7/17/2012 Kaiser Permanente Northwest Region

Preferred Product Formulary List

Page 1 of 44
Product Brand or Generic?
A/B Otic Sol Generic
Abilify Tab 10 mg Brand
Abilify Tab 15 mg Brand
Abilify Tab 20 mg Brand
Abilify Tab 30 mg Brand
Abilify Tab 5 mg Brand
Acarbose Tab 100 mg Generic
Acarbose Tab 50 mg Generic
Acebutolol HCL Cap 200 mg Generic
Acebutolol HCL Cap 400 mg Generic
Acetaminophen / codeine #2 Tab 300-15 mg Generic
Acetaminophen / codeine #3 Tab 300-30 mg Generic
Acetaminophen / codeine Sol 120-12 / 5 Generic
Acetazolamide ER Cap 500 mg ER Generic
Acetazolamide Tab 125 mg Generic
Acetazolamide Tab 250 mg Generic
Acetic Acid Sol 2% Otic Generic
Acetic Acid / aluminum Acetate Sol 2% Otic Generic
Acetylcysteine Sol 10% Generic
Acetylcysteine Sol 20% Generic
Acyclovir Cap 200 mg Generic
Acyclovir Sus 200 / 5 ml Generic
Acyclovir Tab 400 mg Generic
Acyclovir Tab 800 mg Generic
Adcirca Tab 20 mg Brand
Adderall XR Cap 10 mg Brand
Adderall XR Cap 15 mg Brand
Adderall XR Cap 20 mg Brand
Adderall XR Cap 25 mg Brand
Adderall XR Cap 30 mg Brand
Adderall XR Cap 5 mg Brand
Advair Diskus Aer 100 / 50 Brand
Advair Diskus Aer 250 / 50 Brand
Advair Diskus Aer 500 / 50 Brand
Aerochamber Z-stat Plus / flowsignal Mis Stat Pls Brand
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 2 of 44
Product Brand or Generic?
Aerochamber Z-stat Plus / medium Mask Mis Stat Pls Brand
Aggrenox Cap 25-200 mg Brand
Akne-mycin Oin 2% Brand
Albenza Tab 200 mg Brand
Albuterol Sulfate Neb 0.083% Generic
Albuterol Sulfate Neb 0.5% Generic
Alendronate Sodium Tab 10 mg Generic
Alendronate Sodium Tab 40 mg Generic
Alendronate Sodium Tab 70 mg Generic
Alinia Sus 100 mg / 5 ml Brand
Alkeran Tab 2 mg Brand
Allopurinol Tab 100 mg Generic
Allopurinol Tab 300 mg Generic
Alprazolam Tab 0.25 mg Generic
Alprazolam Tab 0.5 mg Generic
Alprazolam Tab 1 mg Generic
Alprazolam Tab 2 mg Generic
Amantadine HCL Cap 100 mg Generic
Amantadine HCL Syp 50 mg / 5 ml Generic
Aminocaproic Acid Tab 500 mg Generic
Amiodarone HCL Tab 200 mg Generic
Amitriptyline HCL Tab 10 mg Generic
Amitriptyline HCL Tab 25 mg Generic
Amitriptyline HCL Tab 50 mg Generic
Amlodipine Besylate Tab 10 mg Generic
Amlodipine Besylate Tab 2.5 mg Generic
Amlodipine Besylate Tab 5 mg Generic
Amoxicillin Cap 250 mg Generic
Amoxicillin Cap 500 mg Generic
Amoxicillin Sus 125 / 5 ml Generic
Amoxicillin Sus 250 / 5 ml Generic
Amoxicillin Sus 400 / 5 ml Generic
Amoxicillin Sus 400 / 5 ml Generic
Amoxicillin Sus 400 / 5 ml Generic
Amoxicillin / clavulanate Potassium Chw 200 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 3 of 44
Product Brand or Generic?
Amoxicillin / clavulanate Potassium Chw 400 mg Generic
Amoxicillin / clavulanate Potassium Sus 600 / 5 ml Generic
Amoxicillin / potassium Clavulanate Sus 200 / 5 ml Generic
Amoxicillin / potassium Clavulanate Sus 400 / 5 ml Generic
Amoxicillin / potassium Clavulanate Tab 500 mg Generic
Amoxicillin / potassium Clavulanate Tab 875 mg Generic
Amphetamine / dextroamphetamine Tab 10 mg Generic
Amphetamine / dextroamphetamine Tab 20 mg Generic
Amphetamine / dextroamphetamine Tab 30 mg Generic
Amphetamine / dextroamphetamine Tab 5 mg Generic
Anagrelide Hydrochloride Cap 0.5 mg Generic
Ancobon Cap 250 mg Brand
Ancobon Cap 500 mg Brand
Antabuse Tab 250 mg Brand
Aptivus Cap 250 mg Brand
Aricept Tab 10 mg Brand
Arimidex Tab 1 mg Brand
Arixtra Sol 10 / 0.8 Brand
Arixtra Sol 2.5 / 0.5 Brand
Arixtra Sol 5.0 / 0.4 Brand
Arixtra Sol 7.5 / 0.6 Brand
Asacol Tab 400 mg DR Brand
Asacol Tab 400 mg DR Brand
Asmanex 120 Metered Doses Aer 220 mcg Brand
Asmanex 30 Metered Doses Aer 110 mcg Brand
Asmanex 60 Metered Doses Aer 220 mcg Brand
Atenolol Tab 100 mg Generic
Atenolol Tab 25 mg Generic
Atenolol Tab 50 mg Generic
Atenolol / chlorthalidone Tab 100-25 mg Generic
Atenolol / chlorthalidone Tab 50-25 mg Generic
Atripla Tab Brand
Atropine Sulfate Oin 1% Op Generic
Atropine Sulfate Sol 1% Op Generic
Atrovent HFA Aer 17 mcg Brand
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 4 of 44
Product Brand or Generic?
Augmented Betamethasone Dipropionate Cre 0.05% Generic
Augmented Betamethasone Dipropionate Gel 0.05% Generic
Augmented Betamethasone Dipropionate Lot 0.05% Generic
Augmented Betamethasone Dipropionate Oin 0.05% Generic
Augmentin Sus 125 / 5 ml Brand
Avc Cre 15% Brand
Avc Cre 15% Brand
Avelox Tab 400 mg Brand
Avonex Kit 30 mcg Brand
Avonex Kit 30 mcg Brand
Avonex Pen Kit 30 mcg Brand
Azathioprine Tab 50 mg Generic
Azelex Cre 20% Brand
Azithromycin Sus 100 / 5 ml Generic
Azithromycin Sus 200 / 5 ml Generic
Azithromycin Tab 250 mg Generic
Azithromycin Tab 600 mg Generic
Bacitracin Oin Op Brand
Bacitracin / neomycin / polymyxin Oin Op Generic
Bacitracin / polymyxin B Oin Op Generic
Baclofen Tab 10 mg Generic
Baclofen Tab 20 mg Generic
Bacteriostatic Water For Injection / benzyl Alcohol Inj Benz Alc Brand
Bactroban Nasal Oin Nasal 2% Brand
Baraclude Tab 0.5 mg Brand
Baraclude Tab 1 mg Brand
BD Insulin Syringe Ultraf Ine / 0.3 ml / 30g X 1 / 2" Mis 0.3 / 30g Brand
BD Insulin Syringe Ultraf Ine / 1 ml / 30g X 1 / 2" Mis 1 ml / 30g Brand
BD Insulin Syringe / U-100 / 0.5 ml / 30g X 1 / 2" Mis 0.5 / 30g Brand
Belladonna Alkaloids / phenobarbital Elx Generic
Belladonna Alkaloids / phenobarbital Tab 16.2 mg Generic
Benazepril HCL Tab 10 mg Generic
Benazepril HCL Tab 20 mg Generic
Benazepril HCL Tab 40 mg Generic
Benazepril HCL Tab 5 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 5 of 44
Product Brand or Generic?
Benefix Inj 1000 unit Brand
Benefix Inj 2000 unit Brand
Benefix Inj 250 unit Brand
Benefix Inj 500 unit Brand
Benzonatate Cap 100 mg Generic
Benztropine Mesylate Tab 0.5 mg Generic
Benztropine Mesylate Tab 1 mg Generic
Benztropine Mesylate Tab 2 mg Generic
Betamethasone Dipropionate Cre 0.05% Generic
Betamethasone Dipropionate Oin 0.05% Generic
Betamethasone Valerate Cre 0.1% Generic
Betamethasone Valerate Lot 0.1% Generic
Betamethasone Valerate Oin 0.1% Brand
Betaseron Inj 0.3 mg Brand
Betaxolol HCL Sol 0.5% Op Generic
Bethanechol Chloride Tab 25 mg Generic
Bicalutamide Tab 50 mg Generic
Biltricide Tab 600 mg Brand
Blephamide S.o.p. Oin S.o.p. Brand
Brimonidine Tartrate Sol 0.2% Op Generic
Bromfenex Pd Cap 6-60 mgcr Generic
Bromocriptine Mesylate Tab 2.5 mg Generic
Bumetanide Tab 0.5 mg Generic
Bumetanide Tab 1 mg Generic
Bumetanide Tab 2 mg Generic
Bupropion HCL SR Tab 100 mg SR Generic
Bupropion HCL SR Tab 150 mg SR Generic
Bupropion HCL SR Tab 200 mg SR Generic
Bupropion HCL Tab 100 mg Generic
Bupropion HCL Tab 75 mg Generic
Bupropion HCL XL Tab 150 mg XL Generic
Bupropion HCL XL Tab 150 mg XL Generic
Bupropion HCL XL Tab 300 mg XL Generic
Buspirone HCL Tab 10 mg Generic
Buspirone HCL Tab 15 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 6 of 44
Product Brand or Generic?
