GEMS Comprehensive Formulary - February 2022.xlsx

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NAPPI CODE DRUG NAME ACTIVE INGREDIENT STRENGTH DRUG FORM CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS Asthma Inhaled B2 agonists 706544 BEROTEC HFA 200 DOSE Fenoterol 100MCG INH Accepted treatment 707882 DUOVENT HFA 200DOSE Fenoterol and ipratropium bromide 50MCG/20MCG INH Accepted treatment 849332 ASTHAVENT 300 DOSE Salbutamol 100MCG INH Accepted treatment 700715 ASTHAVENT 300D ECOHALER CFC FREE Salbutamol 100MCG INH Accepted treatment 878219 ASTHAVENT DP Salbutamol 200MCG CPS Accepted treatment 3003183 GLENBUTE 200 DOSE Salbutamol 100MCG INH Accepted treatment 711213 VENTEZE CFC FREE 200 DOSE Salbutamol 100MCG INH Accepted treatment 720723 VENTIMAX CFC FREE 200 DOSE Salbutamol 100MCG INH Accepted treatment 703371 VENTOLIN INHALER 200 CFC FREE Salbutamol 100MCG INH Accepted treatment 718698 DUOLIN HFA 200DOSE Salbutamol and other drugs for obstructive airway diseases INH Accepted treatment 720748 BRICANYL 100 DOSE Terbutaline .5MG/1DOSE TBH Accepted treatment Long acting B2 agonists 820911 FORADIL DRY Formoterol 12MCG CPS Clinical Review 710307 FORATEC HFA 120DOSE Formoterol 12MCG INH Clinical Review 840246 OXIS TURBUHALER Formoterol 9MCG INH Clinical Review 818496 SEREVENT ACCUHALER Salmeterol 50MCG INH Accepted treatment 708289 SEREVENT CFC-FREE 120DOSE Salmeterol 25MCG INH Accepted treatment 723841 INNUVAIR 100MCG/6MCG 120 DOSE formoterol and beclometasone 100MCG/6MCG INH Accepted treatment 722933 DULERA 200/5UG 120 DOSE Formoterol and mometasone 200MCG/5MCG INH Accepted treatment 722934 DULERA 100/5UG 120 DOSE Formoterol and mometasone 100MCG/5MCG INH Accepted treatment Inhaled corticosteroids 827088 BECEZE INHALER COMPLETE Beclomethasone 100MCG INH Accepted treatment 819638 BECLATE INHALER Beclomethasone 100MCG INH Accepted treatment 820083 BECLATE INHALER Beclomethasone 200MCG INH Accepted treatment 827061 BECEZE 50 200DOSE Beclomethasone 50MCG INH Accepted treatment 819611 BECLATE INHALER Beclomethasone 50MCG INH Accepted treatment 897462 BUDEFLAM CFC FREE 300 DOSE INH Budesonide 100MCG INH Accepted treatment 791423 PULMICORT 100 TURB (200 DOSE) Budesonide 100MCG ATH Accepted treatment 897469 BUDEFLAM CFC FREE 200MCG 300 DOSE INH Budesonide 200MCG INH Accepted treatment 791431 PULMICORT 200 TURB (200 DOSE) Budesonide 200MCG ATH Accepted treatment 704020 INFLAMMIDE 200 NOVOLIZE REFIL Budesonide 200MCG REF Accepted treatment COMPREHENSIVE PMB FORMULARY FEBRUARY 2022 Depending on the specific scheme option, products included on this chronic medicines formulary will not attract a co-payment if authorised by Chronic Medicine Management for a disease on the CDL and obtained from the Designated Service Provider (where applicable). Reimbursement will however be subject to the Chronic Medicine Management clinical guidelines and protocols and the Medicine Price List (MPL). Please Note: Specialist Script - will require a relevant specialist's prescription before reimbursement is considered Specialist Motivation - will require a relevant specialist motivation before reimbursement is considered Special Investigations (SI) - results of recent relevant tests required before reimbursement is considered KEY to Chronic Medicine Management Reimbursement Criteria for use of preferred formulary drugs: Quantity/dosage and duration of authorisation may vary - depending on the requested drug. Accepted Treatment - will be authorised without requesting additional clinical information (unless specific concerns e.g. unusual dose requests). Clinical Review - will be authorised if the drug history or co-morbidity clearly indicates that use of the drug is indicated in the specific patient. Clinical Motivation - specific clinical information required before reimbursement is considered

Transcript of GEMS Comprehensive Formulary - February 2022.xlsx

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

Asthma Inhaled B2 agonists

706544 BEROTEC HFA 200 DOSE Fenoterol 100MCG INH Accepted treatment707882 DUOVENT HFA 200DOSE Fenoterol and ipratropium bromide 50MCG/20MCG INH Accepted treatment849332 ASTHAVENT 300 DOSE Salbutamol 100MCG INH Accepted treatment700715 ASTHAVENT 300D ECOHALER CFC FREE Salbutamol 100MCG INH Accepted treatment878219 ASTHAVENT DP Salbutamol 200MCG CPS Accepted treatment3003183 GLENBUTE 200 DOSE Salbutamol 100MCG INH Accepted treatment711213 VENTEZE CFC FREE 200 DOSE Salbutamol 100MCG INH Accepted treatment720723 VENTIMAX CFC FREE 200 DOSE Salbutamol 100MCG INH Accepted treatment703371 VENTOLIN INHALER 200 CFC FREE Salbutamol 100MCG INH Accepted treatment718698 DUOLIN HFA 200DOSE Salbutamol and other drugs for obstructive airway diseases INH Accepted treatment720748 BRICANYL 100 DOSE Terbutaline .5MG/1DOSE TBH Accepted treatment

Long acting B2 agonists820911 FORADIL DRY Formoterol 12MCG CPS Clinical Review710307 FORATEC HFA 120DOSE Formoterol 12MCG INH Clinical Review840246 OXIS TURBUHALER Formoterol 9MCG INH Clinical Review818496 SEREVENT ACCUHALER Salmeterol 50MCG INH Accepted treatment708289 SEREVENT CFC-FREE 120DOSE Salmeterol 25MCG INH Accepted treatment723841 INNUVAIR 100MCG/6MCG 120 DOSE formoterol and beclometasone 100MCG/6MCG INH Accepted treatment722933 DULERA 200/5UG 120 DOSE Formoterol and mometasone 200MCG/5MCG INH Accepted treatment722934 DULERA 100/5UG 120 DOSE Formoterol and mometasone 100MCG/5MCG INH Accepted treatment

Inhaled corticosteroids827088 BECEZE INHALER COMPLETE Beclomethasone 100MCG INH Accepted treatment819638 BECLATE INHALER Beclomethasone 100MCG INH Accepted treatment820083 BECLATE INHALER Beclomethasone 200MCG INH Accepted treatment827061 BECEZE 50 200DOSE Beclomethasone 50MCG INH Accepted treatment819611 BECLATE INHALER Beclomethasone 50MCG INH Accepted treatment897462 BUDEFLAM CFC FREE 300 DOSE INH Budesonide 100MCG INH Accepted treatment791423 PULMICORT 100 TURB (200 DOSE) Budesonide 100MCG ATH Accepted treatment897469 BUDEFLAM CFC FREE 200MCG 300 DOSE INH Budesonide 200MCG INH Accepted treatment791431 PULMICORT 200 TURB (200 DOSE) Budesonide 200MCG ATH Accepted treatment704020 INFLAMMIDE 200 NOVOLIZE REFIL Budesonide 200MCG REF Accepted treatment

COMPREHENSIVE PMB FORMULARY

FEBRUARY 2022

Depending on the specific scheme option, products included on this chronic medicines formulary will not attract a co-payment if authorised by Chronic Medicine Management for a disease on the CDL and obtained from the Designated Service Provider (where applicable). Reimbursement will however be subject to the Chronic Medicine Management clinical guidelines and protocols and the Medicine Price List (MPL).

Please Note:

Specialist Script - will require a relevant specialist's prescription before reimbursement is consideredSpecialist Motivation - will require a relevant specialist motivation before reimbursement is considered

Special Investigations (SI) - results of recent relevant tests required before reimbursement is considered

KEY to Chronic Medicine Management Reimbursement Criteria for use of preferred formulary drugs: Quantity/dosage and duration of authorisation may vary - depending on the requested drug.

Accepted Treatment - will be authorised without requesting additional clinical information (unless specific concerns e.g. unusual dose requests).Clinical Review - will be authorised if the drug history or co-morbidity clearly indicates that use of the drug is indicated in the specific patient.

Clinical Motivation - specific clinical information required before reimbursement is considered

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

704021 INFLAMMIDE 200 NOVOLIZER COMPL Budesonide 200MCG INH Accepted treatment707879 INFLAMMIDE NOVOLIZER COMPLETE 100DOSE Budesonide 400MCG INH Accepted treatment707881 INFLAMMIDE NOVOLIZER REFILL 100DOSE Budesonide 400MCG REF Accepted treatment720735 CICLOVENT 120 DOSE Ciclesonide 160MCG INH Accepted treatment721620 CICLOVENT 60 DOSE Ciclesonide 160MCG INH Accepted treatment705269 ALVESCO 160MCG 120 DOSE Ciclesonide 160MCG INH Accepted treatment705267 ALVESCO 160MCG 60 DOSE Ciclesonide 160MCG INH Accepted treatment720711 CICLOVENT 120 DOSES Ciclesonide 80MCG INH Accepted treatment721621 CICLOVENT 60 DOSE Ciclesonide 80MCG INH Accepted treatment705265 ALVESCO 80MCG 60 DOSE Ciclesonide 80MCG INH Accepted treatment818453 FLIXOTIDE ACCUHALER Fluticasone 100MCG CAP Accepted treatment897752 FLIXOTIDE CFC FREE (120 ACT) Fluticasone 125MCG INH Accepted treatment818461 FLIXOTIDE ACCUHALER Fluticasone 250MCG CAP Accepted treatment897759 FLIXOTIDE CFC FREE (120 ACT) Fluticasone 250MCG INH Accepted treatment818488 FLIXOTIDE ACCUHALER Fluticasone 500MCG CAP Accepted treatment818445 FLIXOTIDE ACCUHALER Fluticasone 50MCG CAP Accepted treatment703275 FLIXOTIDE 50 CFC FREE 120 ACT Fluticasone 50MCG INH Accepted treatment720219 VANNAIR 160/4.5MCG PER INHALATION 120 DO formoterol and budesonide 4.5MCG/160MCG INH Accepted treatment720218 VANNAIR 80/4.5MCG PER INHALATION 120 DOS formoterol and budesonide 4.5MCG/80MCG INH Accepted treatment700173 SYMBICORD TURBO 120 DOSE Formoterol/Budesonide 4.5MCG/160MCG INH Accepted treatment700172 SYMBICORD TURBO 60 DOSE Formoterol/Budesonide 4.5MCG/160MCG INH Accepted treatment705986 SYMBICORD 80/4.5MCG PER INHALATION Formutoterol and other anti- asthmatics 4.5MCG/80MCG INH Accepted treatment705984 SYMBICORD 320/9MCG PER INHALATION Formutoterol and other anti- asthmatics 9MCG/320MCG INH Accepted treatment717571 ASMANEX TWISTHALER 30 DOSE Mometasone 200MCG/1DOSE TBH Accepted treatment717572 ASMANEX TWISTHALER 60 DOSE Mometasone 200MCG/1DOSE TBH Accepted treatment717581 ASMANEX TWISTHALER 30 DOSE Mometasone 400MCG/1DOSE TBH Accepted treatment717582 ASMANEX TWISTHALER 60 DOSE Mometasone 400MCG/1DOSE TBH Accepted treatment715753 FOXAIR 25/125 120DOSE Salmeterol and other anti-asthmatics 25MCG/125MCG INH Accepted treatment715754 FOXAIR 25/250 120DOSE Salmeterol and other anti-asthmatics 25MCG/250MCG INH Accepted treatment715752 FOXAIR 25/50 120 DOSE Salmeterol and other anti-asthmatics 25MCG/50MCG INH Accepted treatment715190 SEREFLO 25/125 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/125MCG INH Accepted treatment721413 SEREFLO 25/125 HFA SYNCHROBREATHE 120 DO Salmeterol/Fluticasone combinations 25MCG/125MCG INH Accepted treatment894990 SERETIDE 120 DOSE Salmeterol/Fluticasone combinations 25MCG/125MCG INH Accepted treatment715191 SEREFLO 25/250 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/250MCG INH Accepted treatment721414 SEREFLO 25/250 HFA SYNCHROBREATHE 120 DO Salmeterol/Fluticasone combinations 25MCG/250MCG INH Accepted treatment3003304 SEREFLO DPI 50/100 60 DOSE Salmeterol/Fluticasone combinations 50MCG/100MCG ACC Accepted treatment3003305 SEREFLO DPI 50/250 60 DOSE Salmeterol/Fluticasone combinations 50MCG/250MCG ACC Accepted treatment895006 SERETIDE 120 DOSE Salmeterol/Fluticasone combinations 25MCG/250MCG INH Accepted treatment715189 SEREFLO 25/50 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/50MCG INH Accepted treatment721412 SEREFLO 25/50 HFA SYNCHROBREATHE 120 DOS Salmeterol/Fluticasone combinations 25MCG/50MCG INH Accepted treatment894989 SERETIDE 25/50 120 DOSE Salmeterol/Fluticasone combinations 25MCG/50MCG INH Accepted treatment874493 SERETIDE 50/100 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/100MCG INH Accepted treatment874507 SERETIDE 50/250 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/250MCG INH Accepted treatment874515 SERETIDE 50/500 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/500MCG INH Accepted treatment715009 FOXAIR 50/100 ACCUHALER Salmeterol/Fluticasone combinations INH Accepted treatment715008 FOXAIR 50/250 ACCUHALER Salmeterol/Fluticasone combinations INH Accepted treatment715007 FOXAIR 50/500 ACCUHALER Salmeterol/Fluticasone combinations INH Accepted treatment723303 RELVAR ELLIPTA 184/22UG 30 DOSE vilanterol and fluticasone furoate 184MCG/22MCG INH Accepted treatment723300 RELVAR ELLIPTA 92/22UG 30 DOSE vilanterol and fluticasone furoate 92MCG/22MCG INH Accepted treatment

Oral Xanthines725005 EUPHYLLIN RETARD Theophylline 250MG SRT Clinical Review748528 NUELIN LIQUID Theophylline 25MG/5ML SYR Clinical Review748501 NUELIN SA 250 Theophylline 250MG TAB Clinical Review788368 ROLAB-THEOPHYLLINE ANHYDROUS Theophylline 200MG SRT Clinical Review788376 ROLAB-THEOPHYLLINE ANHYDROUS Theophylline 300MG SRT Clinical Review

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

783005 THEOPLUS Theophylline 200MG SRT Clinical Review783013 THEOPLUS Theophylline 300MG SRT Clinical Review785105 UNIPHYL Theophylline 400MG SRT Clinical Review816159 UNIPHYL Theophylline 600MG SRT Clinical Review

Oral Corticosteroids716381 ADCO PREDNISOLONE Prednisolone 15MG/5ML LIQ Specialist script714552 ASPELONE Prednisolone 15MG/5ML LIQ Specialist script814407 CAPSOID Prednisolone 5MG TAB Specialist script800155 LENISOLONE Prednisolone 5MG TAB Specialist script703720 PRELONE Prednisolone 5MG TAB Specialist script805149 PRELONE Prednisolone 15MG/5ML SYR Specialist script742759 METICORTEN Prednisone 50MG TAB Specialist script742732 METICORTEN Prednisone 5MG TAB Specialist script752304 PANAFCORT Prednisone 5MG TAB Specialist script788783 PREDNISONE (BE-TABS) Prednisone 5MG TAB Specialist script836826 PULMISON TABS Prednisone 20MG TAB Specialist script818267 TROLIC Prednisone 5MG TAB Specialist script

Addison's disease Oral Corticosteroids

716693 COVOCORT Hydrocortisone 10MG TAB Accepted treatment726540 FLORINEF ACETATE Fludrocortisone 0.1MG TAB Accepted treatment

Bipolar Mood Disorder Mood Stabilisers

712493 DEGRANOL Carbamazepine 200MG TAB Accepted treatment3001174 GULF CARBAMAZEPINE Carbamazepine 200MG TAB Accepted treatment705602 SANDOZ CARBAMAZIPINE CR400 Carbamazepine 400MG SRT Accepted treatment769398 TEGRETOL Carbamazepine 200MG TAB Clinical Motivation779652 TEGRETOL CR Carbamazepine 200MG SRT Clinical Motivation779660 TEGRETOL CR Carbamazepine 400MG SRT Clinical Motivation769401 TEGRETOL S Carbamazepine 100MG/5ML SUS Clinical Motivation715962 ZEPTOL Carbamazepine 200MG TAB Accepted treatment705441 ASPEN LAMOTRIGINE 100MG Lamotrigine 100MG TAB Clinical Motivation705436 ASPEN LAMOTRIGINE 25MG Lamotrigine 25MG TAB Clinical Motivation705440 ASPEN LAMOTRIGINE 50MG Lamotrigine 50MG TAB Clinical Motivation707789 AUSTELL-LAMOTRIGINE Lamotrigine 100MG TAB Clinical Motivation707790 AUSTELL-LAMOTRIGINE Lamotrigine 200MG TAB Clinical Motivation707787 AUSTELL-LAMOTRIGINE Lamotrigine 25MG TAB Clinical Motivation707788 AUSTELL-LAMOTRIGINE Lamotrigine 50MG TAB Clinical Motivation710389 DYNA-LAMOTRIGINE Lamotrigine 100MG TAB Clinical Motivation710390 DYNA-LAMOTRIGINE Lamotrigine 200MG TAB Clinical Motivation710387 DYNA-LAMOTRIGINE Lamotrigine 25MG TAB Clinical Motivation710388 DYNA-LAMOTRIGINE Lamotrigine 50MG TAB Clinical Motivation704381 EPITEC 100MG Lamotrigine 100MG TAB Clinical Motivation704382 EPITEC 200MG Lamotrigine 200MG TAB Clinical Motivation704379 EPITEC 25MG Lamotrigine 25MG TAB Clinical Motivation704380 EPITEC 50MG Lamotrigine 50MG TAB Clinical Motivation722725 GIROTEC Lamotrigine 50MG TAB Clinical Motivation722726 GIROTEC Lamotrigine 100MG TAB Clinical Motivation722727 GIROTEC Lamotrigine 200MG TAB Clinical Motivation805521 LAMICTIN Lamotrigine 100MG TAB Clinical Motivation819034 LAMICTIN Lamotrigine 200MG TAB Clinical Motivation805505 LAMICTIN Lamotrigine 25MG TAB Clinical Motivation805513 LAMICTIN Lamotrigine 50MG TAB Clinical Motivation

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

813907 LAMICTIN P100 Lamotrigine 100MG DSP Clinical Motivation704533 LAMICTIN P2 Lamotrigine 2MG DSP Clinical Motivation891716 LAMICTIN P200 Lamotrigine 200MG DSP Clinical Motivation813893 LAMICTIN P25 Lamotrigine 25MG DSP Clinical Motivation813885 LAMICTIN P5 Lamotrigine 5MG DSP Clinical Motivation891708 LAMICTIN P50 Lamotrigine 50MG DSP Clinical Motivation710885 LAMIDUS Lamotrigine 50MG TAB Clinical Motivation704488 LAMITOR Lamotrigine 100MG TAB Clinical Motivation704486 LAMITOR Lamotrigine 25MG TAB Clinical Motivation704487 LAMITOR Lamotrigine 50MG TAB Clinical Motivation712217 LAMITOR Lamotrigine 200MG TAB Clinical Motivation705248 SANDOZ LAMOTRIGINE Lamotrigine 100MG TAB Clinical Motivation3000448 SERINEM Lamotrigine 25MG TAB Clinical Motivation3000449 SERINEM Lamotrigine 50MG TAB Clinical Motivation3000451 SERINEM Lamotrigine 100MG TAB Clinical Motivation3000452 SERINEM Lamotrigine 200MG TAB Clinical Motivation712078 CAMCOLIT Lithium 250MG TAB Accepted treatment712086 CAMCOLIT Lithium 400MG TAB Accepted treatment715980 CONVULEX Valproic acid 150MG CAP Accepted treatment781541 CONVULEX Valproic acid 250MG/5ML SYR Accepted treatment715999 CONVULEX Valproic acid 300MG CAP Accepted treatment781568 CONVULEX Valproic acid 500MG CAP Accepted treatment818666 EPILIM CR Valproic acid 200MG SRT Accepted treatment818674 EPILIM CR Valproic acid 300MG SRT Accepted treatment818682 EPILIM CR Valproic acid 500MG SRT Accepted treatment821578 EPILIM CRUSHABLE Valproic acid 100MG TAB Accepted treatment780545 EPILIM SUGAR FREE Valproic acid 200MG/5ML SYR Accepted treatment718274 EPILIZINE CR Valproic acid 200MG SRT Accepted treatment718275 EPILIZINE CR Valproic acid 300MG SRT Accepted treatment718276 EPILIZINE CR Valproic acid 500MG SRT Accepted treatment721460 EPROLEP CR 200 Valproic acid 200MG SRT Accepted treatment720762 EPROLEP CR 300 Valproic acid 300MG SRT Accepted treatment721055 EPROLEP CR 500 Valproic acid 500MG SRT Accepted treatment718465 NAVALPRO CR Valproic acid 200MG SRT Accepted treatment718466 NAVALPRO CR Valproic acid 300MG SRT Accepted treatment718468 NAVALPRO CR Valproic acid 500MG SRT Accepted treatment720026 VANAPRO Valproic acid 300MG SRT Accepted treatment720027 VANAPRO Valproic acid 500MG SRT Accepted treatment

Antipsychotic agents892310 SOLIAN Amisulpride 200MG TAB Clinical Motivation892309 SOLIAN Amisulpride 50MG TAB Clinical Motivation705634 ABILIFY 10MG Aripiprazole 10MG TAB Clinical Motivation705635 ABILIFY 15MG Aripiprazole 15MG TAB Clinical Motivation712192 ABILIFY 5MG Aripiprazole 5MG TAB Clinical Motivation3001455 ABIPIP Aripiprazole 10MG TAB Clinical Motivation3001456 ABIPIP Aripiprazole 15MG TAB Clinical Motivation3001454 ABIPIP Aripiprazole 5MG TAB Clinical Motivation3003284 ABIPIP 10 ODT Aripiprazole 10MG MLT Clinical Motivation3003286 ABIPIP 15 ODT Aripiprazole 15MG MLT Clinical Motivation3002239 APRIPENT Aripiprazole 10MG TAB Clinical Motivation3002240 APRIPENT Aripiprazole 15MG TAB Clinical Motivation3002238 APRIPENT Aripiprazole 5MG TAB Clinical Motivation3002935 APRIZON Aripiprazole 10MG TAB Clinical Motivation3002936 APRIZON Aripiprazole 15MG TAB Clinical Motivation3002934 APRIZON Aripiprazole 5MG TAB Clinical Motivation

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

3003431 ARIDUS Aripiprazole 10MG TAB Clinical Motivation3003440 ARIDUS Aripiprazole 15MG TAB Clinical Motivation723961 ARIZOFY Aripiprazole 5MG TAB Clinical Motivation723962 ARIZOFY Aripiprazole 10MG TAB Clinical Motivation723963 ARIZOFY Aripiprazole 15MG TAB Clinical Motivation3003847 PRIPTRIN Aripiprazole 10MG TAB Clinical Motivation3003848 PRIPTRIN Aripiprazole 15MG TAB Clinical Motivation3003846 PRIPTRIN Aripiprazole 5MG TAB Clinical Motivation3001371 PRIZAL Aripiprazole 10MG TAB Clinical Motivation3001372 PRIZAL Aripiprazole 15MG TAB Clinical Motivation3001370 PRIZAL Aripiprazole 5MG TAB Clinical Motivation3002989 REXULTI Brexpiprazole .5MG TAB Clinical Motivation3003028 REXULTI Brexpiprazole 1MG TAB Clinical Motivation3003029 REXULTI Brexpiprazole 2MG TAB Clinical Motivation3003031 REXULTI Brexpiprazole 3MG TAB Clinical Motivation3003033 REXULTI Brexpiprazole 4MG TAB Clinical Motivation735884 LARGACTIL Chlorpromazine 100MG TAB Accepted treatment735868 LARGACTIL Chlorpromazine 25MG TAB Accepted treatment735876 LARGACTIL Chlorpromazine 50MG TAB Accepted treatment717082 ASPEN CLOZAPINE Clozapine 100MG TAB Accepted treatment717081 ASPEN CLOZAPINE Clozapine 25MG TAB Accepted treatment700178 CLOMENT Clozapine 100MG TAB Accepted treatment700176 CLOMENT Clozapine 25MG TAB Accepted treatment705844 CLOZAPINE OETHMAAN Clozapine 25MG TAB Accepted treatment705845 CLOZAPINE OETHMAAN Clozapine 100MG TAB Accepted treatment736716 LEPONEX Clozapine 100MG TAB Accepted treatment736708 LEPONEX Clozapine 25MG TAB Accepted treatment726656 FLUANXOL Flupenthixol .5MG TAB Accepted treatment726664 FLUANXOL Flupenthixol 1MG TAB Accepted treatment726672 FLUANXOL DEPOT 1ML Flupenthixol 20MG/1ML INJS Accepted treatment726680 FLUANXOL DEPOT 2ML Flupenthixol INJ Accepted treatment744301 MODECATE 1ML Fluphenazine 25MG/1ML INJS Accepted treatment744328 MODECATE+SYRINGE 1ML Fluphenazine 25MG/1ML INJS Accepted treatment719549 GULF HALOPERIDOL Haloperidol 5MG TAB Accepted treatment 730335 HALOPERIDOL 1.5 OETHMAAN Haloperidol 1.5MG TAB Accepted treatment 730327 HALOPERIDOL 5 OETHMAAN Haloperidol 5MG TAB Accepted treatment 763411 SERENACE Haloperidol 0.5MG CAP Accepted treatment763535 SERENACE Haloperidol 10MG TAB Accepted treatment763454 SERENACE Haloperidol 5MG TAB Accepted treatment720687 ADCO OLANZAPINE Olanzapine 2.5MG TAB Accepted treatment720691 ADCO OLANZAPINE Olanzapine 5MG TAB Accepted treatment720692 ADCO OLANZAPINE Olanzapine 10MG TAB Accepted treatment720529 LANAZYP Olanzapine 10MG TAB Accepted treatment720527 LANAZYP Olanzapine 2.5MG TAB Accepted treatment720528 LANAZYP Olanzapine 5MG TAB Accepted treatment723745 ZOLANZ Olanzapine 5MG TAB Accepted treatment723747 ZOLANZ Olanzapine 10MG TAB Accepted treatment718997 MYLAN OLANZAPINE Olanzapine 10MG TAB Accepted treatment718995 MYLAN OLANZAPINE Olanzapine 2.5MG TAB Accepted treatment718996 MYLAN OLANZAPINE Olanzapine 5MG TAB Accepted treatment721389 OLAWIN Olanzapine 10MG TAB Accepted treatment721385 OLAWIN Olanzapine 2.5MG TAB Accepted treatment721388 OLAWIN Olanzapine 5MG TAB Accepted treatment721390 OLAWIN ORADISPERSIBLE Olanzapine 10MG MLT Accepted treatment721386 OLAWIN ORADISPERSIBLE Olanzapine 5MG MLT Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

715996 OLEANZ Olanzapine 10MG TAB Accepted treatment715994 OLEANZ Olanzapine 2.5MG TAB Accepted treatment715995 OLEANZ Olanzapine 5MG TAB Accepted treatment715968 OLEANZ RAPITAB Olanzapine 10MG MLT Accepted treatment715967 OLEANZ RAPITAB Olanzapine 5MG MLT Accepted treatment715659 OLEXAR Olanzapine 10MG TAB Accepted treatment715657 OLEXAR Olanzapine 2.5MG TAB Accepted treatment715658 OLEXAR Olanzapine 5MG TAB Accepted treatment3003670 PHRENPE ORODISPERSIBLE Olanzapine 10MG MLT Accepted treatment3003668 PHRENPE ORODISPERSIBLE Olanzapine 5MG MLT Accepted treatment720714 PREXOLAN Olanzapine 10MG TAB Accepted treatment720712 PREXOLAN Olanzapine 2.5MG TAB Accepted treatment720713 PREXOLAN Olanzapine 5MG TAB Accepted treatment719807 PREXOLAN ODT Olanzapine 10MG MLT Accepted treatment719806 PREXOLAN ODT Olanzapine 5MG MLT Accepted treatment715685 REDILANZ Olanzapine 10MG TAB Accepted treatment715683 REDILANZ Olanzapine 2.5MG TAB Accepted treatment715684 REDILANZ Olanzapine 5MG TAB Accepted treatment721653 ZYLENA Olanzapine 10MG TAB Accepted treatment721652 ZYLENA Olanzapine 5MG TAB Accepted treatment827517 ZYPREXA Olanzapine 10MG TAB Accepted treatment864188 ZYPREXA Olanzapine 2.5MG TAB Accepted treatment827509 ZYPREXA Olanzapine 5MG TAB Accepted treatment707938 ZYPREXA VELOTAB Olanzapine 5MG TAB Accepted treatment707939 ZYPREXA VELOTAB Olanzapine 10MG TAB Accepted treatment3003598 AROQUET Quetiapine 100MG TAB Accepted treatment3003600 AROQUET Quetiapine 200MG TAB Accepted treatment3003597 AROQUET Quetiapine 25MG TAB Accepted treatment3003601 AROQUET Quetiapine 300MG TAB Accepted treatment716051 DOPAQUEL Quetiapine 100MG TAB Accepted treatment716052 DOPAQUEL Quetiapine 200MG TAB Accepted treatment716050 DOPAQUEL Quetiapine 25MG TAB Accepted treatment716053 DOPAQUEL Quetiapine 300MG TAB Accepted treatment720981 KIZOFRIN Quetiapine 200MG TAB Accepted treatment720979 KIZOFRIN Quetiapine 25MG TAB Accepted treatment720980 KIZOFRIN Quetiapine 100MG TAB Accepted treatment720982 KIZOFRIN Quetiapine 300MG TAB Accepted treatment716670 MYLAN QUETIAPINE Quetiapine 100MG TAB Accepted treatment716671 MYLAN QUETIAPINE Quetiapine 200MG TAB Accepted treatment716668 MYLAN QUETIAPINE Quetiapine 25MG TAB Accepted treatment716672 MYLAN QUETIAPINE Quetiapine 300MG TAB Accepted treatment718353 PSYQUET Quetiapine 100MG TAB Accepted treatment718354 PSYQUET Quetiapine 200MG TAB Accepted treatment718352 PSYQUET Quetiapine 25MG TAB Accepted treatment718355 PSYQUET Quetiapine 300MG TAB Accepted treatment721745 QUETIAPINE BIOTECH Quetiapine 100MG TAB Accepted treatment721746 QUETIAPINE BIOTECH Quetiapine 200MG TAB Accepted treatment721744 QUETIAPINE BIOTECH Quetiapine 25MG TAB Accepted treatment721747 QUETIAPINE BIOTECH Quetiapine 300MG TAB Accepted treatment716636 QUETOSER Quetiapine 100MG TAB Accepted treatment716637 QUETOSER Quetiapine 200MG TAB Accepted treatment716635 QUETOSER Quetiapine 25MG TAB Accepted treatment716638 QUETOSER Quetiapine 300MG TAB Accepted treatment716652 SEREZ Quetiapine 100MG TAB Accepted treatment716653 SEREZ Quetiapine 200MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

716651 SEREZ Quetiapine 25MG TAB Accepted treatment716654 SEREZ Quetiapine 300MG TAB Accepted treatment850535 SEROQUEL Quetiapine 100MG TAB Accepted treatment850543 SEROQUEL Quetiapine 200MG TAB Accepted treatment850527 SEROQUEL Quetiapine 25MG TAB Accepted treatment703344 SEROQUEL Quetiapine 300MG TAB Accepted treatment3003646 QUERO XR Quetiapine 50MG SRT Clinical Motivation3003647 QUERO XR Quetiapine 150MG SRT Clinical Motivation3003648 QUERO XR Quetiapine 200MG SRT Clinical Motivation3003649 QUERO XR Quetiapine 300MG SRT Clinical Motivation3003650 QUERO XR Quetiapine 400MG SRT Clinical Motivation713747 SEROQUEL XR Quetiapine 50MG SRT Clinical Motivation717404 SEROQUEL XR Quetiapine 150MG SRT Clinical Motivation713748 SEROQUEL XR Quetiapine 200MG SRT Clinical Motivation713749 SEROQUEL XR Quetiapine 300MG SRT Clinical Motivation713750 SEROQUEL XR Quetiapine 400MG SRT Clinical Motivation718704 SIZONORM Quetiapine 100MG TAB Accepted treatment718705 SIZONORM Quetiapine 200MG TAB Accepted treatment718674 SIZONORM Quetiapine 25MG TAB Accepted treatment718706 SIZONORM Quetiapine 300MG TAB Accepted treatment720894 SPEC QUETIAPINE Quetiapine 100MG TAB Accepted treatment721710 SPEC QUETIAPINE Quetiapine 150MG TAB Accepted treatment720896 SPEC QUETIAPINE Quetiapine 200MG TAB Accepted treatment720893 SPEC QUETIAPINE Quetiapine 25MG TAB Accepted treatment720897 SPEC QUETIAPINE Quetiapine 300MG TAB Accepted treatment716647 TRUVALIN Quetiapine 100MG TAB Accepted treatment716648 TRUVALIN Quetiapine 200MG TAB Accepted treatment716646 TRUVALIN Quetiapine 25MG TAB Accepted treatment716649 TRUVALIN Quetiapine 300MG TAB Accepted treatment3000148 TRUVALIN XR Quetiapine 50MG SRT Clinical Motivation3000149 TRUVALIN XR Quetiapine 150MG SRT Clinical Motivation3000151 TRUVALIN XR Quetiapine 200MG SRT Clinical Motivation3000152 TRUVALIN XR Quetiapine 300MG SRT Clinical Motivation3000153 TRUVALIN XR Quetiapine 400MG SRT Clinical Motivation3000339 ZIMBIQUET Quetiapine 25MG TAB Accepted treatment3000378 ZIMBIQUET Quetiapine 100MG TAB Accepted treatment3000379 ZIMBIQUET Quetiapine 200MG TAB Accepted treatment3000380 ZIMBIQUET Quetiapine 300MG TAB Accepted treatment711471 ASPEN RISPERIDONE Risperidone 0.5MG TAB Accepted treatment711472 ASPEN RISPERIDONE Risperidone 1MG TAB Accepted treatment711473 ASPEN RISPERIDONE Risperidone 2MG TAB Accepted treatment711474 ASPEN RISPERIDONE Risperidone 3MG TAB Accepted treatment711475 ASPEN RISPERIDONE Risperidone 4MG TAB Accepted treatment716500 AUROPERDAL Risperidone .5MG TAB Accepted treatment716501 AUROPERDAL Risperidone 1MG TAB Accepted treatment716502 AUROPERDAL Risperidone 2MG TAB Accepted treatment716503 AUROPERDAL Risperidone 3MG TAB Accepted treatment716504 AUROPERDAL Risperidone 4MG TAB Accepted treatment720334 PERIDA Risperidone .5MG TAB Accepted treatment720335 PERIDA Risperidone 1MG TAB Accepted treatment712617 PERIZAL Risperidone 0.5MG TAB Accepted treatment712618 PERIZAL Risperidone 1MG TAB Accepted treatment712619 PERIZAL Risperidone 2MG TAB Accepted treatment712621 PERIZAL Risperidone 3MG TAB Accepted treatment717996 RISNIA Risperidone .5MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

717997 RISNIA Risperidone 1MG TAB Accepted treatment717998 RISNIA Risperidone 2MG TAB Accepted treatment717999 RISNIA Risperidone 3MG TAB Accepted treatment714101 RISPACOR Risperidone 0.5MG TAB Accepted treatment713967 RISPACOR Risperidone 1MG TAB Accepted treatment713966 RISPACOR Risperidone 2MG TAB Accepted treatment713965 RISPACOR Risperidone 3MG TAB Accepted treatment891523 RISPERDAL Risperidone 0.5MG TAB Accepted treatment828432 RISPERDAL Risperidone 1MG TAB Accepted treatment801860 RISPERDAL Risperidone 2MG TAB Accepted treatment801879 RISPERDAL Risperidone 3MG TAB Accepted treatment828440 RISPERDAL Risperidone 4MG TAB Accepted treatment705474 RISPERDAL CONSTA Risperidone 25MG VIAL Specialist Motivation705475 RISPERDAL CONSTA Risperidone 37.5MG VIAL Specialist Motivation705476 RISPERDAL CONSTA Risperidone 50MG VIAL Specialist Motivation712252 RISPERIDONE HEXAL Risperidone 0.5MG TAB Accepted treatment710790 RISPERIDONE HEXAL Risperidone 1MG TAB Accepted treatment710791 RISPERIDONE HEXAL Risperidone 2MG TAB Accepted treatment710793 RISPERIDONE HEXAL Risperidone 3MG TAB Accepted treatment723314 RISPIDE Risperidone .5MG TAB Accepted treatment723315 RISPIDE Risperidone 1MG TAB Accepted treatment723316 RISPIDE Risperidone 2MG TAB Accepted treatment711419 RISPERLET Risperidone 0.5MG TAB Accepted treatment711420 RISPERLET Risperidone 1MG TAB Accepted treatment711421 RISPERLET Risperidone 2MG TAB Accepted treatment718226 RISPEVON Risperidone 1MG TAB Accepted treatment718227 RISPEVON Risperidone 2MG TAB Accepted treatment718228 RISPEVON Risperidone 3MG TAB Accepted treatment718229 RISPEVON Risperidone 4MG TAB Accepted treatment711537 RISPONZ Risperidone 1MG TAB Accepted treatment711534 RISPONZ Risperidone 2MG TAB Accepted treatment711536 RISPONZ Risperidone 3MG TAB Accepted treatment711538 RISPONZ Risperidone 4MG TAB Accepted treatment715736 SCHIZOROL Risperidone 0.5MG TAB Accepted treatment715737 SCHIZOROL Risperidone 1MG TAB Accepted treatment715738 SCHIZOROL Risperidone 2MG TAB Accepted treatment721750 ZOXADON Risperidone 3MG TAB Accepted treatment721752 ZOXADON Risperidone 4MG TAB Accepted treatment711511 ZOXADON Risperidone 0.5MG TAB Accepted treatment711512 ZOXADON Risperidone 1MG TAB Accepted treatment711513 ZOXADON Risperidone 2MG TAB Accepted treatment705386 BIO-SULPIRIDE Sulpiride 200MG TAB Accepted treatment766410 STELAZINE Trifluoperazine 1MG TAB Accepted treatment766437 STELAZINE Trifluoperazine 5MG TAB Accepted treatment703465 GEODON Ziprasidone 20MG CAP Clinical Motivation703468 GEODON Ziprasidone 40MG CAP Clinical Motivation703475 GEODON Ziprasidone 60MG CAP Clinical Motivation703476 GEODON Ziprasidone 80MG CAP Clinical Motivation789798 CLOPIXOL Zuclopenthixol 10MG TAB Accepted treatment 796751 CLOPIXOL Zuclopenthixol 2MG TAB Accepted treatment 714852 CLOPIXOL DEPOT Zuclopenthixol 200MG/1ML INJS Accepted treatment

