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Drug Therapy Guidelines

Our prescription drug and medical injectable policies promote safe and effective use by helping physicians select the drug product(s) considered most beneficial to their patients. In order to ensure thorough consideration of both quality-of-care and economic issues, some drugs require prior authorization to be covered under a member's prescription drug or medical benefit. We work with a committee of local physicians and pharmacists to identify medications that should require prior authorization and to develop the medical criteria used to determine when coverage for these agents is appropriate.

Prior authorization is required for injectable medications, including self-administered injectable medications except insulin, glucagon, self-administered epinephrine and injectable chemotherapeutic agents when not available in a physician's office. The following is a complete list of medications requiring prior authorization and their committee-approved criteria.

A

  • pdf icon Abbreviated Criteria Abbreviated Criteria: Carbaglu, Dificid, Gralise, Hetlioz, Jetrea, Kanuma, Keveyis, Mulpleta, Nuedexta, Nuplazid, Panretin, Strensiq, Sylvant, Syprine, Xatmep, Xuriden
  • pdf icon Abecma Abecma™ (idecabtagene vicleucel)
  • pdf icon Abiraterone Abiraterone acetate (abiraterone acetate, Zytiga™, Yonsa®)
  • pdf icon Abraxane Abraxane® (paclitaxel protein-bound particles)
  • pdf icon Actemra Actemra® (tocilizumab)
  • pdf icon Actimmune Actimmune® (interferon gamma 1b)
  • pdf icon Adakveo Adakveo® (crizanlizumab-tmca)
  • pdf icon Adalimumab Adalimumab (Hadlima™ [adalimumab-bwwd], Hulio® [adalimumab-fkjp], Humira® [adalimumab], Hyrimoz™ [adalimumab-adaz])
  • pdf icon Adbry Adbry (tralokinumab-ldrm)
  • pdf icon Adcetris Adcetris™ (brentuximab vedotin)
  • pdf icon Additional Quantities of COVID-19 Oral Therapies Additional Quantities of COVID-19 Oral Therapies (Paxlovid [nirmatrelvir; ritonavir], Molnupiravir)
  • pdf icon Addyi Addyi™ (flibanserin)
  • pdf icon Aduhelm Aduhelm™ (aducanumab-avwa)
  • pdf icon Afrezza Afrezza® (insulin human)
  • pdf icon Alecensa Alecensa® (alectinib)
  • pdf icon Aliqopa Aliqopa™ (copanlisib)
  • pdf icon Alpha-1 Proteinase Inhibitors (Human) Alpha-1 Proteinase Inhibitors (Human): Aralast NP, Glassia, Prolastin-C®, Zemaira®
  • pdf icon Alunbrig Alunbrig™ (brigatinib)
  • pdf icon Amantadine ER Amantadine ER (Gocovri®, Osmolex ER™)
  • pdf icon Amifampridine Amifampridine (Firdapse®, Ruzurgi)
  • pdf icon Ampyra Ampyra® (dalfampridine)
  • pdf icon Antiemetic Agents Antiemetic Agents: Zofran®/ODT® (ondansetron/ondansetron ODT/ondansetron oral solution), Zuplenz® (ondansetron oral film), granisetron, Sancuso® (granisetron topical), Anzemet® (dolasetron), Emend® (aprepitant), aprepitant, Akynzeo® (netupitant/palonosetron), Varubi® (rolapitant)
  • pdf icon Apokyn Apokyn® (Apomorphine)
  • pdf icon Appetite Suppressants Appetite Suppressants (Anorexiants) & Weight Loss Agents: Adipex-P®, Suprenza®, Xenical®, Qsymia®, Contrave®, Lomaira™, Saxenda®, Wegovy™
  • pdf icon Arcalyst Arcalyst® (rilonacept)
  • pdf icon Arzerra Arzerra® (ofatumumab)
  • pdf icon Asparagine Specific Enzymes Asparagine Specific Enzymes: Asparlas™ (calaspargase pegol-mknl), Oncaspar® (pegaspargase), Rylaze™ (asparaginase erwinia chrysanthemi [recombinant]-rywn)
  • pdf icon Aspruzyo Sprinkle Aspruzyo Sprinkle (ranolazine)
  • pdf icon Aubagio Aubagio® (teriflunomide)
  • pdf icon Austedo Austedo® (deutetrabenazine)
  • pdf icon Ayvakit Ayvakit (avapritinib)
  • pdf icon Azacitidine Azacitidine Intravenous: Vidaza® (azacitidine), azacitidine Oral: Onureg® (azacitidine)