Buspirone HCL Tab 5 mg Generic
Butalbital / acetaminophen / caffeine Tab Generic
Butalbital / aspirin / caffeine Tab Generic
Cabergoline Tab 0.5 mg Generic
Cafergot Tab 1-100 mg Brand
Calcipotriene Sol 0.005% Generic
Calcitriol Cap 0.25 mcg Generic
Calcitriol Cap 0.5 mcg Generic
Campral Tab 333 mg Brand
Canasa Sup 1000 mg Brand
Captopril Tab 100 mg Generic
Captopril Tab 12.5 mg Generic
Captopril Tab 25 mg Generic
Captopril Tab 50 mg Generic
Carbamazepine Chw 100 mg Generic
Carbamazepine ER Tab 200 mg ER Generic
Carbamazepine ER Tab 400 mg ER Generic
Carbamazepine Sus 100 / 5 ml Generic
Carbamazepine Tab 200 mg Generic
Carbatrol Cap 300 mg Brand
Carbidopa / levodopa ER Tab 25-100 mg Generic
Carbidopa / levodopa ER Tab 50-200 mg Generic
Carbidopa / levodopa Tab 10-100 mg Generic
Carbidopa / levodopa Tab 25-100 mg Generic
Carbidopa / levodopa Tab 25-250 mg Generic
Carvedilol Tab 12.5 mg Generic
Carvedilol Tab 25 mg Generic
Carvedilol Tab 3.125 mg Generic
Carvedilol Tab 6.25 mg Generic
Cayston Inh 75 mg Brand
Ceenu Cap 100 mg Brand
Ceenu Cap 10 mg Brand
Ceenu Cap 40 mg Brand
Cefpodoxime Proxetil Sus 100 / 5 ml Generic
Cefpodoxime Proxetil Sus 50 mg / 5 ml Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 7 of 44
Product Brand or Generic?
Cefpodoxime Proxetil Tab 200 mg Generic
Celontin Cap 300 mg Brand
Cephalexin Cap 250 mg Generic
Cephalexin Cap 500 mg Generic
Cephalexin Sus 125 / 5 ml Generic
Cephalexin Sus 250 / 5 ml Generic
Chemstrip Ugk Tes Ugk Brand
Cheratussin AC Syp AC Generic
Chloral Hydrate Syp 500 / 5 ml Generic
Chlordiazepoxide HCL Cap 10 mg Generic
Chlordiazepoxide HCL Cap 25 mg Generic
Chlordiazepoxide HCL Cap 5 mg Generic
Chlorhexidine Gluconate Oral Rinse Sol 0.12% Generic
Chloroquine Phosphate Tab 500 mg Generic
Chlorpromazine HCL Tab 100 mg Generic
Chlorpromazine HCL Tab 10 mg Generic
Chlorpromazine HCL Tab 200 mg Generic
Chlorpromazine HCL Tab 25 mg Generic
Chlorpromazine HCL Tab 50 mg Generic
Chlorthalidone Tab 25 mg Generic
Chlorthalidone Tab 50 mg Generic
Cholestyramine Light Pow 4 gram Lite Generic
Cholestyramine Pow 4 gram Generic
Cholestyramine Pow 4 gram Generic
Chorionic Gonadotropin Inj 10000 unit Generic
Cilostazol Tab 100 mg Generic
Cilostazol Tab 50 mg Generic
Cimetidine HCL Sol 300 / 5 ml Generic
Ciprofloxacin HCL Tab 250 mg Generic
Ciprofloxacin HCL Tab 500 mg Generic
Ciprofloxacin HCL Tab 750 mg Generic
Citalopram Hydrobromide Sol 10 mg / 5 ml Generic
Citalopram Hydrobromide Tab 10 mg Generic
Citalopram Hydrobromide Tab 20 mg Generic
Citalopram Hydrobromide Tab 40 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 8 of 44
Product Brand or Generic?
Citric Acid / sodium Citrate Sol Sod Citr Generic
Clarithromycin Tab 500 mg Generic
Cleocin Pediatric Granules Sol 75 mg / 5 ml Brand
Climara Dis 0.025 mg Brand
Climara Dis 0.0375 mg Brand
Climara Dis 0.05 mg Brand
Climara Dis 0.06 mg Brand
Climara Dis 0.075 mg Brand
Climara Dis 0.1 mg Brand
Clindamycin HCL Cap 150 mg Generic
Clindamycin HCL Cap 300 mg Generic
Clindamycin Phosphate Gel 1% Generic
Clindamycin Phosphate Lot 10 mg / ml Generic
Clindamycin Phosphate Sol 1% Generic
Clobetasol Propionate Aer 0.05% Generic
Clobetasol Propionate Emollient Cre 0.05% Generic
Clobetasol Propionate Gel 0.05% Generic
Clobetasol Propionate Oin 0.05% Generic
Clomipramine HCL Cap 25 mg Generic
Clomipramine HCL Cap 50 mg Generic
Clomipramine HCL Cap 75 mg Generic
Clonazepam Tab 0.5 mg Generic
Clonazepam Tab 1 mg Generic
Clonazepam Tab 2 mg Generic
Clonidine HCL Tab 0.1 mg Generic
Clonidine HCL Tab 0.2 mg Generic
Clonidine HCL Tab 0.3 mg Generic
Clorazepate Dipotassium Tab 15 mg Generic
Clorazepate Dipotassium Tab 3.75 mg Generic
Clorazepate Dipotassium Tab 7.5 mg Generic
Clotrimazole Tro 10 mg Generic
Clozapine Tab 100 mg Generic
Clozapine Tab 200 mg Generic
Clozapine Tab 25 mg Generic
Clozapine Tab 50 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 9 of 44
Product Brand or Generic?
Codeine Sulfate Tab 30 mg Generic
Codeine Sulfate Tab 60 mg Generic
Colazal Cap 750 mg Brand
Colchicine Tab 0.6 mg Generic
Colcrys Tab 0.6 mg Brand
Colestipol HCL Tab 1 gram Generic
Combivir Tab 150-300 Brand
Complera Tab Brand
Comtan Tab 200 mg Brand
Concerta Tab 18 mg Brand
Concerta Tab 27 mg Brand
Concerta Tab 36 mg Brand
Concerta Tab 54 mg Brand
Condylox Gel 0.5% Brand
Copaxone Kit 20 mg / ml Brand
Cordran Tape Tap 4 mcg / cm Brand
Cozaar Tab 100 mg Brand
Cozaar Tab 25 mg Brand
Crixivan Cap 200 mg Brand
Crixivan Cap 333 mg Brand
Crixivan Cap 400 mg Brand
Cromolyn Sodium Neb 20 mg / 2 ml Generic
Cromolyn Sodium Sol 4% Op Generic
Cuprimine Cap 250 mg Brand
Cyanocobalamin Inj 1000 mcg Generic
Cyclobenzaprine HCL Tab 10 mg Generic
Cyclobenzaprine HCL Tab 5 mg Generic
Cyclogyl Sol 0.5% Op Brand
Cyclogyl Sol 2% Op Brand
Cyclopentolate HCL Sol 1% Op Generic
Cyclopentolate HCL Sol 1% Op Generic
Cyclophosphamide Tab 25 mg Brand
Cyclophosphamide Tab 50 mg Brand
Cyproheptadine HCL Syp 2 mg / 5 ml Generic
Cyproheptadine HCL Tab 4 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 10 of 44
Product Brand or Generic?
Danazol Cap 100 mg Generic
Danazol Cap 200 mg Generic
Danazol Cap 50 mg Generic
Dantrolene Sodium Cap 100 mg Generic
Dantrolene Sodium Cap 25 mg Generic
Dantrolene Sodium Cap 50 mg Generic
Dapsone Tab 100 mg Brand
Dapsone Tab 25 mg Brand
Daraprim Tab 25 mg Brand
Depo-estradiol Inj 5 mg / ml Brand
Desipramine HCL Tab 10 mg Generic
Desipramine HCL Tab 25 mg Generic
Desipramine HCL Tab 50 mg Generic
Desmopressin Acetate Sol 0.01% Generic
Desmopressin Acetate Spr 0.01% Generic
Desmopressin Acetate Spr 0.01% Generic
Desmopressin Acetate Tab 0.1 mg Generic
Desmopressin Acetate Tab 0.2 mg Generic
Desonide Cre 0.05% Generic
Desonide Oin 0.05% Generic
Dexamethasone Elx 0.5 / 5 ml Generic
Dexamethasone Intensol Con 1 mg / ml Brand
Dexamethasone Sodium Phosphate Sol 0.1% Op Generic
Dexamethasone Sol 0.5 / 5 ml Brand
Dexamethasone Tab 0.5 mg Generic
Dexamethasone Tab 0.75 mg Generic
Dexamethasone Tab 4 mg Generic
Dextroamphetamine Sulfate ER Cap 10 mg ER Generic
Dextroamphetamine Sulfate ER Cap 15 mg ER Generic
Dextroamphetamine Sulfate ER Cap 5 mg ER Generic
Dextroamphetamine Sulfate Tab 10 mg Generic
Dextroamphetamine Sulfate Tab 5 mg Generic
Diamox Cap 500 mg CR Brand
Diastat Acudial Gel 12.5-20 Brand
Diastat Acudial Gel 5-10 mg Brand
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 11 of 44
Product Brand or Generic?
