Formulary Medications - Generic

Generic Name: Abaloparatide

Brand Name:

Tymlos®

Medication Type:

Formulary

Conditions:

Inflammatory diseases

Generic Name: Abatacept

Brand Name:

Orencia®

Medication Type:

Formulary

Conditions:

Inflammatory diseases

Generic Name: Abemaciclib

Brand Name:

Verzenio®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Abiraterone Acetate

Brand Name:

Zytiga®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Adalimumab

Brand Name:

Humira®

Medication Type:

Formulary

Conditions:

Inflammatory diseases
Miscellaneous

Generic Name: Afatinib

Brand Name:

Gilotrif®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Alectinib

Brand Name:

Alecensa®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Alirocumab

Brand Name:

Praluent®

Medication Type:

Formulary

Conditions:

Cardiovascular

Generic Name: Altretamine

Brand Name:

Hexalen®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Antihemophilic Factor (Recombinant)

Brand Name:

Adynovate®

Medication Type:

Formulary

Conditions:

Bleeding disorders

Generic Name: Antihemophilic Factor (Recombinant)

Brand Name:

Novoeight®

Medication Type:

Formulary

Conditions:

Bleeding disorders

Generic Name: Antihemophilic Factor (Recombinant)

Brand Name:

Advate

Medication Type:

Formulary

Conditions:

Bleeding disorders

Generic Name: Antihemophilic Factor (Recombinant)

Brand Name:

Xyntha®

Medication Type:

Formulary

Conditions:

Bleeding disorders

Generic Name: Antihemophilic Factor (Recombinant)

Brand Name:

Kogenate FS®

Medication Type:

Formulary

Conditions:

Bleeding disorders

Generic Name: Antihemophilic Factor (Recombinant), Fc Fusion

Brand Name:

Eloctate®

Medication Type:

Formulary

Conditions:

Bleeding disorders

Generic Name: Antihemophilic Factor / Von Willebrand Factor Complex (Human)

Brand Name:

Wilate®

Medication Type:

Formulary

Conditions:

Bleeding disorders

Generic Name: Antihemophilic Factor / Von Willebrand Factor Complex (Human)

Brand Name:

Alphanate®

Medication Type:

Formulary

Conditions:

Bleeding disorders

Generic Name: Antihemophilic Factor/von Willebrand Factor

Brand Name:

Humate-P®

Medication Type:

Formulary

Conditions:

Bleeding disorders

Generic Name: Apalutamide

Brand Name:

Erleada™

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Apremilast

Brand Name:

Otezla®

Medication Type:

Formulary

Conditions:

Inflammatory diseases
Miscellaneous

Generic Name: Axitinib

Brand Name:

Inlyta®

Medication Type:

Formulary

Conditions:

Hematology/oncology
Transplant

Generic Name: Belimumab

Brand Name:

Benlysta®

Medication Type:

Formulary

Conditions:

Inflammatory diseases

Generic Name: Bexarotene

Brand Name:

Targretin®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Bosutinib

Brand Name:

Bosulif®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Cabozantinib

Brand Name:

Cabometyx®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Capecitabine

Brand Name:

Xeloda®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Ceritinib

Brand Name:

Zykadia™

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Certolizumab Pegol

Brand Name:

Cimzia®

Medication Type:

Formulary

Conditions:

Inflammatory diseases

Generic Name: Chlorambucil

Brand Name:

Leukeran®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Chorionic Gonadotropin

Brand Name:

Novarel®

Medication Type:

Formulary

Conditions:

Endocrinology

Generic Name: Coagulation Factor IX (Recombinant)

Brand Name:

Benefix®

Medication Type:

Formulary

Conditions:

Bleeding disorders

Generic Name: Crizotinib

Brand Name:

Xalkori®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Cyclosporine, Modified

Brand Name:

Gengraf®

Medication Type:

Formulary

Conditions:

Transplant

Generic Name: Dabrafenib Mesylate

Brand Name:

Tafinlar®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Daclatasvir

Brand Name:

Daklinza®

Medication Type:

Formulary

Conditions:

Infectious diseases

Generic Name: Dasatinib

Brand Name:

Sprycel®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Deferasirox

Brand Name:

Jadenu®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Deferasirox

Brand Name:

Exjade®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Dimethyl Fumarate

Brand Name:

Tecfidera®

Medication Type:

Formulary

Conditions:

Neurology

Generic Name: Dornase Alfa

Brand Name:

