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The NMHC Preferred Drug List

Choose a Category:    

NOTE:
This Preferred Drug List (PDL) addresses only the most commonly used categories of drugs. If you are taking a drug that is not listed on this PDL, please contact NMHC Rx to determine its classification status. This is a current sample listing that is subject to change during the year.
This list is not all-inclusive and is not a guarantee of coverage. Certain drugs (*) may be subject to Quantity Limits (QL) or Prior Authorization (PA) requirements according to Benefit Design. Use of generic drugs can save you and your health plan money. Branded products with an available generic equivalent may be subject to the highest co-payment according to Benefit Design.

Effective Date: 8/15/2008
Tier 1
(Generic Drug)
Tier 2
(Preferred Brand)
Tier 3
(Non-preferred Brand)
Anti-infectives  Back To Top
Antibiotics - Cephalosporins
cefaclorCedaxCeclor
cefadroxilSpectracefCeftin
cefdinirSuprax SuspCefzil
cefprozil Duricef
cefuroxime Keflex
cephadrine Omnicef
cephalexin Velosef
Antibiotics - Fluoroquinolones
ciprofloxacin/xrAveloxCipro
ofloxacinLevaquinCipro XR
  Floxin
  Maxaquin
  Noroxin
  Penetrex
Antibiotics - Macrolides
azithromycinZithromax (no generics)Biaxin
clarithromycinZmaxBiaxin XL
clarithromycin er E.E.S.
erythromycin Zithromax (with generics)
  Zithromycin (with generics), Z-Pak
Antibiotics - Other
minocycline Adoxa
  Dynacin Tabs
  Ketek
  Zyvox
Antibiotics - Penicillins
amoxicillinAugmentin XRAmoxil
amoxicillin/clavulanic acid Augmentin ( with generics)
ampicillin Pen-Vee K
penicillin V-Cillin-K
Antifungals (PA)
fluconazoleGris-PegDiflucan
griseofulvin Lamisil(QL)
itraconazole Penlac (QL)
ketaconazole Spectazole
nystatin Sporanox
terbinafine (QL)  
Antivirals - Flu
amantadineTamiflu (QL)Relenza (QL)
rimantadine  
Antivirals - Herpes
acyclovirValtrexFamvir
  Zovirax
Antivirals - Other - Interferons / Interferon comb
ribavirinInfergenCopegus
 PegasysRebetol
 Peg-Intron 

Tier 1
(Generic Drug)
Tier 2
(Preferred Brand)
Tier 3
(Non-preferred Brand)
Cardiovascular  Back To Top
ACE Inhibitors and ACE Inhibitor Combinations
benazepril/hctz Accupril
captopril Accuretic
captopril hctz Aceon
enalapril/hctz Altace
fosinopril/hctz Capoten
lisinopril Capozide
lisinopril hctz Lotensin/HCT
moexipril/hctz Mavik
quinapril Monopril
quinapril hctz Prinivil
trandolapril Prinzide
  Uniretic
  Univasc
  Vasotec
  Zestoretic
  Zestril
Alpha/Beta Blockers
acebutolol Coreg
atenolol Coreg CR
bisoprolol Inderal
carvedilol Inderal LA
labetalol Inderide
metoprolol/hctz/er Inderide LA
propranolol/hctz/er Innopran XL
  Lopressor
  Lopressor HCT
  Tenoretic
  Tenormin
  Toprol XL
Angiotensin II Rec Antagonist (ARB) & ARB Combinations
 AtacandAvalide
 Atacand HCTAvapro
 BenicarCozaar
 Benicar HCTHyzaar
 DiovanMicardis
 Diovan HCTMicardis HCT
  Teveten
  Teveten HCT
Antiarrhythmics
amiodarone, disopyramide, flecainide, procainamide, propafenone, quinidine, sotalol/afRythmol SR 
Antihyperlipidemic - HMG (Statins)
lovastatinCrestorAltoprev
pravastatinLipitorLescol
simvastatin Lescol XL
  Mevacor
  Pravachol
  Zocor
Antihyperlipidemic Agents - Other
cholestyramine resinAdvicorColestid
colestipolAntaraLofibra
fenofibrateNiaspanLopid
gemfibrozilSimcorQuestran, Questran Light
 Tricor 
 Triglide 
 Vytorin 
 Welchol 
 Zetia 
Antihypertensive Combinations
amlodipine-benazeprilLotrel (no generics)Azor
  Exforge
  Lexxel
  Lotrel (with generics)
  Tarka
  Teczem CR
Antihypertensive Others
spironolactone/hctz Aldactone, Aldactazide
  Inspra
  Tekturna
Antihypertensive/Antihyperlipidemic Combination
 Caduet 
Antiplatelet Agents
anagrelideAggrenoxAgrylin
cilostazolPlavixPersantine
dipyridamole Pletal
Calcium Channel Blockers
amlodipine Cardene SR
diltiazem Cardizem, SR, CD, LA
felodipine, nicardipine Covera HS
verapamil DynaCirc/CR
  Norvasc
  Plendil
  Sular
  Tiazac
  Verelan/PM