Diastat Pediatric Gel 2.5m Gel Brand
Diazepam Intensol Con 5 mg / ml Brand
Diazepam Tab 10 mg Generic
Diazepam Tab 2 mg Generic
Diazepam Tab 5 mg Generic
Dibenzyline Cap 10 mg Brand
Diclofenac Sodium Sol 0.1% Op Generic
Dicloxacillin Sodium Cap 250 mg Generic
Dicloxacillin Sodium Cap 500 mg Generic
Dicyclomine HCL Cap 10 mg Generic
Dicyclomine HCL Sol 10 mg / 5 ml Generic
Dicyclomine HCL Tab 20 mg Generic
Didanosine Cap 200 mg Generic
Didanosine Cap 250 mg Generic
Didanosine Cap 400 mg Generic
Differin Cre 0.1% Brand
Differin Gel 0.1% Brand
Digoxin Sol 50 mcg / ml Brand
Digoxin Tab 0.125 mg Generic
Digoxin Tab 0.25 mg Generic
Dihydroergotamine Mesylate Inj 1 mg / ml Generic
Dilantin Cap 30 mg Brand
Dilantin Infatabs Chw 50 mg Brand
Dilaudid Sup 3 mg Brand
Diltiazem HCL ER Cap 120 mg ER Generic
Diltiazem HCL ER Cap 180 mg ER Generic
Diltiazem HCL ER Cap 240 mg ER Generic
Diltiazem HCL Tab 120 mg Generic
Diltiazem HCL Tab 30 mg Generic
Diltiazem HCL Tab 60 mg Generic
Diltiazem HCL Tab 90 mg Generic
Diphenoxylate / atropine Liq 2.5 / 5 Brand
Diphenoxylate / atropine Tab 2.5 mg Generic
Dipivefrin HCL Sol 0.1% Op Generic
Dipyridamole Tab 25 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 12 of 44
Product Brand or Generic?
Dipyridamole Tab 50 mg Generic
Dipyridamole Tab 75 mg Generic
Disopyramide Phosphate Cap 100 mg Generic
Disopyramide Phosphate Cap 150 mg Generic
Disopyramide Phosphate ER Cap 150 mg ER Generic
Diuril Sus 250 / 5 ml Brand
Divalproex Sodium Cap 125 mg Generic
Divalproex Sodium DR Tab 125 mg DR Generic
Divalproex Sodium DR Tab 250 mg DR Generic
Divalproex Sodium DR Tab 500 mg DR Generic
Donepezil HCL Tab 5 mg Generic
Dorzolamide HCL Sol 2% Op Generic
Dorzolamide HCL / timolol Maleate Sol 2-0.5%op Generic
Doxazosin Mesylate Tab 1 mg Generic
Doxazosin Mesylate Tab 2 mg Generic
Doxazosin Mesylate Tab 4 mg Generic
Doxazosin Mesylate Tab 8 mg Generic
Doxepin HCL Cap 10 mg Generic
Doxepin HCL Cap 25 mg Generic
Doxepin HCL Cap 50 mg Generic
Doxycycline Hyclate Cap 100 mg Generic
Doxycycline Hyclate Cap 50 mg Generic
Dulera Aer 100-5 mcg Brand
Dulera Aer 200-5 mcg Brand
Dyrenium Cap 100 mg Brand
E.E.S. Granules Sus 200 / 5 ml Brand
Edecrin Tab 25 mg Brand
Edurant Tab 25 mg Brand
Effient Tab 10 mg Brand
Effient Tab 5 mg Brand
Efudex Cre 5% Brand
Elidel Cre 1% Brand
Eliphos Tab 667 mg Brand
Ella Tab 30 mg Brand
Elmiron Cap 100 mg Brand
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 13 of 44
Product Brand or Generic?
Enalapril Maleate Tab 10 mg Generic
Enalapril Maleate Tab 20 mg Generic
Enalapril Maleate Tab 5 mg Generic
Enbrel Inj 25 mg Brand
Enbrel Inj 50 mg / ml Brand
Enbrel Sureclick Inj 50 mg / ml Brand
Epinephrine Inj 0.15 mg Brand
Epinephrine Inj 0.3 mg Brand
Epipen 2-pak Inj 0.3 mg Brand
Epipen Inj 0.3 mg Brand
Epipen Inj 0.3 mg Brand
Epipen Inj 0.3 mg Brand
Epipen-jr Inj 0.15 mg Brand
Epipen-jr Inj 0.15 mg Brand
Epivir Hbv Tab 100 mg Brand
Epivir Sol 10 mg / ml Brand
Epivir Tab 150 mg Brand
Epivir Tab 300 mg Brand
Epzicom Tab Brand
Ergotamine Tartrate / caffeine Tab 1 / 100 Generic
Ery-tab Tab 250 mg EC Brand
Erythromycin Oin Op Generic
Erythromycin Sol 2% Generic
Erythromycin / sulfisoxazole Sus 200-600 Generic
Esterified Estrogens / methyltestosterone DS Tab Mtest DS Generic
Esterified Estrogens / methyltestosterone HS Tab Mtest HS Generic
Estradiol Tab 0.5 mg Generic
Estradiol Tab 1 mg Generic
Estradiol Tab 2 mg Generic
Estradiol Valerate Inj 20 mg / ml Generic
Estradiol Valerate Inj 40 mg / ml Generic
Estring Mis 2 mg Brand
Ethambutol HCL Tab 100 mg Generic
Ethambutol HCL Tab 400 mg Generic
Ethosuximide Cap 250 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 14 of 44
Product Brand or Generic?
Ethosuximide Sol 250 / 5 ml Generic
Etidronate Disodium Tab 200 mg Brand
Etidronate Disodium Tab 400 mg Generic
Etodolac Cap 300 mg Generic
Etodolac Tab 400 mg Generic
Etoposide Cap 50 mg Generic
Exelon Cap 1.5 mg Brand
Exelon Cap 3 mg Brand
Exelon Cap 4.5 mg Brand
Exelon Cap 6 mg Brand
Extavia Inj 0.3 mg Brand
Famotidine Tab 20 mg Generic
Famotidine Tab 40 mg Generic
Femara Tab 2.5 mg Brand
Fenofibrate Tab 160 mg Generic
Fenofibrate Tab 54 mg Generic
Fentanyl Dis 100 mcg / h Generic
Fentanyl Dis 12 mcg / hour Generic
Fentanyl Dis 25 mcg / hour Generic
Fentanyl Dis 50 mcg / hour Generic
Fentanyl Dis 75 mcg / hour Generic
Finacea Gel 15% Brand
Finasteride Tab 5 mg Generic
Flecainide Acetate Tab 100 mg Generic
Flecainide Acetate Tab 50 mg Generic
Fluconazole Tab 100 mg Generic
Fluconazole Tab 150 mg Generic
Fluconazole Tab 200 mg Generic
Fluconazole Tab 50 mg Generic
Fludrocortisone Acetate Tab 0.1 mg Generic
Flunisolide Spr 0.025% Generic
Fluocinolone Acetonide Cre 0.01% Generic
Fluocinolone Acetonide Cre 0.025% Generic
Fluocinolone Acetonide Oin 0.025% Generic
Fluocinolone Acetonide Sol 0.01% Brand
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 15 of 44
Product Brand or Generic?
Fluocinonide Cre 0.05% Generic
Fluocinonide Gel 0.05% Generic
Fluocinonide Oin 0.05% Generic
Fluocinonide-e Cre -e 0.05% Generic
Fluorabon Dro Brand
Fluoridex Daily Defense Gel 1.1% Generic
Fluorometholone Sus 0.1% Op Generic
Fluorouracil Cre 5% Generic
Fluorouracil Sol 2% Generic
Fluoxetine HCL Cap 10 mg Generic
Fluoxetine HCL Cap 20 mg Generic
Fluoxetine HCL Sol 20 mg / 5 ml Generic
Fluphenazine HCL Tab 10 mg Generic
Fluphenazine HCL Tab 1 mg Generic
Fluphenazine HCL Tab 2.5 mg Generic
Fluphenazine HCL Tab 5 mg Generic
Flurbiprofen Sodium Sol 0.03% Op Generic
Flutamide Cap 125 mg Generic
Fluticasone Propionate Spr 50 mcg Generic
Fluvoxamine Maleate Tab 100 mg Generic
Fluvoxamine Maleate Tab 25 mg Generic
Fluvoxamine Maleate Tab 50 mg Generic
Fml Oin 0.1% Op Brand
Folic Acid Tab 1 mg Generic
Fortical Spr 200 / act Brand
Furadantin Sus 25 mg / 5 ml Brand
Furosemide Sol 10 mg / ml Generic
Furosemide Tab 20 mg Generic
Furosemide Tab 40 mg Generic
Furosemide Tab 80 mg Generic
Fuzeon Kit Brand
Gabapentin Cap 100 mg Generic
Gabapentin Cap 300 mg Generic
Gabapentin Cap 400 mg Generic
Gabapentin Tab 600 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 16 of 44
Product Brand or Generic?
Gabapentin Tab 800 mg Generic
Gabitril Tab 12 mg Brand
Gabitril Tab 16 mg Brand
Gabitril Tab 2 mg Brand
Gabitril Tab 4 mg Brand
Galantamine Hydrobromide Cap 16 mg ER Generic
Galantamine Hydrobromide Cap 24 mg ER Generic
Galantamine Hydrobromide Cap 8 mg ER Generic
Galantamine Hydrobromide Tab 12 mg Generic
Galantamine Hydrobromide Tab 4 mg Generic
Galantamine Hydrobromide Tab 8 mg Generic
Ganciclovir Cap 250 mg Brand
Ganciclovir Cap 500 mg Brand
Gemfibrozil Tab 600 mg Generic
Gengraf Cap 100 mg Generic
Gengraf Cap 25 mg Generic
Gentak Oin 0.3% Op Generic
Gentak Sol 0.3% Op Generic
Gentamicin Sulfate Cre 0.1% Generic
Gentamicin Sulfate Oin 0.1% Generic
Geodon Cap 20 mg Brand
Geodon Cap 40 mg Brand
Geodon Cap 60 mg Brand
Geodon Cap 80 mg Brand
Gleevec Tab 100 mg Brand
Glipizide Tab 10 mg Generic
Glipizide Tab 5 mg Generic
Glucagen Hypokit Inj Hypokit Brand
Griseofulvin Microsize Sus 125 / 5 ml Generic
Gris-peg Tab 125 mg Brand
Gris-peg Tab 250 mg Brand
Guaifenesin / phenylephrine HCL ER Tab 600-30 mg Generic
Guanfacine HCL Tab 1 mg Generic
Guanfacine HCL Tab 2 mg Generic
Haloperidol Con 2 mg / ml Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 17 of 44
Product Brand or Generic?
