PA = Prior Authorization is required; QL = Quantity limits apply; ST = Step Therapy applies;
RD = Specialty Formulary, please refer to Specialty Pharmacy Program section for additional information;
OTC = Over-the-counter Product, may be covered if a prescription is written, and it is filled at a retail or mailorder pharmacy
Medications written in all CAPITAL letters are Brand names.
Medications written in all lower case letters are available generically. The brand name is listed in parenthesis for reference only.
M
MALARONE
malathion lotion (Ovide)
maprotiline (Ludiomil)
MATULANE, RD
MAXAIR
MAXALT/MLT, QL
mebendazole (Vermox)
meclizine
meclofenamate
medroxyprogesterone acetate (Provera)
mefenamic acid (Ponstel)
mefloquine (Lariam)
megestrol acetate (Megace)
meloxicam (Mobic)
MENOPUR, reproductive specialist only, RD
meperidine (Demerol)
mephobarbital (Mebaral)
MEPHYTON
MEPRON
mercaptopurine (Purinethol)
mesalamine enema (Rowasa)
mesna injection (Mesnex)
MESNEX tablets
MESTINON
METADATE CD
metaproterenol (Alupent)
metformin (Glucophage)
metformine extended release (Glucophage XR)
metformin/glyburide (Glucovance)
methadone
methazolamide (Neptazane)
methenamine mandelate (Mandelamine)
methenamine/mblu/ba/sal/atp (Urised)
METHERGINE
methimazole (Tapazole)
METHITEST
methocarbamol (Robaxin)
methotrexate inj/tablets (Rheumatrex)
methscopolamine bromide (Pamine, Pamine Forte)
methscopolamine/chorpheniramine/phenylephrine (Drymax)
methyclothiazide (Aquatensen)
methyldopa (Aldomet)
methyldopa/hydrochlorothiazide (Aldoril)
methylphenidate (Ritalin)
methylphenidate extended release (Metadate ER, Ritalin SR)
methylprednisolone (Medrol)
metoclopramide (Reglan)
metolazone (Zaroxolyn)
metoprolol (Lopressor)
metoprolol succinate (Toprol XL)
metoprolol/hydrochlorothiazide (Lopressor HCT)
metronidazole cream/gel (Metrocream, Metrogel)
metronidazole tabs (Flagyl)
mexiletine (Mexitil)
MIACALCIN, inj only
microgestin (Loestrin)
microgestin fe (Loestrin FE)
midodrine (Proamatine)
MIGRANAL, QL
minocycline (Minocin, Solodyn)
minoxidil (Loniten)
MINTEZOL
MIRAPEX
mirtazapine (Remeron)
misoprostol (Cytotec)
mixed amphetamine salts (Adderall)
mixed amphetamine salts XR (Adderall XR)
MOBAN
moexipril (Univasc)
moexipril/hydrochlorothiazide (Uniretic)
mometasone furoate cream/lotion/oint (Elocon)
mononessa (Ortho-Cyclen)
morphine sulfate tablets/soln/suppositories (MSIR, OMS, RMS)
morphine sulfate extended-release (MS Contin)
MOVIPREP
mupirocin oint/cream (Bactroban)
MUSE, QL
MYCOBUTIN
mycophenolate (Cellcept)
MYDRIACYL
MYLERAN
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