B, C, D

  • pdf icon Bafiertam Bafiertam™ (monomethyl fumarate)
  • pdf icon Balversa Balversa™ (erdafitinib)
  • pdf icon Bavencio Bavencio® (avelumab)
  • pdf icon Beleodaq Beleodaq® (belinostat)
  • pdf icon Bempedoic Acid Bempedoic Acid (Nexletol [bempedoic acid], Nexlizet [bempedoic acid, ezetimibe])
  • pdf icon Benlysta Benlysta® (belimumab)
  • pdf icon Beovu Beovu® (brolucizumab-dbll)
  • pdf icon Besponsa Besponsa™ (inotuzumab ozogamicin)
  • pdf icon Besremi Besremi (ropeginterferon alfa-2b-njft)
  • pdf icon Bevacizumab Bevacizumab (Avastin® [bevacizumab], Mvasi® [bevacizumab-awwb], Zirabev™ [bevacizumab-bvzr])
  • pdf icon Blenrep Blenrep™ (belantamab mafodotin-blmf)
  • pdf icon Blincyto Blincyto® (blinatumomab)
  • pdf icon Bonsity Bonsity (teriparatide)
  • pdf icon Bortezumib Bortezomib (bortezomib, Velcade® [bortezomib])
  • pdf icon Bosulif Bosulif® (bosutinib)
  • pdf icon Botulinum Toxins Botulinum Toxins: Botox® (onabotulinumtoxinA), Dysport™ (abobotulinumtoxinA), Myobloc® (rimabotulinumtoxinB), Xeomin® (incobotulinumtoxinA)
  • pdf icon Braftovi Braftovi™ (encorafenib)
  • pdf icon Brexafemme Brexafemme® (ibrexafungerp)
  • pdf icon Breyanzi Breyanzi® (lisocabtagene)
  • pdf icon Brineura Brineura™ (cerliponase alfa)
  • pdf icon Brukinsa Brukinsa™ (zanubrutinib)
  • pdf icon Bylvay Bylvay (odevixibat)
  • pdf icon Cablivi Cablivi® (caplacizumab-yhdp)
  • pdf icon Cabometyx Cabometyx® (cabozantinib)
  • pdf icon Calcitonin Gene-Related Peptide (CGRP) Antagonists Calcitonin Gene-Related Peptide (CGRP) Antagonists: Aimovig™ (erenumab-aooe), Ajovy™ (fremanezumab-vfrm), Emgality™ (galcanezumab-gnlm), Vyepti™ (eptinezumab-jjmr), Nurtec ODT (rimegepant), Ubrelvy (ubrogepant), Qulipta (atogepant)
  • pdf icon Calquence Calquence ® (acalabrutinib)
  • pdf icon Cambia Cambia™ (diclofenac potassium for oral solution)
  • pdf icon Caprelsa Caprelsa® (vandetanib)
  • pdf icon Chenodal Chenodal™ (chenodiol)
  • pdf icon Cholbam Cholbam® (cholic acid)
  • pdf icon Cibinqo Cibinqo (abrocitinib)
  • pdf icon Cimzia Cimzia® (certolizumab pegol)
  • pdf icon Cinqair Cinqair® (reslizumab)
  • pdf icon Colony Stimulating Factors - Filgrastim Agents Colony Stimulating Factors (CSFs): Filgrastim Agents Granix® (Tbo-filgrastim), Neupogen® (filgrastim), Nivestym™ (filgrastim-aafi)
  • pdf icon Colony Stimulating Factors - Pegfilgrastim Agents Colony Stimulating Factors (CSFs): Neulasta (pegfilgrastim), Udenyca (pegfilgrastim-cbqv), Nyvepria (pegfilgrastim-apgf), Ziextenzo (pegfilgrastim-bmez), Fulphila (pegfilgrastim-jmdb)
  • pdf icon Cometriq Cometriq® (cabozantinib)
  • pdf icon Compounded Medications Compounded Medications
  • pdf icon Copiktra Copiktra™ (duvelisib)
  • pdf icon Corlanor Corlanor® (ivabradine)
  • pdf icon Corticotropin Products Corticotropin Products - H.P. Acthar Gel (repository corticotropin), Purified Cortrophin gel (repository corticotropin)
  • pdf icon Cosela Cosela™ (trilaciclib)
  • pdf icon Cosentyx Cosentyx® (secukinumab)
  • pdf icon Cotellic Cotellic™ (cobimetinib)
  • pdf icon Crysvita Crysvita® (burosumab-twza)
  • pdf icon Cyramza Cyramza® (ramucirumab)
  • pdf icon Dacogen Dacogen® (decitabine), decitabine
  • pdf icon Daklinza Daklinza™ (daclatasvir)
  • pdf icon Danyelza Danyelza® (naxitamab-gqgk)
  • pdf icon Dartisla ODT Dartisla ODT (glycopyrrolate orally disintegrating tablets)
  • pdf icon Darzalex Darzalex™ (daratumumab), Darzalex Faspro™ (daratumumab and hyaluronidase-fihj)
  • pdf icon Daurismo Daurismo™ (glasdegib)
  • pdf icon Dermatologic Agents Dermatologic Agents: Tazorac®, Fabior™, tretinoin(Avita®, Retin-A®, Retin-A Micro®, Atralin®, Tretin-X®)
  • pdf icon Desmopressin acetate Desmopressin acetate (Nocdurna®, Noctiva™)
  • pdf icon Diacomit Diacomit® (stiripentol)
  • pdf icon Dojolvi Dojolvi™ (triheptanoin)
  • pdf icon Doptelet Doptelet® (avatrombopag)
  • pdf icon Doxepin cream Doxepin cream: doxepin 5% cream, Prudoxin™, Zonalon®
  • pdf icon Duopa Duopa™ (carbidopa/levodopa enteral suspension)
  • pdf icon Dupixent Dupixent® (dupilumab)
  • pdf icon Durysta Durysta™ (bimatoprost) intracameral implant

