGVW pms-hydromorphone 00885444 PMS ADEFGVW Teva-Hydromorphone 02319403 TEV ADEFGVW Tab Orl 2mg Dilaudid 00125083 PFR ADEFGVW Apo-Hydromorphone 02364123 APX ADEFGVW pms-hydromorphone 00885436 PMS ADEFGVW Teva-Hydromorphone 02319411 TEV ADEFGVW Tab Orl 4mg Dilaudid 00125121 PFR ADEFGVW Apo-Hydromorphone 02364131 APX ADEFGVW pms-hydromorphone 00885401 PMS ADEFGVW Teva-Hydromorphone 02319438 TEV ADEFGVW N02AA05 Tab Orl 8mg Dilaudid 00786543 PFR ADEFGVW Apo-Hydromorphone 02364158 APX ADEFGVW pms-hydromorphone 00885428 PMS ADEFGVW Teva-Hydromorphone 02319446 TEV ADEFGVW OXYCODONE OXYCODONE ERT Orl 10mg Oxyneo 02372525 PFR W L.P. ERT Orl 15mg Oxyneo 02372533 PFR W L.P. ERT Orl 20mg Oxyneo 02372797 PFR W L.P. September 2015 v.1 178

N02AA05 OXYCODONE OXYCODONE ERT Orl 30mg Oxyneo 02372541 PFR W L.P. ERT Orl 40mg Oxyneo 02372568 PFR W L.P. ERT Orl 60mg Oxyneo 02372576 PFR W L.P. ERT Orl 80mg Oxyneo 02372584 PFR W L.P. Sup Rt 10mg Supeudol 00392480 SDZ ADEFGVW Supp. Tab Orl 5mg Oxy-IR 02231934 PFR W (SA) Supeudol 00789739 SDZ (SA) pms-oxycodone IR 02319977 PMS W (SA) Tab Orl 10mg Oxy-IR 02240131 PFR W (SA) Supeudol 00443948 SDZ W (SA) pms-oxycodone IR 02319985 PMS W (SA) N02AA59 Tab Orl 20mg Oxy-IR 02240132 PFR W (SA) Supeudol 02262983 SDZ W (SA) pms-oxycodone IR 02319993 PMS W (SA) CODEINE, COMBINATIONS, EXCLUDING PSYCHOLEPTICS CODÉINE, EN COMBINAISON, À L EXCLUSION DES PSYCHOLEPTIQUES ACETAMINOPHEN / CAFFEINE / CODEINE ACÉTAMINOPHÈNE / CAFÉINE / CODÉINE Tab Orl 300mg/30mg/15mg Tylenol No.3 02163926 JAN ADEFGVW ratio-lenoltec #3 00653276 RPH ADEFGVW Tab Orl 300mg/30mg/30mg Atasol-30 00293512 CHU ADEFGVW ACETAMINOPHEN / CODEINE ACÉTAMINOPHÈNE / CODÉINE Tab Orl 300mg/30mg ratio-emtec-30 00608882 RPH ADEFGVW Tab Orl 300mg/60mg Tylenol No.4 02163918 JAN ADEFGVW ratio-lenoltec #4 00621463 RPH ADEFGVW ACETYLSALICYLIC ACID / CAFFEINE / CODEINE ACIDE ACÉTYLSALICYLIQUE / CAFÉINE / CODÉINE Tab Orl 375mg/30mg/30mg 292 02238645 PDP ADEFGVW September 2015 v.1 179

N02AB N02AB02 N02AB03 PHENYLPIPERIDINE DERIVATIVES DÉRIVÉS DU PHENYLPIPERDINE PETHIDINE (MEPERIDINE) PÉTHIDINE (MÉPÉRIDINE) Tab Orl 50mg Demerol 02138018 SAV W FENTANYL FENTANYL Pth Trd 12mcg Duragesic Mat 02334186 JAN W (SA) Pth Co Fentanyl 02386844 COB W (SA) Mylan-Fentanyl Matrix 02396696 MYL W (SA) pms-fentanyl MTX 02341379 PMS W (SA) Ran-Fentanyl Matrix 02330105 RAN W (SA) Sandoz Fentanyl patch 02327112 SDZ W (SA) Teva-Fentanyl 02311925 TEV W (SA) Pth Trd 25mcg Duragesic Mat 02275813 JAN W (SA) Pth Apo-Fentanyl 02314630 APX W (SA) Co Fentanyl 02386852 COB W (SA) Mylan-Fentanyl Matrix 02396718 MYL W (SA) pms-fentanyl MTX 02341387 PMS W (SA) Ran-Fentanyl Matrix 02330113 RAN W (SA) Sandoz Fentanyl 02327120 SDZ W (SA) Teva-Fentanyl 02282941 TEV W (SA) Pth Trd 37mcg Sandoz Fentanyl 02327139 SDZ W Pth Pth Trd 50mcg Duragesic Mat 02275821 JAN W (SA) Pth Apo-Fentanyl 02314649 APX W (SA) Co Fentanyl 02386879 COB W (SA) Mylan-Fentanyl Matrix 02396726 MYL W (SA) pms-fentanyl MTX 02341395 PMS W (SA) Ran-Fentanyl Matrix 02330121 RAN W (SA) Sandoz Fentanyl 02327147 SDZ W (SA) Teva-Fentanyl 02282968 TEV W (SA) Pth Trd 75mcg Duragesic Mat 02275848 JAN W (SA) Pth Apo-Fentanyl 02314657 APX W (SA) Co Fentanyl 02386887 COB W (SA) Mylan-Fentanyl Matrix 02396734 MYL W (SA) pms-fentanyl MTX 02341409 PMS W (SA) Ran-Fentanyl Matrix 02330148 RAN W (SA) Sandoz Fentanyl 02327155 SDZ W (SA) Teva-Fentanyl 02282976 TEV W (SA) September 2015 v.1 180

N02AB03 N02AD N02B N02AD01 N02BA N02BA01 FENTANYL FENTANYL Pth Trd 100mcg Duragesic Mat 02275856 JAN W (SA) Pth Apo-Fentanyl 02314665 APX W (SA) Co Fentanyl 02386895 COB W (SA) Mylan-Fentanyl Matrix 02396742 MYL W (SA) pms-fentanyl MTX 02341417 PMS W (SA) Ran-Fentanyl Matrix 02330156 RAN W (SA) Sandoz Fentanyl 02327163 SDZ W (SA) Teva-Fentanyl 02282984 TEV W (SA) BENZOMORPHAN DERIVATIVES DÉRIVÉS DU BENZOMORPHANE PENTAZOCINE PENTAZOCINE Tab Orl 50mg Talwin 02137984 SAV W OTHER ANALGESICS AND ANTIPYRETICS AUTRES ANALGÉSIQUES ET ANTIPYRÉTIQUES SALICYLIC ACID AND DERIVATIVES ACIDE SALICYLIQUE ET DÉRIVÉS ACETYLSALICYLIC ACID ACIDE ACÉTYLSALICYLIQUE ECT Orl 81mg ASA daily low dose 02243101 PMS V Ent ASA ECT (Disc/non disp Nov 01/17) 02244993 PMS V Equate daily low-dose EC 02243801 PMS V Exact Coated daily low dose ASA 02243896 PMS V Praxis ASA 02283700 PDP V Rexall Coated low dose ASA 02243802 PMS V ASA EC 02426811 SAS V ECT Orl 325mg Entrophen 00010332 PDP AEFGVW Ent Novasen 00216666 TEV AEFGVW ASATAB EC 02352427 ODN AEFGVW Enteric Coated ASA 02010526 TAN AEFGVW pms-asa EC 02284529 PMS AEFGVW N02BA11 ECT Orl 650mg Entrophen (Disc/non disp Mar 10/16) 00010340 PDP AEFGVW Ent Novasen 00229296 TEV AEFGVW Jamp-ASA EC 00794244 JPC AEFGVW DIFLUNISAL DIFLUNISAL Tab Orl 250mg Diflunisal 02039486 AAP ADEFGVW Novo-Diflunisal 02048493 TEV ADEFGVW Tab Orl 500mg Diflunisal 02039494 AAP ADEFGVW September 2015 v.1 181

N02BA51 N02BA71 ACETYLSALICYLIC ACID, COMBINATIONS EXCLUDING PSYCHOLEPTICS ACIDE ACÉTYLSALICYLIQUE, EN COMBINAISON, À L EXCLUSION DES PSYCHOLEPTIQUES ACETYLSALICYLIC ACID / OXYCODONE ACIDE ACÉTYLSALICYLIQUE / OXYCODONE Tab Orl 325mg/5mg ratio-oxycodan 00608157 RPH ADEFGVW ACETYLSALICYLIC ACID COMBNATIONS WITH PSYCHOLEPTICS ACIDE ACÉTYLSALICYLIQUE, EN COMBINAISON AVEC DES PSYCHOLEPTIQUES BUTALBITAL / ACETYLSALICYLIC ACID / CAFFEINE BUTALBITAL / ACIDE ACÉTYLSALICYLIQUE / CAFÉINE Cap Orl 50mg/330mg/40mg Fiorinal 00226327 NVR W Caps ratio-tecnal 00608238 RPH W Tab Orl 50mg/330mg/40mg ratio-tecnal 00608211 RPH W BUTALBITAL / ACETYLSALICYLIC ACID / CAFFEINE / CODEINE BUTALBITAL / ACIDE ACÉTYLSALICYLIQUE / CAFÉINE/ CODÉINE Cap Orl 50mg/330mg/40mg/15mg Fiorinal C ¼ 00176192 NVR W Caps ratio-tecnal C ¼ 00608203 RPH W N02BE N02BE01 Cap Orl 50mg/330mg/40mg/30mg Fiorinal C ½ 00176206 NVR W Caps ratio-tecnal C ½ 00608181 RPH W ANILIDES ANILIDES PARACETAMOL (ACETAMINOPHEN) PARACETAMOL (ACÉTAMINOPHÉNE) Sup Rt 120mg Abenol 01919385 PDP G Supp. Acet 120 02230434 PDP G Sup Rt 325mg Abenol 01919393 PDP G Supp. Tab Orl 325mg Acetaminophen 01938088 JPC G Apo-Acetaminophen 00544981 APX G Novo-Gesic 00389218 TEV G Tab Orl 500mg Acetaminophen 01939122 JPC G Apo-Acetaminophen 00545007 APX G Apo-Acetaminophen 02229977 APX G Novo-Gesic 00482323 TEV G September 2015 v.1 182

N02BE51 PARACETAMOL (ACETAMINOPHEN), COMBINATIONS EXCLUDING PSYCHOLEPTICS PARACETAMOL (ACÉTAMINOPHÉNE), EN COMBINAISONS, À L EXCLUSION DES PSYCHOLEPTIQUES ACETAMINOPHEN / CAFFEINE / CODEINE ACÉTAMINOPHÈNE / CAFÉINE / CODÉINE Tab Orl 300mg/30mg/15mg Atasol-15 00293504 CHU ADEFGVW Tab Orl 300mg/15mg/15mg Tylenol No.2 02163934 JAN ADEFGVW ratio-lenoltec #2 00653241 RPH ADEFGVW ACETAMINOPHEN / OXYCODONE ACÉTAMINOPHÈNE / OXYCODONE Tab Orl 325mg/2.5mg Percocet Demi 01916491 BRI ADEFGVW N02BG N02C N02BG04 N02CA N02CA01 Tab Orl 325mg/5mg Endocet 01916548 BRI ADEFGVW Percocet 01916475 BRI ADEFGVW Apo-Oxycodone/Acet 02324628 APX ADEFGVW Oxycodone/Acet 02361361 SAS ADEFGVW ratio-oxycocet 00608165 RPH ADEFGVW Sandoz Oxycodone/Acetaminophen 02307898 SDZ ADEFGVW OTHER ANALGESICS AND ANTIPYRETICS AUTRE ANALGÉSIQUES ET ANTIPYRÉTIQUES FLOCTAFENINE FLOCTAFÉNINE Tab Orl 200mg Floctafenine 02244680 AAP ADEFGVW Tab Orl 400mg Floctafenine 02244681 AAP ADEFGVW ANTIMIGRAINE PREPARATIONS PRÉPARATIONS ANTI-MIGRAINES ERGOT ALKALOIDS ALKALOÏDES DE L ERGOT DIHYDROERGOTAMINE DIHYDROERGOTAMINE Inj 1mg/mL Dihydroergotamine 02241163 SDZ ADEFGVW Dihydroergotamine 00027243 STR ADEFGVW Nas 4mg/mL Migranal 02228947 STR ADEFGVW September 2015 v.1 183

N02CA52 N02CC N02CC01 ERGOTAMINE, COMBINATIONS EXCLUDING PSYCHOLEPTICS ERGOTAMINE, EN COMBINAISON, À L EXCLUSION DES PSYCHOLEPTIQUES ERGOTAMINE / CAFFEINE ERGOTAMINE / CAFÉINE Tab Orl 1mg/100mg Cafergot (Disc/non disp Feb 7/16) 00176095 NVR ADEFGVW SELECTIVE 5HT1-RECEPTOR AGONISTS AGONISTES DES RECEPTEURS 5HT1 SELECTIFS SUMATRIPTAN SUMATRIPTAN SC 12mg/mL Imitrex 02212188 GSK (SA) Taro-Sumatriptan 02361698 TAR (SA) Spr Nas 5mg Imitrex 02230418 GSK (SA) Spr Spr Nas 20mg Imitrex 02230420 GSK (SA) Spr Tab Orl 50mg Imitrex DF 02212153 GSK (SA) Act Sumatriptan 02257890 ATV (SA) Apo-Sumatriptan 02268388 APX (SA) Mylan-Sumatriptan 02268914 MYL (SA) pms-sumatriptan 02256436 PMs (SA) Sandoz Sumatriptan 02263025 SDZ (SA) Sumatriptan 02286521 SAS (SA) Sumatriptan DF 02385570 SIV (SA) Teva-Sumatriptan DF 02286823 TEV (SA) N02CC02 Tab Orl 100mg Imitrex DF 02212161 GSK (SA) Act Sumatriptan 02257904 ATV (SA) Apo-Sumatriptan 02268396 APX (SA) Mylan-Sumatriptan 02268922 MYL (SA) pms-sumatriptan 02256444 PMS (SA) Sandoz Sumatriptan 02263033 SDZ (SA) Sumatriptan 02286548 SAS (SA) Sumatriptan DF 02385589 SIV (SA) Teva-Sumatriptan 02239367 TEV (SA) Teva-Sumatriptan DF 02286831 TEV (SA) NARATRIPTAN NARATRIPTAN Tab Orl 1mg Amerge 02237820 GSK (SA) Teva-Naratriptan 02314290 TEV (SA) Tab Orl 2.5mg Amerge 02237821 GSK (SA) Teva-Naratriptan 02314304 TEV (SA) Sandoz Naratriptan 02322323 SDZ (SA) September 2015 v.1 184

N02CC03 ZOLMITRIPTAN ZOLMITRIPTAN ODT Orl 2.5mg Zomig Rapimelt 02243045 AZE (SA) D.O. Jamp-Zolmitriptan ODT 02428237 JPC (SA) Mylan-Zolmitriptan 02387158 MYL (SA) pms-zolmitriptan ODT 02324768 PMS (SA) Sandoz Zolmitriptan ODT 02362996 SDZ (SA) Teva-Zolmitriptan 02342545 TEV (SA) Spr Nas 2.5mg Zomig 02248992 AZE (SA) Spr Spr Nas 5mg Zomig Nasal 02248993 AZE (SA) Spr Tab Orl 2.5mg Zomig 02238660 AZE (SA) Jamp-Zolmitriptan 02421623 JPC (SA) Mar-Zolmitriptan 02399458 MAR (SA) Mylan-Zolmitriptan 02369036 MYL (SA) pms-zolmitriptan 02324229 PMS (SA) Sandoz Zolmitriptan 02362988 SDZ (SA) Teva-Zolmitriptan 02313960 TEV (SA) N02CC04 RIZATRIPTAN RIZATRIPTAN ODT Orl 5mg Maxalt RPD 02240518 FRS (SA) D.O. Act Rizatriptan ODT 02374730 ATV (SA) Apo-Rizatriptan RPD 02393484 APX (SA) Mylan-Rizatriptan ODT 02379198 MYL (SA) pms-rizatriptan RDT 02393360 PMS (SA) Sandoz Rizatriptan ODT 02351870 SDZ (SA) Teva-Rizatriptan ODT 02396661 TEV (SA) ODT Orl 10mg Maxalt RPD 02240519 FRS (SA) D.O. Act Rizatriptan ODT 02374749 ATV (SA) Apo-Rizatriptan RPD 02393492 APX (SA) Mylan-Rizatriptan ODT 02379201 MYL (SA) pms-rizatriptan RDT 02393379 PMS (SA) Sandoz Rizatriptan ODT 02351889 SDZ (SA) Teva-Rizatriptan ODT 02396688 TEV (SA) Tab Orl 5mg Apo-Rizatriptan 02393468 APX (SA) Jamp-Rizatriptan 02380455 JPC (SA) Mar-Rizatriptan 02379651 MAR (SA) Tab Orl 10mg Maxalt 02240521 FRS (SA) Act Rizatriptan 02381702 ATV (SA) Apo-Rizatriptan 02393476 APX (SA) Jamp-Rizatriptan 02380463 JPC (SA) Mar-Rizatriptan 02379678 MAR (SA) September 2015 v.1 185

N02CC05 N02CX N03 N03A N02CX01 N03AA N03AA02 ALMOTRIPTAN ALMOTRIPTAN Tab Orl 6.25mg Axert 02248128 JNJ (SA) Apo-Almotriptan 02405792 APX (SA) Mylan-Almotriptan 02398435 MYL (SA) Tab Orl 12.5mg Axert 02248129 JNJ (SA) Apo-Almotriptan 02405806 APX (SA) Mylan-Almotriptan 02398443 MYL (SA) Sandoz Almotriptan 02405334 SDZ (SA) OTHER ANTIMIGRAINE PREPARATIONS AUTRES PRÉPARATIONS ANTI-MIGRAINE PIZOTIFEN PIZOTIFÈNE Tab Orl 0.5mg Sandomigran 00329320 PAL ADEFGVW Tab Orl 1mg Sandomigran DS 00511552 PAL ADEFGVW ANTIEPILEPTICS ANTIÉPILEPTIQUES ANTIEPILEPTICS ANTIÉPILEPTIQUES BARBITURATES AND DERIVATIVES BARBITURIQUES ET DÉRIVÉS PHENOBARBITAL PHÉNOBARBITAL Elx Orl 5mg/mL Phenobarbital 00645575 PMS ADEFGVW Elx Tab Orl 15mg Phenobarbital 00178799 PDP ADEFGVW Tab Orl 30mg Phenobarbital 00178802 PDP ADEFGVW Tab Orl 60mg Phenobarbital 00178810 PDP ADEFGVW N03AA03 Tab Orl 100mg Phenobarbital 00178829 PDP ADEFGVW PRIMIDONE PRIMIDONE Tab Orl 125mg Primidone 00399310 AAP ADEFGVW September 2015 v.1 186

N03AA03 N03AB N03AB02 PRIMIDONE PRIMIDONE Tab Orl 250mg Primidone 00396761 AAP ADEFGVW HYDANTOIN DERIVATIVES DÉRIVÉS DE L HYDANTOÏNE PHENYTOIN PHÉNYTOÏNE Cap Orl 30mg Dilantin 00022772 PFI ADEFGVW Caps Cap Orl 100mg Dilantin 00022780 PFI ADEFGVW Caps Orl 50mg/mL Phenytoin Sodium 00780626 SDZ V Tab Orl 50mg Dilantin infatabs 00023698 PFI ADEFGVW N03AD N03AD01 N03AE N03AE01 Sus Orl 30mg/5mL Dilantin 30 00023442 PFI ADEFGVW Susp Sus Orl 125mg/5mL Dilantin 125 00023450 PFI ADEFGVW Susp Taro-Phenytoin 02250896 TAR ADEFGVW SUCCINIMIDE DERIVATIVES DÉRIVÉS DU SUCCINIMIDE ETHOSUXIMIDE ÉTHOSUXIMIDE Cap Orl 250mg Zarontin 00022799 ERF ADEFGVW Caps Syr Orl 50mg/mL Zarontin 00023485 ERF ADEFGVW Sir. BENZODIAZEPINE DERIVATIVES DÉRIVÉS DU BENZODIAZÉPINES CLONAZEPAM CLONAZÉPAM Tab Orl 0.25mg pms-clonazepam 02179660 PMS ADEFGVW September 2015 v.1 187

N03AE01 CLONAZEPAM CLONAZÉPAM Tab Orl 0.5mg Rivotril 00382825 HLR ADEFGVW Apo-Clonazepam 02177889 APX ADEFGVW Co Clonazepam 02270641 COB ADEFGVW Mylan-Clonazepam 02230950 MYL ADEFGVW Phl-Clonazepam 02236948 PHL ADEFGVW pms-clonazepam R 02207818 PMS ADEFGVW Sandoz Clonazepam (Disc/non disp Apr 27/17) 02233960 SDZ ADEFGVW Teva-Clonazepam 02239024 TEV ADEFGVW Zym-Clonazepam (Disc/non disp Jun 16/16) 02345676 ZYM ADEFGVW Tab Orl 1mg Phl-Clonazepam 02145235 PHL ADEFGVW pms-clonazepam 02048728 PMS ADEFGVW Sandoz Clonazepam 02233982 SDZ ADEFGVW Zym-Clonazepam (Disc/non disp Jun 16/16) 02303329 ZYM ADEFGVW N03AF N03AF01 Tab Orl 2mg Rivotril 00382841 HLR ADEFGVW Apo-Clonazepam 02177897 APX ADEFGVW Co Clonazepam 02270676 COB ADEFGVW Mylan-Clonazepam 02230951 MYL ADEFGVW Phl-Clonazepam 02145243 PHL ADEFGVW pms-clonazepam 02048736 PMS ADEFGVW Sandoz Clonazepam (Disc/non disp Dec 31/16) 02233985 SDZ ADEFGVW Teva-Clonazepam 02239025 TEV ADEFGVW Zym-Clonazepam (Disc/non disp Jun 16/16) 02303337 ZYM ADEFGVW CARBOXAMIDE DERIVATIVES DÉRIVÉS DU CARBOXAMIDE CARBAMAZEPINE CARBAMAZÉPINE SRT Orl 200mg Tegretol CR 00773611 NVR ADEFGVW L.L. Mylan-Carbamazepine 02241882 MYL ADEFGVW pms-carbamazepine 02231543 PMS ADEFGVW Taro-Carbamazepine CR 02237907 TAR ADEFGVW Sandoz Carbamazepine CR 02261839 SDZ ADEFGVW SRT Orl 400mg Tegretol CR 00755583 NVR ADEFGVW L.L. Mylan-Carbamazepine 02241883 MYL ADEFGVW pms-carbamazepine 02231544 PMS ADEFGVW Taro-Carbamazepine CR 02237908 TAR ADEFGVW Sandoz Carbamazepine CR 02261847 SDZ ADEFGVW Sus Orl 100mg/5mL Tegretol 02194333 NVR ADEFGVW Susp Taro-Carbamazepine 02367394 TAR ADEFGVW Tab Orl 200mg Tegretol 00010405 NVR ADEFGVW Taro-Carbamazepine 02407515 TAR ADEFGVW Teva-Carbamazepine 00782718 TEV ADEFGVW September 2015 v.1 188

N03AF01 N03AF02 CARBAMAZEPINE CARBAMAZÉPINE TabC Orl 100mg Tegretol Chew 00369810 NVR ADEFGVW C. pms-carbamazepine 02231542 PMS ADEFGVW Sandoz Carbamazepine Chewtabs (Disc/non disp Apr 27/17) 02261855 SDZ ADEFGVW TabC Orl 200mg Tegretol Chew 00665088 NVR ADEFGVW C. pms-carbamazepine 02231540 PMS ADEFGVW Sandoz Carbamazepine Chewtabs (Disc/non disp Dec 31/16) 02261863 SDZ ADEFGVW OXCARBAZEPINE OXCARBAZÉPINE Sus Orl 60mg/mL Trileptal 02244673 NVR (SA) Susp Tab Orl 150mg Trileptal 02242067 NVR (SA) Oxcarbazepine 02284294 AAP (SA) Tab Orl 300mg Trileptal 02242068 NVR (SA) Oxcarbazepine 02284308 AAP (SA) Tab Orl 600mg Trileptal 02242069 NVR (SA) Oxcarbazepine 02284316 AAAP (SA) N03AF03 RUFINAMIDE RUFINAMIDE Tab Orl 100mg Banzel 02369613 EIS (SA) Tab Orl 200mg Banzel 02369621 EIS (SA) N03AG N03AG01 Tab Orl 400mg Banzel 02369648 EIS (SA) FATTY ACID DERIVATIVES DÉRIVÉS DES ACIDES GRAS VALPROIC ACID ACIDE VALPROÏQUE ECT Orl 125mg Epival 00596418 BGP ADEFGVW Ent Apo-Divalproex 02239698 APX ADEFGVW Divalproex 02400499 SAS ADEFGVW Novo-Divalproex 02239701 TEV ADEFGVW ECT Orl 250mg Epival 00596426 BGP ADEFGVW Ent Apo-Divalproex 02239699 APX ADEFGVW Divalproex 02400502 SAS ADEFGVW Novo-Divalproex 02239702 TEV ADEFGVW September 2015 v.1 189

N03AG01 VALPROIC ACID ACIDE VALPROÏQUE ECT Orl 500mg Epival 00596434 BGP ADEFGVW Ent Apo-Divalproex 02239700 APX ADEFGVW Divalproex 02400510 SAS ADEFGVW Novo-Divalproex 02239703 TEV ADEFGVW Cap Orl 250mg Depakene 00443840 BGP ADEFGVW Caps Apo-Valproic 02238048 APX ADEFGVW Novo-Valproic 02100630 TEV ADEFGVW pms-valproic Acid 02230768 PMS ADEFGVW Sandoz Valproic (Disc/non disp Nov 15/15) 02239714 SDZ ADEFGVW ECC Orl 500mg pms-valproic Acid 02229628 PMS ADEFGVW Caps.Ent N03AG04 N03AX N03AX09 Syr Orl 250mg/5mL Depakene 00443832 BGP ADEFGVW Sir. Apo-Valproic Acid 02238370 APX ADEFGVW pms-valproic 02236807 PMS ADEFGVW VIGABATRIN VIGABATRIN Pwr Orl 500mg Sabril (Sachet) 02068036 LBK (SA) Pd. Tab Orl 500mg Sabril 02065819 LBK (SA) OTHER ANTIEPILEPTICS AUTRE ANTIÉPILEPTIQUES LAMOTRIGINE LAMOTRIGINE Tab Orl 25mg Lamictal 02142082 GSK ADEFGVW Apo-Lamotrigine 02245208 APX ADEFGVW Auro-Lamotrigine 02381354 ARO ADEFGVW Lamotrigine 02343010 SAS ADEFGVW Lamotrigine 02428202 SIV ADEFGVW Mylan-Lamotrigine 02265494 MYL ADEFGVW pms-lamotrigine 02246897 PMS ADEFGVW Teva-Lamotrigine 02248232 TEV ADEFGVW Tab Orl 100mg Lamictal 02142104 GSK ADEFGVW Apo-Lamotrigine 02245209 APX ADEFGVW Auro-Lamotrigine 02381362 ARO ADEFGVW Lamotrigine 02343029 SAS ADEFGVW Lamotrigine 02428210 SIV ADEFGVW Mylan-Lamotrigine 02265508 MYL ADEFGVW pms-lamotrigine 02246898 PMS ADEFGVW Teva-Lamotrigine 02248233 TEV ADEFGVW September 2015 v.1 190

N03AX09 LAMOTRIGINE LAMOTRIGINE Tab Orl 150mg Lamictal 02142112 GSK ADEFGVW Apo-Lamotrigine 02245210 APX ADEFGVW Auro-Lamotrigine 02381370 ARO ADEFGVW Lamotrigine 02343037 SAS ADEFGVW Lamotrigine 02428229 SIV ADEFGVW Mylan-Lamotrigine 02265516 MYL ADEFGVW pms-lamotrigine 02246899 PMS ADEFGVW Teva-Lamotrigine 02248234 TEV ADEFGVW TabC Orl 2mg Lamictal Chewtabs 02243803 GSK ADEFGVW C N03AX11 TabC Orl 5mg Lamictal Chewtabs 02240115 GSK ADEFGVW C TOPIRAMATE TOPIRAMATE Cap Orl 15mg Topamax 02239907 JAN (SA) Caps Cap Orl 25mg Topamax 02239908 JAN (SA) Caps Tab Orl 25mg Topamax 02230893 JAN ADEFGVW Abbott-Topiramate 02414600 BGP ADEFGVW Act Topiramate 02287765 ATV ADEFGVW Apo-Topiramate 02279614 APX ADEFGVW Auro-Topiramate 02345803 ARO ADEFGVW GD-Topiramate (Disc/non disp Nov 30/15) 02352850 GMD ADEFGVW Jamp-Topiramate 02435608 JPC ADEFGVW Mint-Topiramate 02315645 MNT ADEFGVW Mylan-Topiramate 02263351 MYL ADEFGVW Phl-Topiramate 02271184 PHL ADEFGVW pms-topiramate 02262991 PMS ADEFGVW Ran-Topiramate 02396076 RAN ADEFGVW Sandoz Topiramate 02260050 SDZ ADEFGVW Sandoz Topiramate Tablets 02431807 SDZ ADEFGVW Teva-Topiramate 02248860 TEV ADEFGVW Topiramate 02356856 SAS ADEFGVW Topiramate 02389460 SIS ADEFGVW Topiramate 02395738 AHI ADEFGVW Zym-Topiramate (Disc/non disp Jun 16/16) 02325136 ZYM ADEFGVW Tab Orl 50mg pms-topiramate 02312085 PMS ADEFGVW September 2015 v.1 191

N03AX11 TOPIRAMATE TOPIRAMATE Tab Orl 100mg Topamax 02230894 JAN ADEFGVW Abbott-Topiramate 02414619 BGP ADEFGVW Act Topiramate 02287773 ATV ADEFGVW Apo-Topiramate 02279630 APX ADEFGVW Auro-Topiramate 02345838 ARO ADEFGVW GD-Topiramate (Disc/non disp Nov 30/15) 02352877 GMD ADEFGVW Jamp-Topiramate 02435616 JPC ADEFGVW Mint-Topiramate 02315653 MNT ADEFGVW Mylan-Topiramate 02263378 MYL ADEFGVW Phl-Topiramate 02271192 PHL ADEFGVW pms-topiramate 02263009 PMS ADEFGVW Ran-Topiramate 02396084 RAN ADEFGVW Sandoz Topiramate 02260069 SDZ ADEFGVW Sandoz Topiramate Tablets 02431815 SDZ ADEFGVW Teva-Topiramate 02248861 TEV ADEFGVW Topiramate 02356864 SAS ADEFGVW Topiramate 02389487 SIS ADEFGVW Topiramate 02395746 AHI ADEFGVW Zym-Topiramate (Disc/non disp Jun 16/16) 02325144 ZYM ADEFGVW Tab Orl 200mg Topamax 02230896 JAN ADEFGVW Abbott-Topiramate 02414627 BGP ADEFGVW Act Topiramate 02287781 ATV ADEFGVW Apo-Topiramate 02279649 APX ADEFGVW Auro-Topiramate 02345846 ARO ADEFGVW GD-Topiramate (Disc/non disp Nov 30/15) 02352885 GMD ADEFGVW Jamp-Topiramate 02435624 JPC ADEFGVW Mint-Topiramate 02315661 MNT ADEFGVW Mylan-Topiramate 02263386 MYL ADEFGVW Phl-Topiramate 02271206 PHL ADEFGVW pms-topiramate 02263017 PMS ADEFGVW Ran-Topiramate 02396092 RAN ADEFGVW Sandoz Topiramate 02267837 SDZ ADEFGVW Sandoz Topiramate Tablets 02431823 SDZ ADEFGVW Teva-Topiramate 02248862 TEV ADEFGVW Topiramate 02356872 SAS ADEFGVW Topiramate 02395754 AHI ADEFGVW Zym-Topiramate (Disc/non disp Jun 16/16) 02325152 ZYM ADEFGVW September 2015 v.1 192

N03AX12 GABAPENTIN GABAPENTINE Cap Orl 100mg Neurontin 02084260 PFI ADEFGVW Caps Apo-Gabapentin 02244304 APX ADEFGVW Auro-Gabapentin 02321203 ARO ADEFGVW Co Gabapentin 02256142 COB ADEFGVW Gabapentin 02353245 SAS ADEFGVW Gabapentin 02246314 SIV ADEFGVW GD-Gabapentin 02285819 GMD ADEFGVW Jamp-Gabapentin 02361469 JPC ADEFGVW Mar-Gabapentin 02391473 MAR ADEFGVW Mylan-Gabapentin 02248259 MYL ADEFGVW pms-gabapentin 02243446 PMS ADEFGVW Ran-Gabapentin 02319055 RAN ADEFGVW Teva-Gabapentin 02244513 TEV ADEFGVW Cap Orl 300mg Neurontin 02084279 PFI ADEFGVW Caps Apo-Gabapentin 02244305 APX ADEFGVW Auro-Gabapentin 02321211 ARO ADEFGVW Co Gabapentin 02256150 COB ADEFGVW Gabapentin 02353253 SAS ADEFGVW Gabapentin 02246315 SIV ADEFGVW GD-Gabapentin 02285827 GMD ADEFGVW Jamp-Gabapentin 02361485 JPC ADEFGVW Mar-Gabapentin 02391481 MAR ADEFGVW Mylan-Gabapentin 02248260 MYL ADEFGVW pms-gabapentin 02243447 PMS ADEFGVW Ran-Gabapentin 02319063 RAN ADEFGVW Teva-Gabapentin 02244514 TEV ADEFGVW Cap Orl 400mg Neurontin 02084287 PFI ADEFGVW Caps Apo-Gabapentin 02244306 APX ADEFGVW Auro-Gabapentin 02321238 ARO ADEFGVW Co Gabapentin 02256169 COB ADEFGVW Gabapentin 02353261 SAS ADEFGVW Gabapentin 02246316 SIV ADEFGVW GD-Gabapentin 02285835 GMD ADEFGVW Jamp-Gabapentin 02361493 JPC ADEFGVW Mar-Gabapentin 02391503 MAR ADEFGVW Mylan-Gabapentin 02248261 MYL ADEFGVW pms-gabapentin 02243448 PMS ADEFGVW Ran-Gabapentin 02319071 RAN ADEFGVW Teva-Gabapentin 02244515 TEV ADEFGVW September 2015 v.1 193

N03AX12 GABAPENTIN GABAPENTINE Tab Orl 600mg Neurontin 02239717 PFI ADEFGVW Apo-Gabapentin 02293358 APX ADEFGVW Gabapentin 02392526 AHI ADEFGVW Gabapentin 02431289 SAS ADEFGVW Gabapentin 02388200 SIV ADEFGVW GD-Gabapentin 02285843 GMD ADEFGVW Jamp-Gabapentin 02402289 JPC ADEFGVW Mylan-Gabapentin 02397471 MYL ADEFGVW pms-gabapentin 02255898 PMS ADEFGVW Teva-Gabapentin 02248457 TEV ADEFGVW Tab Orl 800mg Neurontin 02239718 PFI ADEFGVW Apo-Gabapentin 02293366 APX ADEFGVW Gabapentin 02392534 AHI ADEFGVW Gabapentin 02431297 SAS ADEFGVW Gabapentin 02388219 SIV ADEFGVW GD-Gabapentin 02285851 GMD ADEFGVW Jamp-Gabapentin 02402297 JPC ADEFGVW Mylan-Gabapentin 02397498 MYL ADEFGVW pms-gabapentin 02255901 PMS ADEFGVW Teva-Gabapentin 02247346 TEV ADEFGVW N03AX14 LEVETIRACETAM LÉVÉTIRACÉTAM Tab Orl 250mg Keppra 02247027 UCB (SA) Abbott-Levetiracetam 02414805 ABB (SA) Act Levetiracetam 02274183 ATV (SA) Apo-Levetiracetam 02285924 APX (SA) Auro-Levetiracetam 02375249 ARO (SA) Jamp-Levetiracetam 02403005 SIV (SA) Levetiracetam 02353342 SAS (SA) Levetiracetam 02399776 AHI (SA) pms-levetiracetam 02296101 PMS (SA) Ran-Levetiracetam 02396106 RAN (SA) Tab Orl 500mg Keppra 02247028 UCB (SA) Abbott-Leveitracetam 02414791 ABB (SA) Act Levetiracetam 02274191 ATV (SA) Apo-Levetiracetam 02285932 APX (SA) Auro-Levetiracetam 02375257 ARO (SA) Jamp-Levetiracetam 02403021 SIV (SA) Levetiracetam 02399784 AHI (SA) Levetiracetam 02353350 SAS (SA) pms-levetiracetam 02296128 PMS (SA) Ran-Levetiracetam 02396114 RAN (SA) September 2015 v.1 194

N03AX14 N03AX16 LEVETIRACETAM LÉVÉTIRACÉTAM Tab Orl 750mg Keppra 02247029 UCB (SA) Abbott-Levetiracetam 02414783 ABB (SA) Act Levetiracetam 02274205 ATV (SA) Apo-Levetiracetam 02285940 APX (SA) Auro-Levetiracetam 02375265 ARO (SA) Jamp-Levetiracetam 02403048 SIV (SA) Levetiracetam 02353369 SAS (SA) Levetiracetam 02399792 AHI (SA) pms-levetiracetam 02296136 PMS (SA) Ran-Levetiracetam 02396122 RAN (SA) PREGABALIN PRÉGABALINE Cap Orl 25mg Lyrica 02268418 PFI W (SA) Caps Act Pregabalin 02402912 ATV W (SA) Apo-Pregabalin 02394235 APX W (SA) GD-Pregabalin 02360136 GMD W (SA) Mint-Pregabalin 02423804 MNT W (SA) Myl-Pregabalin 02408651 MYL W (SA) pms-pregabalin 02359596 PMS W (SA) Pregabalin 02405539 SAS W (SA) Pregabalin 02411725 SIV W (SA) Pregabalin 02403692 SIV W (SA) Ran-Pregabalin 02392801 RAN W (SA) Sandoz Pregabalin 02390817 SDZ W (SA) Teva-Pregabalin 02361159 TEV W (SA) Mar-Pregabalin 02417529 MAR W (SA) Cap Orl 50mg Lyrica 02268426 PFI W (SA) Caps Act Pregabalin 02402920 ATV W (SA) Apo-Pregabalin 02394243 APX W (SA) GD-Pregabalin 02360144 GMD W (SA) Mint-Pregabalin 02423812 MNT W (SA) Myl-Pregabalin 02408678 MYL W (SA) pms-pregabalin 02359618 PMS W (SA) Pregabalin 02405547 SAS W (SA) Pregabalin 02403706 SIV W (SA) Pregabalin 02411733 SIV W (SA) Ran-Pregabalin 02392828 RAN W (SA) Sandoz Pregabalin 02390825 SDZ W (SA) Teva-Pregabalin 02361175 TEV W (SA) Mar-Pregabalin 02417537 MAR W (SA) September 2015 v.1 195

N03AX16 PREGABALIN PRÉGABALINE Cap Orl 75mg Lyrica 02268434 PFI W (SA) Caps Act Pregabalin 02402939 ATV W (SA) Apo-Pregabalin 02394251 APX W (SA) GD-Pregabalin 02360152 GMD W (SA) Mint-Pregabalin 02424185 MNT W (SA) Myl-Pregabalin 02408686 MYL W (SA) pms-pregabalin 02359626 PMS W (SA) Pregabalin 02405555 SAS W (SA) Pregabalin 02403714 SIV W (SA) Pregabalin 02411741 SIV W (SA) Ran-Pregabalin 02392836 RAN W (SA) Sandoz Pregabalin 02390833 SDZ W (SA) Teva-Pregabalin 02361183 TEV W (SA) Mar-Pregabalin 02417545 MAR W (SA) Cap Orl 150mg Lyrica 02268450 PFI W (SA) Caps Act Pregabalin 02402955 ATV W (SA) Apo-Pregabalin 02394278 APX W (SA) GD-Pregabalin 02360179 GMD W (SA) Mint-Pregabalin 02424207 MNT W (SA) Myl-Pregabalin 02408694 MYL W (SA) pms-pregabalin 02359634 PMS W (SA) Pregabalin 02405563 SAS W (SA) Pregabalin 02403722 SIV W (SA) Pregabalin 02411768 SIV W (SA) Ran-Pregabalin 02392844 RAN W (SA) Sandoz Pregabalin 02390841 SDZ W (SA) Teva-Pregabalin 02361205 TEV W (SA) Mar-Pregabalin 02417561 MAR W (SA) Cap Orl 225mg Lyrica 02268477 PFI W (SA) Caps Act Pregabalin 02402971 ATV W (SA) Apo-Pregabalin 02394286 APX W (SA) GD-Pregabalin 02360195 GMD W (SA) pms-pregabalin 02398079 PMS W (SA) Ran-Pregabalin 02392852 RAN W (SA) Teva-Pregabalin 02361221 TEV W (SA) Cap Orl 300mg Lyrica 02268485 PFI W (SA) Caps Act Pregabalin 02402998 ATV W (SA) Apo-Pregabalin 02394294 APX W (SA) GD-Pregabalin 02360209 GMD W (SA) Myl-Pregabalin 02408708 MYL W (SA) pms-pregabalin 02359642 PMS W (SA) Pregabalin 02405598 SAS W (SA) Pregabalin 02403730 SIV W (SA) Ran-Pregabalin 02392860 RAN W (SA) Sandoz Pregabalin 02390868 SDZ W (SA) Teva-Pregabalin 02361248 TEV W (SA) September 2015 v.1 196

N03AX18 LACOSAMIDE LACOSAMIDE Tab Orl 50mg Vimpat 02357615 UCB (SA) Tab Orl 100mg Vimpat 02357623 UCB (SA) Tab Orl 150mg Vimpat 02357631 UCB (SA) Tab Orl 200mg Vimpat 02357658 UCB (SA) N03AX22 PERAMPANEL PÉRAMPANEL Tab Orl 2mg Fycompa 02404516 EIS (SA) Tab Orl 4mg Fycompa 02404524 EIS (SA) Tab Orl 6mg Fycompa 02404532 EIS (SA) Tab Orl 8mg Fycompa 02404540 EIS (SA) Tab Orl 10mg Fycompa 02404559 EIS (SA) N04 N04A N04AA N04AA01 Tab Orl 12mg Fycompa 02404567 EIS (SA) ANTI-PARKINSON DRUGS MÉDICAMENTS ANTI-PARKINSON ANTI-CHOLINERGIC AGENTS AGENTS ANTI-CHOLINERGIQUES TERTIARY AMINES AMINES TERTIAIRES TRIHEXYPHENIDYL TRIHEXYPHÉNIDYLE Tab Orl 2mg Trihex 00545058 AAP ADEFGVW Tab Orl 5mg Trihex 00545074 AAP ADEFGVW September 2015 v.1 197

N04AA04 PROCYCLIDINE PROCYCLIDINE Elx Orl 2.5mg/5mL pdp-procyclidine 00587362 PDP ADEFGVW Elx. Tab Orl 2.5mg pdp-procyclidine 00649392 PDP ADEFGVW N04AA05 N04AC N04AC01 Tab Orl 5mg pdp-procyclidine 00587354 PDP ADEFGVW PROFENAMINE (ETHOPROPAZINE) PROFÉNAMINE (ÉTHOPROPAZINE) Tab Orl 50mg Parsitan 01927744 ERF ADEFGVW ETHERS OF TROPINE OR TROPINE DERIVATIVES ÉTHERS DE TROPINE OU DÉRIVÉS DU TROPINE BENZATROPINE BENZYTROPINE Inj 1mg/mL Benztropine Omega 02238903 OMG ADEFGVW Tab Orl 1mg pms-benztropine 00706531 PMS ADEFGVW N04B N04BA N04BA02 Tab Orl 2mg Benztropine 00426857 PMS ADEFGVW DOPAMINERGIC AGENTS AGENTS DOPAMINERGIQUES DOPA AND DOPA DERIVATIVES DOPA ET DÉRIVÉS DU DOPA LEVODOPA AND DECARBOXYLASE INHIBITOR LÉVODOPA ET INHIBITEUR DU DÉCARBOXYLASE LEVODOPA / BENSERAZIDE LÉVODOPA / BENSÉRAZIDE Cap Orl 50mg/12.5mg Prolopa 00522597 HLR ADEFGVW Caps Cap Orl 100mg/25mg Prolopa 00386464 HLR ADEFGVW Caps Cap Orl 200mg/50mg Prolopa 00386472 HLR ADEFGVW Caps September 2015 v.1 198

N04BA02 LEVODOPA AND DECARBOXYLASE INHIBITOR LÉVODOPA ET INHIBITEUR DU DÉCARBOXYLASE LEVODOPA / CARBIDOPA LÉVODOPA / CARBIDOPA SRT Orl 100mg/25mg Sinemet CR 02028786 FRS ADEFVW L.L. Apo-Levocarb CR 02272873 APX ADEFVW pms-levocarb CR 02421488 PMS ADEFVW SRT Orl 200mg/50mg Sinemet CR 00870935 FRS ADEFVW L.L. Apo-Levocarb CR 02245211 APX ADEFVW pms-levocarb CR 02421496 PMS ADEFVW Tab Orl 100mg/10mg Sinemet 00355658 FRS ADEFVW Apo-Levocarb 02195933 APX ADEFVW Teva-Levocarbidopa 02244494 TEV ADEFVW Tab Orl 100mg/25mg Sinemet 00513997 FRS ADEFVW Apo-Levocarb 02195941 APX ADEFVW Teva-Levocarbidopa 02244495 TEV ADEFVW Tab Orl 250mg/25mg Sinemet 00328219 FRS ADEFVW Apo-Levocarb 02195968 APX ADEFVW Teva-Levocarbidopa 02244496 TEV ADEFVW N04BA03 LEVODOPA, CARBIDOPA, ENTACAPONE LÉVODOPA, CARBIDOPA, ENTACAPONE Tab Orl 50mg/12.5mg/200mg Stalevo 02305933 NVR (SA) Tab Orl 75mg/18.75mg/200mg Stalevo 02337827 NVR (SA) Tab Orl 100mg/25mg/200mg Stalevo 02305941 NVR (SA) Tab Orl 125mg/31.25mg/200mg Stalevo 02337835 NVR (SA) Tab Orl 150mg/37.5mg/200mg Stalevo 02305968 NVR (SA) N04BB ADAMANTINE DERIVATIVES DÉRIVÉS DE L ADAMANTINE N04BB01 AMANTADINE AMANTADINE Cap Orl 100mg pms-amantadine Hydrochloride 01990403 PMS ADEFGVW Caps Syr Orl 10mg/mL pms-amantadine 02022826 PMS ADEFGVW Sir. September 2015 v.1 199

N04BC N04BC04 DOPAMINE AGONISTS AGONISTES DE LA DOPAMINE ROPINIROLE ROPINIROLE Tab Orl 0.25mg Requip 02232565 GSK ADEFVW Act Ropinirole 02316846 ATV ADEFVW Jamp-Ropinirole 02352338 JPC ADEFVW pms-ropinirole 02326590 PMS ADEFVW Ran-Ropinirole 02314037 RAN ADEFVW Ropinirole 02353040 SAS ADEFVW Tab Orl 1mg Requip 02232567 GSK ADEFVW Act Ropinirole 02316854 ATV ADEFVW Jamp-Ropinirole 02352346 JPC ADEFVW pms-ropinirole 02326612 PMS ADEFVW Ran-Ropinirole 02314053 RAN ADEFVW Ropinirole 02353059 SAS ADEFVW N04BC05 Tab Orl 2mg Requip 02232568 GSK ADEFVW Act Ropinirole 02316862 ATV ADEFVW Jamp-Ropinirole 02352354 JPC ADEFVW pms-ropinirole 02326620 PMS ADEFVW Ran-Ropinirole 02314061 RAN ADEFVW Ropinirole (Disc/non dips Aug 1/16) 02353067 SAS ADEFVW Tab Orl 5mg Requip 02232569 GSK ADEFVW Act Ropinirole 02316870 ATV ADEFVW Jamp-Ropinirole 02352362 JPC ADEFVW pms-ropinirole 02326639 PMS ADEFVW Ran-Ropinirole 02314088 RAN ADEFVW Ropinirole 02353075 SAS ADEFVW PRAMIPEXOLE PRAMIPEXOLE Tab Orl 0.25mg Mirapex 02237145 BOE ADEFVW Act Pramipexole 02297302 ATV ADEFVW Apo-Pramipexole 02292378 APX ADEFVW Mylan-Pramipexole 02376350 MYL ADEFVW pms-pramipexole 02290111 PMS ADEFVW Pramipexole 02367602 SAS ADEFVW Pramipexole 02309122 SIV ADEFVW Sandoz Pramipexole 02315262 SDZ ADEFVW Teva-Pramipexole 02269309 TEV ADEFVW September 2015 v.1 200

