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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: January 1, 2009
Tier 1
(Generic Drug)
Tier 2
(Preferred Brand)
Tier 3
(Non-preferred Brand)
  Back To Top

Tier 1
(Generic Drug)
Tier 2
(Preferred Brand)
Tier 3
(Non-preferred Brand)
Anti-infectives  Back To Top
Antibiotics - Cephalosporins
cefaclorCeftin 125mgCeclor
cefadroxilCeftin Oral SuspCedax
cefdinir Cefzil
cefprozil Duricef
cefuroxime Keflex
cephadrine Omnicef
cephalexin Spectracef
  Suprax
  Velosef
Antibiotics - Fluoroquinolones
ciprofloxacin/xrCipro 100mg, Cipro SuspAvelox
ofloxacinLevaquinCipro
 NoroxinCipro XR
  Floxin
  Maxaquin
  Penetrex
Antibiotics - Macrolides
azithromycin Biaxin
clarithromycin Biaxin XL
clarithromycin er E.E.S.
erythromycin Zithromycin, Z-Pak
Antibiotics - Other
minocyclineAdoxa/Adoxa Pak1/150Dynacin Tabs
 ZyvoxKetek
Antibiotics - Penicillins
amoxicillinAugmentin XR/Susp/Chewable (no generics)Amoxil
amoxicillin/clavulanic acid Augmentin ( with generics)
ampicillin Pen-Vee K
penicillin V-Cillin-K
Antifungals (PA)
fluconazoleAncobonDiflucan
griseofulvinLamisil Oral GranulesGris-Peg
itraconazoleSporanox Oral SolutionLamisil Tabs(QL)
ketaconazoleVfendPenlac (QL)
nystatin Spectazole
terbinafine (QL) Sporanox
Antivirals - Flu
amantadineRelenza (QL) 
rimantadineTamiflu (QL) 
Antivirals - Herpes
acyclovirValtrexFamvir
famciclovir Zovirax
Antivirals - Other - Interferons / Interferon comb
ribavirinPegasysCopegus
 Peg-IntronInfergen
  Rebetol
Miscellaneous
 Dapsone 
 Furadantin 
 Zyvox 

Tier 1
(Generic Drug)
Tier 2
(Preferred Brand)
Tier 3
(Non-preferred Brand)
Cardiovascular  Back To Top
ACE Inhibitors and ACE Inhibitor Combinations
benazepril/hctzAceonAccupril
captoprilAltace TabsAccuretic
captopril hctz Altace Caps
enalapril/hctz Capoten
fosinopril/hctz Capozide
lisinopril Lotensin/HCT
lisinopril hctz Mavik
moexipril/hctz Monopril
quinapril Prinivil
quinapril hctz Prinzide
trandolapril Uniretic
  Univasc
  Vasotec
  Zestoretic
  Zestril
Alpha/Beta Blockers
acebutololCoreg CRCoreg
atenolol Inderal
bisoprolol Inderal LA
carvedilol Inderide
labetalol Inderide LA
metoprolol/hctz/er Innopran XL
propranolol/hctz/er Lopressor
  Lopressor HCT
  Tenoretic
  Tenormin
  Toprol XL
Angiotensin II Rec Antagonist (ARB) & ARB Combinations
 AtacandAvalide
 Atacand HCTAvapro
 BenicarTeveten
 Benicar HCTTeveten HCT
 Cozaar 
 Diovan 
 Diovan HCT 
 Hyzaar 
 Micardis 
 Micardis HCT 
Antiarrhythmics
amiodarone, disopyramide, flecainide, procainamide, propafenone, quinidine, sotalol/afPacerone 
 Rythmol SR 
 Tikosyn 
Antihyperlipidemic - HMG (Statins)
lovastatinAltoprevLescol
pravastatinCrestorLescol XL
simvastatinLipitorMevacor
  Pravachol
  Zocor
Antihyperlipidemic Agents - Other
cholestyramine resinAdvicorAntara
colestipolFenoglideColestid
fenofibrateLovazaLofibra
gemfibrozilNiaspanLopid
 SimcorQuestran, Questran Light
 Tricor 
 Triglide 
 Vytorin 
 Welchol 
 Zetia 
Antihypertensive Combinations
amlodipine-benazeprilExforgeAzor
 Lotrel (no generics)Lexxel
  Lotrel (with generics)
  Tarka
  Teczem CR
Antihypertensive Others
spironolactone/hctzCatapres-TTS PatchAldactone, Aldactazide
 Tekturna/HCTInspra
Antihypertensive/Antihyperlipidemic Combination
  Caduet
Antiplatelet Agents
anagrelideAggrenoxAgrylin
cilostazolPlavixPersantine
dipyridamole Pletal
Jantoven  
pentoxifylline  
ticlopidine  
warfarin  
Calcium Channel Blockers
amlodipineCardizem LACardene SR
diltiazemCovera HSCardizem, SR, CD
felodipine, nicardipineSularDynaCirc/CR
verapamil Norvasc
  Plendil
  Tiazac
  Verelan/PM
Others
 Minitran 
 Ranexa 