Antidepressants3002709 AMITRIPTYLINE 10 MG AUSTELL Amitriptyline 10MG TAB Accepted treatment718746 GULF AMITRIPTYLINE Amitriptyline 25MG TAB Accepted treatment784230 ROLAB-AMITRIPTYLINE HCL Amitriptyline 25MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

772003 TREPILINE Amitriptyline 10MG TAB Accepted treatment771996 TREPILINE Amitriptyline 25MG TAB Accepted treatment713583 ARROW CITALOPRAM Citalopram 20MG TAB Accepted treatment713584 ARROW CITALOPRAM Citalopram 40MG TAB Accepted treatment713356 AURO-CITALOPRAM Citalopram 20MG TAB Accepted treatment707396 AUSTELL-CITALOPRAM Citalopram 10MG TAB Accepted treatment707398 AUSTELL-CITALOPRAM Citalopram 20MG TAB Accepted treatment707397 AUSTELL-CITALOPRAM Citalopram 40MG TAB Accepted treatment3003785 BIO CITALOPRAM Citalopram 10MG TAB Accepted treatment717094 BIO CITALOPRAM Citalopram 20MG TAB Accepted treatment707888 CILATE Citalopram 20MG TAB Accepted treatment700157 CILIFT Citalopram 20MG TAB Accepted treatment711988 CILORAM Citalopram 20MG TAB Accepted treatment810622 CIPRAMIL Citalopram 20MG TAB Accepted treatment3000328 CITALOPRAM 20 OETHMAAN Citalopram 20MG TAB Accepted treatment716521 CITALOPRAM ACTOR Citalopram 20MG TAB Accepted treatment709407 CITALOPRAM-WINTHROP Citalopram 20MG TAB Accepted treatment704328 DEPRAMIL 20MG Citalopram 20MG TAB Accepted treatment705252 DEPRAMIL Citalopram 40MG TAB Accepted treatment717372 GLENMARK CITALOPRAM Citalopram 20MG TAB Accepted treatment3001172 GULF CITALOPRAM Citalopram 20MG TAB Accepted treatment702769 TALOMIL Citalopram 20MG TAB Accepted treatment757888 PROTHIADEN Dosulepin 25MG CAP Accepted treatment816515 SANDOZ DOTHIEPIN HCL Dosulepin 75MG TAB Accepted treatment800198 THADEN Dosulepin 25MG CAP Accepted treatment800201 THADEN Dosulepin 75MG TAB Accepted treatment703391 A-LENNON FLUOXETINE Fluoxetine 20MG CAP Accepted treatment894303 DEPROZAN Fluoxetine 20MG CAP Accepted treatment716520 FLUOXETINE ACTOR Fluoxetine 20MG CAP Accepted treatment3001358 FLUOXETINE BIOTECH Fluoxetine 20MG CAP Accepted treatment820016 LILLY-FLUOXETINE Fluoxetine 20MG CAP Accepted treatment821063 LORIEN Fluoxetine 20MG CAP Accepted treatment700877 LORIEN 20MG Fluoxetine 20MG TAB Accepted treatment840653 NUZAK Fluoxetine 20MG CAP Accepted treatment879282 PROHEXAL Fluoxetine 20MG CAP Accepted treatment894243 PROHEXAL 20T Fluoxetine 20MG DSP Accepted treatment719658 PROLAX Fluoxetine 20MG CAP Accepted treatment822981 PROZAC Fluoxetine 20MG TAB Accepted treatment757969 PROZAC 20 Fluoxetine 20MG CAP Accepted treatment700686 RANFLOCS Fluoxetine 20MG CAP Accepted treatment838713 ROLAB-FLUOXETINE Fluoxetine 20MG CAP Accepted treatment705064 ZYDUS FLUOXETINE Fluoxetine 20MG CAP Accepted treatment724661 ETHIPRAMINE Imipramine 10MG TAB Accepted treatment724688 ETHIPRAMINE Imipramine 25MG TAB Accepted treatment771120 TOFRANIL Imipramine 10MG TAB Accepted treatment771139 TOFRANIL Imipramine 25MG TAB Accepted treatment735795 LANTANON Mianserin 10MG TAB Accepted treatment735817 LANTANON Mianserin 30MG TAB Accepted treatment704904 ADCO-PAROXETINE Paroxetine 20MG TAB Accepted treatment791571 AROPAX Paroxetine 20MG TAB Accepted treatment703219 AROPAX 30 Paroxetine 30MG TAB Accepted treatment704647 AROPAX CR Paroxetine 12.5MG SRT Accepted treatment704646 AROPAX CR Paroxetine 25MG SRT Accepted treatment718058 AURO PAROXETINE Paroxetine 20MG TAB Accepted treatment707399 AUSTELL-PAROXETINE Paroxetine 20MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

707400 AUSTELL-PAROXETINE Paroxetine 30MG TAB Accepted treatment704792 DEPAROC Paroxetine 20MG TAB Accepted treatment705186 PARAX 20 Paroxetine 20MG TAB Accepted treatment716745 PAROXETINE UNICORN Paroxetine 20MG TAB Accepted treatment704794 PAXIL 20 Paroxetine 20MG TAB Accepted treatment705122 SERRAPRESS 20 Paroxetine 20MG TAB Accepted treatment717561 TEXINE Paroxetine 20MG TAB Accepted treatment705633 XET 20MG Paroxetine 20MG TAB Accepted treatment

Bronchiectasis Antibiotic therapy will be evaluated on an individual basis

Chronic Obstructive Pulmonary DiseaseInhaled B2 agonists

849332 ASTHAVENT 300 DOSE Salbutamol 100MCG INH Accepted treatment700715 ASTHAVENT 300D ECOHALER CFC FREE Salbutamol 100MCG INH Accepted treatment878219 ASTHAVENT DP Salbutamol 200MCG CPS Accepted treatment706544 BEROTEC HFA 200 DOSE Fenoterol 100MCG INH Accepted treatment720748 BRICANYL 100 DOSE Terbutaline .5MG/1DOSE TBH Accepted treatment718698 DUOLIN HFA 200DOSE Salbutamol and other drugs for obstructive airway diseases INH Accepted treatment707882 DUOVENT HFA 200DOSE Fenoterol and ipratropium bromide 50MCG/20MCG INH Accepted treatment3003183 GLENBUTE 200 DOSE Salbutamol 100MCG INH Accepted treatment711213 VENTEZE CFC FREE 200 DOSE Salbutamol 100MCG INH Accepted treatment720723 VENTIMAX CFC FREE 200 DOSE Salbutamol 100MCG INH Accepted treatment703371 VENTOLIN INHALER 200 CFC FREE Salbutamol 100MCG INH Accepted treatment

Long acting B2 agonists820911 FORADIL DRY Formoterol 12MCG CPS Accepted treatment710307 FORATEC HFA 120DOSE Formoterol 12MCG INH Accepted treatment717402 ONBREZ BREEZHALER (30 CAPS & INHALER) Indacaterol KIT Accepted treatment840246 OXIS TURBUHALER Formoterol 9MCG INH Accepted treatment818496 SEREVENT ACCUHALER Salmeterol 50MCG INH Accepted treatment708289 SEREVENT CFC-FREE 120DOSE Salmeterol 25MCG INH Accepted treatment722933 DULERA 200/5UG 120 DOSE Formoterol and mometasone 200MCG/5MCG INH Accepted treatment722934 DULERA 100/5UG 120 DOSE Formoterol and mometasone 100MCG/5MCG INH Accepted treatment

Inhaled corticosteroids827088 BECEZE INHALER COMPLETE Beclomethasone 100MCG INH Accepted treatment819638 BECLATE INHALER Beclomethasone 100MCG INH Accepted treatment820083 BECLATE INHALER Beclomethasone 200MCG INH Accepted treatment827061 BECEZE 50 200DOSE Beclomethasone 50MCG INH Accepted treatment819611 BECLATE INHALER Beclomethasone 50MCG INH Accepted treatment897462 BUDEFLAM CFC FREE 300 DOSE INH Budesonide 100MCG INH Accepted treatment791423 PULMICORT 100 TURB (200 DOSE) Budesonide 100MCG ATH Accepted treatment897469 BUDEFLAM CFC FREE 200MCG 300 DOSE INH Budesonide 200MCG INH Accepted treatment791431 PULMICORT 200 TURB (200 DOSE) Budesonide 200MCG ATH Accepted treatment704020 INFLAMMIDE 200 NOVOLIZE REFIL Budesonide 200MCG REF Accepted treatment704021 INFLAMMIDE 200 NOVOLIZER COMPL Budesonide 200MCG INH Accepted treatment707879 INFLAMMIDE NOVOLIZER COMPLETE 100DOSE Budesonide 400MCG INH Accepted treatment707881 INFLAMMIDE NOVOLIZER REFILL 100DOSE Budesonide 400MCG REF Accepted treatment720735 CICLOVENT 120 DOSE Ciclesonide 160MCG INH Accepted treatment721620 CICLOVENT 60 DOSE Ciclesonide 160MCG INH Accepted treatment705269 ALVESCO 160MCG 120 DOSE Ciclesonide 160MCG INH Accepted treatment705267 ALVESCO 160MCG 60 DOSE Ciclesonide 160MCG INH Accepted treatment720711 CICLOVENT 120 DOSES Ciclesonide 80MCG INH Accepted treatment721621 CICLOVENT 60 DOSE Ciclesonide 80MCG INH Accepted treatment705265 ALVESCO 80MCG 60 DOSE Ciclesonide 80MCG INH Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

818453 FLIXOTIDE ACCUHALER Fluticasone 100MCG CAP Accepted treatment897752 FLIXOTIDE CFC FREE (120 ACT) Fluticasone 125MCG INH Accepted treatment818461 FLIXOTIDE ACCUHALER Fluticasone 250MCG CAP Accepted treatment897759 FLIXOTIDE CFC FREE (120 ACT) Fluticasone 250MCG INH Accepted treatment818488 FLIXOTIDE ACCUHALER Fluticasone 500MCG CAP Accepted treatment818445 FLIXOTIDE ACCUHALER Fluticasone 50MCG CAP Accepted treatment703275 FLIXOTIDE 50 CFC FREE 120 ACT Fluticasone 50MCG INH Accepted treatment720218 VANNAIR 80/4.5MCG PER INHALATION 120 DOS formoterol and budesonide 4.5MCG/80MCG INH Accepted treatment720219 VANNAIR 160/4.5MCG PER INHALATION 120 DO formoterol and budesonide 4.5MCG/160MCG INH Accepted treatment700172 SYMBICORD TURBO 60 DOSE Formoterol/Budesonide 4.5MCG/160MCG INH Accepted treatment700173 SYMBICORD TURBO 120 DOSE Formoterol/Budesonide 4.5MCG/160MCG INH Accepted treatment705984 SYMBICORD 320/9MCG PER INHALATION Formutoterol and other anti- asthmatics 9MCG/320MCG INH Accepted treatment705986 SYMBICORD 80/4.5MCG PER INHALATION Formutoterol and other anti- asthmatics 4.5MCG/80MCG INH Accepted treatment717571 ASMANEX TWISTHALER 30 DOSE Mometasone 200MCG/1DOSE TBH Accepted treatment717572 ASMANEX TWISTHALER 60 DOSE Mometasone 200MCG/1DOSE TBH Accepted treatment717581 ASMANEX TWISTHALER 30 DOSE Mometasone 400MCG/1DOSE TBH Accepted treatment717582 ASMANEX TWISTHALER 60 DOSE Mometasone 400MCG/1DOSE TBH Accepted treatment715752 FOXAIR 25/50 120 DOSE Salmeterol and other anti-asthmatics 25MCG/50MCG INH Accepted treatment715753 FOXAIR 25/125 120DOSE Salmeterol and other anti-asthmatics 25MCG/125MCG INH Accepted treatment715754 FOXAIR 25/250 120DOSE Salmeterol and other anti-asthmatics 25MCG/250MCG INH Accepted treatment715007 FOXAIR 50/500 ACCUHALER Salmeterol/Fluticasone combinations INH Accepted treatment715008 FOXAIR 50/250 ACCUHALER Salmeterol/Fluticasone combinations INH Accepted treatment715009 FOXAIR 50/100 ACCUHALER Salmeterol/Fluticasone combinations INH Accepted treatment715189 SEREFLO 25/50 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/50MCG INH Accepted treatment715190 SEREFLO 25/125 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/125MCG INH Accepted treatment715191 SEREFLO 25/250 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/250MCG INH Accepted treatment721412 SEREFLO 25/50 HFA SYNCHROBREATHE 120 DOS Salmeterol/Fluticasone combinations 25MCG/50MCG INH Accepted treatment721413 SEREFLO 25/125 HFA SYNCHROBREATHE 120 DO Salmeterol/Fluticasone combinations 25MCG/125MCG INH Accepted treatment721414 SEREFLO 25/250 HFA SYNCHROBREATHE 120 DO Salmeterol/Fluticasone combinations 25MCG/250MCG INH Accepted treatment3003304 SEREFLO DPI 50/100 60 DOSE Salmeterol/Fluticasone combinations 50MCG/100MCG ACC Accepted treatment3003305 SEREFLO DPI 50/250 60 DOSE Salmeterol/Fluticasone combinations 50MCG/250MCG ACC Accepted treatment874493 SERETIDE 50/100 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/100MCG INH Accepted treatment874507 SERETIDE 50/250 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/250MCG INH Accepted treatment874515 SERETIDE 50/500 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/500MCG INH Accepted treatment894989 SERETIDE 25/50 120 DOSE Salmeterol/Fluticasone combinations 25MCG/50MCG INH Accepted treatment894990 SERETIDE 120 DOSE Salmeterol/Fluticasone combinations 25MCG/125MCG INH Accepted treatment895006 SERETIDE 120 DOSE Salmeterol/Fluticasone combinations 25MCG/250MCG INH Accepted treatment

Anticholinergic inhalers (short acting)706543 ATROVENT HFA 200 DOSE Ipratropium bromide 20MCG INH Accepted treatment715574 IPVENT HFA 200 DOSE Ipratropium bromide 40MCG/1DOSE INH Accepted treatment

Oral Xanthines725005 EUPHYLLIN RETARD Theophylline 250MG SRT Accepted treatment748501 NUELIN SA 250 Theophylline 250MG TAB Accepted treatment788368 ROLAB-THEOPHYLLINE ANHYDROUS Theophylline 200MG SRT Accepted treatment788376 ROLAB-THEOPHYLLINE ANHYDROUS Theophylline 300MG SRT Accepted treatment783005 THEOPLUS Theophylline 200MG SRT Accepted treatment783013 THEOPLUS Theophylline 300MG SRT Accepted treatment785105 UNIPHYL Theophylline 400MG SRT Accepted treatment816159 UNIPHYL Theophylline 600MG SRT Accepted treatment

Oral Corticosteroids814407 CAPSOID Prednisolone 5MG TAB Special Investigations (SI)800155 LENISOLONE Prednisolone 5MG TAB Special Investigations (SI)703720 PRELONE Prednisolone 5MG TAB Special Investigations (SI)742759 METICORTEN Prednisone 50MG TAB Special Investigations (SI)742732 METICORTEN Prednisone 5MG TAB Special Investigations (SI)

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

752304 PANAFCORT Prednisone 5MG TAB Special Investigations (SI)788783 PREDNISONE (BE-TABS) Prednisone 5MG TAB Special Investigations (SI)836826 PULMISON TABS Prednisone 20MG TAB Special Investigations (SI)818267 TROLIC Prednisone 5MG TAB Special Investigations (SI)

Cardiac failure/ CardiomyopathyAnticoagulants

709905 CIPLA WARFARIN 5MG Warfarin 5MG TAB Accepted treatment709906 CIPLA WARFARIN 1MG Warfarin 1MG TAB Accepted treatment778362 WARFARIN Warfarin 5MG TAB Accepted treatment

Diuretics711152 BURINEX Bumetanide 1MG TAB Accepted treatment707423 AUSTELL-FUROSEMIDE Furosemide 40MG TAB Accepted treatment707421 AUSTELL-FUROSEMIDE Furosemide 20MG TAB Accepted treatment821845 BEURISES Furosemide 40MG TAB Accepted treatment716048 DINO-RETIC Furosemide 40MG TAB Accepted treatment705967 DIURESIX Furosemide 40MG TAB Accepted treatment735930 LASIX Furosemide 20MG TAB Accepted treatment735949 LASIX Furosemide 40MG TAB Accepted treatment735957 LASIX Furosemide 500MG TAB Accepted treatment839515 LASIX ORAL Furosemide 10MG/1ML SLN Accepted treatment857769 MYLAN FUROSEMIDE Furosemide 40MG TAB Accepted treatment758272 PURESIS Furosemide 40MG TAB Accepted treatment731668 ROLAB-FUROSEMIDE Furosemide 40MG TAB Accepted treatment3001173 GULF HYDROCHLOROTHIAZIDE Hydrochlorothiazide 25MG TAB Accepted treatment890470 HEXAZIDE Hydrochlorothiazide 25MG TAB Accepted treatment880949 RIDAQ Hydrochlorothiazide 25MG TAB Accepted treatment710437 RIDAQ Hydrochlorothiazide 12.5MG TAB Accepted treatment774057 URIREX-K Hydrochlorothiazide and potassium TAB Accepted treatment780618 ADCO-RETIC Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB Accepted treatment702803 AMILORETIC Hydrochlorothiazide and potassium-sparing agents 50MG/5MG TAB Accepted treatment702811 AMILORETIC HS Hydrochlorothiazide and potassium-sparing agents 2.5MG/25MG TAB Accepted treatment719984 DEZRETIC 5MG/50MG Hydrochlorothiazide and potassium-sparing agents 50MG/5MG TAB Accepted treatment721824 DYAZIDE Hydrochlorothiazide and potassium-sparing agents 25MG/50MG TAB Accepted treatment744379 MODURETIC Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB Accepted treatment780146 RENEZIDE Hydrochlorothiazide and potassium-sparing agents 25MG/50MG TAB Accepted treatment706531 SPEC-CO-AMILORIDE Hydrochlorothiazide and potassium-sparing agents 50MG/5MG TAB Accepted treatment700820 CATEXAN Indapamide 2.5MG TAB Accepted treatment710313 CIPLA-INDAPAMIDE Indapamide 2.5MG TAB Accepted treatment819417 DAPAMAX Indapamide 2.5MG TAB Accepted treatment833045 DAPTRIL Indapamide 2.5MG TAB Accepted treatment716962 DYNA INDAPAMIDE SR Indapamide 1.5MG SRT Accepted treatment822825 HYDRO-LESS Indapamide 2.5MG TAB Accepted treatment703329 MYLAN-INDAPAMIDE Indapamide 2.5MG TAB Accepted treatment746002 NATRILIX Indapamide 2.5MG TAB Accepted treatment830836 NATRILIX SR Indapamide 1.5MG SRT Accepted treatment831026 ROLAB-INDAPAMIDE Indapamide 2.5MG TAB Accepted treatment807818 ARELIX Piretanide 6MG TAB Accepted treatment701807 ALDACTONE Spironolactone 100MG TAB Accepted treatment701793 ALDACTONE Spironolactone 25MG APP Accepted treatment769665 ROLAB-SPIRONOLACTONE Spironolactone 25MG TAB Accepted treatment898937 SPIRACTIN Spironolactone 100MG TAB Accepted treatment765910 SPIRACTIN Spironolactone 25MG TAB Accepted treatment3000185 RISAT Torasemide 5MG TAB Accepted treatment3000186 RISAT Torasemide 10MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

723757 TORASEMIDE BIOTECH Torasemide 5MG TAB Accepted treatment723758 TORASEMIDE BIOTECH Torasemide 10MG TAB Accepted treatment3003210 TORSINAT Torasemide 10MG TAB Accepted treatment3003208 TORSINAT Torasemide 2.5MG TAB Accepted treatment3003209 TORSINAT Torasemide 5MG TAB Accepted treatment820369 UNAT Torasemide 2.5MG TAB Accepted treatment820377 UNAT Torasemide 5MG TAB Accepted treatment820385 UNAT Torasemide 10MG TAB Accepted treatment

Potassium supplementation3002425 BIOGEN POTASSIUM SLOW RELEASE Potassium chloride 600MG TAB Accepted treatment3003819 DIS-CHEM GOLD SLOW RELEASE POTASSIUM Potassium chloride 600MG SRT Accepted treatment755753 PLENISH K Potassium chloride 600MG TAB Accepted treatment3001820 PLENISH-K SR Potassium chloride 600MG SRT Accepted treatment719270 POTASSIUM CHLORIDE UNICORN Potassium chloride 600MG TAB Accepted treatment702947 SANDOZ K-600 Potassium chloride 600MG TAB Accepted treatment764396 SLOW-K Potassium chloride 600MG TAB Accepted treatment768227 SWISS-KAL SR Potassium chloride SRT Accepted treatment718911 ULTIPOT Potassium chloride 600MG TAB Accepted treatment

ACE inhibitors852333 BIO-CAPTOPRIL Captopril 25MG TAB Accepted treatment795267 CAPACE Captopril 25MG TAB Accepted treatment837628 CAPTOHEXAL Captopril 12.5MG TAB Accepted treatment837636 CAPTOHEXAL Captopril 25MG TAB Accepted treatment836451 CAPTOMAX Captopril 25MG TAB Accepted treatment

836478 CAPTOMAX Captopril 50MG TAB Accepted treatment

852619 MYLAN CAPTOPRIL Captopril 25MG TAB Accepted treatment

899429 MYLAN-CAPTOPRIL Captopril 50MG TAB Accepted treatment

839779 ZAPTO Captopril 25MG TAB Accepted treatment839787 ZAPTO Captopril 50MG TAB Accepted treatment792756 INHIBACE Cilazapril 5MG TAB Accepted treatment886843 ADCO-ENALAPRIL 10MG Enalapril 10MG TAB Accepted treatment886851 ADCO-ENALAPRIL 20MG Enalapril 20MG TAB Accepted treatment881481 ALAPREN 10 Enalapril 10MG TAB Accepted treatment881503 ALAPREN 20 Enalapril 20MG TAB Accepted treatment881473 ALAPREN 5 Enalapril 5MG TAB Accepted treatment721626 AUSTELL ENALAPRIL Enalapril 10MG TAB Accepted treatment721627 AUSTELL ENALAPRIL Enalapril 20MG TAB Accepted treatment721625 AUSTELL ENALAPRIL Enalapril 5MG TAB Accepted treatment894324 CIPLATEC 10 Enalapril 10MG TAB Accepted treatment701729 CIPLATEC 20MG Enalapril 20MG TAB Accepted treatment894316 CIPLATEC 5 Enalapril 5MG TAB Accepted treatment723156 ENALAPRIL BIOTECH Enalapril 5MG TAB Accepted treatment723157 ENALAPRIL BIOTECH Enalapril 10MG TAB Accepted treatment723159 ENALAPRIL BIOTECH Enalapril 20MG TAB Accepted treatment3000716 ENALAPRIL UNICORN Enalapril 5MG TAB Accepted treatment891279 ENAP 10MG Enalapril 10MG TAB Accepted treatment891280 ENAP 20MG Enalapril 20MG TAB Accepted treatment891272 ENAP 5MG Enalapril 5MG TAB Accepted treatment712763 ENVAS Enalapril 10MG TAB Accepted treatment712762 ENVAS Enalapril 5MG TAB Accepted treatment867853 HR-ENALAPRIL 10 Enalapril 10MG TAB Accepted treatment867861 HR-ENALAPRIL 20 Enalapril 20MG TAB Accepted treatment867845 HR-ENALAPRIL 5 Enalapril 5MG TAB Accepted treatment

862622 HYPACE Enalapril 5MG TAB Accepted treatment

868914 PHARMAPRESS Enalapril 10MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

868922 PHARMAPRESS Enalapril 20MG TAB Accepted treatment708109 PHARMAPRESS Enalapril 5MG TAB Accepted treatment759783 RENITEC Enalapril 10MG TAB Accepted treatment810355 RENITEC Enalapril 2.5MG TAB Accepted treatment759767 RENITEC Enalapril 20MG TAB Accepted treatment759759 RENITEC Enalapril 5MG TAB Accepted treatment

791962 MONOPRIL Fosinopril 20MG TAB Accepted treatment

715938 APEX-LISINOPRIL Lisinopril 20MG TAB Accepted treatment714678 AURO-LISINOPRIL Lisinopril 10MG TAB Accepted treatment714679 AURO-LISINOPRIL Lisinopril 20MG TAB Accepted treatment714677 AURO-LISINOPRIL Lisinopril 5MG TAB Accepted treatment704354 AUSTELL LISINOPRIL 2.5MG Lisinopril 2.5MG TAB Accepted treatment708189 AUSTELL LISINOPRIL 20MG Lisinopril 20MG TAB Accepted treatment712598 AUSTELL-LISINOPRIL Lisinopril 10MG TAB Accepted treatment701392 HEXAL-LISINOPRIL Lisinopril 10MG TAB Accepted treatment701387 HEXAL-LISINOPRIL Lisinopril 5MG TAB Accepted treatment3000547 LISO Lisinopril 10MG TAB Accepted treatment3000548 LISO Lisinopril 20MG TAB Accepted treatment3000546 LISO Lisinopril 5MG TAB Accepted treatment716794 LYSIN Lisinopril 10MG TAB Accepted treatment716792 LYSIN Lisinopril 5MG TAB Accepted treatment700692 SINOPREN 10 Lisinopril 10MG TAB Accepted treatment700694 SINOPREN 20 Lisinopril 20MG TAB Accepted treatment700691 SINOPREN 5 Lisinopril 5MG TAB Accepted treatment703645 ZEMAX 10 Lisinopril 10MG TAB Accepted treatment703646 ZEMAX 5 Lisinopril 5MG TAB Accepted treatment781703 ZESTRIL Lisinopril 10MG TAB Accepted treatment781711 ZESTRIL Lisinopril 20MG TAB Accepted treatment781681 ZESTRIL Lisinopril 5MG TAB Accepted treatment862053 ZETOMAX (ZESTOMAX) 10MG Lisinopril 10MG TAB Accepted treatment862061 ZETOMAX (ZESTOMAX) 20MG Lisinopril 20MG TAB Accepted treatment862045 ZETOMAX (ZESTOMAX) 5MG Lisinopril 5MG TAB Accepted treatment

890229 PERDIX 15MG Moexipril 15MG TAB Accepted treatment

890222 PERDIX 7.5MG Moexipril 7.5MG TAB Accepted treatment

715649 ACESYL Perindopril 4MG TAB Accepted treatment714869 ACTI-PREX (GLENMARK PERINDOPRIL) Perindopril 4MG TAB Accepted treatment716505 AURO PERINDOPRIL Perindopril 4MG TAB Accepted treatment716506 AURO PERINDOPRIL Perindopril 8MG TAB Accepted treatment717293 BINDACE Perindopril 4MG TAB Accepted treatment717294 BINDACE Perindopril 8MG TAB Accepted treatment710302 CIPLA-PERINDOPRIL Perindopril 4MG TAB Accepted treatment710510 CIPLA-PERINDOPRIL Perindopril 8MG TAB Accepted treatment715786 CIPLASYL Perindopril 4MG TAB Accepted treatment715795 CIPLASYL Perindopril 8MG TAB Accepted treatment3000236 CIRCATOR Perindopril 8MG TAB Accepted treatment708649 CIRCATOR Perindopril 4MG TAB Accepted treatment785121 COVERSYL Perindopril 4MG TAB Accepted treatment705915 COVERSYL Perindopril 10MG TAB Accepted treatment714527 PEARINDA Perindopril 4MG TAB Accepted treatment714528 PEARINDA Perindopril 8MG TAB Accepted treatment717783 PERINDOPRIL UNICORN Perindopril 4MG TAB Accepted treatment717784 PERINDOPRIL UNICORN Perindopril 8MG TAB Accepted treatment721339 PERISTAR Perindopril 4MG TAB Accepted treatment721340 PERISTAR Perindopril 8MG TAB Accepted treatment703541 PREXUM Perindopril 4MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

720387 PREXUM Perindopril 5MG TAB Accepted treatment714646 PREXUM Perindopril 10MG TAB Accepted treatment710611 RAN-PERINDOPRIL Perindopril 4MG TAB Accepted treatment712615 SPEC-PERINDOPRIL Perindopril 4MG TAB Accepted treatment712616 SPEC-PERINDOPRIL Perindopril 8MG TAB Accepted treatment710297 VECTORYL Perindopril 4MG TAB Accepted treatment710925 VECTORYL Perindopril 8MG TAB Accepted treatment716680 ZYDUS PERINDOPRIL Perindopril 4MG TAB Accepted treatment708119 ACCUMAX Quinapril 10MG TAB Accepted treatment708120 ACCUMAX Quinapril 20MG TAB Accepted treatment783293 ACCUPRIL Quinapril 5MG TAB Accepted treatment783307 ACCUPRIL Quinapril 10MG TAB Accepted treatment783315 ACCUPRIL Quinapril 20MG TAB Accepted treatment853186 ACCUPRIL Quinapril 40MG TAB Accepted treatment708981 QUINAGEN Quinapril 5MG TAB Accepted treatment708982 QUINAGEN Quinapril 10MG TAB Accepted treatment708983 QUINAGEN Quinapril 20MG TAB Accepted treatment708985 QUINAGEN Quinapril 40MG TAB Accepted treatment705457 QUINASPEN 10MG Quinapril 10MG TAB Accepted treatment705447 QUINASPEN 20MG Quinapril 20MG TAB Accepted treatment715957 APEX-RAMIPRIL Ramipril 10MG CAP Accepted treatment715954 APEX-RAMIPRIL Ramipril 2.5MG CAP Accepted treatment715955 APEX-RAMIPRIL Ramipril 5MG CAP Accepted treatment705752 AUSTELL-RAMIPRIL 1.25MG Ramipril 1.25MG CAP Accepted treatment705755 AUSTELL-RAMIPRIL 10MG Ramipril 10MG CAP Accepted treatment705753 AUSTELL-RAMIPRIL 2.5MG Ramipril 2.5MG CAP Accepted treatment705754 AUSTELL-RAMIPRIL 5MG Ramipril 5MG CAP Accepted treatment3000178 LIRACEN Ramipril 5MG CAP Accepted treatment3000179 LIRACEN Ramipril 10MG CAP Accepted treatment704374 RAMIPRIL HEXAL Ramipril 2.5MG TAB Accepted treatment704375 RAMIPRIL HEXAL Ramipril 5MG TAB Accepted treatment704023 RAMIWIN Ramipril 2.5MG CAP Accepted treatment704025 RAMIWIN Ramipril 5MG CAP Accepted treatment705426 RAMPIL 1.25MG Ramipril 1.25MG CAP Accepted treatment705429 RAMPIL 10MG Ramipril 10MG CAP Accepted treatment705427 RAMPIL 2.5MG Ramipril 2.5MG CAP Accepted treatment705428 RAMPIL 5MG Ramipril 5MG CAP Accepted treatment841579 TRITACE Ramipril 1.25MG TAB Accepted treatment841587 TRITACE Ramipril 2.5MG TAB Accepted treatment841595 TRITACE Ramipril 5MG TAB Accepted treatment782602 TRITACE Ramipril 10MG CAP Accepted treatment805068 MAVIK (PREVIOUSLY GOPTEN) Trandolapril 2MG CAP Accepted treatment805033 MAVIK (PREVIOUSLY GOPTEN) Trandolapril 0.5MG CAP Accepted treatment

ACE inhibitor and diuretic combinations839795 ZAPTO-CO Captopril and diuretics 50MG/25MG TAB Accepted treatment815055 INHIBACE PLUS Cilazapril and diuretics 5MG/12.5MG TAB Accepted treatment787035 CO-RENITEC Enalapril and diuretics 20MG/12.5MG TAB Accepted treatment891287 ENAP-CO Enalapril and diuretics 20MG/12.5MG TAB Accepted treatment885019 PHARMAPRESS CO Enalapril and diuretics 20MG/12.5MG TAB Accepted treatment716120 AURO-LISINOPRIL CO Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment716121 AURO-LISINOPRIL CO Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment704703 HEXAL LISINOPRIL CO 10 Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment704704 HEXAL LISINOPRIL CO 20 Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment716943 LISINOPRIL CO UNICORN 10MG/12.5MG Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment716945 LISINOPRIL CO UNICORN 20MG/12.5MG Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

704437 LISORETIC 10/12.5 Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment704438 LISORETIC 20/12.5 Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment707292 LISOZIDE 10MG/12.5MG Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment707291 LISOZIDE 20MG/12.5MG Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment817848 ZESTORETIC Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment797685 ZESTORETIC Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment708260 ZESTOZIDE 20 Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment704597 ZETOMAX CO 10/12.5 Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment704598 ZETOMAX CO 20/12.5 Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment715651 ACESYL CO Perindopril and diuretics 1.25MG/4MG TAB Accepted treatment717795 ARIPREL PLUS 4MG/1.25MG Perindopril and diuretics 1.25MG/4MG TAB Accepted treatment708650 CIRCATOR PLUS 4MG/1.25MG Perindopril and diuretics 4MG/1.25MG TAB Accepted treatment721508 BIOPREXUM PLUS 10MG/2.5MG Perindopril and diuretics 10MG/2.5MG TAB Accepted treatment877549 COVERSYL PLUS Perindopril and diuretics 4MG/1.25MG TAB Accepted treatment720389 COVERSYL PLUS 5MG/1.25MG Perindopril and diuretics 5MG/1.25MG TAB Accepted treatment714952 PEARINDA PLUS Perindopril and diuretics 1.25MG/4MG TAB Accepted treatment717782 PERINDOPRIL CO UNICORN 4MG/1.25MG Perindopril and diuretics 1.25MG/4MG TAB Accepted treatment704929 PREXUM PLUS Perindopril and diuretics 4MG/1.25MG TAB Accepted treatment720388 PREXUM PLUS 5MG/1.25MG Perindopril and diuretics 5MG/1.25MG TAB Accepted treatment713763 SPEC-PERINDOPRIL PLUS Perindopril and diuretics 1.25MG/4MG TAB Accepted treatment3003940 TREXEVA PLUS 5MG/1.25MG Perindopril and diuretics 5MG/1.25MG TAB Accepted treatment710298 VECTORYL PLUS Perindopril and diuretics 1.25MG/4MG TAB Accepted treatment717095 ZYDUS PERINDOPRIL CO 4MG/1.25MG Perindopril and diuretics 1.25MG/4MG TAB Accepted treatment708116 ACCUMAX CO Quinapril and diuretics 10MG/12.5MG TAB Accepted treatment708118 ACCUMAX CO Quinapril and diuretics 20MG/12.5MG TAB Accepted treatment795755 ACCURETIC Quinapril and diuretics 10MG/12.5MG TAB Accepted treatment805297 ACCURETIC Quinapril and diuretics 20MG/12.5MG TAB Accepted treatment706235 ADCO-QUINARETIC 10/12.5MG Quinapril and diuretics 10MG/12.5MG TAB Accepted treatment706236 ADCO-QUINARETIC 20/12.5MG Quinapril and diuretics 20MG/12.5MG TAB Accepted treatment718056 AURO QUINAPRIL CO 10MG/12.5MG Quinapril and diuretics 10MG/12.5MG TAB Accepted treatment718057 AURO QUINAPRIL CO 20MG/12.5MG Quinapril and diuretics 20MG/12.5MG TAB Accepted treatment723564 CO-RAMIWIN 2.5MG/12.5MG Ramipril and diuretics 2.5MG/12.5MG TAB Accepted treatment723565 CO-RAMIWIN 5MG/12.5MG Ramipril and diuretics 5MG/12.5MG TAB Accepted treatment723566 CO-RAMIWIN 10MG/12.5MG Ramipril and diuretics 10MG/12.5MG TAB Accepted treatment718093 TRITACE PLUS 10MG/12.5MG Ramipril and diuretics 10MG/12.5MG TAB Accepted treatment718094 TRITACE PLUS 5MG/12.5MG Ramipril and diuretics 5MG/12.5MG TAB Accepted treatment718092 TRITACE PLUS 5MG/25MG Ramipril and diuretics 5MG/25MG TAB Accepted treatment

Angiotensin Receptor Blockers721629 ABECARD Candesartan 8MG TAB Accepted treatment721630 ABECARD Candesartan 16MG TAB Accepted treatment856118 ATACAND Candesartan 16MG TAB Accepted treatment856096 ATACAND Candesartan 8MG TAB Accepted treatment723123 ATERWIN Candesartan 8MG TAB Accepted treatment723124 ATERWIN Candesartan 16MG TAB Accepted treatment719210 MYLACAND Candesartan 16MG TAB Accepted treatment719209 MYLACAND Candesartan 8MG TAB Accepted treatment720582 ANTOSART Irbesartan 150MG TAB Accepted treatment720583 ANTOSART Irbesartan 300MG TAB Accepted treatment837814 APROVEL Irbesartan 150MG TAB Accepted treatment837822 APROVEL Irbesartan 300MG TAB Accepted treatment717793 DYNARB Irbesartan 150MG TAB Accepted treatment717794 DYNARB Irbesartan 300MG TAB Accepted treatment723194 JUBITAN Irbesartan 150MG TAB Accepted treatment723203 JUBITAN Irbesartan 300MG TAB Accepted treatment712385 IRBEWIN Irbesartan 150MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