N04BC05 PRAMIPEXOLE PRAMIPEXOLE Tab Orl 0.5mg Mirapex 02241594 BOE ADEFVW Act Pramipexole 02297310 ATV ADEFVW Apo-Pramipexole 02292386 APX ADEFVW Mylan-Pramipexole 02376369 MYL ADEFVW pms-pramipexole 02290138 PMS ADEFVW Pramipexole 02367610 SAS ADEFVW Pramipexole 02309130 SIV ADEFVW Sandoz Pramipexole 02315270 SDZ ADEFVW Teva-Pramipexole 02269317 TEV ADEFVW Tab Orl 1mg Mirapex 02237146 BOE ADEFVW Act Pramipexole 02297329 ATV ADEFVW Apo-Pramipexole 02292394 APX ADEFVW Mylan-Pramipexole 02376377 MYL ADEFVW pms-pramipexole 02290146 PMS ADEFVW Pramipexole 02367629 SAS ADEFVW Pramipexole 02309149 SIV ADEFVW Sandoz Pramipexole 02315289 SDZ ADEFVW Teva-Pramipexole 02269325 TEV ADEFVW N04BD N04BD01 N04BX N04BX02 Tab Orl 1.5mg Mirapex 02237147 BOE ADEFVW Act Pramipexole 02297337 ATV ADEFVW Apo-Pramipexole 02292408 APX ADEFVW Mylan-Pramipexole 02376385 MYL ADEFVW pms-pramipexole 02290154 PMS ADEFVW Pramipexole 02309157 SIV ADEFVW Sandoz Pramipexole 02315297 SDZ ADEFVW Teva-Pramipexole 02269333 TEV ADEFVW MONOAMINE OXIDASE TYPE B INHIBITORS OXIDASE DE MONOAMINE, INHIBITEURS DE TYPE B SELEGILINE SÉLÉGILINE Tab Orl 5mg Apo-Selegiline 02230641 APX ADEFVW Mylan-Selegiline 02231036 MYL ADEFVW Novo-Selegiline 02068087 TEV ADEFVW OTHER DOPAMINERGIC AGENTS AUTRES AGENTS DOPAMINERGIQUES ENTACAPONE ENTACAPONE Tab Orl 200mg Comtan 02243763 NVR ADEFGVW Mylan-Entacapone 02390337 MYL ADEFGVW Sandoz Entacapone 02380005 SDZ ADEFGVW Teva-Entacapone 02375559 TEV ADEFGVW September 2015 v.1 201

N05 N05A N05AA N05AA01 PSYCHOLEPTICS PSYCHOLEPTIQUES ANTIPSYCHOTICS ANTIPSYCHOTIQUES PHENOTHIAZINE WITH ALIPHATIC SIDE CHAIN PHÉNOTHIAZINE AVEC CHAÎNE LATÉRALE ALIPHATIQUE CHLORPROMAZINE CHLORPROMAZINE Tab Orl 25mg Teva-Chlorpromazine 00232823 TEV ADEFGVW Tab Orl 50mg Teva-Chlorpromazine 00232807 TEV ADEFGVW N05AA02 Tab Orl 100mg Teva-Chlorpromazine 00232831 TEV ADEFGVW LEVOMEPROMAZINE (METHOTRIMEPRAZINE) LÉVOMÉPROMAZINE (MÉTHOTRIMÉPRAZINE) Inj 25mg/mL Nozinan 01927698 SAV ADEFVW Tab Orl 2mg Methoprazine 02238403 AAP ADEFGVW Tab Orl 5mg Methoprazine 02238404 AAP ADEFGVW Tab Orl 25mg Methoprazine 02238405 AAP ADEFGVW N05AB N05AB02 Tab Orl 50mg Methoprazine 02238406 AAP ADEFGVW PHENOTHIAZINE WITH PIPERAZINE STRUCTURE PHÉNOTHIAZINE À STRUCTURE DE PIPÉRAZINE FLUPHENAZINE FLUPHÉNAZINE Inj 100mg/mL Modecate conc 00755575 BRI ADEFGVW Tab Orl 1mg Fluphenazine 00405345 AAP ADEFGVW Tab Orl 2mg Fluphenazine 00410632 AAP ADEFGVW Tab Orl 5mg Fluphenazine 00405361 AAP ADEFGVW September 2015 v.1 202

N05AB03 PERPHENAZINE PERPHÉNAZINE Tab Orl 2mg Perphenazine 00335134 AAP ADEFGVW Tab Orl 4mg Perphenazine 00335126 AAP ADEFGVW Tab Orl 8mg Perphenazine 00335118 AAP ADEFGVW Tab Orl 16mg Perphenazine 00335096 AAP ADEFGVW N05AB04 PROCHLORPERAZINE PROCHLORPÉRAZINE Sup Rt 10mg pms-prochlorperazine 00753688 PMS ADEFGVW Supp Sandoz Prochlorperazine 00789720 SDZ ADEFGVW Tab Orl 5mg Prochlorazine 00886440 AAP ADEFGVW Tab Orl 10mg Prochlorazine 00886432 AAP ADEFGVW N05AB06 TRIFLUOPERAZINE TRIFLUOPÉRAZINE Tab Orl 1mg Trifluoperazine 00345539 AAP ADEFGVW Tab Orl 2mg Trifluoperazine 00312754 AAP ADEFGVW Tab Orl 5mg Trifluoperazine 00312746 AAP ADEFGVW N05AC N05AC01 Tab Orl 10mg Trifluoperazine 00326836 AAP ADEFGVW PHENOTHIAZINE WITH PIPERIDINE STRUCTURE PHÉNOTHIAZINES À STRUCTURE DE PIPÉRIDINE PERICYAZINE PÉRICYAZINE Cap Orl 5mg Neuleptil 01926780 ERF ADEFGVW Caps Cap Orl 10mg Neuleptil 01926772 ERF ADEFGVW Caps September 2015 v.1 203

N05AC01 N05AC04 N05AD N05AD01 PERICYAZINE PÉRICYAZINE Cap Orl 20mg Neuleptil 01926764 ERF ADEFGVW Caps Dps Orl 10mg/mL Neuleptil 01926756 ERF ADEFGVW Gttes PIPOTIAZINE PIPOTIAZINE Inj 25mg/mL Piportil L4 01926667 SAV ADEFGVW Inj 50mg/mL Piportil L4 01926675 SAV ADEFGVW BUTYROPHENONE DERIVATIVES DÉRIVÉS DU BUTYROPHÉNONE HALOPERIDOL HALOPÉRIDOL Tab Orl 0.5mg Apo-Haloperidol (Disc/non disp Dec 09/15) 00396796 APX ADEFGVW Novo-Peridol 00363685 TEV ADEFGVW Tab Orl 1mg Apo-Haloperidol (Disc/non disp Feb 14/16) 00396818 APX ADEFGVW Novo-Peridol 00363677 TEV ADEFGVW Tab Orl 2mg Novo-Peridol 00363669 TEV ADEFGVW Tab Orl 5mg Novo-Peridol 00363650 TEV ADEFGVW Tab Orl 10mg Apo-Haloperidol (Disc/non disp Feb 14/16) 00463698 APX ADEFGVW Novo-Peridol 00713449 TEV ADEFGVW Inj 5mg/mL Haloperidol 00808652 SDZ ADEFGVW Inj 50mg/mL Haloperidol LA 02130297 SDZ ADEFGVW N05AE N05AE04 Inj 100mg/mL Haloperidol LA 02130300 SDZ ADEFGVW INDOLE DERIVATIVES DÉRIVÉS DE L INDOLE ZIPRASIDONE ZIPRASIDONE Cap Orl 20mg Zeldox 02298597 PFI ADEFGVW Caps September 2015 v.1 204

N05AE04 ZIPRASIDONE ZIPRASIDONE Cap Orl 40mg Zeldox 02298600 PFI ADEFGVW Caps Cap Orl 60mg Zeldox 02298619 PFI ADEFGVW Caps N05AE05 Cap Orl 80mg Zeldox 02298627 PFI ADEFGVW Caps LURASIDONE LURASIDONE Tab Orl 20mg Latuda 02422050 SNV (SA) Tab Orl 40mg Latuda 02387751 SNV (SA) Tab Orl 60mg Latuda 02413361 SNV (SA) N05AF N05AF01 Tab Orl 80mg Latuda 02387778 SNV (SA) Tab Orl 120mg Latuda 02387786 SNV (SA) THIOXANTHENE DERIVATIVES DÉRIVÉS DU THIOXANTHÉNE FLUPENTHIXOL FLUPENTHIXOL Tab Orl 0.5mg Fluanxol 02156008 VLH ADEFGVW Tab Orl 3mg Fluanxol 02156016 VLH ADEFGVW Inj 20mg/mL Fluanxol Depot 02156032 VLH ADEFGVW Inj 100mg/mL Fluanxol Depot 02156040 VLH ADEFGVW N05AF04 THIOTHIXENE THIOTHIXÉNE Cap Orl 2mg Navane (Disc/non disp Jun 5/17) 00024430 ERF ADEFGVW Caps September 2015 v.1 205

N05AF04 N05AF05 THIOTHIXENE THIOTHIXÉNE Cap Orl 5mg Navane 00024449 ERF ADEFGVW Caps Cap Orl 10mg Navane (Disc/non disp Jun 5/17) 00024457 ERF ADEFGVW Caps ZUCLOPENTHIXOL ZUCLOPENTHIXOL Tab Orl 10mg Clopixol 02230402 VLH (SA) Tab Orl 25mg Clopixol 02230403 VLH (SA) N05AG N05AG02 N05AH N05AH01 Inj 200mg/mL Clopixol Depot 02230406 VLH ADEFGVW DIPHENYLBUTYLPIPERIDINE DERIVATIVES DÉRIVÉS DE LA DIPHÉNYLBUTYLPIPÉRIDINE PIMOZIDE PIMOZIDE Tab Orl 2mg Orap 00313815 AAP ADEFGVW Pimozide 02245432 AAP ADEFGVW Tab Orl 4mg Orap 00313823 AAP ADEFGVW Pimozide 02245433 AAP ADEFGVW DIAZEPINES, OXAZEPINES, THIAZEPINES AND OXEPINES DIAZÉPINES, OXAZÉPINES, THIAZÉPINES ET OXÉPINNES LOXAPINE LOXAPINE Tab Orl 2.5mg Xylac 02242868 PDP ADEFGVW Tab Orl 5mg Xylac 02230837 PDP ADEFGVW Tab Orl 10mg Xylac 02230838 PDP ADEFGVW Tab Orl 25mg Xylac 02230839 PDP ADEFGVW Tab Orl 50mg Xylac 02230840 PDP ADEFGVW September 2015 v.1 206

N05AH02 CLOZAPINE CLOZAPINE Tab Orl 25mg Clozaril 00894737 NVR ADEFGVW Apo-Clozapine 02248034 APX ADEFGVW Gen-Clozapine 02247243 MYL ADEFGVW Tab Orl 50mg Gen-Clozapine 02305003 MYL ADEFGVW Tab Orl 100mg Clozaril 00894745 NVR ADEFGVW Apo-Clozapine 02248035 APX ADEFGVW Gen-Clozapine 02247244 MYL ADEFGVW Tab Orl 200mg Gen-Clozapine 02305011 MYL ADEFGVW N05AH03 OLANZAPINE OLANZAPINE ODT Orl 5mg Zyprexa Zydis 02243086 LIL W (SA) D.O. Apo-Olanzapine ODT 02360616 APX W (SA) Co Olanzapine ODT 02327562 COB W (SA) Jamp-Olanzapine ODT 02406624 JPC W (SA) Mar-Olanzapine ODT 02389088 MAR W (SA) Mylan-Olanzapine ODT 02382709 MYL W (SA) Olanzapine ODT 02343665 SIV W (SA) Olanzapine ODT 02352974 SAS W (SA) pms-olanzapine ODT 02303191 PMS W (SA) Ran-Olanzapine ODT 02414090 RAN W (SA) Sandoz Olanzapine ODT 02327775 SDZ W (SA) Teva-Olanzapine ODT 02321343 TEV W (SA) ODT Orl 10mg Zyprexa Zydis 02243087 LIL W (SA) D.O. Apo-Olanzapine ODT 02360624 APX W (SA) Co Olanzapine ODT 02327570 COB W (SA) Jamp-Olanzapine ODT 02406632 JPC W (SA) Mar-Olanzapine ODT 02389096 MAR W (SA) Mylan-Olanzapine ODT 02382717 MYL W (SA) Olanzapine ODT 02343673 SIV W (SA) Olanzapine ODT 02352982 SAS W (SA) pms-olanzapine ODT 02303205 PMS W (SA) Ran-Olanzapine ODT 02414104 RAN W (SA) Sandoz Olanzapine ODT 02327783 SDZ W (SA) Teva-Olanzapine ODT 02321351 TEV W (SA) September 2015 v.1 207

N05AH03 OLANZAPINE OLANZAPINE ODT Orl 15mg Zyprexa Zydis 02243088 LIL W (SA) D.O. Apo-Olanzapine ODT 02360632 APX W (SA) Co Olanzapine ODT 02327589 COB W (SA) Jamp-Olanzapine ODT 02406640 JPC W (SA) Mar-Olanzapine ODT 02389118 MAR W (SA) Mylan-Olanzapine ODT 02382725 MYL W (SA) Olanzapine ODT 02343681 SIV W (SA) Olanzapine ODT 02352990 SAS W (SA) pms-olanzapine ODT 02303213 PMS W (SA) Ran-Olanzapine ODT 02414112 RAN W (SA) Sandoz Olanzapine ODT 02327791 SDZ W (SA) Teva-Olanzapine ODT 02321378 TEV W (SA) ODT Orl 20mg Zyprexa Zydis 02243089 LIL W (SA) D.O. Apo-Olanzapine ODT 02360640 APX W (SA) Co Olanzapine ODT 02327597 COB W (SA) Jamp-Olanzapine ODT 02406659 JPC W (SA) Mar-Olanzapine ODT 02389126 MAR W (SA) Mylan-Olanzapine ODT 02382733 MYL W (SA) Olanzapine ODT 02343703 SIV W (SA) pms-olanzapine ODT 02423944 PMS W (SA) Ran-Olanzapine ODT 02414120 RAN W (SA) Sandoz Olanzapine ODT 02327805 SDZ W (SA) Teva-Olanzapine ODT 02321386 TEV W (SA) Tab Orl 2.5mg Zyprexa 02229250 LIL W (SA) Apo-Olanzapine 02281791 APX W (SA) Co Olanzapine 02325659 COB W (SA) Mar-Olanzapine 02421232 MAR W (SA) Mylan-Olanzapine 02337878 MYL W (SA) Olanzapine 02372819 SAS W (SA) Olanzapine 02385864 SIV W (SA) pms-olanzapine 02303116 PMS W (SA) Ran-Olanzapine 02403064 RAN W (SA) Sandoz Olanzapine 02310341 SDZ W (SA) Teva-Olanzapine 02276712 TEV W (SA) Tab Orl 5mg Zyprexa 02229269 LIL W (SA) Apo-Olanzapine 02281805 APX W (SA) Co Olanzapine 02325667 COB W (SA) Mar-Olanzapine 02421240 MAR W (SA) Mylan-Olanzapine 02337886 MYL W (SA) Olanzapine 02372827 SAS W (SA) Olanzapine 02385872 SIV W (SA) pms-olanzapine 02303159 PMS W (SA) Ran-Olanzapine 02403072 RAN W (SA) Sandoz Olanzapine 02310368 SDZ W (SA) Teva-Olanzapine 02276720 TEV W (SA) September 2015 v.1 208

N05AH03 OLANZAPINE OLANZAPINE Tab Orl 7.5mg Zyprexa 02229277 LIL W (SA) Apo-Olanzapine 02281813 APX W (SA) Co Olanzapine 02325675 COB W (SA) Mar-Olanzapine 02421259 MAR W (SA) Mylan-Olanzapine 02337894 MYL W (SA) Olanzapine 02372835 SAS W (SA) Olanzapine 02385880 SIV W (SA) pms-olanzapine 02303167 PMS W (SA) Ran-Olanzapine 02403080 RAN W (SA) Sandoz Olanzapine 02310376 SDZ W (SA) Teva-Olanzapine 02276739 TEV W (SA) Tab Orl 10mg Zyprexa 02229285 LIL W (SA) Apo-Olanzapine 02281821 APX W (SA) Co Olanzapine 02325683 COB W (SA) Mar-Olanzapine 02421267 MAR W (SA) Mylan-Olanzapine 02337908 MYL W (SA) Olanzapine 02372843 SAS W (SA) Olanzapine 02385899 SIV W (SA) pms-olanzapine 02303175 PMS W (SA) Ran-Olanzapine 02403099 RAN W (SA) Sandoz Olanzapine 02310384 SDZ W (SA) Teva-Olanzapine 02276747 TEV W (SA) Tab Orl 15mg Zyprexa 02238850 LIL W (SA) Apo-Olanzapine 02281848 APX W (SA) Co Olanzapine 02325691 COB W (SA) Mar-Olanzapine 02421275 MAR W (SA) Mylan-Olanzapine 02337916 MYL W (SA) Olanzapine 02372851 SAS W (SA) Olanzapine 02385902 SIV W (SA) pms-olanzapine 02303183 PMS W (SA) Ran-Olanzapine 02403102 RAN W (SA) Sandoz Olanzapine 02310392 SDZ W (SA) Teva-Olanzapine 02276755 TEV W (SA) N05AH04 QUETIAPINE QUÉTIAPINE ERT Orl 50mg Seroquel XR 02300184 AZE ADEFGVW L.P. Sandoz Quetiapine XR 02407671 SDZ ADEFGVW Teva-Quetiapine XR 02395444 TEV ADEFGVW ERT Orl 150mg Seroquel XR 02321513 AZE ADEFGVW L.P. Sandoz Quetiapine XR 02407698 SDZ ADEFGVW Teva-Quetiapine XR 02395452 TEV ADEFGVW ERT Orl 200mg Seroquel XR 02300192 AZE ADEFGVW L.P. Sandoz Quetiapine XR 02407701 SDZ ADEFGVW Teva-Quetiapine XR 02395460 TEV ADEFGVW September 2015 v.1 209

N05AH04 QUETIAPINE QUÉTIAPINE ERT Orl 300mg Seroquel XR 02300206 AZE ADEFGVW L.P. Sandoz Quetiapine XR 02407728 SDZ ADEFGVW Teva-Quetiapine XR 02395479 TEV ADEFGVW ERT Orl 400mg Seroquel XR 02300214 AZE ADEFGVW L.P. Sandoz Quetiapine XR 02407736 SDZ ADEFGVW Teva-Quetiapine XR 02395487 TEV ADEFGVW Tab Orl 25mg Seroquel 02236951 AZE ADEFGVW Abbott-Quetiapine 02412977 BGP ADEFGVW Act Quetiapine 02316080 ATV ADEFGVW Apo-Quetiapine 02313901 APX ADEFGVW Auro-Quetiapine 02390205 ARO ADEFGVW Jamp-Quetiapine 02330415 JPC ADEFGVW Mar-Quetiapine 02399822 MAR ADEFGVW Mylan-Quetiapine 02307804 MYL ADEFGVW Phl-Quetiapine 02299054 PHL ADEFGVW pms-quetiapine 02296551 PMS ADEFGVW Quetiapine 02317893 SIV ADEFGVW Quetiapine 02353164 SAS ADEFGVW Quetiapine 02387794 AHI ADEFGVW Ran-Quetiapine 02397099 RAN ADEFGVW Sandoz Quetiapine 02313995 SDZ ADEFGVW Teva-Quetiapine 02284235 TEV ADEFGVW Tab Orl 100mg Seroquel 02236952 AZE ADEFGVW Abbott-Quetiapine 02412985 BGP ADEFGVW Act Quetiapine 02316099 ATV ADEFGVW Apo-Quetiapine 02313928 APX ADEFGVW Auro-Quetiapine 02390213 ARO ADEFGVW Jamp-Quetiapine 02330423 JPC ADEFGVW Mar-Quetiapine 02399830 MAR ADEFGVW Mylan-Quetiapine 02307812 MYL ADEFGVW Phl-Quetiapine 02299062 PHL ADEFGVW pms-quetiapine 02296578 PMS ADEFGVW Quetiapine 02317907 SIV ADEFGVW Quetiapine 02353172 SAS ADEFGVW Quetiapine 02387808 AHI ADEFGVW Ran-Quetiapine 02397102 RAN ADEFGVW Sandoz Quetiapine 02314002 SDZ ADEFGVW Teva-Quetiapine 02284243 TEV ADEFGVW Tab Orl 150mg Teva-Quetiapine 02284251 TEV AEFGVW September 2015 v.1 210

N05AH04 QUETIAPINE QUÉTIAPINE Tab Orl 200mg Seroquel 02236953 AZE ADEFGVW Abbott-Quetiapine 02412993 BGP ADEFGVW Act Quetiapine 02316110 ATV ADEFGVW Apo-Quetiapine 02313936 APX ADEFGVW Auro-Quetiapine 02390248 ARO ADEFGVW Jamp-Quetiapine 02330458 JPC ADEFGVW Mar-Quetiapine 02399849 MAR ADEFGVW Mylan-Quetiapine 02307839 MYL ADEFGVW Phl-Quetiapine 02299089 PHL ADEFGVW pms-quetiapine 02296594 PMS ADEFGVW Quetiapine 02317923 SIV ADEFGVW Quetiapine 02353199 SAS ADEFGVW Quetiapine 02387824 AHI ADEFGVW Ran-Quetiapine 02397110 RAN ADEFGVW Sandoz Quetiapine 02314010 SDZ ADEFGVW Teva-Quetiapine 02284278 TEV ADEFGVW Tab Orl 300mg Seroquel 02244107 AZE ADEFGVW Abbott-Quetaipine 02413000 BGP ADEFGVW Act Quetiapine 02316129 ATV ADEFGVW Apo-Quetiapine 02313944 APX ADEFGVW Auro-Quetiapine 02390256 ARO ADEFGVW Jamp-Quetiapine 02330466 JPC ADEFGVW Mar-Quetiapine 02399857 MAR ADEFGVW Mylan-Quetiapine 02307847 MYL ADEFGVW Phl-Quetiapine 02299097 PHL ADEFGVW pms-quetiapine 02296608 PMS ADEFGVW Quetiapine 02317931 SIV ADEFGVW Quetiapine 02353202 SAS ADEFGVW Quetiapine 02387832 AHI ADEFGVW Ran-Quetiapine 02397129 RAN ADEFGVW Sandoz Quetiapine 02314029 SDZ ADEFGVW Teva-Quetiapine 02284286 TEV ADEFGVW N05AH05 ASENAPINE ASÉNAPINE Slt Orl 5mg Saphris (Sublingual) 02374803 FRS (SA) S.L. N05AN Slt Orl 10mg Saphris (Sublingual) 02374811 FRS (SA) S.L. LITHIUM LITHIUM N05AN01 LITHIUM LITHIUM Cap Orl 150mg Carbolith 00461733 VLN ADEFGVW Caps Lithane 02013231 ERF ADEFGVW Apo-Lithium Carbonate 02242837 APX ADEFGVW pms-lithium Carbonate 02216132 PMS ADEFGVW September 2015 v.1 211

N05AN01 LITHIUM LITHIUM Cap Orl 300mg Carbolith 00236683 VLN ADEFGVW Caps Lithane 00406775 ERF ADEFGVW Apo-Lithium Carbonate 02242838 APX ADEFGVW pms-lithium Carbonate 02216140 PMS ADEFGVW Cap Orl 600mg Carbolith 02011239 VLN ADEFGVW Caps SRT Orl 300mg Lithmax SR 02266695 AAP ADEFGVW L.L. N05AX N05AX08 Orl 8mmol/5mL pms-lithium Citrate 02074834 PMS ADEFGVW OTHER ANTIPSYCHOTICS AUTRES ANTIPSYCHOTIQUES RISPERIDONE RISPÉRIDONE Orl 1mg/mL Risperdal 02236950 JAN ADEFGVW Apo-Risperidone 02280396 APX ADEFGVW pms-risperidone 02279266 PMS ADEFGVW ODT Orl 0.5mg Risperdal M 02247704 JAN W (SA) D.O. Mylan-Risperidone ODT 02413485 MYL W (SA) ODT Orl 1mg Risperdal M 02247705 JAN W (SA) D.O. Mylan-Risperidone ODT 02413493 MYL W (SA) pms-risperidone ODT 02291789 PMS W (SA) ODT Orl 2mg Risperdal M 02247706 JAN W (SA) D.O. Mylan-Risperidone ODT 02413507 MYL W (SA) pms-risperidone ODT 02291797 PMS W (SA) ODT Orl 3mg Risperdal M 02268086 JAN W (SA) D.O. Mylan-Risperidone ODT 02413515 MYL W (SA) pms-risperidone ODT 02370697 PMS W (SA) ODT Orl 4mg Risperdal M 02268094 JAN W (SA) D.O. Mylan-Risperidone ODT 02413523 MYL W (SA) pms-risperidone ODT 02370700 PMS W (SA) Pws IM 12.5mg Risperdal Consta 02298465 JAN (SA) Pds. Pws IM 25mg Risperdal Consta 02255707 JAN (SA) Pds. Pws IM 37.5mg Risperdal Consta 02255723 JAN (SA) Pds. September 2015 v.1 212

N05AX08 RISPERIDONE RISPÉRIDONE Pws IM 50mg Risperdal Consta 02255758 JAN (SA) Pds. Tab Orl 0.25mg Risperdal 02240551 JAN ADEFGVW Act Risperidone 02282585 ATV ADEFGVW Apo-Risperidone 02282119 APX ADEFGVW Jamp-Risperidone 02359529 JPC ADEFGVW Mar-Risperidone 02371766 MAR ADEFGVW Mint-Risperidone 02359790 MNT ADEFGVW Mylan-Risperidone 02282240 MYL ADEFGVW Phl-Risperidone 02258439 PHL ADEFGVW pms-risperidone 02252007 PMS ADEFGVW Ran-Risperidone 02328305 RAN ADEFGVW Risperidone 02356880 SAS ADEFGVW Sandoz Risperidone 02303655 SDZ ADEFGVW Teva-Risperidone 02282690 TEV ADEFGVW Tab Orl 0.5mg Risperdal 02240552 JAN ADEFGVW Act Risperidone 02282593 ATV ADEFGVW Apo-Risperidone 02282127 APX ADEFGVW Jamp-Risperidone 02359537 JPC ADEFGVW Mar-Risperidone 02371774 MAR ADEFGVW Mint-Risperidone 02359804 MNT ADEFGVW Mylan-Risperidone 02282259 MYL ADEFGVW Phl-Risperidone 02258447 PHL ADEFGVW pms-risperidone 02252015 PMS ADEFGVW Ran-Risperidone 02328313 RAN ADEFGVW Risperidone 02356899 SAS ADEFGVW Sandoz Risperidone 02303663 SDZ ADEFGVW Teva-Risperidone 02264188 TEV ADEFGVW Tab Orl 1mg Risperdal 02025280 JAN ADEFGVW Act Risperidone 02282607 ATV ADEFGVW Apo-Risperidone 02282135 APX ADEFGVW Jamp-Risperidone 02359545 JPC ADEFGVW Mar-Risperidone 02371782 MAR ADEFGVW Mint-Risperidone 02359812 MNT ADEFGVW Mylan-Risperidone 02282267 MYL ADEFGVW Phl-Risperidone 02258455 PHL ADEFGVW pms-risperidone 02252023 PMS ADEFGVW Ran-Risperidone 02328321 RAN ADEFGVW Risperidone 02356902 SAS ADEFGVW Sandoz Risperidone 02279800 SDZ ADEFGVW Teva-Risperidone 02264196 TEV ADEFGVW September 2015 v.1 213

N05AX08 RISPERIDONE RISPÉRIDONE Tab Orl 2mg Risperdal 02025299 JAN ADEFGVW Act Risperidone 02282615 ATV ADEFGVW Apo-Risperidone 02282143 APX ADEFGVW Jamp-Risperidone 02359553 JPC ADEFGVW Mar-Risperidone 02371790 MAR ADEFGVW Mint-Risperidone 02359820 MNT ADEFGVW Mylan-Risperidone 02282275 MYL ADEFGVW Phl-Risperidone 02258463 PHL ADEFGVW pms-risperidone 02252031 PMS ADEFGVW Ran-Risperidone 02328348 RAN ADEFGVW Risperidone 02356910 SAS ADEFGVW Sandoz Risperidone 02279819 SDZ ADEFGVW Teva-Risperidone 02264218 TEV ADEFGVW Tab Orl 3mg Risperdal 02025302 JAN ADEFGVW Act Risperidone 02282623 ATV ADEFGVW Apo-Risperidone 02282151 APX ADEFGVW Jamp-Risperidone 02359561 MPC ADEFGVW Mar-Risperidone 02371804 MAR ADEFGVW Mint-Risperidone 02359839 MNT ADEFGVW Mylan-Risperidone 02282283 MYL ADEFGVW Phl-Risperidone 02258471 PHL ADEFGVW pms-risperidone 02252058 PMS ADEFGVW Ran-Risperidone 02328364 RAN ADEFGVW Risperidone 02356929 SAS ADEFGVW Sandoz Risperidone 02279827 SDZ ADEFGVW Teva-Risperidone 02264226 TEV ADEFGVW N05AX12 Tab Orl 4mg Risperdal 02025310 JAN ADEFGVW Act Risperidone 02282631 ATV ADEFGVW Apo-Risperidone 02282178 APX ADEFGVW Jamp-Risperidone 02359588 MPC ADEFGVW Mar-Risperidone 02371812 MAR ADEFGVW Mint-Risperidone 02359847 MNT ADEFGVW Mylan-Risperidone 02282291 MYL ADEFGVW Phl-Risperidone 02258498 PHL ADEFGVW pms-risperidone 02252066 PMS ADEFGVW Ran-Risperidone 02328372 RAN ADEFGVW Risperidone 02356937 SAS ADEFGVW Sandoz Risperidone 02279835 SDZ ADEFGVW Teva-Risperidone 02264234 TEV ADEFGVW ARIPIPRAZOLE ARIPIPRAZOLE Tab Orl 2mg Abilify 02322374 BRI (SA) Tab Orl 5mg Abilify 02322382 BRI (SA) September 2015 v.1 214

N05AX12 ARIPIPRAZOLE ARIPIPRAZOLE Tab Orl 10mg Abilify 02322390 BRI (SA) Tab Orl 15mg Abilify 02322404 BRI (SA) Tab Orl 20mg Abilify 02322412 BRI (SA) Tab Orl 30mg Abilify 02322455 BRI (SA) N05AX13 PALIPERIDONE PALIPÉRIDONE Sus IM 50mg/0.5mL Invega Sustenna 02354217 JAN (SA) Susp Sus IM 75mg/0.75mL Invega Sustenna 02354225 JAN (SA) Susp Sus IM 100mg/mL Invega Sustenna 02354233 JAN (SA) Susp N05B N05BA N05BA01 Sus IM 150mg/1.5mL Invega Sustenna 02354241 JAN (SA) Susp ANXIOLYTICS ANXIOLYTIQUES BENZODIAZEPINE DERIVATIVES DÉRIVÉS DU BENZODIAZEPINE DIAZEPAM DIAZÉPAM Inj 5mg/mL Diazepam 00399728 SDZ ADEFGVW Diazepam 02386143 SDZ ADEFGVW Tab Orl 2mg Apo-Diazepam 00405329 APX ADEFGVW pms-diazepam 02247490 PMS ADEFGVW Tab Orl 5mg Valium 00013285 HLR ADEFGVW Apo-Diazepam 00362158 APX ADEFGVW pms-diazepam 02247491 PMS ADEFGVW Tab Orl 10mg Apo-Diazepam 00405337 APX ADEFGVW pms-diazepam 02247492 PMS ADEFGVW September 2015 v.1 215

N05BA02 CHLORDIAZEPOXIDE CHLORDIAZÉPOXIDE Cap Orl 5mg Chlordiazepoxide 00522724 AAP ADEFGVW Caps Cap Orl 10mg Chlordiazepoxide 00522988 AAP ADEFGVW Caps N05BA04 Cap Orl 25mg Chlordiazepoxide 00522996 AAP ADEFGVW Caps OXAZEPAM OXAZÉPAM Tab Orl 10mg Apo-Oxazepam 00402680 APX ADEFGVW Tab Orl 15mg Apo-Oxazepam 00402745 APX ADEFGVW N05BA05 Tab Orl 30mg Apo-Oxazepam 00402737 APX ADEFGVW CLORAZEPATE DIPOTASSIUM CLORAZÉPATE DIPOTASSIQUE Cap Orl 3.75mg Clorazepate 00860689 AAP ADEFGVW Caps Cap Orl 7.5mg Clorazepate 00860700 AAP ADEFGVW Caps N05BA06 Cap Orl 15mg Clorazepate 00860697 AAP ADEFGVW Caps LORAZEPAM LORAZÉPAM Inj 4mg/mL Lorazepam 02243278 SDZ ADEFVW Slt Orl 0.5mg Ativan SL 02041456 PFI ADEFGVW S.L. Apo-Lorazepam Sublingual 02410745 APX ADEFGVW Slt Orl 1mg Ativan SL 02041464 PFI ADEFGVW S.L. Apo-Lorazepam Sublingual 02410753 APX ADEFGVW Slt Orl 2mg Ativan SL 02041472 PFI ADEFGVW S.L. Apo-Lorazepam Sublingual 02410761 APX ADEFGVW September 2015 v.1 216

N05BA06 LORAZEPAM LORAZÉPAM Tab Orl 0.5mg Ativan 02041413 PFI ADEFGVW Apo-Lorazepam 00655740 APX ADEFGVW Lorazepam 02351072 SAS ADEFGVW Novo-Lorazepam 00711101 TEV ADEFGVW pms-lorazepam 00728187 PMS ADEFGVW Tab Orl 1mg Ativan 02041421 PFI ADEFGVW Apo-Lorazepam 00655759 APX ADEFGVW Lorazepam 02351080 SAS ADEFGVW Novo-Lorazepam 00637742 TEV ADEFGVW pms-lorazepam 00728195 PMS ADEFGVW N05BA08 Tab Orl 2mg Ativan 02041448 PFI ADEFGVW Apo-Lorazepam 00655767 APX ADEFGVW Lorazepam 02351099 SAS ADEFGVW Novo-Lorazepam 00637750 TEV ADEFGVW pms-lorazepam 00728209 PMS ADEFGVW BROMAZEPAM BROMAZÉPAM Tab Orl 1.5mg Apo-Bromazepam 02177153 APX ADEFGVW Tab Orl 3mg Lectopam 00518123 HLR ADEFGVW Apo-Bromazepam 02177161 APX ADEFGVW Teva-Bromazepam 02230584 TEV ADEFGVW N05BA09 N05BA12 Tab Orl 6mg Lectopam 00518131 HLR ADEFGVW Apo-Bromazepam 02177188 APX ADEFGVW Teva-Bromazepam 02230585 TEV ADEFGVW CLOBAZAM CLOBAZAM Tab Orl 10mg Frisium 02221799 LBK ADEFGV Apo-Clobazam 02244638 APX ADEFGV Novo-Clobazam 02238334 TEV ADEFGV pms-clobazam (Disc/non disp Apr 01/17) 02244474 PMS ADEFGV ALPRAZOLAM ALPRAZOLAM Tab Orl 0.25mg Xanax 00548359 PFI ADEFGVW Alprazolam 02349191 SAS ADEFGVW Apo-Alpraz 00865397 APX ADEFGVW Jamp-Alprazolam 02400111 JPC ADEFGVW Mylan-Alprazolam 02137534 MYL ADEFGVW Teva-Alprazolam 01913484 TEV ADEFGVW September 2015 v.1 217

N05BA12 N05BB N05BB01 ALPRAZOLAM ALPRAZOLAM Tab Orl 0.5mg Xanax 00548367 PFI ADEFGVW Alprazolam 02349205 SAS ADEFGVW Apo-Alpraz 00865400 APX ADEFGVW Jamp-Alprazolam 02400138 JPC ADEFGVW Mylan-Alprazolam 02137542 MYL ADEFGVW Teva-Alprazolam 01913492 TEV ADEFGVW DIPHENYLMETHANE DERIVATIVES DÉRIVÉS DU DIPHENYLMETHANE HYDROXYZINE HYDROXYZINE Cap Orl 10mg Apo-Hydroxyzine 00646059 APX ADEFGVW Cap Novo-Hydroxyzine 00738824 TEV ADEFGVW Cap Orl 25mg Apo-Hydroxyzine 00646024 APX ADEFGVW Cap Novo-Hydroxyzine 00738832 TEV ADEFGVW Cap Orl 50mg Apo-Hydroxyzine 00646016 APX ADEFGVW Cap Novo-Hydroxyzine 00738840 TEV ADEFGVW N05BE N05C N05BE01 N05CC N05CC01 N05CD N05CD01 Syr Orl 2mg/mL Atarax 00024694 ERF ADEFGVW Sir. pms-hydroxyzine 00741817 PMS ADEFGVW AZASPIRODECANEDIONE DERIVATIVES DÉRIVÉS DE L AZASPIRODECANEDIONE BUSPIRONE BUSPIRONE Tab Orl 10mg Apo-Buspirone 02211076 APX ADEFGVW Teva-Buspirone 02231492 TEV ADEFGVW pms-buspirone 02230942 PMS ADEFGVW HYPNOTICS AND SEDATIVES HYPNOTIQUES ET SEDATIFS ALDEHYDES AND DERIVATIVES ALDEHYDES ET DÉRIVÉS CHLORAL HYDRATE CHLORAL (HYDRATE DE) Syr Orl 100mg/mL Chloral Hydrate Syrup Odan 02247621 ODN ADEFGVW Sir. pms-chloral Hydrate 00792659 PMS ADEFGVW BENZODIAZEPINE DERIVATIVES DÉRIVÉS DU BENZODIAZEPINE FLURAZEPAM FLURAZÉPAM Cap Orl 15mg Flurazepam 00521698 AAP ADEFGVW Caps September 2015 v.1 218

N05CD01 N05CD02 N05CD05 FLURAZEPAM FLURAZÉPAM Cap Orl 30mg Flurazepam 00521701 AAP ADEFGVW Caps NITRAZEPAM NITRAZÉPAM Tab Orl 5mg Mogadon 00511528 AAP ADEFGVW Nitrazadon (Disc/non disp Jun 25/16) 02229654 VLN ADEFGVW Apo-Nitrazepam (Disc/non disp Apr 24/16) 02245230 APX ADEFGVW Sandoz Nitrazepam (Disc/non disp Jul 30/16) 02234003 SDZ ADEFGVW Tab Orl 10mg Mogadon 00511536 AAP ADEFGVW Nitrazadon (Disc/non disp Jun 25/16) 02229655 VLN ADEFGVW Apo-Nitrazepam (Disc/non disp Apr 24/16) 02245231 APX ADEFGVW Sandoz Nitrazepam (Disc/non disp Jul 30/16) 02234007 SDZ ADEFGVW TRIAZOLAM TRIAZOLAM Tab Orl 0.125mg Triazolam (Disc/non disp Nov 7/16) 00808563 AAP ADEFGVW Tab Orl 0.25mg Triazolam 00808571 AAP ADEFGVW N05CD07 TEMAZEPAM TÉMAZÉPAM Cap Orl 15mg Restoril 00604453 APR ADEFGVW Caps Apo-Temazepam 02225964 APX ADEFGVW Co Temazepam (Disc/Non-Disp Feb 19/17) 02244814 COB ADEFGVW Novo-Temazapam 02230095 TEV ADEFGVW Cap Orl 30mg Restoril 00604461 APR ADEFGVW Caps Apo-Temazepam 02225972 APX ADEFGVW Co Temazepam(Disc/Non-Disp June 2/17) 02244815 COB ADEFGVW Novo-Temazapam 02230102 TEV ADEFGVW N05CD08 MIDAZOLAM MIDAZOLAM Inj 1mg/mL Midazolam 02240285 SDZ ADEFVW Midazolam 02242904 PPC ADEFVW Midazolam Injection 02382873 SDZ ADEFVW Inj 5mg/mL Midazolam 02240286 SDZ ADEFVW Midazolam 02242905 PPC ADEFVW Midazolam Injection 02382903 SDZ ADEFVW September 2015 v.1 219

N05CF N06 N06A N05CF01 N06AA N06AA01 BENZODIAZEPINE RELATED DRUGS MÉDICAMENTS LIÉS AU BENZODIAZÉPINE ZOPICLONE ZOPICLONE Tab Orl 5mg Imovane 02216167 SAV ADEFVW Act Zopiclone 02271931 ATV ADEFVW Apo-Zopiclone 02245077 APX ADEFVW Jamp-Zopiclone 02406969 JPC ADEFVW Mar-Zopiclone 02386771 MAR ADEFVW Mint-Zopiclone 02391716 MNT ADEFVW Mylan-Zopiclone 02296616 MYL ADEFVW Novo-Zopiclone 02251450 TEV ADEFVW Phl-Zopiclone 02294052 PHL ADEFVW pms-zopiclone 02243426 PMS ADEFVW Ran-Zopiclone 02267918 RAN ADEFVW ratio-zopiclone 02246534 TEV ADEFVW Sandoz Zopiclone 02257572 SDZ ADEFVW Septa-Zopiclone 02386909 SPT ADEFVW Zopiclone 02344122 SAS ADEFVW Zopiclone 02385821 SIV ADEFVW Tab Orl 7.5mg Imovane 01926799 SAV ADEFVW Rhovane 02008203 SAV ADEFVW Act Zopiclone 02271958 ATV ADEFVW Apo-Zopiclone 02218313 APX ADEFVW Jamp-Zopiclone 02356805 JPC ADEFVW Jamp-Zopiclone 02406977 JPC ADEFVW Mar-Zopiclone 02386798 MAR ADEFVW Mint-Zopiclone 02391724 MNT ADEFVW Mylan-Zopiclone 02238596 MYL ADEFVW Novo-Zopiclone 02251469 TEV ADEFVW Phl-Zopiclone 02294060 PHL ADEFVW pms-zopiclone 02240606 PMS ADEFVW Ran-Zopiclone 02267926 RAN ADEFVW ratio-zopiclone 02242481 TEV ADEFVW Sandoz Zopiclone 02257580 SDZ ADEFVW Septa-Zopiclone 02386917 SPT ADEFVW Zopiclone 02282445 SAS ADEFVW Zopiclone 02385848 SIV ADEFVW PSYCHOANALEPTICS PSYCHOANALEPTIQUES ANTIDEPRESSANTS ANTIDEPRESSIFS NON-SELECTIVE MONOAMINE REUPTAKE INHIBITORS INHIBITEURS DE LA MONOAMINE NON SÉLECTIFS DU RECAPTAGE DESIPRAMINE DÉSIPRAMINE Tab Orl 10mg Desipramine 02216248 AAP ADEFGVW September 2015 v.1 220

N06AA01 DESIPRAMINE DÉSIPRAMINE Tab Orl 25mg Desipramine 02216256 AAP ADEFGVW Tab Orl 50mg Desipramine 02216264 AAP ADEFGVW Tab Orl 75mg Desipramine 02216272 AAP ADEFGVW Tab Orl 100mg Desipramine 02216280 AAP ADEFGVW N06AA02 IMIPRAMINE IMIPRAMINE Tab Orl 10mg Imipramine 00360201 AAP ADEFGVW Tab Orl 25mg Imipramine 00312797 AAP ADEFGVW Tab Orl 50mg Imipramine 00326852 AAP ADEFGVW N06AA04 Tab Orl 75mg Imipramine 00644579 AAP ADEFGVW CLOMIPRAMINE CLOMIPRAMINE Tab Orl 10mg Anafranil 00330566 APR ADEFGVW Act Clomipramine 02244816 ATV ADEFGVW Apo-Clomipramine 02040786 APX ADEFGVW Tab Orl 25mg Anafranil 00324019 APR ADEFGVW Act Clomipramine 02244817 ATV ADEFGVW Apo-Clomipramine 02040778 APX ADEFGVW N06AA06 Tab Orl 50mg Anafranil 00402591 APR ADEFGVW Act Clomipramine 02244818 ATV ADEFGVW Apo-Clomipramine 02040751 APX ADEFGVW TRIMIPRAMINE TRIMIPRAMINE Tab Orl 12.5mg Trimipramine 00740799 AAP ADEFGVW Tab Orl 25mg Trimipramine 00740802 AAP ADEFGVW September 2015 v.1 221

N06AA06 TRIMIPRAMINE TRIMIPRAMINE Tab Orl 50mg Trimipramine 00740810 AAP ADEFGVW Cap Orl 75mg Trimipramine 02070987 AAP ADEFGVW Cap N06AA09 Tab Orl 100mg Trimipramine 00740829 AAP ADEFGVW AMITRIPTYLINE AMITRIPTYLINE Tab Orl 10mg Elavil 00335053 AAP ADEFGVW Amitriptyline 00370991 PDL ADEFGVW Apo-Amitriptyline 02403137 APX ADEFGVW Tab Orl 25mg Elavil 00335061 AAP ADEFGVW Amitriptyline 00371009 PDL ADEFGVW Apo-Amitriptyline 02403145 APX ADEFGVW Tab Orl 50mg Elavil 00335088 AAP ADEFGVW Apo-Amitriptyline 02403153 APX ADEFGVW Tab Orl 75mg Elavil 00754129 AAP ADEFGVW Apo-Amitriptyline 02403161 APX ADEFGVW N06AA10 NORTRIPTYLINE NORTRIPTYLINE Cap Orl 10mg Aventyl 00015229 AAP ADEFGVW Caps Apo-Nortriptyline (Disc/non disp Jul 17/2016) 02223511 APX ADEFGVW pms-nortriptyline (Disc/non disp Aug 18/16) 02177692 PMS ADEFGVW Teva-Nortriptyline (Disc/non disp Jul 30/16) 02231781 TEV ADEFGVW Cap Orl 25mg Aventyl 00015237 AAP ADEFGVW Caps Apo-Nortriptyline (Disc/non disp Jul 17/2016) 02223538 APX ADEFGVW pms-nortriptyline (Disc/non disp Aug 18/16) 02177706 PMS ADEFGVW Teva-Nortriptyline (Disc/non disp Jul 30/16) 02231782 TEV ADEFGVW N06AA12 DOXEPIN DOXÉPINE Cap Orl 10mg Sinequan 00024325 ERF ADEFGVW Caps Doxepin 02049996 AAP ADEFGVW Cap Orl 25mg Sinequan 00024333 ERF ADEFGVW Caps Doxepin 02050005 AAP ADEFGVW Novo-Doxepin (Disc/non disp Oct 18/15) 01913425 TEV ADEFGVW Cap Orl 50mg Sinequan 00024341 ERF ADEFGVW Caps Doxepin 02050013 AAP ADEFGVW Novo-Doxepin (Disc/non disp Oct 18/15) 01913433 TEV ADEFGVW September 2015 v.1 222

N06AA12 DOXEPIN DOXÉPINE Cap Orl 75mg Sinequan (Disc/non disp Jun 5/17) 00400750 ERF ADEFGVW Caps Doxepin 02050021 AAP ADEFGVW Novo-Doxepin (Disc/non disp Oct 18/15) 01913441 TEV ADEFGVW Cap Orl 100mg Sinequan (Disc/non disp Jun 5/17) 00326925 ERF ADEFGVW Caps Doxepin 02050048 AAP ADEFGVW Novo-Doxepin (Disc/non disp Oct 18/15) 01913468 TEV ADEFGVW N06AA21 Cap Orl 150mg Novo-Doxepin (Disc/non disp Oct 18/15) 01913476 TEV ADEFGVW Caps MAPROTILINE MAPROTILINE Tab Orl 25mg Teva-Maprotiline 02158612 TEV ADEFGVW Tab Orl 50mg Teva-Maprotiline 02158620 TEV ADEFGVW N06AB N06AB03 Tab Orl 75mg Teva-Maprotiline 02158639 TEV ADEFGVW SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRI S) INHIBITEURS SPECIFIQUES DU RECAPTAGE DE LA SEROTONINE FLUOXETINE FLUOXÉTINE Cap Orl 10mg Prozac 02018985 LIL ADEFGVW Caps Act Fluoxetine 02242177 ATV ADEFGVW Apo-Fluoxetine 02216353 APX ADEFGVW Fluoxetine 02286068 SAS ADEFGVW Mylan-Fluoxetine 02237813 MYL ADEFGVW Phl-Fluoxetine 02223481 PHL ADEFGVW pms-fluoxetine 02177579 PMS ADEFGVW Sandoz Fluoxetine 02243486 SDZ ADEFGVW Teva-Fluoxetine 02216582 TEV ADEFGVW Auro-Fluoxetine 02385627 ARO ADEFGVW Fluoxetine 02374447 SIV ADEFGVW Fluoxetine 02393441 AHI ADEFGVW Jamp-Fluoxetine 02401894 JPC ADEFGVW Mar-Fluoxetine 02392909 MAR ADEFGVW Mint-Fluoxetine 02380560 MNT ADEFGVW Ran-Fluoxetine 02405695 RAN ADEFGVW Zym-Fluoxetine (Disc/non disp Jun 16/16) 02302659 ZYM ADEFGVW September 2015 v.1 223