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
 DaytranaFocalin/XR
 Metadate CDMetadate ER
 ProvigilRitalin LA, Tab,SR
 Strattera 
Alzheimers
galantamide cap erAricept, Aricept ODTRazadyne Tab
galantamide tabExelon 
 Namenda 
 Razadyne ER 
Analgesics - Cox 2 Inhibitors (PA) (QL)
 Celebrex 
Analgesics - Narcotic (PA) (QL)
codeine-apapAvinzaActiq
fentanyl patchMS-ContinDarvocet N-100
hydrocodone combinationsOxyContinDarvon
meperidineOxyIRDemerol
morphine sulfate Duragesic
oxycodone combinations Fentora
propoxyphene Fioricet
propoxyphene-n Fiorinal
  Kadian
  Opana/ER
  Percocet
  Percodan
  Tylenol w Codeine
Analgesics - NSAIDs
diclofenac Anaprox
etodolac Anaprox DS
ibuprofen Arthrotec
indomethacin Clinoril
meloxicam Indocin
naproxen/sodium Lodine
sulindac Mobic
  Motrin
  Naprosyn
  Prevacid Nap Kit
  Voltaren
Antianxiety
alprazolam/er Ativan
diazepam Valium
lorazepam Xanax
  Xanax XR
Anticonvulsants
carbamazepineDepakote ERDepakene
gabapentinDiastatDepakote
lamotrigineFelbatolDilantin
oxcarbazepineGabitrilKeppra XR
phenytoinKeppra Solution, 1000mg tabLamictal
valproic acidLyricaNeurontin
zonisamidePeganoneTegretol
 PhenytekTrileptal
 Tegretol XRZonegran
 Topamax 
Antidepressants - Other
amitriptylineTofranil PMAventyl
bupropion er Norpramin
bupropion immediate release Remeron
bupropion sr Tofranil Tablets
bupropion xl 300mg Wellbutrin Immediate Release
desipramine Wellbutrin SR
imipramine Wellbutrin XL
mirtazapine  
nortriptyline  
Antidepressants - SSNRI
venlafaxine immediate releaseCymbaltaEffexor Immediate Release
 Effexor XR 
 Pristiq 
Antidepressants - SSRI
citalopram Celexa
fluoxetine Lexapro
paroxetine/cr Paxil
sertraline Paxil CR
  Pexeva
  Prozac
  Zoloft
Antiparkinson
amantadineApokynRequip
benztropineAzilectSinemet
bromocriptineComtanSinemet CR
carbidopa/levadopaLodosynStalevo
pergolideMirapex 
ropininoleRequip XL 
selegiline  
trihexyphenidyl  
Antipsychotic Agents
clozapineAbilifyInvega
risperidone tabletsClozarilRisperdal Tablets
 GeodonSymbyax
 Moban 
 Orap 
 Risperdal-M 
 Serentil 
 Seroquel 
 Seroquel XR 
 Zyprexa 
 Zyprexa Zydis 
Migraine Products (QL)
 AmergeAxert
 FrovaImitrex Tabs/Inj
 Imitrex Spray 
 Maxalt 
 Maxalt MLT 
 Relpax 
 Zomig 
 Zomig ZMT 
Multiple Sclerosis Drugs
 Avonex 
 Betaseron 
 Copaxone 
 Rebif 
Sedative Hypnotics (QL)
flurazepamAmbien CRAmbien
temazepamRestoril 7.5mg/22.5mgDalmane
triazolam Halcion
zolpedim immediate release Lunesta
  Restoril 15/30mg
  Rozerem
  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
 ApidraNovolin
 Humalog 
 Humulin 
 Lantus, Lantus Solostar 
 Levemir 
 NovoLog 
Diabetes - Insulin Secreting Agents
chlorpropamidePrandinAmaryl
glimepirideStarlixDiabeta
glipzide Diabinese
glipzide ER Glucotrol
glyburide Glucotrol XL
glyburide Glynase
tolazamide Micronase
  Tolinase
Diabetes - Insulin Sensitizing Agents
metforminActosFortamet
metformin ERAvandiaGlucophage Immediate Release
  Glucophage XR
  Glumetza
  Riomet
Diabetes - Other Medications (CT) (ST)
acarboseByettaGlycet
 JanumetPrecose
 Januvia 
 Symlin 
Diabetic Supplies (QL)
 Accu-Chek - Active, Aviva, Comfort CurveEncore Meters, Exatech Meters
 BD-Pen Needles, BD-SyringesGlucometer Meters
 Fast Take, One Touch, One Touch Ultra, SureStep, SureStep Pro 
Thyroid Agents
levothyroxineCytomel 
LevoxylSynthroid 