E, F, G

  • pdf icon Egrifta SV Egrifta SV™ (tesamorelin)
  • pdf icon Elaprase Elaprase® (idursulfase)
  • pdf icon Elzonris Elzonris™ (tagraxofusp-erzs)
  • pdf icon Emflaza Emflaza™ (deflazacort)
  • pdf icon Empaveli Empaveli™ (pegcetacoplan)
  • pdf icon Empliciti Empliciti™ (elotuzumab)
  • pdf icon Endari Endari™ (L-glutamine)
  • pdf icon Enhertu Enhertu® (fam-trastuzumab deruxtecan-nxki)
  • pdf icon Enspryng Enspryng™ (satralizumab-mwge)
  • pdf icon Entadfi Entadfi (finasteride/tadalafil)
  • pdf icon Entyvio Entyvio® (vedolizumab)
  • pdf icon Epaned Epaned® (enalapril powder for oral solution)
  • pdf icon Epclusa Epclusa™ (sofosbuvir and velpatasvir); Sofosbuvir/Velpatasvir (authorized generic)
  • pdf icon Epidiolex Epidiolex® (cannabidiol)
  • pdf icon Eprontia Eprontia (topiramate oral solution)
  • pdf icon Erbitux Erbitux® (cetuximab)
  • pdf icon Erectile Dysfunction (ED) Agents Erectile Dysfunction (ED) Agents: Cialis® (tadalafil), tadalafil, Levitra® (vardenafil), vardenafil, Viagra® (sildenafil), sildenafil, Caverject® (alprostadil), Edex® (alprostadil), Muse® (alprostadil), Staxyn® (vardenafil), Stendra™ (avanafil)
  • pdf icon Ergot Alkaloids Ergot Alkaloids: dihydroergotamine mesylate, Migranal (dihydroergotamine mesylate)
  • pdf icon Erivedge Erivedge® (vismodegib)
  • pdf icon Erleada Erleada™ (apalutamide)
  • pdf icon Erythropoetin Stimulating Agents Erythropoiesis-Stimulating Agents (ESAs): Epogen (epoetin alfa)
  • pdf icon Esbriet Esbriet® (pirfenidone)
  • pdf icon Etanercept Etanercept (Enbrel® [etanercept], Eticovo [etanercept-ykro])
  • pdf icon Evenity Evenity™ (romosozumab-aqqg)
  • pdf icon Everolimus Everolimus (Afinitor® [everolimus], Afinitor DISPERZ® [everolimus], everolimus)
  • pdf icon Evkeeza Evkeeza™ (evinacumab-dgnb)
  • pdf icon Evrysdi Evrysdi™ (risdiplam)
  • pdf icon Exkivity Exkivity™ (mobocertinib)
  • pdf icon Exon Skipping Therapies for Duchenne Muscular Dystrophy Exon Skipping Therapies for Duchenne Muscular Dystrophy - Exondys 51™ (eteplirsen), Vyondys 53™ (golodirsen), Viltepso® (viltolarsen), Amondys 45™ (casimersen)
  • pdf icon Fabrazyme Fabrazyme® (agalsidase beta)
  • pdf icon Farydak Farydak® (panobinostat)
  • pdf icon Fasenra Fasenra™ (benralizumab)
  • pdf icon Ferriprox Ferriprox® (deferiprone)
  • pdf icon Fertility Medications Bravelle®, Cetrotide®, Clomid**, clomiphene**, Follistim AQ®, Ganirelix®, Gonal-F®, human chorionic gonadotropin, leuprolide, Menopur®, Novarel®, Ovidrel®, Pregnyl®, progesterone in oil