N06AB03 N06AB04 FLUOXETINE FLUOXÉTINE Cap Orl 20mg Prozac 00636622 LIL ADEFGVW Caps Act Fluoxetine 02242178 ATV ADEFGVW Apo-Fluoxetine 02216361 APX ADEFGVW Auro-Fluoxetine 02385635 ARO ADEFGVW Fluoxetine 02286076 SAS ADEFGVW Fluoxetine 02374455 SIV ADEFGVW Fluoxetine 02383241 AHI ADEFGVW Jamp-Fluoxetine 02386402 JPC ADEFGVW Mar-Fluoxetine 02392917 MAR ADEFGVW Mint-Fluoxetine 02380579 MNT ADEFGVW Mylan-Fluoxetine 02237814 MYL ADEFGVW Phl-Fluoxetine 02223503 PHL ADEFGVW pms-fluoxetine 02177587 PMS ADEFGVW Ran-Fluoxetine 02405709 RAN ADEFGVW Sandoz Fluoxetine 02243487 SDZ ADEFGVW Teva-Fluoxetine 02216590 TEV ADEFGVW Zym-Fluoxetine (Disc/non disp Jun 16/16) 02302667 ZYM ADEFGVW CITALOPRAM CITALOPRAM Tab Orl 10mg Citalopram 02387948 SIV ADEFGVW Abbott-Citalopram 02414570 ABB ADEFGVW Jamp-Citalopram 02370085 JPC ADEFGVW Mar-Citalopram 02371871 MAR ADEFGVW Mint-Citalopram 02370077 MNT ADEFGVW Nat-Citalopram 02409003 NAT ADEFGVW pms-citalopram 02270609 PMS ADEFGVW Teva-Citalopram 02312336 TEV ADEFGVW Tab Orl 20mg Celexa 02239607 VLH ADEFGVW Abbott-Citalopram 02414589 ABB ADEFGVW Act Citalopram 02248050 ATV ADEFGVW Apo-Citalopram 02246056 APX ADEFGVW Auro-Citalopram 02275562 ARO ADEFGVW Citalopram 02353660 SAS ADEFGVW Citalopram 02387956 SIV ADEFGVW Jamp-Citalopram 02313405 JPC ADEFGVW Mar-Citalopram 02371898 MAR ADEFGVW Mint-Citalopram 02304686 MNT ADEFGVW Mylan-Citalopram 02246594 MYL ADEFGVW Nat-Citalopram 02409011 NAT ADEFGVW pms-citalopram 02248010 PMS ADEFGVW Ran-Citalo 02285622 RAN ADEFGVW Sandoz Citalopram 02248170 SDZ ADEFGVW Septa-Citalopram 02355272 SPT ADEFGVW Teva-Citalopram 02293218 TEV ADEFGVW Tab Orl 30mg CTP 30 02296152 SNV ADEFGVW September 2015 v.1 224

N06AB04 N06AB05 CITALOPRAM CITALOPRAM Tab Orl 40mg Celexa 02239608 VLH ADEFGVW Abbott-Citalopram 02414597 ABB ADEFGVW Act Citalopram 02248051 ATV ADEFGVW Apo-Citalopram 02246057 APX ADEFGVW Auro-Citalopram 02275570 ARO ADEFGVW Citalopram 02353679 SAS ADEFGVW Citalopram 02387964 SIV ADEFGVW Jamp-Citalopram 02313413 JPC ADEFGVW Mar-Citalopram 02371901 MAR ADEFGVW Mint-Citalopram 02304694 MNT ADEFGVW Mylan-Citalopram 02246595 MYL ADEFGVW Nat-Citalopram 02409038 NAT ADEFGVW pms-citalopram 02248011 PMS ADEFGVW Ran-Citalo 02285630 RAN ADEFGVW Sandoz Citalopram 02248171 SDZ ADEFGVW Septa-Citalopram 02355280 SPT ADEFGVW Teva-Citalopram 02293226 TEV ADEFGVW PAROXETINE PAROXÉTINE Tab Orl 20mg Paxil 01940481 GSK ADEFGVW Act Paroxetine 02262754 ATV ADEFGVW Apo-Paroxetine 02240908 APX ADEFGVW Auro-Paroxetine 02383284 ARO ADEFGVW Jamp-Paroxetine 02368870 JPC ADEFGVW Mar-Paroxetine 02411954 MAR ADEFGVW Mint-Paroxetine 02421380 MNT ADEFGVW Mylan-Paroxetine 02248013 MYL ADEFGVW Paroxetine 02282852 SAS ADEFGVW Paroxetine 02388235 SIV ADEFGVW pms-paroxetine 02247751 PMS ADEFGVW Sandoz Paroxetine 02269430 SDZ ADEFGVW Sandoz Paroxetine Tablets 02431785 SDZ ADEFGVW Teva-Paroxetine 02248557 TEV ADEFGVW Tab Orl 30mg Paxil 01940473 GSK ADEFGVW Act Paroxetine 02262762 ATV ADEFGVW Apo-Paroxetine 02240909 APX ADEFGVW Auro-Paroxetine 02383292 ARO ADEFGVW Jamp-Paroxetine 02368889 JPC ADEFGVW Mar-Paroxetine 02411962 MAR ADEFGVW Mint-Paroxetine 02421399 MNT ADEFGVW Mylan-Paroxetine 02248014 MYL ADEFGVW Paroxetine 02282860 SAS ADEFGVW Paroxetine 02388243 SIV ADEFGVW pms-paroxetine 02247752 PMS ADEFGVW Sandoz Paroxetine 02269449 SDZ ADEFGVW Sandoz Paroxetine Tablets 02431793 SDZ ADEFGVW Teva-Paroxetine 02248558 TEV ADEFGVW September 2015 v.1 225

N06AB05 N06AB06 PAROXETINE PAROXÉTINE Tab Orl 40mg pms-paroxetine 02293749 PMS ADEFGVW SERTRALINE SERTRALINE Cap Orl 25mg Zoloft 02132702 PFI ADEFGVW Caps Act Sertraline 02287390 ATV ADEFGVW Apo-Sertraline 02238280 APX ADEFGVW Auro-Sertraline 02390906 ARO ADEFGVW GD-Sertraline 02273683 GMD ADEFGVW Jamp-Sertraline 02357143 JPC ADEFGVW Mar-Sertraline 02399415 MAR ADEFGVW Mint-Sertraline 02402378 MNT ADEFGVW Mylan-Sertraline 02242519 MYL ADEFGVW Phl-Sertraline 02245824 PHL ADEFGVW pms-sertraline 02244838 PMS ADEFGVW Ran-Sertraline 02374552 RAN ADEFGVW Sandoz Sertraline 02245159 SDZ ADEFGVW Sertraline 02353520 SAS ADEFGVW Sertraline 02386070 SIV ADEFGVW Teva-Sertraline 02240485 TEV ADEFGVW Cap Orl 50mg Zoloft 01962817 PFI ADEFGVW Caps Act Sertraline 02287404 ATV ADEFGVW Apo-Sertraline 02238281 APX ADEFGVW Auro-Sertraline 02390914 ARO ADEFGVW GD-Sertraline 02273691 GMD ADEFGVW Jamp-Sertraline 02357151 JPC ADEFGVW Mar-Sertraline 02399423 MAR ADEFGVW Mint-Sertraline 02402394 MNT ADEFGVW Mylan-Sertraline 02242520 MYL ADEFGVW Phl-Sertraline 02245825 PHL ADEFGVW pms-sertraline 02244839 PMS ADEFGVW Ran-Sertraline 02374560 RAN ADEFGVW Sandoz Sertraline 02245160 SDZ ADEFGVW Sertraline 02353539 SAS ADEFGVW Sertraline 02386089 SIV ADEFGVW Teva-Sertraline 02240484 TEV ADEFGVW September 2015 v.1 226

N06AB06 N06AB08 SERTRALINE SERTRALINE Cap Orl 100mg Zoloft 01962779 PFI ADEFGVW Caps Act Sertraline 02287412 ATV ADEFGVW Apo-Sertraline 02238282 APX ADEFGVW Auro-Sertraline 02390922 ARO ADEFGVW GD-Sertraline 02273705 GMD ADEFGVW Jamp-Sertraline 02357178 JPC ADEFGVW Mar-Sertraline 02399431 MAR ADEFGVW Mint-Sertraline 02402408 MNT ADEFGVW Mylan-Sertraline 02242521 MYL ADEFGVW Phl-Sertraline 02245826 PHL ADEFGVW pms-sertraline 02244840 PMS ADEFGVW Ran-Sertraline 02374579 RAN ADEFGVW Sandoz Sertraline 02245161 SDZ ADEFGVW Sertraline 02353547 SAS ADEFGVW Sertraline 02386097 SIV ADEFGVW Teva-Sertraline 02240481 TEV ADEFGVW FLUVOXAMINE FLUVOXAMINE Tab Orl 50mg Luvox 01919342 BGP ADEFGVW Act Fluvoxamine 02255529 ATV ADEFGVW Apo-Fluvoxamine 02231329 APX ADEFGVW Novo-Fluvoxamine 02239953 TEV ADEFGVW pms-fluvoxamine (Disc/non disp Sep 13/15) 02240682 PMS ADEFGVW Ratio-Fluvoxamine 02218453 TEV ADEFGVW Tab Orl 100mg Luvox 01919369 BGP ADEFGVW Act Fluvoxamine 02255537 ATV ADEFGVW Apo-Fluvoxamine 02231330 APX ADEFGVW Novo-Fluvoxamine 02239954 TEV ADEFGVW pms-fluvoxamine (Disc/non disp Sep 13/15) 02240683 PMS ADEFGVW Ratio-Fluvoxamine (Disc/non disp Sept 29/16) 02218461 TEV ADEFGVW N06AB10 ESCITALOPRAM ESCITALOPRAM Tab Orl 10mg Cipralex 02263238 VLH ADEFGVW Act Escitalopram 02313561 ATV ADEFGVW Apo-Escitalopram 02295016 APX ADEFGVW Auro-Escitalopram 02397358 ARO ADEFGVW Escitalopram 02430118 SAS ADEFGVW Jamp-Escitalopram 02429780 JPC ADEFGVW Mar-Escitalopram 02423480 MAR ADEFGVW Mylan-Escitalopram 02309467 MYL ADEFGVW Ran-Escitalopram 02385481 RAN ADEFGVW Sandoz Escitalopram 02364077 SDZ ADEFGVW Teva-Escitalopram 02318180 TEV ADEFGVW September 2015 v.1 227

N06AB10 N06AF N06AF03 N06AF04 N06AG N06AG02 ESCITALOPRAM ESCITALOPRAM Tab Orl 20mg Cipralex 02263254 VLH ADEFGVW Act Escitalopram 02313588 ATV ADEFGVW Apo-Escitalopram 02295024 APX ADEFGVW Auro-Escitalopram 02397374 ARO ADEFGVW Escitalopram 02430126 SAS ADEFGVW Jamp-Escitalopram 02429799 JPC ADEFGVW Mar-Escitalopram 02423502 MAR ADEFGVW Mylan-Escitalopram 02309475 MYL ADEFGVW Ran-Escitalopram 02385503 RAN ADEFGVW Sandoz Escitalopram 02364085 SDZ ADEFGVW Teva-Escitalopram 02318202 TEV ADEFGVW MONOAMINE OXIDASE INHIBITORS, NON-SELECTIVE INHIBITEURS DE LA MONOAMINE OXYDASE, NON SELECTIFS PHENELZINE PHÉNELZINE Tab Orl 15mg Nardil 00476552 ERF ADEFGVW TRANYLCYPROMINE TRANYLCYPROMINE Tab Orl 10mg Parnate 01919598 GSK ADEFGVW MONOAMINE OXIDASE TYPE A INHIBITORS INHIBITEURS DE LA MONOAMINE OXYDASE DE TYPE A MOCLOBEMIDE MOCLOBÉMIDE Tab Orl 100mg Apo-Moclobemide 02232148 APX ADEFGVW Teva-Moclobemide 02239746 TEV ADEFGVW Tab Orl 150mg Manerix 00899356 MVL ADEFGVW Apo-Moclobemide 02232150 APX ADEFGVW Teva-Moclobemide 02239747 TEV ADEFGVW N06AX N06AX02 Tab Orl 300mg Manerix 02166747 MVL ADEFGVW Apo-Moclobemide 02240456 TEV ADEFGVW Teva-Moclobemide 02239748 APX ADEFGVW OTHER ANTIDEPRESSANTS AUTRES ANTIDEPRESSIFS TRYPTOPHAN TRYPTOPHANE Cap Orl 500mg Tryptan 00718149 VLN ADEFGVW Caps Apo-Tryptophan 02248540 APX ADEFGVW Teva-Tryptophan 02240334 TEV ADEFGVW September 2015 v.1 228

N06AX02 TRYPTOPHAN TRYPTOPHANE Tab Orl 250mg Tryptan 02239326 VLN ADEFGVW Tab Orl 500mg Tryptan 02029456 VLN ADEFGVW Apo-Tryptophan 02248538 APX ADEFGVW Ratio-Tryptophan 02240333 TEV ADEFGVW Tab Orl 750mg Tryptan 02239327 VLN ADEFGVW Cap Orl 1000mg Tryptan 00654531 VLN ADEFGVW Caps Apo-Tryptophan 02248539 APX ADEFGVW Teva-Tryptophan 02237250 TEV ADEFGVW N06AX05 TRAZODONE TRAZODONE Tab Orl 50mg Apo-Trazodone 02147637 APX ADEFGVW Mylan-Trazodone 02231683 MYL ADEFGVW Phl-Trazodone 02236941 PHL ADEFGVW pms-trazodone 01937227 PMS ADEFGVW Teva-Trazodone 02144263 TEV ADEFGVW Trazodone 02348772 SAS ADEFGVW Tab Orl 100mg Apo-Trazodone 02147645 APX ADEFGVW Mylan-Trazodone 02231684 MYL ADEFGVW Phl-Trazodone 02236942 PHL ADEFGVW pms-trazodone 01937235 PMS ADEFGVW Teva-Trazodone 02144271 TEV ADEFGVW Trazodone 02348780 SAS ADEFGVW Tab Orl 150mg Apo-Trazodone 02147653 APX ADEFGVW Teva-Trazodone 02144298 TEV ADEFGVW Trazodone 02348799 SAS ADEFGVW N06AX11 MIRTAZAPINE MIRTAZAPINE ODT Orl 15mg Remeron RD 02248542 FRS ADEFGVW D.O. Auro-Mirtazapine OD 02299801 ARO ADEFGVW GD-Mirtazapine OD (Disc/non disp Nov 30/15) 02352826 GMD ADEFGVW Novo-Mirtazapine OD 02279894 TEV ADEFGVW ODT Orl 30mg Remeron RD 02248543 FRS ADEFGVW D.O. Auro-Mirtazapine OD 02299828 ARO ADEFGVW GD-Mirtazapine OD (Disc/non disp Nov 30/15) 02352834 GMD ADEFGVW Novo-Mirtazapine OD 02279908 TEV ADEFGVW ODT Orl 45mg Remeron RD 02248544 FRS ADEFGVW D.O. Auro-Mirtazapine OD 02299836 ARO ADEFGVW GD-Mirtazapine OD (Disc/non disp Nov 30/15) 02352842 GMD ADEFGVW Novo-Mirtazapine OD 02279916 TEV ADEFGVW September 2015 v.1 229

N06AX11 N06AX12 MIRTAZAPINE MIRTAZAPINE Tab Orl 15mg Apo-Mirtazapine 02286610 APX ADEFGVW Auro-Mirtazapine 02411695 ARO ADEFGVW Mirtazapine (Disc/non disp Jun 25/16) 02281732 MEL ADEFGVW Mylan-Mirtazapine 02256096 MYL ADEFGVW pms-mirtazapine 02273942 PMS ADEFGVW Sandoz Mirtazapine 02250594 SDZ ADEFGVW Zym-Mirtazapine (Disc/non disp Jun 16/16) 02325179 ZYM ADEFGVW Tab Orl 30mg Remeron 02243910 FRS ADEFGVW Apo-Mirtazapine 02286629 APX ADEFGVW Auro-Mirtazapine 02411709 ARO ADEFGVW Mirtazapine (Disc/non disp Jun 25/16) 02252279 MEL ADEFGVW Mirtazapine 02370689 SAS ADEFGVW Mylan-Mirtazapine 02256118 MYL ADEFGVW Novo-Mirtazapine 02259354 TEV ADEFGVW pms-mirtazapine 02248762 PMS ADEFGVW Sandoz Mirtazapine 02250608 SDZ ADEFGVW Zym-Mirtazapine (Disc/non disp Jun 16/16) 02325187 ZYM ADEFGVW BUPROPION BUPROPION SRT Orl 100mg Bupropion SR 02391562 SAS ADEFGVW L.L. pms-bupropion 02325373 PMS ADEFGVW ratio-bupropion SR 02285657 TEV ADEFGVW Sandoz Bupropion SR 02275074 SDZ ADEFGVW SRT Orl 150mg Wellbutrin SR 02237825 VLN ADEFGVW L.L. Bupropion SR 02391570 SAS ADEFGVW pms-bupropion 02313421 PMS ADEFGVW ratio-bupropion SR 02285665 TEV ADEFGVW Sandoz Bupropion SR 02275082 SDZ ADEFGVW SRT Orl 150mg Wellbutrin XL 02275090 VLN ADEFGVW L.L. Mylan-Bupropion XL 02382075 MYL ADEFGVW SRT Orl 150mg Zyban 02238441 VLN (SA) L.L. SRT Orl 300mg Wellbutrin XL 02275104 VLN ADEFGVW L.L. Mylan-Bupropion XL 02382083 MYL ADEFGVW September 2015 v.1 230

N06AX16 VENLAFAXINE VENLAFAXINE SRC Orl 37.5mg Effexor XR 02237279 PFI ADEFGVW Caps.L.L. Act Venlafaxine XR 02304317 ATV ADEFGVW Apo-Venlafaxine XR 02331683 APX ADEFGVW GD-Venlafaxine XR 02360020 GMD ADEFGVW Mylan-Venlafaxine XR 02310279 MYL ADEFGVW pms-venlafaxine XR 02278545 PMS ADEFGVW Ran-Venlafaxine XR 02380072 RAN ADEFGVW Sandoz Venlafaxine XR 02310317 SDZ ADEFGVW Teva-Venlafaxine XR 02275023 TEV ADEFGVW Venlafaxine XR 02354713 SAS ADEFGVW Venlafaxine XR 02385929 SIV ADEFGVW SRC Orl 75mg Effexor XR 02237280 PFI ADEFGVW Caps.L.L. Act Venlafaxine XR 02304325 ATV ADEFGVW Apo-Venlafaxine XR 02331691 APX ADEFGVW GD-Venlafaxine XR 02360039 GMD ADEFGVW Mylan-Venlafaxine XR 02310287 MYL ADEFGVW pms-venlafaxine XR 02278553 PMS ADEFGVW Ran-Venlafaxine XR 02380080 RAN ADEFGVW Sandoz Venlafaxine XR 02310325 SDZ ADEFGVW Teva-Venlafaxine XR 02275031 TEV ADEFGVW Venlafaxine XR 02354721 SAS ADEFGVW Venlafaxine XR 02385937 SIV ADEFGVW SRC Orl 150mg Effexor XR 02237282 PFI ADEFGVW Caps.L.L. Act Venlafaxine XR 02304333 ATV ADEFGVW Apo-Venlafaxine XR 02331705 APX ADEFGVW GD-Venlafaxine XR 02360047 GMD ADEFGVW Mylan-Venlafaxine XR 02310295 MYL ADEFGVW pms-venlafaxine XR 02278561 PMS ADEFGVW Ran-Venlafaxine XR 02380099 RAN ADEFGVW Sandoz Venlafaxine XR 02310333 SDZ ADEFGVW Teva-Venlafaxine XR 02275058 TEV ADEFGVW Venlafaxine XR 02354748 SAS ADEFGVW Venlafaxine XR 02385945 SIV ADEFGVW N06AX21 DULOXETINE DULOXÉTINE Cap Orl 30mg Cymbalta 02301482 LIL (SA) Caps Cap Orl 60mg Cymbalta 02301490 LIL (SA) Caps September 2015 v.1 231

N06B N06BA N06BA02 PSYCHOSTIMULANTS, AGENTS USED FOR ADHD AND NOOTROPICS PSYCHOSTIMULANTS, AGENTS UTILISÉS POUR ADHD ET NOOTROPIQUES CENTRALLY ACTING SYMPATHOMIMETICS ADRENERGIQUES AGISSANT CENTRALEMENT DEXAMPHETAMINE DEXAMPHÉTAMINE Tab Orl 5mg Dexedrine 01924516 PAL DEF-18G SRC Orl 10mg Dexedrine 01924559 PAL DEF-18G Caps.L.L. N06BA04 SRC Orl 15mg Dexedrine 01924567 PAL DEF-18G Caps.L.L. METHYLPHENIDATE MÉTHYLPHÉNIDATE ERC Orl 10mg Biphentin 02277166 PFR (SA) Caps.L.P. ERC Orl 15mg Biphentin 02277131 PFR (SA) Caps.L.P. ERC Orl 20mg Biphentin 02277158 PFR (SA) Caps.L.P. ERC Orl 30mg Biphentin 02277174 PFR (SA) Caps.L.P. ERC Orl 40mg Biphentin 02277182 PFR (SA) Caps.L.P. ERC Orl 50mg Biphentin 02277190 PFR (SA) Caps.L.P. ERC Orl 60mg Biphentin 02277204 PFR (SA) Caps.L.P. ERC Orl 80mg Biphentin 02277212 PFR (SA) Caps.L.P. ERT Orl 18mg Concerta ER 02247732 JAN (SA) L.P. pms-methylphenidate ER 02413728 PMS (SA) Teva-Methylphenidate ER-C 02315068 TEV (SA) ERT Orl 27mg Concerta ER 02250241 JAN (SA) L.P. pms-methylphenidate ER 02413736 PMS (SA) Teva-Methylphenidate ER-C 02315076 TEV (SA) September 2015 v.1 232

N06BA04 METHYLPHENIDATE MÉTHYLPHÉNIDATE ERT Orl 36mg Concerta ER 02247733 JAN (SA) L.P. pms-methylphenidate ER 02413744 PMS (SA) Teva-Methylphenidate ER-C 02315084 TEV (SA) ERT Orl 54mg Concerta ER 02247734 JAN (SA) L.P. pms-methylphenidate ER 02413752 PMS (SA) Teva-Methylphenidate ER-C 02315092 TEV (SA) SRT Orl 20mg Ritalin SR 00632775 NVR ADEFGVW L.L. Apo-Methylphenidate SR 02266687 APX ADEFGVW Sandoz Methylphenidate SR 02320312 SDZ ADEFGVW Tab Orl 5mg Apo-Methylphenidate 02273950 APX ADEFGVW pms-methylphenidate 02234749 PMS ADEFGVW Tab Orl 10mg Ritalin 00005606 NVR ADEFGVW Apo-Methylphenidate 02249324 APX ADEFGVW pms-methylphenidate 00584991 PMS ADEFGVW Tab Orl 20mg Ritalin 00005614 NVR ADEFGVW Apo-Methylphenidate 02249332 APX ADEFGVW pms-methylphenidate 00585009 PMS ADEFGVW N06BA07 MODAFINIL MODAFINIL Tab Orl 100mg Alertec 02239665 SHI (SA) Apo-Modafinil 02285398 APX (SA) N06BA12 LISDEXAMFETAMINE LISDEXAMFÉTAMINE Cap Orl 10mg Vyvanse 02439603 SHI (SA) Caps Cap Orl 20mg Vyvanse 02347156 SHI (SA) Caps Cap Orl 30mg Vyvanse 02322951 SHI (SA) Caps Cap Orl 40mg Vyvanse 02347164 SHI (SA) Caps Cap Orl 50mg Vyvanse 02322978 SHI (SA) Caps Cap Orl 60mg Vyvanse 02347172 SHI (SA) Caps September 2015 v.1 233

N06DA N06DA02 N06DA03 ANTICHOLINESTERASES ANTICHOLINESTÉRASES DONEPEZIL DONÉPÉZIL Tab Orl 5mg Aricept 02232043 PFI (SA) Act Donepezil 02397595 ATV (SA) Apo-Donepezil 02362260 APX (SA) Auro-Donepezil 02400561 ARO (SA) Donepezil 02402645 AHI (SA) Donepezil 02420597 SIV (SA) Jamp-Donepezil 02404419 JPC (SA) Jamp-Donepezil 02416948 JPC (SA) Mar-Donepezil 02402092 MAR (SA) Mylan-Donepezil 02359472 MYL (SA) pms-donepezil 02322331 PMS (SA) Ran-Donepezil 02381508 RAN (SA) Sandoz Donepezil 02328666 SDZ (SA) Teva-Donepezil 02340607 TEV (SA) Tab Orl 10mg Aricept 02232044 PFI (SA) Act Donepezil 02397609 ATV (SA) Apo-Donepezil 02362279 APX (SA) Auro-Donepezil 02400588 ARO (SA) Donepezil 02402653 AHI (SA) Donepezil 02420600 SIV (SA) Jamp-Donepezil 02404427 JPC (SA) Jamp-Donepezil 02416956 JPC (SA) Mar-Donepezil 02402106 MAR (SA) Mylan-Donepezil 02359480 MYL (SA) pms-donepezil 02322358 PMS (SA) Ran-Donepezil 02381516 RAN (SA) Sandoz Donepezil 02328682 SDZ (SA) Teva-Donepezil 02340615 TEV (SA) RIVASTIGMINE RIVASTIGMINE Cap Orl 1.5mg Exelon 02242115 NVR (SA) Caps Apo-Rivastigmine 02336715 APX (SA) Mint-Rivastigmine 02406985 MNT (SA) Novo-Rivastigmine 02305984 NOP (SA) pms-rivastigmine 02306034 PMS (SA) ratio-rivastigmine 02311283 TEV (SA) Sandoz Rivastigmine 02324563 SDZ (SA) Cap Orl 3mg Exelon 02242116 NVR (SA) Caps Apo-Rivastigmine 02336723 APX (SA) Mint-Rivastigmine 02406993 MNT (SA) Novo-Rivastigmine 02305992 NOP (SA) pms-rivastigmine 02306042 PMS (SA) ratio-rivastigmine 02311291 TEV (SA) Sandoz Rivastigmine 02324571 SDZ (SA) September 2015 v.1 234

N06DA03 RIVASTIGMINE RIVASTIGMINE Cap Orl 4.5mg Exelon 02242117 NVR (SA) Caps Apo-Rivastigmine 02336731 APX (SA) Mint-Rivastigmine 02407000 MNT (SA) Novo-Rivastigmine 02306018 NOP (SA) pms-rivastigmine 02306050 PMS (SA) ratio-rivastigmine 02311305 TEV (SA) Sandoz Rivastigmine 02324598 SDZ (SA) Cap Orl 6mg Exelon 02242118 NVR (SA) Caps Apo-Rivastigmine 02336758 APX (SA) Mint-Rivastigmine 02407019 MNT (SA) Novo-Rivastigmine 02306026 NOP (SA) ratio-rivastigmine 02311313 TEV (SA) Sandoz Rivastigmine 02324601 SDZ (SA) N06DA04 Orl 2mg Exelon 02245240 NVR (SA) GALANTAMINE GALANTAMINE ERC Orl 8mg Reminyl ER 02266717 JAN (SA) Caps.L.P. Mar-Galantamine ER 02420821 MAR (SA) pms-galantamine ER 02398370 PMS (SA) Teva-Galantamine ER (Disc/non disp Sept 29/16) 02377950 TEV (SA) ERC Orl 16mg Reminyl ER 02266725 JAN (SA) Caps.L.P. Mar-Galantamine ER 02420848 MAR (SA) pms-galantamine ER 02398389 PMS (SA) Teva-Galantamine ER (Disc/non disp Sept 29/16) 02377969 TEV (SA) N07 N07A N07AA ERC Orl 24mg Reminyl ER 02266733 JAN (SA) Caps.L.P. Mar-Galantamine ER 02420856 MAR (SA) pms-galantamine ER 02398397 PMS (SA) Teva-Galantamine ER (Disc/non disp Sept 29/16) 02377977 TEV (SA) OTHER NERVOUS SYSTEM DRUGS AUTRES MÉDICAMENTS DU SYSTÈME NERVEUX PARASYMPATHOMIMETICS PARAADRENERGIQUES ANTICHOLINESTERASES ANTICHOLINESTERASES N07AA02 PYRIDOSTIGMINE PYRIDOSTIGMINE SRT Orl 180mg Mestinon SR 00869953 VLN ADEFGVW L.L. Tab Orl 60mg Mestinon 00869961 VLN ADEFGVW September 2015 v.1 235

N07AB N07AB02 CHOLINE ESTERS ESTERS DE CHOLINE BETHANECHOL BÉTHANÉCHOL Tab Orl 10mg Duvoid 01947958 PAL ADEFGVW Tab Orl 25mg Duvoid 01947931 PAL ADEFGVW N07AB N07AB03 N07AB04 N07AX N07B N07AX01 N07BA N07BA03 Tab Orl 50mg Duvoid 01947923 PAL ADEFGVW DRUGS USED IN ALCOHOL DEPENDENCE MÉDICAMENTS UTULISÉS EN CAS DE DÉPENDENCE AUX ALCOHOLE ACAMPROSATE ACAMPROSATE SRT Orl 333mg Campral 02293269 MYL (SA) L.L. NALTREXONE NALTREXONE Tab Orl 50mg Revia 02213826 TEV (SA) OTHER PARASYMPATHOMIMETICS AUTRES PARAADRENERGIQUES PILOCARPINE PILOCARPINE Tab Orl 5mg Salagen 02216345 PFI (SA) Pilocarpine 02402483 STR (SA) DRUGS USED IN ADDICTIVE DISORDERS MÉDICAMENTS UTULISÉS EN CAS DE TROUBLES AUX DÉPENDENCES DRUGS USED IN NICOTINE DEPENDENCE MEDICAMENTS UTULISES EN CAS DE DEPENDANCE A LA NICOTINE VARENICLINE TARTRATE VARÉNICLINE, TARTRATE DE Tab Orl 0.5mg Champix 02291177 PFI (SA) Tab Orl 1mg Champix 02291185 PFI (SA) Kit Orl 0.5mg, 1mg Champix Starter Kit 02298309 PFI (SA) Tro September 2015 v.1 236

N07BC N07BC02 DRUGS USED IN OPIOID DEPENDENCE MÉDICAMENTS UTULISÉS EN CAS DE DÉPENDENCE AUX OPIACÉS METHADONE MÉTHADONE Orl 1mg/mL Metadol Opioid Dependence / dépendance aux opiacés 00903823 PAL (SA) Pain Management/ gestion de la douleur 00903825 PAL (SA) Orl 10mg/mL Metadol Opioid Dependence / dépendance aux opiacés 00903824 PAL (SA) Pain Management/ gestion de la douleur 00903826 PAL (SA) Methadose Unflavored Opioid Dependence / dépendance aux opiacés 02394618 MAL (SA) Methadose Cherry flavored Opioid Dependence / dépendance aux opiacés 02394596 MAL (SA) Pws Orl Methadone Compounded Oral Solution Pds. Opioid Dependence / dépendance aux opiacés 00999734 (SA) Pain Management/ gestion de la douleur 00999801 (SA) Tab Orl 1mg Metadol 02247698 PAL (SA) Tab Orl 5mg Metadol 02247699 PAL (SA) Tab Orl 10mg Metadol 02247700 PAL (SA) Tab Orl 25mg Metadol 02247701 PAL (SA) N07BC51 BUPRENORPHINE, COMBINATIONS BUPRÉNORPHINE, COMBINAISONS BUPRENORPHINE / NALOXONE BUPRÉNORPHINE / NALOXONE Slt Orl 2mg/0.5mg Suboxone 02295695 ICL (SA) S.L. Mylan-Buprenorphine/Naloxone 02408090 MYL (SA) Teva-Buprenorphine/Naloxone 02424851 TEV (SA) Slt Orl 8mg/2mg Suboxone 02295709 ICL (SA) S.L. Mylan-Buprenorphine/Naloxone 02408104 MYL (SA) Teva-Buprenorphine/Naloxone 02424878 TEV (SA) September 2015 v.1 237

N07C N07CA N07CA01 ANTIVERTIGO PREPARATIONS PRÉPARATIONS ANTIVERTIGINEUX ANTIVERTIGO PREPARATIONS PRÉPARATIONS ANTIVERTIGINEUX BETAHISTINE BÉTAHISTINE Tab Orl 8mg Novo-Betahistine 02280183 NOP (SA) Tab Orl 16mg Serc 02243878 BGP (SA) Act Betahistine 02374757 ATV (SA) Novo-Betahistine 02280191 NOP (SA) Tab Orl 24mg Serc 02247998 BGP (SA) Act Betahistine 02374765 ATV (SA) Novo-Betahistine 02280205 NOP (SA) N07X N07CA03 N07XX N07XX02 N07XX06 N07XX09 FLUNARIZINE FLUNARIZINE Cap Orl 5mg Flunarizine 02246082 AAP DEF Caps OTHER NERVOUS SYSTEM DRUGS AUTRES MÉDICAMENTS DU SYSTEME NERVEUX OTHER NERVOUS SYSTEM DRUGS AUTRES MÉDICAMENTS DU SYSTEME NERVEUX RILUZOLE RILUZOLE Tab Orl 50mg Rilutek 02242763 SAV (SA) Apo-Riluzole 02352583 APX (SA) Mylan-Riluzole 02390299 MYL (SA) TETRABENAZINE TÉTRABENAZINE Tab Orl 25mg Nitoman 02199270 VLN ADEFGVW Apo-Tetrabenazine 02407590 APX ADEFGVW pms-tetrabenazine 02402424 PMS ADEFGVW DIMETHYL FUMARATE FUMARATE DE DIMÉTHYLE CDR Orl 120mg Tecfidera 02404508 BIG H (SA) Caps.L.R CDR Orl 240mg Tecfidera 02420201 BIG H (SA) Caps.L.R September 2015 v.1 238

P01 P01A P01AX P01B P01AX06 P01BA P01BA01 P01BA02 P01BA03 P01BC P01BC01 ANTIPROTOZOALS ANTIPROTOZOAIRES AGENTS AMOEBIASIS & OTHER PROTOZOAL DISEASES ANTIPROTOZOAIRES OTHER AGENTS AMOEBIASIS & OTHER PROTOZOAL DISEASES AUTRES ANTIPROTOZOAIRES ATOVAQUONE ATOVAQUONE Sus Orl 750mg/5mL Mepron 02217422 GSK (SA) Susp ANTIMALARIALS ANTIPALUDIQUES AMINOQUINOLINES AMINOQUINOLINES CHLOROQUINE CHLOROQUINE Tab Orl 250mg Teva-Chloroquine 00021261 TEV ADEFGVW HYDROXYCHLOROQUINE HYDROXYCHLOROQUINE Tab Orl 200mg Plaquenil 02017709 SAV ADEFGVW Apo-Hydroxyquine 02246691 APX ADEFGVW Mylan-Hydroxychloroquine 02252600 MYL ADEFGVW PRIMAQUINE PRIMAQUINE Tab Orl 15mg Primaquine 02017776 SAV ADEFGVW METHANOLQUINOLINES METHANOLQUINOLINES QUININE QUININE Cap Orl 200mg Apo-Quinine 02254514 APX ADEFGV Caps Novo-Quinine 00021008 TEV ADEFGVW Quinine Sulfate 00695440 ODN ADEFGV Cap Orl 300mg Apo-Quinine 02254522 APX ADEFGV Caps Novo-Quinine 00021016 TEV ADEFGVW Quinine Sulfate 00695459 ODN ADEFGV Tab Orl 300mg Quinine Sulfate 00695432 ODN ADEFGVW September 2015 v.1 239

P01C P01CX P02 P02C P01CX01 P02CA P02CA01 P02CC P03 P03A P02CC01 P03AC P03AC04 AGENTS AGAINST LEISHMANIASIS AND TRYPANOSOMIASIS AGENTS CONTRE LEISHMANIOSE ET TRYPANOSOMIASE OTHER AGENTS AGAINST LEISHMANIASIS AND TRYPANOSOMIASIS AUTRE AGENTS CONTRE LEISHMANIOSE ET TRYPANOSOMIASE PENTAMIDINE ISETIONATE PENTAMIDINE ISÉTIONATE Pws Inj 300mg Pentamidine Isetionate 02183080 HOS ADEFGVW Pds. ANTHELMINTICS ANTHELMINTIQUES ANTINEMATODAL AGENTS AGENTS ANTINEMATODAUX BENZIMIDAZOLE AGENTS AGENTS DU BENZIMIDAZOLE MEBENDAZOLE MÉBENDAZOLE Tab Orl 100mg Vermox 00556734 JAN ADEFGVW TETRAHYDROPIRIMIDINE DERIVATIVES DÉRIVÉS DU TETRAHYDROPIRIMIDINE PYRANTEL PYRANTEL Tab Orl 125mg Combantrin 01944363 JNJ EF-18G ECTOPARASITICIDES, INCLUDING SCABICIDES, INSECTICIDES & REPELLANTS ECTOPARASITICIDES, Y COMPRIS LES SCABICIDES, LES INSECTICIDES ET REPULSIFS ECTOPARASITICIDES, INCLUDING SCABICIDES ECTOPARASITICIDES, Y COMPRIS LES SCABICIDES PYRETHRINES, INCLUDING SYNTHETIC COMPOUNDS PYRETHRINES, Y COMPRIS LES COMPOSÉS SYNTHÉTIQUES PERMETHRIN PERMÉTHRINE Crm Top 1% Kwellada-P Crème Rinse 1% 02231480 MDI EFGV Cr. Nix Crème 00771368 INP EFGV Crm Top 5% Nix Dermal 02219905 GCH EFGV Cr. Lot Top 5% Kwellada-P 02231348 MDI EFGV Lot September 2015 v.1 240

P03AC51 PYRETHRUM, COMBINATIONS PYRETHRUM, EN COMBINAISON PYRETHRINS / PIPERONYL BUTOXIDE PYRÉTHRINES / BUTOXYDE DE PIPÉRONYLE Shp Top 3% R & C Shampoo and Conditioner 02125447 MDI EFGV Shp P03AX OTHER ECTOPARACITICIDES, INCLUDING SCABICIDES AUTRES ECTOPARASITICIDES, Y COMPRIS LES SCABICIDES CROTAMITON CROTAMITON Crm Top 10% Eurax 00623377 CLC EF-18G Cr. ISOPROPYL MYRISTATE MYRISTATE D ISOPROPYLE Top 50% Resultz 02279592 MDF EFGV R01 R01A R01AC R01AC01 R01AD R01AD01 R01AD05 NASAL PREPARATIONS PRÉPARATIONS NASALES DECONGESTANTS AND OTHER NASAL PREPARATIONS FOR TOPICAL USE DÉCONGESTIONNANTS ET AUTRES PRÉPARATIONS NASALES, UTILISATION TOP ANTIALLERGIC AGENTS, EXCLUDING CORTICOSTEROIDS AGENTS ANTI-ALLERGIQUES, A L EXCLUSION DES CORTICOSTÉROÏDES CROMOGLICIC ACID ACIDE CROMOGLICIQUE Aem Nas 2% Rhinaris-CS Anti-Allergic Nsl 01950541 PDP ADEFGVW Aém. CORTICOSTEROIDS CORTICOSTÉROÏDES BECLOMETHASONE BÉCLOMÉTHASONE Aem Nas 50mcg Apo-Beclomethasone AQ 02238796 APX ABDEFGVW Aém. Mylan-Beclo AQ 02172712 MYL ABDEFGVW BUDESONIDE BUDÉSONIDE Aem Nas 100mcg Rhinocort 02035324 AZE ADEFVW Aém. Aem Nas 64mcg Rhinocort Aqua 02231923 AZE ADEFVW Aém. Mylan-Budesonide 02241003 MYL ADEFVW Aem Nas 100mcg Mylan-Budesonide 02230648 MYL ADEFGVW Aém. September 2015 v.1 241

R01AD08 R01AD09 R01AX R03 R03A R01AX03 R03AC FLUTICASONE FLUTICASONE Aem Nas 50mcg Flonase AQ 02213672 GSK ABDEFGVW Aém. Apo-Fluticasone 02294745 APX ABDEFGVW ratio-fluticasone 02296071 TEV ABDEFGVW MOMETASONE MOMÉTASONE Asp Nas 0.1% Nasonex Aqueous 02238465 FRS ADEFGVW Asp Apo-Mometasone 02403587 APX ADEFGVW OTHER NASAL PREPARATIONS AUTRES PRÉPARATIONS NASALES IPRATROPIUM BROMIDE BROMURE D IPRATROPIUM Spr Nas 0.03% Atrovent Nasal 02163705 BOE ADEFGVW Vap pms-ipratropium 02239627 PMS ADEFGVW Spr Nas 0.06% Atrovent Nasal 02163713 BOE ADEFGVW Vap Ipravent 02246084 AAP ADEFGVW DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES MÉDICAMENTS CONTRE LES BRONCHOPNEUMOPATHIES OBSTRUCTIVES ADRENERGICS, INHALANTS ADRENERGIQUES, INHALANTS SELECTIVE BETA2-ADRENOCEPTOR AGONISTS AGONISTES DES RECEPTEURS ADRENERGIQUES BETA2 SELECTIFS R03AC02 SALBUTAMOL SALBUTAMOL Aem Inh 100mcg Airomir 02232570 VLN ABDEFGVW Aém. Ventolin 02241497 GSK ABDEFGVW Apo-Salvent CFC Free 02245669 APX ABDEFGVW Novo-Salbutamol 02326450 TEV ABDEFGVW Salbutamol HFA 02419858 SAS ABDEFGVW Inh 1mg/mL Ventolin Nebules P.F. 02213419 GSK BDEF-18GVW Med-Salbutamol 02237414 MED BDEF-18GVW pms-salbutamol 02208229 PMS BDEF-18GVW ratio-salbutamol unit/dose PF (Disc/Non-Disp Feb 10/17) 01986864 TEV BDEF-18GVW Teva-Salbutamol Sterinebs 01926934 TEV BDEF-18GVW Inh 2mg/mL Ventolin Nebules PF 02213427 GSK D-18G pms-salbutamol 02208237 PMS D-18G Teva-Salbutamol Sterinebs 02173360 TEV D-18G Inh 5mg/mL Ventolin 02213486 GSK BDEF-18GVW pms-salbutamol (Disc/non disp Mar 23/17) 02069571 PMS BDEF-18GVW ratio-salbutamol 00860808 TEV BDEF-18GVW Sandoz Salbutamol 02154412 SDZ BDEF-18GVW September 2015 v.1 242

03AC02 R03AC03 R03AC12 R03AC13 SALBUTAMOL SALBUTAMOL Pwr Inh 200mcg Ventolin Diskus 02243115 GSK ADEFGVW Pd. TERBUTALINE TERBUTALINE Pwr Inh 0.5mg Bricanyl Turbuhaler 00786616 AZE ADEFGVW Pd. SALMETEROL SALMÉTÉROL Pwr Inh 50mcg Serevent Diskus 02231129 GSK (SA) Pd. Serevent Diskhaler 02214261 GSK (SA) FORMOTEROL FORMOTÉROL Pwr Inh 6mcg Oxeze 02237225 AZE (SA) Pd. Pwr Inh 12mcg Oxeze 02237224 AZE (SA) Pd. R03AC18 R03AK R03AK06 Cap Inh 12mcg Foradil 02230898 NVR (SA) Caps. INDACATEROL INDACATÉROL Cap Inh 75mcg Onbrez Breezhaler 02376938 NVR (SA) Caps ADRENERGICS AND OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES ADRÉNERGIQUES ET AUTRES MÉDICAMENTS CONTRE LES BRONCHOPNEUMOPATHIES SALMETEROL AND OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES SALMÉTÉROL ET AUTRES MÉDICAMENTS CONTRE LES BRONCHOPNEUMOPATHIES SALMETEROL / FLUTICASONE SALMÉTÉROL / FLUTICASONE Pwr Inh 25mcg/125mcg Advair 125 02245126 GSK W (SA) Pd. Pwr Inh 25mcg/250mcg Advair 250 02245127 GSK W (SA) Pd. Pwr Inh 50mcg/100mcg Advair Diskus 02240835 GSK W (SA) Pd. Pwr Inh 50mcg/250mcg Advair Diskus 02240836 GSK W (SA) Pd. September 2015 v.1 243

R03AK06 R03AK07 SALMETEROL AND OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES SALMÉTÉROL ET AUTRES MÉDICAMENTS CONTRE LES BRONCHOPNEUMOPATHIES SALMETEROL / FLUTICASONE SALMÉTÉROL / FLUTICASONE Pwr Inh 50mcg/500mcg Advair Diskus 02240837 GSK W (SA) Pd. FORMOTEROL AND BUDESONIDE FORMOTÉROL ET BUDÉSONIDE Pwr Inh 100mcg/6mcg Symbicort MDI 02245385 AZE (SA) Pd. Pwr Inh 200mcg/6mcg Symbicort MDI 02245386 AZE (SA) Pd. R03AK09 FORMOTEROL AND MOMETASONE FORMOTÉROL ET MOMÉTASONE Aem Inh 5mcg/50mcg Zenhale (Disc/non disp May 7/17) 02361744 FRS (SA) Aém. Aem Inh 5mcg/100mcg Zenhale 02361752 FRS (SA) Aém. Aem Inh 5mcg/200mcg Zenhale 02361760 FRS (SA) Aém. R03AK10 R03AL R03AL03 VILANTEROL AND FLUTICASONE VILANTÉROL ET FLUTICASONE Pwr Inh 25mcg/100mcg Breo Ellipta 02408872 GSK (SA) Pd. ADRENERGICS IN COMBINATION WITH ANTICHOLINERGICS ADRÉNERGIQUES EN ASSOCIATION AVEC LES ANTICHOLINERGIQUES VILANTEROL AND UMECLIDINIUM BROMIDE VILANTÉROL ET BROMURE D UMÉCLIDINIUM Pwr Inh 25mcg/62.5mcg Anoro Ellipta 02418401 GSK (SA) Pds. R03AL04 INDACATEROL AND GLYCOPYRRONIUM BROMIDE INDACATÉROL ET BROMURE DE GLYCOPYRRONIUM Cap Inh 110mcg/50mcg Ultibro Breezhaler 02418282 NVR (SA) Caps. September 2015 v.1 244

R03B R03BA R03BA01 R03BA02 OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES, INHALANTS AUTRES MÉDICAMENTS CONTRE LES BRONCHOPNEUMOPATHIES OBSTRUCTIVES, INHALANTS GLUCOCORTICOIDS GLUCOCORTICOÏDES BECLOMETHASONE BÉCLOMÉTHASONE Aem Inh 50mcg Qvar 02242029 VLN ADEFGVW Aém. Aem Inh 100mcg Qvar 02242030 VLN ADEFGVW Aém. BUDESONIDE BUDÉSONIDE Pwr Inh 100mcg Pulmicort Turbuhaler 00852074 AZE ABDEFGVW Pd. Pwr Inh 200mcg Pulmicort Turbuhaler 00851752 AZE ABDEFGVW Pd. Pwr Inh 400mcg Pulmicort Turbuhaler 00851760 AZE ABDEFGVW Pd. Sus Inh 0.125mg/mL Pulmicort Nebuamp 02229099 AZE W Susp Sus Inh 0.25mg/mL Pulmicort Nebuamp 01978918 AZE ABDEFGVW Susp Sus Inh 0.5mg/mL Pulmicort Nebuamp 01978926 AZE ABDEFGVW Susp R03BA05 FLUTICASONE FLUTICASONE Aem Inh 50mcg Flovent Metered Dose HFA 02244291 GSK ABDEFGVW Aém. Aem Inh 125mcg Flovent Metered Dose HFA 02244292 GSK ABDEFGVW Aém. Aem Inh 250mcg Flovent Metered Dose HFA 02244293 GSK ABDEFGVW Aém. Pwr Inh 50mcg Flovent Diskus 02237244 GSK ABDEFGVW Pd. Pwr Inh 100mcg Flovent Diskus 02237245 GSK ABDEFGVW Pd. September 2015 v.1 245

R03BA05 FLUTICASONE FLUTICASONE Pwr Inh 250mcg Flovent Diskus 02237246 GSK ABDEFGVW Pd. Pwr Inh 500mcg Flovent Diskus 02237247 GSK ABDEFGVW Pd. R03BA07 MOMETASONE MOMÉTASONE Pwr Inh 200mcg Asmanex Twisthaler 02243595 MSD ADEFGVW Pd. Pwr Inh 400mcg Asmanex Twisthaler 02243596 MSD ADEFGVW Pd. R03BA08 CICLESONIDE CICLÉSONIDE Aem Inh 100mcg Alvesco 02285606 NYC ABDEFGVW Aém. Aem Inh 200mcg Alvesco 02285614 NYC ABDEFGVW Aém. R03BB ANTICHOLINERGICS ANTICHOLINERGIQUES R03BB01 IPRATROPIUM BROMIDE BROMURE D IPRATROPIUM Aem Inh 20mcg Atrovent HFA 02247686 BOE ABDEFGVW Aém. Inh 250mcg/mL Apo-Ipravent 02126222 APX BEF-18GVW Mylan-Ipratropium Soln 02239131 MYL BEF-18GVW Novo-Ipramide 02210479 TEV BEF-18GVW pms-ipratropium 02231136 PMS BEF-18GVW Inh 250mcg/mL pms-ipratropium (1mL nebules) 02231244 PMS BEF-18GVW pms-ipratropium (2mL nebules) 02231245 PMS BEF-18GVW ratio-ipratropium UDV 02097168 TEV BEF-18GVW Teva-Ipratropium 02216221 TEV BEF-18GVW R03BB04 TIOTROPIUM TIOTROPIUM Cap Inh 18mcg Spiriva 02246793 BOE (SA) Caps R03BB05 ACLIDINUM BROMIDE BROMURE D ACLIDINUM Pwr Inh 400mcg Tudorza Genuair 02409720 ALM (SA) Pd. September 2015 v.1 246