712384 IRBEWIN Irbesartan 300MG TAB Accepted treatment718506 IRTANEL Irbesartan 150MG TAB Accepted treatment718507 IRTANEL Irbesartan 300MG TAB Accepted treatment716495 ANNIN Losartan 100MG TAB Accepted treatment716494 ANNIN Losartan 50MG TAB Accepted treatment717069 AUSTELL LOSARTAN Losartan 100MG TAB Accepted treatment717068 AUSTELL LOSARTAN Losartan 50MG TAB Accepted treatment716644 CIPLAZAR Losartan 100MG TAB Accepted treatment716643 CIPLAZAR Losartan 50MG TAB Accepted treatment818739 COZAAR Losartan 50MG TAB Accepted treatment710079 COZAAR Losartan 100MG TAB Accepted treatment717024 HYTENZA Losartan 50MG TAB Accepted treatment717042 HYTENZA Losartan 100MG TAB Accepted treatment3000575 LOSARTAN BIOTECH Losartan 50MG TAB Accepted treatment718366 LOSARTAN UNICORN Losartan 100MG TAB Accepted treatment718365 LOSARTAN UNICORN Losartan 50MG TAB Accepted treatment709909 LOSARTAN-WINTHROP Losartan 50MG TAB Accepted treatment720776 LOZAAN Losartan 100MG TAB Accepted treatment720775 LOZAAN Losartan 50MG TAB Accepted treatment721259 NORMOTEN Losartan 50MG TAB Accepted treatment721260 NORMOTEN Losartan 100MG TAB Accepted treatment717296 RASOL Losartan 100MG TAB Accepted treatment717295 RASOL Losartan 50MG TAB Accepted treatment715871 RENICARD Losartan 50MG TAB Accepted treatment713254 SPEC-LOSARTAN Losartan 100MG TAB Accepted treatment713255 SPEC-LOSARTAN Losartan 50MG TAB Accepted treatment3000513 ZAARIO Losartan 100MG TAB Accepted treatment3000512 ZAARIO Losartan 50MG TAB Accepted treatment709225 ZARTAN Losartan 50MG TAB Accepted treatment709964 ZARTAN Losartan 100MG TAB Accepted treatment3003078 CARDIZ Telmisartan 40MG TAB Accepted treatment3003054 CARDIZ Telmisartan 80MG TAB Accepted treatment3000736 ADCO TELMISARTAN Telmisartan 40MG TAB Accepted treatment3000737 ADCO TELMISARTAN Telmisartan 80MG TAB Accepted treatment860387 MICARDIS Telmisartan 40MG TAB Accepted treatment860395 MICARDIS Telmisartan 80MG TAB Accepted treatment720439 MIZART Telmisartan 40MG TAB Accepted treatment720440 MIZART Telmisartan 80MG TAB Accepted treatment714249 PRITOR Telmisartan 40MG TAB Accepted treatment714250 PRITOR Telmisartan 80MG TAB Accepted treatment3003679 TELEASE Telmisartan 40MG TAB Accepted treatment3003680 TELEASE Telmisartan 80MG TAB Accepted treatment720592 TELGEN Telmisartan 40MG TAB Accepted treatment720593 TELGEN Telmisartan 80MG TAB Accepted treatment3003300 TELMISARTAN 40 TEVA Telmisartan 40MG TAB Accepted treatment3003301 TELMISARTAN 80 TEVA Telmisartan 80MG TAB Accepted treatment721678 TESAR Telmisartan 40MG TAB Accepted treatment721679 TESAR Telmisartan 80MG TAB Accepted treatment723946 ADCO-VALSARTAN Valsartan 80MG TAB Accepted treatment723947 ADCO-VALSARTAN Valsartan 160MG TAB Accepted treatment700710 DIOVAN 160 Valsartan 160MG TAB Accepted treatment700000 DIOVAN 80 Valsartan 80MG TAB Accepted treatment723724 DYNAVAL Valsartan 80MG TAB Accepted treatment723725 DYNAVAL Valsartan 160MG TAB Accepted treatment715569 MIGROBEN Valsartan 160MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

715568 MIGROBEN Valsartan 80MG TAB Accepted treatment3001856 REGOVAL Valsartan 160MG TAB Accepted treatment3001865 REGOVAL Valsartan 80MG TAB Accepted treatment704696 TAREG Valsartan 160MG TAB Accepted treatment705060 TAREG Valsartan 80MG TAB Accepted treatment3000481 VALHEFT Valsartan 160MG TAB Accepted treatment3000480 VALHEFT Valsartan 80MG TAB Accepted treatment718364 VALSARTAN UNICORN Valsartan 160MG TAB Accepted treatment718363 VALSARTAN UNICORN Valsartan 80MG TAB Accepted treatment723770 VASOVAN Valsartan 80MG TAB Accepted treatment723771 VASOVAN Valsartan 160MG TAB Accepted treatment715556 ZOMEVEK Valsartan 160MG TAB Accepted treatment715555 ZOMEVEK Valsartan 80MG TAB Accepted treatment

Angiotensin Receptor Blockers and diuretic combinations898635 ATACAND PLUS Candesartan and diuretics 16MG/12.5MG TAB Accepted treatment719453 CANDEPRES PLUS 16MG/12.5MG Candesartan and diuretics 16MG/12.5MG TAB Accepted treatment719506 MYLACAND PLUS 16MG/12.5MG Candesartan and diuretics 16MG/12.5MG TAB Accepted treatment891353 COAPROVEL Irbesartan and diuretics 150MG/12.5MG TAB Accepted treatment712386 CO-IRBEWIN Irbesartan and diuretics 150MG/12.5MG TAB Accepted treatment898597 COAPROVEL Irbesartan and diuretics 300MG/12.5MG TAB Accepted treatment712387 CO-IRBEWIN Irbesartan and diuretics 300MG/12.5MG TAB Accepted treatment720930 CO-IRBEWIN 300MG/25MG Irbesartan and diuretics 300MG/25MG TAB Accepted treatment723331 COZAAR COMP 100MG/12.5MG Losartan and diuretics 100MG/12.5MG TAB Accepted treatment3000159 CO-NORMOTEN 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment887096 FORTZAAR Losartan and diuretics 100MG/25MG TAB Accepted treatment717084 HYTENZA CO 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment716059 LOHYPE FORTE PLUS 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment715857 LOSAAR PLUS 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment3000577 LOSARTAN COMP BIOTECH 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment718368 LOSARTAN CO UNICORN 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment715739 LOZAAN CO 100/25 Losartan and diuretics 100MG/25MG TAB Accepted treatment715849 NETRASOL CO 100/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment716515 SARTOC 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment716217 ZARTAN CO 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment717070 AUSTELL LOSARTAN CO 50MG/12.5MG Losartan and diuretics 50MG/12.5 MG TAB Accepted treatment3000158 CO-NORMOTEN 50MG/12.5MG Losartan and diuretics 50MG/12.5 MG TAB Accepted treatment828181 COZAAR COMP Losartan and diuretics 50MG/12.5 MG TAB Accepted treatment716476 HYTENZA CO 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment716058 LOHYPE PLUS 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment715856 LOSAAR PLUS 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment716274 LOSACAR CO 50MG/12,5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment3000576 LOSARTAN COMP BIOTECH 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment718367 LOSARTAN CO UNICORN 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment715740 LOZAAN CO 50/12.5 Losartan and diuretics 50MG/12.5MG TAB Accepted treatment715848 NETRASOL CO 50/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment715064 SARTOC 50/12.5 Losartan and diuretics 50MG/12.5MG TAB Accepted treatment716216 ZARTAN CO 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment714251 CO-PRITOR 40/12.5 MG Telmisartan + Hydrochlorothiazide 40MG/12.5MG TAB Accepted treatment714252 CO-PRITOR 80/12.5MG Telmisartan + Hydrochlorothiazide 80MG/12.5MG TAB Accepted treatment716791 CO-MICARDIS 80MG/25MG Telmisartan + Hydrochlorothiazide 80MG/25MG TAB Accepted treatment894614 CO-MICARDIS 40/12.5MG Telmisartan + Hydrochlorothiazide 40MG/12.5MG TAB Accepted treatment894621 CO-MICARDIS 80/12.5MG Telmisartan + Hydrochlorothiazide 80MG/12.5MG TAB Accepted treatment3000422 TELPRES PLUS 40MG/12.5MG Telmisartan + Hydrochlorothiazide 40MG/12.5MG TAB Accepted treatment3000423 TELPRES PLUS 80MG/12.5MG Telmisartan + Hydrochlorothiazide 80MG/12.5MG TAB Accepted treatment3003570 TESAR CO 40MG/12.5MG Telmisartan + Hydrochlorothiazide 40MG/12.5MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

3003582 TESAR CO 80MG/12.5MG Telmisartan + Hydrochlorothiazide 80MG/12.5MG TAB Accepted treatment3003656 TICARDA PLUS 40MG/12.5MG Telmisartan + Hydrochlorothiazide 40MG/12.5MG TAB Accepted treatment3003657 TICARDA PLUS 80MG/12.5MG Telmisartan + Hydrochlorothiazide 80MG/12.5MG TAB Accepted treatment3002446 TREMISTAN PLUS 40MG/12.5MG Telmisartan + Hydrochlorothiazide 40MG/12.5MG TAB Accepted treatment3001913 TREMISTAN PLUS 80MG/12.5MG Telmisartan + Hydrochlorothiazide 80MG/12.5MG TAB Accepted treatment715672 CO-TAREG 160MG/12.5MG Valsartan and diuretics 160MG/12.5MG TAB Accepted treatment891894 CO-DIOVAN Valsartan and diuretics 160MG/12.5MG TAB Accepted treatment706051 CO-DIOVAN PLUS Valsartan and diuretics 160MG/25MG TAB Accepted treatment715673 CO-TAREG PLUS Valsartan and diuretics 160MG/25MG TAB Accepted treatment705068 CO-TAREG 80MG/12.5MG Valsartan and diuretics 80MG TAB Accepted treatment839884 CO-DIOVAN Valsartan and diuretics 80MG/12.5MG TAB Accepted treatment715571 CO-MIGROBEN 160MG/12.5MG Valsartan and diuretics TAB Accepted treatment715572 CO-MIGROBEN 160MG/25MG Valsartan and diuretics TAB Accepted treatment715570 CO-MIGROBEN 80MG/12.5MG Valsartan and diuretics TAB Accepted treatment715559 CO-ZOMEVEK 160MG/12.5MG Valsartan and diuretics TAB Accepted treatment715558 CO-ZOMEVEK 80MG/12.5MG Valsartan and diuretics TAB Accepted treatment715560 CO-ZOMEVEK160MG/25MG Valsartan and diuretics TAB Accepted treatment719205 REGOVAL CO 160MG/12.5MG Valsartan and diuretics 160MG/12.5MG TAB Accepted treatment719206 REGOVAL CO 160MG/25MG Valsartan and diuretics 160MG/25MG TAB Accepted treatment719204 REGOVAL CO 80MG/12.5MG Valsartan and diuretics 80MG/12.5MG TAB Accepted treatment

Beta-blockers786586 ADCO-ATENOLOL Atenolol 100MG TAB Accepted treatment786578 ADCO-ATENOLOL Atenolol 50MG TAB Accepted treatment704651 B-BLOCK Atenolol 100MG TAB Accepted treatment704653 B-BLOCK Atenolol 50MG TAB Accepted treatment715626 GULF ATENOLOL Atenolol 100MG TAB Accepted treatment715625 GULF ATENOLOL Atenolol 50MG TAB Accepted treatment806897 HEXA-BLOK Atenolol 100MG TAB Accepted treatment806889 HEXA-BLOK Atenolol 50MG TAB Accepted treatment826901 NORTON-ATENOLOL Atenolol 100MG TAB Accepted treatment826898 NORTON-ATENOLOL Atenolol 50MG TAB Accepted treatment787914 ROLAB-ATENOLOL Atenolol 100MG TAB Accepted treatment786195 TEN-BLOKA Atenolol 100MG TAB Accepted treatment786187 TEN-BLOKA Atenolol 50MG TAB Accepted treatment705873 TENOPRESS Atenolol 100MG TAB Accepted treatment705872 TENOPRESS Atenolol 25MG TAB Accepted treatment705874 TENOPRESS Atenolol 50MG TAB Accepted treatment797693 TENORMIN Atenolol 25MG TAB Accepted treatment769576 TENORMIN Atenolol 100MG TAB Accepted treatment769584 TENORMIN Atenolol 50MG TAB Accepted treatment719657 ZETENOL Atenolol 100MG TAB Accepted treatment719656 ZETENOL Atenolol 50MG TAB Accepted treatment703914 ADCO BISOCOR 10MG Bisoprolol 10MG TAB Accepted treatment703913 ADCO BISOCOR 5MG Bisoprolol 5MG TAB Accepted treatment706178 BETACOR Bisoprolol 5MG TAB Accepted treatment706179 BETACOR Bisoprolol 10MG TAB Accepted treatment704373 BILOCOR 10 Bisoprolol 10MG TAB Accepted treatment704372 BILOCOR 5 Bisoprolol 5MG TAB Accepted treatment720660 BISBETA Bisoprolol 10MG TAB Accepted treatment720659 BISBETA Bisoprolol 5MG TAB Accepted treatment719154 BISLO Bisoprolol 5MG TAB Accepted treatment719155 BISLO Bisoprolol 10MG TAB Accepted treatment704133 BISOHEXAL 10 Bisoprolol 10MG TAB Accepted treatment704132 BISOHEXAL 5 Bisoprolol 5MG TAB Accepted treatment722055 BISOPROLOL UNICHEM Bisoprolol 5MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

722056 BISOPROLOL UNICHEM Bisoprolol 10MG TAB Accepted treatment716166 BISOPROLOL UNICORN Bisoprolol 10MG TAB Accepted treatment716167 BISOPROLOL UNICORN Bisoprolol 5MG TAB Accepted treatment720043 BISOPROLOL ZYDUS Bisoprolol 10MG TAB Accepted treatment720044 BISOPROLOL ZYDUS Bisoprolol 5MG TAB Accepted treatment704441 CARDICOR 10MG Bisoprolol 10MG TAB Accepted treatment704439 CARDICOR 2.5MG Bisoprolol 2.5MG TAB Accepted treatment704440 CARDICOR 5MG Bisoprolol 5MG TAB Accepted treatment818437 CONCOR Bisoprolol 10MG TAB Accepted treatment818429 CONCOR Bisoprolol 5MG TAB Accepted treatment3003793 EMCOR Bisoprolol 10MG TAB Accepted treatment3003790 EMCOR Bisoprolol 2.5MG TAB Accepted treatment3003792 EMCOR Bisoprolol 5MG TAB Accepted treatment721438 MYLAN BISOPROLOL Bisoprolol 10MG TAB Accepted treatment721437 MYLAN BISOPROLOL Bisoprolol 5MG TAB Accepted treatment3003544 PRESICARD Bisoprolol 10MG TAB Accepted treatment3003484 PRESICARD Bisoprolol 2.5MG TAB Accepted treatment3003543 PRESICARD Bisoprolol 5MG TAB Accepted treatment720821 RETOCAR Bisoprolol 10MG TAB Accepted treatment720820 RETOCAR Bisoprolol 5MG TAB Accepted treatment715276 ZIAPRO Bisoprolol 10MG TAB Accepted treatment715274 ZIAPRO Bisoprolol 5MG TAB Accepted treatment716483 LOVISPES Nebivolol 5MG TAB Accepted treatment700558 NEBILET 5MG Nebivolol 5MG TAB Accepted treatment828009 SOTAHEXAL Sotalol 160MG TAB Specialist Motivation827991 SOTAHEXAL Sotalol 80MG TAB Specialist Motivation

Alpha-beta blockers710339 ASPEN CARVEDILOL Carvedilol 12.5MG TAB Accepted treatment710340 ASPEN CARVEDILOL Carvedilol 25MG TAB Accepted treatment710338 ASPEN CARVEDILOL Carvedilol 6.25MG TAB Accepted treatment897117 CARLOC Carvedilol 25MG TAB Accepted treatment705459 CARLOC 6.25 Carvedilol 6.25MG TAB Accepted treatment700168 CARLOC 12.5 Carvedilol 12.5MG TAB Accepted treatment3000330 CARVEDILOL 12.5 OETHMAAN Carvedilol 12.5MG TAB Accepted treatment716743 CARVEDILOL UNICORN Carvedilol 12.5MG TAB Accepted treatment716744 CARVEDILOL UNICORN Carvedilol 25MG TAB Accepted treatment716742 CARVEDILOL UNICORN Carvedilol 6.25MG TAB Accepted treatment704671 CARVETREND 12.5MG Carvedilol 12.5MG TAB Accepted treatment704672 CARVETREND 25MG Carvedilol 25MG TAB Accepted treatment704670 CARVETREND 6.25MG Carvedilol 6.25MG TAB Accepted treatment836354 DILATREND Carvedilol 12.5MG TAB Accepted treatment788856 DILATREND Carvedilol 25MG TAB Accepted treatment833428 DILATREND Carvedilol 6.25MG TAB Accepted treatment3000278 RUBITREND Carvedilol 12.5MG TAB Accepted treatment3000281 RUBITREND Carvedilol 25MG TAB Accepted treatment3000276 RUBITREND Carvedilol 6.25MG TAB Accepted treatment710959 VEDIBLOK Carvedilol 12.5MG TAB Accepted treatment710960 VEDIBLOK Carvedilol 25MG TAB Accepted treatment710958 VEDIBLOK Carvedilol 6.25MG TAB Accepted treatment

Beta-blocker and diuretic combinations786217 TENCHLOR Atenolol and other diuretics 100MG/25MG TAB Accepted treatment807591 TENCHLOR HS Atenolol and other diuretics 50MG/12.5MG TAB Accepted treatment719202 BILOCOR CO 10MG/6.25MG Bisoprolol and thiazides 10MG/6.25MG TAB Accepted treatment719200 BILOCOR CO 2.5MG/6.25MG Bisoprolol and thiazides 2.5MG/6.25MG TAB Accepted treatment719201 BILOCOR CO 5MG/6.25MG Bisoprolol and thiazides 5MG/6.25MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

721589 BISOPROLOL CO UNICORN 10MG/6.25MG Bisoprolol and thiazides 10MG/6.25MG TAB Accepted treatment721588 BISOPROLOL CO UNICORN 5MG/6.25MG Bisoprolol and thiazides 5MG/6.25MG TAB Accepted treatment718087 BISOPROLOL HYDROCHLOROTHIAZIDE ZYDUS 10MG Bisoprolol and thiazides 10MG/6.25MG TAB Accepted treatment718082 BISOPROLOL HYDROCHLOROTHIAZIDE ZYDUS 2.5MG Bisoprolol and thiazides 2.5MG/6.25MG TAB Accepted treatment718086 BISOPROLOL HYDROCHLOROTHIAZIDE ZYDUS 5MG Bisoprolol and thiazides 5MG/6.25MG TAB Accepted treatment3003506 TEVACARD CO 10MG/6.25MG Bisoprolol and thiazides 10MG/6.25MG TAB Accepted treatment3003503 TEVACARD CO 2.5MG/6.25MG Bisoprolol and thiazides 2.5MG/6.25MG TAB Accepted treatment3003504 TEVACARD CO 5MG/6.25MG Bisoprolol and thiazides 5MG/6.25MG TAB Accepted treatment720033 ZIABETA 10/6.25MG Bisoprolol and thiazides 10MG/6.25MG TAB Accepted treatment720031 ZIABETA 2.5/6.25MG Bisoprolol and thiazides 6.25MG/2.5MG TAB Accepted treatment720032 ZIABETA 5/6.25MG Bisoprolol and thiazides 5MG/6.25MG TAB Accepted treatment852929 ZIAK Bisoprolol and thiazides 10MG/6.25MG TAB Accepted treatment840300 ZIAK Bisoprolol and thiazides 2.5MG/6.25MG TAB Accepted treatment840319 ZIAK Bisoprolol and thiazides 5MG/6.25MG TAB Accepted treatment

Cardiac glycosides735752 LANOXIN Digoxin 0.25MG TAB Accepted treatment735744 LANOXIN PAED Digoxin 0.05MG/1ML SYR Accepted treatment735760 LANOXIN PAED Digoxin 0.063MG TAB Accepted treatment758280 PURGOXIN Digoxin 0.25MG TAB Accepted treatment

Chronic Renal DiseaseFor diuretics and antihypertensives, refer to "Hypertension"Calcium

718735 PHOSPHOSORB 660 Calcium acetate anhydrous 660MG TAB Accepted treatment3000192 OSVAREN Calcium acetate and magnesium carbonate 435MG/235MG TAB Accepted treatment3000916 ENO TABLETS ORANGE FLAVOUR Calcium carbonate 500MG CHU Accepted treatment3000917 ENO TABLETS PEPPERMINT FLAVOUR Calcium carbonate 500MG CHU Accepted treatment703359 ENO TUMS ASSORTED FRUIT FLAVOURS Calcium carbonate 500MG CHU Accepted treatment703364 ENO TUMS ORANGE FLAVOUR ROLLPAC Calcium carbonate 500MG CHU Accepted treatment703361 ENO TUMS PEPPERMINT FLAVOUR ROLLPAC Calcium carbonate 500MG CHU Accepted treatment828289 B-CAL Calcium products > 300MG CHU Accepted treatment

Vitamin D750654 ONE ALPHA (014050) Alfacalcidol 0.25MCG CAP Accepted treatment750662 ONE ALPHA (014052) Alfacalcidol 1MCG CAP Accepted treatment3003368 ZODORAY Alfacalcidol 0.25MCG CAP Accepted treatment3003367 ZODORAY Alfacalcidol 1MCG CAP Accepted treatment761249 ROCALTROL Calcitriol 0.25MCG CAP Accepted treatment3001466 DAILY D3 LIQUID Colecalciferol DRP Accepted treatment3000606 D3 LIQUID Colecalciferol DRP Accepted treatment3000723 D-DROPS (NEW FORMULATION) 30ML Colecalciferol DRP Accepted treatment3001933 METAKIDS D3 LIQUID Colecalciferol 1000IU DRP Accepted treatment3002652 NURTURE VITAMIN D3 Colecalciferol 1000IU DRP Accepted treatment3002180 VITAMIN D3 Colecalciferol 500IU DRP Accepted treatment711640 CALCIFEROL Ergocalciferol 50000IU TAB Accepted treatment711853 CALCIFEROL OILY 15ML Ergocalciferol 5000U/1ML DRP Accepted treatment

Oral Iron and Folic Acid supplementation756571 PREGAMAL Ferrous fumarate and folic acid 200MG/100MCG TAB Accepted treatment723552 FERROUS SULPHATE Ferrous sulfate 30MG TAB Accepted treatment723814 FERROUS SULPHATE Ferrous sulfate 100MG TAB Accepted treatment723553 FERROUS SULPHATE Ferrous sulfate 75MG TAB Accepted treatment705532 AHA FERROUS SULPHATE Ferrous sulfate 30MG TAB Accepted treatment713558 BODY BALANCE FERROUS SULPHATE Ferrous sulfate 75MG TAB Accepted treatment710580 EGOLI FERROUS SULPHATE Ferrous sulfate 30MG TAB Accepted treatment877832 FERROUS SULPHATE Ferrous sulfate 30MG TAB Accepted treatment721690 FERROUS SULPHATE Ferrous sulfate 75MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

710372 FERROUS SULPHATE Ferrous sulfate 75MG TAB Accepted treatment897329 GULF FERROUS SULPHATE COMPOUND Ferrous sulfate TAB Accepted treatment705531 AHA FOLIC ACID Folic acid 0.5MG TAB Accepted treatment810967 BE-TABS FOLIC ACID Folic acid 5MG TAB Accepted treatment721202 CLICKS PAY LESS FOLIC ACID SUPPLEMENT Folic acid 0.5MG TAB Accepted treatment723151 FOLIC ACID Folic acid 0.5MG CAP Accepted treatment721366 FOLIC ACID Folic acid 0.5MG TAB Accepted treatment871281 FOLIC ACID Folic acid .5MG TAB Accepted treatment711922 FOLIC ACID Folic acid 5MG TAB Accepted treatment721661 FOLIK Folic acid .5MG TAB Accepted treatment720727 GULF FOLIC ACID Folic acid 5MG TAB Accepted treatment3003970 MEDIRITE FOLIC ACID Folic acid 0.5MG TAB Accepted treatment723361 SOLAL FOLATE Folic acid 0.5MG TAB Accepted treatment723196 STELLAR ACTIV-FOLATE Folic acid 0.5MG TAB Accepted treatment727024 FOLIGLOBIN Iron vitamin B12 and folic acid TAB Accepted treatment

Parenteral Iron Preparations711596 COSMOFER AMPOULE 2ML Ferric oxide dextran complex 50MG/1ML INJ Clinical motivation720107 FERINJECT VIAL 10ML SOLUTION FOR INJECTI Iron, parenteral preparations 50MG/1ML INJ Clinical motivation722193 MONOFER VIAL 10ML Iron, parenteral preparations 1000MG/10ML INJ Clinical motivation722191 MONOFER VIAL 1ML Iron, parenteral preparations 100MG/1ML INJ Clinical motivation722192 MONOFER VIAL 5ML Iron, parenteral preparations 500MG/5ML INJ Clinical motivation719989 RAUTEVENE SOLUTION FOR INJECTION AMPOULE Iron, parenteral preparations 100MG/5ML INJ Clinical motivation720333 SUCROFER 5ML Iron, parenteral preparations 20MG/1ML INJ Clinical motivation720231 ZYPIRON 5ML VIAL Iron, parenteral preparations 20MG/1ML INJ Clinical motivation713080 COSMOFER AMPOULE 10ML Iron, parenteral preparations 50MG/1ML INJ Clinical motivation717447 EQUIFER AMPOULE 5ML Iron, parenteral preparations 100MG/5ML INJ Clinical motivation725943 FERRIMED 2ML Iron, parenteral preparations 50MG/1ML INJ Clinical motivation873276 VENOFER 5X5ML AMP Iron, parenteral preparations AMP Clinical motivation

Erythropoietin714021 ARANESP PREFILLED SYRINGE 0.3ML Darbepoetin alfa 150MCG/.3ML INJ Specialist motivation714019 ARANESP PREFILLED SYRINGE 0.3ML Darbepoetin alfa 30MCG/.3ML INJ Specialist motivation714020 ARANESP PREFILLED SYRINGE 0.3ML Darbepoetin alfa 60MCG/.3ML INJ Specialist motivation714017 ARANESP PREFILLED SYRINGE 0.4ML Darbepoetin alfa 10MCG/.4ML INJ Specialist motivation715971 ARANESP PREFILLED SYRINGE 0.4ML Darbepoetin alfa 40MCG/.4ML INJ Specialist motivation715974 ARANESP PREFILLED SYRINGE 0.4ML Darbepoetin alfa 80MCG/.4ML INJ Specialist motivation714018 ARANESP PREFILLED SYRINGE 0.5ML Darbepoetin alfa 20MCG/.5ML INJ Specialist motivation715975 ARANESP PREFILLED SYRINGE 0.5ML Darbepoetin alfa 100MCG/.5ML INJ Specialist motivation715973 ARANESP PREFILLED SYRINGE 0.5ML Darbepoetin alfa 50MCG/.5ML INJ Specialist motivation714022 ARANESP PREFILLED SYRINGE 0.6ML Darbepoetin alfa 300MCG/.6ML INJ Specialist motivation3002532 ARANESP PREFILLED SYRINGE 1ML Darbepoetin alfa 500MCG/1ML INJ Specialist motivation839876 EPREX PREFILLED Erythropoietin 10000U/1ML INJ Specialist motivation837318 EPREX PREFILLED Erythropoietin 2000U/.5ML INJ Specialist motivation820741 EPREX PREFILLED Erythropoietin 4000U/.4ML INJ Specialist motivation712391 EPREX PREFILLED SYRINGE 0.6ML Erythropoietin 6000U/.6ML INJ Specialist motivation705487 EPREX PREFILLED Erythropoietin 40000U/1ML INJ Specialist motivation705261 RECORMON 10000 PRE-FILLED SYR Erythropoietin 10000IU INJ Specialist motivation705751 RECORMON 30000 PRE-FILLED SYR Erythropoietin 30000IU INJ Specialist motivation704631 RECORMON 4000 IU/0.3ML Erythropoietin 4000IU/0.3ML INJ Specialist motivation704772 RECORMON 2000 PRE-FILLED SYRINGE Erythropoietin 2000IU INJ Specialist motivation704632 RECORMON 500 IU/0.3ML Erythropoietin 500IU/0.3ML INJ Specialist motivation704630 RECORMON 6000 PRE-FILLED SYR Erythropoietin 6000IU INJ Specialist motivation839264 REPOTIN AMP 1ML Erythropoietin 2000U/1ML INJ Specialist motivation839272 REPOTIN AMP 1ML Erythropoietin 4000U/1ML INJ Specialist motivation712564 MIRCERA PREFILLED SYRINGE 0.3ML Methoxy polyethylene glycol-epoetin beta 100MCG/.3ML INJ Specialist motivation712565 MIRCERA PREFILLED SYRINGE 0.3ML Methoxy polyethylene glycol-epoetin beta 150MCG/.3ML INJ Specialist motivation

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

712567 MIRCERA PREFILLED SYRINGE 0.3ML Methoxy polyethylene glycol-epoetin beta 200MCG/.3ML INJ Specialist motivation712568 MIRCERA PREFILLED SYRINGE 0.3ML Methoxy polyethylene glycol-epoetin beta 250MCG/.3ML INJ Specialist motivation712562 MIRCERA PREFILLED SYRINGE 0.3ML Methoxy polyethylene glycol-epoetin beta 50MCG/.3ML INJ Specialist motivation712563 MIRCERA PREFILLED SYRINGE 0.3ML Methoxy polyethylene glycol-epoetin beta 75MCG/.3ML INJ Specialist motivation717045 MIRCERA PREFILLED SYRINGE 0.3ML Methoxy polyethylene glycol-epoetin beta 120MCG/.3ML INJ Specialist motivation717044 MIRCERA PREFILLED SYRINGE 0.3ML Methoxy polyethylene glycol-epoetin beta 30MCG/.3ML INJ Specialist motivation717046 MIRCERA PREFILLED SYRINGE 0.6ML Methoxy polyethylene glycol-epoetin beta 360MCG/.6ML INJ Specialist motivation

Coronary Artery DiseaseAspirin

706930 BAYER ASPIRIN Acetylsalicylic acid 300MG TAB Accepted treatment862304 BAYER ASPIRIN CARDIO Acetylsalicylic acid 100MG TAB Accepted treatment847283 DISPRIN CV Acetylsalicylic acid 100MG EEF Accepted treatment807206 DISPRIN CV Acetylsalicylic acid 300MG EEF Accepted treatment720577 DISPRIN REGULAR Acetylsalicylic acid 300MG EEF Accepted treatment719673 DR DU TOITS PAIN EXPELLER Acetylsalicylic acid 300MG TAB Accepted treatment823481 ECOTRIN Acetylsalicylic acid 81MG ECT Accepted treatment700909 GULF ASPIRIN Acetylsalicylic acid 300MG TAB Accepted treatment721258 MYOPRIN Acetylsalicylic acid 100MG TAB Accepted treatment712608 PCH ACETYLSALICYLIC ACID CARDIO Acetylsalicylic acid 80MG DSP Accepted treatment704642 SOLUSPIRIN (WAS ASPIRIN SOLUBLE) Acetylsalicylic acid 300MG DSP Accepted treatment722806 SOLUSPRIN CV Acetylsalicylic acid 100MG DSP Accepted treatment

Nitrates703605 ANGISED Glyceryl trinitrate 0.5MG TAB Accepted treatment793418 ELANTAN Isosorbide mononitrate 20MG TAB Accepted treatment860115 ELANTAN LA Isosorbide mononitrate 50MG CAP Accepted treatment821500 IMDUR Isosorbide mononitrate 60MG SRT Accepted treatment734055 ISMO 20 Isosorbide mononitrate 20MG TAB Accepted treatment734381 ISORDIL Isosorbide dinitrate 10MG TAB Accepted treatment734403 ISORDIL Isosorbide dinitrate 30MG TAB Accepted treatment734411 ISORDIL SUBLINGUAL Isosorbide dinitrate 5MG TAB Accepted treatment734438 ISORDIL TEMBID Isosorbide dinitrate 40MG TAB Accepted treatment710251 MONICOR SR Isosorbide mononitrate 60MG TAB Accepted treatment784206 ROLAB-ISOSORBIDE DINITRATE Isosorbide dinitrate 10MG TAB Accepted treatment784192 ROLAB-ISOSORBIDE DINITRATE SUBL Isosorbide dinitrate 5MG TAB Accepted treatment

Beta-blockers786586 ADCO-ATENOLOL Atenolol 100MG TAB Accepted treatment786578 ADCO-ATENOLOL Atenolol 50MG TAB Accepted treatment704651 B-BLOCK Atenolol 100MG TAB Accepted treatment704653 B-BLOCK Atenolol 50MG TAB Accepted treatment715626 GULF ATENOLOL Atenolol 100MG TAB Accepted treatment715625 GULF ATENOLOL Atenolol 50MG TAB Accepted treatment806897 HEXA-BLOK Atenolol 100MG TAB Accepted treatment806889 HEXA-BLOK Atenolol 50MG TAB Accepted treatment826901 NORTON-ATENOLOL Atenolol 100MG TAB Accepted treatment826898 NORTON-ATENOLOL Atenolol 50MG TAB Accepted treatment787914 ROLAB-ATENOLOL Atenolol 100MG TAB Accepted treatment786195 TEN-BLOKA Atenolol 100MG TAB Accepted treatment786187 TEN-BLOKA Atenolol 50MG TAB Accepted treatment705873 TENOPRESS Atenolol 100MG TAB Accepted treatment705872 TENOPRESS Atenolol 25MG TAB Accepted treatment705874 TENOPRESS Atenolol 50MG TAB Accepted treatment797693 TENORMIN Atenolol 25MG TAB Accepted treatment769576 TENORMIN Atenolol 100MG TAB Accepted treatment769584 TENORMIN Atenolol 50MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

719657 ZETENOL Atenolol 100MG TAB Accepted treatment719656 ZETENOL Atenolol 50MG TAB Accepted treatment703914 ADCO BISOCOR 10MG Bisoprolol 10MG TAB Accepted treatment703913 ADCO BISOCOR 5MG Bisoprolol 5MG TAB Accepted treatment706178 BETACOR Bisoprolol 5MG TAB Accepted treatment706179 BETACOR Bisoprolol 10MG TAB Accepted treatment704373 BILOCOR 10 Bisoprolol 10MG TAB Accepted treatment704372 BILOCOR 5 Bisoprolol 5MG TAB Accepted treatment720660 BISBETA Bisoprolol 10MG TAB Accepted treatment720659 BISBETA Bisoprolol 5MG TAB Accepted treatment719154 BISLO Bisoprolol 5MG TAB Accepted treatment719155 BISLO Bisoprolol 10MG TAB Accepted treatment704133 BISOHEXAL 10 Bisoprolol 10MG TAB Accepted treatment704132 BISOHEXAL 5 Bisoprolol 5MG TAB Accepted treatment722055 BISOPROLOL UNICHEM Bisoprolol 5MG TAB Accepted treatment722056 BISOPROLOL UNICHEM Bisoprolol 10MG TAB Accepted treatment716166 BISOPROLOL UNICORN Bisoprolol 10MG TAB Accepted treatment716167 BISOPROLOL UNICORN Bisoprolol 5MG TAB Accepted treatment720043 BISOPROLOL ZYDUS Bisoprolol 10MG TAB Accepted treatment720044 BISOPROLOL ZYDUS Bisoprolol 5MG TAB Accepted treatment704441 CARDICOR 10MG Bisoprolol 10MG TAB Accepted treatment704439 CARDICOR 2.5MG Bisoprolol 2.5MG TAB Accepted treatment704440 CARDICOR 5MG Bisoprolol 5MG TAB Accepted treatment818437 CONCOR Bisoprolol 10MG TAB Accepted treatment818429 CONCOR Bisoprolol 5MG TAB Accepted treatment3003793 EMCOR Bisoprolol 10MG TAB Accepted treatment3003790 EMCOR Bisoprolol 2.5MG TAB Accepted treatment3003792 EMCOR Bisoprolol 5MG TAB Accepted treatment721438 MYLAN BISOPROLOL Bisoprolol 10MG TAB Accepted treatment721437 MYLAN BISOPROLOL Bisoprolol 5MG TAB Accepted treatment3003544 PRESICARD Bisoprolol 10MG TAB Accepted treatment3003484 PRESICARD Bisoprolol 2.5MG TAB Accepted treatment3003543 PRESICARD Bisoprolol 5MG TAB Accepted treatment720821 RETOCAR Bisoprolol 10MG TAB Accepted treatment720820 RETOCAR Bisoprolol 5MG TAB Accepted treatment715276 ZIAPRO Bisoprolol 10MG TAB Accepted treatment715274 ZIAPRO Bisoprolol 5MG TAB Accepted treatment721589 BISOPROLOL CO UNICORN 10MG/6.25MG Bisoprolol and thiazides 10MG/6.25MG TAB Accepted treatment721588 BISOPROLOL CO UNICORN 5MG/6.25MG Bisoprolol and thiazides 5MG/6.25MG TAB Accepted treatment716483 LOVISPES Nebivolol 5MG TAB Accepted treatment700558 NEBILET 5MG Nebivolol 5MG TAB Accepted treatment

Alpha-Beta blockers710339 ASPEN CARVEDILOL Carvedilol 12.5MG TAB Accepted treatment710340 ASPEN CARVEDILOL Carvedilol 25MG TAB Accepted treatment710338 ASPEN CARVEDILOL Carvedilol 6.25MG TAB Accepted treatment897117 CARLOC Carvedilol 25MG TAB Accepted treatment705459 CARLOC 6.25 Carvedilol 6.25MG TAB Accepted treatment700168 CARLOC 12.5 Carvedilol 12.5MG TAB Accepted treatment3000330 CARVEDILOL 12.5 OETHMAAN Carvedilol 12.5MG TAB Accepted treatment716743 CARVEDILOL UNICORN Carvedilol 12.5MG TAB Accepted treatment716744 CARVEDILOL UNICORN Carvedilol 25MG TAB Accepted treatment716742 CARVEDILOL UNICORN Carvedilol 6.25MG TAB Accepted treatment704671 CARVETREND 12.5MG Carvedilol 12.5MG TAB Accepted treatment704672 CARVETREND 25MG Carvedilol 25MG TAB Accepted treatment704670 CARVETREND 6.25MG Carvedilol 6.25MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

836354 DILATREND Carvedilol 12.5MG TAB Accepted treatment788856 DILATREND Carvedilol 25MG APP Accepted treatment833428 DILATREND Carvedilol 6.25MG TAB Accepted treatment3000278 RUBITREND Carvedilol 12.5MG TAB Accepted treatment3000281 RUBITREND Carvedilol 25MG TAB Accepted treatment3000276 RUBITREND Carvedilol 6.25MG TAB Accepted treatment710959 VEDIBLOK Carvedilol 12.5MG TAB Accepted treatment710960 VEDIBLOK Carvedilol 25MG TAB Accepted treatment710958 VEDIBLOK Carvedilol 6.25MG TAB Accepted treatment