Haloperidol Tab 0.5 mg Generic
Haloperidol Tab 10 mg Generic
Haloperidol Tab 1 mg Generic
Haloperidol Tab 2 mg Generic
Haloperidol Tab 5 mg Generic
Hepsera Tab 10 mg Brand
Herceptin Inj 440 mg Brand
Hexalen Cap 50 mg Brand
Humate-p Inj 1000 unit Brand
Humate-p Inj 2000 unit Brand
Humate-p Inj 500 unit Brand
Humira Kit 40 mg / 0.8 Brand
Humira Pen Kit 40 mg / 0.8 Brand
Hydralazine HCL Tab 100 mg Generic
Hydralazine HCL Tab 10 mg Generic
Hydralazine HCL Tab 25 mg Generic
Hydralazine HCL Tab 50 mg Generic
Hydrochlorothiazide Tab 25 mg Generic
Hydrochlorothiazide Tab 50 mg Generic
Hydrocodone Bitartrate / homatropine Methylbromide Tab Homatrop Generic
Hydrocodone / acetaminophen Sol 7.5-500 Generic
Hydrocodone / acetaminophen Tab 10-325 mg Generic
Hydrocodone / acetaminophen Tab 5-325 mg Generic
Hydrocodone / acetaminophen Tab 5-500 mg Generic
Hydrocortisone Butyrate Cre 0.1% Generic
Hydrocortisone Butyrate Oin 0.1% Generic
Hydrocortisone Cre 2.5% Generic
Hydrocortisone Ene 100 mg Generic
Hydrocortisone Oin 2.5% Generic
Hydrocortisone Tab 20 mg Generic
Hydrocortisone Tab 5 mg Generic
Hydromet Syp 5-1.5 / 5 Generic
Hydromorphone HCL Sup 3 mg Brand
Hydromorphone HCL Tab 2 mg Generic
Hydromorphone HCL Tab 4 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 18 of 44
Product Brand or Generic?
Hydroxychloroquine Sulfate Tab 200 mg Generic
Hydroxyurea Cap 500 mg Generic
Hydroxyzine HCL Inj 50 mg / ml Generic
Hydroxyzine HCL Syp 10 mg / 5 ml Generic
Hydroxyzine HCL Tab 10 mg Generic
Hydroxyzine HCL Tab 25 mg Generic
Hydroxyzine HCL Tab 50 mg Generic
Hydroxyzine Pamoate Cap 25 mg Generic
Hydroxyzine Pamoate Cap 50 mg Generic
Hypercare Sol 20% Generic
Ibuprofen Tab 400 mg Generic
Ibuprofen Tab 600 mg Generic
Ibuprofen Tab 800 mg Generic
Imipramine HCL Tab 10 mg Generic
Imipramine HCL Tab 25 mg Generic
Imipramine HCL Tab 50 mg Generic
Implanon Imp 68 mg Brand
Indomethacin Cap 25 mg Generic
Indomethacin Cap 50 mg Generic
Indomethacin ER Cap 75 mg ER Generic
Intal Inhaler Aer 800 mcg Brand
Intelence Tab 100 mg Brand
Intelence Tab 200 mg Brand
Intron-A Kit 10 million units / ml Brand
Intron-A Inj 10 million units Pen Brand
Intron-A Inj 25 million units Brand
Invirase Cap 200 mg Brand
Invirase Tab 500 mg Brand
Ipratropium Bromide Sol 0.02%inh Generic
Ipratropium Bromide Spr 0.03% Generic
Ipratropium Bromide Spr 0.06% Generic
Ipratropium Bromide / albut Erol Sulfate Sol Albuter Generic
Ipratropium Bromide / albut Erol Sulfate Sol Albuter Generic
Isentress Tab 400 mg Brand
Isoniazid Syp 50 mg / 5 ml Brand
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 19 of 44
Product Brand or Generic?
Isoniazid Tab 100 mg Generic
Isoniazid Tab 300 mg Generic
Isopto Carbachol Sol 1.5% Op Brand
Isopto Carbachol Sol 3% Op Brand
Isopto Homatropine Sol 2% Op Brand
Isopto Homatropine Sol 5% Op Brand
Isopto Hyoscine Sol 0.25% Op Brand
Isordil Titradose Tab 40 mg Brand
Isosorbide Dinitrate ER Tab 40 mg ER Generic
Isosorbide Dinitrate Sub 2.5 mg Brand
Isosorbide Dinitrate Sub 5 mg Brand
Isosorbide Dinitrate Tab 10 mg Generic
Isosorbide Dinitrate Tab 20 mg Generic
Isosorbide Dinitrate Tab 5 mg Generic
Isosorbide Mononitrate ER Tab 120 mg ER Generic
Isosorbide Mononitrate ER Tab 30 mg ER Generic
Isosorbide Mononitrate ER Tab 60 mg ER Generic
Kaletra Sol Brand
Kaletra Tab 200-50 mg Brand
Kenalog Aer Spray Brand
Keppra Tab 250 mg Brand
Keppra Tab 500 mg Brand
Keppra Tab 750 mg Brand
Ketoconazole Cre 2% Generic
Ketoconazole Sha 2% Generic
Ketoconazole Tab 200 mg Generic
Ketostix Tes Brand
Klor-con Pow 20 mEq Generic
K-phos Tab Brand
K-tabs Tab 10 mEq CR Brand
Labetalol HCL Tab 100 mg Generic
Labetalol HCL Tab 200 mg Generic
Labetalol HCL Tab 300 mg Generic
Lactulose Sol 10 gram / 15 Generic
Lamotrigine Chw 25 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 20 of 44
Product Brand or Generic?
Lamotrigine Chw 5 mg Generic
Lamotrigine Tab 100 mg Generic
Lamotrigine Tab 150 mg Generic
Lamotrigine Tab 200 mg Generic
Lamotrigine Tab 25 mg Generic
Lantus Inj 100 / ml Brand
Latanoprost Sol 0.005% Generic
Latanoprost Sol 0.005% Generic
Leena Tab Generic
Leflunomide Tab 10 mg Generic
Leflunomide Tab 20 mg Generic
Letairis Tab 10 mg Brand
Letairis Tab 5 mg Brand
Letrozole Tab 2.5 mg Generic
Leucovorin Calcium Tab 5 mg Generic
Leukeran Tab 2 mg Brand
Leuprolide Acetate Inj 1 mg / 0.2 Generic
Levetiracetam Sol 100 mg / ml Generic
Levetiracetam Tab 1000 mg Generic
Levetiracetam Tab 250 mg Generic
Levetiracetam Tab 500 mg Generic
Levetiracetam Tab 750 mg Generic
Levobunolol HCL Sol 0.25% Op Brand
Levobunolol HCL Sol 0.5% Op Generic
Levofloxacin Tab 500 mg Generic
Levora 0.15 / 30-28 Tab 0.15 / 30 Generic
Levothroid Tab 100 mcg Generic
Levothroid Tab 112 mcg Generic
Levothroid Tab 125 mcg Generic
Levothroid Tab 137 mcg Generic
Levothroid Tab 150 mcg Generic
Levothroid Tab 175 mcg Generic
Levothroid Tab 200 mcg Generic
Levothroid Tab 25 mcg Generic
Levothroid Tab 300 mcg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 21 of 44
Product Brand or Generic?
Levothroid Tab 50 mcg Generic
Levothroid Tab 75 mcg Generic
Levothroid Tab 88 mcg Generic
Lexiva Tab 700 mg Brand
Lidocaine HCL J elly Gel 2% J elly Generic
Lidocaine HCL Sol 4% Generic
Lidocaine Oin 5% Generic
Lidocaine Oin 5% Generic
Lidocaine Viscous Sol 2% Visc Generic
Liothyronine Sodium Tab 25 mcg Generic
Liothyronine Sodium Tab 50 mcg Generic
Liothyronine Sodium Tab 5 mcg Generic
Lipitor Tab 80 mg Brand
Lisinopril Tab 10 mg Generic
Lisinopril Tab 2.5 mg Generic
Lisinopril Tab 20 mg Generic
Lisinopril Tab 40 mg Generic
Lisinopril Tab 5 mg Generic
Lisinopril / hydrochlorothiazide Tab 10-12.5 Generic
Lisinopril / hydrochlorothiazide Tab 20-12.5 Generic
Lisinopril / hydrochlorothiazide Tab 20-25 mg Generic
Lithium Carbonate Cap 150 mg Generic
Lithium Carbonate Cap 300 mg Generic
Lithium Carbonate ER Tab 300 mg ER Generic
Lithium Carbonate ER Tab 450 mg ER Generic
Locoid Lipocream Cre 0.1% Brand
Lodosyn Tab 25 mg Brand
Lorazepam Intensol Con 2 mg / ml Brand
Lorazepam Tab 0.5 mg Generic
Lorazepam Tab 1 mg Generic
Lorazepam Tab 2 mg Generic
Losartan Potassium Tab 100 mg Generic
Losartan Potassium Tab 25 mg Generic
Losartan Potassium Tab 50 mg Generic
Losartan Potassium / hydrochlorothiazide Tab 100-12.5 Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 22 of 44
Product Brand or Generic?