Tier 1
(Generic Drug)
Tier 2
(Preferred Brand)
Tier 3
(Non-preferred Brand)
Gastrointestinal/Urinary  Back To Top
Antispasmodic
genericsPamine ForteDonnatal
  Levsin
  Librax
  Robinul
Digestive Aids
pancrelipaseCreon 
 Pancrelipase 
 Ultrase 
 Viokase 
Gallstone Solubilizing Agents
ursodiolUrso 
Genitourinary Medications
oxybutynin/XLDetrolDitropan XL
 Detrol LASanctura
 Enablex 
 Oxytrol Patch 
 Sanctura XR 
 Vesicare 
H-2 Antagonists
cimetidineAxid Oral SolutionPepcid
famotidine Tagamet
nizatidine Zantac
ranitidine  
Inflammatory Bowel (ST)
balsalazideAmitizaLialda
mesalamine enemaAsacolRowasa
sulfasalazineCanasa 
 Colazal 
 Entocort EC 
 Gastrocrom 
 Pentasa 
Misc Stomach/Ulcer Products
 Carafate Suspension 
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) (PA)
 CialisLevitra
 Muse 
 Viagra 
Hormone Replacement
 Androderm 
 Androgel 
 Methitest 
 Testim 
Prostate Health
doxazosinAvodartProscar
finasterideFlomax 
terazosinUroxatral 

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)
  Sancuso Patch
  Zofran(QL)
Antipsoriatics
 TazoracAmevive
Bowel Preparation
 Halflytely 
Fertility
ganirelixBravelleFollistim-AQ
 CetrotideLuveris
 CrinoneMenopur
 Gonal-F, Gonal-FRF 
 Ovidrel 
 Repronex 
Growth Hormone (PA)
 Humatrope/Combo PackGenotropin
 NorditropinOmnitrope
 Norditropin AQSaizen
 Norditropin NordiflexSerostim
 Nutropin AQ PenTev-Tropin
Hematopoetic Growth Factors
 Aranesp Albumin Free 
 Epogen 
 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 (Non - Sedating) (ST)
Alavert OTC, loratadine OTC Coverage/Co-payment Plan DependentAllegra-D 12hr & 24hr, Allegra SuspAllegra Tab 30/60/180mg, Allegra ODT
fexofenadineClarinex, Clarinex Reditabs 
 Clarinex-D 12hr, Clarinex-D 24hr Clarinex-D Syrup 
Asthma - Beta Agonists - Long Acting
 Foradil 
 Serevent Diskus 
Asthma - Beta Agonists - Short Acting
albuterolMaxair AutohalerAlupent
metaproterenolProAir HFAProventil HFA
 Xopenex/HFAVentolin HFA
Asthma - COPD Other
generics, theophyllineAdvair/HFAAtrovent Solution
ipratropiumAtrovent/HFA InhalerBrovana
prednisoloneCombiventDuoNeb
theophyllinePerforomistPrelone
theophyllineSpirivaXolair(PA)
 Symbicort 
 Tilade 
 T-Phyl 
 Uniphyl 
Asthma - Leukotriene Modulators (ST)
 SingulairAccolate
  Zyflo/CR
Asthma - Steroid Inhalants
 AsmanexAeroBid
 Flovent/HFAAeroBid-M
 Pulmicort Respules/ FlexhalerAlvesco
 QVARAzmacort
  Beclovent
  Vanceril
Cough and Cold
genericsTussicaps 
Nasal Products (QL)
flunisolideAstelinBeconase
fluticasoneNasacort AQBeconase AQ
 NasonexFlonase
 Rhinocort AQNasalide
 VeramystNasarel
  Vancenase
  Vancenase AQ

