The following is a list of the most commonly prescribed drugs. It represents anabbreviated version of the preferred drug list that is at the core of your pharmacybenefit plan. The list is not all-inclusive and does not guarantee coverage. In additionto using this list, you are encouraged to ask your doctor to prescribe generic drugs
Georgia Preferred Drug List PLEASE NOTE: The symbol * next to a drug signifies subject to non-preferred State Health Benefit Plan status when generic is available throughout the year. For prior authorization (PA) inquiries or questions regarding the preferred status of drugs not listed on this document, please contact Express Scripts, Inc. at 1-877-650-9340. ANTIINFECTIVES Antidepressants Insulins Antivirals Angiotensin II Receptor Antagonists
(excluding cartridges) PEGASYS [INJ] [QLL]
+ HCT Combos Tertiary Amines Cephalosporins Insulin Sensitizers MUSCULOSKELETAL Beta-Adrenergic DERMATOLOGICAL MEDICATIONS Antagonists MEDICATIONS Oral Hypoglycemics Macrolides Antipsychotic Drugs CNS Muscle Relaxants Antiacne Drugs Oral Antifungals Non-Steroidal Anti- Inflammatory Agents Calcium Antagonists Thyroid Supplements Penicillins Other Endocrine Centrally Acting Antivertigo & Quinolones Antihypertensives Antiemetics Antipsoriasis & Salicylates & Related Antieczema Drugs HMG-CoA Reductase Inhibitors Class II Narcotics Topical Antifungals GASTROINTESTINAL Corticosteroids MEDICATIONS NUTRITION & BLOOD MODIFIERS Antispasmodics/Drugs Topical Antifungal- Combinations Affecting GI Motility Antiplatelet Drugs Corticosteroids Keratolytics Hypolipoproteinemics Class III Narcotics Miscellaneous H. Pylori Drugs Urinary Antiinfectives Dermatologicals Blood Detoxicants Proton Pump Inhibitors CNS Stimulants Therapeutic Vitamins Thiazide & Related & Minerals ANTINEOPLASTIC/ EAR-NOSE Other GI Drugs IMMUNOSUPPRESS- MEDICATIONS ANT DRUGS Drugs Affecting The Antihypertensives OBSTETRICAL & GYNECOLOGICAL MEDICATIONS AUTONOMIC & CNS MEDICATIONS Drugs Affecting The Androgen Drugs Other Drugs For ADHD Nose Anticonvulsants Contraceptives Drugs To Prevent & Treat Headaches CARDIOVASCULAR MEDICATIONS IMMUNOLOGICALS ACE Inhibitors + HCT Sedative/Hypnotics ENDOCRINE MEDICATIONS Interferons Antidementia Drugs Glucocorticoids Selective Serotonin Pegylated Interferons/ Reuptake Inhibitors Oral Ribavirin Agents REVISED JUNE 14, 2005. THIS LIST IS SUBJECT TO CHANGE.
The symbol [G] next to a drug name signifies that a generic is available for at least one or more strengths of the brand medication. Most generics are available at the lowest copay. 2005 Express Scripts, Inc. PRMT-GAP-05 (06/14/05) All Rights Reserved Antihistamine/ Preferred Product Listing for Non-Preferred Drugs Decongestants
The following is a list of some non-preferred brand medications with examples of selected alternatives that are on the preferred
Column 1 lists examples of non-preferred medications.
Column 2 lists some alternatives that can be prescribed.
Antitussive & Expectorants Non-Preferred Preferred Alternative Drugs Non-Preferred Preferred Alternative Drugs Beta-2 Adrenergics Leukotriene Modifiers Methyl Xanthines Estrogen Drugs Other Drugs For
OTC benzoyl peroxide + generic clindamycin
Estrogen/Progestin Combinations
nifedipine extended release, felodipine er,
Prenatal Vitamins
lovastatin, Crestor, Lipitor + aspirin, Zocor
fluoxetine (daily), citalopram, paroxetine,
Progestin Drugs
ciprofloxacin, ofloxacin, Ciloxan ointment*,
UROLOGICAL
OTC benzoyl peroxide + generic clindamycin
MEDICATIONS OPHTHALMIC
nifedipine extended release, felodipine er,
MEDICATIONS Anticholinergic Antispasmodics Antibacterial Drugs Other Genitourinary Products
nifedipine extended release, felodipine er,
DIABETIC SUPPLIES Meters & Strips Antiglaucoma Drugs
fosinopril/hctz, lisinopril/hctz, quinaretic
Corticosteroid Drugs Other Ophthalmic
fluoxetine (daily), citalopram, paroxetine,
The symbol [G] next to a drug name indicates that a generic is available for at least one or more strengths of the brand medication.
The symbol [INJ] next to a drug name indicates that the drug is available in injectable form only. RESPIRATORY
The symbol [PA] next to a drug name indicates that prior authorization is required. The symbol [PDMP] next to a drug name indicates the drug is part of the Progressive Drug Management Program. MEDICATIONS
The symbol [QLL] next to a drug name indicates that quantity or therapy limits exist. The symbol [SNRI] stands for Serotonin-Norepinephrine Reuptake Inhibitor. Antihistamines For the member: Generic medications contain the same active ingredients as their corresponding brand name medications, although they may look different in color or shape. They have been FDA-approved under strict standards. For the physician: Please prescribe preferred products and allow generic substitutions when medically appropriate. Thank you.
Brand name drugs are listed in CAPITAL letters. Generic drugs are listed in lower case letters. REVISED JUNE 14, 2005. THIS LIST IS SUBJECT TO CHANGE.
The symbol [G] next to a drug name signifies that a generic is available for at least one or more strengths of the brand medication. Most generics are available at the lowest copay. 2005 Express Scripts, Inc. PRMT-GAP-05 (06/14/05) All Rights Reserved
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The following is a list of the most commonly prescribed drugs. It represents anabbreviated version of the preferred drug list that is at the core of your pharmacybenefit plan. The list is not all-inclusive and does not guarantee coverage. In additionto using this list, you are encouraged to ask your doctor to prescribe generic drugs
Georgia Preferred Drug List