Losartan Potassium / hydrochlorothiazide Tab 100-12.5 Generic
Losartan Potassium / hydrochlorothiazide Tab 100-12.5 Generic
Losartan Potassium / hydrochlorothiazide Tab 100-25 Generic
Losartan Potassium / hydrochlorothiazide Tab 50-12.5 Generic
Lovastatin Tab 10 mg Generic
Lovastatin Tab 20 mg Generic
Lovastatin Tab 40 mg Generic
Lovenox Inj 100 mg / ml Brand
Lovenox Inj 120 / 0.8 Brand
Lovenox Inj 150 mg / ml Brand
Lovenox Inj 30 / 0.3 ml Brand
Lovenox Inj 300 / 3 ml Brand
Lovenox Inj 40 / 0.4 ml Brand
Lovenox Inj 60 / 0.6 ml Brand
Lovenox Inj 80 / 0.8 ml Brand
Loxapine Succinate Cap 10 mg Generic
Loxapine Succinate Cap 25 mg Generic
Loxapine Succinate Cap 50 mg Generic
Loxapine Succinate Cap 5 mg Generic
Lumigan Sol 0.03% Brand
Lysodren Tab 500 mg Brand
Macrodantin Cap 25 mg Brand
Malarone Tab 250-100 Brand
Malarone Tab 62.5-25 Brand
Matulane Cap 50 mg Brand
Maxalt-MLT Tab 10 mg Brand
Maxalt-MLT Tab 5 mg Brand
Mebendazole Chw 100 mg Brand
Medroxyprogesterone Acetate Inj 150 mg / ml Generic
Medroxyprogesterone Acetate Tab 10 mg Generic
Medroxyprogesterone Acetate Tab 2.5 mg Generic
Medroxyprogesterone Acetate Tab 5 mg Generic
Mefloquine HCL Tab 250 mg Generic
Megestrol Acetate Sus 40 mg / ml Generic
Megestrol Acetate Tab 20 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 23 of 44
Product Brand or Generic?
Megestrol Acetate Tab 40 mg Generic
Meloxicam Tab 15 mg Generic
Meloxicam Tab 7.5 mg Generic
Mephyton Tab 5 mg Brand
Mepron Sus Brand
Mercaptopurine Tab 50 mg Generic
Mesalamine Ene 4 gram Generic
Mesnex Tab 400 mg Brand
Mestinon Timespan Tab Timespan Brand
Metadate CD Cap 10 mg Brand
Metadate CD Cap 20 mg Brand
Metadate CD Cap 30 mg Brand
Metadate CD Cap 40 mg Brand
Metadate CD Cap 50 mg Brand
Metadate CD Cap 60 mg Brand
Metformin HCL Tab 1000 mg Generic
Metformin HCL Tab 500 mg Generic
Metformin HCL Tab 850 mg Generic
Methadone HCL Tab 10 mg Generic
Methadone HCL Tab 5 mg Generic
Methadose Con 10 mg / ml Generic
Methazolamide Tab 50 mg Generic
Methergine Tab 0.2 mg Brand
Methimazole Tab 10 mg Generic
Methimazole Tab 5 mg Generic
Methitest Tab 10 mg Brand
Methocarbamol Tab 500 mg Generic
Methocarbamol Tab 750 mg Generic
Methotrexate Sodium Inj 25 mg / ml Generic
Methotrexate Sodium Inj 25 mg / ml Generic
Methotrexate Tab 2.5 mg Generic
Methyldopa Tab 250 mg Generic
Methyldopa Tab 500 mg Generic
Methylin ER Tab 10 mg ER Generic
Methylin ER Tab 20 mg ER Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 24 of 44
Product Brand or Generic?
Methylin Tab 10 mg Generic
Methylin Tab 20 mg Generic
Methylin Tab 5 mg Generic
Metoclopramide HCL Sol 5 mg / 5 ml Generic
Metoclopramide HCL Tab 10 mg Generic
Metoclopramide HCL Tab 5 mg Generic
Metolazone Tab 10 mg Generic
Metolazone Tab 2.5 mg Generic
Metolazone Tab 5 mg Generic
Metoprolol Tartrate Tab 100 mg Generic
Metoprolol Tartrate Tab 25 mg Generic
Metoprolol Tartrate Tab 50 mg Generic
Metrocream Cre 0.75% Brand
Metrogel Gel 0.75% Brand
Metrolotion Lot 0.75% Brand
Metronidazole Cre 0.75% Generic
Metronidazole Gel 0.75% Generic
Metronidazole Lot 0.75% Generic
Metronidazole Tab 250 mg Generic
Metronidazole Tab 500 mg Generic
Mexiletine HCL Cap 150 mg Brand
Mexiletine HCL Cap 200 mg Brand
Mexiletine HCL Cap 250 mg Brand
Miacalcin Inj 200 / ml Brand
Microgestin Fe 1.5 / 30 Tab Fe1.5 / 30 Generic
Microgestin Fe Tab Fe 1 / 20 Generic
Midazolam HCL Syp 2 mg / ml Generic
Midodrine HCL Tab 2.5 mg Generic
Midodrine HCL Tab 5 mg Generic
Midrin Cap Brand
Migergot Sup 2 / 100 Brand
Migranal Spr 4 mg / ml Brand
Minitran Dis 0.1 mg / hour Generic
Minitran Dis 0.2 mg / hour Generic
Minitran Dis 0.4 mg / hour Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 25 of 44
Product Brand or Generic?
Minitran Dis 0.6 mg / hour Generic
Minocycline HCL Cap 100 mg Generic
Minocycline HCL Cap 50 mg Generic
Mirapex Tab 0.25 mg Brand
Mirapex Tab 1.5 mg Brand
Mirapex Tab 1 mg Brand
Mirena IUD System Brand
Mirtazapine Tab 15 mg Generic
Mirtazapine Tab 30 mg Generic
Mirtazapine Tab 45 mg Generic
Misoprostol Tab 200 mcg Generic
Mometasone Furoate Cre 0.1% Generic
Mometasone Furoate Oin 0.1% Generic
Monarc-m Inj 250-1100 Brand
Morphine Sulfate ER Tab 100 mg ER Generic
Morphine Sulfate ER Tab 15 mg ER Generic
Morphine Sulfate ER Tab 200 mg ER Generic
Morphine Sulfate ER Tab 30 mg ER Generic
Morphine Sulfate ER Tab 60 mg ER Generic
Morphine Sulfate Sol 20 mg / ml Generic
Morphine Sulfate Sup 10 mg Brand
Morphine Sulfate Sup 20 mg Brand
Morphine Sulfate Sup 30 mg Brand
Morphine Sulfate Tab 15 mg Brand
Morphine Sulfate Tab 15 mg Generic
Morphine Sulfate Tab 30 mg Brand
Multi Vit / fl Chw 0.25 mg Generic
Multi-vit / fluoride Chw 1 mg Generic
Multi-vit / iron / fluoride Dro / fl 0.25 Generic
Multi-vitamin / fluoride Chw 0.25 mg Generic
Multi-vitamin / fluoride Chw 0.5 mg Generic
Multi-vitamin / fluoride Chw 0.5 mg Generic
Multi-vitamin / fluoride Chw 1 mg Generic
Mupirocin Oin 2% Generic
Mycobutin Cap 150 mg Brand
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 26 of 44
Product Brand or Generic?
Mycophenolate Mofetil Cap 250 mg Generic
Mycophenolate Mofetil Tab 500 mg Generic
Myleran Tab 2 mg Brand
Nabumetone Tab 500 mg Generic
Nabumetone Tab 750 mg Generic
Nadolol Tab 20 mg Generic
Nadolol Tab 40 mg Generic
Nadolol Tab 80 mg Generic
Naltrexone HCL Tab 50 mg Generic
Namenda Tab 10 mg Brand
Namenda Tab 5 mg Brand
Namenda Titration Pak Tab 5-10 mg Brand
Naproxen Sodium Tab 550 mg Generic
Naproxen Tab 250 mg Generic
Naproxen Tab 375 mg Generic
Naproxen Tab 500 mg Generic
Naratriptan HCL Tab 2.5 mg Generic
Nardil Tab 15 mg Brand
Nardil Tab 15 mg Brand
Natacyn Sus 5% Op Brand
Necon 0.5 / 35-28 Tab 0.5 / 35 Generic
Neo-fradin Sol 125 / 5 ml Brand
Neomycin Sulfate Tab 500 mg Generic
Neomycin / polymyxin B Sulfates Sol 40 / ml Ir Generic
Neomycin / polymyxin / bacitracin / hydrocortisone Oin / HC 1%op Generic
Neomycin / polymyxin / dexamethasone Oin 0.1% Op Generic
Neomycin / polymyxin / dexamethasone Sus 0.1% Op Generic
Neomycin / polymyxin / HC Sol 1% Otic Generic
Neomycin / polymyxin / hydrocortisone Sus 1% Otic Generic
Neoral Sol 100 mg / ml Brand
Neumega Inj 5 mg Brand
Neumega Inj 5 mg Brand
Neupogen Inj 300 / 0.5 Brand
Neupogen Inj 300 mcg Brand
Neupogen Inj 480 / 0.8 Brand
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 27 of 44
Product Brand or Generic?
Neupogen Inj 480 mcg Brand
Nexavar Tab 200 mg Brand
Nexplanon Imp 68 mg Brand
Niacin SR Tab 250 mg SR Generic
Niacin Tab 100 mg Generic
Niacin Tab 500 mg Generic
Niacin Tab 50 mg Generic
Niacin TR Tab 500 mg TR Generic
Nicotine Dis 14 mg / 24 hours Generic
Nicotine Dis 21 mg / 24 hours Generic
Nicotine Dis 7 mg / 24 hours Generic
Nicotine Polacrilex Gum 2 mg Generic
Nicotine Polacrilex Gum 4 mg Reg Generic
Nicotine Transdermal System Kit Transder Brand
Nifedical XL Tab 30 mg Generic
Nifedical XL Tab 60 mg Generic
Nifedipine ER Tab 90 mg ER Generic
Nimodipine Cap 30 mg Generic
Nitro-bid Oin 2% Brand
Nitro-bid Oin 2% Brand
Nitrofurantoin Macrocrystalline Cap 100 mg Generic
Nitrofurantoin Macrocrystalline Cap 50 mg Generic
Nitrofurantoin Monohydrate Cap 100 mg Generic
Nitroglycerin Sub 0.3 mg Generic
Nitroglycerin Sub 0.4 mg Generic
Nitroglycerin Sub 0.6 mg Generic
Nitroglycerin Transdermal Dis 0.1 mg / hour Generic
Nitrolingual Pumpspray Spr Pumpspra Brand
Nitrostat Sub 0.3 mg Brand
Nitrostat Sub 0.4 mg Brand
Nitrostat Sub 0.6 mg Brand
Nora-be Tab 0.35 mg Generic
Norditropin Nordiflex Pen Inj 15 / 1.5 ml Brand
Norethindrone Acetate Tab 5 mg Generic
Norinyl 1+35 Tab 1+35-28 Brand
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 28 of 44
Product Brand or Generic?