  • pdf icon Fintepla Fintepla® (fenfluramine)
  • pdf icon Firdapse Firdapse® (amifampridine)
  • pdf icon Forteo Forteo® (teriparatide)
  • pdf icon Fotivda Fotivda® (tivozanib)
  • pdf icon Galafold Galafold™(migalastat)
  • pdf icon Gamifant Gamifant™ (emapalumab-lzsg)
  • pdf icon Gattex Gattex® (teduglutide [rDNA origin])
  • pdf icon Gaucher’s Disease Agents Gaucher’s Disease Agents: Cerdelga® (eliglustat), Cerezyme® (imiglucerase), Elelyso® (taliglucerase alfa), Vpriv (velaglucerase alfa), Zavesca® (miglustat), miglustat
  • pdf icon Gavreto Gavreto™ (pralsetinib)
  • pdf icon Gazyva Gazyva® (obinutuzumab)
  • pdf icon Gilenya Gilenya™ (fingolimod)
  • pdf icon Gilotrif Gilotrif® (afatinib)
  • pdf icon Givlaari Givlaari™ (givosiran)
  • pdf icon Glassia Glassia [Alpha-1 Proteinase Inhibitor (Human), Intravenous]
  • pdf icon Gleevec Gleevec® imatinib
  • pdf icon Global Authorization Policy
  • pdf icon Gonadotropin-Releasing Hormone Agonists Gonadotropin-Releasing Hormone Agonists- Fensolvi® (leuprolide acetate), Camcevi, Lupaneta® (leuprolide, norethindrone pack), Lupron-Depot®, Lupron Depot-Ped®, Triptodur™ (triptorelin), Synarel® (nafarelin acetate)
  • pdf icon Grastek Grastek® (Timothy Grass Pollen Allergen Extract)
  • pdf icon Growth Stimulating Drugs Growth Stimulating Drugs: Norditropin Flexpro®, Genotropin®, Humatrope®, Omnitrope®, Nutropin®, Saizen®, Serostim®, Skytrofa™, Sogroya®, Zomacton™, Zorbtive® (somatropin, recombinant growth hormone)

H

  • pdf icon Halaven Halaven™ (eribulin mesylate)
  • pdf icon Harvoni Harvoni® (ledipasvir and sofosbuvir); Ledipasvir and Sofosbuvir (authorized generic)
  • pdf icon Hemlibra Hemlibra® (emicizumab-kxwh)
  • pdf icon Hepatitis C Antivirals Pegasys®,Peg-Intron®, ribavirin, Ribasphere®, Ribasphere Ribapak®, Rebetol®, Intron-A®
  • pdf icon Hereditary Angioedema (HAE) Agents Hereditary Angioedema (HAE) Agents: Berinert® (C1 esterase inhibitor [human]), Cinryze® (C1 esterase inhibitor [human]), Haegarda® (C1 esterase inhibitor [human]), icatibant Kalbitor® (ecallantide), Firazyr® (icatibant), Ruconest® (C1 esterase inhibitor [recombinant]), Sajazir (icatibant), Takhzyro™ (lanadelumab-flyo), Orladeyo™ (berotralstat)
  • pdf icon Hetlioz Hetlioz® (tasimelteon)
  • pdf icon Horizant Horizant® (gabapentin enacarbil ER)