Pulmozyme®

Medication Type:

Formulary

Conditions:

Pulmonology

Generic Name: Elbasvir/Grazoprevir

Brand Name:

Zepatier™

Medication Type:

Formulary

Conditions:

Infectious diseases

Generic Name: Eltrombopag Olamine

Brand Name:

Promacta®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Enzalutamide

Brand Name:

Xtandi®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Erlotinib Hydrochloride

Brand Name:

Tarceva®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Estramustine

Brand Name:

Emcyt®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Etanercept

Brand Name:

Enbrel®

Medication Type:

Formulary

Conditions:

Inflammatory diseases

Generic Name: Etoposide

Brand Name:

Vepesid®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Everolimus

Brand Name:

Afinitor®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Everolimus

Brand Name:

Zortress®

Medication Type:

Formulary

Conditions:

Transplant

Generic Name: Evolocumab

Brand Name:

Repatha®

Medication Type:

Formulary

Conditions:

Cardiovascular

Generic Name: Fingolimod Hydrochloride

Brand Name:

Gilenya®

Medication Type:

Formulary

Conditions:

Neurology

Generic Name: Glatiramer Acetate

Brand Name:

Glatopa®

Medication Type:

Formulary

Conditions:

Neurology

Generic Name: Glatiramer Acetate

Brand Name:

Copaxone®

Medication Type:

Formulary

Conditions:

Neurology

Generic Name: Glecaprevir and Pibrentasvir

Brand Name:

Mayvret™

Medication Type:

Formulary

Conditions:

Infectious diseases

Generic Name: Golimumab

Brand Name:

Simponi®

Medication Type:

Formulary

Conditions:

Inflammatory diseases

Generic Name: Hydroxyprogesterone Caproate Injection

Brand Name:

Makena®

Medication Type:

Formulary

Conditions:

Women's health

Generic Name: Ibrutinib

Brand Name:

Imbruvica®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Idelalisib

Brand Name:

Zydelig ™

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Imatinib Mesylate

Brand Name:

Gleevec®

Medication Type:

Formulary

Conditions:

Hematology/oncology
Inflammatory diseases

Generic Name: Infliximab

Brand Name:

Remicade®

Medication Type:

Formulary

Conditions:

Inflammatory diseases
Miscellaneous

Generic Name: Interferon Beta-1a

Brand Name:

Avonex®

Medication Type:

Formulary

Conditions:

Neurology

Generic Name: Interferon Beta-1a

Brand Name:

Rebif®

Medication Type:

Formulary

Conditions:

Neurology

Generic Name: Interferon Beta-1b

Brand Name:

Betaseron®

Medication Type:

Formulary

Conditions:

Neurology

Generic Name: Interferon Beta-1b

Brand Name:

Extavia®

Medication Type:

Formulary

Conditions:

Neurology

Generic Name: Ivacaftor

Brand Name:

Kalydeco®

Medication Type:

Formulary

Conditions:

Pulmonology

Generic Name: Ixazomib

Brand Name:

Ninlaro®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Ixekizumab

Brand Name:

Taltz®

Medication Type:

Formulary

Conditions:

Inflammatory diseases
Miscellaneous

Generic Name: Lapatinib Ditosylate

Brand Name:

Tykerb®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Ledipasvir/Sofosbuvir

Brand Name:

Harvoni®

Medication Type:

Formulary

Conditions:

Infectious diseases

Generic Name: Leuprolide Acetate

Brand Name:

Lupron®

Medication Type:

Formulary

Conditions:

Endocrinology

Generic Name: Lomustine

Brand Name:

Gleostine®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Lumacaftor/Ivacaftor

Brand Name:

Orkambi®

Medication Type:

Formulary

Conditions:

Pulmonology

Generic Name: Methotrexate

Brand Name:

Rasuvo®

Medication Type:

Formulary

Conditions:

Inflammatory diseases

Generic Name: Midostaurin

Brand Name:

Rydapt®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Mitotane

Brand Name:

Lysodren®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Mycophenolate

Brand Name:

Cellcept®

Medication Type:

Formulary

Conditions:

Transplant

Generic Name: Mycophenolic Acid

Brand Name:

Myfortic®

Medication Type:

Formulary

Conditions:

Transplant

Generic Name: Nilotinib Hydrochloride

Brand Name:

Tasigna®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Nintedanib

Brand Name:

Ofev®

Medication Type:

Formulary

Conditions:

Pulmonology

Generic Name: Nirparib

Brand Name:

Zejula™

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Obeticholic Acid

Brand Name:

Ocaliva®

Medication Type:

Formulary

Conditions:

Miscellaneous

Generic Name: Ocrelizumab

Brand Name:

Ocrevus™

Medication Type:

Formulary

Conditions:

Neurology

Generic Name: Olaparib

Brand Name:

Lynparza™

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Ombitasvir/Paritaprevir/Ritonavir/Dasabuvir

Brand Name:

Viekira Pak®

Medication Type:

Formulary

Conditions:

Infectious diseases

Generic Name: Osimertinib

Brand Name:

Tagrisso™

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Palbociclib

Brand Name:

Ibrance®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Pancrelipase (Amylase/Lipase/Protease)

Brand Name:

Pertzye®

Medication Type:

Formulary

Conditions:

Pulmonology

Generic Name: Pancrelipase (Amylase/Lipase/Protease)

Brand Name:

Viokace®

Medication Type:

Formulary

Conditions:

Pulmonology

Generic Name: Pancrelipase (Amylase/Lipase/Protease)

Brand Name:

Zenpep®

Medication Type:

Formulary

Conditions:

Pulmonology

Generic Name: Pancrelipase (Amylase/Lipase/Protease)

Brand Name:

Creon®

Medication Type:

Formulary

Conditions:

Pulmonology

Generic Name: Panobinostat

Brand Name:

Farydak®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Pazopanib Hydrochloride

Brand Name:

Votrient®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Peginterferon Beta-1a

Brand Name:

Plegridy®

Medication Type:

Formulary

Conditions:

Neurology

Generic Name: Pirfenidone

Brand Name:

Esbriet®

Medication Type:

Formulary

Conditions:

Pulmonology

Generic Name: Regorafenib

Brand Name:

Stivarga®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Ribavirin

Brand Name:

Ribapak®

Medication Type:

Formulary

Conditions:

Infectious diseases

Generic Name: Ribavirin

Brand Name:

Ribasphere®

Medication Type:

Formulary

Conditions:

Infectious diseases

Generic Name: Ribociclib

Brand Name:

Kisqali®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Rifaximin

Brand Name:

Xifaxan®

Medication Type:

Formulary

Conditions:

Inflammatory diseases
Miscellaneous

Generic Name: Rituximab

Brand Name:

Rituxan®

Medication Type:

Formulary

Conditions:

Inflammatory diseases
Miscellaneous

Generic Name: Rucaparib

Brand Name:

Rubraca®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Ruxolitinib Phosphate

Brand Name:

Jakafi®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Sarilumab

Brand Name:

Kevzara®

Medication Type:

Formulary

Conditions:

Inflammatory diseases

Generic Name: Secukinumab

Brand Name:

Cosentyx®

Medication Type:

Formulary

Conditions:

Inflammatory diseases
Miscellaneous

Generic Name: Simeprevir

Brand Name:

Olysio®

Medication Type:

Formulary

Conditions:

Infectious diseases

Generic Name: Sirolimus

Brand Name:

Rapamune®

Medication Type:

Formulary

Conditions:

Transplant

Generic Name: Sofosbuvir

Brand Name:

Sovaldi®

Medication Type:

Formulary

Conditions:

Infectious diseases

Generic Name: Sofosbuvir, Velpatasvir and Voxilaprevir

Brand Name:

Vosevi™

Medication Type:

Formulary

Conditions:

Infectious diseases

Generic Name: Sofosbuvir/Velpatasvir

Brand Name:

Epclusa®

Medication Type:

Formulary

Conditions:

Infectious diseases

Generic Name: Somatropin

Brand Name:

Nutropin AQ Nuspin®

Medication Type:

Formulary

Conditions:

Endocrinology

Generic Name: Somatropin, E-Coli Derived

Brand Name:

Genotropin™

Medication Type:

Formulary

Conditions:

Endocrinology

Generic Name: Somatropin, E-Coli Derived

Brand Name:

Omnitrope®

Medication Type:

Formulary

Conditions:

Endocrinology

Generic Name: Somatropin, E-Coli Derived

Brand Name:

Norditropin®

Medication Type:

Formulary

Conditions:

Endocrinology

Generic Name: Sorafenib Tosylate

Brand Name:

Nexavar®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Sunitinib Maleate

Brand Name:

Sutent®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Tacrolimus

Brand Name:

Prograf®

Medication Type:

Formulary

Conditions:

Transplant

Generic Name: Tacrolimus ER

Brand Name:

Envarsus XR®

Medication Type:

Formulary

Conditions:

Transplant

Generic Name: Temozolomide

Brand Name:

Temodar®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Teriparatide

Brand Name:

Forteo®

Medication Type:

Formulary

Conditions:

Generic Name: Test med

Brand Name:

Test med 2

Medication Type:

Formulary

Conditions:

Cardiovascular

Generic Name: Tezacaftor/Ivacaftor

Brand Name:

Symdeko™

Medication Type:

Formulary

Conditions:

Pulmonology

Generic Name: Tobramycin Inhalation Powder

Brand Name:

Tobi® Podhaler™

Medication Type:

Formulary

Conditions:

Pulmonology

Generic Name: Tobramycin Inhalation Solution

Brand Name:

Tobi®

Medication Type:

Formulary

Conditions:

Pulmonology

Generic Name: Tobramycin Inhalation Solution

Brand Name:

Bethkis®

Medication Type:

Formulary

Conditions:

Pulmonology

Generic Name: Tocilizumab

Brand Name:

Actemra®

Medication Type:

Formulary

Conditions:

Inflammatory diseases

Generic Name: Tofacitinib Citrate

Brand Name:

Xeljanz®

Medication Type:

Formulary

Conditions:

Inflammatory diseases

Generic Name: Topotecan

Brand Name:

Hycamtin®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Trametinib Dimethyl Sulfoxide

Brand Name:

Mekinist®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Trifluridine/Tipiracil

Brand Name:

Lonsurf®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Ustekinumab

Brand Name:

Stelara®

Medication Type:

Formulary

Conditions:

Inflammatory diseases
Miscellaneous

Generic Name: Vemurafenib

Brand Name:

Zelboraf™

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Venetoclax

Brand Name:

Venclexta®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Visomodegib

Brand Name:

Erivedge®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Generic Name: Von Willebrand Factor

Brand Name:

Vonvendi®

Medication Type:

Formulary

Conditions:

Bleeding disorders

Generic Name: Vorinostat

Brand Name:

Zolinza®

Medication Type:

Formulary

Conditions:

Hematology/oncology

Pharmacy Services

Formulary Medications - Generic

Generic Name: Abaloparatide

Conditions:

Generic Name: Abatacept

Conditions:

Generic Name: Abemaciclib

Conditions:

Generic Name: Abiraterone Acetate

Conditions:

Generic Name: Adalimumab

Conditions:

Generic Name: Afatinib

Conditions:

Generic Name: Alectinib

Conditions:

Generic Name: Alirocumab

Conditions:

Generic Name: Altretamine

Conditions:

Generic Name: Antihemophilic Factor (Recombinant)

Conditions:

Conditions:

Conditions:

Conditions:

Conditions:

Generic Name: Antihemophilic Factor (Recombinant), Fc Fusion

Conditions:

Generic Name: Antihemophilic Factor / Von Willebrand Factor Complex (Human)

Conditions:

Conditions:

Generic Name: Antihemophilic Factor/von Willebrand Factor

Conditions:

Generic Name: Apalutamide

Conditions:

Generic Name: Apremilast

Conditions:

Generic Name: Axitinib

Conditions:

Generic Name: Belimumab

Conditions:

Generic Name: Bexarotene

Conditions:

Generic Name: Bosutinib

Conditions:

Generic Name: Cabozantinib

Conditions:

Generic Name: Capecitabine

Conditions:

Generic Name: Ceritinib

Conditions:

Generic Name: Certolizumab Pegol

Conditions:

Generic Name: Chlorambucil

Conditions:

Generic Name: Chorionic Gonadotropin

Conditions:

Generic Name: Coagulation Factor IX (Recombinant)

Conditions:

Generic Name: Crizotinib

Conditions:

Generic Name: Cyclosporine, Modified

Conditions:

Generic Name: Dabrafenib Mesylate

Conditions:

Generic Name: Daclatasvir

Conditions:

Generic Name: Dasatinib

Conditions:

Generic Name: Deferasirox

Conditions:

Conditions:

Generic Name: Dimethyl Fumarate

Conditions:

Generic Name: Dornase Alfa

Conditions:

Generic Name: Elbasvir/Grazoprevir

Conditions:

Generic Name: Eltrombopag Olamine

Conditions: