NCTracks
March NC Medicaid and Health Choice Preferred Drug List and Changes in April
The 2017-2018 Medicaid and Health Choice Preferred Drug List (PDL) as of March 1, 2018, is available (below). Additionally, PDL changes will be made effective April 1, 2018. For a list of the changes and the full April PDL, please see the latest Medicaid Phamacy Newsletter, dated February 2018.
|
Preferred Brand |
Non-Preferred Generic |
|---|---|
|
Actiq Lozenge |
fentanyl citrate lozenge |
|
Adderall XR |
amphetamine Salt Combo ER |
|
Aggrenox |
aspirin-dipyridamole ER |
|
Alphagan P |
brimonidine P |
|
Androgel |
testosterone |
|
Avelox |
moxifloxacin |
|
Bactroban Cream |
mupirocin Cream |
|
Benzaclin |
clindamycin/benzoyl Peroxide |
|
Butrans |
buprenorphine |
|
Catapres-TTS |
clonidine patches |
|
Cipro Suspension |
ciprofloxacin suspension |
|
Concerta |
methylphenidate ER |
|
Copaxone |
glatiramer |
|
Derma-Smoothe FS |
fluocinolone 0.01% oil |
|
Differin |
adapalene |
|
Diovan |
valsartan |
|
Diastat Accudial/Pedi System |
diazepam rectal/system |
|
Effient |
prasugrel |
|
Emend |
aprepitant |
|
Evista |
raloxifene |
|
Exelon Patch |
rivastigmine patch |
|
Exforge |
amlodipine / valsartan |
|
Exforge-HCT |
amlodipine / valsartan / HCT |
|
Focalin / Focalin XR |
dexmethylphenidate |
|
Gabitril 2mg and 4mg |
tiagabine |
|
Glyset |
miglitol |
|
Hepsera 10 mg |
adefovir |
|
Invega ER |
paliperidone ER |
|
Kapvay |
clonidine ER |
|
Kitabis Pak |
tobramycin |
|
Lovenox |
enoxaparin |
|
MetroCream |
metronidazole cream |
|
MetroLotion |
metronidazole lotion |
|
Metrogel Topical |
metronidazole gel topical |
|
Methylin Solution |
methylphenidate solution |
|
Namenda Solution |
memantine solution |
|
Natroba |
spinosad |
|
Nexium RX |
esomeprazole |
|
Nuvigil |
armodafinil |
|
Orapred ODT |
prednisolone ODT |
|
Oxycontin |
oxycodone ER |
|
Patanase |
olopatadine |
|
Provigil |
modafinil |
|
Pulmicort respules |
budesonide respules |
|
Renvela powder pkt |
sevelamer powder pkt |
|
Retin-A Cream/Gel |
tretinoin cream/gel |
|
Rythmol SR |
propafenone SR |
|
Suprax Susp |
cefixime Susp |
|
Symbyax |
olanzepine / fluoxetine |
|
Tamiflu |
oseltamivir |
|
Tegretol Tab/ Susp /XR |
carbamazepine Tab/ Susp / XR |
|
TobraDex Drops |
tobramycin / dexamethasone drops |
|
Transderm-Scop |
scopolamine |
|
Vagifem |
estrodiol |
|
Vigamox |
moxifloxacin |
|
Viread |
tenofovir |
|
Vivelle-Dot Patch |
estradiol patch |
|
Voltaren Gel |
diclofenac gel |
|
Zetia |
ezetimibe |