I, J

  • pdf icon Ibrance Ibrance® (palbociclib)
  • pdf icon Iclusig Iclusig® (ponatinib)
  • pdf icon Idhifa Idhifa® (enasidenib)
  • pdf icon Ilaris Ilaris® (canakinumab)
  • pdf icon Ilumya Ilumya™ (tildrakizumab-asmn)
  • pdf icon Imbruvica Imbruvica® (ibrutinib)
  • pdf icon Imcivree Imcivree™ (setmelanotide)
  • pdf icon Imfinzi Imfinzi (durvalumab)
  • pdf icon Imlygic Imlygic™ (talimogene laherparepvec)
  • pdf icon Immune Globulin Intravenous: Asceniv, BIVIGam®, Carimune® NF, Flebogamma® DIF, Gammagard®, Gammagard® S/D, Gammaked®, Gammaplex®, Gamunex-C®, Octagam®, Panzyga, Privigen® Subcutaneous: Cutaquig®, Cuvitru™, Gammagard®, Gammaked®, Gamunex-C®, Hizentra®, HyQvia®, Xembify
  • pdf icon Impoyz Impoyz™ (clobetasol propionate)
  • pdf icon Inbrija Inbrija™ (levodopa) oral inhalation powder
  • pdf icon Increlex Increlex® (mecasermin)
  •  icon Infliximab Remicade [infliximab], Avsola [infliximab-axxq], Inflectra [infliximab-dyyb], Renflexis [infliximab-abda])
  • pdf icon Ingrezza Ingrezza™ (valbenazine)
  • pdf icon Inlyta Inlyta® (axitinib)
  • pdf icon Inqovi Inqovi® (decitabine and cedazuridine)
  • pdf icon Inrebic Inrebic® (fedratinib)
  • pdf icon Intravitreal Corticosteroid Implants Intravitreal Corticosteroid Implants: Iluvien® (fluocinolone acetonide)
  • pdf icon Iressa Iressa® (gefitinib)
  • pdf icon Istodax Istodax® (romidepsin), romidepsin
  • pdf icon Isturisa Isturisa® (osilodrostat)
  • pdf icon Jakafi Jakafi® (ruxolitinib)
  • pdf icon Jelmyto Jelmyto™ (mitomycin)
  • pdf icon Jemperli Jemperli (dostarlimab-gxly)
  • pdf icon Jevtana Jevtana® (cabazitaxel)
  • pdf icon Juxtapid Juxtapid™ (lomitapide)
  • pdf icon Jynarque Jynarque™ (tolvaptan)