Norpace CR Cap 100 mg CR Brand
Norpace CR Cap 150 mg CR Brand
Nortriptyline HCL Cap 10 mg Generic
Nortriptyline HCL Cap 25 mg Generic
Nortriptyline HCL Cap 50 mg Generic
Nortriptyline HCL Cap 75 mg Generic
Norvir Cap 100 mg Brand
Norvir Tab 100 mg Brand
Novolin 70 / 30 Inj 70 / 30 Brand
Novolin N Inj U-100 Brand
Novolin R Inj U-100 Brand
Nystatin Cre 100000 Generic
Nystatin Oin 100000 Generic
Nystatin Sus 100000 Generic
Nystatin / triamcinolone Cre Brand
Nystatin / triamcinolone Oin Generic
Nystop Pow 100000 Generic
Octreotide Acetate Inj 1000 mcg Generic
Octreotide Acetate Inj 100 mcg Generic
Octreotide Acetate Inj 200 mcg Generic
Ofloxacin Dro 0.3% Op Generic
Ofloxacin Dro 0.3%otic Generic
Omeprazole Cap 10 mg Generic
Omeprazole Cap 20 mg Generic
Omnitrope Inj 10 / 1.5 ml Brand
Omnitrope Inj 5.8 mg Brand
Omnitrope Inj 5 / 1.5 ml Brand
Ondansetron HCL Tab 4 mg Generic
Ondansetron HCL Tab 8 mg Generic
Ondansetron ODT Tab 4 mg ODT Generic
Ondansetron ODT Tab 8 mg ODT Generic
Onetouch Ultra Blue Tes Ultra Bl Brand
Ortho Diaphragm All-flex Kit 60 DPR 60 mm Brand
Ortho Diaphragm All-flex Kit 65 DPR 65 mm Brand
Ortho Diaphragm All-flex Kit 70 DPR 70 mm Brand
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 29 of 44
Product Brand or Generic?
Ortho Diaphragm All-flex Kit 75 DPR 75 mm Brand
Ortho Diaphragm All-flex Kit 80 DPR 80 mm Brand
Ortho Diaphragm All-flex Kit 85 DPR 85 mm Brand
Ortho Diaphragm All-flex Kit 90 DPR 90 mm Brand
Oxazepam Cap 10 mg Generic
Oxazepam Cap 15 mg Generic
Oxazepam Cap 30 mg Generic
Oxcarbazepine Sus 300 mg / 5 ml Generic
Oxcarbazepine Tab 150 mg Generic
Oxcarbazepine Tab 300 mg Generic
Oxcarbazepine Tab 600 mg Generic
Oxsoralen Ultra Cap 10 mg Brand
Oxybutynin Chloride ER Tab 10 mg ER Generic
Oxybutynin Chloride ER Tab 15 mg ER Generic
Oxybutynin Chloride ER Tab 5 mg ER Generic
Oxybutynin Chloride Syp 5 mg / 5 ml Generic
Oxybutynin Chloride Syp 5 mg / 5 ml Generic
Oxybutynin Chloride Tab 5 mg Generic
Oxybutynin Chloride Tab 5 mg Generic
Oxycodone HCL Con 20 mg / ml Generic
Oxycodone HCL Tab 5 mg Generic
Oxycodone / acetaminophen Tab 5-325 mg Generic
Oxytrol Dis 3.9 mg / 24 Brand
Pancrease MT 4 Cap 4 Brand
Pancrelipase 10000 Cap 10000 Brand
Pancrelipase 16000 Cap 16000 Brand
Pancrelipase 20000 Cap 20000 Brand
Pancrelipase 4500 Cap 4500 Brand
Pancrelipase Cap 5000 unit Brand
Pangestyme EC Cap Brand
Pangestyme Ul 12 Cap Brand
Pangestyme Ul 18 Cap Brand
Pangestyme Ul 20 Cap Brand
Pantoprazole Sodium Tab 20 mg Generic
Pantoprazole Sodium Tab 40 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 30 of 44
Product Brand or Generic?
Papaverine HCL CR Cap 150 mg CR Generic
Paragard Intrauterine Copper Contraceptive T380a IUD T380a Brand
Paregoric Tin 2 mg / 5 ml Generic
Paromomycin Sulfate Cap 250 mg Generic
Paroxetine HCL Tab 10 mg Generic
Paroxetine HCL Tab 20 mg Generic
Paroxetine HCL Tab 30 mg Generic
Paroxetine HCL Tab 40 mg Generic
Peg 3350 / electrolytes Sol Electrol Generic
Pegasys Inj Brand
Pegasys Kit Brand
Peg-intron Kit 120 mcg Brand
Peg-intron Kit 150 mcg Brand
Peg-intron Kit 80 mcg Brand
Peg-intron Redipen Pak 4 Kit 120 Rp Brand
Peg-intron Redipen Pak 4 Kit 150 Rp Brand
Peg-intron Redipen Pak 4 Kit 50 mcg Rp Brand
Peg-intron Redipen Pak 4 Kit 80 mcg Rp Brand
Penicillin V Potassium Sol 125 / 5 ml Generic
Penicillin V Potassium Sol 250 / 5 ml Generic
Penicillin V Potassium Tab 250 mg Generic
Penicillin V Potassium Tab 500 mg Generic
Penicilln VK Sol 125 / 5 ml Generic
Pentoxifylline ER Tab 400 mg ER Generic
Permethrin Cre 5% Generic
Perphenazine Tab 2 mg Generic
Perphenazine Tab 4 mg Generic
Perphenazine Tab 8 mg Generic
Phenobarbital Elx 20 mg / 5 ml Generic
Phenobarbital Tab 16.2 mg Generic
Phenobarbital Tab 32.4 mg Generic
Phenobarbital Tab 64.8 mg Brand
Phenobarbital Tab 97.2 mg Brand
Phenylephrine HCL Sol 10% Op Generic
Phenylephrine HCL Sol 2.5% Op Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 31 of 44
Product Brand or Generic?
Phenylhistine Expectorant Sol Expect Generic
Phenytoin Sodium Extended Cap 100 mg Generic
Phenytoin Sus 125 / 5 ml Generic
Phenytoin Sus 125 / 5 ml Generic
Phisohex Liq 3% Brand
Phoslo Cap 667 mg Brand
Phoslyra Sol Brand
Phospha 250 Neutral Tab Neutral Generic
Phospholine Iodide Sol 0.125%op Brand
Pilocarpine HCL Sol 0.5% Op Generic
Pilocarpine HCL Sol 1% Op Generic
Pilocarpine HCL Sol 2% Op Generic
Pilocarpine HCL Sol 3% Op Generic
Pilocarpine HCL Sol 4% Op Generic
Pilocarpine Hydrochloride Tab 5 mg Generic
Pilopine HS Gel 4% Op Brand
Plan B One-step Tab 1.5 mg Brand
Plan B One-step Tab 1.5 mg Brand
Plan B Tab 0.75 mg Brand
Plavix Tab 75 mg Brand
Plavix Tab 75 mg Brand
Poly-vitamin / fluoride Dro 0.25 mg Generic
Polyvitamin / fluoride Dro 0.5 mg / ml Generic
Potassium Chloride Liq 10% Generic
Potassium Citrate ER Tab 1080 mg Generic
Potassium Citrate ER Tab 540 mg Generic
Potassium Citrate / citric Acid Sol Citr Acd Generic
Pramipexole Dihydrochloride Tab 0.125 mg Generic
Pramipexole Dihydrochloride Tab 0.5 mg Generic
Pramipexole Dihydrochloride Tab 0.75 mg Generic
Pramosone Cre 1% Brand
Pramosone Cre 1-2.5% Brand
Pramosone Lot 1% Brand
Pramosone Lot 2.5% Brand
Pramosone Oin 1% Brand
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 32 of 44
Product Brand or Generic?
Pramosone Oin 2.5% Brand
Pravastatin Sodium Tab 10 mg Generic
Pravastatin Sodium Tab 20 mg Generic
Pravastatin Sodium Tab 40 mg Generic
Pravastatin Sodium Tab 80 mg Generic
Prazosin HCL Cap 1 mg Generic
Prazosin HCL Cap 2 mg Generic
Prazosin HCL Cap 5 mg Generic
Pred Mild Sus 0.12% Op Brand
Pred-g Sus Op Brand
Prednicarbate Cre 0.1% Generic
Prednisolone Acetate Sus 1% Op Generic
Prednisolone Sodium Phosphate Sol 15 mg / 5 ml Generic
Prednisone Pak 5 mg Generic
Prednisone Tab 10 mg Generic
Prednisone Tab 1 mg Generic
Prednisone Tab 2.5 mg Generic
Prednisone Tab 20 mg Generic
Prednisone Tab 50 mg Brand
Prednisone Tab 5 mg Generic
Premarin Cre 0.625 mg Brand
Prentif Cavity-rim Cervical Cap Mis 31 mm Brand
Prezista Tab 150 mg Brand
Prezista Tab 400 mg Brand
Prezista Tab 600 mg Brand
Prezista Tab 75 mg Brand
Primaquine Phosphate Tab 26.3 mg Brand
Primidone Tab 250 mg Generic
Primidone Tab 50 mg Generic
Proair HFA Aer Brand
Probenecid Tab 500 mg Generic
Probenecid / colchicine Tab 500-0.5 Generic
Prochlorperazine Maleate Tab 10 mg Generic
Prochlorperazine Maleate Tab 5 mg Generic
Prochlorperazine Sup 25 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 33 of 44
Product Brand or Generic?