Calcium channel antagonists723783 AMLODIPINE UNICORN Amlodipine 5MG TAB Accepted treatment714311 AURO-AMLODIPINE Amlodipine 10MG TAB Accepted treatment712954 GULF AMLODIPINE Amlodipine 10MG TAB Accepted treatment712216 KEYSAL Amlodipine 10MG TAB Accepted treatment799122 NORVASC Amlodipine 10MG TAB Accepted treatment708142 ALMADIN Amlodipine 10MG TAB Accepted treatment707278 AMLATE Amlodipine 10MG TAB Accepted treatment703917 AMLOC 10 Amlodipine 10MG TAB Accepted treatment708051 AMLODAC Amlodipine 10MG TAB Accepted treatment704621 AMLOSYN 10 Amlodipine 10MG TAB Accepted treatment713972 AMTAS Amlodipine 10MG TAB Accepted treatment708095 AUSTELL-AMLODIPINE Amlodipine 10MG TAB Accepted treatment708040 CALBLOC Amlodipine 10MG TAB Accepted treatment708152 CIPLAVASC Amlodipine 10MG TAB Accepted treatment707980 CORVADIL Amlodipine 10MG TAB Accepted treatment708191 CPL ALLIANCE AMLODIPINE Amlodipine 10MG TAB Accepted treatment708353 LOMANOR Amlodipine 10MG TAB Accepted treatment710238 PHARMA DYNAMICS AMLODIPINE BESYLATE Amlodipine 10MG TAB Accepted treatment723784 AMLODIPINE UNICORN Amlodipine 10MG TAB Accepted treatment707375 AMLODIPINE 5 OETHMAAN Amlodipine 5MG TAB Accepted treatment714310 AURO-AMLODIPINE Amlodipine 5MG TAB Accepted treatment712953 GULF AMLODIPINE Amlodipine 5MG TAB Accepted treatment712215 KEYSAL Amlodipine 5MG TAB Accepted treatment791245 NORVASC Amlodipine 5MG TAB Accepted treatment708141 ALMADIN Amlodipine 5MG TAB Accepted treatment707277 AMLATE Amlodipine 5MG TAB Accepted treatment703916 AMLOC 5 Amlodipine 5MG TAB Accepted treatment708050 AMLODAC Amlodipine 5MG TAB Accepted treatment704620 AMLOSYN 5 Amlodipine 5MG TAB Accepted treatment713971 AMTAS Amlodipine 5MG TAB Accepted treatment708094 AUSTELL-AMLODIPINE Amlodipine 5MG TAB Accepted treatment708039 CALBLOC Amlodipine 5MG TAB Accepted treatment708150 CIPLAVASC Amlodipine 5MG TAB Accepted treatment707979 CORVADIL Amlodipine 5MG TAB Accepted treatment708190 CPL ALLIANCE AMLODIPINE Amlodipine 5MG TAB Accepted treatment708648 INDO AMLODIPINE Amlodipine 5MG TAB Accepted treatment708162 KLODIP Amlodipine 5MG TAB Accepted treatment708352 LOMANOR Amlodipine 5MG TAB Accepted treatment710236 PHARMA DYNAMICS AMLODIPINE BESYLATE Amlodipine 5MG TAB Accepted treatment839183 ZILDEM Diltiazem 180MG SRC Accepted treatment839191 ZILDEM Diltiazem 240MG SRC Accepted treatment822213 ZILDEM 60 Diltiazem 60MG TAB Accepted treatment824364 ZILDEM 90 BD Diltiazem 90MG TAB Accepted treatment703902 FELODIPINE HEXAL Felodipine 10MG SRT Accepted treatment821896 PLENDIL Felodipine 2.5MG SRT Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

805548 PLENDIL Felodipine 5MG SRT Accepted treatment703221 FELODIPINE HEXAL Felodipine 5MG SRT Accepted treatment826863 BIO-NIFEDIPINE (WAS NORTON-NIFEDIPINE) Nifedipine 5MG CAP Accepted treatment840963 ADCO-VASCARD SR Nifedipine 20MG SRC Accepted treatment780499 CARDIFEN Nifedipine 5MG CAP Accepted treatment780502 CARDIFEN Nifedipine 10MG CAP Accepted treatment864153 CIPALAT RETARD Nifedipine 20MG TAB Accepted treatment793124 ADALAT XL Nifedipine 30MG SRT Accepted treatment723283 CIPALAT XR Nifedipine 30MG SRT Accepted treatment719449 GITSALAT Nifedipine 30MG TAB Accepted treatment718083 BIO NIFEDIPINE XL Nifedipine 30MG SRT Accepted treatment711682 FEDALOC SR Nifedipine 30MG TAB Accepted treatment3002730 FIDOCARE 30 XL Nifedipine 30MG SRT Accepted treatment715000 MACOREL SR Nifedipine 30MG SRT Accepted treatment715002 SPEC NIFEDIPINE SR Nifedipine 30MG SRT Accepted treatment861545 VASCARD SR Nifedipine 30MG CAP Accepted treatment813354 CALCICARD SR Verapamil 240MG SRT Accepted treatment734373 ISOPTIN SR Verapamil 240MG SRT Accepted treatment819573 RAVAMIL SR Verapamil 240MG SRT Accepted treatment700071 VERAHEXAL 240 SR Verapamil 240MG SRT Accepted treatment734071 ISOPTIN DRAGEES Verapamil 40MG TAB Accepted treatment774944 VASOMIL Verapamil 40MG TAB Accepted treatment774952 VASOMIL Verapamil 80MG TAB Accepted treatment775789 VERAPAMIL 40 OETHMAAN Verapamil 40MG TAB Accepted treatment

Crohn's DiseaseAminosalicylic acid preparations

783668 ASACOL Mesalazine 400MG TAB Accepted treatment709076 ASACOL Mesalazine 800MG TAB Accepted treatment720355 MEZAVANT Mesalazine 1200MG ERT Accepted treatment890775 PENTASA Mesalazine 500MG TAB Accepted treatment716333 SALOFALK Mesalazine 1000MG SAC Accepted treatment792519 DIPENTUM Olsalazine 250MG CAP Accepted treatment762008 SALAZOPYRIN Sulfasalazine 500MG TAB Accepted treatment762016 SALAZOPYRIN E.N. Sulfasalazine 500MG ECT Accepted treatment

Immunosuppressants701252 AZAMUN Azathioprine 50MG TAB Accepted treatment706108 AZAPRESS Azathioprine 50MG TAB Accepted treatment712609 AZATHIOPRINE PCH Azathioprine 50MG TAB Accepted treatment732516 IMURAN Azathioprine 50MG TAB Accepted treatment700777 ZAPRINE 50MG Azathioprine 50MG TAB Accepted treatment

Methotrexate782556 ABITREXATE-20ML Methotrexate 500MG/20ML INJ Accepted treatment782548 ABITREXATE-2ML Methotrexate 50MG INJ Accepted treatment712504 EMTHEXATE Methotrexate 2.5MG TAB Accepted treatment825557 EMTHEXATE RTU 500-20 20ML Methotrexate 25MG/1ML INJ Accepted treatment711328 METACHOR VIAL 2ML Methotrexate 25MG/1ML INJ Accepted treatment840815 METHOTREXATE CSV 2ML (P&U) Methotrexate 50MG/2ML INJ Accepted treatment840807 METHOTREXATE CSV 20ML (P&U) Methotrexate 500MG/20ML INJ Accepted treatment742465 METHOTREXATE Methotrexate 2.5MG TAB Accepted treatment

Steroid preparations (oral)716693 COVOCORT Hydrocortisone 10MG TAB Accepted treatment741124 MEDROL Methylprednisone 16MG TAB Accepted treatment741116 MEDROL Methylprednisone 4MG TAB Accepted treatment814407 CAPSOID Prednisolone 5MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

800155 LENISOLONE Prednisolone 5MG TAB Accepted treatment703720 PRELONE Prednisolone 5MG TAB Accepted treatment742759 METICORTEN Prednisone 50MG TAB Accepted treatment742732 METICORTEN Prednisone 5MG TAB Accepted treatment752304 PANAFCORT Prednisone 5MG TAB Accepted treatment788783 PREDNISONE (BE-TABS) Prednisone 5mg TAB Accepted treatment836826 PULMISON TABS Prednisone 20MG TAB Accepted treatment818267 TROLIC Prednisone 5MG TAB Accepted treatment

Steroid preparations (enemas)824593 ENTOCORD ENEMAS Budesonide 2.3MG ENE Accepted treatment

Diabetes Mellitus Type 1Insulin

863572 INSU HUMULIN 30/70 3ML Insulin (human) INJD Accepted treatment863556 INSU HUMULIN N 3.0ML CART 5 Insulin (human) INJD Accepted treatment863564 INSU HUMULIN R 3.0ML CARTRIDGE Insulin (human) INJD Accepted treatment712767 INSU BIOSULIN R CARTRIDGE 3ML Insulin (human) 100IU/1ML INJ Accepted treatment712769 INSU BIOSULIN L CARTRIDGE 3ML Insulin (human) 100IU/1ML INJ Accepted treatment712768 INSU BIOSULIN N CARTRIDGE 3ML Insulin (human) 100IU/1ML INJ Accepted treatment712770 INSU BIOSULIN 30-70 CARTRIDGE 3ML Insulin (human) 100IU/1ML INJ Accepted treatment704456 INSU HUMULIN 30/70 PEN 3ML DISP Insulin (human) 100IU/1ML INJD Accepted treatment853453 INSU HUMULIN N PEN 3ML Insulin (human) 100IU/1ML INJD Accepted treatment897767 INSU NOVORAPID FLEXPEN 3ML PENS Insulin aspart INJD Accepted treatment897775 INSU NOVORAPID 3ML SOLUTION FOR I Insulin aspart 100U INJD Accepted treatment705312 INSU LEVEMIR 3ML FLEXPEN PREFILLED Insulin detemir 100MG/1ML INJ Accepted treatment705313 INSU LEVEMIR 3ML PREFILLED CARTRIDGE Insulin detemir 100MG/1ML INJ Accepted treatment721502 OPTISULIN PEN 3ML Insulin glargine 100IU/1ML INJ Accepted treatment723474 OPTISULIN CARTRIDGE 3ML Insulin glargine 100IU/1ML INJ Accepted treatment722456 BASAGLAR CARTRIDGE 3ML Insulin glargine 100U/1ML INJ Accepted treatment722454 BASAGLAR PRE-FILLED PEN 3ML Insulin glargine 100U/1ML INJ Accepted treatment706039 INSU APIDRA CARTIDGES Insulin glulisine 100IU/1ML INJD Accepted treatment709861 INSU APIDRA SOLOSTAR DISPOSABLE PENS 3ML Insulin glulisine 100IU/1ML INJD Accepted treatment723920 HUMALOG KWIKPEN 3ML Insulin lispro 200U/1ML INJ Accepted treatment862355 INSU HUMALOG INJ 3.0ML CART Insulin lispro INJD Accepted treatment861782 INSU HUMALOG MIX 25 CART 3ML Insulin lispro INJD Accepted treatment705074 INSU HUMALOG MIX 50 CART Insulin lispro 3ML INJD Accepted treatment706761 INSU MIRIO PEN HUMALOG MIX 25 Insulin lispro INJD Accepted treatment706762 INSU MIRIO PEN HUMALOG MIX 50 Insulin lispro INJD Accepted treatment706760 INSU MIRIO PEN HUMALOG Insulin lispro INJD Accepted treatment

AppliancesDiabetic strips, needles and lancets Accepted treatment

Diabetes Mellitus Type 2Biguanides

714427 ACCORD METFORMIN Metformin 500MG TAB Accepted treatment714426 ACCORD METFORMIN Metformin 850MG TAB Accepted treatment707670 APEX-METFORMIN Metformin 500MG TAB Accepted treatment707669 APEX-METFORMIN FORTE Metformin 850MG TAB Accepted treatment706672 ARROW METFORMIN Metformin 500MG TAB Accepted treatment706673 ARROW METFORMIN Metformin 850MG TAB Accepted treatment714683 AURO-METFORMIN Metformin 1000MG TAB Accepted treatment714680 AURO-METFORMIN Metformin 500MG TAB Accepted treatment714681 AURO-METFORMIN Metformin 850MG TAB Accepted treatment705757 AUSTELL-METFORMIN 500MG Metformin 500MG TAB Accepted treatment705758 AUSTELL-METFORMIN 850MG Metformin 850MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

708281 BIGSENS Metformin 500MG TAB Accepted treatment708282 BIGSENS Metformin 850MG TAB Accepted treatment709172 BIGSENS Metformin 1000MG TAB Accepted treatment3001226 BIGSENS XR Metformin 500MG SRT Accepted treatment705358 DIABETMIN Metformin 850MG TAB Accepted treatment719786 DIAPHAGE Metformin 1000MG TAB Accepted treatment719784 DIAPHAGE Metformin 500MG TAB Accepted treatment719785 DIAPHAGE Metformin 850MG TAB Accepted treatment715936 DIAFORMIN Metformin 500MG TAB Accepted treatment715937 DIAFORMIN FORTE Metformin 850MG TAB Accepted treatment714186 DIAMIN Metformin 500MG TAB Accepted treatment714187 DIAMIN Metformin 850MG TAB Accepted treatment708009 FORMINAL Metformin 500MG TAB Accepted treatment708010 FORMINAL Metformin 850MG TAB Accepted treatment714525 GLUCONORM Metformin 500MG TAB Accepted treatment714526 GLUCONORM Metformin 850MG TAB Accepted treatment729159 GLUCOPHAGE Metformin 500MG TAB Accepted treatment703909 GLUCOPHAGE Metformin 1000MG TAB Accepted treatment729167 GLUCOPHAGE FORTE Metformin 850MG TAB Accepted treatment710196 GLUCOPHAGE XR Metformin 500MG SRT Accepted treatment720925 GLUCOPHAGE XR Metformin 750MG SRT Accepted treatment720926 GLUCOPHAGE XR Metformin 1000MG SRT Accepted treatment709338 INDO METFORMIN FC Metformin 500MG TAB Accepted treatment709339 INDO METFORMIN FC Metformin 850MG TAB Accepted treatment3000810 METFORMIN XR ACCORD Metformin 500MG SRT Accepted treatment718828 METFORMIN ALKEM Metformin 500MG TAB Accepted treatment718827 METFORMIN ALKEM Metformin 850MG TAB Accepted treatment3003996 METFORMIN TEVA ER Metformin 1000MG SRT Accepted treatment3001357 METFORMIN 500 BIOTECH Metformin 500MG TAB Accepted treatment3001356 METFORMIN 850 BIOTECH Metformin 850MG TAB Accepted treatment897957 MYLAN-METFORMIN Metformin 500MG TAB Accepted treatment897961 MYLAN-METFORMIN Metformin 850MG TAB Accepted treatment721443 MYLAN METFORMIN Metformin 1000MG TAB Accepted treatment718231 METCHEK Metformin 500MG TAB Accepted treatment718232 METCHEK Metformin 850MG TAB Accepted treatment702385 METFORAL 500 Metformin 500MG TAB Accepted treatment702363 METFORAL 850 Metformin 850MG TAB Accepted treatment711773 METORED Metformin 1000MG TAB Accepted treatment711636 METORED Metformin 500MG TAB Accepted treatment711638 METORED Metformin 850MG TAB Accepted treatment709246 METPHAGE Metformin 500MG TAB Accepted treatment709247 METPHAGE Metformin 850MG TAB Accepted treatment815225 ROLAB-METFORMIN HCL 500 FC Metformin 500MG TAB Accepted treatment815233 ROLAB-METFORMIN HCL 850 FC Metformin 850MG TAB Accepted treatment719645 ROMIDAB Metformin 1000MG TAB Accepted treatment719644 ROMIDAB Metformin 850MG TAB Accepted treatment719643 ROMIDAB Metformin 500MG TAB Accepted treatment

Sulphonylureas894502 DIACARE Glibenclamide 5MG TAB Accepted treatment729361 GLYCOMIN Glibenclamide 5MG TAB Accepted treatment827053 NORTON-GLIBENCLAMIDE Glibenclamide 5MG TAB Accepted treatment781258 ROLAB-GLIBENCLAMIDE Glibenclamide 5MG TAB Accepted treatment707587 ALEMBIC GLICLAZIDE Gliclazide 80MG TAB Accepted treatment705759 AUSTELL-GLICLAZIDE Gliclazide 40MG TAB Accepted treatment705760 AUSTELL-GLICLAZIDE Gliclazide 80MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

868906 DIAGLUCIDE Gliclazide 80MG TAB Accepted treatment720665 DIAGLUMED Gliclazide 80MG TAB Accepted treatment714582 DIAGLUCIDE MR Gliclazide 30MG TAB Accepted treatment718247 DIAGLUCIDE MR Gliclazide 60MG SRT Accepted treatment702923 DIAMICRON MR Gliclazide 30MG TAB Accepted treatment718245 DIAMICRON MR Gliclazide 60MG SRT Accepted treatment714909 DIARAN MR Gliclazide 30MG SRT Accepted treatment716953 DYNA GLICLAZIDE SR Gliclazide 30MG SRT Accepted treatment3004170 GLICLAZIDE MR AUSTELL Gliclazide 30MG SRT Accepted treatment3004171 GLICLAZIDE MR AUSTELL Gliclazide 60MG SRT Accepted treatment721692 GLICLAZIDE UNICORN MR Gliclazide 30MG SRT Accepted treatment719463 GLICLAZIDE UNICORN MR Gliclazide 80MG TAB Accepted treatment834599 GLUCOMED Gliclazide 80MG TAB Accepted treatment838209 GLYCRON Gliclazide 80MG TAB Accepted treatment700717 GLYGARD Gliclazide 80MG TAB Accepted treatment3000684 GLYTAB MR Gliclazide 30MG SRT Accepted treatment700639 MYLAN-GLICLAZIDE Gliclazide 80MG TAB Accepted treatment834866 ROLAB-GLICLAZIDE Gliclazide 80MG TAB Accepted treatment716714 ACCORD GLIMEPIRIDE Glimepiride 1MG TAB Accepted treatment716715 ACCORD GLIMEPIRIDE Glimepiride 2MG TAB Accepted treatment831557 AMARYL Glimepiride 1MG TAB Accepted treatment831565 AMARYL Glimepiride 2MG TAB Accepted treatment714854 ASPEN GLIMEPIRIDE Glimepiride 1MG TAB Accepted treatment714855 ASPEN GLIMEPIRIDE Glimepiride 2MG TAB Accepted treatment717076 AUSTELL GLIMEPIRIDE Glimepiride 1MG TAB Accepted treatment717077 AUSTELL GLIMEPIRIDE Glimepiride 2MG TAB Accepted treatment710207 EUGLIM Glimepiride 1MG TAB Accepted treatment710208 EUGLIM Glimepiride 2MG TAB Accepted treatment704362 GLAMARYL 1MG Glimepiride 1MG TAB Accepted treatment704363 GLAMARYL 2MG Glimepiride 2MG TAB Accepted treatment710904 SULPHONUR Glimepiride 1MG TAB Accepted treatment710905 SULPHONUR Glimepiride 2MG TAB Accepted treatment

Combination products718106 AMARYL COMBI 2MG/500MG Metformin and sulfonamides 2MG/500MG TAB Special Investigations (SI)701109 GLUCOVANCE 250/1,25 Metformin/Glibenclamide 250MG/1.25MG TAB Special Investigations (SI)701111 GLUCOVANCE 500/2.5 Metformin/Glibenclamide 500MG/2.5MG TAB Special Investigations (SI)701112 GLUCOVANCE 500/5 Metformin/Glibenclamide 500MG/5MG TAB Special Investigations (SI)

Thiazolidines718148 ACCORD PIOGLITAZONE Pioglitazone 15MG TAB Special Investigations (SI)718150 ACCORD PIOGLITAZONE Pioglitazone 30MG TAB Special Investigations (SI)718151 ACCORD PIOGLITAZONE Pioglitazone 45MG TAB Special Investigations (SI)878243 ACTOS 15MG Pioglitazone 15MG TAB Special Investigations (SI)878251 ACTOS 30MG Pioglitazone 30MG TAB Special Investigations (SI)707974 CIPLA PIOGLITAZONE 15 Pioglitazone 15MG TAB Special Investigations (SI)707981 CIPLA PIOGLITAZONE 30 Pioglitazone 30MG TAB Special Investigations (SI)3000543 PIOGLITAZONE HYDROCHLORIDE MACLEODS Pioglitazone 15MG TAB Special Investigations (SI)3000544 PIOGLITAZONE HYDROCHLORIDE MACLEODS Pioglitazone 30MG TAB Special Investigations (SI)

Insulin863572 INSU HUMULIN 30/70 3ML Insulin (human) INJD Accepted treatment863556 INSU HUMULIN N 3.0ML CART 5 Insulin (human) INJD Accepted treatment863564 INSU HUMULIN R 3.0ML CARTRIDGE Insulin (human) INJD Accepted treatment712767 INSU BIOSULIN R CARTRIDGE 3ML Insulin (human) 100IU/1ML INJ Accepted treatment712769 INSU BIOSULIN L CARTRIDGE 3ML Insulin (human) 100IU/1ML INJ Accepted treatment712768 INSU BIOSULIN N CARTRIDGE 3ML Insulin (human) 100IU/1ML INJ Accepted treatment712770 INSU BIOSULIN 30-70 CARTRIDGE 3ML Insulin (human) 100IU/1ML INJ Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

704456 INSU HUMULIN 30/70 PEN 3ML DISP Insulin (human) 100IU/1ML INJD Accepted treatment853453 INSU HUMULIN N PEN 3ML Insulin (human) 100IU/1ML INJD Accepted treatment897767 INSU NOVORAPID FLEXPEN 3ML PENS Insulin aspart INJD Accepted treatment897775 INSU NOVORAPID 3ML SOLUTION FOR I Insulin aspart 100U INJD Accepted treatment705312 INSU LEVEMIR 3ML FLEXPEN PREFILLED Insulin detemir 100MG/1ML INJ Accepted treatment705313 INSU LEVEMIR 3ML PREFILLED CARTRIDGE Insulin detemir 100MG/1ML INJ Accepted treatment721502 OPTISULIN PEN 3ML Insulin glargine 100IU/1ML INJ Accepted treatment723474 OPTISULIN CARTRIDGE 3ML Insulin glargine 100IU/1ML INJ Accepted treatment722454 BASAGLAR PRE-FILLED PEN 3ML Insulin glargine 100U/1ML INJ Accepted treatment722456 BASAGLAR CARTRIDGE 3ML Insulin glargine 100U/1ML INJ Accepted treatment706039 INSU APIDRA CARTIDGES Insulin glulisine 100IU/1ML INJD Accepted treatment709861 INSU APIDRA SOLOSTAR DISPOSABLE PENS 3ML Insulin glulisine 100IU/1ML INJD Accepted treatment723920 HUMALOG KWIKPEN 3ML Insulin lispro 200U/1ML INJ Accepted treatment862355 INSU HUMALOG INJ 3.0ML CART Insulin lispro INJD Accepted treatment861782 INSU HUMALOG MIX 25 CART 3ML Insulin lispro INJD Accepted treatment705074 INSU HUMALOG MIX 50 CART Insulin lispro 3ML INJ Accepted treatment706761 INSU MIRIO PEN HUMALOG MIX 25 Insulin lispro INJD Accepted treatment706762 INSU MIRIO PEN HUMALOG MIX 50 Insulin lispro INJD Accepted treatment706760 INSU MIRIO PEN HUMALOG Insulin lispro INJD Accepted treatment

AppliancesDiabetic strips, needles and lancets Clinical review

Diabetes InsipidusDesmopressin

837563 DDAVP Desmopressin 0.1MG TAB Special Investigations (SI)703639 DDAVP Desmopressin 0.2MG TAB Special Investigations (SI)837555 DDAVP 5ML Desmopressin 0.1MG/1ML NAS Special Investigations (SI)717746 DDAVP INTRANASAL SOLUTION Desmopressin 0.1MG/1ML NOD Special Investigations (SI)722060 MINIRIN MELT Desmopressin 120MCG SLT Special Investigations (SI)722061 MINIRIN MELT Desmopressin 240MCG SLT Special Investigations (SI)

DysrhythmiasAnticoagulants

778362 WARFARIN Warfarin 5MG TAB Accepted treatment709906 CIPLA WARFARIN 1MG Warfarin 1MG TAB Accepted treatment709905 CIPLA WARFARIN 5MG Warfarin 5MG TAB Accepted treatment

Antiplatelet agents706930 BAYER ASPIRIN Acetylsalicylic acid 300MG TAB Accepted treatment862304 BAYER ASPIRIN CARDIO Acetylsalicylic acid 100MG TAB Accepted treatment847283 DISPRIN CV Acetylsalicylic acid 100MG EEF Accepted treatment807206 DISPRIN CV Acetylsalicylic acid 300MG EEF Accepted treatment720577 DISPRIN REGULAR Acetylsalicylic acid 300MG EEF Accepted treatment719673 DR DU TOITS PAIN EXPELLER Acetylsalicylic acid 300MG TAB Accepted treatment823481 ECOTRIN Acetylsalicylic acid 81MG ECT Accepted treatment700909 GULF ASPIRIN Acetylsalicylic acid 300MG TAB Accepted treatment721258 MYOPRIN Acetylsalicylic acid 100MG TAB Accepted treatment712608 PCH ACETYLSALICYLIC ACID CARDIO Acetylsalicylic acid 80MG DSP Accepted treatment704642 SOLUSPIRIN (WAS ASPIRIN SOLUBLE) Acetylsalicylic acid 300MG DSP Accepted treatment722806 SOLUSPRIN CV Acetylsalicylic acid 100MG DSP Accepted treatment

Beta-blockers786586 ADCO-ATENOLOL Atenolol 100MG TAB Accepted treatment786578 ADCO-ATENOLOL Atenolol 50MG TAB Accepted treatment704651 B-BLOCK Atenolol 100MG TAB Accepted treatment704653 B-BLOCK Atenolol 50MG TAB Accepted treatment715626 GULF ATENOLOL Atenolol 100MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

715625 GULF ATENOLOL Atenolol 50MG TAB Accepted treatment806897 HEXA-BLOK Atenolol 100MG TAB Accepted treatment806889 HEXA-BLOK Atenolol 50MG TAB Accepted treatment826901 NORTON-ATENOLOL Atenolol 100MG TAB Accepted treatment826898 NORTON-ATENOLOL Atenolol 50MG TAB Accepted treatment787914 ROLAB-ATENOLOL Atenolol 100MG TAB Accepted treatment786195 TEN-BLOKA Atenolol 100MG TAB Accepted treatment786187 TEN-BLOKA Atenolol 50MG TAB Accepted treatment705873 TENOPRESS Atenolol 100MG TAB Accepted treatment705872 TENOPRESS Atenolol 25MG TAB Accepted treatment705874 TENOPRESS Atenolol 50MG TAB Accepted treatment797693 TENORMIN Atenolol 25MG TAB Accepted treatment769576 TENORMIN Atenolol 100MG TAB Accepted treatment769584 TENORMIN Atenolol 50MG TAB Accepted treatment719657 ZETENOL Atenolol 100MG TAB Accepted treatment719656 ZETENOL Atenolol 50MG TAB Accepted treatment703914 ADCO BISOCOR 10MG Bisoprolol 10MG TAB Accepted treatment703913 ADCO BISOCOR 5MG Bisoprolol 5MG TAB Accepted treatment721438 MYLAN BISOPROLOL Bisoprolol 10MG TAB Accepted treatment721437 MYLAN BISOPROLOL Bisoprolol 5MG TAB Accepted treatment722055 BISOPROLOL UNICHEM Bisoprolol 5MG TAB Accepted treatment722056 BISOPROLOL UNICHEM Bisoprolol 10MG TAB Accepted treatment706179 BETACOR Bisoprolol 10MG TAB Accepted treatment706178 BETACOR Bisoprolol 5MG TAB Accepted treatment704373 BILOCOR 10 Bisoprolol 10MG TAB Accepted treatment704372 BILOCOR 5 Bisoprolol 5MG TAB Accepted treatment719154 BISLO Bisoprolol 5MG TAB Accepted treatment719155 BISLO Bisoprolol 10MG TAB Accepted treatment720660 BISBETA Bisoprolol 10MG TAB Accepted treatment720659 BISBETA Bisoprolol 5MG TAB Accepted treatment704133 BISOHEXAL 10 Bisoprolol 10MG TAB Accepted treatment704132 BISOHEXAL 5 Bisoprolol 5MG TAB Accepted treatment716166 BISOPROLOL UNICORN Bisoprolol 10MG TAB Accepted treatment716167 BISOPROLOL UNICORN Bisoprolol 5MG TAB Accepted treatment720043 BISOPROLOL ZYDUS Bisoprolol 10MG TAB Accepted treatment720044 BISOPROLOL ZYDUS Bisoprolol 5MG TAB Accepted treatment704441 CARDICOR 10MG Bisoprolol 10MG TAB Accepted treatment704439 CARDICOR 2.5MG Bisoprolol 2.5MG TAB Accepted treatment704440 CARDICOR 5MG Bisoprolol 5MG TAB Accepted treatment818437 CONCOR Bisoprolol 10MG TAB Accepted treatment818429 CONCOR Bisoprolol 5MG TAB Accepted treatment3003793 EMCOR Bisoprolol 10MG TAB Accepted treatment3003790 EMCOR Bisoprolol 2.5MG TAB Accepted treatment3003792 EMCOR Bisoprolol 5MG TAB Accepted treatment3003544 PRESICARD Bisoprolol 10MG TAB Accepted treatment3003484 PRESICARD Bisoprolol 2.5MG TAB Accepted treatment3003543 PRESICARD Bisoprolol 5MG TAB Accepted treatment720821 RETOCAR Bisoprolol 10MG TAB Accepted treatment720820 RETOCAR Bisoprolol 5MG TAB Accepted treatment715276 ZIAPRO Bisoprolol 10MG TAB Accepted treatment715274 ZIAPRO Bisoprolol 5MG TAB Accepted treatment721589 BISOPROLOL CO UNICORN 10MG/6.25MG Bisoprolol and thiazides 10MG/6.25MG TAB Accepted treatment721588 BISOPROLOL CO UNICORN 5MG/6.25MG Bisoprolol and thiazides 5MG/6.25MG TAB Accepted treatment716483 LOVISPES Nebivolol 5MG TAB Accepted treatment700558 NEBILET 5MG Nebivolol 5MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

828009 SOTAHEXAL Sotalol 160MG TAB Specialist script827991 SOTAHEXAL Sotalol 80MG TAB Specialist script

Alpha-Beta blockers710339 ASPEN CARVEDILOL Carvedilol 12.5MG TAB Accepted treatment710340 ASPEN CARVEDILOL Carvedilol 25MG TAB Accepted treatment710338 ASPEN CARVEDILOL Carvedilol 6.25MG TAB Accepted treatment897117 CARLOC Carvedilol 25MG TAB Accepted treatment705459 CARLOC 6.25 Carvedilol 6.25MG TAB Accepted treatment700168 CARLOC 12.5 Carvedilol 12.5MG TAB Accepted treatment3000330 CARVEDILOL 12.5 OETHMAAN Carvedilol 12.5MG TAB Accepted treatment716743 CARVEDILOL UNICORN Carvedilol 12.5MG TAB Accepted treatment716744 CARVEDILOL UNICORN Carvedilol 25MG TAB Accepted treatment716742 CARVEDILOL UNICORN Carvedilol 6.25MG TAB Accepted treatment704671 CARVETREND 12.5MG Carvedilol 12.5MG TAB Accepted treatment704672 CARVETREND 25MG Carvedilol 25MG TAB Accepted treatment704670 CARVETREND 6.25MG Carvedilol 6.25MG TAB Accepted treatment836354 DILATREND Carvedilol 12.5MG TAB Accepted treatment788856 DILATREND Carvedilol 25MG APP Accepted treatment833428 DILATREND Carvedilol 6.25MG TAB Accepted treatment3000278 RUBITREND Carvedilol 12.5MG TAB Accepted treatment3000281 RUBITREND Carvedilol 25MG TAB Accepted treatment3000276 RUBITREND Carvedilol 6.25MG TAB Accepted treatment710959 VEDIBLOK Carvedilol 12.5MG TAB Accepted treatment710960 VEDIBLOK Carvedilol 25MG TAB Accepted treatment710958 VEDIBLOK Carvedilol 6.25MG TAB Accepted treatment

Cardiac glycosides735752 LANOXIN Digoxin 0.25MG TAB Accepted treatment735744 LANOXIN PAED Digoxin 0.05MG/1ML SYR Accepted treatment735760 LANOXIN PAED Digoxin 0.063MG TAB Accepted treatment758280 PURGOXIN Digoxin 0.25MG TAB Accepted treatment

Calcium channel antagonists839183 ZILDEM Diltiazem 180MG SRC Accepted treatment839191 ZILDEM Diltiazem 240MG SRC Accepted treatment822213 ZILDEM 60 Diltiazem 60MG TAB Accepted treatment824364 ZILDEM 90 BD Diltiazem 90MG TAB Accepted treatment813354 CALCICARD SR Verapamil 240MG SRT Accepted treatment734071 ISOPTIN DRAGEES Verapamil 40MG TAB Accepted treatment734373 ISOPTIN SR Verapamil 240MG SRT Accepted treatment819573 RAVAMIL SR Verapamil 240MG SRT Accepted treatment774944 VASOMIL Verapamil 40MG TAB Accepted treatment774952 VASOMIL Verapamil 80MG TAB Accepted treatment775789 VERAPAMIL 40 OETHMAAN Verapamil 40MG TAB Accepted treatment700071 VERAHEXAL 240 SR Verapamil 240MG SRT Accepted treatment

Anti-arrhythmics703515 ARYCOR Amiodarone 100MG TAB Accepted treatment703513 ARYCOR Amiodarone 200MG TAB Accepted treatment707851 BIO-AMIODARONE Amiodarone 200MG TAB Accepted treatment800554 CORDARONE X Amiodarone 100MG TAB Accepted treatment716111 CORDARONE X Amiodarone 200MG TAB Accepted treatment863157 HEXARONE 100MG Amiodarone 100MG TAB Accepted treatment863165 HEXARONE 200MG Amiodarone 200MG TAB Accepted treatment

Epilepsy705602 SANDOZ CARBAMAZIPINE CR400 Carbamazepine 400MG SRT Accepted treatment712493 DEGRANOL Carbamazepine 200MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

3001174 GULF CARBAMAZEPINE Carbamazepine 200MG TAB Accepted treatment715962 ZEPTOL Carbamazepine 200MG TAB Accepted treatment769398 TEGRETOL Carbamazepine 200MG TAB Accepted treatment769401 TEGRETOL S Carbamazepine 100MG/5ML SUS Accepted treatment779652 TEGRETOL CR Carbamazepine 200MG SRT Accepted treatment779660 TEGRETOL CR Carbamazepine 400MG SRT Accepted treatment721545 CLONAM Clonazepam .5MG TAB Accepted treatment721546 CLONAM Clonazepam 2MG TAB Accepted treatment761079 RIVOTRIL Clonazepam 0.5MG TAB Accepted treatment761087 RIVOTRIL Clonazepam 2MG TAB Accepted treatment835129 RIVOTRIL Clonazepam 2.5MG/1ML DRP Accepted treatment779105 ZARONTIN Ethosuximide 250MG/5ML SYR Accepted treatment707622 EPLEPTIN Gabapentin 100MG CAP Specialist motivation707623 EPLEPTIN Gabapentin 300MG CAP Specialist motivation707624 EPLEPTIN Gabapentin 400MG CAP Specialist motivation722865 EPIGAB Gabapentin 100MG CAP Specialist motivation722866 EPIGAB Gabapentin 300MG CAP Specialist motivation722867 EPIGAB Gabapentin 400MG CAP Specialist motivation721740 BIOTECH GABAPENTIN Gabapentin 100MG CAP Specialist motivation721741 BIOTECH GABAPENTIN Gabapentin 300MG CAP Specialist motivation721742 BIOTECH GABAPENTIN Gabapentin 400MG CAP Specialist motivation807443 NEURONTIN Gabapentin 100MG CAP Specialist motivation807451 NEURONTIN Gabapentin 300MG CAP Specialist motivation807478 NEURONTIN Gabapentin 400MG CAP Specialist motivation704379 EPITEC 25MG Lamotrigine 25MG TAB Accepted treatment704380 EPITEC 50MG Lamotrigine 50MG TAB Accepted treatment704381 EPITEC 100MG Lamotrigine 100MG TAB Accepted treatment704382 EPITEC 200MG Lamotrigine 200MG TAB Accepted treatment704486 LAMITOR Lamotrigine 25MG TAB Accepted treatment704487 LAMITOR Lamotrigine 50MG TAB Accepted treatment704488 LAMITOR Lamotrigine 100MG TAB Accepted treatment704533 LAMICTIN P2 Lamotrigine 2MG DSP Accepted treatment705248 SANDOZ LAMOTRIGINE Lamotrigine 100MG TAB Accepted treatment3000448 SERINEM Lamotrigine 25MG TAB Accepted treatment3000449 SERINEM Lamotrigine 50MG TAB Accepted treatment3000451 SERINEM Lamotrigine 100MG TAB Accepted treatment3000452 SERINEM Lamotrigine 200MG TAB Accepted treatment705436 ASPEN LAMOTRIGINE 25MG Lamotrigine 25MG TAB Accepted treatment705440 ASPEN LAMOTRIGINE 50MG Lamotrigine 50MG TAB Accepted treatment705441 ASPEN LAMOTRIGINE 100MG Lamotrigine 100MG TAB Accepted treatment707787 AUSTELL-LAMOTRIGINE Lamotrigine 25MG TAB Accepted treatment707788 AUSTELL-LAMOTRIGINE Lamotrigine 50MG TAB Accepted treatment707789 AUSTELL-LAMOTRIGINE Lamotrigine 100MG TAB Accepted treatment707790 AUSTELL-LAMOTRIGINE Lamotrigine 200MG TAB Accepted treatment710387 DYNA-LAMOTRIGINE Lamotrigine 25MG TAB Accepted treatment710388 DYNA-LAMOTRIGINE Lamotrigine 50MG TAB Accepted treatment710389 DYNA-LAMOTRIGINE Lamotrigine 100MG TAB Accepted treatment710390 DYNA-LAMOTRIGINE Lamotrigine 200MG TAB Accepted treatment710885 LAMIDUS Lamotrigine 50MG TAB Accepted treatment712217 LAMITOR Lamotrigine 200MG TAB Accepted treatment722725 GIROTEC Lamotrigine 50MG TAB Accepted treatment722726 GIROTEC Lamotrigine 100MG TAB Accepted treatment722727 GIROTEC Lamotrigine 200MG TAB Accepted treatment805505 LAMICTIN Lamotrigine 25MG TAB Accepted treatment805513 LAMICTIN Lamotrigine 50MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