K, L

M, N, O

P, Q

  • pdf icon Padcev Padcev™ (enfortumab vedotin-ejfv)
  • pdf icon Palforzia Palforzia (Peanut [Arachis hypogaea] Allergen Powder-dnfp)
  • pdf icon Palynziq Palynziq® (pegvaliase-pqpz)
  • pdf icon PCSK9 Inhibitors PCSK9 Inhibitors: Praluent™, Repatha™
  • pdf icon Pemazyre Pemazyre™ (pemigatinib)
  • pdf icon Penicillamine Therapy Penicillamine Therapy – Cuprimine®, Depen®, penicillamine
  • pdf icon Pepaxto Pepaxto® (melphalan flufenamide)
  • pdf icon Perjeta Perjeta™ (pertuzumab)
  • pdf icon Phesgo Phesgo™ (pertuzumab, trastuzumab, and hyaluronidase-zzxf)
  • pdf icon Piqray Piqray® (alepelisib)
  • pdf icon Polivy Polivy™ (polatuzumab vedotin-piiq)
  • pdf icon Pomalyst Pomalyst® (pomalidomide)
  • pdf icon Ponvory Ponvory™ (ponesimod)
  • pdf icon Portrazza Portrazza® (necitumumab)
  • pdf icon Poteligeo Poteligeo® (mogamulizumab-kpkc)
  • pdf icon Preferred Drug Step Therapy Angiotensin Receptor Blockers (ARBs); Antipsychotics, 2nd generation; BPH (alpha-antagonists); Beta Agonist Inhalers; Calcipotriene Agents; Carbinoxamine, ; CNS Stimulants; Conjupri; Consensi; Constipation Agents; Desvenlafaxine; DPP-4 Inhibitors; Drizalma Sprinkle; Duexis; Duobrii; Elyxyb; Epaned; Epinephrine Products; Fenofibrates; Hemady; Impeklo, Incretin Mimetics; Inhaled Combinations; Inhaled Corticosteroids; Insulin; Insulin, Basal; Intranasal Steroids; Katerzia; Metformin ER Products; Muscle Relaxants, Select Non-Steroidal Anti-Inflammatory Drugs (NSAIDs); Niacin IR; Niacin ER; Osteoporosis Agents; Ozobax; Pancreatic Enzymes; Pizensy; Prexxartan, Prostaglandin Analogs; Proton Pump Inhibitors (PPIs); Qbrelis; Rayos (prednisone delayed-release); Renin Inhibitors; Rho Kinase Inhibitors; Riluzole; Selective Serotonin Reuptake Inhibitors (SSRIs); Sympazan; Test Strips for Blood Glucose; Testosterone Replacements; Select Tetracyclines; Topical Antifungals; Topical Dermatologics; Urinary Agents; Verzacloz; Vimovo; Yupelri
  • pdf icon Prevymis Prevymis™ (letermovir)
  • pdf icon Procysbi Procysbi® (cysteamine bitartrate delayed release capsules)
  • pdf icon Promacta Promacta® (eltrombopag)
  • pdf icon Provenge Provenge® (sipuleucel-T)
  • pdf icon Pyrukynd Pyrukynd (mitapivat)
  • pdf icon Pulmonary Arterial Hypertension (PAH) Agents Pulmonary Arterial Hypertension (PAH) Agents: Revatio™ (sildenafil), Ventavis® (iloprost), Tracleer®(bosentan), Letairis™ (ambrisentan), Adcirca®(tadalafil), Tyvaso® (treprostinil), Remodulin®(treprostinil), Flolan®/Veletri® (epoprostenol),Adempas® (riociguat), Opsumit® (macitentan),Orenitram® (treprostinil), Uptravi® (selexipag), Alyq (tadalafil)
  • pdf icon Qbrelis Qbrelis™ (lisinopril oral solution)
  • pdf icon Qbrexza Qbrexza™ (glycopyrronium 2.4% cloth)
  • pdf icon Qinlock Qinlock™ (ripretinib)
  • pdf icon Qutenza Qutenza® (8% capsaicin patch)