Tier 1
(Generic Drug)
Tier 2
(Preferred Brand)
Tier 3
(Non-preferred Brand)
Central Nervous System  Back To Top
ADHD Medications (QL) (ST)
dextroamphetamineAdderall XRDexedrine
methylphenidateConcertaDextrostat
 StratteraFocalin/XR
  Metadate CD,ER
  Ritalin LA, Tab,SR
Alzheimers
 Aricept 
 Exelon 
 Namenda 
Analgesics - Cox 2 Inhibitors (PA) (QL)
 Celebrex 
Analgesics - Narcotic (PA) (QL)
codeine-apapActiqDarvocet N-100
fentanyl patchAvinzaDarvon
hydrocodone combinationsOxyContinDemerol
meperidine Duragesic
morphine sulfate Fentora
oxycodone combinations Fioricet
propoxyphene Fiorinal
propoxyphene-n Kadian
  Opana/ER
  Percocet
  Percodan
  Tylenol w Codeine
Analgesics - NSAIDs
diclofenac Anaprox
etodolac Anaprox DS
ibuprofen Clinoril
indomethacin Indocin
meloxicam Lodine
naproxen/sodium Mobic
sulindac Motrin
  Naprosyn
  Prevacid Nap Kit
  Voltaren
Antianxiety
alprazolam/er Ativan
diazepam Valium
lorazepam Xanax
  Xanax XR
Anticonvulsants
carbamazepineDepakote ERDepakene
gabapentinDilantinDepakote
lamotrigineGabitrilLamictal
oxcarbazepineKeppraNeurontin
phenytoinLyricaTegretol
valproic acidPhenytekTrileptal
zonisamide Zonegran
Antidepressants - Other
amitriptylineTofranil PMAventyl
bupropion erWellbutrin XL 150mgNorpramin
bupropion immediate release Remeron
bupropion sr Tofranil Tablets
bupropion xl 300mg Wellbutrin Immediate Release
desipramine Wellbutrin SR
imipramine Wellbutrin XL 300mg
mirtazapine  
nortriptyline  
Antidepressants - SSNRI
venlafaxine immediate releaseEffexor XRCymbalta
  Effexor Immediate Release
Antidepressants - SSRI
citalopram Celexa
fluoxetine Lexapro
paroxetine/cr Paxil
sertraline Paxil CR
  Pexeva
  Prozac
  Zoloft
Antiparkinson
amantadineComtanRequip
benztropineMirapexSinemet
bromocriptine Sinemet CR
carbidopa/levadopa Stalevo
pergolide  
ropininole  
selegiline  
trihexyphenidyl  
Antipsychotic Agents
clozapineAbilifyClozaril
risperidone tabletsGeodonInvega
 Risperdal-MRisperdal Tablets
 Seroquel 
 Seroquel XR 
 Symbyax 
 Zyprexa 
 Zyprexa Zydis 
Migraine Products (QL)
 AmergeMaxalt
 AxertMaxalt MLT
 Imitrex 
 Relpax 
 Zomig 
 Zomig ZMT 
Multiple Sclerosis Drugs
 CopaxoneAvonex
 RebifBetaseron
Sedative Hypnotics (QL)
flurazepamRestoril 7.5mg/22.5mgAmbien
temazepamRozeremAmbien CR
triazolam Dalmane
zolpedim immediate release Halcion
  Lunesta
  Restoril 15/30mg
  Sonata
Skeletal Muscle Relaxants
carisoprodolSkelaxinFlexeril
cyclobenzaprine Soma
tizanidine Zanaflex

Tier 1
(Generic Drug)
Tier 2
(Preferred Brand)
Tier 3
(Non-preferred Brand)
Endocrine  Back To Top
Corticosteroids - Systemic
dexamethasone, methylprednisolone, prednisone, prednisolone Orapred Solution
Diabetes - Combinations
glipizide/metforminActoplus MetGlucovance
glyburide/metforminAvandametMetaglip
 Avandaryl 
 Duetact 
Diabetes - Insulin
 Apidra 
 Humalog 
 Humulin 
 Lantus 
 Levemir 
 Novolin 
 NovoLog 
Diabetes - Insulin Secreting Agents
chlorpropamidePrandinAmaryl
glimepirideStarlixDiabeta
glipzide Diabinese
glipzide ER Glucotrol
glyburide Glucotrol XL
glyburide Micronase
tolazamide Tolinase
Diabetes - Insulin Sensitizing Agents
metforminActosFortamet
metformin ERAvandiaGlucophage Immediate Release
  Glucophage XR
  Glumetza
  Riomet
Diabetes - Other Medications (CT) (ST)
acarboseByettaJanumet
 SymlinJanuvia
  Precose
Diabetic Supplies (QL)
 Accu-Chek - Active, Advantage, Aviva, Compact, CompleteEncore Meters, Exatech Meters
 BD-Pen Needles, BD-SyringesGlucometer Meters
 Lifescan: One Touch II, Basic, InDuo, FastTake, SureStep, Ultra, UltraSmart 
Thyroid Agents
levothyroxineSynthroid 
Levoxyl  