R03BB06 R03BC R03BC01 R03BX R03C R03BX99 R03CB R03CB03 R03CC R03D R03CC02 R03DA R03DA02 GLYCOPYRRONIUM BROMIDE BROMURE DE GLYCOPYRRONIUM Cap Inh 50mcg Seebri Breezhaler 02394936 NVR (SA) Caps ANTIALLERGIC AGENTS, EXCLUDING CORTICOSTEROIDS AGENTS ANTIALLERGIQUES, A L EXCLUSION DES CORTICOSTÉROÏDES CROMOGLICIC ACID ACIDE CROMOGLICIQUE Inh 1% pms-sodium Cromoglycate 02046113 PMS ABDEFGVW OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES, INHALANTS AUTRES MÉDICAMENTS CONTRE LES BRONCHOPNEUMOPATHIES OBSTRUCTIVES, INHALANTS HYPERTONIC SODIUM CHLORIDE CHLORURE DE SODIUM, HYPERTONIQUE Inh 7% Hyper-Sal 80029414 KEG BDEFG ADRENERGICS FOR SYSTEMIC USE ADRENERGIQUES, PRÉPARATIONS SYSTEMIQUES NON-SELECTIVE BETA-ADRENOCEPTOR AGONISTS AGONISTES DES RECEPTEURS ADRENERGIQUES BETA NON SELECTIFS ORCIPRENALINE ORCIPRÉNALINE Syr Orl 2mg/mL Orciprenaline 02236783 AAP ADEFGVW Sir. SELECTIVE BETA2-ADRENOCEPTOR AGONISTS AGONISTES DES RECEPTEURS ADRENERGIQUES BETA2 SELECTIFS SALBUTAMOL SALBUTAMOL Tab Orl 2mg Apo-Salvent 02146843 APX ADEFGVW Tab Orl 4mg Apo-Salvent 02146851 APX ADEFGVW OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES AUTRES MÉDICAMENTS CONTRE LES BRONCHOPNEUMOPATHIES OBSTRUCTIVES XANTHINES XANTHINES CHOLINE THEOPHYLLINATE (OXTRIPHYLLINE) THÉOPHYLLINATE CHOLINE (OXTRIPHYLLINE) Elx Orl 100mg/5mL Choledyl 00476366 ERF ADEFGVW Elx September 2015 v.1 247

R03DA04 THEOPHYLLINE THÉOPHYLLINE Orl 80mg/15mL Theolair 01966219 VLN ADEFGVW SRT Orl 100mg Apo-Theo LA 00692689 APX ADEFGVW L.L. Teva-Theophylline 02230085 TEV ADEFGVW SRT Orl 200mg Apo-Theo LA 00692697 APX ADEFGVW L.L. Teva-Theophylline SR 02230086 TEV ADEFGVW SRT Orl 300mg Apo-Theo LA 00692700 APX ADEFGVW L.L. Teva-Theophylline SR 02230087 TEV ADEFGVW SRT Orl 400mg Theo ER 02360101 AAP ADEFGVW L.L. Uniphyl 02014165 PFR ADEFGVW R03DC R03DC01 R03DC03 SRT Orl 600mg Theo ER 02360128 AAP ADEFGVW L.L. Uniphyl 02014181 PFR ADEFGVW LEUKOTRIENE RECEPTOR ANTAGONISTS ANTAGONISTES DES RECEPTEURS DU LEUCOTRIENE ZAFIRLUKAST ZAFIRLUKAST Tab Orl 20mg Accolate 02236606 AZE (SA) MONTELUKAST MONTÉLUKAST Gra Orl 4mg Singulair 02247997 FRS (SA) Gra Sandoz Montelukast 02358611 SDZ (SA) TabC Orl 4mg Singulair 02243602 FRS (SA) C. Apo-Montelukast 02377608 APX (SA) Auro-Montelukast Chewable 02422867 ARO (SA) Mar-Montelukast 02399865 MAR (SA) Mint-Montelukast 02408627 MNT (SA) Montelukast 02379317 SAS (SA) Montelukast 02382458 SIV (SA) Mylan-Montelukast 02380749 MYL (SA) pms-montelukast 02354977 PMS (SA) Ran-Montelukast 02402793 RAN (SA) Sandoz Montelukast 02330385 SDZ (SA) Teva-Montelukast 02355507 TEV (SA) September 2015 v.1 248

R05 R05C R03DC03 R05CA R05CA03 R05CB R05CB01 MONTELUKAST MONTÉLUKAST TabC Orl 5mg Singulair 02238216 FRS (SA) C. Apo-Montelukast 02377616 APX (SA) Mar-Montelukast 02399873 MAR (SA) Mint-Montelukast 02408635 MNT (SA) Montelukast 02379325 SAS (SA) Montelukast 02382466 SIV (SA) Mylan-Montelukast 02380757 MYL (SA) pms-montelukast 02354985 PMS (SA) Ran-Montelukast 02402807 RAN (SA) Sandoz Montelukast 02330393 SDZ (SA) Teva-Montelukast 02355515 TEV (SA) Tab Orl 10mg Singulair 02238217 FRS (SA) Apo-Montelukast 02374609 APX (SA) Auro-Montelukast 02401274 ARO (SA) Jamp-Montelukast 02391422 JPC (SA) Mar-Montelukast 02399997 MAR (SA) Mint-Montelukast 02408643 MNT (SA) Montelukast 02379333 SAS (SA) Montelukast 02382474 SIV (SA) Montelukast Sodium 02379236 AHI (SA) Mylan-Montelukast 02368226 MYL (SA) pms-montelukast 02373947 PMS (SA) Ran-Montelukast 02389517 RAN (SA) Sandoz Montelukast 02328593 SDZ (SA) Teva-Montelukast 02355523 TEV (SA) COUGH AND COLD PREPARATIONS PRÉPARATIONS CONTRE LA TOUX ET LE RHUME EXPECTORANTS, EXCLUDING COMBINATIONS WITH COUGH SUPPRESSANTS EXPECTORANTS, A L EXCLUSION D UNE COMBINAISON AVEC UN ANTITUSSIF EXPECTORANTS EXPECTORANTS GUAIFENESIN GUAIFÉNÉSINE Syr Orl 100mg/5mL Balminil 00608920 ROG G Sir Balminil Expect Sans Sucrose 00609951 ROG G Robitussin 01931032 WCH G MUCOLYTICS MUCOLYTIQUES ACETYLCYSTEINE ACÉTYLCYSTÉINE Inh 200mg/mL Mucomyst 02091526 WLS ADEFGVW Parvolex 02181460 BCH W Acetylcysteine 02243098 SDZ ADEFGVW September 2015 v.1 249

R05D R05CB13 R05DA R05DA04 DORNASE ALFA DORNASE ALPHA Inh 1mg/mL Pulmozyme 02046733 HLR (SA) COUGH SUPPRESSANTS, EXCLUDING COMBINATIONS WITH EXPECTORANTS ANTITUSSIFS, A L EXCLSION D UNE COMBINAISON AVEC UN EXPECTORANT OPIUM ALKALOIDS AND DERIVATIVES ALKALOIDES D OPIUM ET DÉRIVÉS CODEINE CODÉINE Inj 30mg/mL Codeine Phosphate 00544884 SDZ W Syr Orl 5mg/mL Codeine Phosphate 00050024 ATL ADEFGVW Sir ratio-codeine 00779474 RPH ADEFGVW Tab Orl 15mg Codeine 00779458 ROG ADEFGVW ratio-codeine 00593435 RPH ADEFGVW Tab Orl 30mg ratio-codeine 00593451 RPH ADEFGVW SRT Orl 50mg Codeine Contin 02230302 PFR W (SA) L.L. SRT Orl 100mg Codeine Contin 02163748 PFR W (SA) L.L. SRT Orl 150mg Codeine Contin 02163780 PFR W (SA) L.L. R05DA09 SRT Orl 200mg Codeine Contin 02163799 PFR W (SA) L.L. DEXTROMETHORPHAN DEXTROMÉTHORPHANE Orl 15mg/mL Koffex Sugar Free Clear 01928791 ROG G Sus Orl 30mg/5mL Delsym 02018403 NNC G Susp Syr Orl 3mg/mL Balminil DM 00436895 ROG G Sir Benylin DM 01944738 JNJ G Koffex DM 01928783 ROG G September 2015 v.1 250

R05F R05FA R06 R06A R05FA02 R06AA R06AA02 COUGH SUPPRESSANTS AND EXPECTORANTS, COMBINATIONS ANTITUSSIFS ET EXPECTORANTS, EN COMBINAISON OPIUM DERIVATIVES AND EXPECTORANTS DÉRIVÉS DE L OPIUM ET EXPECTORANTS OPIUM DERIVATIVES AND EXPECTORANTS DÉRIVÉS DE L OPIUM ET EXPECTORANTS GUAIFENESIN / DEXTROMETHORPHAN GUAIFÉNÉSINE / DEXTROMÉTHORPHANE Orl 20mg/3mg Robitussin DM Exp 01931024 WCH G GUAIFENESIN / DEXTROMETHORPHAN / PSEUDOEPHEDRINE GUAIFÉNÉSINE / DEXTROMÉTHORPHANE / PSEUDOÉPHÉDRINE Syr Orl 100mg/50mg/30mg Benylin DM-D-E 01944673 JNJ G Sir ANTIHISTAMINES FOR SYSTEMIC USE ANTIHISTAMINIQUES SYSTEMIQUES ANTIHISTAMINES FOR SYSTEMIC USE ANTIHISTAMINIQUES SYSTEMIQUES AMINOALKYL ETHERS AMINOALKYLETHERS DIPHENHYDRAMINE DIPHENHYDRAMINE Elx Orl 12.5mg/5mL Benadryl 02019736 JNJ G Elx Tab Orl 25mg Benadryl 02017849 JNJ G Diphenhydramine 02257548 JPC G R06AA09 R06AB R06AB04 Tab Orl 50mg Diphenhydramine 02257556 JPC G DOXYLAMINE DOXYLAMINE SRT Orl 10mg/10mg Diclectin 00609129 DUI DEFG L.L. SUBSTITUTED ALKYL AMINES AMINO-ALKYLES SUBSTITUTES CHLORPHENAMINE CHLORPHÉNAMINE Tab Orl 4mg Chlor-Tripolon 00738972 SCO G Novo-Pheniram 00021288 TEV G September 2015 v.1 251

R06AE R06AE07 R06AX R07 R07A R06AX13 R06AX17 R07AX S01 S01A R07AX02 S01AA S01AA07 PIPERAZINE DERIVATIVES DÉRIVÉS DU PIPERAZINE CETIRIZINE CÉTIRIZINE Tab Orl 10mg Reactine 02223554 JNJ G Apo-Cetirizine 02231603 APX G Extra Strength Allergy Relief 02315955 PMS G OTHER ANTIHISTAMINES FOR SYSTEMIC USE DIVERS ANTIHISTAMINIQUES SYSTEMIQUES LORATADINE LORATADINE Tab Orl 10mg Claritin 00782696 SCO G Apo-Loratadine 02243880 APX G KETOTIFEN KÉTOTIFÈNE Syr Orl 1mg/5mL Zaditen 00600784 TEV DEFG Sir Novo-Ketotifen (Disc/non disp Sep 11/15) 02176084 TEV DEFG Tab Orl 1mg Zaditen 00577308 TEV DEFG OTHER RESPIRATORY SYSTEM PRODUCTS AUTRES PRODUITS DU SYSTÈME RESPIRATOIRE OTHER RESPIRATORY SYSTEM PRODUCTS AUTRES PRODUITS DU SYSTÈME RESPIRATOIRE OTHER RESPIRATORY SYSTEM PRODUCTS AUTRES PRODUITS DU SYSTÈME RESPIRATOIRE IVACAFTOR IVACAFTOR Tab Orl 150mg Kalydeco 02397412 VTX (SA) OPHTHALMOLOGICALS AGENTS OPHTHALMOLOGIQUES ANTIINFECTIVES ANTIINFECTIEUX ANTIBIOTICS ANTIBIOTIQUES FRAMYCETIN FRAMYCÉTINE Dps Oph 0.5% Soframycin 02224887 ERF ADEFGVW Gttes September 2015 v.1 252

S01AA11 S01AA12 GENTAMICIN GENTAMICINE Dps Oph 0.3% Garamycin (Disc/non disp Sept 2/16) 00512192 FRS ADEFGVW Gttes TOBRAMYCIN TOBRAMYCINE Oph 0.3% Tobrex 00513962 ALC ADEFGVW pms-tobramycin (Disc/non disp Jun 1/16) 02239577 PMS ADEFGVW Sandoz Tobramycin 02241755 SDZ ADEFGVW Ont Oph 0.3% Tobrex 00614254 ALC ADEFGVW Ont S01AA17 S01AA30 S01AB S01AB04 S01AD S01AD02 S01AX S01AX11 ERYTHROMYCIN ÉRYTHROMYCINE Ont Oph 0.5% Erythromycin 02326663 SGQ ADEFGVW Ont pms-erythromycin 01912755 PMS ADEFGVW COMBINATIONS OF DIFFERENT ANTIBIOTICS EN COMBINAISON AVEC DIFFERENTS ANTIBIOTIQUES POLYMYXIN B SULFATE / BACITRACIN ZINC POLYMYXINE B (SULFATE DE) / BACITRACINE Ont Oph 10000IU/500IU Polysporin 02239157 JNJ G Ont SULFONAMIDES SULFONAMIDES SULFACETAMIDE SULFACÉTAMIDE Dps Oph 10% Sodium Sulamyd (Disc/non disp Dec 15/16) 00028053 SDZ ADEFGVW Gttes ANTIVIRALS ANTIVIRAUX TRIFLURIDINE TRIFLURIDINE Oph 1% Viroptic 00687456 VLN ADEFGVW OTHER ANTIINFECTIVES AUTRES ANTIINFECTIEUX OFLOXACIN OFLOXACINE Oph 0.3% Ocuflox 02143291 ALL W (SA) Apo-Ofloxacin 02248398 APX W (SA) Sandoz Ofloxacin (Disc/non disp Dec 31/16) 02247189 SDZ W (SA) September 2015 v.1 253

S01B S01AX13 S01AX20 S01BA S01BA01 S01BA04 CIPROFLOXACIN CIPROFLOXACINE Oph 0.3% Ciloxan 01945270 ALC W (SA) Sandoz Ciprofloxacin 02387131 SDZ W (SA) Ont Oph 0.3% Ciloxan 02200864 ALC W (SA) Ont OCRIPLASMIN OCRIPLASMINE IVL 2.5mg/mL Jetrea 02410818 ALC (SA) ANTIINFLAMMATORY AGENTS AGENTS ANTIINFLAMMATOIRES CORTICOSTEROIDS, PLAIN CORTICOSTÉROÏDES, ORDINAIRES DEXAMETHASONE DEXAMÉTHASONE Dps Oph 0.1% Maxidex 00042560 ALC ADEFGVW Gttes Ont Oph 0.1% Maxidex 00042579 ALC ADEFGVW Ont PREDNISOLONE PREDNISOLONE Oph 0.12% Pred Mild 00299405 ALL ADEFGVW Sus Oph 1% Pred Forte 00301175 ALL ADEFGVW Susp ratio-prednisolone 00700401 RPH ADEFGVW Sandoz Prednisolone 01916203 SDZ ADEFGVW S01BA07 FLUOROMETHOLONE FLUOROMÉTHOLONE Dps Oph 0.1% FML 00247855 ALL ADEFGVW Gttes pms-fluorometholone (Disc/non disp Jun 11/16) 02238568 PMS ADEFGVW Sandoz Fluorometholone 00432814 SDZ ADEFGVW Sus Oph 0.25% FML Forte 00707511 ALL ADEFGVW Susp Sus Oph 0.1% Flarex 00756784 ALC ADEFGVW Susp September 2015 v.1 254

S01BC S01C S01BC03 S01BC05 S01CA S01CA01 ANTIINFLAMMATORY AGENTS, NON STEROIDS AGENTS ANTIINFLAMMATOIRES, NON STÉROÏDIENS DICLOFENAC DICLOFÉNAC Oph 0.1% Voltaren 01940414 ALC ADEFGVW KETOROLAC KÉTOROLAC Oph 0.45% Acuvail 02369362 ALL ADEFGVW Oph 0.5% Acular 01968300 ALL ADEFGVW Ketorolac 02245821 AAP ADEFGVW ANTIINFLAMMATORY AGENTS & ANTIINFECTIVES IN COMBINATION AGENTS ANTIINFLAMMATOIRES ET ANTIINFECTIEUX EN COMBINAISON CORTICOSTEROIDS AND ANTIINFECTIVES IN COMBINATION CORTICOSTÉROÏDES ET ANTIINFECTIEUX EN COMBINAISON DEXAMETHASONE AND ANTIINFECTIVES DEXAMÉTHASONE ET ANTIINFECTIEUX DEXAMETHASONE / NEOMYCIN / POLYMYXIN B DEXAMÉTHASONE / NÉOMYCINE / POLYMYXINE B Sus Oph 1mg/3.5mg/6000IU Maxitrol 00042676 ALC ADEFGVW Susp Ont Oph 1mg / 3.5mg / 6000IU Maxitrol 00358177 ALC ADEFGVW Ont DEXAMETHASONE / TOBRAMYCIN DEXAMÉTHASONE / TOBRAMYCINE Ont Oph 0.3% / 0.1% Tobradex 00778915 ALC ADEFGVW Ont S01CA02 Sus Oph 0.3% / 0.1% Tobradex 00778907 ALC ADEFGVW Susp PREDNISOLONE AND ANTIINFECTIVES PREDNISOLONE ET ANTIINFECTIEUX PREDNISOLONE / SULFACETAMIDE PREDNISOLONE / SULFACÉTAMIDE Dps Oph 10% / 0.2% Blephamide 00807788 ALL ADEFGVW Gttes Ont Oph 10% / 0.2% Blephamide S.O.P. 00307246 ALL ADEFGVW Ont September 2015 v.1 255

S01E S01EA S01EA03 S01EA05 S01EB S01EB01 ANTIGLAUCOMA PREPARATIONS AND MIOTICS PRÉPARATIONS ANTIGLAUCOME ET MIOTIQUES SYMPATHOMIMETICS IN GLAUCOMA THERAPY ADRENERGIQUES POUR LE TRAITEMENT DU GLAUCOME APRACLONIDINE APRACLONIDINE Oph 0.5% Iopidine 02076306 ALC ADEFVW BRIMONIDINE BRIMONIDINE Oph 0.15% Alphagan P 02248151 ALL ADEFVW Brimonidine P 02301334 AAP ADEFVW Oph 0.2% Alphagan 02236876 ALL ADEFVW Apo-Brimonidine 02260077 APX ADEFVW pms-brimonidine 02246284 PMS ADEFVW ratio-brimonidine 02243026 TEV ADEFVW Sandoz Brimonidine 02305429 SDZ ADEFVW PARASYMPATHOMIMETICS PARA-ADRENERGIQUES PILOCARPINE PILOCARPINE Dps Oph 1% Isopto Carpine 00000841 ALC ADEFGVW Gttes Dps Oph 2% Isopto Carpine 00000868 ALC ADEFGVW Gttes Dps Oph 4% Isopto Carpine 00000884 ALC ADEFGVW Gttes S01EC S01EC01 S01EC03 Dps Oph 6% Pilocarpine 02230239 IVX ADEFGVW Gttes CARBONIC ANHYDRASE INHIBITORS INHIBITEURS DE L ANHYDRASE CARBONIQUE ACETAZOLAMIDE ACÉTAZOLAMIDE Tab Orl 250mg Acetazolamide 00545015 AAP ADEFGVW DORZOLAMIDE DORZOLAMIDE Oph 2% Trusopt 02216205 FRS ADEF18+VW Sandoz Dorzolamide 02316307 SDZ ADEF18+VW September 2015 v.1 256

S01EC04 S01EC05 S01ED BRINZOLAMIDE BRINZOLAMIDE Oph 1% Azopt 02238873 ALC ADEF18+V METHAZOLAMIDE MÉTHAZOLAMIDE Tab Orl 50mg Methazolamide 02245882 AAP ADEFGVW BETA BLOCKING AGENTS BETA-BLOQUANTS S01ED01 TIMOLOL TIMOLOL Dps Oph 0.25% Apo-Timop 00755826 APX ADEFGVW Gttes pms-timolol 02083353 PMS ADEFGVW Sandoz Timolol Maleate 02166712 SDZ ADEFGVW Dps Oph 0.5% Timoptic Oph 00451207 FRS ADEFGVW Gttes Apo-Timop 00755834 APX ADEFGVW pms-timolol 02083345 PMS ADEFGVW Sandoz Timolol Maleate 02166720 SDZ ADEFGVW Oph 0.25% Timoptic-XE Oph 02171880 FRS ADEFGVW Timolol Maleate-EX 02242275 SDZ ADEFGVW Oph 0.5% Timoptic-XE Oph 02171899 FRS ADEFGVW Timolol Maleate-EX 02242276 SDZ ADEFGVW Apo-Timop 02290812 APX ADEFGVW S01ED02 BETAXOLOL BÉTAXOLOL Sus Oph 0.25% Betoptic S 01908448 ALC ADEFVW Susp S01ED03 LEVOBUNOLOL LÉVOBUNOLOL Oph 0.25% ratio-levobunolol (Disc/non disp Sept 29/16) 02031159 TEV ADEFGVW Oph 0.5% Betagan 00637661 ALL ADEFGVW ratio-levobunolol (Disc/non disp Sept 29/16) 02031167 TEV ADEFGVW Sandoz Levobunolol (Disc/non disp Dec 31/16) 02241716 SDZ ADEFGVW S01ED51 TIMOLOL COMBINATIONS TIMOLOL EN COMBINAISON TIMOLOL / BRIMONIDINE TIMOLOL / BRIMONIDINE Oph 0.5%/0.2% Combigan 02248347 ALL ADEFGVW September 2015 v.1 257

S01EE S01ED51 S01EE01 S01EE03 S01EE04 TIMOLOL COMBINATIONS TIMOLOL EN COMBINAISON TIMOLOL / BRINZOLAMIDE TIMOLOL / BRINZOLAMIDE Sus Oph 0.5%/1% Azarga 02331624 ALC ADEF18+VW Susp TIMOLOL / DORZOLAMIDE TIMOLOL / DORZOLAMIDE Oph 2%/0.5% Cosopt 02240113 FRS ADEFVW Act Dorzotimolol 02404389 ATV ADEFVW Apo-Dorzo-Timop 02299615 APX ADEFVW Sandoz Dorzolamide/Timolol 02344351 SDZ ADEFVW Teva-Dorzotimol 02320525 TEV ADEFVW TIMOLOL / LATANOPROST TIMOLOL / LATANOPROST Oph 0.005%/0.5% Xalacom 02246619 PFI ADEFVW Apo-Latanoprost-Timop 02414155 APX ADEFVW GD-Latanoprost/Timolol 02373068 GMD ADEFVW Sandoz Latanoprost/Timolol 02394685 SDZ ADEFVW TIMOLOL / TRAVOPROST TIMOLOL / TRAVOPROST Oph 0.5%/0.004% Duo Trav 02278251 ALC ADEFVW PROSTAGLANDIN ANALOGUES ANALOGUES DE LA PROSTAGLANDINE LATANOPROST LATANOPROST Oph 0.005% Xalatan 02231493 PFI ADEFGVW Apo-Latanoprost 02296527 APX ADEFGVW Act Latanoprost 02254786 ATV ADEFGVW GD-Latanoprost 02373041 GMD ADEFGVW Latanoprost 02375508 PMS ADEFGVW Sandoz Latanoprost 02367335 SDZ ADEFGVW pms-latanoprost 02317125 PMS ADEFGVW BIMATOPROST BIMATOPROST Oph 0.01% Lumigan RC 02324997 ALL ADEFGVW TRAVOPROST TRAVOPROST Oph 0.004% Travatan Z 02318008 ALC ADEFGVW Apo-Travoprost Z 02415739 APX ADEFGVW Sandoz Travoprost 02413167 SDZ ADEFGVW Teva-Travoprost 02412063 TEV ADEFGVW September 2015 v.1 258

S01F S01FA S01FA01 S01FA04 S01FA05 MYDRIATICS AND CYCLOPLEGICS MYDRIATIQUES ET CYCLOPLEGIQUES ANTICHOLINERGICS ANTICHOLINERGIQUES ATROPINE ATROPINE Dps Oph 1% Isopto Atropine 00035017 ALC ADEFGVW Gttes CYCLOPENTOLATE CYCLOPENTOLATE Oph 1% Cyclogyl 00252506 ALC ADEFGVW HOMATROPINE HOMATROPINE Oph 2% Isopto Homatropine 00000779 ALC ADEFGVW Oph 5% Isopto Homatropine 00000787 ALC ADEFGVW S01G S01FA06 S01GX S01GX01 S01GX08 TROPICAMIDE TROPICAMIDE Oph 0.5% Mydriacyl 00000981 ALC ADEFGVW Oph 1% Mydriacyl 00001007 ALC ADEFGVW DECONGESTANTS AND ANTIALLERGICS DÉCONGESTIONNANTS ET ANTIALLERGIQUES OTHER ANTIALLERGICS AUTRES ANTIALLERGIQUES CROMOGLICIC ACID ACIDE CROMOGLICIQUE Oph 2% Cromolyn Ophthalmic Solution 02009277 PDP ADEFGVW Opticrom 02230621 ALL ADEFGVW KETOTIFEN KÉTOTIFÈNE Oph 0.025% Zaditor 02242324 NVO ADEFGVW September 2015 v.1 259

S01GX09 OLOPATADINE OLOPATADINE Oph 0.2% Pataday 02362171 ALC ADEFGVW S01L S01LA S01LA04 OCULAR VASCULAR DISORDER AGENTS AGENTS POUR LES TROUBLES VASCULAIRES OCULAIRES ANTINEOVASCULARISATION AGENTS AGENTS ANTINÉOVASCULAIRES RANIBIZUMAB RANIBIZUMAB IVL 10mg/mL Lucentis 02296810 NVO (SA) S01LA05 AFLIBERCEPT AFLIBERCEPT IVL 40mg/mL Eylea 02415992 BAY (SA) S01X S01XA S01XA03 OTHER OPTHALMOLOGICALS AUTRES OPTHALMOLOGIQUES OTHER OPTHALMOLOGICALS AUTRES OPTHALMOLOGIQUES SODIUM CHLORIDE, HYPERTONIC CHLORURE DE SODIUM, HYPERTONIQUE Dps Oph 5% Muro 128 00750824 BSH AEFGVW Gttes S02 S02A S02AA S02AA14 Ont Oph 5% Muro 128 00750816 BSH AEFGVW Ont Odan-Sodium Chloride 80046696 ODN AEFGVW OTOLOGICALS AGENTS OTOLOGIQUES ANTIINFECTIVES ANTIINFECTIEUX ANTIINFECTIVES ANTIINFECTIEUX GENTAMICIN GENTAMICINE Dps Ot 0.3% Garamycin (Disc/non disp Mar 3/16) 00512184 FRS ADEFGVW Gttes Sandoz Gentamicin 02229441 SDZ ADEFGVW September 2015 v.1 260

S02C S02AA30 S02CA S02CA02 S02CA06 ANTIINFECTIVES, COMBINATIONS ANTIINFECTIEUX, EN COMBINAISON ALUMINUM ACETATE / BENZETHONIUM CHLORIDE ACÉTATE D ALUMINIUM / CHLORURE DE BENZÉTHONIUM Ot 0.5%/0.03% Buro-Sol Otic (Disc/Non-Disp Jan 5/17) 00674222 TCD ADEFGVW CORTICOSTEROIDS AND ANTIINFECTIVES IN COMBINATION CORTICOSTÉROÏDES ET ANTIINFECTIEUX EN COMBINAISON CORTICOSTEROIDS AND ANTIINFECTIVES IN COMBINATION CORTICOSTÉROÏDES ET ANTIINFECTIEUX EN COMBINAISON FLUMETASONE AND ANTIINFECTIVES FLUMETASONE ET ANTIINFECTIEUX FLUMETASONE / CLIOQUINOL FLUMÉTASONE / CLIOQUINOL Dps Ot 1%/0.02% Locacorten-Vioform 00074454 PAL ADEFGVW Gttes DEXAMETHASONE AND CIPROFLOXACINE DEXAMÉTHASONE ET CIPROFLOXACINE Ot 0.3%/0.1% Ciprodex 02252716 ALC (SA) S03 OPHTHALMOLOGICAL AND OTOLOGICAL PREPARATIONS PRÉPARATIONS OPHTHALMOLOGIQUES ET OTOLOGIQUES S03C CORTICOSTEROIDS AND ANTIINFECTIVES IN COMBINATION CORTICOSTÉROÏDES ET ANTIINFECTIEUX EN COMBINAISON S03CA CORTICOSTEROIDS AND ANTIINFECTIVES IN COMBINATION CORTICOSTÉROÏDES ET ANTIINFECTIEUX EN COMBINAISON S03CA01 DEXAMETHASONE AND ANTIINFECTIVES DEXAMÉTHASONE ET ANTIINFECTIEUX DEXAMETHASONE / FRAMYCETIN / GRAMICIDIN DEXAMÉTHASONE / FRAMYCÉTINE / GRAMICIDINE S03CA06 Dps Oph 5mg/0.5mg/0.05mg Sofracort E/E 02224623 SAV ADEFGV Gttes BETAMETHASONE AND ANTIINFECTIVES BÉTAMÉTHASONE ET ANTIINFECTIEUX BETAMETHASONE / GENTAMICIN BÉTAMÉTHASONE / GENTAMICINE Oph 0.3%/0.1% Garasone (Disc/non disp Apr 01/16) 00682217 FRS ADEFGVW Sandoz Pentasone 02244999 SDZ ADEFGVW September 2015 v.1 261

V01 V01A V01AA V01AA02 ALLERGENS ALLERGENES ALLERGENS ALLERGENES ALLERGEN EXTRACTS EXTRAITS D ALLERGENES GRASS POLLEN POLLEN DE GRAMINÉES Slt Orl 100IR Oralair 02381885 STA (SA) S.L. Slt Orl 300IR Oralair 02381893 STA (SA) S.L. V03 V03A V01AA20 V03AC V03AC01 V03AC03 VARIOUS ALLERGEN EXTRACTS DIVERS EXTRAITS D ALLERGENE Inj Allergy Sera 00999938 HJM EF-18G ALL OTHER THERAPEUTIC PRODUCTS TOUS LES AUTRES PRODUITS THERAPEUTIQUES ALL OTHER THERAPEUTIC PRODUCTS TOUS LES AUTRES PRODUITS THERAPEUTIQUES IRON CHELATING AGENTS AGENTS CHÉLATEURS DE FER DEFEROXAMINE DÉFÉROXAMINE Pws Inj 500mg Desferal 01981242 NVR ADEFGVW Pds. Deferoxamine Mesilate 02241600 HOS ADEFGVW pms-deferoxamine 02242055 PMS ADEFGVW Pws Inj 2g Desferal 01981250 NVR ADEFGVW Pds. Deferoxamine Mesilate 02247022 HOS ADEFGVW pms-deferoxamine 02243450 PMS ADEFGVW DEFERASIROX DÉFÉRASIROX Tab Orl 125mg Exjade 02287420 NVR (SA) Tab Orl 250mg Exjade 02287439 NVR (SA) Tab Orl 500mg Exjade 02287447 NVR (SA) September 2015 v.1 262

V03AE V03AF V03AE01 V03AE02 V03AF03 V03AG V04 V04C V04CJ V03AG99 V04CJ01 FOR TREATMENT OF HYPERKALEMIA AND HYPERPHOSPHATEMIA POUR LE TRAITEMENT DE HYPERKALEMIA ET HYPERPHOSPHATEMIA POLYSTYRENE SULFONATE POLYSTYRÈNE SULFONATE Pws Orl 100% Kayexalate 02026961 SAV ADEFGVW Pds. Solystat 00755338 PDP ADEFGVW Sus Orl 250mg/mL Solystat 00769541 PDP ADEFGVW Susp SEVELAMER SEVELAMER Tab Orl 800mg Renagel 02244310 SAV (SA) DETOXIFYING AGENTS FOR ANTINEOPLASTIC TREATMENT AGENTS DÉTOXIFIANTS POUR TRAITEMENT ANTINÉOPLASIQUE CALCIUM FOLINATE FOLINATE DE CALCIUM Tab Orl 5mg Leucovorin Calcium 02170493 PFI ADEFGVW DRUGS FOR TREATMENT OF HYPERCALCEMIA MÉDICAMENTS POUR LE TRAITEMENT DE L HYPERCALCEMIE DRUGS FOR TREATMENT OF HYPERCALCEMIA MÉDICAMENTS POUR LE TRAITEMENT DE L HYPERCALCEMIE SODIUM ACID PHOSPHATE / SODIUM BICARBONATE / POTASSIUM PHOSPHATE ACIDE DE SODIUM / SODIUM (BICARBONATE DE) / POTASSIUM Evt Orl 356mg/350mg/315mg Phosphate Novartis 80027202 NVR G Eff. DIAGNOSTIC AGENTS AGENTS DIAGNOSTIQUES OTHER DIAGNOSTIC AGENTS AUTRES AGENTS DIAGNOSTIQUES TESTS FOR THYREOIDEA FUNCTION TESTS DE LA FONCTION THYROÏDIENNE THYROTROPIN THYROTROPINE Pws IM 0.9mg Thyrogen 02246016 GZM (SA) Pds September 2015 v.1 263

V07 V07A V07AY V07AY90 ALL OTHER NON-THERAPEUTIC PRODUCTS TOUS LES AUTRES PRODUITS NON THERAPEUTIQUES ALL OTHER NON-THERAPEUTIC PRODUCTS TOUS LES AUTRES PRODUITS NON THERAPEUTIQUES OTHER NON-THERAPEUTIC AUXILLIARY PRODUCTS AUTRES PRODUITS AUXILIAIRES NON THERAPEUTIQUES PLACEBO PLACEBO Cap Orl 100mg Placebo 00501190 ODN AEFGVW Caps September 2015 v.1 264

APPENDIX I-A / ANNEXE I-A ABBREVIATIONS OF DOSAGE FORMS / ABRÉVIATIONS DES FORMES POSOLOGIQUES FORM CODE FORME Metered-Dose Aerosol Aem/Aém. Aérosol-dose mesurée Aerosol (with propellants) Aer/Aér. Aérosol (avec agents de propulsion) Aerosol (without propellants) Asp Aérosol (sans agents de propulsion) Capsule Cap/Caps Capsule Chewable Tablets TabC/C. Comprimés à croquer Controlled Delivery Capsules CDC/Caps.L.C. Capsules à libération contrôlée Cleanser Clr/Net Nettoyant Cream Crm/Cr. Crème Cartridge Ctg/Cart Cartouche Douche Dch Douche Delayed Action (Injectables) Dla Soluté injectable-retard Delayed Release Capsule CDR/Caps.L.R. Capsule à liberation retardée Drop Dps/Gttes Gouttes Dressing Dre Pansement Enteric Coated Capsule ECC/Caps.Ent. Capsule entérique Each Ech/Ch Chacun Enteric Coated Granule Ecg Granule entérique Enteric Coated Tablet ECT/Ent Comprimés entérique Elixir Elx Élixir Emulsion Eml/Émuls Émulsion Enema Enm/Lav. Lavement Extended Release ER À libération prolongée Extended Release Capsules ERC/Caps.L.P. Capsules à libération prolongée Extended Release Tablets ERT/L.P. Comprimés à libération prolongée Effervescent Granule Evg/Gev Granule effervescente Effervescent Powder Ecp/Pev Poudre effervescente Effervescent Tablet Evt/Eff. Comprimé effervescent Film Coated FC pelliculés Gas Gas Gaz Gel Gel Gelée Granules Gran Granules Immediate release IR Libération immédiate September 2015 v.1 A - 1

APPENDIX I-A / ANNEXE I-A ABBREVIATIONS OF DOSAGE FORMS / ABRÉVIATIONS DES FORMES POSOLOGIQUES FORM CODE FORME Inhaler Inh Inhalateur Instrument Ins Pièce à insérer Insulin Ins Insuline Kit Kit/Tro Trousse Liniment Lin Liniment uid uide Lente Suspension Lla/Susp. Suspension Lotion Lot Lotion Lozenge Loz Pastille Miscellaneous Misc Divers Mist, Aerosol Mst/Baer Bruine en aérosol Mouthwash MWH/R.-B. rince-bouche Nebules Neb Nébules Orally Disintegrating Film ODF Film à désintégration orale Orally Disintegrating Tablet ODT/D.O. Comprimés à désintégration orale Oral liquid O/L uide Oral Ointment Ont Onguent, pommade Pad Pad/Gaze Compresse Package Pck Paquet Paste Pst Pâte Patch Pth Timbre cutané Preservative Free PF Sans agent de conservation Powder Pwr/Pd. Poudre Powder For Solution Pws/Pds. Poudre pour solution Rapid Dissolving RD Dissolution rapide Rapid Disintegrating RPD Désintégration rapide Shampoo Shp Shampooing Semi-Lente Suspension SLA Suspension semi-lente Slow release SR Libération lente Sublingual Tablet Slt/S.L. Comprimé sublingual Spray Spr/Vap Vaporisateur September 2015 v.1 A - 2

APPENDIX I-A / ANNEXE I-A ABBREVIATIONS OF DOSAGE FORMS / ABRÉVIATIONS DES FORMES POSOLOGIQUES FORM CODE FORME Sustained-Released Capsule SRC/Caps.L.L. Capsule à liberation lente Packet Packet/Sachets Sachet/Paquet, Sustained-Release Disc Srd Disque à action soutenue Sustained-Release Syrup SRS Sirop à action soutenue Sustained-Release Tablet SRT/L.L. Comprimé à liberation lente Suppository Sup/Supp. Suppositoire Suspension Susp/Susp Suspension Syrup Syr/Sir. Sirop Tablet Tab/ Comprimé Ultra-Lente Suspension Ula Suspension ultra-lente Wafer Waf Gaufrette September 2015 v.1 A - 3

APPENDIX I-B/ ANNEXE I-B ABBREVIATIONS OF ROUTES / ABRÉVIATIONS DES VOIES D ADMINISTRATION ROUTE CODE VOIE Buccal Buc Buccale, orale Dental Den Dentaire Intra Articular IA Intra-articulaire Intrabursal IBU Intrabursique Intracardiac ICD Intracardiaque Intracavity ICV Intra-cavitaire Intradermal ID Intradermique Intramuscular IM Intramusculaire Intervertebral IND Intervertébrale Intrafollicular INF Intra-folliculaire Inhalation Inh Inhalation Injectable Inj Injectable Instrument(s) Ins Instrument(s) Intrathecal INT Intra-thécale Intraocular IO Intraoculaire Intraperitoneal IP Intrapéritonéale Intrapleural IPL Intrapleurale Intrapulmonary IPU Intrapulmonaire Intravitreal IVL Intravitréenne Irrigation IR Irrigation Instillation ISL Instillation Intravenous IV intraveineuse Intraventicular IVR Intraventriculaire Miscellaneous Mis Divers Nasal Nas Nasale Nil NIL Néant Ophthalmic Oph Ophtalmique Oral Orl Orale Otic Ot Otique Parenteral (Unspecified) Prt Parentérale (non spécifiée) Retrobulbar RB Rétrobulbaire September 2015 v.1 A - 4

APPENDIX I-B/ ANNEXE I-B ABBREVIATIONS OF ROUTES / ABRÉVIATIONS DES VOIES D ADMINISTRATION ROUTE CODE VOIE Rectal Rt Rectale Sublingual Slg Sublinguale Topical Top Topique Transdermal Trd Transdermique Vaginal Vag Vaginale September 2015 v.1 A - 5

APPENDIX I-C/ ANNEXE I-C ABBREVIATIONS OF UNITS / ABRÉVIATIONS DES UNITÉS DE MESURE UNIT CODE UNITÉS Ampoule Amp Ampoule Billion B Milliard Bottle Bottl Flacon, bouteille Box Box Boîte Capsule Cap Capsule Cubic Centimetre CC Centimètre cube Centimetre cm Centimètre Disk Disk Disque Fluid Ounce Fl oz Once liquide Gallon Gal Gallon Gram g Gramme Grain Gr Grain Kilogram kg Kilogramme Kit Kit/Tro Trousse Litre L Litre Pound lb Livre Lozenge Loz Pastille Million M Million Microgram mcg Microgramme Milli-equivalent meq Milli-équivalent Milligram mg Milligramme Drop dps/gttes Goutte Millitre ml Millilitre Millimole Mmol Millimole Nil Nil Néant Ounce oz Once Package Pcg Paquet, emballage Syringe SYR Seringue Tablet Tab/ Comprimé Tablespoon Tbs Cuillerée à soupe Trace Trace Trace September 2015 v.1 A - 6

APPENDIX I-C/ ANNEXE I-C ABBREVIATIONS OF UNITS / ABRÉVIATIONS DES UNITÉS DE MESURE UNIT CODE UNITÉS Teaspoon Tsp Cuillerée à thé Tube Tube Tube International Unit IU Unité internationale Vial Vial Fiole By Weight w/w En poids September 2015 v.1 A - 7

APPENDIX I-D / ANNEXE I-D ABBREVIATIONS OF MANUFACTURER'S NAMES/ABRÉVIATIONS DES NOMS DE FABRICANTS AAP ABB AGA AHI AJP ALC ALL APR APX ARO ASL ASP ATL ATV AVE AXC AXS AZE BAX BAY BCH BGP BIF BIG BOE BRI BSH CDX CHU CLC COB CYI DCL DPT DUI EMD ERF EUR FEI FRS GAC GCH GIL GLE GMD GMP GNC GND GSK HAL HHC HJM HLR HOS INP IVX JAM JAN JCB JNJ JPC KNG KRI AA Pharma Inc. Abbott Laboratories, Ltd. Amgen Canada Inc. Accord Healthcare Inc. Agila-Jamp Canada Inc. Alcon Canada Inc. Allergan Inc. Aspri Pharma Canada Inc. Apotex Inc. Auro Pharma Inc. Astellas Pharma Canada Inc. Actavis Specialty Pharmaceuticals Laboratoire Atlas Inc. Actavis Pharma Company Aventis Pharma Inc. Aptalis Axxess Pharma Inc. Astra Zeneca Pharma Baxter Corporation Bayer Inc., HealthCare Division Bioniche Inc. BGP Pharma Inc. Bioforce Canada Ltd/Ltee. Biogen Idec Canada, Inc. Boehringer Ingelheim (Canada) Ltd. Bristol-Myers Squibb Canada Inc. Baush & Lomb Canada Inc. Canderm Pharma Inc. Church and Dwight Canada Corp. Columbia Laboratories Canada Inc. Cobalt Pharmaceuticals Company Cytex Pharmaceuticals Inc. D.C. Labs Limited Dermtek Pharmaceuticals Ltd Duchesnay EMD Serono Canada Inc. Erfa Canada Inc. Europharm International Canada Inc. Ferring Inc. Merck Canada Inc. Galderma Canada Inc. GlaxoSmithKline Consumer Healthcare Inc. Gilead Sciences Inc. Glenwood Laboratories Canada Ltd. GenMed, a division of Pfizer Canada Inc. Generic Medical Partners General Nutrition Canada Inc. Golden Neo-Life Diamite International Lt GlaxoSmithKline Hall Laboratories Ltd. Holista Health Corporation Medavie Blue Cross Hoffmann-La Roche Ltd/Ltee. Hospira Healthcare Corporation Insight Pharmaceuticals Corp. Ivax Pharmaceuticals Canada Inc. Jamieson Laboratories Ltd. Janssen Inc. Jacobus Pharmaceutical Company Inc. Johnson & Johnson Consumer Group Jamp Pharma Corporation King Pharmaceuticals Canada Kripps Pharmacy Ltd LBK LEO LIL MAR MDI MDS MED MEL MJO MLA MNT MRS MTP MVL MYL NEO NGP NNC NNO NOP NSE NUM NVO NVR NYC ODN OMG PAL PAT PDL PDP PFI PFR PHL PMS PMT PPC PVR QGT RAN RHG RIK ROG RPH SAS SAV SCH SCO SDZ SEP SEV SHI SIV SNE SNS SNV SPH SPT STR SWS TAR TCD Lundbeck Inc. Leo Pharma Inc. Eli Lilly Canada Inc. Marcan Pharmaceuticals Inc Medtech Products Inc. Medicis Canada LTD./LTEE. Medican Pharma Inc. Meliapharm Inc. Mead Johnson Canada Proctor & Gamble Healthcare Mint Pharmaceuticals Inc. Merus Labs Inc. Methapharm Inc. Meda Valeant Pharma Canada Inc. Mylan Pharmaceuticals ULC Neo Lab Inc. Next Generation Pharma Inc. Novartis Consumer Health Canada Inc. Novo Nordisk Canada Inc. Novopharm Ltd. Nutri Souce Inc Les Aliments 4349121 Canada Inc. Novartis Ophthalmics Novartis Pharmaceuticals Canada Inc. Nycomed Canada Inc. Odan Laboratories Ltd. Omega Laboratories Limited Paladin Labs Inc. Pathogenesis Canada Ltd Pro Doc Laboratories Ltd PendoPharm, a Division of Pharmascience Inc. Pfizer Canada Inc. Purdue Pharma Pharmel Inc (Div of PMS/Price D.Shipp) Pharmascience Inc. Pharmetics Inc. Pharmaceutical Partners of Canada Pharmavite Corporation Sigma-Tau Ranbaxy Pharmaceuticals Canada Inc. Rheningold Food International Ltd. 3M Pharmaceuticals Rougier Pharma Inc, Div of Ratiopharm Ratiopharm Inc. Sanis Health Inc. Sanofi-Aventis Canada Inc. Schering-Plough Canada Inc. Schering-Plough (Canada) Inc. Sandoz Canada Incorporated Sepracor Pharmaceuticals Inc. Servier Canada Inc. Shire Canada Inc. Sivem Pharmaceuticals Smith & Nephew, Inc. Sanofi-Synthelabo Canada Inc. Sunovion Pharmaceuticals Canada Inc Solvay Pharma Inc. Septa Pharmaceuticals Inc. Sterimax Inc. Swiss Herbal Remedies Ltd Taro Pharmaceuticals Inc. Trans Canaderm Inc. September 2015 v.1 A - 8

APPENDIX I-D / ANNEXE I-D ABBREVIATIONS OF MANUFACTURER'S NAMES/ABRÉVIATIONS DES NOMS DE FABRICANTS TCH TEV TPH TRB TRI UCB VAL VIV VLH Technilab, Inc. Teva Canada Limited TaroPharma, Divison of Taro Pharmaceuticals Tribute Pharmaceuticals Triton Pharma Inc. UCB Canada Inc. Valeo Pharma Inc. ViiV Healthcare ULC Lundbeck Canada Inc. VLN VTH WAM WCH WLS WNC XPI YNO ZYM Valeant Canada Ltd. Vita Health Company (1985) Ltd Wampole Brands Wyeth Consumer Healthcare Inc. Wellspring Pharmaceutical Cananda Corp. Warner Chilcott Canada Xediton Pharmaceuticals Inc. Bayer Inc. Consumer Care Division Zymcan Pharmaceuticals Inc. September 2015 v.1 A - 9

APPENDIX II Extemporaneous Preparations Extemporaneous preparations are defined as a drug or mixture of drugs prepared or compounded in a pharmacy according to the order of a prescriber. To be eligible as a benefit, extemporaneous preparations must be in the list below or: 1. be specifically tailored to a physician's prescription and 2. contain one or more drugs presently considered a benefit and 3. not duplicate the formulation of a manufactured drug product and 4. not contain drugs in the exclusion list Claims for Extemporaneous Preparations listed below are to be submitted electronically using the PIN assigned to the product. Claims for Extemporaneous Preparations not listed below are to be submitted electronically using the DIN of at least one ingredient which is a program benefit. This claim must be identified by entering the appropriate CPhA version 3 code. Note: When there is a shortage or no supply of a commercially available product and the healthcare professional has determined a medical need for this product, the product may be compounded during the period of shortage or no supply only. (Health Products and Food Branch Inspectorate Policy on Manufacturing and Compounding Drug Products in Canada) Regular Benefits Product Name PIN Plans Anthralin Ointment 0.4% 00901113 ADEFGV Anthralin Soft Paste 0.05% 00902063 ADEFGV Anthralin Soft Paste 0.1% 00900907 ADEFGV Anthralin Soft Paste 0.2% 00900915 ADEFGV Anthralin Weak Ointment 0.2% 00901105 ADEFGV Disulfiram powder 00999087 ADEFG Hydrochlorothiazide powders and suspensions for oral use 00999106* ADEFGV Hydrocortisone powder for topical applications >0.5% 00990841* ADEFGV LCD (Coal Tar Solution) in compounds for topical applications 00358495* ADEFGV Meclizine Powder 00903076 ADEFGV Prednisone powders and suspension for oral use 00999108* ADEFGV Progesterone powder in compounds for topical application 00990876* ADEFGV Propylene Glycol uid in compounds for topical applications 00990884* ADEFGV Salicylic Acid in compounds for topical applications 00900788* ADEFGV Saturated Solution Potassium Iodide 00999105* ADEFGV Spironolactone powders and suspensions for oral use 00999107* ADEFGV Sulphur in compounds for topical applications 00900826* ADEFGV * This PIN must be used to submit claims for any strength of this extemporaneous preparation. September 2015 v.1 A - 10