R, S

  • pdf icon Radicava Radicava® (edaravone)
  • pdf icon Ragwitek Ragwitek® (Short Ragweed Pollen Allergen Extract)
  • pdf icon Ravicti Ravicti™ (glycerol phenylbutyrate)
  • pdf icon Reblozyl Reblozyl® (luspatercept-aamt)
  • pdf icon Recorlev Recorlev (levoketoconazole)
  • pdf icon Relistor Relistor® (methylnaltrexone bromide)
  • pdf icon Retevmo Retevmo™ (selpercatinib)
  • pdf icon Revcovi Revcovi™ (elapegademase-lvlr)
  • pdf icon Revlimid Revlimid® (lenalidomide)
  • pdf icon Reyvow Reyvow™ (lasmiditan)
  • pdf icon Rezurock Rezurock™ (belumosudil)
  • pdf icon Rinvoq Rinvoq™ (upadacitinib)
  • pdf icon Rituximab Rituximab (Rituxan® [rituximab], Rituxan Hycela® [rituximab/hyaluronidase human, recombinant], Ruxience™ [rituximab-pvvr], Truxima® [rituximab-abbs])
  • pdf icon Rozlytrek Rozlytrek™ (entrectinib)
  • pdf icon Rubraca Rubraca® (rucaparib)
  • pdf icon Rybrevant Rybrevant™ (amivantamab-vmjw)
  • pdf icon Rydapt Rydapt® (midostaurin)
  • pdf icon Ryplazim Ryplazim® (plasminogen, human-tvmh)
  • pdf icon Samsca Samsca® (tolvaptan)
  • pdf icon Saphnelo Saphnelo™ (anifrolumab-Fnia)
  • pdf icon Sarclisa Sarclisa® (isatuximab-irfc)
  • pdf icon Scemblix Scemblix® (asciminib)
  • pdf icon Scenesse Scenesse® (afamelanotide)
  • pdf icon Sedative Hypnotics Sedative Hypnotics: zolpidem, Ambien®, zolpidem CR, Ambien CR®, zaleplon, Sonata®, DayvigoTM, Lunesta®, Rozerem®, ramelteon, EdluarTM, ZolpimistTM, doxepin (generic Silenor®), Silenor®, Intermezzo®/zolpidem SL, Belsomra®
  • pdf icon Signifor Signifor®, Signifor® LAR (pasireotide)
  • pdf icon Siliq Siliq™ (brodalumab)
  • pdf icon Simponi Simponi®, Simponi Aria® (golimumab)
  • pdf icon Sitavig Sitavig® (acyclovir)
  • pdf icon Skyrizi Skyrizi™ (risankizumab-rzaa)
  • pdf icon Sodium oxybate Sodium oxybate (Xyrem® [sodium oxybate], Xywav™ [calcium, magnesium, potassium, and sodium oxybates])
  • pdf icon Solaraze Solaraze®, diclofenac 3% gel
  • pdf icon Soliris Soliris™ (eculizumab)
  • pdf icon Somavert Somavert® (pegvisomant)
  • pdf icon Sovaldi Sovaldi™ (sofosbuvir)
  • pdf icon Spinraza Spinraza™ (nusinersen)
  • pdf icon Spravato Spravato™ (esketamine) nasal spray
  • pdf icon Sprycel Sprycel® (dasatinib)
  • pdf icon Stelara Stelara® (ustekinumab)
  • pdf icon Stivarga Stivarga® (regorafenib)
  • pdf icon Sucraid Sucraid® (sacrosidase)
  • pdf icon Sunosi Sunosi™ (solriamfetol)
  • pdf icon Sutent Sutent® (sunitinib)
  • pdf icon Sylatron Sylatron™ (peginterferon alfa-2b)
  • pdf icon Symdeko Symdeko™ (tezacaftor/ivacaftor)
  • pdf icon Symlin Symlin® (pramlintide acetate)
  • pdf icon Symproic Symproic® (naldemedine)
  • pdf icon Synagis Synagis® (palivizumab injection)
  • pdf icon Synribo Synribo® (omacetaxine mepesuccinate)
  • pdf icon Siklos Siklos (hydroxyurea)

