24:00 Cardiovascular Drugs

24:04.04 ANTIARRHYTHMIC AGENTS

AMIODARONE HYDROCHLORIDE

Table: AMIODARONE HYDROCHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST100MG Tablet 02292173 PMS-AMIODARONE PMS
ST200MG Tablet 02364336 AMIODARONE SAN
ST200MG Tablet 02385465 AMIODARONE SIV
ST200MG Tablet 02246194 APO-AMIODARONE APX
ST200MG Tablet 02246331 DOM-AMIODARONE DPC
ST200MG Tablet 02242472 PMS-AMIODARONE PMS
ST200MG Tablet 02309661 PRO-AMIODARONE PDL
ST200MG Tablet 02247217 RIVA-AMIODARONE RIV
ST200MG Tablet 02243836 SANDOZ AMIODARONE SDZ
ST200MG Tablet 02239835 TEVA-AMIODARONE TEV
ST pDIN For Extemporaneous Mixture 99503016 AMIODARONE ORAL LIQUID UNK

DISOPYRAMIDE

Table: DISOPYRAMIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST100MG Capsule 02224801 RYTHMODAN SAC

FLECAINIDE ACETATE

Table: FLECAINIDE ACETATE
Drug strength and dosage form DIN Brand name Manufacturer code
ST50MG Tablet 02275538 APO-FLECAINIDE APX
ST50MG Tablet 02459957 AURO-FLECAINIDE AUR
ST100MG Tablet 02275546 APO-FLECAINIDE APX
ST100MG Tablet 02459965 AURO-FLECAINIDE AUR

MEXILETINE HYDROCHLORIDE

Table: MEXILETINE HYDROCHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST100MG Capsule 02230359 TEVA-MEXILETINE TEV
ST200MG Capsule 02230360 TEVA-MEXILETINE TEV

PROCAINAMIDE HYDROCHLORIDE

Table: PROCAINAMIDE HYDROCHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST250MG Capsule 00713325 APO-PROCAINAMIDE APX
ST250MG Tablet (Extended Release) 00638692 PROCAN SR ERF

PROPAFENONE HYDROCHLORIDE

Table: PROPAFENONE HYDROCHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST150MG Tablet 02243324 APO-PROPAFENONE APX
ST150MG Tablet 02457172 MYLAN-PROPAFENONE MYL
ST150MG Tablet 02343053 PROPAFENONE SAN
ST150MG Tablet 00603708 RYTHMOL BGP
ST300MG Tablet 02243325 APO-PROPAFENONE APX
ST300MG Tablet 02457164 MYLAN-PROPAFENONE MYL
ST300MG Tablet 02294575 PMS-PROPAFENONE PMS
ST300MG Tablet 02343061 PROPAFENONE SAN
ST300MG Tablet 00603716 RYTHMOL BGP

24:04.08 CARDIOTONIC AGENTS

DIGOXIN

Table: DIGOXIN
Drug strength and dosage form DIN Brand name Manufacturer code
ST0.05MG/ML Solution 02242320 TOLOXIN PED
ST0.0625MG Tablet 02335700 TOLOXIN PED
ST0.125MG Tablet 02335719 TOLOXIN PED
ST0.250MG Tablet 02335727 TOLOXIN PED

24:04.92 MISCELLANEOUS CARDIAC DRUGS

IVABRADINE (IVABRADINE HYDROCHLORIDE)

Limited use benefit (prior approval required).

For the treatment of stable chronic heart failure with New York Heart Association (NYHA) class II or III symptoms in adult patients if the following criteria are met:

  • left ventricular ejection fraction ≤ 35%; and
  • resting heart rate must be documented as ≥ 77 bpm on average using either an ECG on at least three separate visits or by continuous monitoring; and
  • patient has had at least one hospitalization due to heart failure in the last year; and
  • NYHA class II to III symptoms despite at least four weeks of treatment with an angiotensin converting enzyme inhibitor (ACEI) or an angiotensin II receptor antagonist (ARB) in combination with a beta blocker and, if tolerated, a mineralocorticoid receptor antagonist (MRA).
Table: IVABRADINE (IVABRADINE HYDROCHLORIDE)
Drug strength and dosage form DIN Brand name Manufacturer code
5MG Tablet 02459973 LANCORA SEV
7.5MG Tablet 02459981 LANCORA SEV