805521 LAMICTIN Lamotrigine 100MG TAB Accepted treatment813885 LAMICTIN P5 Lamotrigine 5MG DSP Accepted treatment813893 LAMICTIN P25 Lamotrigine 25MG DSP Accepted treatment813907 LAMICTIN P100 Lamotrigine 100MG DSP Accepted treatment819034 LAMICTIN Lamotrigine 200MG TAB Accepted treatment891708 LAMICTIN P50 Lamotrigine 50MG DSP Accepted treatment891716 LAMICTIN P200 Lamotrigine 200MG DSP Accepted treatment700958 KEPPRA 250MG Levetiracetam 250MG TAB Accepted treatment700959 KEPPRA 500MG Levetiracetam 500MG TAB Accepted treatment703165 KEPPRA Levetiracetam 750MG TAB Accepted treatment714166 KEPPRA Levetiracetam 100MG/1ML SOL Accepted treatment714662 REDILEV Levetiracetam 250MG TAB Accepted treatment714663 REDILEV Levetiracetam 500MG TAB Accepted treatment714664 REDILEV Levetiracetam 750MG TAB Accepted treatment718484 DYNA LEVETIRACETAM Levetiracetam 750MG TAB Accepted treatment718485 DYNA LEVETIRACETAM Levetiracetam 500MG TAB Accepted treatment718486 DYNA LEVETIRACETAM Levetiracetam 250MG TAB Accepted treatment720696 LEVETIRACETAM BIOTECH Levetiracetam 750MG TAB Accepted treatment720697 LEVETIRACETAM BIOTECH Levetiracetam 250MG TAB Accepted treatment720700 DYNA LEVETIRACETAM Levetiracetam 1000MG TAB Accepted treatment721701 EPIKEPP Levetiracetam 250MG TAB Accepted treatment721702 EPIKEPP Levetiracetam 500MG TAB Accepted treatment721703 EPIKEPP Levetiracetam 750MG TAB Accepted treatment722150 LEVETIRACETAM UNICORN Levetiracetam 250MG TAB Accepted treatment722151 LEVETIRACETAM UNICORN Levetiracetam 750MG TAB Accepted treatment717226 MYLAN OXCARBAZEPINE Oxcarbazepine 300MG TAB Specialist motivation717227 MYLAN OXCARBAZEPINE Oxcarbazepine 600MG TAB Specialist motivation892484 TRILEPTAL FCT Oxcarbazepine 300MG TAB Specialist motivation892491 TRILEPTAL FCT Oxcarbazepine 600MG TAB Specialist motivation737844 LETHYL Phenobarbital 30MG TAB Accepted treatment754803 ADCO-PHENOBARB VITALET ELIXIR Phenobarbital 100ML SYR Accepted treatment814946 SEDABARB Phenobarbital 30MG TAB Accepted treatment723525 EPANUTIN Phenytoin 100MG APP Accepted treatment723533 EPANUTIN FORTE Phenytoin 125MG/5ML SUS Accepted treatment754870 PHENYTOIN SOD Phenytoin 100MG TAB Accepted treatment708389 TOPLEP Topiramate 25MG TAB Specialist motivation708390 TOPLEP Topiramate 50MG TAB Specialist motivation708391 TOPLEP Topiramate 100MG TAB Specialist motivation708392 TOPLEP Topiramate 200MG TAB Specialist motivation709284 SANDOZ TOPIRAMATE Topiramate 25MG TAB Specialist motivation709285 SANDOZ TOPIRAMATE Topiramate 50MG TAB Specialist motivation709286 SANDOZ TOPIRAMATE Topiramate 100MG TAB Specialist motivation709287 SANDOZ TOPIRAMATE Topiramate 200MG TAB Specialist motivation710899 EPITOZ Topiramate 25MG TAB Specialist motivation710900 EPITOZ Topiramate 50MG TAB Specialist motivation710901 EPITOZ Topiramate 100MG TAB Specialist motivation715978 TOPALEX Topiramate 25MG TAB Specialist motivation715979 TOPALEX Topiramate 50MG TAB Specialist motivation715981 TOPALEX Topiramate 100MG TAB Specialist motivation716000 PAMIRAM Topiramate 25MG TAB Specialist motivation716001 PAMIRAM Topiramate 50MG TAB Specialist motivation716468 PAMIRAM Topiramate 100MG TAB Specialist motivation716482 PAMIRAM Topiramate 200MG TAB Specialist motivation718288 TOPIROL Topiramate 25MG TAB Specialist motivation718290 TOPIROL Topiramate 50MG TAB Specialist motivation

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

718291 TOPIROL Topiramate 100MG TAB Specialist motivation718855 EPIMATE Topiramate 25MG TAB Specialist motivation718856 EPIMATE Topiramate 50MG TAB Specialist motivation718857 EPIMATE Topiramate 100MG TAB Specialist motivation718858 EPIMATE Topiramate 200MG TAB Specialist motivation822515 TOPAMAX Topiramate 25MG TAB Specialist motivation822523 TOPAMAX Topiramate 50MG TAB Specialist motivation822531 TOPAMAX Topiramate 100MG TAB Specialist motivation836753 TOPAMAX Topiramate 200MG TAB Specialist motivation878014 TOPAMAX SC SPRINKLE Topiramate 15MG CAP Specialist motivation878022 TOPAMAX SC SPRINKLE Topiramate 25MG CAP Specialist motivation890728 TOPAMAX SC SPRINKLE Topiramate 50MG CAP Specialist motivation715980 CONVULEX Valproic acid 150MG CAP Accepted treatment715999 CONVULEX Valproic acid 300MG CAP Accepted treatment718274 EPILIZINE CR Valproic acid 200MG SRT Accepted treatment718275 EPILIZINE CR Valproic acid 300MG SRT Accepted treatment718276 EPILIZINE CR Valproic acid 500MG SRT Accepted treatment718465 NAVALPRO CR Valproic acid 200MG SRT Accepted treatment718466 NAVALPRO CR Valproic acid 300MG SRT Accepted treatment718468 NAVALPRO CR Valproic acid 500MG SRT Accepted treatment720026 VANAPRO Valproic acid 300MG SRT Accepted treatment720027 VANAPRO Valproic acid 500MG SRT Accepted treatment720762 EPROLEP CR 300 Valproic acid 300MG SRT Accepted treatment721055 EPROLEP CR 500 Valproic acid 500MG SRT Accepted treatment721460 EPROLEP CR 200 Valproic acid 200MG SRT Accepted treatment780545 EPILIM SUGAR FREE Valproic acid 200MG/5ML SYR Accepted treatment781541 CONVULEX Valproic acid 250MG/5ML SYR Accepted treatment781568 CONVULEX Valproic acid 500MG CAP Accepted treatment818666 EPILIM CR Valproic acid 200MG SRT Accepted treatment818674 EPILIM CR Valproic acid 300MG SRT Accepted treatment818682 EPILIM CR Valproic acid 500MG SRT Accepted treatment821578 EPILIM CRUSHABLE Valproic acid 100MG TAB Accepted treatment

GlaucomaSympathomimetics

709410 ALPHAGAN PURITE 5ML Brimonidine 1.5MG/1ML OPD Clinical review721293 BRIMOCT 5ML Brimonidine 2MG/1ML OPD Clinical review

Parasympathomimetics734284 ISOPTO CARPINE 15ML Pilocarpine 10MG/1ML APP Accepted treatment734179 ISOPTO CARPINE 15ML Pilocarpine 20MG/1ML OPD Accepted treatment734195 ISOPTO CARPINE 15ML Pilocarpine 40MG/1ML OPD Accepted treatment

Carbonic anhydrase inhibitor701523 AZOPTIC EYE DROP Brinzolamide 10MG/1ML OPD Clinical review819832 TRUSOPT 5ML Dorzolamide 20MG/1ML DRP Clinical review720983 GLAUCOPRESS 5ML Dorzolamide 0.02 OPD Clinical review

Beta-blockers708445 BETOPTIC 5ML Betaxolol 5MG/1ML OPD Accepted treatment836052 BETOPTIC S 5ML Betaxolol 2.5MG/1ML OPD Accepted treatment722010 LOXOPTIC 5ML Betaxolol 0.005 OPD Accepted treatment781134 BETAGAN Levobunolol 0.005 OPD Accepted treatment723286 BETAGAN LIQUIFILM 5ML Levobunolol 5MG/1ML OPD Accepted treatment816736 BETA-OPTHIOLE 5ML Metipranolol 0.006 OPD Accepted treatment821624 GLAUCOSAN 0.5 % 5ML Timolol 5MG/1ML OPD Accepted treatment702142 NYOGEL EYE GEL 5G Timolol 0.001 OPD Accepted treatment720734 OCCUMOL Timolol 0.005 OPD Accepted treatment770833 TIMOPTOL 5ML Timolol 2.5MG/1ML OPD Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

770841 TIMOPTOL 5ML Timolol 5MG/1ML OPD Accepted treatment819816 TIMOPTOL-XE 0.25% 2.5ML Timolol 2.5MG/1ML DRP Accepted treatment819824 TIMOPTOL-XE 0.50 % 2.5ML Timolol 5MG/1ML DRP Accepted treatment

Combination products717260 AZARGA 5ML Timolol, combinations OPD Accepted treatment709863 COMBIGAN 2MG/5MG 5ML Timolol, combinations OPD Accepted treatment860379 COSOPT 5ML Timolol, combinations 0.005 OPD Accepted treatment722712 CO-ATANA 2.5ML Timolol, combinations OPD Accepted treatment708877 DUOTRAV 2.5ML Timolol, combinations OPD Accepted treatment714110 GANFORT 3ML Timolol, combinations 0.3MG/5MG OPD Accepted treatment721902 GLAUMIDE-CO 10ML Timolol, combinations OPD Accepted treatment721977 GLAUOPT CO 5ML Timolol, combinations 20MG/5MG OPD Accepted treatment702983 XALACOM 2.5ML Timolol, combinations 50MCG/5MG OPD Accepted treatment3000372 OCUDOR CO 5ML Timolol, combinations OPD Accepted treatment

Prostaglandin derivatives720971 ATANA 2.5ML Latanoprost 0.00005 OPD Clinical review716754 LUMIGAN Bimatoprost 0.01% OPD Clinical review703666 LUMIGAN 3ML Bimatoprost 0.3MG/1ML OPD Clinical review715961 OCUPROST 3ML Latanoprost 50MCG/1ML OPD Clinical review720401 SAFLUTAN SINGLE DOSE CONTAINER 0.3ML Tafluprost 15MCG/1ML OPD Clinical review723018 SPERSATAN 2.5ML Latanoprost 50MCG OPD Clinical review702534 TRAVATAN 2.5ML Travoprost OPD Clinical review833223 XALATAN 2.5ML Latanoprost 50MCG/1ML OPD Clinical review

Acetazolamide789771 AZOMID Acetazolamide 250MG TAB Clinical review719471 DIAMOX Acetazolamide 250MG TAB Clinical review

HaemophiliaTranexamic Acid

717134 CYKLOKAPRON Tranexamic acid 500MG TAB Accepted treatment716276 TRANIC Tranexamic acid 500MG TAB Accepted treatment719414 MORWAK Tranexamic acid 500MG TAB Accepted treatment

Desmopressin837563 DDAVP Desmopressin 0.1MG TAB Accepted treatment703639 DDAVP Desmopressin 0.2MG TAB Accepted treatment837555 DDAVP 5ML Desmopressin 0.1MG/1ML NAS Accepted treatment717746 DDAVP INTRANASAL SOLUTION Desmopressin 0.1MG/1ML NOD Accepted treatment722060 MINIRIN MELT Desmopressin 120MCG SLT Accepted treatment722061 MINIRIN MELT Desmopressin 240MCG SLT Accepted treatment

Analgesics792101 ACTAMOL Paracetamol 120MG/5ML SYR Accepted treatment717725 ACTAMOL Paracetamol 500MG TAB Accepted treatment701634 DIS-CHEM PARACETAMOL Paracetamol 500MG TAB Accepted treatment704093 ACTAMOL RED (UN-BOXED) Paracetamol 120MG/5ML SYR Accepted treatment716045 ADCO-NAPAMOL Paracetamol 500MG TAB Accepted treatment894281 ADCO-PARACETAMOL Paracetamol 120MG/5ML SYR Accepted treatment805467 ANTALGIC 500 Paracetamol 500MG TAB Accepted treatment713153 AUSTELL-PARACETAMOL Paracetamol 500MG TAB Accepted treatment717187 BARRS PARACETAMOL Paracetamol 120MG/5ML SYR Accepted treatment789526 BRUNOMOL Paracetamol 120MG/5ML SYR Accepted treatment711993 CALPOL Paracetamol 120MG/5ML SUS Accepted treatment3001556 CALPOL Paracetamol 500MG TAB Accepted treatment714499 CLICKS PARACETAMOL Paracetamol 500MG TAB Accepted treatment720860 DOLOROL Paracetamol 500MG TAB Accepted treatment798045 DYNADOL Paracetamol 120MG/5ML SYR Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

798053 DYNADOL Paracetamol 500MG TAB Accepted treatment863742 FEVERPAIN (BOXED) Paracetamol 120MG/5ML SYR Accepted treatment703820 FEVERPAIN Paracetamol 120MG/5ML SYR Accepted treatment824992 GENCETAMOL Paracetamol 500MG TAB Accepted treatment895199 GO-PAIN P Paracetamol 120mg/5ml SYR Accepted treatment715112 GRAYS PARACETAMOL Paracetamol 500MG TAB Accepted treatment867950 GULF PARACETAMOL Paracetamol 500MG TAB Accepted treatment894212 JP PARACETAMOL Paracetamol 500MG TAB Accepted treatment715280 LENNON PARACETAMOL Paracetamol 500MG TAB Accepted treatment745715 NAPAMOL Paracetamol 120MG/5ML SYR Accepted treatment745723 NAPAMOL Paracetamol 500MG TAB Accepted treatment752118 PAINAMOL Paracetamol 120MG/5ML SYR Accepted treatment799629 PAINAMOL (GREEN) Paracetamol 500MG TAB Accepted treatment752142 PAINAMOL WHITE Paracetamol 500MG TAB Accepted treatment889772 PAINBLOK Paracetamol 120MG/5ML SYR Accepted treatment867969 PAINBLOK Paracetamol 500MG TAB Accepted treatment703349 PAINBLOK (GLASS BOTTLE) Paracetamol 120MG/5ML SYR Accepted treatment704450 PAINOGESIC Paracetamol 120MG/5ML SYR Accepted treatment704465 PAINOGESIC Paracetamol 500MG TAB Accepted treatment752274 PANADO Paracetamol 500MG TAB Accepted treatment752355 PANADO Paracetamol 500MG CAP Accepted treatment708432 PANADO CHILDRENS Paracetamol 125MG MLT Accepted treatment720327 PANADO BLISTER PACK Paracetamol 500MG TAB Accepted treatment788953 PANADO ( ALCO/SUGAR FREE) Paracetamol 120MG/5ML SYR Accepted treatment752282 PANADO PAED SYRUP Paracetamol 120MG/5ML SYR Accepted treatment3003458 PANADO PAEDIATRIC SYRUP 5ML Paracetamol 120MG/5ML SYR Accepted treatment703118 PANADO PAEDIATRIC SYRUP STRAWBERRY Paracetamol 120MG/5ML SYR Accepted treatment720438 PARAFIZZ Paracetamol 500MG EFT Accepted treatment707583 PARACETAMOL ELIXIR SAD (ALCOHOL FREE) Paracetamol 120MG/5ML SYR Accepted treatment784443 PARAMED Paracetamol 500MG TAB Accepted treatment752878 PARAPANE Paracetamol 500MG TAB Accepted treatment757403 PROLIEF Paracetamol 500MG TAB Accepted treatment714708 PYNGESIC S Paracetamol 120MG/5ML SYR Accepted treatment714707 PYNGESIC T Paracetamol 500MG TAB Accepted treatment758558 PYRALEN Paracetamol 120MG/5ML SYR Accepted treatment826588 THERA-PAIN Paracetamol 500MG TAB Accepted treatment3003420 VARIPAN SUGAR FREE Paracetamol 120MG/5ML SYR Accepted treatment885863 VON PARACETAMOL Paracetamol 500MG TAB Accepted treatment710452 WOODWARD'S PARACETAMOL Paracetamol 120MG/5ML SYR Accepted treatment837652 DINO-COD (BEI) Paracetamol and codeine TAB Accepted treatment720879 DOLOROL FORTE Paracetamol and codeine TAB Accepted treatment745707 NAPACOD Paracetamol and codeine TAB Accepted treatment707910 PAINAMOL PLUS (BETACOD) Paracetamol and codeine TAB Accepted treatment895030 PAINCODEIN Paracetamol and codeine 500MG/8MG TAB Accepted treatment761303 ROCODIN Paracetamol and codeine TAB Accepted treatment765635 SPECTRAPAIN Paracetamol and codeine CAP Accepted treatment713688 VARI-COCODAMOL 8MG/500MG Paracetamol and codeine 8MG/500MG TAB Accepted treatment787043 CODOROL Paracetamol combinations payable by PBM TAB Accepted treatment719662 COGESIC Paracetamol combinations payable by PBM 500MG/8MG TAB Accepted treatment752614 PARACETACOD Paracetamol combinations payable by PBM TAB Accepted treatment

HyperlipidaemiaStatins

718073 ADCO ATORVASTATIN Atorvastatin 10MG TAB Special Investigations (SI)718074 ADCO ATORVASTATIN Atorvastatin 20MG TAB Special Investigations (SI)

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

718075 ADCO ATORVASTATIN Atorvastatin 40MG TAB Special Investigations (SI)3003467 ALIPTO Atorvastatin 10MG TAB Special Investigations (SI)3003468 ALIPTO Atorvastatin 20MG TAB Special Investigations (SI)3003469 ALIPTO Atorvastatin 40MG TAB Special Investigations (SI)708121 ASPAVOR Atorvastatin 10MG TAB Special Investigations (SI)708122 ASPAVOR Atorvastatin 20MG TAB Special Investigations (SI)710912 ASPAVOR Atorvastatin 40MG TAB Special Investigations (SI)720211 ASPAVOR Atorvastatin 80MG TAB Special Investigations (SI)719185 ASTOR Atorvastatin 10MG TAB Special Investigations (SI)719186 ASTOR Atorvastatin 20MG TAB Special Investigations (SI)719187 ASTOR Atorvastatin 40MG TAB Special Investigations (SI)719189 ASTOR Atorvastatin 80MG TAB Special Investigations (SI)714370 ATOLIP Atorvastatin 10MG TAB Special Investigations (SI)714371 ATOLIP Atorvastatin 20MG TAB Special Investigations (SI)714372 ATOLIP Atorvastatin 40MG TAB Special Investigations (SI)714373 ATOLIP Atorvastatin 80MG TAB Special Investigations (SI)723710 ATORVASTATIN LHC Atorvastatin 10MG TAB Special Investigations (SI)723712 ATORVASTATIN LHC Atorvastatin 20MG TAB Special Investigations (SI)723713 ATORVASTATIN LHC Atorvastatin 40MG TAB Special Investigations (SI)711621 ATORVASTATIN UNICORN Atorvastatin 10MG TAB Special Investigations (SI)712170 ATORVASTATIN UNICORN Atorvastatin 20MG TAB Special Investigations (SI)713522 ATORVASTATIN UNICORN Atorvastatin 40MG TAB Special Investigations (SI)716615 ATORVASTATIN WINTHROP Atorvastatin 10MG TAB Special Investigations (SI)716616 ATORVASTATIN WINTHROP Atorvastatin 20MG TAB Special Investigations (SI)716617 ATORVASTATIN WINTHROP Atorvastatin 40MG TAB Special Investigations (SI)3003434 CHOLMIN Atorvastatin 10MG TAB Special Investigations (SI)3003435 CHOLMIN Atorvastatin 20MG TAB Special Investigations (SI)3003436 CHOLMIN Atorvastatin 40MG TAB Special Investigations (SI)3003437 CHOLMIN Atorvastatin 80MG TAB Special Investigations (SI)3001254 DEZZOLIP Atorvastatin 10MG TAB Special Investigations (SI)3001255 DEZZOLIP Atorvastatin 20MG TAB Special Investigations (SI)3001256 DEZZOLIP Atorvastatin 40MG TAB Special Investigations (SI)3001257 DEZZOLIP Atorvastatin 80MG TAB Special Investigations (SI)718218 DYNATOR Atorvastatin 10MG TAB Special Investigations (SI)718219 DYNATOR Atorvastatin 20MG TAB Special Investigations (SI)718220 DYNATOR Atorvastatin 40MG TAB Special Investigations (SI)718221 DYNATOR Atorvastatin 80MG TAB Special Investigations (SI)719366 LESTAVOR Atorvastatin 10MG TAB Special Investigations (SI)719367 LESTAVOR Atorvastatin 20MG TAB Special Investigations (SI)719368 LESTAVOR Atorvastatin 40MG TAB Special Investigations (SI)719369 LESTAVOR Atorvastatin 80MG TAB Special Investigations (SI)831484 LIPITOR Atorvastatin 10MG TAB Special Investigations (SI)831492 LIPITOR Atorvastatin 20MG TAB Special Investigations (SI)886015 LIPITOR Atorvastatin 40MG TAB Special Investigations (SI)704186 LIPITOR Atorvastatin 80MG TAB Special Investigations (SI)714071 LIPOGEN Atorvastatin 10MG TAB Special Investigations (SI)714072 LIPOGEN Atorvastatin 20MG TAB Special Investigations (SI)714073 LIPOGEN Atorvastatin 40MG TAB Special Investigations (SI)714074 LIPOGEN Atorvastatin 80MG TAB Special Investigations (SI)714075 RAN-ATORVASTATIN Atorvastatin 10MG TAB Special Investigations (SI)714076 RAN-ATORVASTATIN Atorvastatin 20MG TAB Special Investigations (SI)714077 RAN-ATORVASTATIN Atorvastatin 40MG TAB Special Investigations (SI)714078 RAN-ATORVASTATIN Atorvastatin 80MG TAB Special Investigations (SI)718933 VASTOR Atorvastatin 10MG TAB Special Investigations (SI)718934 VASTOR Atorvastatin 20MG TAB Special Investigations (SI)

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

718935 VASTOR Atorvastatin 40MG TAB Special Investigations (SI)718936 VASTOR Atorvastatin 80MG TAB Special Investigations (SI)700963 LESCOL XL Fluvastatin 80MG ECT Special Investigations (SI)718208 VATICOL XL Fluvastatin 80MG TAB Special Investigations (SI)705212 ASPEN PRAVASTATIN Pravastatin 10MG TAB Special Investigations (SI)705213 ASPEN PRAVASTATIN Pravastatin 20MG TAB Special Investigations (SI)705214 ASPEN PRAVASTATIN Pravastatin 40MG TAB Special Investigations (SI)717073 AUSTELL PRAVASTATIN Pravastatin 10MG TAB Special Investigations (SI)717074 AUSTELL PRAVASTATIN Pravastatin 20MG TAB Special Investigations (SI)717075 AUSTELL PRAVASTATIN Pravastatin 40MG TAB Special Investigations (SI)710974 COLITE Pravastatin 10MG TAB Special Investigations (SI)710975 COLITE Pravastatin 20MG TAB Special Investigations (SI)710976 COLITE Pravastatin 40MG TAB Special Investigations (SI)715709 PRAVACOR Pravastatin 10MG TAB Special Investigations (SI)715710 PRAVACOR Pravastatin 20MG TAB Special Investigations (SI)715711 PRAVACOR Pravastatin 40MG TAB Special Investigations (SI)705901 SANDOZ PRAVASTATIN 10 Pravastatin 10MG TAB Special Investigations (SI)705902 SANDOZ PRAVASTATIN 20 Pravastatin 20MG TAB Special Investigations (SI)705903 SANDOZ PRAVASTATIN 40 Pravastatin 40MG TAB Special Investigations (SI)701276 ADCO-SIMVASTATIN Simvastatin 10MG TAB Special Investigations (SI)701279 ADCO-SIMVASTATIN Simvastatin 20MG TAB Special Investigations (SI)701281 ADCO-SIMVASTATIN Simvastatin 40MG TAB Special Investigations (SI)707089 ARROW SIMVASTATIN Simvastatin 10MG TAB Special Investigations (SI)707090 ARROW SIMVASTATIN Simvastatin 20MG TAB Special Investigations (SI)707091 ARROW SIMVASTATIN Simvastatin 40MG TAB Special Investigations (SI)706714 ASPEN SIMVASTATIN Simvastatin 10MG TAB Special Investigations (SI)706715 ASPEN SIMVASTATIN Simvastatin 20MG TAB Special Investigations (SI)706716 ASPEN SIMVASTATIN Simvastatin 40MG TAB Special Investigations (SI)705464 AUSTELL-SIMVASTATIN 10MG Simvastatin 10MG TAB Special Investigations (SI)705465 AUSTELL-SIMVASTATIN 20MG Simvastatin 20MG TAB Special Investigations (SI)705467 AUSTELL-SIMVASTATIN 40MG Simvastatin 40MG TAB Special Investigations (SI)709668 BIOVAC SIMVASTATIN Simvastatin 10MG TAB Special Investigations (SI)709822 BIOVAC SIMVASTATIN Simvastatin 20MG TAB Special Investigations (SI)709823 BIOVAC SIMVASTATIN Simvastatin 40MG TAB Special Investigations (SI)715708 CHOLESTE Simvastatin 10MG TAB Special Investigations (SI)714705 CHOLESTE Simvastatin 20MG TAB Special Investigations (SI)714706 CHOLESTE Simvastatin 40MG TAB Special Investigations (SI)708307 CIPLA-SIMVASTATIN Simvastatin 10MG TAB Special Investigations (SI)708308 CIPLA-SIMVASTATIN Simvastatin 20MG TAB Special Investigations (SI)710511 CIPLA-SIMVASTATIN Simvastatin 40MG TAB Special Investigations (SI)710513 CIPLA-SIMVASTATIN Simvastatin 80MG TAB Special Investigations (SI)705076 LIPIDEX Simvastatin 10MG TAB Special Investigations (SI)705077 LIPIDEX Simvastatin 20MG TAB Special Investigations (SI)710868 MICHOL Simvastatin 10MG TAB Special Investigations (SI)710869 MICHOL Simvastatin 20MG TAB Special Investigations (SI)710870 MICHOL Simvastatin 40MG TAB Special Investigations (SI)710871 MICHOL Simvastatin 80MG TAB Special Investigations (SI)705382 MYLAN-SIMVASTATIN 20MG Simvastatin 20MG TAB Special Investigations (SI)705281 SIMCARD Simvastatin 10MG TAB Special Investigations (SI)705282 SIMCARD Simvastatin 20MG TAB Special Investigations (SI)700519 SIMVACOR 10 Simvastatin 10MG TAB Special Investigations (SI)700520 SIMVACOR 20 Simvastatin 20MG TAB Special Investigations (SI)708463 SIMVACOR Simvastatin 40MG TAB Special Investigations (SI)704174 SIMVASTATIN 40 STRIDES Simvastatin 40MG TAB Special Investigations (SI)703525 SIMVOTIN 10 Simvastatin 10MG TAB Special Investigations (SI)

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

703526 SIMVOTIN 20 Simvastatin 20MG TAB Special Investigations (SI)703527 SIMVOTIN 40 Simvastatin 40MG TAB Special Investigations (SI)783951 ZOCOR Simvastatin 10MG TAB Special Investigations (SI)783978 ZOCOR Simvastatin 20MG TAB Special Investigations (SI)836265 ZOCOR Simvastatin 40MG TAB Special Investigations (SI)710826 ZYSIM Simvastatin 10MG TAB Special Investigations (SI)710827 ZYSIM Simvastatin 20MG TAB Special Investigations (SI)710828 ZYSIM Simvastatin 40MG TAB Special Investigations (SI)

Fibrates710337 BEZACHOLE SR Bezafibrate 400MG TAB Special Investigations (SI)708453 BEZALIP Bezafibrate 200MG TAB Special Investigations (SI)779644 BEZALIP RETARD Bezafibrate 400MG TAB Special Investigations (SI)710122 DYNA-BEZAFIBRATE SR Bezafibrate 400MG SRT Special Investigations (SI)828300 ROLAB-BEZAFIBRATE Bezafibrate 400MG TAB Special Investigations (SI)705708 LIPANTHYL Fenofibrate 200MG CAP Special Investigations (SI)788627 LOPID Gemfibrozil 600MG TAB Special Investigations (SI)

Nicotinic Acid891322 NICOTINIC ACID Nicotinic acid 20MG TAB Special Investigations (SI)

HypertensionSympathetic Nervous System Blockers

869856 CARDURA XL Doxazosin 4MG TAB Clinical review869864 CARDURA XL Doxazosin 8MG TAB Clinical review714292 CARZIN XL Doxazosin 4MG TAB Clinical review701425 CARDUGEN WAS MERCK DOXAZOSIN Doxazosin 1MG TAB Clinical review701426 CARDUGEN WAS MERCK DOXAZOSIN Doxazosin 4MG TAB Clinical review3000184 URODOXA Doxazosin 4MG TAB Clinical review782122 PRATSIOL Prazosin 1MG TAB Clinical review782130 PRATSIOL Prazosin 2MG TAB Clinical review760048 RESERPINE Reserpine .25MG TAB Accepted treatment806358 HYTRIN Terazosin 1MG TAB Accepted treatment806366 HYTRIN Terazosin 2MG TAB Accepted treatment

Arterial Vasodilators731714 HYPERPHEN Hydralazine 10MG TAB Clinical review731722 HYPERPHEN Hydralazine 50MG TAB Clinical review761400 ROLAB-HYDRALAZINE HCL Hydralazine 25MG TAB Clinical review

Diuretics711152 BURINEX Bumetanide 1MG TAB Accepted treatment707423 AUSTELL-FUROSEMIDE Furosemide 40MG TAB Accepted treatment707421 AUSTELL-FUROSEMIDE Furosemide 20MG TAB Accepted treatment821845 BEURISES Furosemide 40MG TAB Accepted treatment716048 DINO-RETIC Furosemide 40MG TAB Accepted treatment705967 DIURESIX Furosemide 40MG TAB Accepted treatment735930 LASIX Furosemide 20MG TAB Accepted treatment735949 LASIX Furosemide 40MG TAB Accepted treatment735957 LASIX Furosemide 500MG TAB Accepted treatment839515 LASIX ORAL Furosemide 10MG/1ML SLN Clinical review857769 MYLAN FUROSEMIDE Furosemide 40MG TAB Accepted treatment758272 PURESIS Furosemide 40MG TAB Accepted treatment731668 ROLAB-FUROSEMIDE Furosemide 40MG TAB Accepted treatment3001173 GULF HYDROCHLOROTHIAZIDE Hydrochlorothiazide 25MG TAB Accepted treatment890470 HEXAZIDE Hydrochlorothiazide 25MG TAB Accepted treatment880949 RIDAQ Hydrochlorothiazide 25MG TAB Accepted treatment710437 RIDAQ Hydrochlorothiazide 12.5MG TAB Accepted treatment774057 URIREX-K Hydrochlorothiazide and potassium TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

780618 ADCO-RETIC Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB Accepted treatment702803 AMILORETIC Hydrochlorothiazide and potassium-sparing agents 50MG/5MG TAB Accepted treatment702811 AMILORETIC HS Hydrochlorothiazide and potassium-sparing agents 2.5MG/25MG TAB Accepted treatment719984 DEZRETIC 5MG/50MG Hydrochlorothiazide and potassium-sparing agents 50MG/5MG TAB Accepted treatment721824 DYAZIDE Hydrochlorothiazide and potassium-sparing agents 25MG/50MG TAB Accepted treatment744379 MODURETIC Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB Accepted treatment780146 RENEZIDE Hydrochlorothiazide and potassium-sparing agents 25MG/50MG TAB Accepted treatment706531 SPEC-CO-AMILORIDE Hydrochlorothiazide and potassium-sparing agents 50MG/5MG TAB Accepted treatment700820 CATEXAN Indapamide 2.5MG TAB Accepted treatment710313 CIPLA-INDAPAMIDE Indapamide 2.5MG TAB Accepted treatment819417 DAPAMAX Indapamide 2.5MG TAB Accepted treatment833045 DAPTRIL Indapamide 2.5MG TAB Accepted treatment716962 DYNA INDAPAMIDE SR Indapamide 1.5MG SRT Accepted treatment822825 HYDRO-LESS Indapamide 2.5MG TAB Accepted treatment703329 MYLAN-INDAPAMIDE Indapamide 2.5MG TAB Accepted treatment746002 NATRILIX Indapamide 2.5MG TAB Accepted treatment830836 NATRILIX SR Indapamide 1.5MG SRT Accepted treatment831026 ROLAB-INDAPAMIDE Indapamide 2.5MG TAB Accepted treatment807818 ARELIX Piretanide 6MG TAB Accepted treatment701807 ALDACTONE Spironolactone 100MG TAB Accepted treatment701793 ALDACTONE Spironolactone 25MG APP Accepted treatment769665 ROLAB-SPIRONOLACTONE Spironolactone 25MG TAB Accepted treatment898937 SPIRACTIN Spironolactone 100MG TAB Accepted treatment765910 SPIRACTIN Spironolactone 25MG TAB Accepted treatment

Beta-blockers786586 ADCO-ATENOLOL Atenolol 100MG TAB Accepted treatment786578 ADCO-ATENOLOL Atenolol 50MG TAB Accepted treatment704651 B-BLOCK Atenolol 100MG TAB Accepted treatment704653 B-BLOCK Atenolol 50MG TAB Accepted treatment715626 GULF ATENOLOL Atenolol 100MG TAB Accepted treatment715625 GULF ATENOLOL Atenolol 50MG TAB Accepted treatment806897 HEXA-BLOK Atenolol 100MG TAB Accepted treatment806889 HEXA-BLOK Atenolol 50MG TAB Accepted treatment826901 NORTON-ATENOLOL Atenolol 100MG TAB Accepted treatment826898 NORTON-ATENOLOL Atenolol 50MG TAB Accepted treatment787914 ROLAB-ATENOLOL Atenolol 100MG TAB Accepted treatment786195 TEN-BLOKA Atenolol 100MG TAB Accepted treatment786187 TEN-BLOKA Atenolol 50MG TAB Accepted treatment705873 TENOPRESS Atenolol 100MG TAB Accepted treatment705872 TENOPRESS Atenolol 25MG TAB Accepted treatment705874 TENOPRESS Atenolol 50MG TAB Accepted treatment797693 TENORMIN Atenolol 25MG TAB Accepted treatment769576 TENORMIN Atenolol 100MG TAB Accepted treatment769584 TENORMIN Atenolol 50MG TAB Accepted treatment719657 ZETENOL Atenolol 100MG TAB Accepted treatment719656 ZETENOL Atenolol 50MG TAB Accepted treatment703914 ADCO BISOCOR 10MG Bisoprolol 10MG TAB Accepted treatment703913 ADCO BISOCOR 5MG Bisoprolol 5MG TAB Accepted treatment721438 MYLAN BISOPROLOL Bisoprolol 10MG TAB Accepted treatment721437 MYLAN BISOPROLOL Bisoprolol 5MG TAB Accepted treatment722055 BISOPROLOL UNICHEM Bisoprolol 5MG TAB Accepted treatment722056 BISOPROLOL UNICHEM Bisoprolol 10MG TAB Accepted treatment706179 BETACOR Bisoprolol 10MG TAB Accepted treatment706178 BETACOR Bisoprolol 5MG TAB Accepted treatment704373 BILOCOR 10 Bisoprolol 10MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

704372 BILOCOR 5 Bisoprolol 5MG TAB Accepted treatment719154 BISLO Bisoprolol 5MG TAB Accepted treatment719155 BISLO Bisoprolol 10MG TAB Accepted treatment720660 BISBETA Bisoprolol 10MG TAB Accepted treatment720659 BISBETA Bisoprolol 5MG TAB Accepted treatment704133 BISOHEXAL 10 Bisoprolol 10MG TAB Accepted treatment704132 BISOHEXAL 5 Bisoprolol 5MG TAB Accepted treatment716166 BISOPROLOL UNICORN Bisoprolol 10MG TAB Accepted treatment716167 BISOPROLOL UNICORN Bisoprolol 5MG TAB Accepted treatment720043 BISOPROLOL ZYDUS Bisoprolol 10MG TAB Accepted treatment720044 BISOPROLOL ZYDUS Bisoprolol 5MG TAB Accepted treatment704441 CARDICOR 10MG Bisoprolol 10MG TAB Accepted treatment704439 CARDICOR 2.5MG Bisoprolol 2.5MG TAB Accepted treatment704440 CARDICOR 5MG Bisoprolol 5MG TAB Accepted treatment818437 CONCOR Bisoprolol 10MG TAB Accepted treatment818429 CONCOR Bisoprolol 5MG TAB Accepted treatment3003793 EMCOR Bisoprolol 10MG TAB Accepted treatment3003790 EMCOR Bisoprolol 2.5MG TAB Accepted treatment3003792 EMCOR Bisoprolol 5MG TAB Accepted treatment3003544 PRESICARD Bisoprolol 10MG TAB Accepted treatment3003484 PRESICARD Bisoprolol 2.5MG TAB Accepted treatment3003543 PRESICARD Bisoprolol 5MG TAB Accepted treatment720821 RETOCAR Bisoprolol 10MG TAB Accepted treatment720820 RETOCAR Bisoprolol 5MG TAB Accepted treatment715276 ZIAPRO Bisoprolol 10MG TAB Accepted treatment715274 ZIAPRO Bisoprolol 5MG TAB Accepted treatment716483 LOVISPES Nebivolol 5MG TAB Accepted treatment700558 NEBILET 5MG Nebivolol 5MG TAB Accepted treatment

Alpha-beta blockers710339 ASPEN CARVEDILOL Carvedilol 12.5MG TAB Accepted treatment710340 ASPEN CARVEDILOL Carvedilol 25MG TAB Accepted treatment710338 ASPEN CARVEDILOL Carvedilol 6.25MG TAB Accepted treatment897117 CARLOC Carvedilol 25MG TAB Accepted treatment705459 CARLOC 6.25 Carvedilol 6.25MG TAB Accepted treatment700168 CARLOC 12.5 Carvedilol 12.5MG TAB Accepted treatment3000330 CARVEDILOL 12.5 OETHMAAN Carvedilol 12.5MG TAB Accepted treatment716743 CARVEDILOL UNICORN Carvedilol 12.5MG TAB Accepted treatment716744 CARVEDILOL UNICORN Carvedilol 25MG TAB Accepted treatment716742 CARVEDILOL UNICORN Carvedilol 6.25MG TAB Accepted treatment704671 CARVETREND 12.5MG Carvedilol 12.5MG TAB Accepted treatment704672 CARVETREND 25MG Carvedilol 25MG TAB Accepted treatment704670 CARVETREND 6.25MG Carvedilol 6.25MG TAB Accepted treatment836354 DILATREND Carvedilol 12.5MG TAB Accepted treatment788856 DILATREND Carvedilol 25MG APP Accepted treatment833428 DILATREND Carvedilol 6.25MG TAB Accepted treatment3000278 RUBITREND Carvedilol 12.5MG TAB Accepted treatment3000281 RUBITREND Carvedilol 25MG TAB Accepted treatment3000276 RUBITREND Carvedilol 6.25MG TAB Accepted treatment710959 VEDIBLOK Carvedilol 12.5MG TAB Accepted treatment710960 VEDIBLOK Carvedilol 25MG TAB Accepted treatment710958 VEDIBLOK Carvedilol 6.25MG TAB Accepted treatment

Beta-blocker and diuretic combinations786217 TENCHLOR Atenolol and other diuretics 100MG/25MG TAB Accepted treatment807591 TENCHLOR HS Atenolol and other diuretics 50MG/12.5MG TAB Accepted treatment719202 BILOCOR CO 10MG/6.25MG Bisoprolol and thiazides 10MG/6.25MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

719200 BILOCOR CO 2.5MG/6.25MG Bisoprolol and thiazides 2.5MG/6.25MG TAB Accepted treatment719201 BILOCOR CO 5MG/6.25MG Bisoprolol and thiazides 5MG/6.25MG TAB Accepted treatment718087 BISOPROLOL HYDROCHLOROTHIAZIDE ZYDUS 10M Bisoprolol and thiazides 10MG/6.25MG TAB Accepted treatment718082 BISOPROLOL HYDROCHLOROTHIAZIDE ZYDUS 2.5 Bisoprolol and thiazides 2.5MG/6.25MG TAB Accepted treatment718086 BISOPROLOL HYDROCHLOROTHIAZIDE ZYDUS 5MG Bisoprolol and thiazides 5MG/6.25MG TAB Accepted treatment3003506 TEVACARD CO 10MG/6.25MG Bisoprolol and thiazides 10MG/6.25MG TAB Accepted treatment3003503 TEVACARD CO 2.5MG/6.25MG Bisoprolol and thiazides 2.5MG/6.25MG TAB Accepted treatment3003504 TEVACARD CO 5MG/6.25MG Bisoprolol and thiazides 5MG/6.25MG TAB Accepted treatment852929 ZIAK Bisoprolol and thiazides 10MG/6.25MG TAB Accepted treatment840300 ZIAK Bisoprolol and thiazides 2.5MG/6.25MG TAB Accepted treatment840319 ZIAK Bisoprolol and thiazides 5MG/6.25MG TAB Accepted treatment721589 BISOPROLOL CO UNICORN 10MG/6.25MG Bisoprolol and thiazides 10MG/6.25MG TAB Accepted treatment721588 BISOPROLOL CO UNICORN 5MG/6.25MG Bisoprolol and thiazides 5MG/6.25MG TAB Accepted treatment720033 ZIABETA 10/6.25MG Bisoprolol and thiazides 10MG/6.25MG TAB Accepted treatment720031 ZIABETA 2.5/6.25MG Bisoprolol and thiazides 6.25MG/2.5MG TAB Accepted treatment720032 ZIABETA 5/6.25MG Bisoprolol and thiazides 5MG/6.25MG TAB Accepted treatment

Calcium channel antagonists707375 AMLODIPINE 5 OETHMAAN Amlodipine 5MG TAB Accepted treatment723783 AMLODIPINE UNICORN Amlodipine 5MG TAB Accepted treatment723784 AMLODIPINE UNICORN Amlodipine 10MG TAB Accepted treatment708142 ALMADIN Amlodipine 10MG TAB Accepted treatment708141 ALMADIN Amlodipine 5MG TAB Accepted treatment707278 AMLATE Amlodipine 10MG TAB Accepted treatment707277 AMLATE Amlodipine 5MG TAB Accepted treatment703917 AMLOC 10 Amlodipine 10MG TAB Accepted treatment703916 AMLOC 5 Amlodipine 5MG TAB Accepted treatment708051 AMLODAC Amlodipine 10MG TAB Accepted treatment708050 AMLODAC Amlodipine 5MG TAB Accepted treatment704621 AMLOSYN 10 Amlodipine 10MG TAB Accepted treatment704620 AMLOSYN 5 Amlodipine 5MG TAB Accepted treatment713972 AMTAS Amlodipine 10MG TAB Accepted treatment713971 AMTAS Amlodipine 5MG TAB Accepted treatment714311 AURO-AMLODIPINE Amlodipine 10MG TAB Accepted treatment714310 AURO-AMLODIPINE Amlodipine 5MG TAB Accepted treatment708095 AUSTELL-AMLODIPINE Amlodipine 10MG TAB Accepted treatment708094 AUSTELL-AMLODIPINE Amlodipine 5MG TAB Accepted treatment708040 CALBLOC Amlodipine 10MG TAB Accepted treatment708039 CALBLOC Amlodipine 5MG TAB Accepted treatment708152 CIPLAVASC Amlodipine 10MG TAB Accepted treatment708150 CIPLAVASC Amlodipine 5MG TAB Accepted treatment707980 CORVADIL Amlodipine 10MG TAB Accepted treatment707979 CORVADIL Amlodipine 5MG TAB Accepted treatment708191 CPL ALLIANCE AMLODIPINE Amlodipine 10MG TAB Accepted treatment708190 CPL ALLIANCE AMLODIPINE Amlodipine 5MG TAB Accepted treatment712954 GULF AMLODIPINE Amlodipine 10MG TAB Accepted treatment712953 GULF AMLODIPINE Amlodipine 5MG TAB Accepted treatment708648 INDO AMLODIPINE Amlodipine 5MG TAB Accepted treatment712216 KEYSAL Amlodipine 10MG TAB Accepted treatment712215 KEYSAL Amlodipine 5MG TAB Accepted treatment708162 KLODIP Amlodipine 5MG TAB Accepted treatment708352 LOMANOR Amlodipine 5MG TAB Accepted treatment708353 LOMANOR Amlodipine 10MG TAB Accepted treatment799122 NORVASC Amlodipine 10MG TAB Accepted treatment791245 NORVASC Amlodipine 5MG TAB Accepted treatment710238 PHARMA DYNAMICS AMLODIPINE BESYLATE Amlodipine 10MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

710236 PHARMA DYNAMICS AMLODIPINE BESYLATE Amlodipine 5MG TAB Accepted treatment839183 ZILDEM Diltiazem 180MG SRC Accepted treatment839191 ZILDEM Diltiazem 240MG SRC Accepted treatment822213 ZILDEM 60 Diltiazem 60MG TAB Accepted treatment824364 ZILDEM 90 BD Diltiazem 90MG TAB Accepted treatment805548 PLENDIL Felodipine 5MG SRT Accepted treatment821896 PLENDIL Felodipine 2.5MG SRT Accepted treatment703902 FELODIPINE HEXAL Felodipine 10MG SRT Accepted treatment703221 FELODIPINE HEXAL Felodipine 5MG SRT Accepted treatment793124 ADALAT XL Nifedipine 30MG SRT Accepted treatment826863 BIO-NIFEDIPINE (WAS NORTON-NIFEDIPINE) Nifedipine 5MG CAP Accepted treatment780499 CARDIFEN Nifedipine 5MG CAP Accepted treatment780502 CARDIFEN Nifedipine 10MG CAP Accepted treatment723283 CIPALAT XR Nifedipine 30MG SRT Accepted treatment719449 GITSALAT Nifedipine 30MG TAB Accepted treatment840963 ADCO-VASCARD SR Nifedipine 20MG SRC Accepted treatment718083 BIO NIFEDIPINE XL Nifedipine 30MG SRT Accepted treatment864153 CIPALAT RETARD Nifedipine 20MG TAB Accepted treatment711682 FEDALOC SR Nifedipine 30MG TAB Accepted treatment3002730 FIDOCARE 30 XL Nifedipine 30MG SRT Accepted treatment715000 MACOREL SR Nifedipine 30MG SRT Accepted treatment715002 SPEC NIFEDIPINE SR Nifedipine 30MG SRT Accepted treatment861545 VASCARD SR Nifedipine 30MG CAP Accepted treatment813354 CALCICARD SR Verapamil 240MG SRT Accepted treatment734071 ISOPTIN DRAGEES Verapamil 40MG TAB Accepted treatment734373 ISOPTIN SR Verapamil 240MG SRT Accepted treatment819573 RAVAMIL SR Verapamil 240MG SRT Accepted treatment774944 VASOMIL Verapamil 40MG TAB Accepted treatment774952 VASOMIL Verapamil 80MG TAB Accepted treatment775789 VERAPAMIL 40 OETHMAAN Verapamil 40MG TAB Accepted treatment700071 VERAHEXAL 240 SR Verapamil 240MG SRT Accepted treatment

ACE inhibitors852333 BIO-CAPTOPRIL Captopril 25MG TAB Accepted treatment795267 CAPACE Captopril 25MG TAB Accepted treatment837628 CAPTOHEXAL Captopril 12.5MG TAB Accepted treatment837636 CAPTOHEXAL Captopril 25MG TAB Accepted treatment

836451 CAPTOMAX Captopril 25MG TAB Accepted treatment

836478 CAPTOMAX Captopril 50MG TAB Accepted treatment

852619 MYLAN CAPTOPRIL Captopril 25MG TAB Accepted treatment

899429 MYLAN-CAPTOPRIL Captopril 50MG TAB Accepted treatment

839779 ZAPTO Captopril 25MG TAB Accepted treatment839787 ZAPTO Captopril 50MG TAB Accepted treatment792756 INHIBACE Cilazapril 5MG TAB Accepted treatment886843 ADCO-ENALAPRIL 10MG Enalapril 10MG TAB Accepted treatment886851 ADCO-ENALAPRIL 20MG Enalapril 20MG TAB Accepted treatment881481 ALAPREN 10 Enalapril 10MG TAB Accepted treatment881503 ALAPREN 20 Enalapril 20MG TAB Accepted treatment881473 ALAPREN 5 Enalapril 5MG TAB Accepted treatment721626 AUSTELL ENALAPRIL Enalapril 10MG TAB Accepted treatment721627 AUSTELL ENALAPRIL Enalapril 20MG TAB Accepted treatment721625 AUSTELL ENALAPRIL Enalapril 5MG TAB Accepted treatment894324 CIPLATEC 10 Enalapril 10MG TAB Accepted treatment701729 CIPLATEC 20MG Enalapril 20MG TAB Accepted treatment894316 CIPLATEC 5 Enalapril 5MG TAB Accepted treatment723156 ENALAPRIL BIOTECH Enalapril 5MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

723157 ENALAPRIL BIOTECH Enalapril 10MG TAB Accepted treatment723159 ENALAPRIL BIOTECH Enalapril 20MG TAB Accepted treatment3000716 ENALAPRIL UNICORN Enalapril 5MG TAB Accepted treatment891279 ENAP 10MG Enalapril 10MG TAB Accepted treatment891280 ENAP 20MG Enalapril 20MG TAB Accepted treatment891272 ENAP 5MG Enalapril 5MG TAB Accepted treatment712763 ENVAS Enalapril 10MG TAB Accepted treatment712762 ENVAS Enalapril 5MG TAB Accepted treatment867853 HR-ENALAPRIL 10 Enalapril 10MG TAB Accepted treatment867861 HR-ENALAPRIL 20 Enalapril 20MG TAB Accepted treatment867845 HR-ENALAPRIL 5 Enalapril 5MG TAB Accepted treatment862622 HYPACE Enalapril 5MG TAB Accepted treatment868914 PHARMAPRESS Enalapril 10MG TAB Accepted treatment868922 PHARMAPRESS Enalapril 20MG TAB Accepted treatment708109 PHARMAPRESS Enalapril 5MG TAB Accepted treatment759783 RENITEC Enalapril 10MG TAB Accepted treatment810355 RENITEC Enalapril 2.5MG TAB Accepted treatment759767 RENITEC Enalapril 20MG TAB Accepted treatment759759 RENITEC Enalapril 5MG TAB Accepted treatment791962 MONOPRIL Fosinopril 20MG TAB Accepted treatment715938 APEX-LISINOPRIL Lisinopril 20MG TAB Accepted treatment714678 AURO-LISINOPRIL Lisinopril 10MG TAB Accepted treatment714679 AURO-LISINOPRIL Lisinopril 20MG TAB Accepted treatment714677 AURO-LISINOPRIL Lisinopril 5MG TAB Accepted treatment704354 AUSTELL LISINOPRIL 2.5MG Lisinopril 2.5MG TAB Accepted treatment708189 AUSTELL LISINOPRIL 20MG Lisinopril 20MG TAB Accepted treatment712598 AUSTELL-LISINOPRIL Lisinopril 10MG TAB Accepted treatment701392 HEXAL-LISINOPRIL Lisinopril 10MG TAB Accepted treatment701387 HEXAL-LISINOPRIL Lisinopril 5MG TAB Accepted treatment716794 LYSIN Lisinopril 10MG TAB Accepted treatment716792 LYSIN Lisinopril 5MG TAB Accepted treatment3000546 LISO Lisinopril 5MG TAB Accepted treatment3000547 LISO Lisinopril 10MG TAB Accepted treatment3000548 LISO Lisinopril 20MG TAB Accepted treatment700692 SINOPREN 10 Lisinopril 10MG TAB Accepted treatment700694 SINOPREN 20 Lisinopril 20MG TAB Accepted treatment700691 SINOPREN 5 Lisinopril 5MG TAB Accepted treatment703645 ZEMAX 10 Lisinopril 10MG TAB Accepted treatment703646 ZEMAX 5 Lisinopril 5MG TAB Accepted treatment781703 ZESTRIL Lisinopril 10MG TAB Accepted treatment781711 ZESTRIL Lisinopril 20MG TAB Accepted treatment781681 ZESTRIL Lisinopril 5MG TAB Accepted treatment862053 ZETOMAX (ZESTOMAX) 10MG Lisinopril 10MG TAB Accepted treatment862061 ZETOMAX (ZESTOMAX) 20MG Lisinopril 20MG TAB Accepted treatment862045 ZETOMAX (ZESTOMAX) 5MG Lisinopril 5MG TAB Accepted treatment

890229 PERDIX 15MG Moexipril 15MG TAB Accepted treatment

890222 PERDIX 7.5MG Moexipril 7.5MG TAB Accepted treatment

715649 ACESYL Perindopril 4MG TAB Accepted treatment714869 ACTI-PREX (GLENMARK PERINDOPRIL) Perindopril 4MG TAB Accepted treatment716505 AURO PERINDOPRIL Perindopril 4MG TAB Accepted treatment716506 AURO PERINDOPRIL Perindopril 8MG TAB Accepted treatment717293 BINDACE Perindopril 4MG TAB Accepted treatment717294 BINDACE Perindopril 8MG TAB Accepted treatment710302 CIPLA-PERINDOPRIL Perindopril 4MG TAB Accepted treatment710510 CIPLA-PERINDOPRIL Perindopril 8MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

715786 CIPLASYL Perindopril 4MG TAB Accepted treatment715795 CIPLASYL Perindopril 8MG TAB Accepted treatment3000236 CIRCATOR Perindopril 8MG TAB Accepted treatment708649 CIRCATOR Perindopril 4MG TAB Accepted treatment785121 COVERSYL Perindopril 4MG TAB Accepted treatment705915 COVERSYL Perindopril 10MG TAB Accepted treatment714527 PEARINDA Perindopril 4MG TAB Accepted treatment714528 PEARINDA Perindopril 8MG TAB Accepted treatment717783 PERINDOPRIL UNICORN Perindopril 4MG TAB Accepted treatment717784 PERINDOPRIL UNICORN Perindopril 8MG TAB Accepted treatment721339 PERISTAR Perindopril 4MG TAB Accepted treatment721340 PERISTAR Perindopril 8MG TAB Accepted treatment703541 PREXUM Perindopril 4MG TAB Accepted treatment720387 PREXUM Perindopril 5MG TAB Accepted treatment714646 PREXUM Perindopril 10MG TAB Accepted treatment710611 RAN-PERINDOPRIL Perindopril 4MG TAB Accepted treatment712615 SPEC-PERINDOPRIL Perindopril 4MG TAB Accepted treatment712616 SPEC-PERINDOPRIL Perindopril 8MG TAB Accepted treatment710297 VECTORYL Perindopril 4MG TAB Accepted treatment710925 VECTORYL Perindopril 8MG TAB Accepted treatment716680 ZYDUS PERINDOPRIL Perindopril 4MG TAB Accepted treatment708119 ACCUMAX Quinapril 10MG TAB Accepted treatment708120 ACCUMAX Quinapril 20MG TAB Accepted treatment783293 ACCUPRIL Quinapril 5MG TAB Accepted treatment783307 ACCUPRIL Quinapril 10MG TAB Accepted treatment783315 ACCUPRIL Quinapril 20MG TAB Accepted treatment853186 ACCUPRIL Quinapril 40MG TAB Accepted treatment708981 QUINAGEN Quinapril 5MG TAB Accepted treatment708982 QUINAGEN Quinapril 10MG TAB Accepted treatment708983 QUINAGEN Quinapril 20MG TAB Accepted treatment708985 QUINAGEN Quinapril 40MG TAB Accepted treatment705457 QUINASPEN 10MG Quinapril 10MG TAB Accepted treatment705447 QUINASPEN 20MG Quinapril 20MG TAB Accepted treatment715957 APEX-RAMIPRIL Ramipril 10MG CAP Accepted treatment715954 APEX-RAMIPRIL Ramipril 2.5MG CAP Accepted treatment715955 APEX-RAMIPRIL Ramipril 5MG CAP Accepted treatment705752 AUSTELL-RAMIPRIL 1.25MG Ramipril 1.25MG CAP Accepted treatment705755 AUSTELL-RAMIPRIL 10MG Ramipril 10MG CAP Accepted treatment705753 AUSTELL-RAMIPRIL 2.5MG Ramipril 2.5MG CAP Accepted treatment705754 AUSTELL-RAMIPRIL 5MG Ramipril 5MG CAP Accepted treatment3000178 LIRACEN Ramipril 5MG CAP Accepted treatment3000179 LIRACEN Ramipril 10MG CAP Accepted treatment704374 RAMIPRIL HEXAL Ramipril 2.5MG TAB Accepted treatment704375 RAMIPRIL HEXAL Ramipril 5MG TAB Accepted treatment704023 RAMIWIN Ramipril 2.5MG CAP Accepted treatment704025 RAMIWIN Ramipril 5MG CAP Accepted treatment705426 RAMPIL 1.25MG Ramipril 1.25MG CAP Accepted treatment705429 RAMPIL 10MG Ramipril 10MG CAP Accepted treatment705427 RAMPIL 2.5MG Ramipril 2.5MG CAP Accepted treatment705428 RAMPIL 5MG Ramipril 5MG CAP Accepted treatment841579 TRITACE Ramipril 1.25MG TAB Accepted treatment841587 TRITACE Ramipril 2.5MG TAB Accepted treatment841595 TRITACE Ramipril 5MG TAB Accepted treatment782602 TRITACE Ramipril 10MG CAP Accepted treatment805068 MAVIK (PREVIOUSLY GOPTEN) Trandolapril 2MG CAP Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

805033 MAVIK (PREVIOUSLY GOPTEN) Trandolapril 0.5MG CAP Accepted treatmentACE inhibitor and calcium channel antagonist combinations

719853 COVERAM 10/10 perindopril and amlodipine 10MG/10MG TAB Accepted treatment719854 COVERAM 10/5 perindopril and amlodipine 10MG/5MG TAB Accepted treatment719852 COVERAM 5/10 perindopril and amlodipine 5MG/10MG TAB Accepted treatment719855 COVERAM 5/5 perindopril and amlodipine 5MG/5MG TAB Accepted treatment3003576 MIXANVAL 10MG/10MG perindopril and amlodipine 10MG/10MG TAB Accepted treatment3003575 MIXANVAL 10MG/5MG perindopril and amlodipine 10MG/5MG TAB Accepted treatment3003574 MIXANVAL 5MG/10MG perindopril and amlodipine 5MG/10MG TAB Accepted treatment3003573 MIXANVAL 5MG/5MG perindopril and amlodipine 5MG/5MG TAB Accepted treatment3003563 PEARLOC 4MG/10MG perindopril and amlodipine 4MG/10MG TAB Accepted treatment3003551 PEARLOC 4MG/5MG perindopril and amlodipine 4MG/5MG TAB Accepted treatment3003565 PEARLOC 8MG/10MG perindopril and amlodipine 8MG/10MG TAB Accepted treatment3003564 PEARLOC 8MG/5MG perindopril and amlodipine 8MG/5MG TAB Accepted treatment3001159 REAPTAN 10MG/10 MG perindopril and amlodipine 10MG/10MG TAB Accepted treatment3001158 REAPTAN 10MG/5 MG perindopril and amlodipine 10MG/5MG TAB Accepted treatment3001157 REAPTAN 5MG/10MG perindopril and amlodipine 5MG/10MG TAB Accepted treatment3001150 REAPTAN 5MG/5MG perindopril and amlodipine 5MG/5MG TAB Accepted treatment

ACE inhibitor and diuretic combinations839795 ZAPTO-CO Captopril and diuretics 50MG/25MG TAB Accepted treatment815055 INHIBACE PLUS Cilazapril and diuretics 5MG/12.5MG TAB Accepted treatment787035 CO-RENITEC Enalapril and diuretics 20MG/12.5MG TAB Accepted treatment891287 ENAP-CO Enalapril and diuretics 20MG/12.5MG TAB Accepted treatment885019 PHARMAPRESS CO Enalapril and diuretics 20MG/12.5MG TAB Accepted treatment716120 AURO-LISINOPRIL CO Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment716121 AURO-LISINOPRIL CO Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment704703 HEXAL LISINOPRIL CO 10 Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment704704 HEXAL LISINOPRIL CO 20 Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment716943 LISINOPRIL CO UNICORN 10MG/12.5MG Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment716945 LISINOPRIL CO UNICORN 20MG/12.5MG Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment704437 LISORETIC 10/12.5 Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment704438 LISORETIC 20/12.5 Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment707292 LISOZIDE 10MG/12.5MG Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment707291 LISOZIDE 20MG/12.5MG Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment704597 ZETOMAX CO 10/12.5 Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment704598 ZETOMAX CO 20/12.5 Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment817848 ZESTORETIC Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment797685 ZESTORETIC Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment708260 ZESTOZIDE 20 Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment715651 ACESYL CO Perindopril and diuretics 1.25MG/4MG TAB Accepted treatment717795 ARIPREL PLUS 4MG/1.25MG Perindopril and diuretics 1.25MG/4MG TAB Accepted treatment721508 BIOPREXUM PLUS 10MG/2.5MG Perindopril and diuretics 10MG/2.5MG TAB Accepted treatment877549 COVERSYL PLUS Perindopril and diuretics 4MG/1.25MG TAB Accepted treatment720389 COVERSYL PLUS 5MG/1.25MG Perindopril and diuretics 5MG/1.25MG TAB Accepted treatment714952 PEARINDA PLUS Perindopril and diuretics 1.25MG/4MG TAB Accepted treatment717782 PERINDOPRIL CO UNICORN 4MG/1.25MG Perindopril and diuretics 1.25MG/4MG TAB Accepted treatment704929 PREXUM PLUS Perindopril and diuretics 4MG/1.25MG TAB Accepted treatment720388 PREXUM PLUS 5MG/1.25MG Perindopril and diuretics 5MG/1.25MG TAB Accepted treatment713763 SPEC-PERINDOPRIL PLUS Perindopril and diuretics 1.25MG/4MG TAB Accepted treatment3003940 TREXEVA PLUS 5MG/1.25MG Perindopril and diuretics 5MG/1.25MG TAB Accepted treatment710298 VECTORYL PLUS Perindopril and diuretics 1.25MG/4MG TAB Accepted treatment717095 ZYDUS PERINDOPRIL CO 4MG/1.25MG Perindopril and diuretics 1.25MG/4MG TAB Accepted treatment708116 ACCUMAX CO Quinapril and diuretics 10MG/12.5MG TAB Accepted treatment708118 ACCUMAX CO Quinapril and diuretics 20MG/12.5MG TAB Accepted treatment795755 ACCURETIC Quinapril and diuretics 10MG/12.5MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

805297 ACCURETIC Quinapril and diuretics 20MG/12.5MG TAB Accepted treatment706235 ADCO-QUINARETIC 10/12.5MG Quinapril and diuretics 10MG/12.5MG TAB Accepted treatment706236 ADCO-QUINARETIC 20/12.5MG Quinapril and diuretics 20MG/12.5MG TAB Accepted treatment718056 AURO QUINAPRIL CO 10MG/12.5MG Quinapril and diuretics 10MG/12.5MG TAB Accepted treatment718057 AURO QUINAPRIL CO 20MG/12.5MG Quinapril and diuretics 20MG/12.5MG TAB Accepted treatment723564 CO-RAMIWIN 2.5MG/12.5MG Ramipril and diuretics 2.5MG/12.5MG TAB Accepted treatment723565 CO-RAMIWIN 5MG/12.5MG Ramipril and diuretics 5MG/12.5MG TAB Accepted treatment723566 CO-RAMIWIN 10MG/12.5MG Ramipril and diuretics 10MG/12.5MG TAB Accepted treatment718093 TRITACE PLUS 10MG/12.5MG Ramipril and diuretics 10MG/12.5MG TAB Accepted treatment718094 TRITACE PLUS 5MG/12.5MG Ramipril and diuretics 5MG/12.5MG TAB Accepted treatment718092 TRITACE PLUS 5MG/25MG Ramipril and diuretics 5MG/25MG TAB Accepted treatment

Angiotensin Receptor Blockers723123 ATERWIN Candesartan 8MG TAB Accepted treatment723124 ATERWIN Candesartan 16MG TAB Accepted treatment856118 ATACAND Candesartan 16MG TAB Accepted treatment856096 ATACAND Candesartan 8MG TAB Accepted treatment721629 ABECARD Candesartan 8MG TAB Accepted treatment721630 ABECARD Candesartan 16MG TAB Accepted treatment719210 MYLACAND Candesartan 16MG TAB Accepted treatment719209 MYLACAND Candesartan 8MG TAB Accepted treatment720582 ANTOSART Irbesartan 150MG TAB Accepted treatment720583 ANTOSART Irbesartan 300MG TAB Accepted treatment837814 APROVEL Irbesartan 150MG TAB Accepted treatment837822 APROVEL Irbesartan 300MG TAB Accepted treatment717793 DYNARB Irbesartan 150MG TAB Accepted treatment717794 DYNARB Irbesartan 300MG TAB Accepted treatment723194 JUBITAN Irbesartan 150MG TAB Accepted treatment723203 JUBITAN Irbesartan 300MG TAB Accepted treatment712385 IRBEWIN Irbesartan 150MG TAB Accepted treatment712384 IRBEWIN Irbesartan 300MG TAB Accepted treatment718506 IRTANEL Irbesartan 150MG TAB Accepted treatment718507 IRTANEL Irbesartan 300MG TAB Accepted treatment716495 ANNIN Losartan 100MG TAB Accepted treatment716494 ANNIN Losartan 50MG TAB Accepted treatment717069 AUSTELL LOSARTAN Losartan 100MG TAB Accepted treatment717068 AUSTELL LOSARTAN Losartan 50MG TAB Accepted treatment716644 CIPLAZAR Losartan 100MG TAB Accepted treatment716643 CIPLAZAR Losartan 50MG TAB Accepted treatment818739 COZAAR Losartan 50MG TAB Accepted treatment710079 COZAAR Losartan 100MG TAB Accepted treatment717024 HYTENZA Losartan 50MG TAB Accepted treatment717042 HYTENZA Losartan 100MG TAB Accepted treatment720776 LOZAAN Losartan 100MG TAB Accepted treatment720775 LOZAAN Losartan 50MG TAB Accepted treatment3000575 LOSARTAN BIOTECH Losartan 50MG TAB Accepted treatment718366 LOSARTAN UNICORN Losartan 100MG TAB Accepted treatment718365 LOSARTAN UNICORN Losartan 50MG TAB Accepted treatment709909 LOSARTAN-WINTHROP Losartan 50MG TAB Accepted treatment717296 RASOL Losartan 100MG TAB Accepted treatment717295 RASOL Losartan 50MG TAB Accepted treatment715871 RENICARD Losartan 50MG TAB Accepted treatment713254 SPEC-LOSARTAN Losartan 100MG TAB Accepted treatment713255 SPEC-LOSARTAN Losartan 50MG TAB Accepted treatment3000513 ZAARIO Losartan 100MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

3000512 ZAARIO Losartan 50MG TAB Accepted treatment709225 ZARTAN Losartan 50MG TAB Accepted treatment709964 ZARTAN Losartan 100MG TAB Accepted treatment3003078 CARDIZ Telmisartan 40MG TAB Accepted treatment3003054 CARDIZ Telmisartan 80MG TAB Accepted treatment3000736 ADCO TELMISARTAN Telmisartan 40MG TAB Accepted treatment3000737 ADCO TELMISARTAN Telmisartan 80MG TAB Accepted treatment860387 MICARDIS Telmisartan 40MG TAB Accepted treatment860395 MICARDIS Telmisartan 80MG TAB Accepted treatment721678 TESAR Telmisartan 40MG TAB Accepted treatment721679 TESAR Telmisartan 80MG TAB Accepted treatment720439 MIZART Telmisartan 40MG TAB Accepted treatment720440 MIZART Telmisartan 80MG TAB Accepted treatment714249 PRITOR Telmisartan 40MG TAB Accepted treatment714250 PRITOR Telmisartan 80MG TAB Accepted treatment3003679 TELEASE Telmisartan 40MG TAB Accepted treatment3003680 TELEASE Telmisartan 80MG TAB Accepted treatment720592 TELGEN Telmisartan 40MG TAB Accepted treatment720593 TELGEN Telmisartan 80MG TAB Accepted treatment3003300 TELMISARTAN 40 TEVA Telmisartan 40MG TAB Accepted treatment3003301 TELMISARTAN 80 TEVA Telmisartan 80MG TAB Accepted treatment723946 ADCO-VALSARTAN Valsartan 80MG TAB Accepted treatment723947 ADCO-VALSARTAN Valsartan 160MG TAB Accepted treatment700710 DIOVAN 160 Valsartan 160MG TAB Accepted treatment700000 DIOVAN 80 Valsartan 80MG TAB Accepted treatment723724 DYNAVAL Valsartan 80MG TAB Accepted treatment723725 DYNAVAL Valsartan 160MG TAB Accepted treatment715569 MIGROBEN Valsartan 160MG TAB Accepted treatment715568 MIGROBEN Valsartan 80MG TAB Accepted treatment704696 TAREG Valsartan 160MG TAB Accepted treatment705060 TAREG Valsartan 80MG TAB Accepted treatment3001856 REGOVAL Valsartan 160MG TAB Accepted treatment3001865 REGOVAL Valsartan 80MG TAB Accepted treatment3000481 VALHEFT Valsartan 160MG TAB Accepted treatment3000480 VALHEFT Valsartan 80MG TAB Accepted treatment718364 VALSARTAN UNICORN Valsartan 160MG TAB Accepted treatment718363 VALSARTAN UNICORN Valsartan 80MG TAB Accepted treatment723770 VASOVAN Valsartan 80MG TAB Accepted treatment723771 VASOVAN Valsartan 160MG TAB Accepted treatment715556 ZOMEVEK Valsartan 160MG TAB Accepted treatment715555 ZOMEVEK Valsartan 80MG TAB Accepted treatment

Angiotensin Receptor Blockers and diuretic combinations898635 ATACAND PLUS Candesartan and diuretics 16MG/12.5MG TAB Accepted treatment719453 CANDEPRES PLUS 16MG/12.5MG Candesartan and diuretics 16MG/12.5MG TAB Accepted treatment719506 MYLACAND PLUS 16MG/12.5MG Candesartan and diuretics 16MG/12.5MG TAB Accepted treatment891353 COAPROVEL Irbesartan and diuretics 150MG/12.5MG TAB Accepted treatment712386 CO-IRBEWIN Irbesartan and diuretics 150MG/12.5MG TAB Accepted treatment898597 COAPROVEL Irbesartan and diuretics 300MG/12.5MG TAB Accepted treatment712387 CO-IRBEWIN Irbesartan and diuretics 300MG/12.5MG TAB Accepted treatment720930 CO-IRBEWIN 300MG/25MG Irbesartan and diuretics 300MG/25MG TAB Accepted treatment723331 COZAAR COMP 100MG/12.5MG Losartan and diuretics 100MG/12.5MG TAB Accepted treatment3000159 CO-NORMOTEN 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment887096 FORTZAAR Losartan and diuretics 100MG/25MG TAB Accepted treatment717084 HYTENZA CO 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

716059 LOHYPE FORTE PLUS 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment715857 LOSAAR PLUS 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment3000577 LOSARTAN COMP BIOTECH 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment718368 LOSARTAN CO UNICORN 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment715739 LOZAAN CO 100/25 Losartan and diuretics 100MG/25MG TAB Accepted treatment715849 NETRASOL CO 100/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment716515 SARTOC 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment716217 ZARTAN CO 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment717070 AUSTELL LOSARTAN CO 50MG/12.5MG Losartan and diuretics 50MG/12.5 MG TAB Accepted treatment3000158 CO-NORMOTEN 50MG/12.5MG Losartan and diuretics 50MG/12.5 MG TAB Accepted treatment828181 COZAAR COMP Losartan and diuretics 50MG/12.5 MG TAB Accepted treatment716476 HYTENZA CO 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment716058 LOHYPE PLUS 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment715856 LOSAAR PLUS 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment716274 LOSACAR CO 50MG/12,5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment3000576 LOSARTAN COMP BIOTECH 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment718367 LOSARTAN CO UNICORN 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment715740 LOZAAN CO 50/12.5 Losartan and diuretics 50MG/12.5MG TAB Accepted treatment715848 NETRASOL CO 50/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment715064 SARTOC 50/12.5 Losartan and diuretics 50MG/12.5MG TAB Accepted treatment716216 ZARTAN CO 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment714251 CO-PRITOR 40/12.5 MG Telmisartan + Hydrochlorothiazide 40MG/12.5MG TAB Accepted treatment714252 CO-PRITOR 80/12.5MG Telmisartan + Hydrochlorothiazide 80MG/12.5MG TAB Accepted treatment716791 CO-MICARDIS 80MG/25MG Telmisartan + Hydrochlorothiazide 80MG/25MG TAB Accepted treatment894614 CO-MICARDIS 40/12.5MG Telmisartan + Hydrochlorothiazide 40MG/12.5MG TAB Accepted treatment894621 CO-MICARDIS 80/12.5MG Telmisartan + Hydrochlorothiazide 80MG/12.5MG TAB Accepted treatment3000422 TELPRES PLUS 40MG/12.5MG Telmisartan + Hydrochlorothiazide 40MG/12.5MG TAB Accepted treatment3000423 TELPRES PLUS 80MG/12.5MG Telmisartan + Hydrochlorothiazide 80MG/12.5MG TAB Accepted treatment3003570 TESAR CO 40MG/12.5MG Telmisartan + Hydrochlorothiazide 40MG/12.5MG TAB Accepted treatment3003582 TESAR CO 80MG/12.5MG Telmisartan + Hydrochlorothiazide 80MG/12.5MG TAB Accepted treatment3003656 TICARDA PLUS 40MG/12.5MG Telmisartan + Hydrochlorothiazide 40MG/12.5MG TAB Accepted treatment3003657 TICARDA PLUS 80MG/12.5MG Telmisartan + Hydrochlorothiazide 80MG/12.5MG TAB Accepted treatment3002446 TREMISTAN PLUS 40MG/12.5MG Telmisartan + Hydrochlorothiazide 40MG/12.5MG TAB Accepted treatment3001913 TREMISTAN PLUS 80MG/12.5MG Telmisartan + Hydrochlorothiazide 80MG/12.5MG TAB Accepted treatment715672 CO-TAREG 160MG/12.5MG Valsartan and diuretics 160MG/12.5MG TAB Accepted treatment891894 CO-DIOVAN Valsartan and diuretics 160MG/12.5MG TAB Accepted treatment706051 CO-DIOVAN PLUS Valsartan and diuretics 160MG/25MG TAB Accepted treatment715673 CO-TAREG PLUS Valsartan and diuretics 160MG/25MG TAB Accepted treatment705068 CO-TAREG 80MG/12.5MG Valsartan and diuretics 80MG TAB Accepted treatment839884 CO-DIOVAN Valsartan and diuretics 80MG/12.5MG TAB Accepted treatment715571 CO-MIGROBEN 160MG/12.5MG Valsartan and diuretics Accepted treatment715572 CO-MIGROBEN 160MG/25MG Valsartan and diuretics Accepted treatment715570 CO-MIGROBEN 80MG/12.5MG Valsartan and diuretics Accepted treatment715559 CO-ZOMEVEK 160MG/12.5MG Valsartan and diuretics TAB Accepted treatment715558 CO-ZOMEVEK 80MG/12.5MG Valsartan and diuretics TAB Accepted treatment715560 CO-ZOMEVEK160MG/25MG Valsartan and diuretics TAB Accepted treatment719205 REGOVAL CO 160MG/12.5MG Valsartan and diuretics 160MG/12.5MG TAB Accepted treatment719206 REGOVAL CO 160MG/25MG Valsartan and diuretics 160MG/25MG TAB Accepted treatment719204 REGOVAL CO 80MG/12.5MG Valsartan and diuretics 80MG/12.5MG TAB Accepted treatment

Combination antihypertensives711444 ZANERIL Enalapril and Lercanidipine 10MG/10MG TAB Accepted treatment3000161 AMZAAR 5MG/100MG Losartan and amlodipine 100MG/5MG TAB Accepted treatment3000160 AMZAAR 5MG/50MG Losartan and amlodipine 50MG/5MG TAB Accepted treatment862207 TRI-PLEN Ramipril and calcium channel blockers 2.5MG/2.5MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

717367 TWYNSTA 40MG/10MG telmisartan and amlodipine 40MG/10MG TAB Accepted treatment717366 TWYNSTA 40MG/5MG telmisartan and amlodipine 40MG/5MG TAB Accepted treatment717369 TWYNSTA 80MG/10MG telmisartan and amlodipine 80MG/10MG TAB Accepted treatment717368 TWYNSTA 80MG/5MG telmisartan and amlodipine 80MG/5MG TAB Accepted treatment3003568 CALSAR 10MG/160MG Valsartan and amlodipine 10MG/160MG TAB Accepted treatment3003567 CALSAR 5MG/160MG Valsartan and amlodipine 5MG/160MG TAB Accepted treatment721594 COPALIA 10MG/160MG Valsartan and amlodipine 10MG/160MG TAB Accepted treatment721593 COPALIA 5MG/160MG Valsartan and amlodipine 5MG/160MG TAB Accepted treatment711254 EXFORGE Valsartan and Amlodipine 10MG/160MG TAB Accepted treatment711253 EXFORGE Valsartan and Amlodipine 5MG/160MG TAB Accepted treatment3000682 VALDUO 5MG/160MG Valsartan and Amlodipine 5MG/160MG TAB Accepted treatment3000683 VALDUO 10MG/160MG Valsartan and Amlodipine 10MG/160MG TAB Accepted treatment3003281 VALVASC 10/160 Valsartan and amlodipine 10MG/160MG TAB Accepted treatment3003280 VALVASC 5/160 Valsartan and amlodipine 5MG/160MG TAB Accepted treatment3001675 CO-COPALIA 10MG/160MG/12.5MG valsartan, amlodipine and hydrochlorothiazide TAB Accepted treatment3001666 CO-COPALIA 10MG/160MG/25MG valsartan, amlodipine and hydrochlorothiazide TAB Accepted treatment3001732 CO-COPALIA 5MG/160MG/12.5MG valsartan, amlodipine and hydrochlorothiazide TAB Accepted treatment3001659 CO-COPALIA 5MG/160MG/25MG valsartan, amlodipine and hydrochlorothiazide TAB Accepted treatment717633 CO EXFORGE 10MG/160MG/12.5MG valsartan, amlodipine and hydrochlorothiazide TAB Accepted treatment717634 CO EXFORGE 10MG/160MG/25MG valsartan, amlodipine and hydrochlorothiazide TAB Accepted treatment717631 CO EXFORGE 5MG/160MG/12.5MG valsartan, amlodipine and hydrochlorothiazide TAB Accepted treatment717632 CO EXFORGE 5MG/160MG/25MG valsartan, amlodipine and hydrochlorothiazide TAB Accepted treatment723032 TRIPLIXAM 10/2.5/10MG perindopril, amlodipine and indapamide TAB Accepted treatment723033 TRIPLIXAM 10/2.5/5MG perindopril, amlodipine and indapamide TAB Accepted treatment723034 TRIPLIXAM 5/1.25/10MG perindopril, amlodipine and indapamide TAB Accepted treatment723031 TRIPLIXAM 5/1.25/5MG perindopril, amlodipine and indapamide TAB Accepted treatment

Hypothyroidism722944 ELTROXIN Levothyroxine sodium 0.05MG TAB Accepted treatment722952 ELTROXIN Levothyroxine sodium 0.1MG TAB Accepted treatment723167 ELTROXIN NEW FORMULATION Levothyroxine sodium 25MCG TAB Accepted treatment723168 ELTROXIN NEW FORMULATION Levothyroxine sodium 50MCG TAB Accepted treatment723170 ELTROXIN NEW FORMULATION Levothyroxine sodium 75MCG TAB Accepted treatment723171 ELTROXIN NEW FORMULATION Levothyroxine sodium 100MCG TAB Accepted treatment723172 ELTROXIN NEW FORMULATION Levothyroxine sodium 200MCG TAB Accepted treatment713169 EUTHYROX Levothyroxine sodium 100MCG TAB Accepted treatment713172 EUTHYROX Levothyroxine sodium 25MCG TAB Accepted treatment713168 EUTHYROX Levothyroxine sodium 50MCG TAB Accepted treatment

Multiple sclerosisAnticholinergics

720658 DITROPAN Oxybutynin 5MG TAB Accepted treatment872253 LENDITRO Oxybutynin 5MG TAB Accepted treatment701893 MYLAN OXYBUTYNIN CHLORIDE 5 Oxybutynin 5MG TAB Accepted treatment722063 OXYREST Oxybutynin 5MG TAB Accepted treatment

Immunosuppressants782556 ABITREXATE-20ML Methotrexate 500MG/20ML INJ Accepted treatment782548 ABITREXATE-2ML Methotrexate 50MG INJ Accepted treatment701252 AZAMUN Azathioprine 50MG TAB Accepted treatment706108 AZAPRESS Azathioprine 50MG TAB Accepted treatment712609 AZATHIOPRINE PCH Azathioprine 50MG TAB Accepted treatment712504 EMTHEXATE Methotrexate 2.5MG TAB Accepted treatment825557 EMTHEXATE RTU 500-20 20ML Methotrexate 25MG/1ML INJ Accepted treatment711328 METACHOR VIAL 2ML Methotrexate 25MG/1ML INJ Accepted treatment723274 ENDOXAN Cyclophosphamide 50MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

732516 IMURAN Azathioprine 50MG TAB Accepted treatment840815 METHOTREXATE CSV 2ML (P&U) Methotrexate 50MG/2ML INJ Accepted treatment840807 METHOTREXATE CSV 20ML (P&U) Methotrexate 500MG/20ML INJ Accepted treatment742465 METHOTREXATE Methotrexate 2.5MG TAB Accepted treatment700777 ZAPRINE 50MG Azathioprine 50MG TAB Accepted treatment

Muscle relaxants738344 LIORESAL Baclofen 10MG TAB Accepted treatment865567 BIO-BACLOFEN Baclofen 10MG TAB Accepted treatment712607 TEVA BACLOFEN Baclofen 10MG TAB Accepted treatment722015 ASPEN BACLOFEN Baclofen 10MG TAB Accepted treatment

Tricyclic Antidepressants3002709 AMITRIPTYLINE 10 MG AUSTELL Amitriptyline 10MG TAB Accepted treatment718746 GULF AMITRIPTYLINE Amitriptyline 25MG TAB Accepted treatment784230 ROLAB-AMITRIPTYLINE HCL Amitriptyline 25MG TAB Accepted treatment772003 TREPILINE Amitriptyline 10MG TAB Accepted treatment771996 TREPILINE Amitriptyline 25MG TAB Accepted treatment757888 PROTHIADEN Dothiepin 25MG CAP Accepted treatment800198 THADEN Dothiepin 25MG CAP Accepted treatment800201 THADEN Dothiepin 75MG TAB Accepted treatment724661 ETHIPRAMINE Imipramine 10MG TAB Accepted treatment724688 ETHIPRAMINE Imipramine 25MG TAB Accepted treatment771120 TOFRANIL Imipramine 10MG TAB Accepted treatment771139 TOFRANIL Imipramine 25MG TAB Accepted treatment

Carbamazepine712493 DEGRANOL Carbamazepine 200MG TAB Accepted treatment3001174 GULF CARBAMAZEPINE Carbamazepine 200MG TAB Accepted treatment769398 TEGRETOL Carbamazepine 200MG TAB Accepted treatment779652 TEGRETOL CR Carbamazepine 200MG SRT Accepted treatment779660 TEGRETOL CR Carbamazepine 400MG SRT Accepted treatment715962 ZEPTOL Carbamazepine 200MG TAB Accepted treatment

Analgesics717725 ACTAMOL Paracetamol 500MG TAB Accepted treatment701634 DIS-CHEM PARACETAMOL Paracetamol 500MG TAB Accepted treatment716045 ADCO-NAPAMOL Paracetamol 500MG TAB Accepted treatment805467 ANTALGIC 500 Paracetamol 500MG TAB Accepted treatment713153 AUSTELL-PARACETAMOL Paracetamol 500MG TAB Accepted treatment714499 CLICKS PARACETAMOL Paracetamol 500MG TAB Accepted treatment3001556 CALPOL Paracetamol 500MG TAB Accepted treatment787043 CODOROL Paracetamol combinations payable by PBM TAB Accepted treatment719662 COGESIC Paracetamol combinations payable by PBM 500MG/8MG TAB Accepted treatment837652 DINO-COD (BEI) Paracetamol and codeine TAB Accepted treatment720860 DOLOROL Paracetamol 500MG TAB Accepted treatment720879 DOLOROL FORTE Paracetamol combinations payable by PBM TAB Accepted treatment798053 DYNADOL Paracetamol 500MG TAB Accepted treatment824992 GENCETAMOL Paracetamol 500MG TAB Accepted treatment715112 GRAYS PARACETAMOL Paracetamol 500MG TAB Accepted treatment867950 GULF PARACETAMOL Paracetamol 500MG TAB Accepted treatment894212 JP PARACETAMOL Paracetamol 500MG TAB Accepted treatment715280 LENNON PARACETAMOL Paracetamol 500MG TAB Accepted treatment745707 NAPACOD Paracetamol combinations payable by PBM TAB Accepted treatment745723 NAPAMOL Paracetamol 500MG TAB Accepted treatment799629 PAINAMOL (GREEN) Paracetamol 500MG TAB Accepted treatment707910 PAINAMOL PLUS (BETACOD) Paracetamol combinations payable by PBM TAB Accepted treatment752142 PAINAMOL WHITE Paracetamol 500MG TAB Accepted treatment867969 PAINBLOK Paracetamol 500MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

752126 PAINCOD Acetylsalicylic acid comb. excl. psycholeptics TAB Accepted treatment895030 PAINCODEIN Paracetamol combinations payable by PBM 500MG/8MG TAB Accepted treatment704465 PAINOGESIC Paracetamol 500MG TAB Accepted treatment752274 PANADO Paracetamol 500MG TAB Accepted treatment752355 PANADO Paracetamol 500MG CAP Accepted treatment708432 PANADO CHILDRENS Paracetamol 125MG MLT Accepted treatment720438 PARAFIZZ Paracetamol 500MG EFT Accepted treatment752614 PARACETACOD Paracetamol combinations payable by PBM TAB Accepted treatment784443 PARAMED Paracetamol 500MG TAB Accepted treatment752878 PARAPANE Paracetamol 500MG TAB Accepted treatment757403 PROLIEF Paracetamol 500MG TAB Accepted treatment714707 PYNGESIC T Paracetamol 500MG TAB Accepted treatment761303 ROCODIN Paracetamol and codeine TAB Accepted treatment765635 SPECTRAPAIN Paracetamol combinations payable by PBM CAP Accepted treatment826588 THERA-PAIN Paracetamol 500MG TAB Accepted treatment713688 VARI-COCODAMOL 8MG/500MG Paracetamol combinations payable by PBM 8MG/500MG TAB Accepted treatment3003420 VARIPAN SUGAR FREE Paracetamol 120MG/5ML SYR Accepted treatment885863 VON PARACETAMOL Paracetamol 500MG TAB Accepted treatment

Non-steroidal anti-inflammatories862444 CELEBREX Celecoxib 100MG CAP Accepted treatment862452 CELEBREX Celecoxib 200MG CAP Accepted treatment724014 CELECOXIB UNICORN Celecoxib 100MG CAP Accepted treatment724015 CELECOXIB UNICORN Celecoxib 200MG CAP Accepted treatment723329 COXLEON Celecoxib 100MG CAP Accepted treatment723330 COXLEON Celecoxib 200MG CAP Accepted treatment786594 ADCO-DICLOFENAC Diclofenac 25MG TAB Accepted treatment788597 ADCO-DICLOFENAC Diclofenac 50MG TAB Accepted treatment893390 A-LENNON DICLOFENAC Diclofenac 25MG TAB Accepted treatment893391 A-LENNON DICLOFENAC Diclofenac 50MG TAB Accepted treatment718479 DICLOFENAC BIOTECH Diclofenac 25MG TAB Accepted treatment718480 DICLOFENAC SR BIOTECH Diclofenac 100MG SRT Accepted treatment706314 DIFEN SR Diclofenac 100MG TAB Accepted treatment791547 FORTFEN SR Diclofenac 100MG SRC Accepted treatment786012 MYLAN DICLOFENAC (ARCANAFENAC) Diclofenac 25MG TAB Accepted treatment786020 MYLAN DICLOFENAC SOD (ARCANAFENAC) Diclofenac 50MG TAB Accepted treatment752398 PANAMOR AT-50 Diclofenac 50MG TAB Accepted treatment827592 PANAMOR SR Diclofenac 100MG TAB Accepted treatment752371 PANAMOR-25 Diclofenac 25MG TAB Accepted treatment719838 ROLAB-DICLOFENAC SODIUM Diclofenac 50MG TAB Accepted treatment787272 VELTEX CR Diclofenac 100MG SRC Accepted treatment778206 VOLTAREN Diclofenac 25MG TAB Accepted treatment835218 VOLTAREN DROPS Diclofenac 15MG/1ML DRP Clinical Review778222 VOLTAREN GT Diclofenac 50MG TAB Accepted treatment778230 VOLTAREN SR Diclofenac 100MG TAB Accepted treatment813044 ARTHROTEC Diclofenac, combinations 50MG/200MCG ECT Clinical Review869805 ARTHROTEC Diclofenac, combinations 75MG/200mcg ECT Clinical Review721118 AUSTIFEN Ibuprofen 200MG TAB Accepted treatment721119 AUSTIFEN Ibuprofen 400MG TAB Accepted treatment710830 BRUFEN Ibuprofen 400MG TAB Accepted treatment780596 ADCO-IBUPROFEN Ibuprofen 400MG TAB Accepted treatment717155 AUSTELL IBUPROFEN Ibuprofen 200MG TAB Accepted treatment717153 AUSTELL IBUPROFEN Ibuprofen 400MG TAB Accepted treatment710822 BRUFEN Ibuprofen 200MG TAB Accepted treatment892302 ADVIL LIQUI GEL Ibuprofen 200MG CAP Accepted treatment716004 ADVIL LIQUI GEL Ibuprofen 400MG CAP Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

708186 BETAGESIC Ibuprofen 200MG TAB Accepted treatment787426 BETAPROFEN Ibuprofen 200MG TAB Accepted treatment701975 BETAPROFEN 400 FC Ibuprofen 400MG TAB Accepted treatment708290 BREN Ibuprofen 400MG TAB Accepted treatment895196 IBOFLAM Ibuprofen 200MG TAB Accepted treatment705940 IBU Ibuprofen 200MG TAB Accepted treatment721114 IBUCARE Ibuprofen 200MG TAB Accepted treatment721116 IBUCARE Ibuprofen 400MG TAB Accepted treatment721117 IBUCARE Ibuprofen 600MG TAB Accepted treatment704781 IBUGESIC Ibuprofen 100MG/5ML SUS Accepted treatment700316 IBUMAX Ibuprofen 200MG TAB Accepted treatment700318 IBUMAX Ibuprofen 400MG TAB Accepted treatment809268 IBUMED Ibuprofen 200MG CAP Accepted treatment868221 IBUNATE Ibuprofen 200MG TAB Accepted treatment708536 IBUSOR Ibuprofen 200MG TAB Accepted treatment721335 INFLAMAX PAEDIATRIC Ibuprofen 100MG/5ML SUS Accepted treatment733741 INZA Ibuprofen 200MG TAB Accepted treatment733768 INZA Ibuprofen 400MG TAB Accepted treatment868469 LENAFEN Ibuprofen 200MG TAB Accepted treatment748560 NUROFEN Ibuprofen 200MG TAB Accepted treatment3001126 NUROFEN EXPRESS Ibuprofen 200MG TAB Accepted treatment897984 NUROFEN EXTRA STRENGTH Ibuprofen 400MG TAB Accepted treatment824852 RANFEN Ibuprofen 200MG TAB Accepted treatment701654 RANFEN 400 Ibuprofen 400MG TAB Accepted treatment701891 AMDOCIN Indometacin 25MG CAP Accepted treatment704725 ARTHREXIN Indometacin 25MG APP Accepted treatment704741 ARTHREXIN Indometacin 100MG SUP Accepted treatment787833 BETACIN Indometacin 25MG CAP Accepted treatment868213 GULF INDOMETHACIN Indometacin 25MG CAP Accepted treatment788996 MEDIFLEX Indometacin 25MG CAP Accepted treatment814393 METHOCAPS Indometacin 25MG CAP Accepted treatment704776 ROLAB-INDOMETHACIN Indometacin 25MG CAP Accepted treatment822205 KETOFLAM SR Ketoprofen 200MG SRC Accepted treatment883102 ADCO-MEFENAMIC ACID Mefenamic acid 250MG CAP Accepted treatment797707 FENAMIN Mefenamic acid 250MG CAP Accepted treatment797715 FENAMIN Mefenamic acid 500MG TAB Accepted treatment796433 PONAC Mefenamic acid 250MG CAP Accepted treatment794201 PONAC FORTE Mefenamic acid 500MG TAB Accepted treatment756148 PONSTAN Mefenamic acid 250MG CAP Accepted treatment756156 PONSTAN Mefenamic acid 50MG/5ML SUS Accepted treatment812250 PONSTEL 250 Mefenamic acid 250MG CAP Accepted treatment810371 PONSTEL FORTE Mefenamic acid 500MG TAB Accepted treatment705376 ADCO-MELOXICAM 15MG Meloxicam 15MG TAB Accepted treatment705375 ADCO-MELOXICAM 7.5MG Meloxicam 7.5MG TAB Accepted treatment707668 APEX-MELOXICAM Meloxicam 15MG TAB Accepted treatment707667 APEX-MELOXICAM Meloxicam 7.5MG TAB Accepted treatment711325 ARROW MELOXICAM Meloxicam 15MG TAB Accepted treatment711324 ARROW MELOXICAM Meloxicam 7.5MG TAB Accepted treatment899070 COXFLAM Meloxicam 15MG TAB Accepted treatment899066 COXFLAM Meloxicam 7.5MG TAB Accepted treatment717092 FLAMARYX Meloxicam 15MG TAB Accepted treatment717091 FLAMARYX Meloxicam 7.5MG TAB Accepted treatment704828 FLEXOCAM Meloxicam 15MG TAB Accepted treatment704829 FLEXOCAM Meloxicam 7.5MG TAB Accepted treatment718305 GLENMARK MELOXICAM Meloxicam 15MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

718306 GLENMARK MELOXICAM Meloxicam 7.5MG TAB Accepted treatment701522 LOXIFLAM 15 Meloxicam 15MG TAB Accepted treatment701520 LOXIFLAM 7.5 Meloxicam 7.5MG TAB Accepted treatment705177 M-CAM 15MG Meloxicam 15MG TAB Accepted treatment705176 M-CAM 7.5MG Meloxicam 7.5MG TAB Accepted treatment718382 MEDOXICAM Meloxicam 15MG TAB Accepted treatment718381 MEDOXICAM Meloxicam 7.5MG TAB Accepted treatment705297 MELFLAM 15 Meloxicam 15MG TAB Accepted treatment705296 MELFLAM 7.5 Meloxicam 7.5MG TAB Accepted treatment716169 MELOXICAM UNICORN Meloxicam 15MG TAB Accepted treatment716168 MELOXICAM UNICORN Meloxicam 7.5MG TAB Accepted treatment818615 MOBIC Meloxicam 7.5MG TAB Accepted treatment842052 MOBIC 15MG Meloxicam 15MG TAB Accepted treatment705230 ZYDUS-MELOXICAM 15MG Meloxicam 15MG TAB Accepted treatment705229 ZYDUS-MELOXICAM 7.5MG Meloxicam 7.5MG TAB Accepted treatment722843 BIO-NAPROXEN Naproxen 500MG TAB Accepted treatment785245 ADCO-NAPROXEN Naproxen 250MG TAB Accepted treatment715831 BIO-NAPROXEN Naproxen 250MG TAB Accepted treatment810185 MYLAN NAPROXEN (ARCANA-NAPROXEN) Naproxen 250MG TAB Accepted treatment812625 NAFASOL EC-250 Naproxen 250MG ECT Accepted treatment812633 NAFASOL EC-500 Naproxen 500MG ECT Accepted treatment806447 NAPFLAM Naproxen 250MG TAB Accepted treatment808474 NAPFLAM Naproxen 500MG TAB Accepted treatment805238 NAPROSCRIPT Naproxen 250MG TAB Accepted treatment718724 VIMOVO 500/20MG naproxen and esomeprazole TAB Clinical Review785253 ADCO-PIROXICAM Piroxicam 10MG CAP Accepted treatment800724 BREXECAM Piroxicam 20MG TAB Accepted treatment716517 PIROXICAM ACTOR DT Piroxicam 20MG DSP Accepted treatment827428 PIXICAM Piroxicam 20MG DSP Accepted treatment799432 PYROCAPS Piroxicam 20MG CAP Accepted treatment821144 RHEUGESIC Piroxicam 20MG DSP Accepted treatment701072 ROXIFEN Piroxicam 20MG CAP Accepted treatment797030 XYCAM Piroxicam 20MG CAP Accepted treatment797049 XYCAM DISPERS Piroxicam 20MG DSP Accepted treatment

Parkinson's DiseaseLevodopa combinations

824321 CARBILEV Levodopa and decarboxylase inhibitor 25MG/100MG TAB Accepted treatment824348 CARBILEV Levodopa and decarboxylase inhibitor 25MG/250MG TAB Accepted treatment3000000 LECARDOP 25/100 Levodopa and decarboxylase inhibitor 25MG/100MG TAB Accepted treatment3000001 LECARDOP 25/250 Levodopa and decarboxylase inhibitor 25MG/250MG TAB Accepted treatment739928 MADOPAR Levodopa and decarboxylase inhibitor 50MG/200MG TAB Accepted treatment828483 MADOPAR HBS Levodopa and decarboxylase inhibitor 25MG/100MG CAP Accepted treatment764078 SINEMET Levodopa and decarboxylase inhibitor 25MG/100MG TAB Accepted treatment764086 SINEMET Levodopa and decarboxylase inhibitor 25MG/250MG TAB Accepted treatment794635 SINEMET CR Levodopa and decarboxylase inhibitor 50MG/200MG SRT Accepted treatment710286 TEVA CARBI-LEVO 25/100 Levodopa and decarboxylase inhibitor 25MG/100MG TAB Accepted treatment710468 TEVA CARBI-LEVO 25/250 Levodopa and decarboxylase inhibitor 25MG/250MG TAB Accepted treatment

Dopamine agonists and other700500 SYMADIN (WAS FLUSTOP) Amantadine 100MG CAP Accepted treatment768243 SYMMETREL Amantadine 100MG CAP Accepted treatment701491 AKINETON Biperiden 2MG TAB Accepted treatment713209 LENNON-BIPERIDEN Biperiden 2MG TAB Accepted treatment720542 DISIPAL Orphenadrine (chloride) 50MG TAB Accepted treatment719542 OXPOLA Pramipexole .125MG TAB Specialist motivation

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

719543 OXPOLA Pramipexole .25MG TAB Specialist motivation719545 OXPOLA Pramipexole 1MG TAB Specialist motivation722748 MYLAN PRAMIPEXOLE Pramipexole .125MG TAB Specialist motivation722749 MYLAN PRAMIPEXOLE Pramipexole .25MG TAB Specialist motivation722750 MYLAN PRAMIPEXOLE Pramipexole 1MG TAB Specialist motivation721393 PAZORAM Pramipexole .125MG TAB Specialist motivation721392 PAZORAM Pramipexole .25MG TAB Specialist motivation721391 PAZORAM Pramipexole 1MG TAB Specialist motivation723740 PEXASP Pramipexole .25MG TAB Specialist motivation723741 PEXASP Pramipexole .125MG TAB Specialist motivation723742 PEXASP Pramipexole 1MG TAB Specialist motivation898836 PEXOLA .125MG Pramipexole 0.125MG TAB Specialist motivation898848 PEXOLA .25MG Pramipexole 0.25MG TAB Specialist motivation898828 PEXOLA 1MG Pramipexole 1MG TAB Specialist motivation718253 PEXOLA ER Pramipexole .375MG SRT Specialist motivation718255 PEXOLA ER Pramipexole .75MG SRT Specialist motivation718256 PEXOLA ER Pramipexole 1.5MG SRT Specialist motivation718257 PEXOLA ER Pramipexole 3MG SRT Specialist motivation718258 PEXOLA ER Pramipexole 4.5MG SRT Specialist motivation719844 PRAMEX Pramipexole .125MG TAB Specialist motivation719843 PRAMEX Pramipexole .25MG TAB Specialist motivation719845 PRAMEX Pramipexole 1MG TAB Specialist motivation719569 ACCORD ROPINIROLE Ropinirole .25MG TAB Specialist motivation719570 ACCORD ROPINIROLE Ropinirole .5MG TAB Specialist motivation719571 ACCORD ROPINIROLE Ropinirole 1MG TAB Specialist motivation719572 ACCORD ROPINIROLE Ropinirole 2MG TAB Specialist motivation719573 ACCORD ROPINIROLE Ropinirole 5MG TAB Specialist motivation700647 REQUIP 0.25MG Ropinirole 0.25MG TAB Specialist motivation700650 REQUIP 0.5MG Ropinirole 0.5MG TAB Specialist motivation700652 REQUIP 1MG Ropinirole 1MG TAB Specialist motivation700655 REQUIP 2MG Ropinirole 2MG TAB Specialist motivation700658 REQUIP 5MG Ropinirole 5MG TAB Specialist motivation711090 REQUIP XL Ropinirole 2MG SRT Specialist motivation711091 REQUIP XL Ropinirole 4MG SRT Specialist motivation711092 REQUIP XL Ropinirole 8MG SRT Specialist motivation713210 BENZHEXOL Trihexyphenidyl 2MG TAB Accepted treatment

MONOAMINE OXIDASE TYPE B INHIBITORS711769 AZILECT Rasagiline 1MG TAB Accepted treatment

Rheumatoid arthritisDisease modifying agents

878790 MIRQUIN Chloroquine 50MG/5ML SYR Accepted treatment747297 NIVAQUINE Chloroquine 200MG TAB Accepted treatment794333 PLASMOQUINE Chloroquine 200MG CAP Accepted treatment898171 ARAVA Leflunomide 10MG TAB Specialist motivation898175 ARAVA Leflunomide 20MG TAB Specialist motivation721806 LUNAR Leflunomide 20MG TAB Specialist motivation3000528 RAVALEF Leflunomide 10MG TAB Specialist motivation3000529 RAVALEF Leflunomide 20MG TAB Specialist motivation721609 RHEUMALEF Leflunomide 10MG TAB Specialist motivation721610 RHEUMALEF Leflunomide 20MG TAB Specialist motivation782556 ABITREXATE-20ML Methotrexate 500MG/20ML INJ Accepted treatment782548 ABITREXATE-2ML Methotrexate 50MG INJ Accepted treatment712504 EMTHEXATE Methotrexate 2.5MG TAB Accepted treatment825557 EMTHEXATE RTU 500-20 20ML Methotrexate 25MG/1ML INJ Accepted treatment711328 METACHOR VIAL 2ML Methotrexate 25MG/1ML INJ Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

840815 METHOTREXATE CSV 2ML (P&U) Methotrexate 50MG/2ML INJ Accepted treatment840807 METHOTREXATE CSV 20ML (P&U) Methotrexate 500MG/20ML INJ Accepted treatment742465 METHOTREXATE Methotrexate 2.5MG TAB Accepted treatment762008 SALAZOPYRIN Sulfasalazine 500MG TAB Accepted treatment762016 SALAZOPYRIN E.N. Sulfasalazine 500MG ECT Accepted treatment

Immunosuppressants701252 AZAMUN Azathioprine 50MG TAB Accepted treatment706108 AZAPRESS Azathioprine 50MG TAB Accepted treatment712609 AZATHIOPRINE PCH Azathioprine 50MG TAB Accepted treatment732516 IMURAN Azathioprine 50MG TAB Accepted treatment700777 ZAPRINE 50MG Azathioprine 50MG TAB Accepted treatment

Alkylating agents723274 ENDOXAN Cyclosphosphamide 50MG TAB Specialist motivation737887 LEUKERAN Chlorambucil 2MG TAB Specialist motivation

Non-steroidal anti-inflammatories862444 CELEBREX Celecoxib 100MG CAP Accepted treatment862452 CELEBREX Celecoxib 200MG CAP Accepted treatment724014 CELECOXIB UNICORN Celecoxib 100MG CAP Accepted treatment724015 CELECOXIB UNICORN Celecoxib 200MG CAP Accepted treatment723329 COXLEON Celecoxib 100MG CAP Accepted treatment723330 COXLEON Celecoxib 200MG CAP Accepted treatment786594 ADCO-DICLOFENAC Diclofenac 25MG TAB Accepted treatment788597 ADCO-DICLOFENAC Diclofenac 50MG TAB Accepted treatment893390 A-LENNON DICLOFENAC Diclofenac 25MG TAB Accepted treatment893391 A-LENNON DICLOFENAC Diclofenac 50MG TAB Accepted treatment718479 DICLOFENAC BIOTECH Diclofenac 25MG TAB Accepted treatment718480 DICLOFENAC SR BIOTECH Diclofenac 100MG SRT Accepted treatment706314 DIFEN SR Diclofenac 100MG TAB Accepted treatment791547 FORTFEN SR Diclofenac 100MG SRC Accepted treatment786012 MYLAN DICLOFENAC (ARCANAFENAC) Diclofenac 25MG TAB Accepted treatment786020 MYLAN DICLOFENAC SOD (ARCANAFENAC) Diclofenac 50MG TAB Accepted treatment752398 PANAMOR AT-50 Diclofenac 50MG TAB Accepted treatment827592 PANAMOR SR Diclofenac 100MG TAB Accepted treatment752371 PANAMOR-25 Diclofenac 25MG TAB Accepted treatment719838 ROLAB-DICLOFENAC SODIUM Diclofenac 50MG TAB Accepted treatment787272 VELTEX CR Diclofenac 100MG SRC Accepted treatment778206 VOLTAREN Diclofenac 25MG TAB Accepted treatment835218 VOLTAREN DROPS Diclofenac 15MG/1ML DRP Clinical review778222 VOLTAREN GT Diclofenac 50MG TAB Accepted treatment778230 VOLTAREN SR Diclofenac 100MG TAB Accepted treatment813044 ARTHROTEC Diclofenac, combinations 50MG/200MCG ECT Clinical review869805 ARTHROTEC Diclofenac, combinations 75MG/200mcg ECT Clinical review721118 AUSTIFEN Ibuprofen 200MG TAB Accepted treatment721119 AUSTIFEN Ibuprofen 400MG TAB Accepted treatment780596 ADCO-IBUPROFEN Ibuprofen 400MG TAB Accepted treatment717155 AUSTELL IBUPROFEN Ibuprofen 200MG TAB Accepted treatment717153 AUSTELL IBUPROFEN Ibuprofen 400MG TAB Accepted treatment710822 BRUFEN Ibuprofen 200MG TAB Accepted treatment710830 BRUFEN Ibuprofen 400MG TAB Accepted treatment892302 ADVIL LIQUI GEL Ibuprofen 200MG CAP Accepted treatment716004 ADVIL LIQUI GEL Ibuprofen 400MG CAP Accepted treatment708186 BETAGESIC Ibuprofen 200MG TAB Accepted treatment787426 BETAPROFEN Ibuprofen 200MG TAB Accepted treatment701975 BETAPROFEN 400 FC Ibuprofen 400MG TAB Accepted treatment708290 BREN Ibuprofen 400MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

710830 BRUFEN Ibuprofen 400MG TAB Accepted treatment710857 BRUFEN PAED SUSP Ibuprofen 100MG/5ML SUS Accepted treatment895196 IBOFLAM Ibuprofen 200MG TAB Accepted treatment705940 IBU Ibuprofen 200MG TAB Accepted treatment721114 IBUCARE Ibuprofen 200MG TAB Accepted treatment721116 IBUCARE Ibuprofen 400MG TAB Accepted treatment721117 IBUCARE Ibuprofen 600MG TAB Accepted treatment704781 IBUGESIC Ibuprofen 100MG/5ML SUS Accepted treatment700316 IBUMAX Ibuprofen 200MG TAB Accepted treatment700318 IBUMAX Ibuprofen 400MG TAB Accepted treatment700315 IBUMAX PAEDIATRIC Ibuprofen 100MG/5ML SUS Accepted treatment809268 IBUMED Ibuprofen 200MG CAP Accepted treatment868221 IBUNATE Ibuprofen 200MG TAB Accepted treatment708536 IBUSOR Ibuprofen 200MG TAB Accepted treatment721335 INFLAMAX PAEDIATRIC Ibuprofen 100MG/5ML SUS Accepted treatment733741 INZA Ibuprofen 200MG TAB Accepted treatment733768 INZA Ibuprofen 400MG TAB Accepted treatment868469 LENAFEN Ibuprofen 200MG TAB Accepted treatment748560 NUROFEN Ibuprofen 200MG TAB Accepted treatment3001126 NUROFEN EXPRESS Ibuprofen 200MG TAB Accepted treatment897984 NUROFEN EXTRA STRENGTH Ibuprofen 400MG TAB Accepted treatment700695 NUROFEN FOR CHILDREN SUGAR FREE Ibuprofen 100MG/5ML SUS Accepted treatment712683 NUROFEN FOR CHILDREN STRAWBERRY Ibuprofen 100MG/5ML SUS Accepted treatment824852 RANFEN Ibuprofen 200MG TAB Accepted treatment701654 RANFEN 400 Ibuprofen 400MG TAB Accepted treatment701891 AMDOCIN Indometacin CAP Accepted treatment704725 ARTHREXIN Indometacin 25MG APP Accepted treatment704741 ARTHREXIN Indometacin 100MG SUP Accepted treatment787833 BETACIN Indometacin 25MG CAP Accepted treatment868213 GULF INDOMETHACIN Indometacin 25MG CAP Accepted treatment788996 MEDIFLEX Indometacin 25MG CAP Accepted treatment814393 METHOCAPS Indometacin 25MG CAP Accepted treatment704776 ROLAB-INDOMETHACIN Indometacin 25MG CAP Accepted treatment822205 KETOFLAM SR Ketoprofen 200MG SRC Accepted treatment883102 ADCO-MEFENAMIC ACID Mefenamic acid 250MG CAP Accepted treatment875643 ADCO-MEFENAMIC SUS Mefenamic acid 50MG/5ML SUS Accepted treatment797707 FENAMIN Mefenamic acid 250MG CAP Accepted treatment797715 FENAMIN Mefenamic acid 500MG TAB Accepted treatment797014 FENAMIN Mefenamic acid 50MG/5ML SUS Accepted treatment796433 PONAC Mefenamic acid 250MG CAP Accepted treatment793264 PONAC Mefenamic acid 50MG/5ML SUS Accepted treatment794201 PONAC FORTE Mefenamic acid 500MG TAB Accepted treatment756148 PONSTAN Mefenamic acid 250MG CAP Accepted treatment756156 PONSTAN Mefenamic acid 50MG/5ML SUS Accepted treatment812250 PONSTEL 250 Mefenamic acid 250MG CAP Accepted treatment810371 PONSTEL FORTE Mefenamic acid 500MG TAB Accepted treatment810398 PONSTEL S Mefenamic acid 50MG/5ML SUS Accepted treatment705376 ADCO-MELOXICAM 15MG Meloxicam 15MG TAB Accepted treatment705375 ADCO-MELOXICAM 7.5MG Meloxicam 7.5MG TAB Accepted treatment707668 APEX-MELOXICAM Meloxicam 15MG TAB Accepted treatment707667 APEX-MELOXICAM Meloxicam 7.5MG TAB Accepted treatment711325 ARROW MELOXICAM Meloxicam 15MG TAB Accepted treatment711324 ARROW MELOXICAM Meloxicam 7.5MG TAB Accepted treatment899070 COXFLAM Meloxicam 15MG TAB Accepted treatment899066 COXFLAM Meloxicam 7.5MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

717092 FLAMARYX Meloxicam 15MG TAB Accepted treatment717091 FLAMARYX Meloxicam 7.5MG TAB Accepted treatment704828 FLEXOCAM Meloxicam 15MG TAB Accepted treatment704829 FLEXOCAM Meloxicam 7.5MG TAB Accepted treatment718305 GLENMARK MELOXICAM Meloxicam 15MG TAB Accepted treatment718306 GLENMARK MELOXICAM Meloxicam 7.5MG TAB Accepted treatment701522 LOXIFLAM 15 Meloxicam 15MG TAB Accepted treatment701520 LOXIFLAM 7.5 Meloxicam 7.5MG TAB Accepted treatment705177 M-CAM 15MG Meloxicam 15MG TAB Accepted treatment705176 M-CAM 7.5MG Meloxicam 7.5MG TAB Accepted treatment718382 MEDOXICAM Meloxicam 15MG TAB Accepted treatment718381 MEDOXICAM Meloxicam 7.5MG TAB Accepted treatment705297 MELFLAM 15 Meloxicam 15MG TAB Accepted treatment705296 MELFLAM 7.5 Meloxicam 7.5MG TAB Accepted treatment716169 MELOXICAM UNICORN Meloxicam 15MG TAB Accepted treatment716168 MELOXICAM UNICORN Meloxicam 7.5MG TAB Accepted treatment818615 MOBIC Meloxicam 7.5MG TAB Accepted treatment842052 MOBIC 15MG Meloxicam 15MG TAB Accepted treatment705230 ZYDUS-MELOXICAM 15MG Meloxicam 15MG TAB Accepted treatment705229 ZYDUS-MELOXICAM 7.5MG Meloxicam 7.5MG TAB Accepted treatment722843 BIO-NAPROXEN Naproxen 500MG TAB Accepted treatment785245 ADCO-NAPROXEN Naproxen 250MG TAB Accepted treatment715831 BIO-NAPROXEN Naproxen 250MG TAB Accepted treatment810185 MYLAN NAPROXEN (ARCANA-NAPROXEN) Naproxen 250MG TAB Accepted treatment812625 NAFASOL EC-250 Naproxen 250MG ECT Accepted treatment812633 NAFASOL EC-500 Naproxen 500MG ECT Accepted treatment806447 NAPFLAM Naproxen 250MG TAB Accepted treatment808474 NAPFLAM Naproxen 500MG TAB Accepted treatment805238 NAPROSCRIPT Naproxen 250MG TAB Accepted treatment718724 VIMOVO 500/20MG naproxen and esomeprazole TAB Clinical review785253 ADCO-PIROXICAM Piroxicam 10MG CAP Accepted treatment800724 BREXECAM Piroxicam 20MG TAB Accepted treatment716517 PIROXICAM ACTOR DT Piroxicam 20MG DSP Accepted treatment827428 PIXICAM Piroxicam 20MG DSP Accepted treatment799432 PYROCAPS Piroxicam 20MG CAP Accepted treatment821144 RHEUGESIC Piroxicam 20MG DSP Accepted treatment701072 ROXIFEN Piroxicam 20MG CAP Accepted treatment797030 XYCAM Piroxicam 20MG CAP Accepted treatment797049 XYCAM DISPERS Piroxicam 20MG DSP Accepted treatment

Oral Corticosteroids716381 ADCO PREDNISOLONE Prednisolone 15MG/5ML LIQ Accepted treatment714552 ASPELONE Prednisolone 15MG/5ML LIQ Accepted treatment814407 CAPSOID Prednisolone 5MG TAB Accepted treatment800155 LENISOLONE Prednisolone 5MG TAB Accepted treatment703720 PRELONE Prednisolone 5MG TAB Accepted treatment805149 PRELONE Prednisolone 15MG/5ML SYR Accepted treatment742759 METICORTEN Prednisone 50MG TAB Accepted treatment742732 METICORTEN Prednisone 5MG TAB Accepted treatment752304 PANAFCORT Prednisone 5MG TAB Accepted treatment788783 PREDNISONE (BE-TABS) Prednisone 5MG TAB Accepted treatment836826 PULMISON TABS Prednisone 20MG TAB Accepted treatment818267 TROLIC Prednisone 5MG TAB Accepted treatment

