D

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.


D
danazol (Danocrine)
dantrolene (Dantrium)
dapsone
DARAPRIM
demeclocycline (Declomycin) 
DERMA-SMOOTHE/FS 0.01% KIT
desipramine (Norpramin)
desmopressin acetate inj/nasal spray/tabs (DDAVP)
desonide cream/oint/lotion, 0.05% (Desowen)
desoximetasone cream/gel, 0.05% (Topicort)
desoximetasone cream/oint, 0.25% (Topicort)
DESOXYN
DETROL
DETROL LA
dexamethasone tabs/eye drops (Decadron) 
dexmethylphenidate (Focalin)
dextroamphetamine (Dexedrine, Dextrostat)
dextromethorphan/phenylephrine/brompheniramine (Alacol DM)
dextromethorphan/phenylephrine/chlorpheniramine (Nasohist DM)
dextromethorphan/phenylephrine/dexbrompheniramine (Tussall)
dextromethorphan/pseudoephedrine/chlorpheniramine (Accuhist PDX)
dextromethorphan/pseudoephedrine/dexchlorpheniramine (Sutan-DM, Tandur DM)
DIASTAT, QL
diazepam tabs/inj (Valium)
DIBENZYLINE
diclofenac extended-release (Voltaren XR)
diclofenac potassium (Cataflam)
diclofenac sodium (Voltaren)
dicloxicillin (Dynapen)
dicyclomine (Bentyl)
didanosine (Videx, Videx EC)
DIFFERIN
diflorasone diacetate cream/oint, 0.05% (Psorcon)
diflunisal (Dolobid)
digoxin, not caps (Lanoxin)
dihydrocodeine/brompheniramine/phenylephrine (Poly-Tussin DHC)
dihydroergotamine inj (D.H.E. 45)
DILANTIN infatab/caps (30mg dose only) 
diflorasone diacetate oint, 0.05% (Psorcon)
diltiazem (Cardizem)
diltiazem extended-release 12 hr (Cardizem SR)
diltiazem extended-release 24 hr (Cardizem CD, Dilacor XR, Tiazac)
DIVIGEL, QL
DIOVAN, ST
DIOVAN HCT, ST
DIPENTUM
diphenoxylate/atropine (Lomotil)
dipivfrin (Propine)
dipyridamole (Persantine)
disopyramide (Norpace)
disopyramide extended-release (Norpace CR)
disulfuram (Antabuse)
divalproex sodium delayed-release tablets (Depakote)
divalproex sodium extended-release (Depakote ER)
divalproex sprinkle capsules (Depakote Sprinkle)
dorzolamide (Trusopt)
dorzolamide/timolol (Cosopt)
DOVONEX oint/cream
doxazosin (Cardura)
doxepin cream/tabs (Sinequan, Zonalon)
doxycycline tab/caps/susp (Periostat, Monodox, Vibramycin, Adoxa)
dronabinol (Marinol), QL, PA 


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