APPENDIX III Special Authorization Certain drugs are only eligible for coverage under New Brunswick Drug Plans (NB Drug Plans) through special authorization. The criteria are developed by the Atlantic and Canadian Expert Advisory Committees. Drugs eligible for consideration through special authorization: Drugs listed as special authorization benefits have specific criteria which must be met in order to be approved. These drugs are listed alphabetically by generic name in the following section. Under exceptional circumstances, requests for drugs without specific criteria may be reviewed case-by-case and assessed based on the published medical evidence. Drugs not eligible for consideration through special authorization: New drugs not yet reviewed by the expert advisory committee Drugs excluded as eligible benefits further to the expert advisory committee s review and recommendation Drugs not licensed or marketed in Canada (e.g. drugs obtained through Health Canada s Special Access Program) Products specifically excluded as benefits as identified on the exclusion list (Formulary pages IV and V). Reimbursement of brand name products when generics exist When interchangeable generic products are available for a brand name drug, the New Brunswick Drug Plans (NB Drug Plans) will only reimburse pharmacies for the lowest cost generic product. Patients, who choose to receive a brand name product when a generic product exists, are responsible for paying any difference in price. The NB Drug Plans will consider requests for reimbursement of brand name drugs when a patient has had a hypersensitivity reaction (e.g. edema, respiratory distress, serum sickness, anaphylaxis) to a non-medicinal ingredient contained in the interchangeable generic product. Requests may be made by submitting a completed Special Authorization Request Form and providing details of the hypersensitivity reaction. Information on the safety and effectiveness of generic drugs is available on Health Canada s website at http://www.hcsc.gc.ca/hl-vs/iyh-vsv/med/med-gen-eng.php. September 2015 v.1 A - 11

Special authorization requests must be submitted in writing by the prescriber and include the following information: Patient Identification Name of patient NB Medicare number Date of birth Prescriber Identification Name, address, telephone number and FAX number (if applicable) of prescriber Drug Requested Drug name, strength and dosage form Dosage schedule Expected duration of therapy Reason for the Request Diagnosis and/or indication for which the drug is being used Information regarding previous drugs which have been used and the patient s response to therapy where appropriate Any additional information that may assist in making a decision on the request for special authorization. Special authorization requests for patients of Plans A,B,D,E,F,G,R,V should be sent by mail or FAX to: Special Authorization Unit New Brunswick Drug Plans P.O. Box 690 Moncton, NB E1C 8M7 Local Fax: 506-867-4872 Toll Free Fax: 1-888-455-8322 NB Drug Plans Inquiry Line: 1-800-332-3691 Plan U (HIV - Infected Persons) special authorization requests should be sent by mail or FAX to: Special Authorization Unit Plan U New Brunswick Prescription Drug Program P.O. Box 690 Moncton, NB E1C 8M7 Local fax: 506-867-4339 Toll Free Fax: 1-866-770-7746 Toll Free Telephone: 1-800-332-3691 September 2015 v.1 A - 12

The New Brunswick Drug Plans Special Authorization Criteria ABATACEPT (ORENCIA) 250mg vial for intravenous injection Juvenile Rheumatoid Arthritis For the treatment of Juvenile Rheumatoid Arthritis: - In children (age 6-17) with moderate to severe active polyarticular juvenile idiopathic arthritis/juvenile rheumatoid arthritis who are intolerant to, or who have not had an adequate response from etanercept. - Initial treatment is limited to a maximum of 16 weeks. Retreatment is permitted for children who demonstrated an adequate initial treatment response and who are experiencing a disease flare. Clinical Notes: Intravenous infusion: initial IV infusion dose is administered at 0, 2, and 4 weeks then every 4 weeks thereafter. Abatacept will not be reimbursed in combination with anti-tnf agents. Claim Note: Must be prescribed by a rheumatologist. ABATACEPT (ORENCIA) 250mg vial for intravenous injection, and 125mg subcutaneous injection Rheumatoid Arthritis For patients with moderate to severe active rheumatoid arthritis who: - Have not responded to, or have had intolerable side-effects with, an adequate trial of combination therapy of at least two traditional DMARDs (disease modifying antirheumatic drugs). Combination DMARD therapy must include methotrexate unless contraindicated or not tolerated, OR - Are not candidates for combination DMARD therapy must have had adequate trial of at least three traditional DMARDs in sequence, one of which must have been methotrexate unless contraindicated Clinical Notes: Intravenous infusion: initial IV infusion dose is administered at 0, 2, and 4 weeks then every 4 weeks thereafter. Subcutaneous injection: a single IV loading dose of up to 1000 mg/dose followed by 125 mg subcutaneous injection within a day, then once-weekly subcutaneous injections. Abatacept will not be reimbursed in combination with anti-tnf agents. Claim Note: Must be prescribed by a rheumatologist. ABIRATERONE (ZYTIGA) 250mg tablet In combination with prednisone for the treatment of metastatic prostate cancer (castration-resistant prostate cancer) in patients who: are asymptomatic or mildly symptomatic after failure of androgen deprivation therapy, OR have received prior chemotherapy containing docetaxel after failure of androgen deprivation therapy. ACAMPROSATE CALCIUM (CAMPRAL) 333mg tablet For the maintenance of abstinence from alcohol in patients with alcohol dependence who have been abstinent for at least four days, and who have contraindications to naltrexone (e.g. currently receiving opioids, acute hepatitis or liver failure). Clinical Note: Treatment with acamprosate should be part of a comprehensive management plan that includes counseling. ACLIDINUM BROMIDE (TUDORZA GENUAIR) 400mcg powder for inhalation Chronic Obstructive Pulmonary Disease For the treatment of chronic obstructive pulmonary disease (COPD) if symptoms persist after 2-3 months of short-acting bronchodilator therapy (i.e. salbutamol at a maximum dose of 8 puffs/day or ipratropium at maximum dose of 12 puffs/day). September 2015 v.1 A - 13

Coverage can be provided without a trial of short-acting agent if there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1 /FVC ratio < 0.7) and significant symptoms (i.e. Medical Research Council (MRC) Dyspnea Scale score of 3-5). Combination therapy with aclidinum bromide AND a long-acting beta2-adrenergic agonist/inhaled corticosteroid (LABA/ICS) will only be considered if: - there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1/FVC ratio < 0.7), and significant symptoms (i.e. MRC score of 3-5) AND - there is evidence of one or more moderate-to-severe exacerbations per year, on average, for 2 consecutive years requiring antibiotics and/or systemic (oral or intravenous) corticosteroids. Clinical Note: If spirometry cannot be obtained, reasons must be clearly explained and other evidence regarding severity of condition must be provided for consideration (i.e. MRC scale). Spirometry reports from any point in time will be accepted. COPD Stage MODERATE MRC 3 to 4 SEVERE MRC 5 Medical Research Council (MRC) Dyspnea Scale Symptoms Shortness of breath from COPD causing the patient to stop after walking about 100 meters (or after a few minutes) on the level. Shortness of breath from COPD resulting in the patient being too breathless to leave the house or breathless after undressing, or the presence of chronic respiratory failure or clinical signs of right heart failure. ADALIMUMAB (HUMIRA) 40mg/0.8mL (50mg/mL) injection Ankylosing Spondylitis For the treatment of patients with moderate to severe ankylosing spondylitis (e.g. Bath AS Disease Activity Index (BASDAI) score 4 on 10 point scale) who: - Have axial symptoms* and who have failed to respond to the sequential use of at least 2 NSAIDs at the optimum dose for a minimum period of 3 months observation or in whom NSAIDs are contraindicated OR - Have peripheral symptoms and who have failed to respond to, or have contraindications to, the sequential use of at least 2 NSAIDs at the optimum dose for a minimum period of 3 months observation and have had an inadequate response to an optimal dose or maximal tolerated dose of a DMARD. Requests for renewal must include information showing the beneficial effects of the treatment, specifically: - A decrease of at least 2 points on the BASDAI scale, compared with the pre-treatment score OR - Patient and expert opinion of an adequate clinical response as indicated by a significant functional improvement (measured by outcomes such as HAQ or ability to return to work ) Clinical Notes: 1. *Patients with recurrent uveitis (2 or more episodes within 12 months) as a complication to axial disease do not require a trial of NSAIDs alone. 2. Adalimumab will not be reimbursed in combination with other anti-tnf agents Claim Notes: Must be prescribed by a rheumatologist or internist Approval will be for a maximum of 6 months Approvals will be for a maximum dose of 40mg every two weeks Crohn s Disease For moderately to severely active Crohn's disease in patients who are refractory or have contraindications to an adequate course of 5-aminosalicylic acid and corticosteroids and other immunosuppressive therapy. Clinical Notes: 1. Eligible patients should receive an induction dose of 160mg followed by 80mg two weeks later. 2. Clinical response should be assessed four weeks after the first induction dose. Claim Notes: Initial requests will be approved for a maximum of 12 weeks. Ongoing coverage for maintenance therapy will only be reimbursed for responders and for a dose not exceeding 40mg every two weeks. September 2015 v.1 A - 14

Polyarticular Juvenile Idiopathic Arthritis (pjia) For the treatment of children (age 4-17) with moderately to severely active polyarticular juvenile idiopathic arthritis (pjia) who have had inadequate response to one or more disease modifying antirheumatic drugs (DMARDs). Claim Note: Must be prescribed by a rheumatologist. Psoriatic Arthritis For the treatment of active psoriatic arthritis in patients who: - Have at least three active and tender joints, and - Have not responded to an adequate trial of two DMARDs or have an intolerance or contraindication to DMARDs. Clinical Note: Should not be used in combination with other tumor necrosis factor (TNF) antagonists. Claim Notes: Must be prescribed by a rheumatologist. The number of doses is limited to twenty-six 40 mg doses per year with no dose escalation permitted. Rheumatoid Arthritis For patients with moderate to severe active rheumatoid arthritis who: - Have not responded to, or have had intolerable side-effects with, an adequate trial of combination therapy of at least two traditional DMARDs (disease modifying antirheumatic drugs). Combination DMARD therapy must include methotrexate unless contraindicated or not tolerated, OR - Are not candidates for combination DMARD therapy must have had adequate trial of at least three traditional DMARDs in sequence, one of which must have been methotrexate unless contraindicated Clinical Note: Should not be used in combination with other tumor necrosis factor (TNF) antagonists. Claim Notes: Must be prescribed by a rheumatologist. The number of doses is limited to twenty-six 40 mg doses per year with no dose escalation permitted. Plaque Psoriasis Requests will be considered for treatment of patients with severe, debilitating chronic plaque psoriasis who meet all of the following criteria: - Body surface area (BSA) involvement of >10% and/or significant involvement of the face, hands, feet or genital region; - Failure to respond to, contraindications to or intolerance to methotrexate and cyclosporine; - Failure to respond to, intolerance to or unable to access phototherapy Clinical Notes: 1. Continuation of therapy beyond 16 weeks will be based on response. Patients not responding adequately at these time points should have treatment discontinued with no further treatment with the same agent recommended. 2. An adequate response is defined as either: - 75% reduction in the Psoriasis Area and Severity Index (PASI) score from when treatment started (PASI 75), OR - 50% reduction in the PASI score (PASI 50) with a 5 point improvement in the Dermatology Life Quality Index (DLQI) from when treatment started, OR - A quantitative reduction in BSA affected with qualitative consideration of specific regions such as face, hands, feet, or genital region. 3. Concurrent use of >1 biologic will not be approved Claim Notes: Initial approval limited to 16 weeks. Must be prescribed by a dermatologist Approval limited to a dose of 80 mg administered once followed by 40 mg after 1 week of initial dose, then 40 mg every other week thereafter, up to a year (if response criteria met at 16 weeks). September 2015 v.1 A - 15

ADEFOVIR DIPIVOXIL (HEPSERA and generic brand) 10mg tablet For the treatment of Hepatitis B when used in combination with lamivudine, in patients who have failed lamivudine, as defined by an increase in HBV DNA of > 1 log 10 IU/mL above the nadir, measured on two separate occasions within an interval of at least one month, after the first three months of lamivudine therapy, and when lamivudine failure is not due to poor adherence to therapy. AFATINIB DIMALEATE (GIOTRIF) 20mg, 30mg, 40mg tablets For the first-line treatment of patients with EGFR mutation positive advanced or metastatic adenocarcinoma of the lung who have an ECOG performance status 0 or 1. Renewal Criteria: Written confirmation that the patient has responded to treatment and in whom there is no evidence of disease progression. Clinical Note: Patients who receive afatinib 1st line are not eligible for erlotinib for 2nd line, 3rd line, or maintenance therapy). Claim Notes: Doses of more than 40 mg once daily will not be approved. Approval duration: 6 months AFILBERCEPT (EYLEA) 40mg/mL solution for intravitreal injection 1. Neovascular (wet) age-related macular degeneration (AMD) Initial Coverage: For the treatment of patients with neovascular (wet) age-related macular degeneration (AMD) where all of the following apply to the eye to be treated: Best Corrected Visual Acuity (BCVA) is between 6/12 and 6/96 The lesion size is less than or equal to 12 disc areas in greatest linear dimension There is evidence of recent (< 3 months) presumed disease progression (blood vessel growth, as indicated by fluorescein angiography, or optical coherence tomography (OCT) Administration is to be done by a qualified ophthalmologist experienced in intravitreal injections. The interval between doses should not be shorter than 1 month. Continued Coverage: Treatment should be continued only in people who maintain adequate response to therapy. Clinical Notes: Coverage will not be approved for patients: - With permanent retinal damage as defined by the Royal College of Ophthalmology guidelines - Receiving concurrent treatment with verteporfin. Aflibercept should be permanently discontinued if any one of the following occurs: - Reduction in BCVA in the treated eye to less than 15 letters (absolute) on 2 consecutive visits in the treated eye, attributed to AMD in the absence of other pathology - Reductions in BCVA of 30 letters or more compared to either baseline and/or best recorded level since baseline as this may indicate either poor treatment effect, adverse events or both. - There is evidence of deterioration of the lesion morphology despite optimum treatment over 3 consecutive visits. Claim Notes: An initial claim of up to two vials of aflibercept (1 vial per eye treated) will be automatically reimbursed when prescribed by an ophthalmologist. If additional medication is required, a request should be made through special authorization. Reimbursement will be limited to a maximum of 1 vial of aflibercept per eye treated every 30 days. Claims submitted for greater than 1 vial, or submitted within 30 days of a previous claim, will not be reimbursed. Please refer to Quantities for Claims Submissions for the correct unit of measure. September 2015 v.1 A - 16

2. Diabetic macular edema (DME) Initial coverage: For the treatment of visual impairment due to diabetic macular edema (DME) in patients who meet all of the following criteria: clinically significant centre-involving macular edema for whom laser photocoagulation is also indicated hemoglobin A1c test in the past 6 months with a value of less than or equal to 11% best corrected visual acuity of 20/32 to 20/400 central retinal thickness greater than or equal to 250 micrometers Renewal Criteria: confirm that a hemoglobin A1c test in the past 6 months had a value of less than or equal to 11% date of last visit and results of best corrected visual acuity at that visit date of last OCT and central retinal thickness on that examination if aflibercept is being administered monthly, please provide details on the rationale Clinical Notes: Treatment should be given monthly until maximum visual acuity is achieved (i.e. stable visual acuity for three consecutive months while on aflibercept). Thereafter, visual acuity should be monitored monthly. Treatment should be resumed when monitoring indicates a loss of visual acuity due to DME and continued until stable visual acuity is reached again for three consecutive months. Claim Notes: Approval Period: 1 year Please refer to Quantities for Claims Submissions for the correct unit of measure. 3. Central retinal vein occlusion (CRVO) For the treatment of visual impairment due to macular edema secondary to central retinal vein occlusion (CRVO). Clinical Notes: Treatment should be given monthly until maximum visual acuity is achieved (i.e. stable visual acuity for three consecutive months while on aflibercept). Thereafter, visual acuity should be monitored monthly. Treatment should be resumed when monitoring indicates a loss of visual acuity due to macular edema secondary to central retinal vein occlusion and continued until stable visual acuity is reached again for three consecutive months. Claim Notes: Approval Period: 1 year Please refer to Quantities for Claims Submissions for the correct unit of measure. ALENDRONATE (generic brand) 40mg tablet For the treatment of Paget s disease. ALGLUCOSIDASE ALFA (MYOZYME) 50mg vial injection For the treatment of infantile-onset Pompe disease, as demonstrated by onset of symptoms and confirmed cardiomyopathy within the first 12 months of life. Monitoring of therapy The monitoring of markers of disease severity and response to treatment must include at least: 1. Weight, length and head circumference. 2. Need for ventilatory assistance, including supplementary oxygen, CPAP, BiPAP, or endotracheal intubation and ventilation. 3. Left ventricular mass index (LVMI) as determined by echocardiography (not ECG alone). 4. Periodic consultation with cardiology. 5. Periodic consultation with respirology. Withdrawal of therapy 1. Patients to be considered for reimbursement of drug costs for alglucosidase alfa treatment must be willing to participate in the long-term evaluation of the efficacy of treatment by periodic medical assessment. Failure to comply with recommended medical assessment and investigations may result in withdrawal of financial support of drug therapy. September 2015 v.1 A - 17

2. The development of the need for continuing invasive ventilatory support after the initiation of ERT should be considered a treatment failure. Funding for ERT should not be continued for infants who fail to achieve ventilatorfree status, or who deteriorate further, within 6 months after the initiation of ventilatory support. 3. Deterioration of cardiac function, as shown by failure of LV hypertrophy (as indicated by LV mass index) to regress by more than Z=1 unit, or persistent clinical or echocardiographic findings of cardiac systolic or diastolic failure without evidence of improvement, in spite of 24 weeks of ERT, should be considered a treatment failure and funding for ERT should be discontinued. ALMOTRIPTAN (AXERT and generic brands) 6.25mg and 12.5mg tablets For the treatment of migraine 1 headache of moderate 2 intensity when other therapies (e.g. NSAIDs, acetaminophen, DHE spray) are not effective AND patients have not responded to oral sumatriptan, zolmitriptan, rizatriptan and naratriptan. For the treatment of migraine 1 headache of severe 2 or ultra severe 2 intensity when patients have not responded to oral sumatriptan, zolmitriptan, rizatriptan and/or naratriptan. Clinical Notes: 1. 1 As diagnosed based on current Canadian guidelines. 2. 2 Definitions: - Moderate - pain is distracting causing need to slow down and limit activities; - Severe - pain affects ability to concentrate and very difficult to continue with daily activities; - Ultra severe - unable to speak or think clearly; not able to function; likely lying down or sleeping Claim Notes: Coverage limited to 6 doses / 30 days 3 - patients with >3 migraines/month on average despite prophylactic therapy may be considered for up to a maximum of 12 doses / 30 days 3 Reimbursement will be available for a maximum quantity of triptan doses as outlined in criteria per 30 days regardless of the agent(s) used within the 30 day period. Special authorization for the products almotriptan 6.25mg and 12.5mg tablets, naratriptan 1mg and 2.5mg tablets, rizatriptan 5mg and 10mg tablets and wafers, sumatriptan 5mg and 20mg nasal spray and zolmitriptan 2.5mg tablets and orally dispersible tablets, 2.5mg and 5mg nasal spray will be considered as a set. Approvals will include all products in this list, however reimbursement will be available for a maximum quantity of one agent per month. AMBRISENTAN (VOLIBRIS) 5mg and 10mg tablets For treatment of patients with pulmonary arterial hypertension (PAH), of at least World Health Organization (WHO) functional class III, which is associated with either idiopathic or connective tissue disease and who have failed to respond to or who have contraindications to, or who are not a candidate for sildenafil. Clinical Notes: 1. Diagnosis of PAH should be confirmed by cardiac catheterization 2. Ambrisentan will not be approved when used concurrently with other endothelin receptor antagonists, epoprostenol, treprostinil or sildenafil. Claim Note: The maximum dose of ambrisentan that will be reimbursed is 10mg daily APIXABAN (ELIQUIS) 2.5mg and 5mg tablets Atrial fibrillation For the prevention of stroke and systemic embolism in at-risk patients with non-valvular atrial fibrillation for whom: Anticoagulation is inadequate following at least a two month trial on warfarin; OR Warfarin is contraindicated or not possible due to inability to regularly monitor through International Normalized Ratio (INR) testing (i.e. no access to INR testing services at a laboratory, clinic, pharmacy, and at home). Clinical Notes: The following patient groups are excluded from coverage for apixaban for atrial fibrillation: - Patients with impaired renal function (creatinine clearance or estimated glomerular filtration rate <25 ml/min) - Patients 75 years of age or older without documented stable renal function - Patients with hemodynamically significant rheumatic valvular heart disease, especially mitral stenosis - Patients with prosthetic heart valves. September 2015 v.1 A - 18

At-risk patients with atrial fibrillation are defined as those with a CHADS 2 score of 1. Prescribers may consider an antiplatelet regimen or oral anticoagulation for patients with a CHADS 2 score of 1. Inadequate anticoagulation is defined as INR testing results that are outside the desired INR range for at least 35% of the tests during the monitoring period (i.e. adequate anticoagulation is defined as INR test results that are within the desired INR range for at least 65% of the tests during the monitoring period). Documented stable renal function is defined as creatinine clearance or estimated glomerular filtration rate that is maintained for at least 3 months. The usual recommended dose is 5mg twice daily; a reduced dose of apixaban 2.5mg twice daily is recommended for patients with at least two of the following: age > 80 years, body weight < 60kg, or serum creatinine > 133 micromole/litre. Since renal impairment can increase bleeding risk, renal function should be regularly monitored. Other factors that increase bleeding risk should also be assessed and monitored (see apixaban product monograph). Patients starting apixaban should have ready access to appropriate medical services to manage a major bleeding event. There is currently no data to support that apixaban provides adequate anticoagulation in patients with rheumatic valvular disease or those with prosthetic heart valves. As a result, apixaban is not recommended in these populations. APIXABAN (ELIQUIS) 2.5mg tablet VTE prophylaxis For the prevention of venous thromboembolic events (VTE) in patients who have undergone elective total knee replacement (TKR) surgery. For the prevention of VTE in patients who have undergone elective total hip replacement (THR) surgery. Clinical Notes: 1. The total duration of therapy includes the period during which doses are administered post-operatively in an acute care (hospital) setting, and the approval period is for the balance of the total duration after discharge. 2. The first dose is typically administered 12 to 24 hours after surgery, assuming adequate hemostasis has been achieved. 3. The ADVANCE clinical trial program did not evaluate the efficacy or safety of sequential use of molecular weight heparin followed by apixaban for the prophylaxis of VTE. Due to the current lack of evidence for sequential use, coverage is not intended for this practice. 4. Clinical judgment is warranted to assess the increased risk for VTE and/or adverse effects in patients with a history of previous VTE, myocardial infarction, transient ischemic attack or ischemic stroke; a history of intraocular or intracerebral bleeding; a history of gastrointestinal disease with gastrointestinal bleeding; moderate or severe renal insufficiency (estimated creatinine clearance <30 ml/min); severe liver disease; concurrent use of other anticoagulants; or age greater than 75 years. 5. Apixaban has not been studied in clinical trials in patients undergoing hip fracture surgery, and is not recommended in these patients. Claim Notes: Maximum reimbursement without Special Authorization will be limited to 14 days of therapy (28 tablets) for TKR or 30 days of therapy (60 tablets) for THR, within a 6 month period. Subsequent reimbursement for prophylaxis within a 6 month period (i.e. second joint replacement procedure within the 6 month period) will require Special Authorization. APREPITANT (EMEND) 80mg and 125mg capsules; Tri-Pack For the prevention of acute and delayed nausea and vomiting due to highly emetogenic cancer chemotherapy (e.g. cisplatin >70 mg/m 2 ) in patients who have experienced emesis despite treatment with a combination of a 5-HT 3 antagonist and dexamethasone in a previous cycle of highly emetogenic chemotherapy. Claim Note: Prescription claims for up to a maximum of 2 Tri-packs, or 6 capsules will be automatically reimbursed every 28 days when the prescription is written by an oncologist or an oncology clinical associate/general practitionersoncology. If additional medication is required within a 28 day period subsequent to the initial prescription, a request should be made through special authorization. ARIPIPRAZOLE (ABILIFY) 2mg, 5mg, 10mg, 15mg, 20mg and 30mg tablets For the treatment of schizophrenia and related psychotic disorders (not dementia related) in patients with a history of failure, intolerance, or contraindication to at least one less expensive antipsychotic agent. September 2015 v.1 A - 19

ASENAPINE (SAPHRIS) 5mg and 10mg sublingual tablets For the acute treatment of manic or mixed episodes associated with bipolar I disorder as either: Monotherapy, after a trial of lithium or divalproex sodium has failed, and trials of less expensive atypical antipsychotic agents have failed due to intolerance or lack of response Co-therapy with lithium or divalproex sodium, after trials of less expensive atypical antipsychotic agents have failed due to intolerance or lack of response. ATOVAQUONE (MEPRON) 750mg/5mL suspension For the treatment of mild to moderate Pneumocystis Carinii pneumonia in patients who are intolerant to trimethoprimsulfamethoxazole. AXITINIB (INLYTA) 1mg and 5mg tablets As a second-line treatment for patients with metastatic clear cell renal carcinoma, who, based on the mutual assessment of the treating physician and patient, are unable to tolerate ongoing use of an effective dose of everolimus or who have a contraindication to everolimus. AZITHROMYCIN (ZITHROMAX and generic brands) 600mg tablet For the prevention of disseminated Mycobacterium Avium Complex (MAC) in HIV positive patients who are severely immunocompromised with CD4 levels <0.1 x 10 9 /L. BETAHISTINE (SERC and generic brands) 8mg, 16mg and 24mg tablets For the symptomatic treatment of the recurrent episodes of vertigo associated with Ménière s disease. BOCEPREVIR (VICTRELIS) 200mg capsule BOCEPREVIR/RIBAVIRIN PLUS PEGINTERFERON ALFA-2B (VICTRELIS TRIPLE) 200mg / 200mg capsules plus 80mcg injection 200mg / 200mg capsules plus 100mcg injection 200mg / 200mg capsules plus 120mcg injection 200mg / 200mg capsules plus 150mcg injection For the treatment of chronic hepatitis C genotype 1 infection in patients with compensated liver disease, in combination with peginterferon alpha and ribavirin, if the following criteria are met: Detectable levels of hepatitis C virus (HCV) RNA in the last six months Fibrosis stage of F2, F3 or F4 or on the recommendation of an Internal Medicine Specialist Claim Note: One course of treatment only (for up to 44 weeks duration) will be approved. BOSENTAN (TRACLEER and generic brands) 62.5mg and 125mg tablets For treatment of pulmonary arterial hypertension (PAH) in patients with World Health Organization (WHO) functional class III or IV Clinical Notes: Idiopathic pulmonary arterial hypertension (IPAH) in patients who do not demonstrate vasoreactivity on testing or who demonstrate vasoreactivity on testing but fail a trial of, or are intolerant to, calcium channel blockers. Pulmonary arterial hypertension associated with connective tissue disease or congenital heart disease or human immunodeficiency virus (HIV) who do not respond adequately to conventional therapy. BUDESONIDE/FORMOTEROL (SYMBICORT) 100mcg/6mcg and 200mcg/6mcg metered dose inhalers Reversible Obstructive Airway Disease For patients with reversible obstructive airways disease who are: - Stabilized on an inhaled corticosteroid and a long-acting beta2-adrenergic agonist, OR - Using optimal doses of inhaled corticosteroids but are still poorly controlled. September 2015 v.1 A - 20

Chronic Obstructive Pulmonary Disease For the treatment of chronic obstructive pulmonary disease (COPD) if symptoms persist after 2-3 months of short-acting bronchodilator therapy (i.e. salbutamol at a maximum dose of 8 puffs/day or ipratropium at maximum dose of 12 puffs/day). Coverage can be provided without a trial of short-acting agent if there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1 /FVC ratio < 0.7) and significant symptoms (i.e. Medical Research Council (MRC) Dyspnea Scale score of 3-5). Combination therapy with a long-acting muscarinic antagonist (LAMA) AND a long-acting beta2-adrenergic agonist/inhaled corticosteroid (LABA/ICS) will only be considered if: - there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1/FVC ratio < 0.7), and significant symptoms (i.e. MRC score of 3-5) AND - there is evidence of one or more moderate-to-severe exacerbations per year, on average, for 2 consecutive years requiring antibiotics and/or systemic (oral or intravenous) corticosteroids. Clinical Note: If spirometry cannot be obtained, reasons must be clearly explained and other evidence regarding severity of condition must be provided for consideration (i.e. MRC scale). Spirometry reports from any point in time will be accepted. COPD Stage MODERATE MRC 3 to 4 SEVERE MRC 5 Medical Research Council (MRC) Dyspnea Scale Symptoms Shortness of breath from COPD causing the patient to stop after walking about 100 meters (or after a few minutes) on the level. Shortness of breath from COPD resulting in the patient being too breathless to leave the house or breathless after undressing, or the presence of chronic respiratory failure or clinical signs of right heart failure. BUPRENORPHINE / NALOXONE (SUBOXONE and generic brands) 2mg/0.5mg and 8mg/2mg sublingual tablets For the treatment of opioid dependence for patients in whom methadone is contraindicated (e.g. patients at high risk of, or with QT prolongation, or hypersensitivity to methadone). Clinical Note: Commonly reported adverse effects associated with methadone therapy (e.g. sweating, constipation, insomnia, etc.) will not be considered to be hypersensitivity. Claim Note: Requests from New Brunswick physicians authorized to prescribe methadone or physicians with experience in the treatment of opioid dependence will be considered. BUPROPION (ZYBAN) 150mg tablet For smoking cessation treatment in adults 18 years of age and older. Claim Notes: A maximum of 168 tablets (12 weeks of treatment) will be reimbursed annually without special authorization. A second 12 week course may be approved under special authorization for individuals who have demonstrated some success with smoking cessation and require additional treatment. BUSERELIN ACETATE (SUPREFACT) 1mg/mL nasal solution 1. For the palliative treatment of stage D 2 carcinoma of the prostate (Plans D and F). 2. For the hormonal management of endometriosis Claim Notes: Buserelin is a regular benefit for Plans A and V. Approval period is limited to a maximum of 6 months. September 2015 v.1 A - 21

CABERGOLINE (DOSTINEX and generic brand) 0.5mg tablet For the treatment of patients with hyperprolactinemia who have failed or are intolerant to bromocriptine CAPECITABINE (XELODA and generic brand) 150mg and 500mg tablets Colorectal Cancer For single agent therapy of colorectal cancer in patients who are chemotherapy naive or patients who have progressed 6 months after completion of adjuvant 5-FU/ leucovorin therapy. Coverage will be limited to: a) Metastatic colorectal cancer, with an ECOG performance status of 0-2*, when first line combination chemotherapy (5-FU/ leucovorin/irinotecan) is declined or not tolerated. b) Stage III (Dukes C) colon cancer and ECOG status 0-1 as adjuvant therapy. As part of the CAPOX (capecitabine-oxaliplatin) regimen for the first-line and second-line treatment of Metastatic Colorectal Cancer (mcrc) for patients with an ECOG performance status of 0-2*. Metastatic Breast Cancer For treatment of metastatic breast cancer where patients have progressed after prior chemotherapy and who have an ECOG performance status of 0-2*. Clinical Note: *Patients who are asymptomatic and those who are symptomatic and in bed less than 50% of the time. Claim Note: Prescriptions written by New Brunswick hematologists, oncologists or an oncology clinical associate/general practitioners-oncology do not require special authorization. CARVEDILOL (generic brands) 3.125mg, 6.25mg, 12.5mg and 25mg tablets For the treatment of stable symptomatic heart failure in patients with a left ventricular ejection fraction (LVEF) less than or equal to 40%. Claim Note: Prescriptions written by cardiologists or internists do not require special authorization. Subsequent refills ordered by other practitioners will not require special authorization. CELECOXIB (CELEBREX and generic brands) 100mg and 200mg capsules 1. For the treatment of osteoarthritis and rheumatoid arthritis in patients who have at least one of the following risk factors: Past history of ulcers Concurrent warfarin therapy Concurrent prednisone therapy Failure or intolerance to at least two other NSAIDs (e.g. ibuprofen, diclofenac, naproxen) Clinical Note: Recommended maximum daily doses: - 200mg for osteoarthritis - 400mg for rheumatoid arthritis 2. For patients who are at high risk of upper gastrointestinal (GI) complications and have had failure or intolerance to at least two other NSAIDs. 3. For patients who have a documented history of ulcers proven radiographically and/or endoscopically. Claim Note: Celecoxib is a regular benefit for patients age 65 and over. September 2015 v.1 A - 22

CHOLINESTERASE INHIBITORS (Donepezil, Galantamine, Rivastigmine) - For the treatment of mild to moderate Alzheimer s disease To initiate therapy: Requests must be submitted on the appropriate NB Drug Plans special authorization form. http://www.gnb.ca/0212/alzheimers-e.asp For a patient being started on a first cholinesterase inhibitor (ChEI): For a patient who has previously taken no more than one other ChEI and is switching: Patients who meet all of the following reimbursement criteria will be approved for an initial 6 months of therapy: a diagnosis of probable Alzheimer s disease or possible Alzheimer s disease with vascular component or Lewy bodies; a Mini Mental Score Exam (MMSE) score of 10 to 30; and a Functional Assessment & Staging Test (FAST) score of 4 to 5 Patients will be approved for an initial 6 months of therapy with a second ChEI when the following information is provided: the reason for discontinuing the first ChEI Requests to switch from one agent in the class to another will not be considered beyond the initial 6 month approval. To continue therapy for 1 year period (once initial 6 month approval has been completed): Patients who meet the following monitoring criteria will be approved for 1 year periods of therapy: MMSE score of 10 to 30 (Note: MMSE score must be provided 6 months after starting a ChEI and then only annually thereafter.); AND FAST score of 4 to 5 (Note: FAST score must be provided 6 months after starting a ChEI and then only annually thereafter.) Note: Monitoring of target symptoms will no longer be required; however, physicians will be asked at the initial and subsequent reassessments if, in their opinion, the patient is benefiting from the drug. CIPROFLOXACIN (CILOXAN and generic brand) 0.3% ophthalmic solution and 0.3% ophthalmic ointment For the treatment of corneal ulcers and bacterial conjunctivitis. Claim Note: Prescriptions written by New Brunswick ophthalmologists and optometrists do not require special authorization. CIPROFLOXACIN (CIPRO and generic brands) 250mg, 500mg and 750mg tablets 500mg/5mL Oral Suspension For the treatment of: Complicated urinary tract infections caused by resistant bacteria. Skin, soft tissue, bone and joint infections caused by Gram negative bacteria. Severe ( malignant ) otitis externa. Infections with Pseudomonas aeruginosa (susceptible strains resistance is now common). Claim Notes: Prescriptions written by New Brunswick urologists, infectious disease specialists, medical oncologists, hematologists, respiratory medicine specialists or medical microbiologists do not require special authorization. Ciprofloxacin 250mg, 500mg, and 750mg tablets are regular benefit for Plan B. CIPROFLOXACIN (CIPRO XL) 1000mg tablet For the treatment of complicated urinary tract infection and acute uncomplicated pyelonephritis when alternative agents are ineffective, not tolerated or contraindicated. Claim Note: Prescriptions written by New Brunswick urologists, infectious disease specialists and medical microbiologists do not require special authorization. September 2015 v.1 A - 23

CIPROFLOXACIN HCL / DEXAMETHASONE (CIPRODEX) 0.3% / 0.1% otic suspension For the treatment of acute otitis media with otorrhea through tympanostomy tubes who require treatment. For the treatment of acute otitis externa in the presence of a tympanostomy tube or known perforation of the tympanic membrane. Claim Note: Prescriptions written by certified New Brunswick otolaryngologists do not require special authorization. CLOPIDOGREL (PLAVIX and generic brands) 75mg tablet 1. Secondary prevention of vascular ischemic events (myocardial infarction, stroke) in patients with a history of symptomatic atherosclerotic disease (including symptomatic peripheral artery disease) who have had treatment failure or are intolerant or allergic to ASA. 2. For the prevention of thrombosis post stent implantation for a period of up to 6 months for bare-metal stents (BMS) and 12 months for drug- eluting stents (DES). 3. For the prevention of vascular ischemic events in patients who have been hospitalized with acute coronary syndrome (i.e. unstable angina or non-st segment elevation myocardial infarction) in combination with ASA for a period of three months. Longer term combination therapy may be considered for a period of 12 months post NSTE-ACS for patients: with a second acute coronary syndrome within 12 months, or with complex or extensive CAD (i.e. diffuse 3 vessel CAD not amenable to revascularization), or who have had a previous stroke, transient ischemic attack or symptomatic PAD Claim Note: Prescriptions written by cardiologists do not require special authorization. CODEINE (CODEINE CONTIN) 50mg, 100mg, 150mg, and 200mg tablets (controlled release) For the treatment of mild to moderate cancer-related or chronic non-cancer pain. CRIZOTINIB (XALKORI) 200mg and 250mg capsules Second-line therapy for patients with anaplastic lymphoma kinase (ALK) -positive advanced non-small cell lung cancer (NSCLC) with an ECOG performance status of 0-2. DABIGATRAN (PRADAXA) 110mg and 150mg capsules For the prevention of stroke and systemic embolism in at-risk patients with non-valvular atrial fibrillation for whom: Anticoagulation is inadequate following at least a two month trial of warfarin; or Warfarin is contraindicated or not possible due to inability to regularly monitor through International Normalized Ratio (INR) testing (i.e. no access to INR testing services at a laboratory, clinic, pharmacy and at home). Clinical Notes: 1. The following patient groups are excluded from coverage for dabigatran for atrial fibrillation: - Patients with impaired renal function (creatinine clearance or estimated glomerular filtration rate < 30 ml/min) - Patients 75 years of age or older without documented stable renal function - Patients with hemodynamically significant rheumatic valvular heart disease, especially mitral stenosis - Patients with prosthetic heart valves 2. At-risk patients with atrial fibrillation are defined as those with a CHADS 2 score of 1. 3. Inadequate anticoagulation is defined as INR testing results that are outside the desired INR range for at least 35% of the tests during the monitoring period (i.e. adequate anticoagulation is defined as INR test results that are within the desired INR range for at least 65% of the tests during the monitoring period). 4. Since renal impairment can increase bleeding risk, renal function should be regularly monitored. Other factors that increase bleeding risk should also be assessed and monitored (see dabigatran Product Monograph). 5. Documented stable renal function is defined as creatinine clearance or estimated glomerular filtration rate that maintained for at least three months (i.e. 30-49 ml/min for 110 mg twice daily dosing or 50 ml/min for 150 mg twice daily dosing). 6. There is currently no data to support that dabigatran provides adequate anticoagulation in patients with rheumatic valvular disease or those with prosthetic heart valves, so dabigatran is not recommended in these populations. 7. Patients starting dabigatran should have ready access to appropriate medical services to manage a major bleeding event. September 2015 v.1 A - 24

DABRAFENIB (TAFINLAR) 50mg and 75mg capsules As monotherapy for the first line treatment of patients with BRAF V600 mutation-positive unresectable or metastatic melanoma with ECOG performance status of 0 or 1. If brain metastases are present, patients should be asymptomatic or stable. As monotherapy for the second line treatment of patients with BRAF V600 mutation-positive unresectable or metastatic melanoma for patients who have progressed after receiving chemotherapy treatment in the first line setting with ECOG performance status of 0 or 1. If brain metastases are present, patients should be asymptomatic or stable. Clinical Notes: Recommended Dose: 150 mg twice daily until disease progression or development of unacceptable toxicity requiring discontinuation of dabrafenib. Dabrafenib will not be reimbursed in patients who have progressed on a prior BRAF therapy. Claim Notes: Initial approval duration: 6 months Renewal approval duration: 6 months DALTEPARIN SODIUM (FRAGMIN) Pre-filled syringes, ampoule, single dose vial, and multidose vial See criteria under Low Molecular Weight Heparins. DARBEPOETIN (ARANESP) 10, 20, 30, 40, 50, 60, 80, 100, 130, 150, 200, 300 and 500mcg SingleJect pre-filled Syringes For the treatment of anemia associated with chronic renal failure. Claim Note: Patients on dialysis (end-stage renal disease) receive darbepoetin through the dialysis units. For the treatment of transfusion dependent patients with hematologic malignancies whose transfusion requirements are 2 units of packed red blood cells per month over 3 months. Clinical Note: Approval of further 12 week cycles is dependent on evidence of satisfactory clinical response or reduced treatment requirement to less than 2 units of PRBC monthly. Claim Note: Initial approval for 12 weeks. DARIFENACIN HYDROBROMIDE (ENABLEX) 7.5mg and 15mg extended release tablets For the treatment of overactive bladder with symptoms of urinary frequency, urgency and/or urge incontinence in patients who have not tolerated a reasonable trial of immediate-release oxybutynin. Clinical Note: Requests for the treatment of stress incontinence will not be considered. Claim Notes: If the beneficiary has had a claim for oxybutynin in the previous 24 months, the adjudication system will recognize this. Information and the claim for darifenacin will be automatically reimbursed without the need for a written special authorization request. Written special authorization will continue to be available as an option for patients who may not have the relevant first line agent on history due to changes in drug coverage or other factors. DASATINIB (SPRYCEL) 20mg, 50mg, 70mg, 80mg, 100mg and 140mg tablets Chronic Myeloid Leukemia (CML) For adult patients with chronic phase CML with primary or acquired resistance to imatinib 600mg per day. Dosing recommendation: 100mg per day or 70mg two times daily who progress to accelerated phase on imatinib 600mg per day. Dosing recommendation: 140mg per day who have blast crisis while on imatinib 600mg per day. Dosing recommendation: 140mg per day who have intolerance to imatinib or have experienced grade 3 or higher toxicities to imatinib September 2015 v.1 A - 25

Renewal Criteria: Request for renewal must specify how the patient has benefited from therapy and is expected to continue to do so. Claim Notes: Initial approval period: 1 year Renewal period: 1 year Acute Lymphoblastic Leukemia (ALL) For adult patients with Philadelphia chromosome positive acute lymphoblastic leukemia (ALL) whose disease is resistant to imatinib-containing chemotherapy (patient must have tried 600mg/day) or have experienced grade 3 nonhematologic toxicity, or grade 4 hematologic toxicity persisting for more than 7 days as a result of therapy with imatinib. Renewal Criteria: Written confirmation that the patient has benefited from therapy and is expected to continue to do so. Claim Notes: Initial approval period: 1 year Renewal period: 1 year DEFERASIROX (EXJADE) 125mg, 250mg and 500mg dispersible tablets for suspension For patients who require iron chelation but in whom deferoxamine is contraindicated. DENOSUMAB (PROLIA) 60mg/mL pre-filled syringe For the treatment of osteoporosis in postmenopausal women who would otherwise be eligible for coverage of oral bisphosphonate therapy and who have clinically or radiographically-documented fracture due to osteoporosis AND Contraindication to oral bisphosphonates for one of the following reasons: immune-mediated hypersensitivity reaction to oral bisphosphonates; OR abnormalities of the esophagus which delay esophageal emptying such as stricture or achalasia. Clinical Note: Please note that commonly reported adverse effects or intolerance to bisphosphonates will not be considered to be hypersensitivity. DENOSUMAB (XGEVA) 120mg/1.7mL single use vial For the prevention of skeletal-related events (SREs) in patients with castrate-resistant prostate cancer (CRPC) with one or more documented bone metastases and an ECOG performance status of 0-2*. Clinical Note: *Patients who are asymptomatic and those who are symptomatic and in bed less than 50% of the time. DESMOPRESSIN (DDAVP and generic brands) 0.1mg and 0.2mg tablets DESMOPRESSIN (DDAVP MELT) 60mcg, 120mcg and 240mcg tablets For the management of diabetes insipidus. For the treatment of patients 18 years and older with nocturnal enuresis. Claim Note: Desmopressin oral formulations are a regular benefit for Plans DEFG-18. DESMOPRESSIN (DDAVP and generic brand) 10mcg/metered dose nasal spray and 0.1mg/mL intranasal solution For the treatment of patients with diabetes insipidus. Clinical Note: The nasal formulations are no longer indicated for nocturnal enuresis due to the risk of hyponatremia. September 2015 v.1 A - 26

DIENOGEST (VISANNE) 2mg tablet For the management of pelvic pain associated with endometriosis in patients for whom one or more less costly hormonal options are either ineffective or cannot be used. Clinical Note: Continuous combined oral contraceptives and medroxyprogesterone are examples of less costly hormonal options. DIMETHYL FUMARATE (TECFIDERA) 120mg and 240mg delayed-release capsules For the treatment of relapsing-remitting multiple sclerosis (RRMS) in patients who meet the following criteria: Two disabling attacks of MS in the previous two years, and Ambulatory with or without aid (EDSS of less than or equal to 6.5) Clinical Note: An attack is defined as the appearance of new symptoms or worsening of old symptoms, lasting at least 24 hours in the absence of fever, and preceded by stability for at least one month. Claim Note: Prescriptions written by New Brunswick neurologists do not require special authorization. DIPYRIDAMOLE EXTENDED RELEASE/ASA IMMEDIATE RELEASE (AGGRENOX) 200mg/25mg capsule For the secondary prevention of ischemic stroke/tia in patients who have experienced a recurrent thrombotic event (stroke, symptoms of TIA) while taking ASA. DONEPEZIL (ARICEPT and generic brands) 5mg and 10mg tablets See criteria under Cholinesterase Inhibitors. DORNASE ALPHA RECOMBINANT (PULMOZYME) 1 mg/ml solution For cystic fibrosis (Plan B) patients with a FEV 1<70% predicted with clinically significant decline in FEV 1 not responsive to usual treatment. DULOXETINE (CYMBALTA) 30 mg and 60 mg capsules For the treatment of peripheral neuropathic pain in diabetic patients who have failed treatment with at least 2 other less costly agents used for the treatment of neuropathic pain. (i.e. tricyclic antidepressants and/or an anticonvulsants). Claim Note: The maximum allowable dose is 60 mg/day. ECULIZUMAB (SOLIRIS) 10mg/mL vial For the treatment of paroxysmal nocturnal hemoglobinuria (PNH). Clinical Notes: 1. A Request for Coverage including the completed consent and specific special authorization forms must be submitted and the patient must: a. Satisfy the Clinical Criteria for eculizumab (initial or continued coverage, as appropriate); b. Not meet any of the criteria specified in Contraindications to Coverage or Discontinuance of Coverage. 2. Please contact the NB Drug Plans at 1-800-332-3691 for a packet containing the Clinical Criteria and required forms. Claim Note: Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate transactions as outlined here. September 2015 v.1 A - 27

ELVITEGRAVIR/COBICISTAT/EMTRICITABINE/TENOFOVIR DISOPROXIL FUMARATE (STRIBILD) 150mg/150mg/200mg/300mg tablet As a complete regimen for antiretroviral treatment naïve HIV-1 infected patients in whom efavirenz is not indicated. Claim Note: Prescriptions written by NB Infectious Disease Specialists and Medical Microbiologists experienced in treating patients with HIV/AIDS, do not require special authorization. ENOXAPARIN SODIUM (LOVENOX) Pre-filled syringes and multidose vials ENOXAPARIN SODIUM (LOVENOX HP) Pre-filled syringes See criteria under Low Molecular Weight Heparins. ENTECAVIR (BARACLUDE and generic brands) 0.5mg tablet For the treatment of chronic hepatitis B infection in patients with cirrhosis documented on radiologic or histologic grounds and a HBV DNA concentration above 2,000 lu/ml. ENZALUTAMIDE (XTANDI) 40mg capsule For treatment of patients with metastatic castration resistant prostate cancer, who have progressed on docetaxelbased chemotherapy with an ECOG performance status 2 and no risk factors for seizures and would be an alternative to abiraterone for patients in the post-docetaxel setting but would not be an add-on therapy to abiraterone treatment. EPOETIN ALFA (EPREX) 1000IU/0.5mL, 2000IU/0.5mL, 3000IU/0.3mL, 4000IU/0.4mL, 5000IU/.5mL, 6000IU/.6mL, 8000IU/.8mL, 10000IU/mL, 20000IU/mL, 30,000IU/0.75mL and 40000IU/mL vials and pre-filled syringes 1. Treatment of anemia associated with chronic renal failure. Claim Note: Patients on dialysis (end-stage renal disease) receive epoetin through the dialysis units. 2. Treatment of transfusion dependent anemia related to therapy with zidovudine in HIV-infected patients. 3. Treatment of transfusion dependent patients with hematologic malignancies whose transfusion requirements are 2 units of packed red blood cells per month over 3 months. Clinical Note: Approval of further 12 week cycles is dependent on evidence of satisfactory clinical response or reduced treatment requirement to less than 2 units of PRBC monthly. Claim Note: Initial approval for 12 weeks. EPOPROSTENOL SODIUM (CARIPUL and FLOLAN) 0.5mg and 1.5mg vials for injection 1. For the treatment of World Health Organization (WHO) class III or IV idiopathic pulmonary arterial hypertension in patients who do not demonstrate vasoreactivity on testing or who demonstrate vasoreactivity on testing but fail a trial of, or are intolerant to, calcium channel blockers. 2. For the treatment of WHO class III or IV pulmonary arterial hypertension associated with scleroderma in patients who do not respond adequately to conventional therapy. ERLOTINIB (TARCEVA) 25mg, 100mg and 150mg tablets Non-small Cell Lung Cancer (NSCLC) For the treatment of patients with locally advanced or metastatic NSCLC after failure of at least one prior chemotherapy regimen and whose EGFR mutation status is positive or unknown. September 2015 v.1 A - 28

