Number of generics override needed B4 approval of Category and rejected Drug covered in category Grandfathering Overrides Scriptwise Message 2 Antihypertensives - brand ARBs Cozaar (Losartan) Hyzaar (Losartan Hydrochlorothiazide)
Teveten HCT (Eprosartan/Hydrochlorothiazide)
· Exforge · Valturna 3 niacin containing products- not covered AT ALL · Advicor brand Antihistamine Eye Drops brand Migraine (Triptans) Medications 〈 Relpax 6 Enlarged prostate A Step Therapy Category B (only after Category A has be
de) iled): 6B Enlarged prostate B Step Therapy Category B (only after Category A has
all brands in the category (rapaflo, uroxatral)
7 alzheimers Step Therapy Category B (only after Category A has b incontinence Step Therapy Category B (only after 2 of Category A has been tried and failed): vesicare Lantus/levemir Step Therapy Category B (only after 2 of Category A has been tried and failed): Lantus anti inflammatory/nsaid eye drops Step Therapy Category B (only after 2 of Category A has been tried and failed): Nevanac Opthalmic Prostaglandins etc… Step Therapy Category B (only after 3 of Category A has been tried and failed): Lumigan Use Xalataan PA 866-718-2375 Use Xalataan PA 866-718-2375 Use Cosopt PA 866-718-2375 Use trusopt PA 866-718-2375 Use timolol PA 866-718-2375 Use alphagan P0.15% PA 866-718-2375 sleep aids/insomnia Step Therapy Category B PA required for approvalAmbien (Zolpidem) Edluar Diabetes Step Therapy Category B (only after 2 of Category A has been tried and failed)one of which must be metformin: byetta
sulfonylureas (glyburide, tolazamide, glimepiride, Glipizide,
asthma Step Therapy Category B (only after 1of Category A has been tried and failed): Combivent
albuterol inhaler (proventil/proair/ventolin)
Step Therapy Category B (only after all of Category l en tried and failed): all generic Fenofibrates under this gpi all generic Fenofibrates under this gpi all generic Fenofibrates under this gpi all generic Fenofibrates under this gpi all generic Fenofibrates under this gpi Neuropathic pain (lyrica) gabapentin Step Therapy Category B (only after all of Category A e tried and failed): Nortriptylline Desipramine Carbamazepine Osteoporosis Step Therapy Category B (only after one of Category A has been tried and failed): fosamax (Alendronate) Boniva (Ibandronate) 3. Antihistamines - Non-Sedating- UPDATE NO ANTIHISTAMINES TO BE PAID- FULL COST OF DRUG SHOULD BE MEMBERS COPAY 〈 OTC Loratadine
〈 Generic Fexofenadine - termed 5/30/11
〈 OTC Allegra (Fexofenadine) - Effective 5/31/11
〈 Brand Allegra (not a protocol for Xyzal) - termed 5/30/11
Step Therapy Category C (only after Category B has been tried and failed):
〈 Fexofenadine (effective 12/1/09) - (termed 5/30/11)
〈 OTC Allegra-D/Fexofenadine-D (effective 5/31/11)
Step Therapy Category B (only after Category A has been tried and failed):
〈 Allegra-D (effective 12/1/09) - (termed 5/30/11)
〈 Allegra-D (effective 12/1/09)- (termed 5/30/11)
〈 Allegra-D (effective 12/1/09)- (termed 5/30/11)
〈 Allegra-D (effective 12/1/09)- (termed 5/30/11)
NO PPIS TO BE PAID- FULL COST OF DRUG SHOULD BE MEMBERS COPAY 1. Proton Pump Inhibitors- COPAY= COST OF DRUG
At different times, you’ll find he is distracted, confused, uncooperative, angry, and withdrawn. He may de-mand things from you immediately. He may angrily challenge you as you try to protect him from injury. Hemay refuse to do therapeutic exercises with you. He may even yell and threaten when you ask him to do theWhen you’re trying your hardest to give him the best possible care in very ch
OFFICERS BOARD MEMBERS Corrine Dreyfus 334-567-8009 Christina Flack 334-669-1240 Milly Frakes 334-396-0132 Trigg Grieshop 334-409-2998 George Lemaster 334-281-4502 Goodwyn Community Center on Perry Hill Road The “Tailwagger” is the official newsletter of the Montgomery Kennel Club Inc. Its purpose is to share information among Club Members and other interested parties. Articles