Drug Benefit List 2012 - Palliative Care Formulary

12:00 AUTONOMIC DRUGS

12:08.08 ANTIMUSCARINICS / ANTISPASMODICS

ATROPINE SULFATE

0.4mg/mL Injection

00392782 ATROPINE SULFATE SDZ

00497231 ATROPINE SULFATE ABB

00960624 ATROPINE SULFATE SDZ

0.6mg/mL Injection

00012076 ATROPINE SULFATE GSK

00392693 ATROPINE SULFATE SDZ

00497258 ATROPINE SULFATE ABB

GLYCOPYRROLATE

0.2mg/mL Injection

02039508 GLYCOPYRROLATE SDZ

HYOSCINE BUTYLBROMIDE

20mg/mL Injection

00363839 BUSCOPAN BOE

02229868 HYOSCINE SDZ

SCOPOLAMINE HYDROBROMIDE

0.4mg/mL Injection

00541869 SCOPOLAMINE ABB

0.6mg/mL Injection

00541877 SCOPOLAMINE ABB

28:00 CENTRAL NERVOUS SYSTEM AGENTS

28:08.08 OPIATE AGONISTS

FENTANYL

12mcg Transdermal Patch

02311925 RATIO-FENTANYL TRANSDERMAL SYSTEM RPH

02327112 SANDOZ FENTANYL 12MCG/HR PATCH SDZ

12mcg/h Transdermal Patch

02341379 PMS-FENTANYL MTX PMS

02330105 RAN-FENTANYL MATRIX RBY

25mcg Transdermal Patch

02330113 RAN-FENTANYL MATRIX PATCH 25 RBY

02282941 RATIO-FENTANYL TRANSDERMAL SYSTEM RPH

02327120 SANDOZ FENTANYL SDZ

25mcg/h Transdermal Patch

02275813 DURAGESIC MAT 25MCG/HR PATCH JNO

02314630 NOVO-FENTANYL 25MCG PATCH TEV

02341387 PMS-FENTANYL MTX PMS

50mcg Transdermal Patch

02330121 RAN-FENTANYL MATRIX PATCH 50 RBY

02282968 RATIO-FENTANYL TRANSDERMAL SYSTEM RPH

02327147 SANDOZ FENTANYL 50MCG/HR PATCH SDZ

50mcg/h Transdermal Patch

02275821 DURAGESIC MAT 50MCG/HR PATCH JNO

02314649 NOVO-FENTANYL 50MCG PATCH TEV

02341395 PMS-FENTANYL MTX PMS

75mcg Transdermal Patch

02330148 RAN-FENTANYL MATRIX PATCH 75 RBY

02282976 RATIO-FENTANYL TRANSDERMAL SYSTEM RPH

02327155 SANDOZ FENTANYL 75MCG/HR PATCH SDZ

75mcg/h Transdermal Patch

02275848 DURAGESIC MAT 75MCG/HR PATCH JNO

02314657 NOVO-FENTANYL 75MCG PATCH TEV

02341409 PMS-FENTANYL MTX PMS

100mcg Transdermal Patch

02282984 RATIO-FENTANYL 100MCG/HR PATCH RPH

02327163 SANDOZ FENTANYL SDZ

100mcg/h Transdermal Patch

02275856 DURAGESIC MAT 100MCG/HR PATCH JNO

02314665 NOVO-FENTANYL 100MCG PATCH TEV

02341417 PMS-FENTANYL MTX PMS

02330156 RAN-FENTANYL MATRIX PATCH 100 RBY

FENTANYL CITRATE

50mcg/mL Injection

00888346 FENTANYL CITRATE HOS

02126648 FENTANYL CITRATE HOS

02240434 FENTANYL CITRATE SDZ

28:16.08 ANTIPSYCHOTIC AGENTS

METHOTRIMEPRAZINE

25mg/mL Injection

01927698 NOZINAN SAC

28:24.08 ANXIOLYTICS, SEDATIVES AND HYPNOTICS - BENZODIAZEPINES

DIAZEPAM

5mg/mL Injection

02065614 DIAZEMULS VL ACG

00399728 DIAZEPAM SDZ

LORAZEPAM

4mg/mL Injection

02243278 LORAZEPAM SDZ

MIDAZOLAM

1mg/mL Injection

02240285 MIDAZOLAM SDZ

02242904 MIDAZOLAM PPC

02243934 MIDAZOLAM TEV

5mg/mL Injection

02240286 MIDAZOLAM SDZ

02242905 MIDAZOLAM PPC

02243935 MIDAZOLAM TEV

56:00 GASTROINTESTINAL DRUGS

56:32.00 PROKINETIC AGENTS

METOCLOPRAMIDE

5mg/mL Injection

02185431 METOCLOPRAMIDE SDZ

02243563 METOCLOPRAMIDE OMEGA OMG

56:92.00 MISCELLANEOUS GI DRUGS

METHYLNALTREXONE BROMIDE

20mg/mL Injection

02308215 RELISTOR PFI