SchizophreniaAntipsychotic agents

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

892310 SOLIAN Amisulpride 200MG TAB Accepted treatment892309 SOLIAN Amisulpride 50MG TAB Accepted treatment705634 ABILIFY 10MG Aripiprazole 10MG TAB Accepted treatment705635 ABILIFY 15MG Aripiprazole 15MG TAB Accepted treatment712192 ABILIFY 5MG Aripiprazole 5MG TAB Accepted treatment3001455 ABIPIP Aripiprazole 10MG TAB Accepted treatment3001456 ABIPIP Aripiprazole 15MG TAB Accepted treatment3001454 ABIPIP Aripiprazole 5MG TAB Accepted treatment3003284 ABIPIP 10 ODT Aripiprazole 10MG MLT Accepted treatment3003286 ABIPIP 15 ODT Aripiprazole 15MG MLT Accepted treatment3002239 APRIPENT Aripiprazole 10MG TAB Accepted treatment3002240 APRIPENT Aripiprazole 15MG TAB Accepted treatment3002238 APRIPENT Aripiprazole 5MG TAB Accepted treatment3002935 APRIZON Aripiprazole 10MG TAB Accepted treatment3002936 APRIZON Aripiprazole 15MG TAB Accepted treatment3002934 APRIZON Aripiprazole 5MG TAB Accepted treatment3003431 ARIDUS Aripiprazole 10MG TAB Accepted treatment3003440 ARIDUS Aripiprazole 15MG TAB Accepted treatment723961 ARIZOFY Aripiprazole 5MG TAB Accepted treatment723962 ARIZOFY Aripiprazole 10MG TAB Accepted treatment723963 ARIZOFY Aripiprazole 15MG TAB Accepted treatment3003847 PRIPTRIN Aripiprazole 10MG TAB Accepted treatment3003848 PRIPTRIN Aripiprazole 15MG TAB Accepted treatment3003846 PRIPTRIN Aripiprazole 5MG TAB Accepted treatment3001371 PRIZAL Aripiprazole 10MG TAB Accepted treatment3001372 PRIZAL Aripiprazole 15MG TAB Accepted treatment3001370 PRIZAL Aripiprazole 5MG TAB Accepted treatment3002581 ABILIFY MAINTENA POWD & SOLVENT FOR SUSP Aripiprazole 400MG INJ Specialist motivation3002583 ABILIFY MAINTENA POWDER & SOLVENT FOR SU Aripiprazole 400MG INJ Specialist motivation3002989 REXULTI Brexpiprazole .5MG TAB Accepted treatment3003028 REXULTI Brexpiprazole 1MG TAB Accepted treatment3003029 REXULTI Brexpiprazole 2MG TAB Accepted treatment3003031 REXULTI Brexpiprazole 3MG TAB Accepted treatment3003033 REXULTI Brexpiprazole 4MG TAB Accepted treatment735884 LARGACTIL Chlorpromazine 100MG TAB Accepted treatment735868 LARGACTIL Chlorpromazine 25MG TAB Accepted treatment735876 LARGACTIL Chlorpromazine 50MG TAB Accepted treatment717082 ASPEN CLOZAPINE Clozapine 100MG TAB Accepted treatment717081 ASPEN CLOZAPINE Clozapine 25MG TAB Accepted treatment700178 CLOMENT Clozapine 100MG TAB Accepted treatment700176 CLOMENT Clozapine 25MG TAB Accepted treatment705844 CLOZAPINE OETHMAAN Clozapine 25MG TAB Accepted treatment705845 CLOZAPINE OETHMAAN Clozapine 100MG TAB Accepted treatment736716 LEPONEX Clozapine 100MG TAB Accepted treatment736708 LEPONEX Clozapine 25MG TAB Accepted treatment726656 FLUANXOL Flupenthixol .5MG TAB Accepted treatment 726664 FLUANXOL Flupenthixol 1MG TAB Accepted treatment 726672 FLUANXOL DEPOT 1ML Flupenthixol 20MG/1ML INJS Accepted treatment 726680 FLUANXOL DEPOT 2ML Flupenthixol INJ Accepted treatment744301 MODECATE 1ML Fluphenazine 25MG/1ML INJS Accepted treatment744328 MODECATE+SYRINGE 1ML Fluphenazine 25MG/1ML INJS Accepted treatment719549 GULF HALOPERIDOL Haloperidol 5MG TAB Accepted treatment730335 HALOPERIDOL 1.5 OETHMAAN Haloperidol 1.5MG TAB Accepted treatment 730327 HALOPERIDOL 5 OETHMAAN Haloperidol 5MG TAB Accepted treatment 763411 SERENACE Haloperidol 0.5MG CAP Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

763535 SERENACE Haloperidol 10MG TAB Accepted treatment763454 SERENACE Haloperidol 5MG TAB Accepted treatment723745 ZOLANZ Olanzapine 5MG TAB Accepted treatment723747 ZOLANZ Olanzapine 10MG TAB Accepted treatment720692 ADCO OLANZAPINE Olanzapine 10MG TAB Accepted treatment720687 ADCO OLANZAPINE Olanzapine 2.5MG TAB Accepted treatment720691 ADCO OLANZAPINE Olanzapine 5MG TAB Accepted treatment720529 LANAZYP Olanzapine 10MG TAB Accepted treatment 720527 LANAZYP Olanzapine 2.5MG TAB Accepted treatment 720528 LANAZYP Olanzapine 5MG TAB Accepted treatment 718997 MYLAN OLANZAPINE Olanzapine 10MG TAB Accepted treatment718995 MYLAN OLANZAPINE Olanzapine 2.5MG TAB Accepted treatment718996 MYLAN OLANZAPINE Olanzapine 5MG TAB Accepted treatment721389 OLAWIN Olanzapine 10MG TAB Accepted treatment721385 OLAWIN Olanzapine 2.5MG TAB Accepted treatment721388 OLAWIN Olanzapine 5MG TAB Accepted treatment721390 OLAWIN ORADISPERSIBLE Olanzapine 10MG MLT Accepted treatment721386 OLAWIN ORADISPERSIBLE Olanzapine 5MG MLT Accepted treatment715996 OLEANZ Olanzapine 10MG TAB Accepted treatment715994 OLEANZ Olanzapine 2.5MG TAB Accepted treatment715995 OLEANZ Olanzapine 5MG TAB Accepted treatment715968 OLEANZ RAPITAB Olanzapine 10MG MLT Accepted treatment715967 OLEANZ RAPITAB Olanzapine 5MG MLT Accepted treatment715659 OLEXAR Olanzapine 10MG TAB Accepted treatment715657 OLEXAR Olanzapine 2.5MG TAB Accepted treatment715658 OLEXAR Olanzapine 5MG TAB Accepted treatment3003670 PHRENPE ORODISPERSIBLE Olanzapine 10MG MLT Accepted treatment3003668 PHRENPE ORODISPERSIBLE Olanzapine 5MG MLT Accepted treatment720714 PREXOLAN Olanzapine 10MG TAB Accepted treatment720712 PREXOLAN Olanzapine 2.5MG TAB Accepted treatment720713 PREXOLAN Olanzapine 5MG TAB Accepted treatment719807 PREXOLAN ODT Olanzapine 10MG MLT Accepted treatment719806 PREXOLAN ODT Olanzapine 5MG MLT Accepted treatment715685 REDILANZ Olanzapine 10MG TAB Accepted treatment715683 REDILANZ Olanzapine 2.5MG TAB Accepted treatment715684 REDILANZ Olanzapine 5MG TAB Accepted treatment721653 ZYLENA Olanzapine 10MG TAB Accepted treatment721652 ZYLENA Olanzapine 5MG TAB Accepted treatment827517 ZYPREXA Olanzapine 10MG TAB Accepted treatment864188 ZYPREXA Olanzapine 2.5MG TAB Accepted treatment827509 ZYPREXA Olanzapine 5MG TAB Accepted treatment707938 ZYPREXA VELOTAB Olanzapine 5MG TAB Accepted treatment707939 ZYPREXA VELOTAB Olanzapine 10MG TAB Accepted treatment715666 INVEGA Paliperidone 3MG SRT Accepted treatment715667 INVEGA Paliperidone 6MG SRT Accepted treatment715668 INVEGA Paliperidone 9MG SRT Accepted treatment3002705 TREVICTA PRE-FILLED SYRINGE Paliperidone 175MG/.875ML INJ Specialist motivation3002704 TREVICTA PRE-FILLED SYRINGE Paliperidone 263MG/1.315ML INJ Specialist motivation3002703 TREVICTA PRE-FILLED SYRINGE Paliperidone 350MG/1.75ML INJ Specialist motivation3002702 TREVICTA PRE-FILLED SYRINGE Paliperidone 525MG/2.625ML INJ Specialist motivation718469 XEPLION PREFILLED SYRINGE 0.5ML Paliperidone 50MG/.5ML INJ Specialist motivation718470 XEPLION PREFILLED SYRINGE 0.75ML Paliperidone 75MG/.75ML INJ Specialist motivation718472 XEPLION PREFILLED SYRINGE 1.5ML Paliperidone 150MG/1.5ML INJ Specialist motivation718471 XEPLION PREFILLED SYRINGE 1ML Paliperidone 100MG/1ML INJ Specialist motivation751073 ORAP Pimozide 1MG TAB Specialist motivation

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

751081 ORAP Pimozide 4MG TAB Specialist motivation3003598 AROQUET Quetiapine 100MG TAB Accepted treatment3003600 AROQUET Quetiapine 200MG TAB Accepted treatment3003597 AROQUET Quetiapine 25MG TAB Accepted treatment3003601 AROQUET Quetiapine 300MG TAB Accepted treatment716051 DOPAQUEL Quetiapine 100MG TAB Accepted treatment716052 DOPAQUEL Quetiapine 200MG TAB Accepted treatment716050 DOPAQUEL Quetiapine 25MG TAB Accepted treatment716053 DOPAQUEL Quetiapine 300MG TAB Accepted treatment720980 KIZOFRIN Quetiapine 100MG TAB Accepted treatment720981 KIZOFRIN Quetiapine 200MG TAB Accepted treatment720979 KIZOFRIN Quetiapine 25MG TAB Accepted treatment720982 KIZOFRIN Quetiapine 300MG TAB Accepted treatment716670 MYLAN QUETIAPINE Quetiapine 100MG TAB Accepted treatment716671 MYLAN QUETIAPINE Quetiapine 200MG TAB Accepted treatment716668 MYLAN QUETIAPINE Quetiapine 25MG TAB Accepted treatment716672 MYLAN QUETIAPINE Quetiapine 300MG TAB Accepted treatment718353 PSYQUET Quetiapine 100MG TAB Accepted treatment718354 PSYQUET Quetiapine 200MG TAB Accepted treatment718352 PSYQUET Quetiapine 25MG TAB Accepted treatment718355 PSYQUET Quetiapine 300MG TAB Accepted treatment721745 QUETIAPINE BIOTECH Quetiapine 100MG TAB Accepted treatment721746 QUETIAPINE BIOTECH Quetiapine 200MG TAB Accepted treatment721744 QUETIAPINE BIOTECH Quetiapine 25MG TAB Accepted treatment721747 QUETIAPINE BIOTECH Quetiapine 300MG TAB Accepted treatment716652 SEREZ Quetiapine 100MG TAB Accepted treatment716653 SEREZ Quetiapine 200MG TAB Accepted treatment716651 SEREZ Quetiapine 25MG TAB Accepted treatment716654 SEREZ Quetiapine 300MG TAB Accepted treatment850535 SEROQUEL Quetiapine 100MG TAB Accepted treatment850543 SEROQUEL Quetiapine 200MG TAB Accepted treatment850527 SEROQUEL Quetiapine 25MG TAB Accepted treatment703344 SEROQUEL Quetiapine 300MG TAB Accepted treatment3003646 QUERO XR Quetiapine 50MG SRT Specialist motivation3003647 QUERO XR Quetiapine 150MG SRT Specialist motivation3003648 QUERO XR Quetiapine 200MG SRT Specialist motivation3003649 QUERO XR Quetiapine 300MG SRT Specialist motivation3003650 QUERO XR Quetiapine 400MG SRT Specialist motivation717404 SEROQUEL XR Quetiapine 150MG SRT Specialist motivation713748 SEROQUEL XR Quetiapine 200MG SRT Specialist motivation713749 SEROQUEL XR Quetiapine 300MG SRT Specialist motivation713750 SEROQUEL XR Quetiapine 400MG SRT Specialist motivation713747 SEROQUEL XR Quetiapine 50MG SRT Specialist motivation718704 SIZONORM Quetiapine 100MG TAB Accepted treatment718705 SIZONORM Quetiapine 200MG TAB Accepted treatment718674 SIZONORM Quetiapine 25MG TAB Accepted treatment718706 SIZONORM Quetiapine 300MG TAB Accepted treatment720894 SPEC QUETIAPINE Quetiapine 100MG TAB Accepted treatment721710 SPEC QUETIAPINE Quetiapine 150MG TAB Accepted treatment720896 SPEC QUETIAPINE Quetiapine 200MG TAB Accepted treatment720893 SPEC QUETIAPINE Quetiapine 25MG TAB Accepted treatment720897 SPEC QUETIAPINE Quetiapine 300MG TAB Accepted treatment3000148 TRUVALIN XR Quetiapine 50MG SRT Specialist motivation3000149 TRUVALIN XR Quetiapine 150MG SRT Specialist motivation3000151 TRUVALIN XR Quetiapine 200MG SRT Specialist motivation

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

3000152 TRUVALIN XR Quetiapine 300MG SRT Specialist motivation3000153 TRUVALIN XR Quetiapine 400MG SRT Specialist motivation3000339 ZIMBIQUET Quetiapine 25MG TAB Accepted treatment3000378 ZIMBIQUET Quetiapine 100MG TAB Accepted treatment3000379 ZIMBIQUET Quetiapine 200MG TAB Accepted treatment3000380 ZIMBIQUET Quetiapine 300MG TAB Accepted treatment711471 ASPEN RISPERIDONE Risperidone 0.5MG TAB Accepted treatment711472 ASPEN RISPERIDONE Risperidone 1MG TAB Accepted treatment711473 ASPEN RISPERIDONE Risperidone 2MG TAB Accepted treatment711474 ASPEN RISPERIDONE Risperidone 3MG TAB Accepted treatment711475 ASPEN RISPERIDONE Risperidone 4MG TAB Accepted treatment716500 AUROPERDAL Risperidone .5MG TAB Accepted treatment716501 AUROPERDAL Risperidone 1MG TAB Accepted treatment716502 AUROPERDAL Risperidone 2MG TAB Accepted treatment716503 AUROPERDAL Risperidone 3MG TAB Accepted treatment716504 AUROPERDAL Risperidone 4MG TAB Accepted treatment720334 PERIDA Risperidone .5MG TAB Accepted treatment720335 PERIDA Risperidone 1MG TAB Accepted treatment712617 PERIZAL Risperidone 0.5MG TAB Accepted treatment712618 PERIZAL Risperidone 1MG TAB Accepted treatment712619 PERIZAL Risperidone 2MG TAB Accepted treatment712621 PERIZAL Risperidone 3MG TAB Accepted treatment717996 RISNIA Risperidone .5MG TAB Accepted treatment717997 RISNIA Risperidone 1MG TAB Accepted treatment717998 RISNIA Risperidone 2MG TAB Accepted treatment717999 RISNIA Risperidone 3MG TAB Accepted treatment714101 RISPACOR Risperidone 0.5MG TAB Accepted treatment713967 RISPACOR Risperidone 1MG TAB Accepted treatment713966 RISPACOR Risperidone 2MG TAB Accepted treatment713965 RISPACOR Risperidone 3MG TAB Accepted treatment891523 RISPERDAL Risperidone 0.5MG TAB Accepted treatment828432 RISPERDAL Risperidone 1MG TAB Accepted treatment801860 RISPERDAL Risperidone 2MG TAB Accepted treatment801879 RISPERDAL Risperidone 3MG TAB Accepted treatment828440 RISPERDAL Risperidone 4MG TAB Accepted treatment705474 RISPERDAL CONSTA Risperidone 25MG VIAL Specialist Motivation705475 RISPERDAL CONSTA Risperidone 37.5MG VIAL Specialist Motivation705476 RISPERDAL CONSTA Risperidone 50MG VIAL Specialist Motivation712252 RISPERIDONE HEXAL Risperidone 0.5MG TAB Accepted treatment710790 RISPERIDONE HEXAL Risperidone 1MG TAB Accepted treatment710791 RISPERIDONE HEXAL Risperidone 2MG TAB Accepted treatment710793 RISPERIDONE HEXAL Risperidone 3MG TAB Accepted treatment711419 RISPERLET Risperidone 0.5MG TAB Accepted treatment711420 RISPERLET Risperidone 1MG TAB Accepted treatment711421 RISPERLET Risperidone 2MG TAB Accepted treatment718226 RISPEVON Risperidone 1MG TAB Accepted treatment718227 RISPEVON Risperidone 2MG TAB Accepted treatment718228 RISPEVON Risperidone 3MG TAB Accepted treatment718229 RISPEVON Risperidone 4MG TAB Accepted treatment723314 RISPIDE Risperidone .5MG TAB Accepted treatment723315 RISPIDE Risperidone 1MG TAB Accepted treatment723316 RISPIDE Risperidone 2MG TAB Accepted treatment711537 RISPONZ Risperidone 1MG TAB Accepted treatment711534 RISPONZ Risperidone 2MG TAB Accepted treatment711536 RISPONZ Risperidone 3MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

711538 RISPONZ Risperidone 4MG TAB Accepted treatment715736 SCHIZOROL Risperidone 0.5MG TAB Accepted treatment715737 SCHIZOROL Risperidone 1MG TAB Accepted treatment715738 SCHIZOROL Risperidone 2MG TAB Accepted treatment721750 ZOXADON Risperidone 3MG TAB Accepted treatment721752 ZOXADON Risperidone 4MG TAB Accepted treatment711511 ZOXADON Risperidone 0.5MG TAB Accepted treatment711512 ZOXADON Risperidone 1MG TAB Accepted treatment711513 ZOXADON Risperidone 2MG TAB Accepted treatment705386 BIO-SULPIRIDE Sulpiride 200MG TAB Accepted treatment766410 STELAZINE Trifluoperazine 1MG TAB Accepted treatment766437 STELAZINE Trifluoperazine 5MG TAB Accepted treatment703465 GEODON Ziprasidone 20MG CAP Accepted treatment703468 GEODON Ziprasidone 40MG CAP Accepted treatment703475 GEODON Ziprasidone 60MG CAP Accepted treatment703476 GEODON Ziprasidone 80MG CAP Accepted treatment789798 CLOPIXOL Zuclopenthixol 10MG TAB Accepted treatment796751 CLOPIXOL Zuclopenthixol 2MG TAB Accepted treatment 714852 CLOPIXOL DEPOT Zuclopenthixol 200MG/1ML INJS Accepted treatment

Antidepressants3002709 AMITRIPTYLINE 10 MG AUSTELL Amitriptyline 10MG TAB Accepted treatment718746 GULF AMITRIPTYLINE Amitriptyline 25MG TAB Accepted treatment784230 ROLAB-AMITRIPTYLINE HCL Amitriptyline 25MG TAB Accepted treatment772003 TREPILINE Amitriptyline 10MG TAB Accepted treatment771996 TREPILINE Amitriptyline 25MG TAB Accepted treatment757888 PROTHIADEN Dosulepin 25MG CAP Accepted treatment816515 SANDOZ DOTHIEPIN HCL Dosulepin 75MG TAB Accepted treatment800198 THADEN Dosulepin 25MG CAP Accepted treatment800201 THADEN Dosulepin 75MG TAB Accepted treatment724661 ETHIPRAMINE Imipramine 10MG TAB Accepted treatment724688 ETHIPRAMINE Imipramine 25MG TAB Accepted treatment771120 TOFRANIL Imipramine 10MG TAB Accepted treatment771139 TOFRANIL Imipramine 25MG TAB Accepted treatment

Mood Stabilisers712493 DEGRANOL Carbamazepine 200MG TAB Accepted treatment3001174 GULF CARBAMAZEPINE Carbamazepine 200MG TAB Accepted treatment705602 SANDOZ CARBAMAZIPINE CR400 Carbamazepine 400MG SRT Accepted treatment769398 TEGRETOL Carbamazepine 200MG TAB Clinical Motivation779652 TEGRETOL CR Carbamazepine 200MG SRT Clinical Motivation779660 TEGRETOL CR Carbamazepine 400MG SRT Clinical Motivation715962 ZEPTOL Carbamazepine 200MG TAB Accepted treatment705441 ASPEN LAMOTRIGINE 100MG Lamotrigine 100MG TAB Accepted treatment705436 ASPEN LAMOTRIGINE 25MG Lamotrigine 25MG TAB Accepted treatment705440 ASPEN LAMOTRIGINE 50MG Lamotrigine 50MG TAB Accepted treatment707789 AUSTELL-LAMOTRIGINE Lamotrigine 100MG TAB Accepted treatment707790 AUSTELL-LAMOTRIGINE Lamotrigine 200MG TAB Accepted treatment707787 AUSTELL-LAMOTRIGINE Lamotrigine 25MG TAB Accepted treatment707788 AUSTELL-LAMOTRIGINE Lamotrigine 50MG TAB Accepted treatment710389 DYNA-LAMOTRIGINE Lamotrigine 100MG TAB Accepted treatment710390 DYNA-LAMOTRIGINE Lamotrigine 200MG TAB Accepted treatment710387 DYNA-LAMOTRIGINE Lamotrigine 25MG TAB Accepted treatment710388 DYNA-LAMOTRIGINE Lamotrigine 50MG TAB Accepted treatment722725 GIROTEC Lamotrigine 50MG TAB Accepted treatment722726 GIROTEC Lamotrigine 100MG TAB Accepted treatment722727 GIROTEC Lamotrigine 200MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

704381 EPITEC 100MG Lamotrigine 100MG TAB Accepted treatment704382 EPITEC 200MG Lamotrigine 200MG TAB Accepted treatment704379 EPITEC 25MG Lamotrigine 25MG TAB Accepted treatment704380 EPITEC 50MG Lamotrigine 50MG TAB Accepted treatment805521 LAMICTIN Lamotrigine 100MG TAB Accepted treatment819034 LAMICTIN Lamotrigine 200MG TAB Accepted treatment805505 LAMICTIN Lamotrigine 25MG TAB Accepted treatment805513 LAMICTIN Lamotrigine 50MG TAB Accepted treatment813907 LAMICTIN P100 Lamotrigine 100MG DSP Accepted treatment704533 LAMICTIN P2 Lamotrigine 2MG DSP Accepted treatment891716 LAMICTIN P200 Lamotrigine 200MG DSP Accepted treatment813893 LAMICTIN P25 Lamotrigine 25MG DSP Accepted treatment813885 LAMICTIN P5 Lamotrigine 5MG DSP Accepted treatment891708 LAMICTIN P50 Lamotrigine 50MG DSP Accepted treatment710885 LAMIDUS Lamotrigine 50MG TAB Accepted treatment704488 LAMITOR Lamotrigine 100MG TAB Accepted treatment704486 LAMITOR Lamotrigine 25MG TAB Accepted treatment704487 LAMITOR Lamotrigine 50MG TAB Accepted treatment712217 LAMITOR Lamotrigine 200MG TAB Accepted treatment705248 SANDOZ LAMOTRIGINE Lamotrigine 100MG TAB Accepted treatment3000448 SERINEM Lamotrigine 25MG TAB Accepted treatment3000449 SERINEM Lamotrigine 50MG TAB Accepted treatment3000451 SERINEM Lamotrigine 100MG TAB Accepted treatment3000452 SERINEM Lamotrigine 200MG TAB Accepted treatment715980 CONVULEX Valproic acid 150MG CAP Accepted treatment715999 CONVULEX Valproic acid 300MG CAP Accepted treatment781568 CONVULEX Valproic acid 500MG CAP Accepted treatment818666 EPILIM CR Valproic acid 200MG SRT Accepted treatment818674 EPILIM CR Valproic acid 300MG SRT Accepted treatment818682 EPILIM CR Valproic acid 500MG SRT Accepted treatment821578 EPILIM CRUSHABLE Valproic acid 100MG TAB Accepted treatment718274 EPILIZINE CR Valproic acid 200MG SRT Accepted treatment718275 EPILIZINE CR Valproic acid 300MG SRT Accepted treatment718276 EPILIZINE CR Valproic acid 500MG SRT Accepted treatment721460 EPROLEP CR 200 Valproic acid 200MG SRT Accepted treatment720762 EPROLEP CR 300 Valproic acid 300MG SRT Accepted treatment721055 EPROLEP CR 500 Valproic acid 500MG SRT Accepted treatment718465 NAVALPRO CR Valproic acid 200MG SRT Accepted treatment718466 NAVALPRO CR Valproic acid 300MG SRT Accepted treatment718468 NAVALPRO CR Valproic acid 500MG SRT Accepted treatment720026 VANAPRO Valproic acid 300MG SRT Accepted treatment720027 VANAPRO Valproic acid 500MG SRT Accepted treatment

Systemic Lupus ErythematosusNon-steroidal anti-inflammatories

862304 BAYER ASPIRIN CARDIO Acetylsalicylic acid 100MG TAB Accepted treatment722806 SOLUSPRIN CV Acetylsalicylic acid 100MG DSP Accepted treatment847283 DISPRIN CV Acetylsalicylic acid 100MG EEF Accepted treatment721258 MYOPRIN Acetylsalicylic acid 100MG TAB Accepted treatment706930 BAYER ASPIRIN Acetylsalicylic acid 300MG TAB Accepted treatment807206 DISPRIN CV Acetylsalicylic acid 300MG EEF Accepted treatment720577 DISPRIN REGULAR Acetylsalicylic acid 300MG EEF Accepted treatment719673 DR DU TOITS PAIN EXPELLER Acetylsalicylic acid 300MG TAB Accepted treatment700909 GULF ASPIRIN Acetylsalicylic acid 300MG TAB Accepted treatment704642 SOLUSPIRIN (WAS ASPIRIN SOLUBLE) Acetylsalicylic acid 300MG DSP Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

712608 PCH ACETYLSALICYLIC ACID CARDIO Acetylsalicylic acid 80MG DSP Accepted treatment823481 ECOTRIN Acetylsalicylic acid 81MG ECT Accepted treatment862444 CELEBREX Celecoxib 100MG CAP Accepted treatment862452 CELEBREX Celecoxib 200MG CAP Accepted treatment724014 CELECOXIB UNICORN Celecoxib 100MG CAP Accepted treatment724015 CELECOXIB UNICORN Celecoxib 200MG CAP Accepted treatment723329 COXLEON Celecoxib 100MG CAP Accepted treatment723330 COXLEON Celecoxib 200MG CAP Accepted treatment786594 ADCO-DICLOFENAC Diclofenac 25MG TAB Accepted treatment788597 ADCO-DICLOFENAC Diclofenac 50MG TAB Accepted treatment893390 A-LENNON DICLOFENAC Diclofenac 25MG TAB Accepted treatment893391 A-LENNON DICLOFENAC Diclofenac 50MG TAB Accepted treatment718479 DICLOFENAC BIOTECH Diclofenac 25MG TAB Accepted treatment718480 DICLOFENAC SR BIOTECH Diclofenac 100MG SRT Accepted treatment706314 DIFEN SR Diclofenac 100MG TAB Accepted treatment791547 FORTFEN SR Diclofenac 100MG SRC Accepted treatment786012 MYLAN DICLOFENAC (ARCANAFENAC) Diclofenac 25MG TAB Accepted treatment786020 MYLAN DICLOFENAC SOD (ARCANAFENAC) Diclofenac 50MG TAB Accepted treatment752398 PANAMOR AT-50 Diclofenac 50MG TAB Accepted treatment827592 PANAMOR SR Diclofenac 100MG TAB Accepted treatment752371 PANAMOR-25 Diclofenac 25MG TAB Accepted treatment719838 ROLAB-DICLOFENAC SODIUM Diclofenac 50MG TAB Accepted treatment787272 VELTEX CR Diclofenac 100MG SRC Accepted treatment778206 VOLTAREN Diclofenac 25MG TAB Accepted treatment778222 VOLTAREN GT Diclofenac 50MG TAB Accepted treatment778230 VOLTAREN SR Diclofenac 100MG TAB Accepted treatment813044 ARTHROTEC Diclofenac, combinations 50MG/200MCG ECT Clinical review869805 ARTHROTEC Diclofenac, combinations 75MG/200mcg ECT Clinical review780596 ADCO-IBUPROFEN Ibuprofen 400MG TAB Accepted treatment717155 AUSTELL IBUPROFEN Ibuprofen 200MG TAB Accepted treatment717153 AUSTELL IBUPROFEN Ibuprofen 400MG TAB Accepted treatment721118 AUSTIFEN Ibuprofen 200MG TAB Accepted treatment721119 AUSTIFEN Ibuprofen 400MG TAB Accepted treatment710822 BRUFEN Ibuprofen 200MG TAB Accepted treatment892302 ADVIL LIQUI GEL Ibuprofen 200MG CAP Accepted treatment716004 ADVIL LIQUI GEL Ibuprofen 400MG CAP Accepted treatment708186 BETAGESIC Ibuprofen 200MG TAB Accepted treatment787426 BETAPROFEN Ibuprofen 200MG TAB Accepted treatment701975 BETAPROFEN 400 FC Ibuprofen 400MG TAB Accepted treatment708290 BREN Ibuprofen 400MG TAB Accepted treatment710830 BRUFEN Ibuprofen 400MG TAB Accepted treatment895196 IBOFLAM Ibuprofen 200MG TAB Accepted treatment705940 IBU Ibuprofen 200MG TAB Accepted treatment721114 IBUCARE Ibuprofen 200MG TAB Accepted treatment721116 IBUCARE Ibuprofen 400MG TAB Accepted treatment721117 IBUCARE Ibuprofen 600MG TAB Accepted treatment704781 IBUGESIC Ibuprofen 100MG/5ML SUS Accepted treatment700316 IBUMAX Ibuprofen 200MG TAB Accepted treatment700318 IBUMAX Ibuprofen 400MG TAB Accepted treatment700315 IBUMAX PAEDIATRIC Ibuprofen 100MG/5ML SUS Accepted treatment809268 IBUMED Ibuprofen 200MG CAP Accepted treatment868221 IBUNATE Ibuprofen 200MG TAB Accepted treatment708536 IBUSOR Ibuprofen 200MG TAB Accepted treatment721335 INFLAMAX PAEDIATRIC Ibuprofen 100MG/5ML SUS Accepted treatment733741 INZA Ibuprofen 200MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

733768 INZA Ibuprofen 400MG TAB Accepted treatment868469 LENAFEN Ibuprofen 200MG TAB Accepted treatment748560 NUROFEN Ibuprofen 200MG TAB Accepted treatment3001126 NUROFEN EXPRESS Ibuprofen 200MG TAB Accepted treatment897984 NUROFEN EXTRA STRENGTH Ibuprofen 400MG TAB Accepted treatment824852 RANFEN Ibuprofen 200MG TAB Accepted treatment701654 RANFEN 400 Ibuprofen 400MG TAB Accepted treatment701891 AMDOCIN Indometacin CAP Accepted treatment704725 ARTHREXIN Indometacin 25MG APP Accepted treatment704741 ARTHREXIN Indometacin 100MG SUP Accepted treatment787833 BETACIN Indometacin 25MG CAP Accepted treatment868213 GULF INDOMETHACIN Indometacin 25MG CAP Accepted treatment788996 MEDIFLEX Indometacin 25MG CAP Accepted treatment814393 METHOCAPS Indometacin 25MG CAP Accepted treatment704776 ROLAB-INDOMETHACIN Indometacin 25MG CAP Accepted treatment822205 KETOFLAM SR Ketoprofen 200MG SRC Accepted treatment883102 ADCO-MEFENAMIC ACID Mefenamic acid 250MG CAP Accepted treatment797707 FENAMIN Mefenamic acid 250MG CAP Accepted treatment797715 FENAMIN Mefenamic acid 500MG TAB Accepted treatment797014 FENAMIN Mefenamic acid 50MG/5ML SUS Accepted treatment796433 PONAC Mefenamic acid 250MG CAP Accepted treatment794201 PONAC FORTE Mefenamic acid 500MG TAB Accepted treatment756148 PONSTAN Mefenamic acid 250MG CAP Accepted treatment812250 PONSTEL 250 Mefenamic acid 250MG CAP Accepted treatment810371 PONSTEL FORTE Mefenamic acid 500MG TAB Accepted treatment705376 ADCO-MELOXICAM 15MG Meloxicam 15MG TAB Accepted treatment705375 ADCO-MELOXICAM 7.5MG Meloxicam 7.5MG TAB Accepted treatment707668 APEX-MELOXICAM Meloxicam 15MG TAB Accepted treatment707667 APEX-MELOXICAM Meloxicam 7.5MG TAB Accepted treatment711325 ARROW MELOXICAM Meloxicam 15MG TAB Accepted treatment711324 ARROW MELOXICAM Meloxicam 7.5MG TAB Accepted treatment899070 COXFLAM Meloxicam 15MG TAB Accepted treatment899066 COXFLAM Meloxicam 7.5MG TAB Accepted treatment717092 FLAMARYX Meloxicam 15MG TAB Accepted treatment717091 FLAMARYX Meloxicam 7.5MG TAB Accepted treatment704828 FLEXOCAM Meloxicam 15MG TAB Accepted treatment704829 FLEXOCAM Meloxicam 7.5MG TAB Accepted treatment718305 GLENMARK MELOXICAM Meloxicam 15MG TAB Accepted treatment718306 GLENMARK MELOXICAM Meloxicam 7.5MG TAB Accepted treatment701522 LOXIFLAM 15 Meloxicam 15MG TAB Accepted treatment701520 LOXIFLAM 7.5 Meloxicam 7.5MG TAB Accepted treatment705177 M-CAM 15MG Meloxicam 15MG TAB Accepted treatment705176 M-CAM 7.5MG Meloxicam 7.5MG TAB Accepted treatment718382 MEDOXICAM Meloxicam 15MG TAB Accepted treatment718381 MEDOXICAM Meloxicam 7.5MG TAB Accepted treatment705297 MELFLAM 15 Meloxicam 15MG TAB Accepted treatment705296 MELFLAM 7.5 Meloxicam 7.5MG TAB Accepted treatment716169 MELOXICAM UNICORN Meloxicam 15MG TAB Accepted treatment716168 MELOXICAM UNICORN Meloxicam 7.5MG TAB Accepted treatment818615 MOBIC Meloxicam 7.5MG TAB Accepted treatment842052 MOBIC 15MG Meloxicam 15MG TAB Accepted treatment705230 ZYDUS-MELOXICAM 15MG Meloxicam 15MG TAB Accepted treatment705229 ZYDUS-MELOXICAM 7.5MG Meloxicam 7.5MG TAB Accepted treatment785245 ADCO-NAPROXEN Naproxen 250MG TAB Accepted treatment715831 BIO-NAPROXEN Naproxen 250MG TAB Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

810185 MYLAN NAPROXEN (ARCANA-NAPROXEN) Naproxen 250MG TAB Accepted treatment812625 NAFASOL EC-250 Naproxen 250MG ECT Accepted treatment812633 NAFASOL EC-500 Naproxen 500MG ECT Accepted treatment806447 NAPFLAM Naproxen 250MG TAB Accepted treatment808474 NAPFLAM Naproxen 500MG TAB Accepted treatment805238 NAPROSCRIPT Naproxen 250MG TAB Accepted treatment718724 VIMOVO 500/20MG naproxen and esomeprazole TAB Clinical review800724 BREXECAM Piroxicam 20MG TAB Accepted treatment716517 PIROXICAM ACTOR DT Piroxicam 20MG DSP Accepted treatment827428 PIXICAM Piroxicam 20MG DSP Accepted treatment799432 PYROCAPS Piroxicam 20MG CAP Accepted treatment821144 RHEUGESIC Piroxicam 20MG DSP Accepted treatment701072 ROXIFEN Piroxicam 20MG CAP Accepted treatment797030 XYCAM Piroxicam 20MG CAP Accepted treatment797049 XYCAM DISPERS Piroxicam 20MG DSP Accepted treatment

Oral Corticosteroids814407 CAPSOID Prednisolone 5MG TAB Accepted treatment800155 LENISOLONE Prednisolone 5MG TAB Accepted treatment703720 PRELONE Prednisolone 5MG TAB Accepted treatment742759 METICORTEN Prednisone 50MG TAB Accepted treatment742732 METICORTEN Prednisone 5MG TAB Accepted treatment752304 PANAFCORT Prednisone 5MG TAB Accepted treatment788783 PREDNISONE (BE-TABS) Prednisone 5MG TAB Accepted treatment836826 PULMISON TABS Prednisone 20MG TAB Accepted treatment818267 TROLIC Prednisone 5MG TAB Accepted treatment

Disease modifying agents782556 ABITREXATE-20ML Methotrexate 500MG/20ML INJ Accepted treatment782548 ABITREXATE-2ML Methotrexate 50MG INJ Accepted treatment712504 EMTHEXATE Methotrexate 2.5MG TAB Accepted treatment825557 EMTHEXATE RTU 500-20 20ML Methotrexate 25MG/1ML INJ Accepted treatment711328 METACHOR VIAL 2ML Methotrexate 25MG/1ML INJ Accepted treatment840815 METHOTREXATE CSV 2ML (P&U) Methotrexate 50MG/2ML INJ Accepted treatment840807 METHOTREXATE CSV 20ML (P&U) Methotrexate 500MG/20ML INJ Accepted treatment742465 METHOTREXATE Methotrexate 2.5MG TAB Accepted treatment

Immunosuppressants701252 AZAMUN Azathioprine 50MG TAB Accepted treatment706108 AZAPRESS Azathioprine 50MG TAB Accepted treatment712609 AZATHIOPRINE PCH Azathioprine 50MG TAB Accepted treatment732516 IMURAN Azathioprine 50MG TAB Accepted treatment700777 ZAPRINE 50MG Azathioprine 50MG TAB Accepted treatment

Alkylating agents723274 ENDOXAN Cyclosphosphamide 50MG TAB Specialist Motivation

Ulcerative colitisAminosalicylic acid preparations

783668 ASACOL Mesalazine 400MG TAB Accepted treatment709076 ASACOL Mesalazine 800MG TAB Accepted treatment720355 MEZAVANT Mesalazine 1200MG ERT Accepted treatment722335 PENTASA Mesalazine 1G SAC Accepted treatment722336 PENTASA Mesalazine 2G SAC Accepted treatment890775 PENTASA Mesalazine 500MG TAB Accepted treatment716333 SALOFALK Mesalazine 1000MG SAC Accepted treatment792519 DIPENTUM Olsalazine 250MG CAP Accepted treatment762008 SALAZOPYRIN Sulfasalazine 500MG TAB Accepted treatment762016 SALAZOPYRIN E.N. Sulfasalazine 500MG ECT Accepted treatment

NAPPI CODE

DRUG NAME ACTIVE INGREDIENT STRENGTHDRUG FORM

CHRONIC MEDICINE MANAGEMENT REIMBURSEMENT CRITERIA FOR PREFERRED FORMULARY DRUGS

Immunosuppressants701252 AZAMUN Azathioprine 50MG TAB Accepted treatment706108 AZAPRESS Azathioprine 50MG TAB Accepted treatment712609 AZATHIOPRINE PCH Azathioprine 50MG TAB Accepted treatment732516 IMURAN Azathioprine 50MG TAB Accepted treatment700777 ZAPRINE 50MG Azathioprine 50MG TAB Accepted treatment

Steroid preparations (oral)716693 COVOCORT Hydrocortisone 10MG TAB Accepted treatment741124 MEDROL Methylprednisone 16MG TAB Accepted treatment741116 MEDROL Methylprednisone 4MG TAB Accepted treatment814407 CAPSOID Prednisolone 5MG TAB Accepted treatment800155 LENISOLONE Prednisolone 5MG TAB Accepted treatment703720 PRELONE Prednisolone 5MG TAB Accepted treatment742759 METICORTEN Prednisone 50MG TAB Accepted treatment742732 METICORTEN Prednisone 5MG TAB Accepted treatment752304 PANAFCORT Prednisone 5MG TAB Accepted treatment788783 PREDNISONE (BE-TABS) Prednisone 5MG TAB Accepted treatment836826 PULMISON TABS Prednisone 20MG TAB Accepted treatment818267 TROLIC Prednisone 5MG TAB Accepted treatment

Steroid preparations (enemas)824593 ENTOCORD ENEMAS Budesonide 2.3MG ENE Accepted treatment