T, U, V

  • pdf icon Tabrecta Tabrecta™ (capmatinib)
  • pdf icon Tafinlar Tafinlar® (dabrafenib)
  • pdf icon Taltz Taltz® (ixekizumab)
  • pdf icon Talzenna Talzenna™ (talazoparib)
  • pdf icon Tarceva Tarceva® (erlotinib), erlotinib
  • pdf icon Targretin Targretin®/bexarotene capsules, Targretin® gel
  • pdf icon Tarpeyo Tarpeyo (budesonide)
  • pdf icon Tasigna Tasigna® (nilotinib)
  • pdf icon Tavalisse Tavalisse™ (fostamatinib)
  • pdf icon Tagrisso Tagrisso™ (osimertinib)
  • pdf icon Tavneos Tavneos (avacopan)
  • pdf icon Tazverik Tazverik™ (tazemetostat)
  • pdf icon Tecartus Tecartus™ (brexucabtagene autoleucel)
  • pdf icon Tecentriq Tecentriq® (atezolizumab)
  • pdf icon Tecfidera Tecfidera® (dimethyl fumarate)
  • pdf icon Technivie Technivie™ (ombitasvir, paritaprevir, ritonavir)
  • pdf icon Tegsedi Tegsedi™ (inotersen)
  • pdf icon Temodar Temodar®, temozolomide
  • pdf icon Tepezza Tepezza (teprotumumab-trbw)
  • pdf icon Tepmetko Tepmetko™ (tepotinib)
  • pdf icon Tetrabenazine Tetrabenazine (Xenazine® [tetrabenazine], tetrabenazine)
  • pdf icon Tezspire Tezspire (tezepelumab-ekko). Monoclonal Antibodies for the Treatment of Asthma and Eosinophilic Conditions.
  • pdf icon Tibsovo Tibsovo® (ivosidenib)
  • pdf icon Tivdak Tivdak™ (tisotumab vedotin-tftv)
  • pdf icon Tolsura Tolsura™ (itraconazole)
  • pdf icon Topical Immunomodulators Topical Immunomodulators- Elidel® (pimecrolimus cream), Eucrisa® (crisaborole ointment), pimecrolimus cream
  • pdf icon Torisel Torisel® (temsirolimus), temsirolimus
  • pdf icon Transmucosal Immediate Release Fentanyl Abstral® (sublingual tablet), Actiq® (oral transmucosal lozenge), fentanyl powder, Fentora® (buccal tablet), Lazanda® (nasal spray), Onsolis® (buccal soluble film), Subsys® (sublingual spray)
  • pdf icon Trastuzumab Trastuzumab (Herceptin® [trastuzumab], Herceptin Hylecta™ [trastuzumab and hyaluronidase-oysk], Kanjinti™ [trastuzumab-anns], Ogivri[trastuzumab-dkst], Ontruzant (trastuzumab-dttb), Trazimera™ [trastuzumab-qyyp])
  • pdf icon Tremfya Tremfya™(guselkumab)
  • pdf icon Trikafta Trikafta™ (elexacaftor, tezacaftor, ivacaftor; ivacaftor)
  • pdf icon Triptans Triptans: almotriptan, Amerge®, Axert®, Frova®, Imitrex® and sumatriptan tablets/nasal spray/injection, Maxalt/MLT®, naratriptan, Onzetra™ Xsail™, Relpax® and eletriptan tablets, rizatriptan/ODT, Sumavel®, Tosymra™, Treximet®, Zembrace™ SymTouch™, zolmitriptan/ODT tablets, Zomig/ZMT® tablets/nasal spray
  • pdf icon Trodelvy Trodelvy™ (sacituzumab govitecan-hziy)
  • pdf icon Trogarzo Trogarzo™ (ibalizumab-uiyk)
  • pdf icon Truseltiq Truseltiq (infigratinib)
  • pdf icon Tukysa Tukysa™ (tucatinib)
  • pdf icon Turalio Turalio™ (pexidartinib)
  • pdf icon Tykerb Tykerb® (lapatinib)
  • pdf icon Tymlos Tymlos® (abaloparatide)
  • pdf icon Tysabri Tysabri® (natalizumab)
  • pdf icon Ukoniq Ukoniq™ (umbralisib)
  • pdf icon Uloric Uloric® (febuxostat)
  • pdf icon Ultomiris Ultomiris™ (ravulizumab-cwvz)
  • pdf icon Unituxin Unituxin™ (dinutuximab)
  • pdf icon Uplizna Uplizna™ (inebilizumab-cdon)
  • pdf icon Valchlor Valchlor® (mechlorethamine gel)
  • pdf icon Vectibix Vectibix® (panitumumab)
  • pdf icon Venclexta Venclexta® (venetoclax)
  • pdf icon Verkazia Verkazia® (cyclosporine ophthalmic emulsion)
  • pdf icon Verquvo Verquvo™ (verciguat)
  • pdf icon Verzenio Verzenio™ (abemaciclib)
  • pdf icon Viekira Viekira Pak™ (ombitasvir, paritaprevir, and ritonavir tablets; dasabuvir tablets), Viekira XR™ (dasabuvir, ombitasvir, paritaprevir, and ritonavir) extended-release tablets
  • pdf icon Vimizim Vimizim® (elosulfase alfa)
  • pdf icon Vitrakvi Vitrakvi® (larotrectinib)
  • pdf icon Vizimpro Vizimpro® (dacomitinib)
  • pdf icon Vonjo Vonjo (pacritinib)
  • pdf icon Vosevi Vosevi™ (sofosbuvir, velpatasvir, and voxilaprevir)
  • pdf icon Votrient Votrient® (pazopanib)
  • pdf icon Voxzogo Voxzogo (vosoritide)
  • pdf icon Vuity Vuity™ (pilocarpine)
  • pdf icon Vumerity Vumerity™ (diroximel fumarate)
  • pdf icon Vyleesi Vyleesi ™ (bremelanotide)
  • pdf icon Vyndaqel Vyndamax Vyndaqel® (tafamidis meglumine); Vyndamax™ (tafamidis)
  • pdf icon Vyvgart Vyvgart (efgartigmod alfa-fcab)
  • pdf icon Vyxeos Vyxeos™ (daunorubicin and cytarabine) liposome for injection

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