Procrit Inj 10000 / ml Brand
Procrit Inj 2000 / ml Brand
Procrit Inj 20000 / ml Brand
Procrit Inj 3000 / ml Brand
Procrit Inj 4000 / ml Brand
Procrit Inj 40000 / ml Brand
Proctosol HC Cre 2.5% Generic
Prograf Cap 0.5 mg Brand
Prograf Cap 1 mg Brand
Prograf Cap 5 mg Brand
Promacta Tab 25 mg Brand
Promacta Tab 50 mg Brand
Promacta Tab 75 mg Brand
Promethazine HCL Plain Syp 6.25 / 5 ml Generic
Promethazine HCL Tab 25 mg Generic
Promethazine VC Plain Syp Plain Generic
Promethazine VC / codeine Syp Codeine Generic
Promethazine / codeine Syp 6.25-10 Generic
Promethazine / dextromethorphan Syp DM Generic
Promethegan Sup 12.5 mg Generic
Promethegan Sup 25 mg Generic
Propafenone HCL Tab 150 mg Generic
Propafenone HCL Tab 225 mg Generic
Propafenone HCL Tab 300 mg Generic
Propantheline Bromide Tab 15 mg Brand
Propranolol HCL Sol 40 mg / 5 ml Brand
Propranolol HCL Tab 10 mg Generic
Propranolol HCL Tab 20 mg Generic
Propranolol HCL Tab 40 mg Generic
Propranolol HCL Tab 80 mg Generic
Propylthiouracil Tab 50 mg Generic
Prostigmin Tab 15 mg Brand
Protonix Pak Brand
Protriptyline HCL Tab 10 mg Generic
Protriptyline HCL Tab 5 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 34 of 44
Product Brand or Generic?
Psoriatec Cre 1% Generic
Pulmicort Flexhaler Inh 180 mcg Brand
Pulmozyme Sol 1 mg / ml Brand
Pyrazinamide Tab 500 mg Generic
Pyridostigmine Bromide Tab 60 mg Generic
Quinidine Gluconate CR Tab 324 mg CR Generic
Quinidine Sulfate Tab 200 mg Generic
Qvar Aer 40 mcg Brand
Qvar Aer 80 mcg Brand
Ranitidine HCL Syp 75 mg / 5 ml Generic
Ranitidine HCL Tab 150 mg Generic
Ranitidine HCL Tab 300 mg Generic
Rapamune Sol 1 mg / ml Brand
Rapamune Tab 0.5 mg Brand
Rapamune Tab 1 mg Brand
Rebif Inj 22 / 0.5 Brand
Rebif Inj 44 / 0.5 Brand
Rebif Titration Pack Sol Pack Brand
Recombinate Inj 220-400 Brand
Recombinate Inj 401-800 Brand
Recombinate Inj 801-1240 Brand
Relenza Diskhaler Mis Diskhale Brand
Renvela Tab 800 mg Brand
Rescriptor Tab 100 Mg Brand
Rescriptor Tab 200 mg Brand
Retin-A Cre 0.025% Brand
Retin-A Cre 0.05% Brand
Retin-A Cre 0.1% Brand
Retin-A Gel 0.01% Brand
Retin-A Gel 0.025% Brand
Retin-A Micro Gel 0.1% Brand
Retrovir Syp 50 mg / 5 ml Brand
Revlimid Cap 10 mg Brand
Revlimid Cap 15 mg Brand
Revlimid Cap 25 mg Brand
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 35 of 44
Product Brand or Generic?
Revlimid Cap 5 mg Brand
Reyataz Cap 200 mg Brand
Reyataz Cap 300 mg Brand
Ribavirin Cap 200 mg Generic
Ridaura Cap 3 mg Brand
Rifamate Cap Brand
Rifampin Cap 300 mg Generic
Rilutek Tab 50 mg Brand
Rimantadine HCL Tab 100 mg Generic
Rimso-50 Sol 50% Brand
Rimso-50 Sol 50% Brand
Risperidone Sol 1 mg / ml Generic
Risperidone Tab 0.25 mg Generic
Risperidone Tab 0.5 mg Generic
Risperidone Tab 1 mg Generic
Risperidone Tab 2 mg Generic
Risperidone Tab 3 mg Generic
Risperidone Tab 4 mg Generic
Rms Sup 5 mg Brand
Rocaltrol Cap 0.25 mcg Brand
Rocaltrol Cap 0.5 mcg Brand
Ropinirole HCL Tab 0.25 mg Generic
Ropinirole HCL Tab 0.5 mg Generic
Ropinirole HCL Tab 1 mg Generic
Ropinirole HCL Tab 2 mg Generic
Ropinirole HCL Tab 3 mg Generic
Ropinirole HCL Tab 4 mg Generic
Ropinirole HCL Tab 5 mg Generic
Rosaderm Emu Cleanser Generic
Roxicet Sol 5-325 / 5 Brand
Salsalate Tab 500 mg Generic
Salsalate Tab 750 mg Generic
Sandimmune Cap 100 mg Brand
Sandimmune Cap 25 mg Brand
Sandostatin Inj 100 mcg Brand
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 36 of 44
Product Brand or Generic?
Sandostatin Inj 500 mcg Brand
Scopace Tab 0.4 mg Brand
Selegiline HCL Cap 5 mg Generic
Selegiline HCL Tab 5 mg Generic
Selenium Sulfide Sha 2.5% Generic
Selzentry Tab 150 mg Brand
Selzentry Tab 300 mg Brand
Serevent Diskus Aer 50 mcg Brand
Seroquel Tab 100 mg Brand
Seroquel Tab 200 mg Brand
Seroquel Tab 25 mg Brand
Seroquel Tab 300 mg Brand
Seroquel Tab 400 mg Brand
Seroquel Tab 50 mg Brand
Sertraline HCL Tab 100 mg Generic
Sertraline HCL Tab 25 mg Generic
Sertraline HCL Tab 50 mg Generic
Simvastatin Tab 20 mg Generic
Simvastatin Tab 40 mg Generic
Simvastatin Tab 80 mg Generic
Sodium Chloride Dey-pak Neb 10% Generic
Sodium Fluoride Chw 1.1 mg Generic
Sodium Fluoride Chw 2.2 mg Generic
Sodium Polystyrene Sulfonate Sus 15 gram / 60 Generic
Sodium Sulfacetamide Sol 10% Op Generic
Sodium Sulfacetamide / sulfur Lot 10-5% Generic
Sodium Sulfacetamide / sulfur Lot 10-5% Generic
Solu-cortef Inj 100 mg Brand
Solu-cortef Inj 250 mg Brand
Soriatane Cap 10 mg Brand
Soriatane Cap 25 mg Brand
Soriatane CK Kit 10 mg Brand
Soriatane CK Kit 25 mg Brand
Sotalol HCL Tab 120 mg Generic
Sotalol HCL Tab 160 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 37 of 44
Product Brand or Generic?
Sotalol HCL Tab 240 mg Generic
Sotalol HCL Tab 80 mg Generic
Sotret Cap 10 mg Generic
Sotret Cap 20 mg Generic
Sotret Cap 30 mg Generic
Sotret Cap 40 mg Generic
Spiriva Handihaler Cap Handihlr Brand
Spironolactone Tab 100 mg Generic
Spironolactone Tab 25 mg Generic
Spironolactone Tab 50 mg Generic
Spironolactone / hydrochlorothiazide Tab 25 / 25 Generic
Sprintec 28 Tab 28 Day Generic
Sprycel Tab 20 mg Brand
Sprycel Tab 50 mg Brand
Sprycel Tab 70 mg Brand
SSD Cre 1% Generic
SSKI Sol 1 gram / ml Brand
Stalevo 100 Tab Brand
Stalevo 125 Tab Brand
Stalevo 150 Tab Brand
Stalevo 200 Tab Brand
Stalevo 50 Tab Brand
Stalevo 75 Tab Brand
Stavudine Cap 15 mg Generic
Stavudine Cap 20 mg Generic
Stavudine Cap 30 mg Generic
Stavudine Cap 40 mg Generic
Sterile Water For Injection Inj Generic
Suboxone Sub 2-0.5 mg Brand
Suboxone Sub 8-2 mg Brand
Suclor Cap 8-120 CR Generic
Sucralfate Tab 1 gram Generic
Sulfacetamide Sodium / prednisolone Sodium Phosphate Sol Op Generic
Sulfadiazine Tab 500 mg Brand
Sulfamethoxazole / trimethoprim DS Tab 800-160 Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 38 of 44
Product Brand or Generic?
Sulfamethoxazole / trimethoprim Tab 400-80 mg Generic
Sulfasalazine Tab 500 mg DR Generic
Sulfatrim Sus 200-40 / 5 Generic
Sulfazine Tab 500 mg Generic
Sulindac Tab 150 mg Generic
Sulindac Tab 200 mg Generic
Sumatriptan Spr 20 mg / act Brand
Sumatriptan Succinate Inj 6 mg / 0.5 Generic
Sumatriptan Succinate Inj 6 mg / 0.5 Generic
Sumatriptan Succinate Refill Inj 6 mg / 0.5 Generic
Sumatriptan Succinate Tab 100 mg Generic
Sumatriptan Succinate Tab 25 mg Generic
Sumatriptan Succinate Tab 50 mg Generic
Suprax Tab 400 mg Brand
Sustiva Cap 200 mg Brand
Sustiva Tab 600 mg Brand
Sutent Cap 12.5 mg Brand
Sutent Cap 12.5 mg Brand
Sutent Cap 25 mg Brand
Sutent Cap 50 mg Brand
Synarel Sol 2 mg / ml Brand
Tabloid Tab 40 mg Brand
Tacrolimus Cap 0.5 mg Generic
Tacrolimus Cap 1 mg Generic
Tacrolimus Cap 5 mg Generic
Tamiflu Cap 75 mg Brand
Tamiflu Sus 12 mg / ml Brand
Tamiflu Sus 6 mg / ml Brand
Tamoxifen Citrate Tab 10 mg Generic
Tamoxifen Citrate Tab 20 mg Generic
Tamsulosin HCL Cap 0.4 mg Generic
Tannate Pediatric Sus Generic
Tarceva Tab 100 mg Brand
Tarceva Tab 150 mg Brand
Tarceva Tab 25 mg Brand
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 39 of 44
Product Brand or Generic?