Renewal Criteria: Written confirmation that the patient has responded to treatment and in whom there is no evidence of disease progression. Claim Notes: Initial approval period: 6 month trial Renewal period: 6 months ESTRADIOL-17β (ESTRADOT and generic brand) 25 mcg, 37.5mcg, 50mcg, 75mcg and 100mcg transdermal patch For the treatment of menopausal symptoms in women for whom oral forms of HRT are not tolerated or indicated. ETANERCEPT (ENBREL) 25mg liquid injection 50mg/mL pre-filled syringe Ankylosing Spondylitis For the treatment of patients with moderate to severe ankylosing spondylitis (e.g. Bath AS Disease Activity Index (BASDAI) score 4 on 10 point scale) who: have axial symptoms* and who have failed to respond to the sequential use of at least 2 NSAIDs at the optimum dose for a minimum period of 3 months observation or in whom NSAIDs are contraindicated OR have peripheral symptoms and who have failed to respond to, or have contraindications to, the sequential use of at least 2 NSAIDs at the optimum dose for a minimum period of 3 months observation and have had an inadequate response to an optimal dose or maximal tolerated dose of a DMARD. Requests for renewal must include information showing the beneficial effects of the treatment, specifically: a decrease of at least 2 points on the BASDAI scale, compared with the pre-treatment score; OR patient and expert opinion of an adequate clinical response as indicated by a significant functional improvement (measured by outcomes such as HAQ or ability to return to work ) Clinical Notes: 1. * Patients with recurrent uveitis (2 or more episodes within 12 months) as a complication to axial, disease do not require a trial of NSAIDs alone. 2. Etanercept will not be reimbursed in combination with other anti-tnf agents. Claim Notes: Must be prescribed by a rheumatologist or internist Approval will be for a maximum of 6 months Approvals will be for a maximum dose of 50mg per week. Juvenile Rheumatoid Arthritis For the treatment of children (age 4-17) with moderately to severely active polyarticular juvenile rheumatoid arthritis who have: not responded to adequate treatment with one or more disease modifying antirheumatic drug (DMARD) for at least 3 months, OR intolerance to DMARDs Claim Note: Must be prescribed by a rheumatologist. Psoriatic Arthritis For the treatment of patients with active psoriatic arthritis who have not responded to an adequate trial with two disease modifying antirheumatic drugs (DMARDs) or who have an intolerance or contraindication to DMARDs. Claim Note: Must be prescribed by a rheumatologist. Rheumatoid Arthritis For patients with moderate to severe active rheumatoid arthritis who: Have not responded to, or have had intolerable side-effects with, an adequate trial of combination therapy of at least two traditional DMARDs (disease modifying antirheumatic drugs). Combination DMARD therapy must include methotrexate unless contraindicated or not tolerated, OR September 2015 v.1 A - 29

Are not candidates for combination DMARD therapy must have had adequate trial of at least three traditional DMARDs in sequence, one of which must have been methotrexate unless contraindicated Claim Note: Must be prescribed by a rheumatologist. Plaque Psoriasis Requests will be considered for treatment of patients with severe, debilitating chronic plaque psoriasis who meet all of the following criteria: Body surface area (BSA) involvement of >10% and/or significant involvement of the face, hands, feet or genital region; Failure to respond to, contraindications to or intolerance to methotrexate and cyclosporine; Failure to respond to, intolerance to or unable to access phototherapy Clinical Notes: 1. Continuation of therapy beyond 12 weeks will be based on response. Patients not responding adequately at these time points should have treatment discontinued with no further treatment with the same agent recommended. 2. An adequate response is defined as either: - 75% reduction in the Psoriasis Area and Severity Index (PASI) score from when treatment started (PASI 75), OR - 50% reduction in the PASI score (PASI 50) with a 5 point improvement in the Dermatology Life Quality Index (DLQI) from when treatment started, OR - A quantitative reduction in BSA affected with qualitative consideration of specific regions such as face, hands, feet, or genital region. 3. Concurrent use of >1 biologic will not be approved Claim Notes: Initial approval limited to 12 weeks. Must be prescribed by a dermatologist Approval limited to a dose of 50 mg twice weekly for an initial 12 weeks, then 50 mg weekly, thereafter up to a year (if response criteria met at 12 weeks) ETIDRONATE (DIDRONEL and generic brands) 200mg tablet See criteria under Osteoporosis Drugs. ETIDRONATE AND CALCIUM (DIDROCAL and generic brands) 400mg/500mg tablet See criteria under Osteoporosis Drugs. ETONOGESTREL / ETHINYL ESTRADIOL (NUVARING) 11.4mg/2.6mg vaginal ring For conception control in women who are unable to take oral contraceptives. ETRAVIRINE (INTELENCE) 100mg and 200mg tablets For the treatment of HIV-1 infection in patients who are antiretroviral experienced and have virologic failure due to HIV-1 strains resistant to multiple antiretroviral agents, including other non-nucleoside reverse transcriptase inhibitors. EVEROLIMUS (AFINITOR) 2.5mg, 5mg and 10mg tablets 1. For the treatment of metastatic renal cell carcinoma (mrcc) with clear cell morphology, in patients previously treated with a tyrosine kinase inhibitor. 2. In combination with exemestane, for the treatment of hormone-receptor positive, HER2 negative advanced breast cancer, in postmenopausal women with ECOG performance status 2 after recurrence or progression following a non-steroidal aromatase inhibitor (NSAI), if the treating oncologist would consider using exemestane. 3. For the treatment of patients with progressive, unresectable, well or moderately differentiated, locally advanced or metastatic pancreatic neuroendocrine tumours (pnet) with good performance status (ECOG 0-2), until disease progression. Claim Note: Dosing for above indications: maximum 10mg daily September 2015 v.1 A - 30

EZETIMIBE (EZETROL and generic brands) 10mg tablets For the treatment of hypercholesterolemia As adjunctive therapy with a statin, in patients who have not reached treatment goals on maximum tolerated statin therapy alone, OR As monotherapy in patients who are intolerant to statins and, when appropriate, fibrates. FEBUXOSTAT (ULORIC) 80mg tablet For patients with symptomatic gout who have documented hypersensitivity to allopurinol. Hypersensitivity to allopurinol is a rare condition that is characterized by a major skin manifestation, fever, multi-organ involvement, lymphadenopathy and hematological abnormalities (eosinophilia, atypical lymphocytes). Clinical Note: Intolerance or lack of response to allopurinol will not be covered by these criteria. FENTANYL (DURAGESIC MAT and generic brands) Transdermal system 12mcg/hr, 25mcg/hr, 50mcg/hr, 75mcg/hr and 100mcg/hr For the management of malignant or chronic non-malignant pain in adult patients; who were previously receiving continuous opioid administration (i.e. not opioid naive), OR who are unable to take oral therapy. FERUMOXYTOL (FERAHEME) 30mg/mL (510mg/17mL) intravenous injection For the treatment of iron deficiency anemia in patients with chronic kidney disease who are predialysis or receiving home hemodialysis or peritoneal dialysis. Claim Notes: Requests will be considered from a practitioner with a specialty in nephrology. The maximum dose that will be reimbursed is 510mg. FESOTERODINE FUMARATE (TOVIAZ) 4mg and 8mg extended-release tablets For the treatment of overactive bladder with symptoms of urinary frequency, urgency and/or urge incontinence in patients who have not tolerated a reasonable trial of immediate release oxybutynin. Clinical Note: Requests for the treatment of stress incontinence will not be considered. Claim Notes: If the beneficiary has had a claim for oxybutynin in the previous 24 months, the adjudication system will recognize this information and the claim for fesoterodine fumarate will be automatically reimbursed without the need for a written special authorization request. Written special authorization will continue to be available as an option for patients who may not have the relevant first line agent on history due to changes in drug coverage or other factors. FIDAXOMICIN (DIFICID) 200mg tablet For the treatment of Clostridium Difficile Infection (CDI) where the patient: has experienced a third or subsequent episode within 6 months of treatment with vancomyin for prior episode(s), with no previous trial of fidaxomicin; OR has experienced treatment failure* with oral vancomycin for the current CDI episode; OR has had a documented allergy (immune-mediated reaction) to oral vancomycin; OR has experienced a severe adverse reaction or intolerance** to oral vancomycin treatment that resulted in the discontinuation of vancomycin therapy. September 2015 v.1 A - 31

Re-treatment criteria: Re-treatment with fidaxomicin will only be considered for an early relapse occurring within 30 days of the completion of the most recent fidaxomicin course. Relapse/recurrence occurring beyond 30 days after the completion of the most recent fidaxomicin course will require a trial with vancomycin, unless there is a documented allergy, severe adverse reaction or intolerance to prior oral vancomycin use. Clinical Notes: *Treatment failure is defined as 7 days of vancomycin therapy without acceptable clinical improvement. **Details of severe adverse reaction or intolerance must be provided and should be clinically related to oral administration of vancomycin. Claim Note: Requests will be approved for 200mg twice a day for 10 days. FILGRASTIM (NEUPOGEN - AMGEN) 300mcg/1mL and 480mcg/1.6mL injections CHEMOTHERAPY SUPPORT Primary prophylaxis: When given as an integral part of an aggressive chemotherapy regimen with curative intent, in order to maintain dose intensity in compressed interval or dose dense treatment, as specified in a chemotherapy protocol. Secondary prophylaxis: - For use in patients receiving myelosuppressive chemotherapy who have experienced an episode of febrile neutropenia, neutropenic sepsis or profound neutropenia in a previous cycle of chemotherapy; or - For use in patients who have experienced a dose reduction or treatment delay longer than one week, due to neutropenia. Dosing for Chemotherapy support: The manufacturer recommends an initial dose of 5mcg/kg/day. When dose scavenging techniques are not available, the following recommendations are suggested: - Patients 70 Kg use 1 ml vial (300mcg) DIN 01968017 - Patients > 70 Kg use 1.6 ml vial (480mcg) PIN 00999001 NON-MALIGNANT INDICATIONS Treatment of congenital neutropenia, idiopathic neutropenia or cyclic neutropenia in patients with recurrent clinical infections. Drug-induced neutropenia (e.g. antiviral therapy in patients with HIV). Refer to product monograph for dosing recommendations. STEM-CELL TRANSPLANTATION Mobilization: As an adjunct to progenitor cell transplantation, for mobilization of peripheral blood stem cells (PBSC). The recommended dosage is 10mcg/kg/day. Reconstitution/Engraftment: Post bone marrow transplantation (BMT) or PBSC transplantation to speed hematopoietic reconstitution. The recommended dosage is 5mcg/kg/day. UNACCEPTABLE USE Treatment of febrile neutropenia or in the prevention of febrile neutropenia in the palliative setting. Claim Note: Filgrastim must be prescribed or requested by a certified hematologist or medical oncologist. FINGOLIMOD (GILENYA) 0.5 mg capsule For the treatment of patients with Relapsing Remitting Multiple Sclerosis (RRMS) who meet all of the following criteria: Failure to respond to full and adequate courses 1 of at least one interferon OR glatiramer acetate; OR documented intolerance 2 to both therapies Have experienced one or more clinically disabling relapses in the previous year Demonstrate a significant increase in T2 lesion load compared with that from a previous MRI scan (i.e. 3 or more new lesions) OR have at least one gadolinium enhancing lesion Request is being made by and followed by a neurologist experienced in the management of RRMS Patient has a recent Expanded Disability Status Scale (EDSS) score less than or equal to 5.5 (i.e. patients must be able to ambulate at least 100 meters without assistance) September 2015 v.1 A - 32

Exclusion Criteria: Combination therapy of fingolimod with other disease modifying therapies (e.g. Avonex, Betaseron, Copaxone, Rebif, Extavia, Tysabri) will not be funded. Combination therapy of fingolimid with Fampyra will not be funded. Patients with EDSS > 5.5 will not be funded Patients who have experienced a heart attack or stroke within the 6 months prior to the funding request will not be considered. Patients with a history of sick sinus syndrome, atrioventricular block, significant QT prolongation, bradycardia, ischemic heart disease, or congestive heart failure will not be considered. Patients younger than 18 years of age will not be considered. Patients with needle phobia or those having a preference for an oral therapy over an injection and who do not have one or more clinical contraindications to interferon or glatiramer therapy will not be funded. Skin reactions at the site of the injection do NOT qualify as a contraindication to interferon or glatiramer therapy. Requirements for Initial Requests: The patient s physician must provide documentation setting out the details of the patient s most recent neurological examination within ninety (90) days of the submitted request. This must include a description of any recent attacks, the dates, and the neurological findings. Renewal requests will be considered. Date and details of the most recent neurological examination and EDSS scores must be provided (exam must have occurred within that last 90 days); AND Patient must be stable or have experienced no more than 1 disabling attack/relapse in the past year; AND The recent Expanded Disability Status Scale (EDSS) score must be less than or equal to 5.5 (i.e. patients must be able to ambulate at least 100 meters without assistance) Clinical Notes: 1. 1 Failure to respond to full and adequate courses is defined as a trial of at least 6 months of interferon or glatiramer therapy AND experienced at least one disabling relapse (attack) while on interferon or glatiramer therapy (MRI report does not need to be submitted with the request) 2. 2 Intolerance is defined as documented serious adverse effects or contraindications that are incompatible with further use of that class of drug. (Note that skin reactions at the site of the injection do NOT qualify as a contraindication to interferon or glatiramer therapy.) Claim Notes: Dosage: 0.5 mg once daily Initial approval period: 1 year Renewal approval period: 2 years FLUDARABINE (FLUDARA) 10mg tablet For the first-line treatment of chronic lymphocytic leukemia (CLL) in combination with rituximab (with or without cyclophosphamide). FORMOTEROL (FORADIL) 12 mcg dry powder for inhalation Reversible obstructive airway disease: For the treatment of patients, 12 years of age or older, with reversible obstructive airway disease who are using optimal corticosteroid treatment, but are still poorly controlled. Chronic Obstructive Pulmonary Disease For the treatment of chronic obstructive pulmonary disease (COPD) if symptoms persist after 2-3 months of short-acting bronchodilator therapy (i.e. salbutamol at a maximum dose of 8 puffs/day or ipratropium at maximum dose of 12 puffs/day). Coverage can be provided without a trial of short-acting agent if there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1 /FVC ratio < 0.7) and significant symptoms (i.e. Medical Research Council (MRC) Dyspnea Scale score of 3-5). Combination therapy with tiotropium AND a long-acting beta2-adrenergic agonist/inhaled corticosteroid (LABA/ICS) will only be considered if: - there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1/FVC ratio < 0.7), and significant symptoms i.e. MRC score of 3-5) AND - there is evidence of one or more moderate-to-severe exacerbations per year, on average, for 2 consecutive years requiring antibiotics and/or systemic (oral or intravenous) corticosteroids. September 2015 v.1 A - 33

Clinical Note: If spirometry cannot be obtained, reasons must be clearly explained and other evidence regarding severity of condition must be provided for consideration (i.e. MRC scale). Spirometry reports from any point in time will be accepted. COPD Stage MODERATE MRC 3 to 4 SEVERE MRC 5 Medical Research Council (MRC) Dyspnea Scale Symptoms Shortness of breath from COPD causing the patient to stop after walking about 100 meters (or after a few minutes) on the level. Shortness of breath from COPD resulting in the patient being too breathless to leave the house or breathless after undressing, or the presence of chronic respiratory failure or clinical signs of right heart failure. Claim Note: Prescriptions written by certified New Brunswick respirologists do not require special authorization. Subsequent refills ordered by other practitioners will not require special authorization. FORMOTEROL (OXEZE) 6 mcg and 12 mcg turbuhalers Reversible obstructive airway disease: For the treatment of patients, 12 years of age or older, with reversible obstructive airway disease who are using optimal corticosteroid treatment, but are still poorly controlled. Chronic Obstructive Pulmonary Disease For the treatment of chronic obstructive pulmonary disease (COPD) if symptoms persist after 2-3 months of short-acting bronchodilator therapy (i.e. salbutamol at a maximum dose of 8 puffs/day or ipratropium at maximum dose of 12 puffs/day). Coverage can be provided without a trial of short-acting agent if there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1 /FVC ratio < 0.7) and significant symptoms (i.e. Medical Research Council (MRC) Dyspnea Scale score of 3-5). Combination therapy with tiotropium AND a long-acting beta2-adrenergic agonist/inhaled corticosteroid (LABA/ICS) will only be considered if: - there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1/FVC ratio < 0.7), and significant symptoms i.e. MRC score of 3-5) AND - there is evidence of one or more moderate-to-severe exacerbations per year, on average, for 2 consecutive years requiring antibiotics and/or systemic (oral or intravenous) corticosteroids. Clinical Note: If spirometry cannot be obtained, reasons must be clearly explained and other evidence regarding severity of condition must be provided for consideration (i.e. MRC scale). Spirometry reports from any point in time will be accepted. COPD Stage MODERATE MRC 3 to 4 SEVERE MRC 5 Medical Research Council (MRC) Dyspnea Scale Symptoms Shortness of breath from COPD causing the patient to stop after walking about 100 meters (or after a few minutes) on the level. Shortness of breath from COPD resulting in the patient being too breathless to leave the house or breathless after undressing, or the presence of chronic respiratory failure or clinical signs of right heart failure. Claim Note: Prescriptions written by certified New Brunswick respirologists do not require special authorization. Subsequent refills ordered by other practitioners will not require special authorization. FOSFOMYCIN (MONUROL) 3g sachet For the treatment of uncomplicated urinary tract infections in adult female patients where: The infecting organism is resistant to other oral agents, OR Other less costly agents are not tolerated. Clinical Note: Fosfomycin is not indicated in the treatment of pyelonephritis or perinephric abscess. September 2015 v.1 A - 34

GALANTAMINE (REMINYL ER and generic brands) 8mg, 16mg, and 24mg capsules See criteria under Cholinesterase Inhibitors. GLATIRAMER ACETATE (COPAXONE) 20mg injection 1. For the treatment of patients with clinically definite multiple sclerosis (CDMS) including relapsing-remitting multiple sclerosis or secondary progressive multiple sclerosis who meet the following criteria: Two disabling attacks of MS in the previous two years, AND Ambulatory with or without aid (EDSS of less than or equal to 6.5) 2. For the treatment of patients who have experienced a clinically isolated syndrome (CIS) and are considered at risk for developing CDMS. Clinical Note: An attack is defined as the appearance of new symptoms or worsening of old symptoms, lasting at least 24 hours in the absence of fever, and preceded by stability for at least one month. Claim Note: Prescriptions written by New Brunswick neurologists do not require special authorization. GLYCOPYRRONIUM BROMIDE (SEEBRI BREEZHALER) 50mcg capsule Chronic Obstructive Pulmonary Disease For the treatment of chronic obstructive pulmonary disease (COPD) if symptoms persist after 2-3 months of short-acting bronchodilator therapy (i.e. salbutamol at a maximum dose of 8 puffs/day or ipratropium at maximum dose of 12 puffs/day). Coverage can be provided without a trial of short-acting agent if there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1 /FVC ratio < 0.7) and significant symptoms (i.e. Medical Research Council (MRC) Dyspnea Scale score of 3-5). Combination therapy with glycopyrronium bromide AND a long-acting beta2-adrenergic agonist/inhaled corticosteroid (LABA/ICS) will only be considered if: - there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1/FVC ratio < 0.7), and significant symptoms (i.e. MRC score of 3-5) AND - there is evidence of one or more moderate-to-severe exacerbations per year, on average, for 2 consecutive years requiring antibiotics and/or systemic (oral or intravenous) corticosteroids. Clinical Note: If spirometry cannot be obtained, reasons must be clearly explained and other evidence regarding severity of condition must be provided for consideration (i.e. MRC scale). Spirometry reports from any point in time will be accepted. COPD Stage MODERATE MRC 3 to 4 SEVERE MRC 5 Medical Research Council (MRC) Dyspnea Scale Symptoms Shortness of breath from COPD causing the patient to stop after walking about 100 meters (or after a few minutes) on the level. Shortness of breath from COPD resulting in the patient being too breathless to leave the house or breathless after undressing, or the presence of chronic respiratory failure or clinical signs of right heart failure. GOLIMUMAB (SIMPONI) 50mg/0.5mL autoinjector/pre-filled syringe 1. For the treatment of patients with moderate to severe ankylosing spondylitis (e.g. Bath AS Disease Activity Index (BASDAI) score 4 on 10 point scale) who: Have axial symptoms* and who have failed to respond to the sequential use of at least 2 NSAIDs at the optimum dose for a minimum 3 month observation period or in whom NSAIDs are contraindicated OR Have peripheral symptoms and who have failed to respond to, or have contraindications to, the sequential use of at least 2 NSAIDs at the optimum dose for a minimum 3 month observation period and have had an inadequate response to an optimal dose or maximal tolerated dose of a DMARD. September 2015 v.1 A - 35

Renewal requests: Requests for continuation of therapy must include information showing the clinical beneficial effects of the treatment, specifically: - a decrease of at least 2 points on the BASDAI scale, compared with the pre-treatment score OR - patient and expert opinion of an adequate clinical response as indicated by a significant functional improvement (measured by outcomes such as HAQ or ability to return to work ) Clinical Notes: 1. Golimumab will not be reimbursed in combination with other anti-tnf agents. 2. * Patients with recurrent uveitis (2 or more episodes within 12 months) as a complication to axial disease do not require a trial of NSAIDs alone. Claim Notes: Must be prescribed by a rheumatologist or internist. Initial approval will be for 4 x 50 mg doses in a 4 month period. Approvals for continuation of therapy will be for 12 x 50 mg doses annually with no dose escalation permitted. 2. For the treatment of moderate to severe psoriatic arthritis in patients who: Have at least three active and tender joints, AND Have not responded to an adequate trial of two DMARDs or have an intolerance or contraindication to DMARDs. Renewal Requests: Requests for continuation of therapy must include information demonstrating clinical beneficial effects of the treatment. Clinical Note: Golimumab will not be reimbursed in combination with other anti-tnf agents. Claim Notes: Must be prescribed by a rheumatologist or internist Initial approval will be for 4 x 50mg doses in a 4 month period. Approvals for continuation of therapy will be for 12 x 50 mg doses annually with no dose escalation permitted. 3. For patients with moderate to severe active rheumatoid arthritis who: Have not responded to, or have had intolerable side-effects with, an adequate trial of combination therapy of at least two traditional DMARDs (disease modifying antirheumatic drugs). Combination DMARD therapy must include methotrexate unless contraindicated or not tolerated, OR Are not candidates for combination DMARD therapy must have had adequate trial of at least three traditional DMARDs in sequence, one of which must have been methotrexate unless contraindicated. Renewal Requests: Requests for continuation of therapy must include information demonstrating clinical beneficial effects of the treatment. Clinical Note: Golimumab will not be reimbursed in combination with anti-tnf agents. Claim Notes: Must be prescribed by a rheumatologist. Initial approval will be for 4 x 50 mg doses in a 4 month period. Approvals for continuation of therapy will be for 12 x 50 mg doses annually with no dose escalation permitted. GRANISETRON (KYTRIL and generic brand) 1mg tablet For the treatment of emesis in patients who are: receiving moderately or severely emetogenic chemotherapy OR receiving intravenous chemotherapy or radiotherapy and who have not experienced adequate control with other available antiemetics OR receiving any intravenous chemotherapy or radiotherapy and have experienced emesis with a prior cycle of chemotherapy with intolerable side effects to other antiemetics, including steroids and anti-dopaminergic agents. September 2015 v.1 A - 36

Clinical Notes: 1. Only requests for the oral dosage forms are eligible for consideration. Usually a single oral dose prechemotherapy is sufficient to control symptoms. 2. Some patients may require additional therapy up to 48 hours after the last dose of chemotherapy or last radiation treatment. Benefit beyond 48 hours has not been established. 3. When used in combination with aprepitant, only a single oral dose pre-chemotherapy will be covered. Claim Note: Prescription claims for up to a maximum of 12 tablets of ondansetron or 2 tablets of granisetron will be automatically reimbursed every 28 days when the prescription is written by an oncologist or an oncology clinical associate/general practitioners-oncology. If additional medication is required within a 28 day period subsequent to the initial prescription, a request should be made through special authorization. GRASS POLLEN ALLERGEN EXTRACT (ORALAIR) 100IR and 300IR sublingual tablets For the seasonal treatment of grass pollen allergic rhinitis in patients who have not adequately responded to, or tolerated, conventional pharmacotherapy. Clinical Notes: Treatment with grass pollen allergen extract must be initiated by physicians with adequate training and experience in the treatment of respiratory allergic diseases. Treatment should be initiated four months before the onset of pollen season and should only be continued until the end of the season Treatment should not be taken for more than three consecutive years Hp-PAC (Containing LANSOPRAZOLE 30mg Cap, AMOXICILLIN 500mg Cap, CLARITHROMYCIN 500mg Tab) For the treatment of patients with H. pylori infection and active duodenal ulcer disease. Clinical Notes: 1. Treatment should be limited to a period of 7 days for first-line therapy. 2. In cases of H. pylori treatment failure or re-infection, second-line treatment should be limited to a period of 7-14 days provided at least 4 weeks have elapsed from first-line treatment. In addition, if treatment failure or reinfection occurs within a three month period of first-line treatment, a different antibiotic should be used. IMATINIB (GLEEVEC and generic brands) 100mg and 400mg tablets Requests from specialists in hematology/oncology will be considered for: 1. Patients who have documented evidence of Philadelphia chromosome positive (Ph+) chronic myeloid leukemia (CML), with an ECOG performance status of 0-2*. 2. Patients with C-Kit positive (CD117), metastatic or locally advanced, inoperable gastrointestinal stromal tumours (GIST), who have an ECOG performance status of 0-2*. 3. For the treatment of adult patients with newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) when used as a single agent for induction and maintenance phase therapy. Clinical Note: *Patients who are asymptomatic and those who are symptomatic and in bed less than 50% of the time. IMIQUIMOD (ALDARA and generic brand) 5% cream 1. For the treatment of external genital and external perianal/condyloma acuminata warts. Claim Note: Approval Period: 16 weeks 2. For the treatment of actinic keratosis in patients who have failed treatment with 5-Fluorouracil (5-FU) and cryotherapy. Claim Note: Approval Period: 16 weeks 3. For the treatment of biopsy-confirmed primary superficial basal cell carcinoma: with a tumour diameter of 2 cm AND located on the trunk, neck or extremities (excluding hands and feet) AND September 2015 v.1 A - 37

where surgery or irradiation therapy is not medically indicated - recurrent lesions in previously irradiated area OR - multiple lesions, too numerous to irradiate or remove surgically. Clinical Note: Surgical management should be considered first-line for superficial basal cell carcinoma in most patients, especially for isolated lesions. Claim Note: Approval Period: 6 weeks INCOBOTULINUMTOXIN-A (XEOMIN) 50 LD 50 units/ vial and 100 unit vial for injection For the treatment of blepharospasm in patients 18 years of age and older. For the treatment of cervical dystonia (spasmodic torticollis) in patients 18 years of age or older. INDACATEROL MALEATE (ONBREZ BREEZHALER) 75mcg inhalation powder hard capsules Chronic Obstructive Pulmonary Disease For the treatment of chronic obstructive pulmonary disease (COPD) if symptoms persist after 2-3 months of short-acting bronchodilator therapy (i.e. salbutamol at a maximum dose of 8 puffs/day or ipratropium at maximum dose of 12 puffs/day). Coverage can be provided without a trial of short-acting agent if there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1 /FVC ratio < 0.7) and significant symptoms (i.e. Medical Research Council (MRC) Dyspnea Scale score of 3-5). Combination therapy with tiotropium AND a long-acting beta2-adrenergic agonist/inhaled corticosteroid (LABA/ICS) will only be considered if: - there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1/FVC ratio < 0.7), and significant symptoms i.e. MRC score of 3-5) AND - there is evidence of one or more moderate-to-severe exacerbations per year, on average, for 2 consecutive years requiring antibiotics and/or systemic (oral or intravenous) corticosteroids. Clinical Notes: Dose not to exceed 75 mcg/day If spirometry cannot be obtained, reasons must be clearly explained and other evidence regarding severity of condition must be provided for consideration (i.e. MRC scale). Spirometry reports from any point in time will be accepted. COPD Stage MODERATE MRC 3 to 4 SEVERE MRC 5 Medical Research Council (MRC) Dyspnea Scale Symptoms Shortness of breath from COPD causing the patient to stop after walking about 100 meters (or after a few minutes) on the level. Shortness of breath from COPD resulting in the patient being too breathless to leave the house or breathless after undressing, or the presence of chronic respiratory failure or clinical signs of right heart failure. Claim Note: Prescriptions written by certified New Brunswick respirologists do not require special authorization. Subsequent refills ordered by other practitioners will not require special authorization. INDACATEROL / GLYCOPYRROLATE (ULTIBRO BREEZEHALER) 110mcg / 50mcg powder for inhalation For the treatment of moderate to severe chronic obstructive pulmonary disease (COPD), as defined by spirometry, in patients with an inadequate response to a long-acting beta-2 agonist (LABA) or long-acting anticholinergic (LAAC). Clinical notes: Moderate to severe COPD is defined by spirometry (post-bronchodilator) FEV 1 < 60% predicted and FEV 1/FVC ratio of < 0.70. Spirometry reports from any point in time will be accepted. September 2015 v.1 A - 38

If spirometry cannot be obtained, reasons must be clearly explained and other evidence regarding COPD severity must be provided for consideration (i.e. Medical Research Council (MRC) Dyspnea Scale score of at least Grade 3). MRC Grade 3 is described as: walks slower than people of same age on the level because of shortness of breath (SOB) from COPD or has to stop for breath when walking at own pace on the level. Inadequate response is defined as persistent symptoms after at least 2 months of long-acting beta-2 agonist (LABA) or long-acting anticholinergic therapy (LAAC). INFLIXIMAB (REMICADE) 100mg liquid injection Ankylosing Spondylitis For the treatment of patients with moderate to severe ankylosing spondylitis (e.g. Bath AS Disease Activity Index (BASDAI) score 4 on 10 point scale) who: - have axial symptoms* and who have failed to respond to the sequential use of at least 2 NSAIDs at the optimum dose for a minimum period of 3 months observation or in whom NSAIDs are contraindicated OR - have peripheral symptoms and who have failed to respond to, or have contraindications to, the sequential use of at least 2 NSAIDs at the optimum dose for a minimum period of 3 months observation and have had an inadequate response to an optimal dose or maximal tolerated dose of a DMARD. Renewal Requests: Requests for renewal must include information showing the beneficial effects of the treatment, specifically: - a decrease of at least 2 points on the BASDAI scale, compared with the pre-treatment score; OR - patient and expert opinion of an adequate clinical response as indicated by a significant functional improvement (measured by outcomes such as HAQ or ability to return to work ) Clinical Notes: 1. Patients with recurrent uveitis (2 or more episodes within 12 months) as a complication to axial disease, do not require a trial of NSAIDs alone 2. Infliximab will not be reimbursed in combination with other anti-tnf agents. Claim Notes: Must be prescribed by a rheumatologist or internist Approval will be for a maximum of 6 months Approvals will be for a maximum of 5mg/kg at weeks 0, 2 and 6, then every 6 to 8 weeks thereafter. Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate transactions as outlined here. Crohn s Disease For moderately to severely active Crohn's disease in patients who are refractory or have contraindications to an adequate course of 5-aminosalicylic acid and corticosteroids and other immunosuppressive therapy. Initial approval will consist of 3 doses of 5 mg/kg given at weeks 0, 2 and 6. Clinical Note: Infliximab will not be reimbursed in combination with other anti-tnf agents. Claim Notes: Ongoing coverage for maintenance therapy will only be reimbursed for responders and for a dose not exceeding 5mg/kg every 8 weeks. Coverage must be reassessed annually and is dependent on evidence of continued response. Must be prescribed by, or in consultation with, a gastroenterologist or physician with a specialty in gastroenterology. Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate transactions as outlined here. Plaque Psoriasis Requests will be considered for treatment of patients with severe, debilitating chronic plaque psoriasis who meet all of the following criteria: - Body surface area (BSA) involvement of >10% and/or significant involvement of the face, hands, feet or genital region; - Failure to respond to, contraindications to or intolerance to methotrexate and cyclosporine; - Failure to respond to, intolerance to or unable to access phototherapy September 2015 v.1 A - 39

Clinical Notes: 1. Continuation of therapy beyond 12 weeks will be based on response. Patients not responding adequately at these time points should have treatment discontinued with no further treatment with the same agent recommended. 2. An adequate response is defined as either: - 75% reduction in the Psoriasis Area and Severity Index (PASI) score from when treatment started (PASI 75), OR - 50% reduction in the PASI score (PASI 50) with a 5 point improvement in the Dermatology Life Quality Index (DLQI) from when treatment started, OR - A quantitative reduction in BSA affected with qualitative consideration of specific regions such as face, hands, feet, or genital region. 3. Concurrent use of >1 biologic will not be approved Claim Notes: Initial approval limited to 12 weeks. Must be prescribed by a dermatologist Approval limited to a dose of 5 mg/kg administered at 0, 2, and 6 weeks, then every 8 weeks up to a year (if response criteria met at 12 weeks) Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate transactions as outlined here. Rheumatoid Arthritis For patients with moderate to severe active rheumatoid arthritis who: - Have not responded to, or have had intolerable side-effects with, an adequate trial of combination therapy of at least two traditional DMARDs (disease modifying antirheumatic drugs). Combination DMARD therapy must include methotrexate unless contraindicated or not tolerated, OR - Are not candidates for combination DMARD therapy must have had adequate trial of at least three traditional DMARDs in sequence, one of which must have been methotrexate unless contraindicated Claim Note: Must be prescribed by a rheumatologist. Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate transactions as outlined here. INSULIN ASPART (NOVORAPID) 10mL vials and 5x3mL cartridges For patients with type I or II diabetes who have experienced frequent episodes of postprandial hypoglycemia; have unpredictable mealtimes; have insulin resistance; or who are using continuous subcutaneous insulin infusion. Claim Note: Prescriptions written by New Brunswick endocrinologists and internists do not require special authorization. Subsequent refills ordered by other practitioners will not require special authorization. INSULIN DETEMIR (LEVEMIR PENFILL) 100 U/mL cartridge For the treatment of patients who have been diagnosed with Type 1 or Type 2 diabetes requiring insulin and have previously taken insulin NPH and/or pre-mix daily at optimal dosing. AND 1. Have experienced unexplained nocturnal hypoglycemia at least once a month despite optimal management. OR 2. Have documented severe or continuing systemic or local allergic reaction to existing insulin(s). Claim Note: Requests should be submitted on the long-acting insulin analogue special authorization request form. INSULIN GLARGINE (LANTUS) 100U/mL vial, cartridge, and SoloSTAR For the treatment of patients who have been diagnosed with Type 1 or Type 2 diabetes requiring insulin and have previously taken insulin NPH and/or pre-mix daily at optimal dosing. AND 1. Have experienced unexplained nocturnal hypoglycemia at least once a month despite optimal management. OR September 2015 v.1 A - 40

2. Have documented severe or continuing systemic or local allergic reaction to existing insulin(s). Claim Note: Requests should be submitted on the long-acting insulin analogue special authorization request form. INSULIN GLULISINE (APIDRA) 100IU/mL vials, cartridges and SoloSTAR pre-filled pens For patients with type I or II diabetes who have experienced frequent episodes of postprandial hypoglycemia; have unpredictable mealtimes; have insulin resistance; or who are using continuous subcutaneous insulin infusion. Claim Notes: Prescriptions written by New Brunswick endocrinologists and internists do not require special authorization. Subsequent refills ordered by other practitioners will not require special authorization. Insulin glulisine is a regular benefit for Plans DEFG<18 years of age. INSULIN LISPRO (HUMALOG) 10mL vials, 1.5mL and 3mL cartridges, and KwikPen pre-filled pen For patients with type I or II diabetes who have experienced frequent episodes of postprandial hypoglycemia; have unpredictable mealtimes; have insulin resistance; or who are using continuous subcutaneous insulin infusion. Claim Note: Prescriptions written by New Brunswick endocrinologists and internists do not require special authorization. Subsequent refills ordered by other practitioners will not require special authorization. INTERFERON BETA-1A (AVONEX PS) 30mcg/0.5mL injection INTERFERON BETA-1A (REBIF) 22mcg/0.5mL, 66mcg/1.5mL, 44mcg/0.5mL, 132mcg/1.5mL INTERFERON BETA-1B (BETASERON, EXTAVIA) 0.3mg injection 1. For the treatment of patients with clinically definite multiple sclerosis (CDMS) including relapsing-remitting multiple sclerosis, secondary progressive multiple sclerosis or relapsing progressive multiple sclerosis who meet the following criteria: Two disabling attacks of MS in the previous two years, AND Ambulatory with or without aid (EDSS of less than or equal to 6.5) 2. For the treatment of patients who have experienced a clinically isolated syndrome (CIS) and are considered at risk for developing CDMS. Clinical Note: An attack is defined as the appearance of new symptoms or worsening of old symptoms, lasting at least 24 hours in the absence of fever, and preceded by stability for at least one month. Claim Note: Prescriptions written by New Brunswick neurologists do not require special authorization. IRON DEXTRAN (DEXIRON) 50mg/mL injection For the treatment of iron deficiency anemia in patients who are intolerant to oral iron replacement products, OR have not responded to adequate therapy with oral iron. IRON SUCROSE (VENOFER) 20mg/mL injection For the treatment of iron deficiency anemia in patients who are intolerant to oral iron replacement products, OR have not responded to adequate therapy with oral iron. September 2015 v.1 A - 41

ITRACONAZOLE (SPORANOX) 100mg capsule 1. For the treatment of severe systemic fungal infections not responding to alternative therapy. 2. For the treatment of severe or resistant fungal infections in immunocompromised patients not responding to alternative therapy. 3. For the treatment of skin infections (excluding onychomycosis) caused by dermatophyte fungi not responding to alternative therapy. IVACAFTOR (KALYDECO) 150mg tablet For the treatment of cystic fibrosis in patients who meet the following criteria: age 6 years and older; and have documented G551D mutation in the Cystic Fibrosis Transmembrane conductance Regulator (CFTR) gene. Claim Note: Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate transactions as outlined here. Initial renewal criteria: Renewal requests will be considered in patients with documented response to treatment (after at least 6 months of therapy) as evidenced by the following: In cases where the patient s sweat chloride levels prior to commencing therapy were above 60mmol/litre: the patient's sweat chloride level fell below 60mmol/litre; or the patient's sweat chloride level is 30% lower than the level reported in a previous test; In cases where the baseline sweat chloride levels prior to commencing therapy were below 60mmol/litre: the patient's sweat chloride level is 30% lower than the level reported in a previous test; or the patient demonstrates a sustained absolute improvement in FEV1 of at least 5% when compared to the FEV1 test conducted prior to the commencement of therapy. Subsequent renewal criteria: The patient is continuing to benefit from therapy. Clinical Notes: The patient s sweat chloride level and FEV1 must be provided with each request. A sweat chloride test must be performed within a few months of starting ivacaftor therapy to determine if sweat chloride levels are reducing. - If the expected reduction occurs, a sweat chloride test must be performed again 6 months after starting therapy to determine if the full reduction has been achieved. Thereafter, sweat chloride levels must be checked annually. - If the expected reduction does not occur, a sweat chloride test should be performed again one week later. If the criteria are not met, funding will be discontinued. Claim Notes: Requests will be considered for individuals enrolled in Plans ADEFGV. Approved dose: 150mg every 12 hours Initial and renewal approval duration: 1 year LACOSAMIDE (VIMPAT) 50mg, 100mg, 150mg and 200mg tablets For the adjunctive treatment of refractory partial-onset seizures in patients who meet all of the following criteria: are under the care of a physician experienced in the treatment of epilepsy, AND are currently receiving two or more antiepileptic drugs, AND in whom all other antiepileptic drugs are ineffective or not appropriate September 2015 v.1 A - 42

LACTULOSE (various brands) 667 mg/ml syrup For the treatment of hepatic encephalopathy in patients with liver disease. Clinical Note: Please note requests for treatment of constipation will not be considered. LANREOTIDE ACETATE (SOMATULINE AUTOGEL) 60mg/0.3mL, 90mg/0.3mL, 120mg/0.5mL pre-filled syringes For the treatment of acromegaly. LANSOPRAZOLE (PREVACID and generic brands) 15mg and 30mg capsules See criteria under Proton Pump Inhibitors. LANSOPRAZOLE (PREVACID FASTAB) 15mg and 30mg delayed release tablets For patients who meet the special authorization criteria for a proton pump inhibitor and require administration through a feeding tube. LAPATINIB (TYKERB) 250mg tablet For use in combination with capecitabine, for the treatment of HER2-positive patients with advanced or metastatic breast cancer who have progressed on trastuzumab-based treatments (e.g. taxanes, anthracycline, trastuzumab) and who have an ECOG performance status of 0-2. Renewal criteria: Written confirmation that the patient has responded to treatment and that there is no evidence of disease progression. Clinical Note: Requests will not be considered for use in combination with trastuzumab for second-line HER2-positive metastatic breast cancer or in the adjuvant setting Claim Notes: Initial approval period: 6 months Renewal period: 6 months LENALIDOMIDE (REVLIMID) 5mg, 10mg, 15mg and 25mg capsules 1. For the treatment of Myelodysplastic Syndrome (MDS) in patients with: Demonstrated diagnosis of MDS on bone marrow aspiration Presence of 5-q deletion documented by appropriate genetic testing International Prognostic Scoring System (IPSS) risk category low or intermediate-1 Presence of symptomatic anemia (defined as transfusion dependent)* Renewal criteria: For patients who were transfusion-dependent and have demonstrated a reduction in transfusion requirements of at least 50%. Renewal requests for all other patients will be considered on a case-by-case basis. Information describing the results of serial CBC (pre- and post-lenalidomide) and any other objective evidence of response should be included. Clinical Notes: calculator available on www.uptodate.com *Requests for patients who are not transfusion-dependent will be considered on a case-by-case basis. The physician should provide clinical evidence of symptomatic anemia affecting the patient s quality of life and the rationale for why transfusions are not being used. Claim Notes: Initial approval period: 6 months Renewal period: 1 year September 2015 v.1 A - 43

2. For the treatment of multiple myeloma when used in combination with dexamethasone, in patients who: Are not candidates for autologous stem cell transplant; AND Where the patient is either: - Refractory to or has relapsed after the conclusion of initial or subsequent treatments and who is suitable for further chemotherapy; OR - Has completed at least one full treatment regimen as initial therapy and is experiencing intolerance to their current chemotherapy. 3. For the maintenance treatment of patients with newly diagnosed multiple myeloma, following autologous stem-cell transplantation (ASCT), who have stable disease or better, with no evidence of disease progression. Renewal criteria: Written confirmation that there is no evidence of disease progression. Clinical Notes: Recommended Dose: Initial dose of 10 mg daily. Dose adjustments (5-15 mg) may be necessary based on individual patient characteristics/responses. Lenalinomide may be continued until evidence of disease progression or development of unacceptable toxicity requiring discontinuation of lenalidomide. Claim Notes: Initial approval duration: 1 year Renewal approval duration: 1 year Clinical Note: Due to its structural similarities to thalidomide, lenalidomide (Revlimid) is only available through a controlled distribution program called RevAid to minimize the risk of fetal exposure. Only prescribers and pharmacists registered with this program are able to prescribe and dispense lenalidomide (Revlimid). In addition, patients must be registered and meet all the conditions of the program in order to receive the product. For information, call 1-888-RevAid1 or log onto www.revaid.ca. Claim Note: Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate transactions as outlined here. LEUPROLIDE (LUPRON) 5mg injection 1. For the palliative treatment of stage D 2 carcinoma of the prostate (Plans D and F). 2. For the treatment of central precocious puberty. Claim Note: Lupron 5mg injection is a regular benefit for Plans A and V. LEVETIRACETAM (KEPPRA and generic brands) 250mg, 500mg and 750mg tablets As an adjunctive therapy in the management of patients with epilepsy who are not satisfactorily controlled by conventional therapy. LEVOCARNITINE (CARNITOR) 100mg/mL oral liquid and 330mg tablet 1. For the treatment of patients with primary systemic carnitine deficiency. 2. For the treatment of patients with an inborn error of metabolism that results in secondary carnitine deficiency. LEVODOPA/CARBIDOPA / ENTACAPONE (STALEVO) 50/12.5/200 mg, 75/18.75/200 mg, 100/25/200 mg, 125/31.25/200 mg, and 150/37.5/200 mg tablets For the treatment of patients with Parkinson s disease who are currently receiving immediate-release levodopa/carbidopa and entacapone, OR who are not well controlled and are experiencing significant wearing off symptoms despite optimal therapy with levodopa/decarboxylase. September 2015 v.1 A - 44

LEVOFLOXACIN (LEVAQUIN and generic brands) 250mg and 500mg tablets For the completion of therapy instituted in the hospital setting for the treatment of nosocomial pneumonia, community acquired pneumonia (CAP) or acute exacerbation of chronic bronchitis (AECB). For the treatment of severe pneumonia in nursing home patients (regular benefit for Plan V). For the treatment 1 of CAP in patients; - with co-morbidity 2 upon radiographic confirmation of pneumonia, OR - who have failed first line therapies (macrolide, doxycycline, amoxicillin-clavulanate). For the treatment 1 of AECB in complicated patients 3 who have failed treatment with one of the following (amoxicillin, doxycycline, TMP-SMX, cefuroxime, macrolide, ketolide or amoxicillin-clavulanate). Clinical Notes: 1. 1 If treated with an antibiotic within the past 3 months choose an antibiotic from a different class. 2. 2 Co-morbidity includes chronic lung disease, malignancy, diabetes, liver, renal or congestive heart failure, use of antibiotics or steroids in the past 3 months, suspected macroaspiration, hospitalization within last 3 months, HIV/AIDs, smoking, malnutrition or acute weight loss. 3. 3 Complicated AECB defined as increased cough and sputum, sputum purulence and increased dyspnea AND FEV 1 < 50% predicted OR FEV 1 50-65% and one of the following: - 4 exacerbations per year - Ischemic heart disease - Chronic oral steroid use - Antibiotic use in the past 3 months Claim Notes: Prescriptions written by New Brunswick infectious disease specialists, medical microbiologists, medical oncologists, respirologists and internal medicine specialists will not require special authorization. Levofloxacin is a regular benefit for Plan V. LINAGLIPTIN (TRAJENTA) 5mg tablets For patients with type 2 diabetes mellitus with inadequate glycemic control while on optimal doses of metformin and a sulfonylurea, and for whom NPH insulin is not an option, when added as a third agent. LINEZOLID (ZYVOXAM and generic brands) 600mg tablets For treatment of proven vancomycin-resistant enterocci (VRE) infections. For the treatment of proven methicillin-resistant Staphylococcus aureus (MRSA) / methicillin-resistant Staphylococcus epidermidis (MRSE) infections in patients who are unresponsive to, or intolerant of, intravenous vancomycin or in whom intravenous vancomycin is not appropriate. Claim Note: The drug must be prescribed by, or in consultation with, an infectious disease specialist or medical microbiologist. LISDEXAMFETAMINE DIMESYLATE (VYVANSE) 10mg, 20mg, 30mg, 40mg, 50mg, 60mg capsules For treatment of Attention Deficit Hyperactivity Disorder (ADHD) in patients age 6 to 25 years who: Demonstrate significant and problematic disruptive behaviour or who have problems with inattention that interfere with learning; AND Have been tried on methylphenidate (immediate release or long-acting formulation) or dexamphetamine with unsatisfactory results. Claim Notes: Requests will be considered from specialists in pediatric psychiatry, pediatricians or general practitioners with expertise in ADHD. The maximum dose reimbursed is 60mg daily. September 2015 v.1 A - 45