Tier 1
(Generic Drug)
Tier 2
(Preferred Brand)
Tier 3
(Non-preferred Brand)
Gastrointestinal/Urinary  Back To Top
Antispasmodic
generics Donnatal
  Levsin
  Librax
  Pamine
  Robinul
Digestive Aids
pancrelipaseCreon 
 Ultrase 
 Viokase 
Gallstone Solubilizing Agents
ursodiolUrso 
Genitourinary Medications
oxybutynin/XLDetrolDitropan XL
 Detrol LAVesicare
 Enablex 
 Oxytrol Patch 
 Sanctura/XR 
H-2 Antagonists
cimetidine Axid
famotidine Pepcid
nizatidine Tagamet
ranitidine Zantac
Inflammatory Bowel (ST)
balsalazideAsacolColazal
mesalamine enemaCanasaLialda
sulfasalazineEntocort ECRowasa
Proton Pump Inhibitors (PA) (QL)
omeprazoleNexiumAciphex
pantoprazole Prevacid
  Prevacid SoluTabs
  Prilosec Rx
  Protonix
  Zegerid

Tier 1
(Generic Drug)
Tier 2
(Preferred Brand)
Tier 3
(Non-preferred Brand)
Men’s Health  Back To Top
Erectile Dysfunction (QL)
 Cialis 
 Levitra 
Erectile Dysfunction (QL) (PA)
 Muse 
 Viagra 
Hormone Replacement
 Androgel 
 Testim 
Prostate Health
doxazosinAvodartProscar
finasterideFlomaxUroxatral
terazosin  

Tier 1
(Generic Drug)
Tier 2
(Preferred Brand)
Tier 3
(Non-preferred Brand)
Miscellaneous  Back To Top
Anaphylaxis
 Epipen 
 Twinject 
Antiemetics (QL) (PA)
granisetron (QL)Emend(QL)Anzemet(QL)
ondansetron Cesamet (1QL)
  Kytril (QL)
  Zofran(QL)
Antipsoriatics
 TazoracAmevive
Bowel Preparation
 Halflytely 
Fertility
ganirelixAntagonGonal-F
 Bravelle 
 Cetrotide 
 Crinone 
 Follistim AQ 
 Luveris 
 Menopur 
 Ovidrel 
 Repronex 
Growth Hormone (PA)
 GenotropinHumatrope
 NorditropinNutropin/AQ
 Norditropin AQOmnitrope
 Norditropin NordiflexSaizen
  Serostim
  Tev-Tropin
Hematopoetic Growth Factors
 EpogenAranesp
 Procrit 
Immunosuppressive Agents
azathioprineCellCeptMyfortic
cyclosporine  
PTH Ca Phos Regulator
 Sensipar 
Rheumatoid Arthritis
methotrexateTrexallRemicade
Saliva Stimulants
 Evoxac 

Tier 1
(Generic Drug)
Tier 2
(Preferred Brand)
Tier 3
(Non-preferred Brand)
Respiratory  Back To Top
Antihistamines (Low Sedating) (ST)
 
 
Antihistamines (Non - Sedating) (ST)
Alavert OTC, loratadine OTC Coverage/Co-payment Plan DependentAllegra (Coverage/Co-payment Plan Dependent)
fexofenadineClarinex, Clarinex Syrup (Coverage/Co-payment Plan Dependent)Allegra-D (Coverage/Co-payment Plan Dependent)
  Clarinex/Clarinex Syrup (Coverage/Co-payment Plan Dependent)
Asthma - Beta Agonists - Long Acting
 Foradil 
 Serevent Diskus 
Asthma - Beta Agonists - Short Acting
albuterolProAir HFAAlupent
metaproterenolProventil HFAMaxair
  Ventolin HFA
  Xopenex
Asthma - COPD Other
generics, theophyllineAdvair/HFAAtrovent Solution
ipratropiumAtrovent/HFA InhalerBrovana
prednisoloneCombiventDuoNeb
theophyllineSpirivaPerforomist
theophyllineSymbicortPrelone
 TiladeUniphyl
 T-PhylXolair(PA)
Asthma - Leukotriene Modulators (ST)
 AccolateZyflo/CR
 Singulair 
Asthma - Steroid Inhalants
 AsmanexAeroBid
 Flovent/HFAAeroBid-M
 PulmicortAzmacort
 QVARBeclovent
  Vanceril
Cough and Cold
generics  
Nasal Products (QL)
flunisolideAstelinBeconase
fluticasoneNasonexBeconase AQ
 Rhinocort AQFlonase
  Nasacort AQ
  Nasalide
  Nasarel
  Vancenase
  Vancenase AQ
  Veramyst

Tier 1
(Generic Drug)
Tier 2
(Preferred Brand)
Tier 3
(Non-prefer