Tier 1
(Generic Drug)
Tier 2
(Preferred Brand)
Tier 3
(Non-preferred Brand)
Topical  Back To Top
Ears
 Ciprodex 
 Floxin Otic 
Eye - Allergy
cromolynAlamastAcular/LS/PF
ketotifenLivostinAlocril
 OptivarAlomide
 PatadayCrolom
 PatanolElestat
  Emadine
Eye - Glaucoma
betaxololAlphagan-PCombigan
levobunololAlphgan-PTimoptic
timololAzopt 
 Betimol 
 Betoptic-S 
 Cosopt 
 Isopto Carbachol 
 Istalol 
 Lumigan 
 Pilopine HS 
 Travatan, Travatan Z 
 Trusopt 
 Xalatan 
Eye Miscellaneous
 Alrex 
 Ciloxan 
 Iquix 
 Lotemax 
 Natacyn 
 Quixin 
 Tobradex 
 Tobrex Ointment 
 Vigamox 
 Voltaren 
 ZyLET 
 Zymar 
Skin - Acne
benzoyl peroxideBenzaclinAccutane
benzoyl peroxide-erythromycinBenzamycinCleocin-T
clindamycin topicalDuac CS KitKlaron
erythromycin topicalMetrocreamNoritate
isotretinoinMetrogel 
 Retin-A Micro 
 Zoderm 
Skin - all
betamethasoneAnalpram-HC LotionDesonate Gel
desonideDiprolene LotionElocon
fluocinoloneEfudexLotrisone Lotion
mometasoneElidelMycolog
mometasoneErtaczoMycostatin
nystatinFinacea GelSynalar
nystatin-triamcinoloneLidoderm PatchValisone
 Locoid Lipocream 
 Mentax 
 Pramosone 
 Protopic 
 Solaraze 

Tier 1
(Generic Drug)
Tier 2
(Preferred Brand)
Tier 3
(Non-preferred Brand)
Women's Health  Back To Top
Combination HRT
 ActivellaClimara Pro
 CombiPatchPrefest
 Premphase 
 Prempro 
 Prempro Low Dose 
Contraceptives (QL)
ApriCyclessaAlesse
AvianeLybrelBrevicon
BalzivaNuvaringDemulen
JolessaOrtho-Tri-Cyclen LoDesogen
KarivaPlan BEstrostep Fe
LevoraSeasoniqueLo/Ovral
Low-OgestrelYazLoestrin/Fe
Microgestin FE Mircette
Necon Nordette
Nortrel Norinyl
Ocella Ovcon
Quasense Ovral
Sprintec Ovrette
Tilia Fe Seasonale
Trivora Tri-Norinyl
Zovia Triphasil
  Yasmin
Hormone Replacement Therapy HRT
estradiolCenestinEstrace
 ClimaraEstrogel Pump
 EnjuviaFemring
 EstradermMenest
 Estring 
 Evamist 
 Premarin 
 Prometrium 
 Vagifem 
 Vivelle-Dot 
Osteoporosis - Calcium Regulators
alendronateBonivaActonel/w Calcium
 ForteoDidronel
 Fosamax+D, Fosamax Oral SolutionFosamax
 Miacalcin 
Osteoporosis - Hormone Receptor Modulators
 Evista 
Prenatal Vitamins
GenericsPrecare 
 Precare Concieve 
 Premesis Rx 
 Primacare 
Vaginal Products
clotrimazoleClindesseDiflucan 150mg (QL)
fluconazoleGynazole-1Metrogel Vaginal
terconazole Terazol