LOW MOLECULAR WEIGHT HEPARINS (Dalteparin Sodium, Enoxaparin Sodium, Nadroparin Calcium, Tinzaparin Sodium). 1. For the treatment of venous thromboembolism (VTE) and/or pulmonary embolism (PE) for a maximum of 30 days. 2. For the extended treatment of recurrent symptomatic venous thromboembolism (VTE) that has occurred while patients are on therapeutic doses of warfarin. 3. For the prophylaxis of venous thromboembolism (VTE) up to 35 days following elective hip replacement or hip fracture surgery. 4. For the prophylaxis of VTE up to 10 days following elective knee replacement surgery. 5. For the treatment and secondary prevention of symptomatic venous thromboembolism (VTE) or pulmonary embolism (PE) for a period of up to 6 months in patients with cancer for whom warfarin therapy is not an option. Claim Note: An annual quantity limit of approximately 30 days of therapy is applied to all Low Molecular Weight Heparin DINs listed in the table. If the DIN does not appear in the table or if an additional quantity is required, a request must be made through special authorization. Product Name Dalteparin sodium (Fragmin) 2,500IU/0.2mL pre-filled syringe 5,000IU/0.2mL pre-filled syringe 7,500IU/0.3mL pre-filled syringe 10,000IU/0.4mL pre-filled syringe 12,500IU/0.5mL pre-filled syringe 15,000IU/0.6mL pre-filled syringe 18,000IU/0.72mL pre-filled syringe 25,000IU/mL multidose vial Enoxaparin sodium (Lovenox & Lovenox HP) 30mg/0.3mL pre-filled syringe 40mg/0.4mL pre-filled syringe 60mg/0.6mL pre-filled syringe 80mg/0.8mL pre-filled syringe 100mg/mL pre-filled syringe 120mg/0.8mL pre-filled syringe (HP) 150mg/mL pre-filled syringe (HP) Nadroparin calcium (Fraxiparin & Fraxiparin Forte) 2,850IU/0.3mL pre-filled syringe 3.800IU/0.4mL pre-filled syringe 5,700IU/0.6mL pre-filled syringe 7,600IU/0.8mL pre-filled syringe 9,500IU/mL pre-filled syringe 11,400IU/0.6mL pre-filled syringe 15,200IU/0.8mL pre-filled syringe 19,000IU/mL pre-filled syringe Tinzaparin sodium (Innohep) 2,500IU/0.25mL pre-filled syringe 3,500IU/0.35mL pre-filled syringe 4,500IU/0.45mL pre-filled syringe 8,000IU/0.4mL pre-filled syringe 10,000IU/0.5mL pre-filled syringe 12,000IU/0.6mL pre-filled syringe 14,000IU/0.7mL pre-filled syringe 16,000IU/0.8mL pre-filled syringe 18,000IU/0.9mL pre-filled syringe DIN 2132621 2132648 2352648 2352656 2352664 2352672 2352680 2231171 2012472 2236883 2378426 2378434 2378442 2242692 2378469 2236913 2240114 2229755 2358158 2358166 2429462 2231478 2429470 2358174 2429489 2358182 Approximate 30 Day Treatment Quantity 0.2mL x 30 syringes = 6mL 0.2mL x 30 syringes = 6mL 0.3mL x 30 syringes = 9mL 0.4mL x 30 syringes = 12mL 0.5mL x 30 syringes = 15mL 0.6mL x 30 syringes = 18mL 0.72mL x 30 syringes = 24mL 3.8mL x 6 vials = 24mL 0.3mL x 30 syringes = 9mL 0.4mL x 30 syringes = 12mL 0.6mL x 30 syringes = 18mL 0.8mL x 30 syringes = 24mL 1mL x 30 syringes = 30mL 0.8mL x 30 syringes = 24mL 1mL x 30 syringes = 30mL 0.3mL x 30 syringes = 9mL 0.4mL x 30 syringes = 12mL 0.6mL x 30 syringes = 18mL 0.8mL x 30 syringes = 24mL 1mL x 30 syringes = 10mL 0.6mL x 30 syringes = 18mL 0.8mL x 30 syringes = 24mL 1.0mL x 30 syringes = 30mL 0.25mL x 30 syringes = 7.5mL 0.35mL x 30 syringes = 10.5mL 0.45mL x 30 syringes = 13.5mL 0.4mL x 30 syringes = 12mL 0.5mL x 30 syringes = 15mL 0.6mL x 30 syringes = 18mL 0.7mL x 30 syringes = 21mL 0.8mL x 30 syringes = 24mL 0.9mL x 30 syringes = 27mL September 2015 v.1 A - 46

LURASIDONE (LATUDA) 20mg, 40mg, 60mg, 80mg, 120mg film-coated tablets For the treatment of schizophrenia and related psychotic disorders (not dementia related) in patients with a history of failure, intolerance, or contraindication to at least one less expensive antipsychotic agent. MARAVIROC (CELSENTRI) 150mg and 300mg tablets For the treatment of HIV-1 infection in patients who have CCR5 tropic viruses and who have documented resistance to at least one agent from each of the three major classes of antiretrovirals (i.e. nucleoside/tide reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors and protease inhibitors.) Clinical Note: Requests for HIV-1 treatment-naïve patients will not be considered. METFORMIN / SAXAGLIPTIN (KOMBOGLYZE) 500mg/2.5mg, 850mg/2.5mg, and 1000mg/2.5mg tablets For the treatment of type 2 diabetes mellitus in patients: for whom insulin is not an option AND who are already stabilized on therapy with metformin, a sulfonylurea and saxagliptin, to replace the individual components of saxagliptin and metformin. METHADONE Compounded Oral Solution Requests from New Brunswick physicians authorized to prescribe methadone will be considered: 1. For the treatment of severe cancer-related or chronic non-malignant pain as an alternative to other opioids. 2. For the treatment of opioid dependence. All requests must meet requirements set out by the New Brunswick Drug Plans. Pharmacy Claims: Claims submitted by pharmacies must be billed using the applicable PIN. Opioid dependence 00999734 Chronic pain 00999801 METHADONE HCL (METHADOSE) 10mg/mL dye-free, sugar-free, unflavored oral concentrate and cherry flavored oral concentrate Requests from New Brunswick physicians authorized to prescribe methadone will be considered: 1. For the treatment of opioid dependence. All requests must meet requirements set out by the New Brunswick Drug Plans. Pharmacy Claims: Claims submitted by pharmacies must be billed using DIN 02394618 or DIN 02394596. METHADONE HCL (METADOL) 1 mg/ml oral solution and 10 mg/ml oral concentrate Requests from New Brunswick physicians authorized to prescribe methadone will be considered: 1. For the treatment of severe cancer-related or chronic non-malignant pain as an alternative to other opioids. 2. For the treatment of opioid dependence. All requests must meet requirements set out by the New Brunswick Drug Plans. Pharmacy Claims: Claims submitted by pharmacies must be billed using the applicable PIN. 1mg/mL oral solution Opioid dependence 00903823 Chronic pain 00903825 10mg/mL oral concentrate Opioid dependence 00903824 Chronic pain 00903826 September 2015 v.1 A - 47

METHADONE HCL (METADOL) 1mg, 5mg, 10mg and 25mg tablets Requests from New Brunswick physicians authorized to prescribe methadone will be considered: 1. For the treatment of severe cancer-related or chronic non-malignant pain as an alternative to other opioids. Claim Note: Requests will not be considered: 1. For the treatment of opioid dependence. 2. Preparations compounded using Metadol tablets will not be considered. METHYLPHENIDATE (BIPHENTIN) 10mg, 15mg, 20mg, 30mg, 40mg, 50mg, 60mg and 80mg controlled release capsules For the treatment of Attention-Deficit Hyperactivity Disorder (ADHD) in children age 6 to 25 years who demonstrate significant symptoms and who have tried immediate release and slow release methylphenidate with unsatisfactory results. Claim Note: Requests will be considered from specialists in pediatric psychiatry, pediatricians or general practitioners with expertise in ADHD. METHYLPHENIDATE-ER (CONCERTA and generic brands) 18mg, 27mg, 36mg and 54mg extended-release tablets For the treatment of Attention-Deficit Hyperactivity Disorder (ADHD) in children aged 6 to 25 years who demonstrate significant symptoms and who have tried immediate release or slow release methylphenidate with unsatisfactory results. Claim Note: Requests will be considered from specialists in pediatric psychiatry, pediatricians or general practitioners with expertise in ADHD. MODAFINIL (ALERTEC and generic brand) 100mg tablet For the treatment of narcolepsy confirmed by a sleep study. MOMETASONE FUROATE/FORMOTEROL FUMARATE DIHYDRATE (ZENHALE) 5mcg/50mcg, 5mcg/100mcg and 5mcg/200mcg per actuation metered-dose inhalers For patients with reversible obstructive airways disease who are: Stabilized on an inhaled corticosteroid and a long-acting beta2-adrenergic agonist OR Using optimal doses of inhaled corticosteroids but are still poorly controlled. MONTELUKAST (SINGULAIR and generic brands) 4mg and 5mg chewable tablets 10mg tablet 4mg oral granules For the treatment of moderate to severe asthma in patients who: Are not adequately controlled with moderate to high dose inhaled corticosteroids despite compliance with treatment AND Require increasing amounts of short-acting beta2-adrenergic agonists. MOXIFLOXACIN (AVELOX) 400mg tablet For the completion of therapy instituted in the hospital setting for the treatment of nosocomial pneumonia, community acquired pneumonia (CAP) or acute exacerbation of chronic bronchitis (AECB). For the treatment of severe pneumonia in nursing home patients (regular benefit for Plan V). For the treatment 1 of CAP in patients; - with co-morbidity 2 upon radiographic confirmation of pneumonia, OR - who have failed first line therapies (macrolide, doxycycline, amoxicillin-clavulanate). For the treatment 1 of AECB in complicated patients 3 who have failed treatment with one of the following (amoxicillin, doxycycline, TMP-SMX, cefuroxime, macrolide, ketolide or amoxicillin-clavulanate). September 2015 v.1 A - 48

Clinical Notes: 1. 1 If treated with an antibiotic within the past 3 months choose an antibiotic from a different class. 2. 2 Co-morbidity includes chronic lung disease, malignancy, diabetes, liver, renal or congestive heart failure, use of antibiotics or steroids in the past 3 months, suspected macroaspiration, hospitalization within last 3 months, HIV/AIDs, smoking, malnutrition or acute weight loss. 3. 3 Complicated AECB defined as increased cough and sputum, sputum purulence and increased dyspnea AND - FEV 1 < 50% predicted OR - FEV 1 50-65% and one of the following: 4 exacerbations per year Ischemic heart disease Chronic oral steroid use Antibiotic use in the past 3 months Claim Notes: Prescriptions written by New Brunswick infectious disease specialists, medical microbiologists, medical oncologists, respirologists and internal medicine specialists will not require special authorization. Moxifloxacin is a regular benefit for Plan V. NABILONE (CESAMET and generic brands) 0.25mg, 0.5mg and 1mg capsules For the management of severe nausea and vomiting associated with cancer chemotherapy. NADROPARIN CALCIUM (FRAXIPARIN) Pre-filled syringes NADROPARIN CALCIUM (FRAXIPARIN FORTE) Pre-filled syringes See criteria under Low Molecular Weight Heparins. NAFARELIN ACETATE (SYNAREL) 2mg/mL nasal solution Approved for the hormonal management of endometriosis, including pain relief and reduction of endometriotic lesions. Clinical Note: Requests will be considered for women age 18 and older. Claim Note: Approval limits payment to a maximum of 6 months of therapy. NALTREXONE (REVIA) 50mg tablet For the treatment of alcohol dependence, as an adjunct to a comprehensive program to support abstinence, and reduce the risk of relapse. For the maintenance of opioid-free state in individuals who were previously opioid-dependent but have successfully completed detoxification. Treatment should not be attempted until the patient has remained opioidfree for 7-10 days. Requests will be considered only when used as an adjunct to psychosocial intervention. In the event that a patient participates in a program other than those offered by New Brunswick Addiction Services, details on the type of counselling/supportive program the patient will be involved in will be requested. Continued coverage will require information on the outcome of therapy as well as patient's compliance with treatment programs. Claim Note: Coverage will be approved initially for 12 weeks. NARATRIPTAN (AMERGE and generic brands) 1mg and 2.5mg tablets For the treatment of migraine 1 headache when: - Migraines are moderate 2 in severity and other therapies (e.g. NSAIDs, acetaminophen, DHE spray) are not effective, OR - Migraine attacks are severe 2 or ultra severe 2 September 2015 v.1 A - 49

Clinical Notes: 1. 1 As diagnosed based on current Canadian guidelines. 2. 2 Definitions: Moderate - pain is distracting causing need to slow down and limit activities; Severe - pain affects ability to concentrate and very difficult to continue with daily activities; Ultra severe - unable to speak or think clearly; not able to function; likely lying down or sleeping Claim Notes: Coverage limited to 6 doses / 30 days 3 - patients with >3 migraines/month on average despite prophylactic therapy may be considered for up to a maximum of 12 doses / 30 days 3 Reimbursement will be available for a maximum quantity of triptan doses as outlined in criteria per 30 days regardless of the agent(s) used within the 30 day period. Special authorization for the products almotriptan 6.25mg and 12.5mg tablets, naratriptan 1mg and 2.5mg tablets, rizatriptan 5mg and 10mg tablets and wafers, sumatriptan 5mg and 20mg nasal spray and zolmitriptan 2.5mg tablets and orally dispersible tablets, 2.5mg and 5mg nasal spray will be considered as a set. Approvals will include all products in this list, however reimbursement will be available for a maximum quantity of one agent per month. NATALIZUMAB (TYSABRI) 300mg/15mL vial Initial Request: For the treatment of Relapsing-Remitting Multiple Sclerosis (RRMS) in patients who meet all the following criteria: The patient s physician is a neurologist experienced in the management of relapsing-remitting multiple sclerosis (RRMS); AND The patient; Has a current EDSS less than or equal to 5.0; AND Has failed to respond to a full and adequate course (see note below) of at least ONE disease modifying therapy OR has contraindications/intolerance to at least TWO disease modifying therapies; AND Has had ONE of the following types of relapses in the past year: - The occurrence of one relapse with partial recovery during the past year AND has at least ONE gadoliniumenhancing lesion on brain MRI, OR significant increase in T2 lesion load compared to a previous MRI; OR - The occurrence of two or more relapses with partial recovery during the past year; OR - The occurrence of two or more relapses with complete recovery during the past year AND has at least ONE gadolinium-enhancing lesion on brain MRI, OR significant increase in T2 lesion load compared to a previous MRI. Requirements for Initial Requests: The patient s physician provides documentation setting out the details of the patient s most recent neurological examination within ninety (90) days of the submitted request. This must include a description of any recent attacks, the dates, and the neurological findings. MRI reports do NOT need to be submitted with the initial request Renewal Criteria: Date and details of the most recent neurological examination and EDSS scores must be provided (exam must have occurred within that last 90 days) AND Patients must be stable or have experienced no more than 1 disabling attack/relapse in the past year; AND Recent Expanded Disability Status Scale (EDSS) score less than or equal to 5.0 Clinical Notes: 1. Failure to respond to a full and adequate course: defined as a trial of at least 6 months of interferon or glatiramer therapy AND experienced at least one disabling relapse (attack) while on interferon or glatiramer therapy. 2. Combination therapy of Natalizumab with other disease modifying therapies (e.g. Avonex, Betaseron, Copaxone, Rebif, Extavia, Gilenya) will not be funded. Claim Note: Approval Period: 1 year September 2015 v.1 A - 50

NILOTINIB (TASIGNA) 150mg capsule For the first-line treatment of adult patients with Philadelphia chromosome positive chronic myeloid leukemia (Ph+ CML) in chronic phase. NILOTINIB (TASIGNA) 200mg capsule For the treatment of chronic phase (CP) and accelerated phase (AP) Philadelphia chromosome positive (Ph+) chronic myeloid leukemia (CML) in adult patients who: are resistant or intolerant to imatinib, OR intolerant to dasatinib NORETHINDRONE ACETATE / ESTRADIOL-17β (ESTALIS) 140/50mcg and 250/50mcg transdermal patches For the treatment of menopausal symptoms in women for whom oral forms of HRT are not tolerated or indicated. OCRIPLASMIN (JETREA) 2.5mg/mL intravitreal injection For the treatment of symptomatic vitreomacular adhesion (VMA) if the following clinical criteria and conditions are met: Diagnosis of VMA has been confirmed through optical coherence tomography. Patients do not have any of the following: large diameter macular holes (greater than 400 micrometres), high myopia (greater than 8 dioptre spherical correction or axial length greater than 28 millimetres), aphakia, history of retinal detachment, lens zonule instability, recent ocular surgery or intraocular injection (including laser therapy), proliferative diabetic retinopathy, ischemic retinopathies, retinal vein occlusions, exudative age-related macular degeneration, or vitreous hemorrhage. Clinical Notes: Ocriplasmin should be administered by an ophthalmologist experienced in intravitreal injections. Treatment with ocriplasmin should be limited to a single injection per eye (i.e. retreatments are not covered). OFLOXACIN (OCUFLOX and generic brands) 0.3% ophthalmic solution For the treatment of bacterial conjunctivitis. Claim Note: Prescriptions written by New Brunswick ophthalmologists and optometrists do not require special authorization. OLANZAPINE (ZYPREXA and generic brands) 2.5mg, 5mg, 7.5mg, 10mg and 15mg tablets OLANZAPINE (ZYPREXA ZYDIS and generic brands) 5mg, 10mg, 15mg and 20mg oral disintegrating tablets For the acute and maintenance treatment of schizophrenia and related psychotic disorders. For the acute treatment of manic or mixed episodes in bipolar l disorder in patients with intolerance or a history of failure to one other atypical antipsychotic. For maintenance treatment in patients with bipolar disorder who are currently stabilized on olanzapine. Clinical Note: Advice from a psychiatrist is suggested prior to starting therapy. Claim Note: Prescriptions written by New Brunswick psychiatrists do not require special authorization. Subsequent refills ordered by other practitioners will not require special authorization. ONABOTULINUMTOXINA (BOTOX) 50 Allergan units per vial (PIN 00903741) and 100 Allergan units per vial 1. For the treatment of equinus foot deformity in cerebral palsy in patients 2 years of age and older. 2. To reduce the subjective symptoms and objective signs of cervical dystonia (spasmodic torticollis) in adults. 3. For the treatment of blepharospasm, hemifacial spasm (VII nerve disorder) and strabismus in patients 12 years of age and older. 4. For the treatment of upper and lower limb (at or below the knee) focal spasticity following stroke in adults. Initial approval period for focal spasticity following stroke will be 6 months. Continued approval will require documented benefit of improved passive and/or active range of motion, muscle tone, or improved gait (in the case of lower limb spasticity). September 2015 v.1 A - 51

Clinical Notes: The following conditions are excluded from coverage: - Chronic migraine - Chronic pain - Hyperhidrosis - Muscle contracture for support of perineal care. ONABOTULINUMTOXINA (BOTOX) 200 Allergan units per vial (PIN 00999505) For the treatment of urinary incontinence due to neurogenic detrusor overactivity resulting from neurogenic bladder associated with multiple sclerosis (MS) or subcervical spinal cord injury (SCI) if the following conditions are met: patient failed to respond to behavioural modification and anticholinergics and/or is intolerant to anticholinergics subsequent treatments are provided at intervals no less than every 36 weeks Clinical Note: Patients who fail to respond to initial treatment with onabotulinumtoxina should not be retreated. ONDANSETRON (ZOFRAN and generic brands) 4mg and 8mg tablets 4mg/5mL oral solution For the treatment of emesis in patients who are: receiving moderately or severely emetogenic chemotherapy OR receiving intravenous chemotherapy or radiotherapy and who have not experienced adequate control with other available antiemetics OR receiving any intravenous chemotherapy or radiotherapy and have experienced emesis with a prior cycle of chemotherapy with intolerable side effects to other antiemetics, including steroids and anti-dopaminergic agents. Clinical Notes: 1. Only requests for the oral dosage forms are eligible for consideration. Usually a single oral dose prechemotherapy is sufficient to control symptoms. 2. Some patients may require additional therapy up to 48 hours after the last dose of chemotherapy or last radiation treatment. Benefit beyond 48 hours has not been established. 3. When used in combination with aprepitant, only a single oral dose pre-chemotherapy will be covered. Claim Note: Prescription claims for up to a maximum of 12 tablets of ondansetron or 2 tablets of granisetron will be automatically reimbursed every 28 days when the prescription is written by an oncologist or an oncology clinical associate/general practitioners-oncology. If additional medication is required within a 28 day period subsequent to the initial prescription, a request should be made through special authorization. ONDANSETRON (ZOFRAN ODT and generic brand) 4mg and 8mg oral disintegrating tablets Requests will be considered for the treatment of emesis in patients who have difficulty swallowing oral tablets and are: receiving moderately or severely emetogenic chemotherapy OR receiving intravenous chemotherapy or radiotherapy and who have not experienced adequate control with other available antiemetics OR receiving any intravenous chemotherapy or radiotherapy and have experienced emesis with a prior cycle of chemotherapy with intolerable side effects to other antiemetics, including steroids and anti-dopaminergic agents. Clinical Notes: 1. Only requests for the oral dosage forms are eligible for consideration. Usually a single oral dose prechemotherapy is sufficient to control symptoms. 2. Some patients may require additional therapy up to 48 hours after the last dose of chemotherapy or last radiation treatment. Benefit beyond 48 hours has not been established. 3. When used in combination with aprepitant, only a single oral dose prechemotherapy will be covered. September 2015 v.1 A - 52

OSELTAMIVIR (TAMIFLU) 30mg, 45mg and 75mg capsules For beneficiaries residing in long-term care facilities* during an influenza outbreak situation and further to the recommendation of a Medical Officer of Health: For treatment of long-term care residents with clinically suspected or lab confirmed influenza A or B. A clinically suspected case is one in which the patient meets the criteria of influenza-like illness and there is confirmation of influenza A or B circulating within the facility or surrounding community. For prophylaxis of long-term care residents where the facility has an influenza A or B outbreak. Prophylaxis should be continued until the outbreak is over. An outbreak is declared over 7 days after the onset of the last case in the facility. Clinical note: *In these criteria, long-term care facility refers to a licensed nursing home and does not include special care homes. OSTEOPOROSIS DRUGS (etidronate and raloxifene) Requests for osteoporosis drugs for patients without documented fracture should reference the most recent (2010) version of the Canadian Association of Radiologist and Osteoporosis Canada (CAROC) table 1, or the World Health Organization (WHO) Fracture Risk Assessment Tool (FRAX) http://www.shef.ac.uk/frax/tool.jsp?lang=en when determining whether the patient meets criteria for high (>20%) 10-year fracture risk. Fracture Risk Tables Age (years) Low Risk < 10% Women 10-YEAR RISK Moderate Risk 10% - 20% High Risk > 20% LOWEST T-SCORE femoral neck 50 > - 2.5-2.5 to - 3.8 < - 3.8 55 > - 2.5-2.5 to - 3.8 < - 3.8 60 > - 2.3-2.3 to - 3.7 < - 3.7 65 > - 1.9-1.9 to - 3.5 < - 3.5 70 > - 1.7-1.7 to - 3.2 < - 3.2 75 > - 1.2-1.2 to - 2.9 < - 2.9 80 > - 0.5-0.5 to - 2.6 < - 2.6 85 > +0.1 + 0.1 to - 2.2 < - 2.2 Age (years) Low Risk < 10% Men 10-YEAR RISK Moderate Risk 10% - 20% High Risk > 20% LOWEST T-SCORE femoral neck 50 > -2.5-2.5 to - 3.9 < - 3.9 55 > -2.5-2.5 to - 3.9 < - 3.9 60 > -2.5-2.5 to - 3.7 < - 3.7 65 > -2.4-2.4 to - 3.7 < - 3.7 70 > -2.3-2.3 to - 3.7 < - 3.7 75 > -2.3-2.3 to - 3.8 < - 3.8 80 > -2.1-2.1 to - 3.8 < - 3.8 85 > -2.0-2.0 to - 3.8 < - 3.8 1 Ref: Can Assoc Radiol J, 2011; 62(4): 243-50 ETIDRONATE (DIDRONEL and generic brands) 200mg tablets ETIDRONATE AND CALCIUM (DIDROCAL KIT and generic brands) 400mg/500mg tablets For the treatment of osteoporosis: with documented fragility fracture when alendronate or risedronate are not tolerated or contraindicated; OR without documented fractures in patients at high 10-year fracture risk (see fracture risk tables) when alendronate or risedronate are not tolerated or contraindicated. RALOXIFENE (EVISTA and generic brands) 60mg tablets For the treatment of postmenopausal osteoporosis with documented fragility fracture when bisphosphonates are not tolerated or contraindicated; OR without documented fractures in patients at high 10-year fracture risk (see fracture risk tables) when bisphosphonates are not tolerated or contraindicated. September 2015 v.1 A - 53

OXCARBAZEPINE (TRILEPTAL and generic brand) 150mg, 300mg and 600mg tablets 60mg/mL suspension For the treatment of epilepsy in patients who have had an inadequate response or are intolerant to at least 3 other antileptics including carbamazepine. OXYBUTYNIN (DITROPAN XL) 5mg and 10mg tablets For the treatment of overactive bladder with symptoms of urinary frequency, urgency and/or urge incontinence in patients who have not tolerated a reasonable trial of immediate release oxybutynin. Clinical Note: Requests for the treatment of stress incontinence will not be considered. OXYCODONE (OXY IR and generic and SUPEUDOL) 5mg, 10mg and 20mg tablets (immediate release) For the treatment of moderate to severe cancer-related or chronic non-malignant pain. PALIPERIDONE (INVEGA SUSTENNA) 50mg/0.5mL, 75mg/0.75mL, 100mg/mL and 150mg/1.5mL pre-filled syringes For the treatment of schizophrenia in patients: for whom compliance with an oral antipsychotic presents problems, OR who are currently receiving a typical depot antipsychotic and experiencing significant side effects (EPS or TD) or lack of efficacy. PANTOPRAZOLE SODIUM (PANTOLOC and generic brands) 20mg and 40mg tablets See criteria under Proton Pump Inhibitors. PAZOPANIB (VOTRIENT) 200mg tablet 1. As a first-line treatment for patients with advanced or metastatic clear cell renal carcinoma and good performance status. 2. For the treatment of advanced or metastatic renal cell (clear cell) carcinoma (mrcc) in patients who are unable to tolerate sunitinib and who have an ECOG performance status of 0 or 1. Renewal Criteria: Written confirmation that the patient has benefited from therapy and is expected to continue to do so. Claim Notes: Initial approval period: 1 year Renewal period: 1 year PEGFILGRASTIM (NEULASTA) 6mg pre-filled syringe Requests will be considered for the following indications: Chemotherapy Support Primary prophylaxis: - For use in previously untreated patients receiving a moderate to severely myelosuppressive chemotherapy regimen (i.e. 40% incidence of febrile neutropenia). Febrile neutropenia is defined as a temperature 38.5 C or > 38.0 C three times in a 24 hour period and neutropenia with an absolute neutrophil count (ANC) < 0.5 x 10 9 /L. Secondary prophylaxis: - For use in patients receiving myelosuppressive chemotherapy who have experienced an episode of febrile neutropenia, neutropenic sepsis or profound neutropenia in a previous cycle of chemotherapy; or - For use in patients who have experienced a dose reduction or treatment delay longer than one week, due to neutropenia. September 2015 v.1 A - 54

Dosing for chemotherapy support: - The recommended dosage of pegfilgrastim is a single subcutaneous injection of 6mg, administered once per cycle of chemotherapy. Pegfilgrastim should be administered no sooner than 24 hours after the administration of cytotoxic chemotherapy. Clinical Notes: 1. Pegfilgrastim is not indicated and requests will not be considered for the following: - Myeloid malignancies - Pediatric patients with cancer receiving myelosuppressive chemotherapy - Non-malignant neutropenias - Stem-cell transplantation - Treatment of febrile neutropenia or in the prevention of febrile neutropenia in the palliative setting 2. Filgrastim (Neupogen ) dosing is 5 mcg/kg/day. For patients 60 kg who are prescribed filgrastim 300mcg for 9 or fewer days, the cost of filgrastim therapy is less than the cost of pegfilgrastim 6mg. Claim Note: Requests will be considered when prescribed by, or on the advice of, a hematologist or medical oncologist. PEGINTERFERON ALFA-2A (PEGASYS) 180mcg/0.5mL pre-filled syringe and ProClick Autoinjector Requests will be considered for the treatment of: Chronic hepatitis C (HCV RNA positive) for patients who cannot tolerate ribavirin. - Initial coverage of 24 weeks will be approved for all patients. Coverage for an additional 24 weeks will be approved for patients with HCV genotype 1. - A positive HCV RNA assay after 24 weeks of therapy is an indication to stop treatment. HBeAg negative chronic hepatitis B patients with compensated liver disease, liver inflammation and evidence of viral replication with demonstrated intolerance or failure to lamivudine therapy. - Maximum duration of coverage will be 48 weeks. Claim Note: Requests will be considered from internal medicine specialists. PEGINTERFERON ALFA-2A AND RIBAVIRIN (PEGASYS RBV) 180mcg injection and 200mg tablet (pre-filled syringe and ProClick Autoinjector) 1. For the treatment of peginterferon and ribavirin treatment-naïve chronic hepatitis C (HCV RNA positive) patients. Clinical Note: A positive HCV RNA assay after 24 weeks of therapy is an indication to stop treatment. Claim Notes: Initial coverage of 24 weeks will be approved for all patients. Coverage for an additional 24 weeks will be approved for patients with HCV genotypes other than 2 and 3. Requests will be considered from internal medicine specialists 2. For the treatment of patients with chronic hepatitis C genotype 1 infection (HCV RNA positive) in combination with boceprevir or telaprevir. Claim Notes: Coverage will be approved for up to a total of 48 weeks in combination with boceprevir or telaprevir. Requests will be considered from internal medicine specialists PEGINTERFERON ALFA-2B AND RIBAVIRIN (PEGETRON and PEGETRON CLEARCLICK) 50mcg injection and 200mg capsule, 80mcg injection and 200mg capsule 100mcg injection and 200mg capsule, 120mcg injection and 200mg capsule 150mcg injection and 200mg capsule 1. For the treatment of peginterferon and ribavirin treatment-naïve chronic hepatitis C (HCV RNA positive) patients. Clinical Note: A positive HCV RNA assay after 24 weeks of therapy is an indication to stop treatment. Claim Notes: Initial coverage of 24 weeks will be approved for all patients. Coverage for an additional 24 weeks will be approved for patients with HCV genotypes other than 2 and 3. Requests will be considered from internal medicine specialists September 2015 v.1 A - 55

2. For the treatment of patients with chronic hepatitis C genotype 1 infection (HCV RNA positive) in combination with boceprevir or telaprevir. Claim Notes: Coverage will be approved for up to a total of 48 weeks in combination with boceprevir or telaprevir. Requests will be considered from internal medicine specialists PERAMPANEL (FYCOMPA) 2mg, 4mg, 6mg, 8mg, 10mg, 12mg tablets For the adjunctive treatment of refractory partial-onset seizures in patients who meet all of the following criteria: are under the care of a physician experienced in the treatment of epilepsy, AND are currently receiving two or more antiepileptic drugs, AND in whom less costly antiepileptic drugs* are ineffective or not appropriate. Clinical Notes: The combination of lacosamide (Vimpat) and perampanel (Fycompa) will not be reimbursed. *Less costly antiepileptic drugs may include the following: carbamazepine, gabapentin, lamotrigine, phenytoin, topiramate, vigabatrin. PILOCARPINE (SALAGEN and generic brand) 5mg tablet For the treatment of the symptoms of xerostomia (dry mouth) due to salivary gland hypofunction caused by radiotherapy for cancer of the head and neck. For the treatment of the symptoms of xerostomia (dry mouth) and xerophthalmia (dry eyes) in patients with Sjögren's syndrome. PIOGLITAZONE (ACTOS and generic brands) 15mg, 30mg and 45mg tablets For patients with type 2 diabetes who are not adequately controlled by diet, exercise and drug therapy. Drug therapy should include a trial of a sulfonylurea and metformin, alone and in combination, unless one of these agents is not tolerated or is contraindicated. PIRFENIDONE (ESBRIET) 267mg capsule Initial approval criteria: Adult patients who have a diagnosis of mild to moderate idiopathic pulmonary fibrosis (IPF)* confirmed by a respirologist and a high-resolution CT scan within the previous 24 months. *Mild-moderate IPF is defined as: a FVC between 50-80% predicted, and a Percent Carbon Monoxide Diffusing Capacity (%DLCO) between 30-90% predicted. Initial renewal criteria: Patients must NOT demonstrate progression of disease defined as an absolute decline in percent predicted FVC of 10% from initiation of therapy until renewal (initial 6 month treatment period).if a patient has experienced progression as defined above, then the results should be validated with a confirmatory pulmonary function test conducted 4 weeks later. Second renewal (12 months after initiation of therapy): Patients must NOT demonstrate progression of disease defined as an absolute decline in percent predicted FVC of 10% since initiation of therapy (baseline). If a patient has experienced progression as defined above, then the results should be validated with a confirmatory pulmonary function test conducted 4 weeks later. Claim Notes: Initial approval period: 7 months (allow 4 weeks for repeat pulmonary function tests) Renewal Approval period: 6 months Second renewal approval period: 12 months PLERIXAFOR (MOZOBIL) 24mg/1.2mL solution for injection For use in combination with filgrastim to mobilize hematopoietic stem cells for subsequent autologous transplantation in patients with Non-Hodgkin s lymphoma (NHL) or multiple myeloma (MM) if one of the following criteria are met: September 2015 v.1 A - 56

A PBCD34+ count of < 10 cells/ul after 4 days of filgrastim; OR Less than 50% of the target CD34 yield is achieved on the 1st day of apheresis (after being mobilized with filgrastim alone or following chemotherapy); OR If a patient has failed a previous stem cell mobilization with filgrastim alone or following chemotherapy. Claim Note: Reimbursement is limited to a maximum of 4 doses (0.24mg/kg given daily) for a single mobilization attempt and to prescriptions written by an oncologist or hematologist. POMALIDOMIDE (POMALYST) 1mg, 2mg, 3mg and 4mg capsules For the treatment of patients with relapsed and/or refractory multiple myeloma who: Have previously failed at least two treatments including both bortezomib and lenalidomide, and Demonstrated disease progression on the last treatment. Clinical Note: Requests for pomalidomide will be considered in rare instances where bortezomib is contraindicated or when patients are intolerant to it; however, in all cases patients should have failed lenalidomide which they may have received in the maintenance setting. Claim Note: Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate transactions as outlined here. PRASUGREL HYDROCHLORIDE (EFFIENT) 10mg tablet In combination with ASA for patients with: ST-elevated myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) who have not received antiplatelet therapy prior to arrival in the catheterization lab. Treatment must be initiated in hospital. OR Acute coronary syndrome who failed on optimal clopidogrel and ASA therapy as defined by definite stent thrombosis1, or recurrent STEMI, or NSTEMI or UA after prior revascularization via PCI. Clinical Notes: 1. Definite stent thrombosis, according to the Academic Research Consortium, is a total occlusion originating in or within 5 mm of the stent or is a visible thrombus within the stent or is within 5 mm of the stent in the presence of an acute ischemic clinical syndrome within 48 hours. Definite stent thrombosis must be confirmed by angiography or by pathologic evidence of acute thrombosis. 2. As per the product monograph, prasugrel is contraindicated in patients with a known history of transient ischemic attack or stroke; those with active pathological bleeding such as gastrointestinal bleeding or intracranial hemorrhage; and those with severe hepatic impairment (Child-Pugh Class C). 3. As per the product monograph, prasugrel is not recommended in patients 75 years of age because of the increase risk of fatal and intracranial bleeding; or those with body weight < 60 kg because of increased risk of major bleeding due to an increase in exposure to the active metabolite of prasugrel. Claim Notes: Approval will be for a maximum of 12 months. Prescriptions written by invasive (interventional) cardiologists do not require special authorization. PREGABALIN (LYRICA and generic brands) 25mg, 50mg, 75mg, 150mg, 225mg and 300mg capsules For the treatment of neuropathic pain (e.g. diabetic peripheral neuropathy, postherpetic neuralgia) in patients who have failed a trial of a tricyclic antidepressant (e.g. amitriptyline, desipramine, imipramine, nortriptyline). September 2015 v.1 A - 57

PROTON PUMP INHIBITORS (Lansoprazole, Pantoprazole Sodium) Lansoprazole 15mg & 30mg capsules and Pantoprazole Sodium 20mg & 40mg tablets Requests for lansoprazole and pantoprazole sodium will be considered for patients in whom there has been a therapeutic failure with regular benefit PPIs (e.g. rabeprazole, omeprazole). Approval Periods Requests for lansoprazole and pantoprazole sodium, meeting criteria above, will be considered for the following maximum approval periods: Indication and Diagnostic Information Maximum Approval Period 1 2 Symptomatic GERD or other refluxassociated indications (i.e. non-cardiac chest pain) Erosive/ulcerative esophagitis or Barrett s esophagus Considered for short-term (8-12 week) approval Considered for long term approval 3 Zollinger-Ellison Syndrome Considered for long-term approval 4 Gastric/duodenal ulcers in individuals who are H. pylori negative or having uninvestigated peptic ulcer disease (PUD) Considered for up to 12 weeks 5 H. pylori positive patients with PUD H. pylori regimens containing lansoprazole or pantoprazole sodium will be reimbursed only under special authorization. 6 Gastro-duodenal protection (ulcer prophylaxis) for high risk patients (e.g. high risk NSAID users) Considered for one year with reassessment QUINAGOLIDE (NORPROLAC) 0.075mg, 0.15mg tablets For the treatment of patients with hyperprolactinemia who have failed or are intolerant to bromocriptine. RALOXIFENE (EVISTA and generic brands) 60mg tablet See criteria under Osteoporosis Drugs. RANIBIZUMAB (LUCENTIS) 10mg/mL solution for intravitreal injection 1. Neovascular (wet) age-related macular degeneration (AMD) Initial Coverage: For the treatment of patients with neovascular (wet) age-related macular degeneration (AMD) where all of the following apply to the eye to be treated: Best Corrected Visual Acuity (BCVA) is between 6/12 and 6/96 The lesion size is less than or equal to 12 disc areas in greatest linear dimension There is evidence of recent (< 3 months) presumed disease progression (blood vessel growth, as indicated by fluorescein angiography, or optical coherence tomography (OCT) Administration is to be done by a qualified ophthalmologist experienced in intravitreal injections. The interval between doses should not be shorter than 1 month. Continued Coverage: Treatment with ranibizumab should be continued only in people who maintain adequate response to therapy. September 2015 v.1 A - 58

Clinical Notes: 1. Coverage will not be approved for patients: - With permanent retinal damage as defined by the Royal College of Ophthalmology guidelines - Receiving concurrent treatment with verteporfin. 2. Ranibizumab should be permanently discontinued if any one of the following occurs: Reduction in BCVA in the treated eye to less than 15 letters (absolute) on 2 consecutive visits in the treated eye, attributed to AMD in the absence of other pathology Reductions in BCVA of 30 letters or more compared to either baseline and/or best recorded level since baseline as this may indicate either poor treatment effect, adverse events or both. There is evidence of deterioration of the lesion morphology despite optimum treatment over 3 consecutive visits. Claim Notes: An initial claim of up to two vials of ranibizumab (one vial per eye treated) will be automatically reimbursed when prescribed by an ophthalmologist. If additional medication is required, a request should be made through special authorization. The NBPDP will limit reimbursement to a maximum of 1 vial of ranibizumab per eye treated every 30 days. Claims submitted for greater than 1 vial, or submitted within 30 days of a previous claim will not be reimbursed. Please refer to Quantities for Claims Submissions for the correct unit of measure. 2. Diabetic macular edema (DME) Initial coverage: For the treatment of visual impairment due to diabetic macular edema (DME) in patients who meet all of the following criteria: clinically significant centre-involving macular edema for whom laser photocoagulation is also indicated hemoglobin A1c test in the past 6 months with a value of less than or equal to 11% best corrected visual acuity of 20/32 to 20/400 central retinal thickness greater than or equal to 250 micrometers Renewal Criteria: confirm that a hemoglobin A1c test in the past 6 months had a value of less than or equal to 11% date of last visit and results of best corrected visual acuity at that visit date of last OCT and central retinal thickness on that examination if ranibizumab is being administered monthly, please provide details on the rationale Clinical Notes: Treatment should be given monthly until maximum visual acuity is achieved (i.e. stable visual acuity for three consecutive months while on ranibizumab). Thereafter, the patient's visual acuity should be monitored monthly. Treatment should be resumed when monitoring indicates a loss of visual acuity due to DME until stable visual acuity is reached again for three consecutive months. Claim Notes: Approval Period: 1 year Please refer to Quantities for Claims Submissionsfor the correct unit of measure. REGORAFENIB (STIVARGA) 150mg tablet For the treatment of patients with metastatic and/or unresectable gastrointestinal stromal tumors (GIST) who have had disease progression on, or intolerance to, imatinib and sunitinib, and who have an ECOG performance status of 0 or 1. Renewal Criteria: Written confirmation that the patient continues to benefit from therapy. Clinical Note: Recommended dose: 160mg once daily (3 weeks on, 1 week off). Claim Notes: Initial approval duration: 6 months Renewal approval duration: 6 months September 2015 v.1 A - 59

REPAGLINIDE (GLUCONORM and generic brands) 0.5mg, 1mg and 2mg tablets For patients with type 2 diabetes who are not adequately controlled by diet and exercise and glyburide and/or metformin or who have frequent or severe hypoglycemic episodes despite dosage adjustment of glyburide. RIBAVIRIN (IBAVYR) 400mg and 600mg tablets For use in combination with other drugs for the treatment of chronic hepatitis C. The applicable criteria for the combination regimen must be met. RIFABUTIN (MYCOBUTIN) 150mg tablet Requests will be considered for the prophylaxis of disseminated Mycobacterium avium complex (MAC) disease in the following patients: HIV infected patients with an AIDS defining diagnosis and CD4+ cell count less than or equal to 200/mm 3. HIV positive patients without an AIDS defining diagnosis and CD4+ cell count less than or equal to 100/mm 3. RILUZOLE (RILUTEK and generic brands) 50mg tablet For the treatment of amyotrophic lateral sclerosis (ALS) or Lou Gehrig s Disease, when initiated by a physician with expertise in the management of ALS in patients who have: A probable or definite diagnosis of ALS as defined by the World Federation of Neurology criteria. ALS symptoms for less than five years. FVC > 60 % predicted upon initiation of therapy. No tracheostomy for invasive ventilation Clinical Note: Coverage cannot be renewed once the patient has a tracheostomy for the purpose of invasive ventilation. Claim Note: Requests will be approved for a maximum of six months coverage. RIOCIGUAT (ADEMPAS) 0.5mg, 1mg, 1.5mg, 2mg, and 2.5mg film-coated tablets For the treatment of inoperable chronic thromboembolic pulmonary hypertension (CTEPH) World Health Organization [WHO] Group 4) or persistent or recurrent CTEPH after surgical treatment in adult patients (18 years of age or older) with WHO Functional Class II or III pulmonary hypertension. Clinical Note: Requests will be considered from physicians with experience in the diagnosis and treatment of CTEPH. Claim Note: Approval duration: 1 year RISEDRONATE (ACTONEL and generic brand) 30mg tablet For the treatment of Paget s disease. RISPERIDONE (RISPERDAL M and generic brands) 0.5mg, 1mg, 2mg, 3mg and 4mg oral disintegrating tablets 1. For the treatment of schizophrenia and related psychotic disorders. 2. For use in severe dementia for the short-term symptomatic management of inappropriate behaviour due to aggression and/or psychosis. 3. For the acute management of manic episodes associated with Bipolar 1 disorder. Clinical Note: Requests will be considered for patients who have difficulty swallowing oral tablets. Claim Note: Prescriptions written by New Brunswick psychiatrists do not require special authorization. Subsequent refills ordered by other practitioners will not require special authorization. September 2015 v.1 A - 60

RISPERIDONE (RISPERDAL CONSTA) Prolonged release suspension for injection 12.5mg, 25mg, 37.5mg and 50mg vials For the treatment of schizophrenia in patients: for whom compliance with an oral antipsychotic presents problems, OR who are currently receiving a typical depot antipsychotic and experiencing significant side effects (EPS or TD) or lack of efficacy RITUXIMAB (RITUXAN) 10mg/mL injection 1. Rheumatoid Arthritis For the treatment of adult patients with severe active rheumatoid arthritis who have failed to respond to an adequate trial with an anti-tnf agent. Clinical Notes: Rituximab will not be reimbursed concomitantly with anti-tnf agents. Approval for re-treatment with rituximab will only be considered for patients who have achieved a response, followed by a subsequent loss of effect and, after an interval of no less than six months from the previous dose. 2. Polyangiitis For the induction of remission in patients with severely active granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) who have severe intolerance or other contraindication to cyclophosphamide, or who have failed an adequate trial of cyclophosphamide. RIVAROXABAN (XARELTO) 10mg film-coated tablet Venous thromboembolism prophylaxis (following total knee or total hip replacement surgery) For the prophylaxis of venous thromboembolism as an alternative to low molecular weight heparins for total knee replacement (usual duration up to 14 days) OR total hip replacement surgery (usual duration up to 35 days). Claim Notes: The maximum dose of rivaroxaban that will be reimbursed is 10 mg daily for up to 30 days during a 6 month period. Subsequent requirements for prophylaxis within a 6 month period (i.e. second joint replacement procedure within the 6 month period) will require Special Authorization. RIVAROXABAN (XARELTO) 15mg and 20mg film-coated tablets Atrial fibrillation For the prevention of stroke and systemic embolism in at-risk patients with non-valvular atrial fibrillation for whom: Anticoagulation is inadequate following a at least a two month trial on warfarin; or Warfarin is contraindicated or not possible due to inability to regularly monitor through International Normalized Ratio (INR) testing (i.e. no access to INR testing services at a laboratory, clinic, pharmacy, and at home). Clinical Notes: The following patient groups are excluded from coverage for rivaroxaban for atrial fibrillation: - Patients with impaired renal function (creatinine clearance or estimated glomerular filtration rate <30 ml/min) - Patients 75 years of age or older without documented stable renal function - Patients with hemodynamically significant rheumatic valvular heart disease, especially mitral stenosis - Patients with prosthetic heart valves. At-risk patients with atrial fibrillation are defined as those with a CHADS 2 score of 1. Although the ROCKET-AF trial included patients with higher CHADS 2 scores ( 2), other landmark studies with the other newer oral anticoagulants demonstrated a therapeutic benefit in patients with a CHADS 2 score of 1. Prescribers may consider an antiplatelet regimen or oral anticoagulation for patients with a CHADS 2 score of 1. Inadequate anticoagulation is defined as INR testing results that are outside the desired INR range for at least 35% of the tests during the monitoring period (i.e., adequate anticoagulation is defined as INR test results that are within the desired INR range for at least 65% of the tests during the monitoring period). Since renal impairment can increase bleeding risk, renal function should be regularly monitored. Other factors that increase bleeding risk should also be assessed and monitored (see rivaroxaban product monograph). Documented stable renal function is defined as creatinine clearance or estimated glomerular filtration rate that is maintained for at least 3 months (i.e. 30-49 ml/min for 15 mg once daily dosing or 50 ml/min for 20 mg once daily dosing). September 2015 v.1 A - 61

There is currently no data to support that rivaroxaban provides adequate anticoagulation in patients with rheumatic valvular disease or those with prosthetic heart valves, rivaroxaban is not recommended in these populations. Patients starting rivaroxaban should have ready access to appropriate medical services to manage a major bleeding event. Venous thromboembolic events (VTE) treatment For the treatment of VTE (deep vein thrombosis (DVT) or pulmonary embolism (PE)). Clinical Notes: The recommended dose of rivaroxaban for patients initiating DVT or PE treatment is 15mg twice daily for 3 weeks, followed by 20mg once daily. Drug plan coverage for rivaroxaban is an alternative to heparin/warfarin for up to 6 months. When used for greater than 6 months, rivaroxaban is more costly than heparin/warfarin. As such, patients with an intended duration of therapy greater than 6 months should be considered for initiation on heparin/warfarin. Since renal impairment can increase bleeding risk, it is important to monitor renal function regularly. Other factors that increase bleeding risks should also be assessed and monitored (see product monograph). Claim Note: Approval Period: Up to 6 months RIVASTIGMINE (EXELON and generic brands) 1.5mg, 3mg, 4.5mg and 6mg capsules 2mg/mL oral liquid See criteria under Cholinesterase Inhibitors. RIZATRIPTAN (MAXALT and generic brands) 5mg and 10mg tablets RIZATRIPTAN (MAXALT RPD and generic brands) 5mg and 10mg oral disintegrating tablets For the treatment of migraine 1 headache when: - Migraines are moderate 2 in severity and other therapies (e.g. NSAIDs, acetaminophen, DHE spray) are not effective, OR - Migraine attacks are severe 2 or ultra severe 2 Clinical Notes: 1 As diagnosed based on current Canadian guidelines. 2 Definitions: - Moderate - pain is distracting causing need to slow down and limit activities; - Severe - pain affects ability to concentrate and very difficult to continue with daily activities; - Ultra severe - unable to speak or think clearly; not able to function; likely lying down or sleeping Claim Notes: A maximum of 72 tablets will be reimbursed annually without special authorization. If additional medication is required within the year, a request should be made through special authorization. Patients with >3 migraines/month on average despite prophylactic therapy may be considered for up to a maximum of 12 doses / 30 days. RUFINAMIDE (BANZEL) 100mg, 200mg and 400mg tablets For the adjunctive treatment of seizures associated with Lennox-Gastaut syndrome for patients who meet all of the following criteria: are under the care of a physician experienced in treating Lennox-Gastaut syndrome-associated seizures, AND are currently receiving two or more antiepileptic drugs, AND in whom less costly antiepileptic drugs are ineffective or not appropriate. September 2015 v.1 A - 62

