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.
E
econazole (Spectazole)
EDECRIN
EFFEXOR XR,
ST ELIDEL,
QL ELMIRON
EMCYT
EMEND 40mg,
QL EMEND 80 mg, 125 mg
QL, oncologists /hematologists onlyEMTRIVA
enalapril (Vasotec)
enalapril/hydrochlorothiazide (Vaseretic)
ENBREL,
QL, RD, rheumatologists/dermatologists only ENDOMETRIN
enpresse (Triphasil)
ENTOCORT EC
EPIFRIN
EPINAL
epinephrine
EPIPEN,
QL
EPIPEN Jr.,
QL EPIVIR
EPIVIR HBV,
RDeplerenone (Inspra)
EPOGEN,
PA, RD EPZICOM
ERGAMISOL
ergotamine/belladonna /phenobarbital (Bellergal-S)
ergotamine/caffeine (Cafergot)
errin (Ortho Micronor, Nor-Q-D)
erythromycin 2% soln/gel/pledgets (Emgel, Erycette, Eryderm)
erythromycin base (Eryc, Ery-Tab)
erythromycin/benzoyl peroxide (Benzamycin)
erythromycin ethylsuccinate (EES)
erythromycin stearate
erythromycin/sulfisoxazole (Pediazole)
estazolam (Prosom)
esterified estrogens/methyltestosteron (Estratest/HS)
ESTRADERM,
QL estradiol transdermal (Climara),
QL estradiol (Estrace)
estradiol/norethindrone (Activella)
ESTRING
estropipate (Ortho-Est)
ethambutol (Myambutol)
ethosuximide (Zarontin)
etidronate (Didronel)
etodolac (Lodine)
etodolac extended-release (Lodine XL)
etoposide (Vepesid)
EURAX
EVISTA
EVOXAC
EXELON capsules/patches
exetuss-dm (Aquatab-C)
extendryl g (Duraphen)
Return to Alpha Listreturn to top