Tazorac Cre 0.05% Brand
Tazorac Cre 0.1% Brand
Tazorac Gel 0.05% Brand
Tazorac Gel 0.1% Brand
Tegretol-XR Tab 100 mg Brand
Temazepam Cap 15 mg Generic
Temazepam Cap 30 mg Generic
Temazepam Cap 30 mg Generic
Temodar Cap 100 mg Brand
Temodar Cap 100 mg Brand
Temodar Cap 140 mg Brand
Temodar Cap 140 mg Brand
Temodar Cap 180 mg Brand
Temodar Cap 180 mg Brand
Temodar Cap 20 mg Brand
Temodar Cap 20 mg Brand
Temodar Cap 250 mg Brand
Temodar Cap 5 mg Brand
Temodar Cap 5 mg Brand
Terazosin HCL Cap 10 mg Generic
Terazosin HCL Cap 1 mg Generic
Terazosin HCL Cap 2 mg Generic
Terazosin HCL Cap 5 mg Generic
Terbutaline Sulfate Tab 2.5 mg Generic
Terbutaline Sulfate Tab 5 mg Generic
Testosterone Cypionate Inj 100 mg / ml Generic
Testosterone Cypionate Inj 200 mg / ml Generic
Testosterone Enanthate Inj 200 mg / ml Generic
Tetracycline HCL Cap 250 mg Generic
Tetracycline HCL Cap 500 mg Generic
Theophylline ER Tab 100 mg ER Generic
Theophylline ER Tab 200 mg ER Generic
Theophylline ER Tab 300 mg ER Generic
Thiothixene Cap 10 mg Generic
Thiothixene Cap 1 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 40 of 44
Product Brand or Generic?
Thiothixene Cap 2 mg Generic
Thiothixene Cap 5 mg Generic
Tikosyn Cap 125 mcg Brand
Tikosyn Cap 250 mcg Brand
Tikosyn Cap 500 mcg Brand
Timolol Maleate Sol 0.25% Op Generic
Timolol Maleate Sol 0.5% Op Generic
Tizanidine HCL Tab 4 mg Generic
Tobi Neb 300 / 5 ml Brand
Tobramycin Sulfate Sol 0.3% Op Generic
Tolbutamide Tab 500 mg Brand
Topiramate Cap 15 mg Generic
Topiramate Cap 25 mg Generic
Topiramate Tab 100 mg Generic
Topiramate Tab 200 mg Generic
Topiramate Tab 25 mg Generic
Topiramate Tab 50 mg Generic
Tracleer Tab 125 mg Brand
Tracleer Tab 62.5 mg Brand
Tramadol HCL Tab 50 mg Generic
Transderm-scop Dis 1.5 mg Brand
Tranylcypromine Sulfate Tab 10 mg Generic
Trazodone HCL Tab 100 mg Generic
Trazodone HCL Tab 50 mg Generic
Trecator Tab 250 mg Brand
Tretinoin Cap 10 mg Brand
Triamcinolon Cre 0.025% Generic
Triamcinolone Acetonide Cre 0.025% Generic
Triamcinolone Acetonide Cre 0.1% Generic
Triamcinolone Acetonide Oin 0.025% Generic
Triamcinolone Acetonide Oin 0.025% Generic
Triamcinolone Acetonide Oin 0.1% Generic
Triamcinolone In Orabase Pst 0.1% Generic
Triamterene / hydrochlorothiazide Tab 37.5-25 Generic
Triamterene / hydrochlorothiazide Tab 75-50 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 41 of 44
Product Brand or Generic?
Trifluoperazine HCL Tab 10 mg Generic
Trifluoperazine HCL Tab 1 mg Generic
Trifluoperazine HCL Tab 2 mg Generic
Trifluoperazine HCL Tab 5 mg Generic
Trifluridine Sol 1% Op Generic
Trihexyphenidyl HCL Tab 2 mg Generic
Trihexyphenidyl HCL Tab 5 mg Generic
Trileptal Sus 300 mg / 5 ml Brand
Trimethobenzamide HCL Cap 300 mg Generic
Trimethoprim Sulfate / polymyxin B Sulfate Sol Polymyxn Generic
Trimethoprim Tab 100 mg Generic
Tri-sprintec Tab Generic
Tri-vitamin / fluoride Dro 0.25 mg Generic
Tri-vitamin / fluoride Dro 0.25 mg Generic
Tri-vitamin / fluoride Dro 0.5 mg Generic
Tri-vitamin / fluoride Dro 0.5 mg Generic
Tri-vitamin / iron / fluoride Dro / fl 0.25 Generic
Trivora-28 Tab Generic
Trizivir Tab Brand
Trospium Chloride Tab 20 mg Generic
Truvada Tab Brand
Tykerb Tab 250 mg Brand
Ultrase MT 12 Cap Brand
Ultrase MT 18 Cap Brand
Ultrase MT 20 Cap Brand
Ursodiol Cap 300 mg Generic
Valcyte Sol 50 mg / ml Brand
Valcyte Tab 450 mg Brand
Valproic Acid Cap 250 mg Generic
Valproic Acid Syp 250 / 5 ml Generic
Vancocin HCL Cap 125 mg Brand
Vancomycin HCL Cap 125 mg Generic
Vancomycin HCL Cap 250 mg Generic
Vectical Oin 3 mcg / gram Brand
Velcade Inj 3.5 mg Brand
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 42 of 44
Product Brand or Generic?
Venlafaxine HCL ER Cap 150 mg ER Generic
Venlafaxine HCL ER Cap 37.5 mg Generic
Venlafaxine HCL ER Cap 75 mg ER Generic
Venlafaxine HCL Tab 100 mg Generic
Venlafaxine HCL Tab 25 mg Generic
Venlafaxine HCL Tab 37.5 mg Generic
Venlafaxine HCL Tab 50 mg Generic
Venlafaxine HCL Tab 75 mg Generic
Venofer Inj 20 mg / ml Brand
Verapamil HCL ER Tab 180 mg ER Generic
Verapamil HCL ER Tab 240 mg ER Generic
Verapamil HCL Tab 120 mg Generic
Verapamil HCL Tab 80 mg Generic
Vfend Tab 200 mg Brand
Vfend Tab 50 mg Brand
Videx EC Cap 125 mg Brand
Viracept Pow 50 mg / gram Brand
Viracept Tab 250 mg Brand
Viracept Tab 625 mg Brand
Viramune Tab 200 mg Brand
Viramune XR Tab Brand
Viread Tab 300 mg Brand
Visudyne Inj 15 mg Brand
Vitamin D Cap 50000 unit Generic
Vivotif Berna Cap EC Brand
Votrient Tab 200 mg Brand
Warfarin Sodium Tab 10 mg Generic
Warfarin Sodium Tab 1 mg Generic
Warfarin Sodium Tab 2.5 mg Generic
Warfarin Sodium Tab 2.5 mg Generic
Warfarin Sodium Tab 2 mg Generic
Warfarin Sodium Tab 3 mg Generic
Warfarin Sodium Tab 4 mg Generic
Warfarin Sodium Tab 5 mg Generic
Warfarin Sodium Tab 6 mg Generic
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 43 of 44
Product Brand or Generic?
Warfarin Sodium Tab 7.5 mg Generic
Xalkori Cap 200 mg Brand
Xalkori Cap 250 mg Brand
Xarelto Tab 10 mg Brand
Xeloda Tab 150 mg Brand
Xeloda Tab 500 mg Brand
Xenaderm Oin Brand
Xerac AC Sol 6.25% Brand
Yasmin 28 Tab 3-0.03 mg Brand
Yodoxin Tab 650 mg Brand
Zelboraf Tab 240 mg Brand
Zenpep Cap 10000 unit Brand
Zenpep Cap 15000 unit Brand
Zenpep Cap 20000 unit Brand
Ziagen Sol 20 mg / ml Brand
Ziagen Tab 300 mg Brand
Zidovudine Cap 100 mg Generic
Zidovudine Tab 300 mg Generic
Zolpidem Tartrate Tab 10 mg Generic
Zolpidem Tartrate Tab 5 mg Generic
Zonisamide Cap 100 mg Generic
Zonisamide Cap 25 mg Generic
Zonisamide Cap 50 mg Generic
Zortress Tab 0.25 mg Brand
Zortress Tab 0.5 mg Brand
Zortress Tab 0.75 mg Brand
Zovia 1 / 35e Tab Generic
Zovia 1 / 50e Tab Brand
Zymar Dro 0.3% Brand
Zymaxid Sol 0.5% Brand
Zyprexa Tab 10 mg Brand
Zyprexa Tab 15 mg Brand
Zyprexa Tab 2.5 mg Brand
Zyprexa Tab 20 mg Brand
Zyprexa Tab 5 mg Brand
7/17/2012 Kaiser Permanente Northwest Region
Preferred Product Formulary List
Page 44 of 44
Product Brand or Generic?
Zyprexa Tab 7.5 mg Brand
Zytiga Tab 250 mg Brand
Zyvox Sus 100 mg / 5 ml Brand
Zyvox Tab 600 mg Brand