RUXOLITINIB (JAKAVI) 5mg, 15mg, 20mg tablets For patients with intermediate to high risk symptomatic Myelofibrosis (MF) as assessed using the Dynamic International Prognostic Scoring System (DIPSS) Plus or patients with symptomatic splenomegaly. Patients should have ECOG performance status 3 and be either previously untreated or refractory to other treatment. SALMETEROL/FLUTICASONE (ADVAIR) 50/100mcg, 50/250mcg and 50/500mcg discus 25/125mcg and 25/250mcg metered dose inhalers Reversible Obstructive Airway Disease For patients with reversible obstructive airways disease who are: - Stabilized on an inhaled corticosteroid and a long-acting beta2-adrenergic agonist, OR - Using optimal doses of inhaled corticosteroids but are still poorly controlled. Chronic Obstructive Pulmonary Disease For the treatment of chronic obstructive pulmonary disease (COPD) if symptoms persist after 2-3 months of short-acting bronchodilator therapy (i.e. salbutamol at a maximum dose of 8 puffs/day or ipratropium at maximum dose of 12 puffs/day). Coverage can be provided without a trial of short-acting agent if there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1 /FVC ratio < 0.7) and significant symptoms (i.e. Medical Research Council (MRC) Dyspnea Scale score of 3-5). Combination therapy with a long-acting muscarinic antagonist (LAMA) AND a long-acting beta2-adrenergic agonist/inhaled corticosteroid (LABA/ICS) will only be considered if: - there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1/FVC ratio < 0.7), and significant symptoms (i.e. MRC score of 3-5) AND - there is evidence of one or more moderate-to-severe exacerbations per year, on average, for 2 consecutive years requiring antibiotics and/or systemic (oral or intravenous) corticosteroids. Clinical Note: If spirometry cannot be obtained, reasons must be clearly explained and other evidence regarding severity of condition must be provided for consideration (i.e. MRC scale). Spirometry reports from any point in time will be accepted. COPD Stage MODERATE MRC 3 to 4 SEVERE MRC 5 Medical Research Council (MRC) Dyspnea Scale Symptoms Shortness of breath from COPD causing the patient to stop after walking about 100 meters (or after a few minutes) on the level. Shortness of breath from COPD resulting in the patient being too breathless to leave the house or breathless after undressing, or the presence of chronic respiratory failure or clinical signs of right heart failure. SALMETEROL XINAFOATE (SEREVENT) 50mcg diskus and diskhaler Reversible Obstructive Airway Disease: For the treatment of patients, 12 years of age or older, with reversible obstructive airway disease who are using optimal corticosteroid treatment, but are still poorly controlled. Chronic Obstructive Pulmonary Disease For the treatment of chronic obstructive pulmonary disease (COPD) if symptoms persist after 2-3 months of short-acting bronchodilator therapy (i.e. salbutamol at a maximum dose of 8 puffs/day or ipratropium at maximum dose of 12 puffs/day). Coverage can be provided without a trial of short-acting agent if there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1 /FVC ratio < 0.7) and significant symptoms (i.e. Medical Research Council (MRC) Dyspnea Scale score of 3-5). Combination therapy with tiotropium AND a long-acting beta2-adrenergic agonist/inhaled corticosteroid (LABA/ICS) will only be considered if: - there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1/FVC ratio < 0.7), and significant symptoms i.e. MRC score of 3-5) AND - there is evidence of one or more moderate-to-severe exacerbations per year, on average, for 2 consecutive years requiring antibiotics and/or systemic (oral or intravenous) corticosteroids. September 2015 v.1 A - 63

Clinical Note: If spirometry cannot be obtained, reasons must be clearly explained and other evidence regarding severity of condition must be provided for consideration (i.e. MRC scale). Spirometry reports from any point in time will be accepted. COPD Stage MODERATE MRC 3 to 4 SEVERE MRC 5 Medical Research Council (MRC) Dyspnea Scale Symptoms Shortness of breath from COPD causing the patient to stop after walking about 100 meters (or after a few minutes) on the level. Shortness of breath from COPD resulting in the patient being too breathless to leave the house or breathless after undressing, or the presence of chronic respiratory failure or clinical signs of right heart failure. Claim Note: Prescriptions written by certified New Brunswick respirologists do not require special authorization. Subsequent refills ordered by other practitioners will not require special authorization. SAXAGLIPTIN (ONGLYZA) 2.5mg and 5mg tablets For the treatment of type 2 diabetes mellitus, in addition to metformin and a sulfonylurea, in patients with inadequate glycemic control on metformin and a sulfonylurea and for whom insulin is not an option. SEVELAMER (RENAGEL) 800mg tablet Treatment of severe renal failure, where a calcium salt is contraindicated or not tolerated or when a phosphate binder is needed in association with a calcium salt, where a calcium salt alone does not produce optimal control of the hyperphosphatemia. Claim Note: The prescription must be initiated by a nephrologist. SILDENAFIL CITRATE (REVATIO and generic brands) 20mg tablet For the treatment of patients with World Health Organization (WHO) functional class III idiopathic pulmonary arterial hypertension (IPAH) who do not demonstrate vasoreactivity on testing or who do demonstrate vasoreactivity on testing but fail a trial of calcium channel blockers. For the treatment of patients with World Health Organization (WHO) functional class III pulmonary arterial hypertension (PAH) associated with connective tissue diseases who do not respond to conventional therapy. Diagnosis of PAH should be confirmed by cardiac catheterization. Claim Note: The maximum dose of sildenafil that will be reimbursed is 20mg three times daily. SIMEPREVIR (GALEXOS) 150mg capsule For the treatment of chronic hepatitis C genotype 1 infection in patients with compensated liver disease, in combination with peginterferon alpha and ribavirin, if the following criteria are met: Detectable levels of hepatitis C virus (HCV) RNA in the last six months. Fibrosis stage of F2, F3 or F4 (Metavir score or equivalent). Exclusion Criteria: Patients with the NS3 Q80K polymorphism should not be treated with simeprevir. Patients who have received a prior full therapeutic course of boceprevir or telaprevir in combination with peginterferon alpha and ribavirin and did not receive an adequate response. Decompensated liver disease. Patients less than 18 years old. Patients who have had prior organ transplant including liver transplant. Simeprevir in combination with sofosbuvir. September 2015 v.1 A - 64

Clinical Notes: 1. Recommended dose is 150mg once daily in combination with peginterferon alpha and ribavirin. 2. Duration of treatment is to be determined using Response-Guided Therapy. Patient Group HCV RNA at Week 4 Triple Therapy Simeprevir, Peginterferon alfa and Ribavirin Dual Therapy Peginterferon alfa and Ribavirin Total Treatment Duration Treatment-Naïve and Prior Relapsers Undetectable First 12 weeks Additional 12 weeks 24 weeks <25 IU/mL detectable First 12 weeks Additional 36 weeks 48 weeks Prior Non- Responders (Including Partial and Null Responder) Undetectable or <25 IU/mL detectable First 12 weeks Additional 36 weeks 48 weeks 3. Discontinuation of treatment is recommended in patients with inadequate on-treatment virologic response since it is unlikely that they will achieve a sustained virologic response and may develop treatment-emergent resistance. HCV RNA Treatment Week 4: 25 IU/mL Treatment Week 12: detectable Treatment Week 24: detectable Action Discontinue simeprevir, peginterferon alfa and ribavirin Discontinue peginterferon alfa and ribavirin (treatment with simeprevir is complete at Week 12) Discontinue peginterferon alfa and ribavirin Please refer to the product monograph for full prescribing information. Claim Notes: Only one course of treatment (for up to 12 weeks duration) will be approved. Renewals will not be considered. Requests will be considered for individuals enrolled in Plans ADEFGV. Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate transactions as outlined here. SITAGLIPTIN (JANUVIA) 25mg, 50mg and 100mg tablets SITAGLIPTIN / METFORMIN (JANUMET) 50mg/500mg, 50mg/850mg and 50mg/1000mg tablets SITAGLIPTIN / METFORMIN (JANUMET XR) 50mg/1000mg tablets extended release tablet For the treatment of Type 2 diabetes mellitus in patients for whom NPH insulin is not an option and: Who have inadequate glycemic control while on optimal doses of metformin and a sulfonylurea when added as a third agent; OR In combination with metformin when a sulfonylurea is not suitable due to contraindications or intolerance; OR As monotherapy when metformin and sulfonylurea are not suitable due to contraindications or intolerance SODIUM FERRIC GLUCONATE COMPLEX (FERRLECIT) 12.5mg/mL injection For the treatment of iron deficiency anemia in patients who are intolerant to oral iron replacement products, OR have not responded to adequate therapy with oral iron. September 2015 v.1 A - 65

SOFOSBUVIR (SOVALDI) 400mg tablet For the treatment of adult patients 18 years of age or older with chronic hepatitis C infection with compensated liver disease (including compensated cirrhosis) as follows: Approval Period and Regimen Genotype 1: Treatment-naive patients Genotype 2: Treatment-naïve patients in whom interferon (IFN) is medically contraindicated, or Peginterferon / ribavirin (PegIFN/RBV) treatment-experienced patients Genotype 3: Treatment-naïve patients in whom IFN is medically contraindicated, or PegIFN/RBV treatment-experienced patients 12 weeks of sofosbuvir in combination with PegIFN/RBV 12 weeks of sofosbuvir in combination with RBV 24 weeks of sofosbuvir in combination with RBV Patients must also meet ALL of the following: Prescribed by a hepatologist, gastroenterologist, or an infectious disease specialist (or other physician experienced in treating hepatitis C). Lab-confirmed hepatitis C genotype 1, 2 or 3. Patient has a quantitative HCV RNA value within the last 6 months. Fibrosis stage F2 or greater (Metavir scale or equivalent). Exclusion Criteria: Patients currently being treated with another HCV antiviral agent. Patients who have previously received a treatment course of sofosbuvir (re-treatment requests will not be considered). Clinical Notes: Compensated cirrhosis is defined as cirrhosis with a Child Pugh Score = A (5-6). Medical contraindication to interferon is defined as hypersensitivity to peginterferon or interferon alfa-2a or 2b, polyethylene glycol or any component of the formulation resulting in discontinuation of therapy; or presence of significant clinical comorbidities which are deemed to have a high risk of worsening with interferon treatment. Details are required regarding a patient s contraindications and/or risk of worsening significant comorbidities. Genotype 2 or 3 treatment-experienced patients are patients who have previously been treated with PegIFN/RBV and did not receive adequate response. HIV / HCV co-infected patients may be considered as per criteria listed above. Claim Notes: Requests will be considered for individuals enrolled in Plans ADEFGV. Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate transactions as outlined here. SOFOSBUVIR / LEDIPASVIR (HARVONI) 400mg / 90mg tablet For the treatment of chronic hepatitis C genotype 1 infection in adult patients. Genotype 1 Treatment naïve patients with no cirrhosis, viral load < 6 million IU/mL Treatment naïve patients with no cirrhosis, viral load 6 million IU/mL or Treatment naïve patients with compensated cirrhosis or Treatment-experienced patients with no cirrhosis Treatment-experienced patients with compensated cirrhosis Approval Period 8 weeks 12 weeks 24 weeks September 2015 v.1 A - 66

Patients must also meet all of the following criteria: 1. Prescribed by a hepatologist, gastroenterologist or an infectious disease specialist (or other physician experienced in treating hepatitis C) 2. Lab-confirmed hepatitis C genotype 1 3. Patient has a quantitative HCV RNA value within the last 6 months 4. Fibrosis stage F2 or greater (Metavir scale or equivalent) Exclusion Criteria: Patients currently being treated with another HCV antiviral agent. Patients who have previously received a treatment course of ledipasvir/sofosbuvir (re-treatment requests will not be considered). Clinical notes: 1. For treatment naïve patients with no cirrhosis, viral load < 6 million IU/mL, evidence has shown that the SVR rates with the 8-week and 12-week treatment regimens are similar. Treatment regimens of up to 12 weeks are recognized as a Health Canada approved treatment option. Patients with severe fibrosis/borderline cirrhosis (F3-4) or HIV/HCV co-infected patients may be considered for 12 weeks coverage. 2. Compensated cirrhosis is defined as cirrhosis with a Child Pugh Score = A (5-6) 3. Treatment-experienced patients are patients who have previously been treated with peginterferon / ribavirin (PegIFN/RBV) regimen, including regimens containing HCV protease inhibitors and did not receive adequate response. 4. HIV-HCV co-infected patients may be considered as per criteria listed above. Claim notes: Requests will be considered for individuals enrolled in Plans ADEFGV. Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate transactions as outlined here. SOLIFENACIN (VESICARE) 5mg and 10mg tablets For the treatment of overactive bladder with symptoms of urinary frequency, urgency and/or urge incontinence in patients who have not tolerated a reasonable trial of immediate-release oxybutynin. Clinical Note: Requests for the treatment of stress incontinence will not be considered. Claim Notes: If the beneficiary has had a claim for oxybutynin in the previous 24 months, the adjudication system will recognize this information and the claim for solifenacin will be automatically reimbursed without the need for a written special authorization request. Written special authorization will continue to be available as an option for patients who may not have the relevant first line agent on history due to changes in drug coverage or other factors. SOMATROPIN (GENOTROPIN) 0.6mg, 0.8mg, 1mg, 1.2mg, 1.4mg, 1.6mg, 1.8mg, 2mg MiniQuick pre-filled syringes 5.3mg, 12mg GoQuick pre-filled pens 1. Growth Hormone Deficiency in Children For the treatment of growth hormone deficiency in children under the age of 18. Claim Notes: Must be prescribed by, or in consultation with, an endocrinologist. Somatropin is a regular benefit for Plan T 2. Turner Syndrome For the treatment of short stature associated with Turner Syndrome in patients whose epiphyses are not closed. Claim Note: Must be prescribed by, or in consultation with, an endocrinologist. SOMATROPIN (HUMATROPE) 1mg, 6mg, 12mg and 24mg/vial injection 1. Growth Hormone Deficiency in Children For the treatment of growth hormone deficiency in children under the age of 18. Claim Notes: Must be prescribed by, or in consultation with, an endocrinologist. Somatropin is a regular benefit for Plan T. September 2015 v.1 A - 67

2. Turner Syndrome For the treatment of short stature associated with Turner Syndrome in patients whose epiphyses are not closed. Claim Note: Must be prescribed by, or in consultation with, an endocrinologist. SOMATROPIN (NUTROPIN AQ Pen Cartridge) 10mg/2mL pen cartridge SOMATROPIN (NUTROPIN AQ NuSpin) 5mg/2mL, 10mg/2mL, and 20mg/2mL cartridges SOMATROPIN (SAIZEN) 3.33mg, 5mg and 8.8mg/vial injections 6mg, 12mg and 20mg cartridges 1. Growth Hormone Deficiency in Children For the treatment of growth hormone deficiency in children under the age of 18. Claim Notes: Must be prescribed by, or in consultation with, an endocrinologist. Somatropin is a regular benefit for Plan T. 2. Turner Syndrome For the treatment of short stature associated with Turner Syndrome in patients whose epiphyses are not closed. Claim Note: Must be prescribed by, or in consultation with, an endocrinologist. 3. Chronic Renal Insufficiency For the treatment of children with growth failure associated with chronic renal insufficiency, up to the time of renal transplantation, who meet the following criteria: A glomerular filtration rate less than or equal to 1.25 ml/s/1.73m² (75 ml/min/1.73m²) Evidence of growth impairment: - Z score (HSDS) less than -1.88 (HSDS = height standard deviation score, a statistical comparison to the average of normal values for age and sex) or height-for-age at the 3rd percentile OR - Height velocity-for-age SDS less than -1.88 or height velocity-for-age less than 3 rd percentile, persisting for greater than 3 months despite treatment of nutritional deficiencies and metabolic abnormalities. Claim Note: Somatropin must be prescribed by, or in consultation with, a specialist in pediatric nephrology. SOMATROPIN (OMNITROPE) 3.33mg and 6.7mg/cartridges For the treatment of growth hormone deficiency in children under the age of 18. Claim Notes: Must be prescribed by, or in consultation with, an endocrinologist. Somatropin is a regular benefit for Plan T. SORAFENIB (NEXAVAR) 200mg tablet Metastatic Renal Cell Carcinoma (MRCC) As second-line therapy for patients with histologically confirmed metastatic clear cell renal cell carcinoma, who: have disease progression after prior cytokine therapy (e.g. interferon; aldesleukin) within the previous 8 months; AND have a performance status of 0 or 1 on the basis of the Eastern Cooperative Oncology Group (ECOG) criteria ; AND have a favourable or intermediate risk status, according to the Memorial Sloan-Kettering Cancer Center (MSKCC) prognostic score. Renewal criteria: Written confirmation that the patient has benefited from therapy and is expected to continue to do so. Clinical Note: Patients who are asymptomatic and those who are symptomatic but completely ambulant. Claim Notes: Initial approval period: 1 year. Renewal period: 1 year. September 2015 v.1 A - 68

Advanced Hepatocellular Carcinoma (HCC) For patients with Child-Pugh Class A* who have: A performance status of 0,1, or 2 on the basis of the Eastern Cooperative Oncology Group (ECOG) criteria; AND Either progressed on trans-arterial chemoembolization (TACE) or not suitable for the TACE procedure. Coverage may be renewed for patients with documentation of radiography and/or scan results indicating no progression Clinical Notes: 1. Sorafenib will not be reimbursed if used with induction or adjuvant intent along with other curative-intent treatments; for maintenance therapy after trans-arterial chemoembolization; or if patients have Child-Pugh B or Child-Pugh C cirrhosis. 2. *A Child-Pugh score of 5-6 is considered class A (well-compensated disease); 7-9 is class B (significant functional compromise); and 10-15 is class C (decompensated disease). 3. Patients who are asymptomatic and those who are symptomatic and in bed less than 50% of the time. 4. The Memorial Sloan-Kettering Cancer Center (MSKCC) Prognostic Score categorizes patients into three risk groups according to the number of pre-treatment risk factors present: Favourable = none; Intermediate = one or two; Poor = three or more. Pre-treatment risk factors: - Low Karnofsky performance status (<80%) - Lactate Dehydrogenase level greater than 1.5 times the upper limit of normal - Hemoglobin level below the lower limit of normal - High corrected serum calcium level (>10 mg/dl or 2.5 mmol/l) - Interval of less than 1 year between diagnosis and treatment Claim Notes: Initial approval period: 6 months Approval period for renewal: 1 year SUMATRIPTAN (IMITREX AND IMITREX DF and generic brands) 50mg and 100mg tablets For the treatment of migraine 1 headache when: - Migraines are moderate 2 in severity and other therapies (e.g. NSAIDs, acetaminophen, DHE spray) are not effective, OR - Migraine attacks are severe 2 or ultra severe 2 Clinical Notes: 1. 1 As diagnosed based on current Canadian guidelines. 2. 2 Definitions: - Moderate - pain is distracting causing need to slow down and limit activities; - Severe - pain affects ability to concentrate and very difficult to continue with daily activities; - Ultra severe - unable to speak or think clearly; not able to function; likely lying down or sleeping Claim Notes: Coverage limited to 6 doses / 30 days 3 - patients with >3 migraines/month on average despite prophylactic therapy may be considered for up to a maximum of 12 doses / 30 days 3 Reimbursement will be available for a maximum quantity of triptan doses as outlined in criteria per 30 days regardless of the agent(s) used within the 30 day period. Special authorization for the products almotriptan 6.25mg and 12.5mg tablets, naratriptan 1mg and 2.5mg tablets, rizatriptan 5mg and 10mg tablets and wafers, sumatriptan 5mg and 20mg nasal spray and zolmitriptan 2.5mg tablets and orally dispersible tablets, 2.5mg and 5mg nasal spray will be considered as a set. Approvals will include all products in this list, however reimbursement will be available for a maximum quantity of one agent per month. SUMATRIPTAN (IMITREX NASAL SPRAY) 5mg and 20mg nasal sprays For the treatment of migraine 1 headache of moderate 2 intensity when other therapies (e.g. NSAIDs, acetaminophen, DHE spray) are not effective AND patients have not responded to oral sumatriptan, zolmitriptan, rizatriptan and naratriptan. For the treatment of migraine 1 headache of severe 2 or ultra severe 2 intensity when patients have not responded to oral sumatriptan, zolmitriptan, rizatriptan and/or naratriptan. September 2015 v.1 A - 69

Clinical Notes: 1. 1 As diagnosed based on current Canadian guidelines. 2. 2 Definitions: - Moderate - pain is distracting causing need to slow down and limit activities; - Severe - pain affects ability to concentrate and very difficult to continue with daily activities; - Ultra severe - unable to speak or think clearly; not able to function; likely lying down or sleeping Claim Notes: Coverage limited to 6 doses / 30 days 3 - patients with >3 migraines/month on average despite prophylactic therapy may be considered for up to a maximum of 12 doses / 30 days 3 Reimbursement will be available for a maximum quantity of triptan doses as outlined in criteria per 30 days regardless of the agent(s) used within the 30 day period. Special authorization for the products almotriptan 6.25mg and 12.5mg tablets, naratriptan 1mg and 2.5mg tablets, rizatriptan 5mg and 10mg tablets and wafers, sumatriptan 5mg and 20mg nasal spray and zolmitriptan 2.5mg tablets and orally dispersible tablets, 2.5mg and 5mg nasal spray will be considered as a set. Approvals will include all products in this list, however reimbursement will be available for a maximum quantity of one agent per month. SUMATRIPTAN (IMITREX INJECTION and generic brand) 6mg injection For the treatment of migraine 1 headache of moderate 2 intensity when other therapies (e.g. NSAIDs, acetaminophen, DHE spray) are not effective AND oral and nasal triptans are not appropriate. For the treatment of migraine 1 headache of severe 2 or ultra severe 2 intensity when oral and nasal triptans are not appropriate. Clinical Notes: 1. 1 As diagnosed based on current Canadian guidelines. 2. 2 Definitions: - Moderate - pain is distracting causing need to slow down and limit activities; - Severe - pain affects ability to concentrate and very difficult to continue with daily activities; - Ultra severe - unable to speak or think clearly; not able to function; likely lying down or sleeping Claim Notes: Coverage limited to 6 doses / 30 days 3 - patients with >3 migraines/month on average despite prophylactic therapy may be considered for up to a maximum of 12 doses / 30 days 3 Reimbursement will be available for a maximum quantity of triptan doses as outlined in criteria per 30 days regardless of the agent(s) used within the 30 day period. SUNITINIB (SUTENT) 12.5mg, 25mg and 50mg capsules 1. Pancreatic Neuroendocrine Tumors (pnet) For the treatment of patients with progressive, unresectable, well or moderately differentiated, locally advanced or metastatic pancreatic neuroendocrine tumors (pnet) with an ECOG performance status of 0-2, until disease progression. 2. Gastrointestinal Stromal Tumour (GIST) For the treatment of patients with c-kit expressing (CD117+) unresectable or metastatic/recurrent gastrointestinal stromal tumour (GIST) who meet the criteria for imatinib and who have: Early progression (within 6 months) while on imatinib; Progression following treatment with optimum (escalated) doses of imatinib; OR Intolerance to imatinib Clinical Notes: Response to sunitinib therapy should be assessed at least every six months and therapy should be discontinued when there is objective evidence of disease progression Sunitinib will not be reimbursed concomitantly with imatinib Claim Note: The dose reimbursed will be 50mg per day (4 weeks on, 2 weeks off) September 2015 v.1 A - 70

3. Metastatic Renal Cell Carcinoma (MRCC) For patients with histologically confirmed metastatic renal cell carcinoma (MRCC), who require: First-line therapy for the treatment of MRCC, and the patient is either a favourable or intermediate risk according to the Memorial Sloan-Kettering Cancer Center (MSKCC) prognostic score* OR Second-line therapy for the treatment of MRCC, provided that disease progression has occurred after prior cytokine therapy (e.g. interferon; aldesleukin). Renewal criteria: Written confirmation that the patient has benefited from therapy and is expected to continue to do so. Clinical Notes: The Memorial Sloan-Kettering Cancer Center (MSKCC) Prognostic Score categorizes patients into three risk groups according to the number of pre-treatment risk factors present: Favourable = none; Intermediate = one or two; Poor = three or more. Pre-treatment risk factors: - Low Karnofsky performance status (<80%) - Lactate Dehydrogenase level greater than 1.5 times the upper limit of normal - Hemoglobin level below the lower limit of normal - High corrected serum calcium level (>10 mg/dl or 2.5 mmol/l) - Interval of less than 1 year between diagnosis and treatment Reference: Motzer RJ, Bacik J, Murphy BA et al. Interferon-alfa as a comparative treatment for clinical trials of new therapies against advanced renal cell carcinoma. J Clin Oncol 2002;20;289-96. Claim Notes: The prescribed dosage is 50mg daily for four weeks, followed by two weeks off. This dosage is repeated in six week cycles. Initial approval period: 1 year Renewal period: 1 year TACROLIMUS (PROTOPIC) 0.03% ointment For children over 2 years of age with refractory atopic dermatitis. Claim Note: Approvals will be given for up to twelve months at a time. TACROLIMUS (PROTOPIC) 0.1% ointment For the treatment of adults with moderate to severe atopic dermatitis who have failed or are intolerant to a site appropriate strength of corticosteroid therapy (i.e. low potency for the face versus intermediate to high potency for the trunk and extremities). TEMOZOLOMIDE (TEMODAL and generic brand) 5mg, 20mg, 100mg, 140mg and 250mg capsules For the treatment of newly diagnosed high grade glioma patients with a good performance status (Karnofsky performance status greater or equal to 60%) when used in combination with radiotherapy or as adjuvant therapy post-radiation up to a maximum of 6 cycles. TENOFOVIR (VIREAD) 300mg tablet For the treatment of adult patients who have experienced adverse events or virologic failure with nucleoside reverse transcriptase inhibitors. For the treatment of chronic hepatitis B infection in patients with cirrhosis documented on radiologic or histologic grounds and a HBV DNA concentration above 2000 lu/ml. TERBINAFINE HYDROCHLORIDE (LAMISIL and generic brands) 250mg tablet Treatment of onychomycosis Treatment of dermatophyte infection unresponsive to other treatments or unlikely to respond to other treatments due to the site or severity of the infection. Claim Notes: Approval limits payment for 6 weeks for the treatment of fingernail mycosis. Approval limits payment for 12 weeks for the treatment of toenail mycosis. September 2015 v.1 A - 71

TERIFLUNOMIDE (AUBAGIO) 14mg film-coated tablet For the treatment of relapsing-remitting multiple sclerosis (RRMS) in patients who meet the following criteria: Two disabling attacks of MS in the previous two years, and Ambulatory with or without aid (EDSS of less than or equal to 6.5) Clinical Note: An attack is defined as the appearance of new symptoms or worsening of old symptoms, lasting at least 24 hours in the absence of fever, and preceded by stability for at least one month. Claim Notes: Requests will be considered for individuals enrolled in Plans ADEFGV. Prescriptions written by New Brunswick neurologists do not require special authorization. TESTOSTERONE (ANDRODERM, ANDROGEL, TESTIM) 12.2mg and 24.3mg patches, 2.5g and 5g packets, 1% gel TESTOSTERONE UNDECANDOATE (ANDRIOL and generic brands) 40 mg capsule For the treatment of congenital and acquired primary or secondary hypogonadism in males with a specific diagnosis of: Primary: cryptorchidism, Klinefelter s, orchiectomy, and other established causes Secondary: Pituitary-hypothalamic injury due to tumors, trauma, radiation Testosterone deficiency should be clearly demonstrated by clinical features and confirmed by two separate free testosterone measurements before initiating any replacement therapy Clinical Note: Older males with non-specific symptoms of fatigue, malaise, or depression who have low testosterone levels do not satisfy these criteria. THYROTROPIN ALPHA (THYROGEN) 0.9mg/mL injection 1. For on-going evaluation in patients who have documented evidence of thyroid cancer, have undergone appropriate surgical and/or medical management, and require monitoring for recurrence and metastatic disease. This includes: The patient has failed to respond to, or relapsed during: - Primary use in patients with inability to raise an endogenous TSH level ( 25 mu/l) with thyroid hormone withdrawal. - Primary use in patients with one of the following documented comorbidities in whom severe hypothyroidism could be life threatening: unstable angina recent myocardial infarction class III-IV congestive heart failure uncontrolled psychiatric illness other medical condition in which the clinical course could lead to a potential life threatening situation - Secondary use in patients with previous thyroid hormone withdrawal resulting in a documented life threatening event. 2. As an adjunctive treatment as pre-therapeutic stimulation for radioiodine ablation of thyroid tissue remnants in patients maintained on thyroid hormone suppression therapy who have undergone near-total or total thyroidectomy for well-differentiated thyroid cancer without evidence of distant metastatic thyroid cancer. TICAGRELOR (BRILINTA) 90mg tablet To be taken in combination with ASA 75mg -150mg daily a for patients with acute coronary syndrome (i.e. ST elevation myocardial infarction (STEMI), non-st elevation myocardial infarction (NSTEMI), or unstable angina (UA), as follows: STEMI b,c STEMI patients undergoing primary PCI September 2015 v.1 A - 72

NSTEMI or UA b,c Presence of high risk features irrespective of intent to perform revascularization: - High GRACE risk score (>140) - High TIMI risk score (5-7) - Second ACS within 12 months - Complex or extensive coronary artery disease e.g. diffuse three vessel disease - Definite documented cerebrovascular or peripheral vascular disease - Previous CABG OR Undergoing PCI + high risk angiographic anatomy d Clinical Notes: 1. a Co-administration of ticagrelor with high maintenance dose ASA (>150mg daily) is not recommended. 2. b In the PLATO study more patients on ticagrelor experienced non CABG related major bleeding than patients on clopidogrel, however, there was no difference between the rate of overall major bleeding, between patients treated with ticagrelor and those treated with clopidogrel. As with all other antiplatelet treatments the benefit/risk ratio of antithrombotic effect vs. bleeding complications should be evaluated. 3. c Ticagrelor is contraindicated in patients with active pathological bleeding, in those with a history of intracranial hemorrhage and moderate to severe hepatic impairment. 4. d High risk angiographic anatomy is defined as any of the following: left main stenting, high risk bifurcation stenting (i.e., two-stent techniques), long stents 38 mm or overlapping stents, small stents 2.5 mm in patients with diabetes. Claim Notes: Approval will be for a maximum of 12 months. Prescriptions written by invasive (interventional) cardiologists do not require special authorization. TINZAPARIN SODIUM (INNOHEP) 10,000IU/mL multidose vials and pre-filled syringes 20,000IU/mL multidose vials and pre-filled syringes See criteria under Low Molecular Weight Heparins TIOTROPIUM (SPIRIVA) 18mcg capsule for inhalation Chronic Obstructive Pulmonary Disease For the treatment of chronic obstructive pulmonary disease (COPD) if symptoms persist after 2-3 months of short-acting bronchodilator therapy (i.e. salbutamol at a maximum dose of 8 puffs/day or ipratropium at maximum dose of 12 puffs/day). Coverage can be provided without a trial of short-acting agent if there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1 /FVC ratio < 0.7) and significant symptoms (i.e. Medical Research Council (MRC) Dyspnea Scale score of 3-5). Combination therapy with tiotropium AND a long-acting beta2-adrenergic agonist/inhaled corticosteroid (LABA/ICS) will only be considered if: - there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1/FVC ratio < 0.7), and significant symptoms (i.e. MRC score of 3-5) AND - there is evidence of one or more moderate-to-severe exacerbations per year, on average, for 2 consecutive years requiring antibiotics and/or systemic (oral or intravenous) corticosteroids. Clinical Note: If spirometry cannot be obtained, reasons must be clearly explained and other evidence regarding severity of condition must be provided for consideration (i.e. MRC scale). Spirometry reports from any point in time will be accepted. COPD Stage MODERATE MRC 3 to 4 SEVERE MRC 5 Medical Research Council (MRC) Dyspnea Scale Symptoms Shortness of breath from COPD causing the patient to stop after walking about 100 meters (or after a few minutes) on the level. Shortness of breath from COPD resulting in the patient being too breathless to leave the house or breathless after undressing, or the presence of chronic respiratory failure or clinical signs of right heart failure. September 2015 v.1 A - 73

TIPRANAVIR (APTIVUS) 250mg capsule For the treatment of adult patients with HIV-1 infection who are treatment experienced, have demonstrated failure to multiple protease inhibitors and in whom no other protease inhibitor is a treatment option. TIZANIDINE (ZANAFLEX and generic brands) 4mg tablet For the treatment of spasticity caused by traumatic brain injury, multiple sclerosis (MS), spinal cord injury (SCI) or cerebral vascular accident (CVA) in patients in whom baclofen is contraindicated, ineffective or not tolerated. TOBRAMYCIN (TOBI) 300mg/5mL solution for inhalation For the treatment of cystic fibrosis patients who do not tolerate injectable tobramycin when used for inhalation. TOCILIZUMAB (ACTEMRA) 80mg, 200mg and 400mg single dose vials (20mg/mL) Rheumatoid Arthritis For patients with moderate to severe active rheumatoid arthritis who: Have not responded to an adequate trial of combination therapy of at least two traditional DMARDs (diseasemodifying antirheumatic drugs). Combination DMARD therapy must include methotrexate unless contraindicated or not tolerated, OR Are not candidates for combination DMARD therapy, must have had adequate trial of at least three traditional DMARDs in sequence, one of which must have been methotrexate unless contraindicated AND Have had an inadequate response to a tumour necrosis factor (TNF)-alpha antagonist. Clinical Notes: 1. Requests for continuation of therapy must include information demonstrating clinical response. 2. No dose escalation permitted above 8 mg/kg every 4 weeks or a maximum dose of 800 mg per infusion for individuals whose body weight is more than 100 kg. 3. Will not be reimbursed in combination with other biologic agents. Claim Notes: Must be prescribed by a rheumatologist. Initial approval will be for 16 weeks at a dose of 4 mg/kg. Systemic Juvenile Idiopathic Arthritis (sjia) For the treatment of active systemic juvenile idiopathic arthritis (sjia), in patients 2 years of age or older, who have responded inadequately to non-steroidal anti-inflammatory drugs (NSAIDs) and systemic corticosteroids (with or without methotrexate) due to intolerance or lack of efficacy. Clinical Notes: 1. Coverage will be approved for a dose of 12 mg/kg for patients weighing less than 30kg or 8 mg/kg for patients weighing greater than or equal to 30kg to a maximum of 800mg, administered every two weeks. 2. Continued coverage will be dependent on a positive patient response as determined by a pediatric rheumatologist. Claim Notes: Must be prescribed by, or in consultation with, a pediatric rheumatologist. Initial approval period: 16 weeks Renewal period: 1 year TOLTERODINE (DETROL) 1mg and 2mg tablets For the treatment of overactive bladder with symptoms of urinary frequency, urgency and/or urge incontinence in patients who have not tolerated a reasonable trial of immediate release oxybutynin. Clinical Note: Requests for the treatment of stress incontinence will not be considered. Claim Notes: If the beneficiary has had a claim for oxybutynin in the previous 24 months, the adjudication system will recognize this information and the claim for tolterodine will be automatically reimbursed without the need for a written special authorization request. Written special authorization will continue to be available as an option for patients who may not have the relevant first line agent on history due to changes in drug coverage or other factors. September 2015 v.1 A - 74

TOLTERODINE (DETROL LA) 2mg and 4mg capsules For the treatment of overactive bladder with symptoms of urinary frequency, urgency and/or urge incontinence in patients who have not tolerated a reasonable trial of immediate release oxybutynin. Clinical Note: Requests for the treatment of stress incontinence will not be considered. TOPIRAMATE (TOPAMAX) 15mg and 25mg sprinkle capsules For the treatment of refractory epilepsy not well controlled with conventional therapy. To reduce the frequency of migraine headaches in adult patients who have failed an adequate trial of, or have contraindications to, beta blockers AND tricyclics for prophylaxis. TRAMETINIB (MEKINIST) 0.5mg and 2mg tablets As monotherapy for the first line treatment of patients with BRAF V600 mutation-positive unresectable or metastatic melanoma with ECOG performance status of 0 or 1. If brain metastases are present, patients should be stable. As monotherapy for the second line treatment of patients with BRAF V600 mutation-positive unresectable or metastatic melanoma for patients who have progressed after receiving chemotherapy treatment in the first line setting with ECOG performance status of 0 or 1. If brain metastases are present, patients should be stable. Clinical Notes: Recommended Dose: 2 mg once daily until disease progression or development of unacceptable toxicity requiring discontinuation of trametinib. Trametinib will not be reimbursed in patients who have progressed on a prior BRAF therapy. Claim Notes: Initial approval duration: 6 months Renewal approval duration: 6 months TREPROSTINIL (REMODULIN) 1mg/mL, 2.5mg/mL, 5mg/mL and 10mg/mL solution For the treatment of patients with primary pulmonary hypertension or pulmonary hypertension secondary to collagen vascular disease, with New York Heart Association class III or IV disease who have both: 1. failed to respond to non-prostanoid therapies AND 2. who are not candidates for epoprostenol therapy because of: prior recurrent complications with central line access (e.g. infection, thrombosis) OR; inability to operate the complicated delivery system of epoprostenol OR; they reside in an area without ready access to medical care, which could complicate problems associated with an abrupt interruption of epoprostenol. TRETINOIN (VESANOID) 10mg capsule For the induction of remission in acute promyelocytic leukemia (APL) in previously untreated patients as well as in those who have relapsed after, or were refractory to, standard chemotherapy. TROSPIUM (TROSEC) 20mg tablet For the treatment of overactive bladder with symptoms of urinary frequency, urgency and/or urge incontinence in patients who have not tolerated a reasonable trial of immediate-release oxybutynin. Clinical Note: Requests for the treatment of stress incontinence will not be considered. Claim Notes: If the beneficiary has had a claim for oxybutynin in the previous 24 months, the adjudication system will recognize this information and the claim for trospium will be automatically reimbursed without the need for a written special authorization request. Written special authorization will continue to be available as an option for patients who may not have the relevant first line agent on history due to changes in drug coverage or other factors. September 2015 v.1 A - 75

URSODIOL (URSO and generic brand) 250mg tablet URSODIOL (URSO DS and generic brand) 500mg tablet For the management of cholestatic liver diseases, such as primary biliary cirrhosis. USTEKINUMAB (STELARA) 45 mg/0.5 ml and 90 mg/1 ml pre-filled syringes For patients with severe, debilitating chronic plaque psoriasis who meet all of the following criteria: Body surface area (BSA) involvement of >10% and/or significant involvement of the face, hands, feet or genital region; Failure to respond to, contraindications to, or intolerant to methotrexate and cyclosporine; Failure to respond to, intolerant to, or unable to access phototherapy Clinical Notes: 1. Continuation of therapy beyond 16 weeks will be based on response. Patients not responding adequately at these time points should have treatment discontinued with no further treatment with the same agent recommended 2. An adequate response is defined as either: - 75% reduction in Psoriasis Area Severity Index (PASI) score from when treatment started, or - 50% reduction in PASI with a 5 point improvement in the Dermatology Life Quality Index (DLQI), or - A quantitative reduction in BSA affected with qualitative consideration of specific regions such as the face, hands, feet or genital region. 3. Concurrent use of >1 biologic will not be approved 4. Approval limited to a dose of 90 mg administered initially at weeks 0, 4 and 16, then 90 mg every 12 weeks thereafter, up to a year (if response criteria met at 16 weeks). Claim Notes: Initial approval limited to 16 weeks. Must be prescribed by a dermatologist VALGANCICLOVIR (VALCYTE and generic brand) 450mg tablet 50mg/mL oral suspension For the treatment of cytomegalovirus (CMV) retinitis in HIV positive patients on the advice of an infectious disease specialist. For the prevention of cytomegalovirus (CMV) disease in solid organ transplant patients at high-risk (i.e. donor CMV seropositive / recipient seronegative.) Claim Note: Coverage will be for a maximum of 100 days post transplant. VARENICLINE (CHAMPIX) 0.5mg and 1mg tablets For smoking cessation treatment in adults 18 years of age and older. Claim Notes: Maximum of 168 tablets (12 weeks of treatment) will be reimbursed annually. Individuals who have already completed a full course of treatment with Zyban will not be eligible for reimbursement of Champix within the same fiscal year. VEMURAFENIB (ZELBORAF) 240mg film-coated tablet For the first line treatment of patients with BRAF V600 mutation-positive unresectable or metastatic melanoma who have an ECOG status performance of 0 or 1. For the second line treatment of patients with BRAF V600 mutation-positive unresectable or metastatic melanoma who have an ECOG performance status of 0 or 1 and did not receive vemurafenib as first line treatment. Clinical Notes: Recommended Dose: 960mg twice daily until disease progression or development of unacceptable toxicity requiring discontinuation of vemurafenib. Vemrurafenib will not be reimbursed in patients who have progressed on a prior BRAF therapy Claim Notes: Initial approval duration: 6 months Renewal approval duration: 6 months September 2015 v.1 A - 76

VIGABATRIN (SABRIL) 500mg tablet and 500mg sachet Requests will be considered for: the adjunctive management of epilepsy which is not satisfactorily controlled by conventional therapy. initial monotherapy for the management of infantile spasms. Claim Note: The maximum approved dose will be 4g/day VILANTEROL TRIFENATATE / FLUTICASONE FUROATE (BREO ELLIPTA) 25mcg / 100mcg powder for inhalation Chronic Obstructive Pulmonary Disease: For the treatment of chronic obstructive pulmonary disease (COPD) if symptoms persist after 2-3 months of short-acting bronchodilator therapy (i.e. salbutamol at a maximum dose of 8 puffs/day or ipratropium at maximum dose of 12 puffs/day). Coverage can be provided without a trial of short-acting agent if there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1 /FVC ratio < 0.7) and significant symptoms (i.e. Medical Research Council (MRC) Dyspnea Scale score of 3-5). Combination therapy with a long-acting muscarinic antagonist (LAMA) AND a long-acting beta2-adrenergic agonist/inhaled corticosteroid (LABA/ICS) will only be considered if: - there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1/FVC ratio < 0.7), and significant symptoms (i.e. MRC score of 3-5) AND - there is evidence of one or more moderate-to-severe exacerbations per year, on average, for 2 consecutive years requiring antibiotics and/or systemic (oral or intravenous) corticosteroids. Clinical Note: If spirometry cannot be obtained, reasons must be clearly explained and other evidence regarding severity of condition must be provided for consideration (i.e. MRC scale). Spirometry reports from any point in time will be accepted. COPD Stage MODERATE MRC 3 to 4 SEVERE MRC 5 Medical Research Council (MRC) Dyspnea Scale Symptoms Shortness of breath from COPD causing the patient to stop after walking about 100 meters (or after a few minutes) on the level. Shortness of breath from COPD resulting in the patient being too breathless to leave the house or breathless after undressing, or the presence of chronic respiratory failure or clinical signs of right heart failure. VILANTEROL / UMECLIDINUM BROMIDE (ANORO ELLIPTA) 25mcg/62.5mcg powder for inhalation For the treatment of moderate to severe chronic obstructive pulmonary disease (COPD), as defined by spirometry, in patients with an inadequate response to a long-acting beta-2 agonist (LABA) or long-acting anticholinergic (LAAC). Clinical Notes: Moderate to severe COPD is defined by spirometry (post-bronchodilator) FEV 1 < 60% predicted and FEV 1/FVC ratio of < 0.70. Spirometry reports from any point in time will be accepted. If spirometry cannot be obtained, reasons must be clearly explained and other evidence regarding COPD severity must be provided for consideration (i.e. Medical Research Council (MRC) Dyspnea Scale score of at least Grade 3). MRC Grade 3 is described as: walks slower than people of same age on the level because of shortness of breath (SOB) from COPD or has to stop for breath when walking at own pace on the level. Inadequate response is defined as persistent symptoms after at least 2 months of long-acting beta-2 agonist (LABA) or long-acting anticholinergic therapy (LAAC). VISMODEGIB (ERIVEDGE) 150mg capsule Initial Requests: For patients with metastatic basal cell carcinoma (BCC) or with locally advanced BCC (including patients with basal cell nevus syndrome, i.e. Gorlin syndrome) who have measurable metastatic disease or locally advanced disease, which is considered inoperable or inappropriate for surgery 1 AND inappropriate for radiotherapy 2 AND September 2015 v.1 A - 77

Patient 18 years or age or older; AND Patient has ECOG 2 Patient preference for oral therapy will not be considered Information Required Physicians must provide rationale for why surgery 1 AND radiation 2 cannot be considered The request must include a surgical consultation report that provides a preoperative/surgical evaluation why surgery is not appropriate for the patient; AND A consultation report as to why radiation therapy is not appropriate for the patient Both of the above evaluations must come from a physician who is not the requesting physician Confirmation that the patient has been discussed at a multi-disciplinary cancer conference or equivalent (e.g. Regional Tumour Board). Renewal criteria: The physician has confirmed that the patient has not experienced disease progression while on Erivedge therapy. Clinical Notes: 1 Considered inoperable or inappropriate for surgery for one of the following reasons: - Technically not possible to perform surgery due to size/location/invasiveness of BCC (either lesion too large or can be several small lesions making surgery not feasible) - Recurrence of BCC after two or more surgical procedures and curative resection unlikely - Substantial deformity and/or morbidity anticipated from surgery 2 Considered inappropriate for radiation for one of the following reasons: - Contraindication to radiation (e.g. Gorlin syndrome) - Prior radiation to lesion - Suboptimal outcomes expected due to size/location/invasiveness of BCC Dose: 150mg orally once daily taken until disease progression or unacceptable toxicity. Claim Notes: Initial approval duration: 1 year Renewal approval duration: 1 year VORICONAZOLE (VFEND and generic brands) 50mg and 200mg tablets For the treatment of invasive aspergillosis. For culture proven invasive candidiasis with documented resistance to fluconazole. Claim Notes: Must be prescribed in consultation with a specialist in infectious diseases or medical microbiology. Initial requests will be approved for a maximum of 3 months. ZAFIRLUKAST (ACCOLATE) 20mg tablet For the treatment of moderate to severe asthma in patients who: Are not adequately controlled with moderate to high dose inhaled corticosteroids despite compliance with treatment AND Require increasing amounts of short-acting beta2-adrenergic agonists. ZANAMIVIR (RELENZA) 5mg powder for inhalation For beneficiaries residing in long-term care facilities meeting the same criteria as for oseltamivir and for whom there is suspected or confirmed oseltamivir resistance, or for whom oseltamivir is contraindicated. ZOLEDRONIC ACID (ACLASTA and generic brands) 5mg/100mL solution for infusion Osteoporosis For the treatment of osteoporosis in postmenopausal women who were previously approved or would otherwise be eligible for coverage of oral bisphosphonates and who: Have experienced further significant decline in bone mineral density (BMD) after 1 year of continuous oral bisphosphonate therapy. OR September 2015 v.1 A - 78

Have experienced serious intolerance to oral bisphosphonates. OR Have a contraindication to oral bisphosphonates. Clinical Note: Serious intolerance is defined as esophageal ulceration, erosion or stricture, or lower gastrointestinal symptoms severe enough to cause discontinuation of oral bisphosphonates, or swallowing disorders that will increase the risk of esophageal ulceration from oral bisphosphonates. Paget s Disease For the treatment of Paget s disease of bone. ZOLMITRIPTAN (ZOMIG and generic brands) 2.5mg tablet ZOLMITRIPTAN (ZOMIG RAPIMELT and generic brands) 2.5mg oral disintegrating tablets For the treatment of migraine 1 headache when: Migraines are moderate 2 in severity and other therapies (e.g. NSAIDs, acetaminophen, DHE spray) are not effective, OR Migraine attacks are severe 2 or ultra severe 2 Clinical Notes: 1 As diagnosed based on current Canadian guidelines. 2 Definitions: - Moderate - pain is distracting causing need to slow down and limit activities; - Severe - pain affects ability to concentrate and very difficult to continue with daily activities; - Ultra severe - unable to speak or think clearly; not able to function; likely lying down or sleeping Claim Notes: A maximum of 72 tablets will be reimbursed annually without special authorization. If additional medication is required within the year, a request should be made through special authorization. Patients with >3 migraines/month on average despite prophylactic therapy may be considered for up to a maximum of 12 doses / 30 days. ZOLMITRIPTAN (ZOMIG NASAL SPRAY) 2.5mg and 5mg nasal sprays For the treatment of migraine 1 headache of moderate 2 intensity when other therapies (e.g. NSAIDs, acetaminophen, DHE spray) are not effective AND patients have not responded to oral sumatriptan, zolmitriptan, rizatriptan and naratriptan. For the treatment of migraine 1 headache of severe 2 or ultra severe 2 intensity when patients have not responded to oral sumatriptan, zolmitriptan, rizatriptan and/or naratriptan. Clinical Notes: 1. 1 As diagnosed based on current Canadian guidelines. 2. 2 Definitions: - Moderate - pain is distracting causing need to slow down and limit activities; - Severe - pain affects ability to concentrate and very difficult to continue with daily activities; - Ultra severe - unable to speak or think clearly; not able to function; likely lying down or sleeping Claim Notes: Coverage limited to 6 doses / 30 days 3 - patients with >3 migraines/month on average despite prophylactic therapy may be considered for up to a maximum of 12 doses / 30 days 3 Reimbursement will be available for a maximum quantity of triptan doses as outlined in criteria per 30 days regardless of the agent(s) used within the 30 day period. Special authorization for the products almotriptan 6.25mg and 12.5mg tablets, naratriptan 1mg and 2.5mg tablets, rizatriptan 5mg and 10mg tablets and wafers, sumatriptan 5mg and 20mg nasal spray and zolmitriptan 2.5mg tablets and orally dispersible tablets, 2.5mg and 5mg nasal spray will be considered as a set. Approvals will include all products in this list, however reimbursement will be available for a maximum quantity of one agent per month. ZUCLOPENTHIXOL (CLOPIXOL) 10mg and 25mg tablets For the treatment of schizophrenia in patients with a history of failure, intolerance, or contraindication to at least one antipsychotic agent. September 2015 v.1 A - 79