24:06.04 BILE ACID SEQUESTRANTS

CHOLESTYRAMINE RESIN

Table: CHOLESTYRAMINE RESIN
Drug strength and dosage form DIN Brand name Manufacturer code
ST4G Powder For Suspension 02455609 CHOLESTYRAMINE-ODAN ODN
4G Powder For Suspension 02478595 JAMP-CHOLESTYRAMINE JMP
ST4G Powder For Suspension 00890960 OLESTYR PMS
ST4G Powder For Suspension 02210320 OLESTYR PMS

COLESEVELAM HYDROCHLORIDE

Table: COLESEVELAM HYDROCHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST3.75G Powder For Suspension 02432463 LODALIS VAE
ST625MG Tablet 02373955 LODALIS VAE

COLESTIPOL HYDROCHLORIDE

Table: COLESTIPOL HYDROCHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST5G Granules 00642975 COLESTID PFI
ST1G Tablet 02132680 COLESTID PFI

24:06.05 CHOLESTEROL ABSORPTION INHIBITORS

EZETIMIBE

Table: EZETIMIBE
Drug strength and dosage form DIN Brand name Manufacturer code
ST10MG Tablet 02425610 ACH-EZETIMIBE ACC
10MG Tablet 02475898 AG-EZETIMIBE ANG
ST10MG Tablet 02427826 APO-EZETIMIBE APX
ST10MG Tablet 02469286 AURO-EZETIMIBE AUR
ST10MG Tablet 02422549 EZETIMIBE PDL
ST10MG Tablet 02429659 EZETIMIBE SIV
ST10MG Tablet 02431300 EZETIMIBE SAN
10MG Tablet 02478544 EZETIMIBE RIV
ST10MG Tablet 02247521 EZETROL FRS
ST10MG Tablet 02423235 JAMP-EZETIMIBE JMP
ST10MG Tablet 02422662 MAR-EZETIMIBE MAR
10MG Tablet 02467437 M-EZETIMIBE MAN
ST10MG Tablet 02423243 MINT-EZETIMIBE MIN
10MG Tablet 02481669 NRA-EZETIMIBE UNK
ST10MG Tablet 02416409 PMS-EZETIMIBE PMS
ST10MG Tablet 02425238 PRIVA-EZETIMIBE PHA
ST10MG Tablet 02419548 RAN-EZETIMIBE RBY
ST10MG Tablet 02416778 SANDOZ EZETIMIBE SDZ
ST10MG Tablet 02354101 TEVA-EZETIMIBE TEV

24:06.06 FIBRIC ACID DERIVATIVES

BEZAFIBRATE

Table: BEZAFIBRATE
Drug strength and dosage form DIN Brand name Manufacturer code
ST200MG Tablet 02240331 PMS-BEZAFIBRATE PMS
ST400MG Tablet (Extended Release) 02083523 BEZALIP SR ALL
ST400MG Tablet (Extended Release) 02453312 JAMP-BEZAFIBRATE JMP

FENOFIBRATE

Table: FENOFIBRATE
Drug strength and dosage form DIN Brand name Manufacturer code
ST67MG Capsule 02243180 AA-FENO-MICRO AAP
ST100MG Capsule 02225980 FENOFIBRATE AAP
ST160MG Capsule 02250004 FENOMAX CIP
ST200MG Capsule 02239864 AA-FENO-MICRO AAP
ST200MG Capsule 02240360 FENO-MICRO PDL
ST48MG Tablet 02269074 LIPIDIL EZ BGP
ST48MG Tablet 02390698 SANDOZ FENOFIBRATE E SDZ
ST100MG Tablet 02246859 APO-FENO-SUPER APX
ST100MG Tablet 02288044 SANDOZ FENOFIBRATE S SDZ
ST145MG Tablet 02269082 LIPIDIL EZ BGP
ST145MG Tablet 02390701 SANDOZ FENOFIBRATE E SDZ
ST160MG Tablet 02246860 APO-FENO-SUPER APX
ST160MG Tablet 02241602 LIPIDIL SUPRA BGP
ST160MG Tablet 02288052 SANDOZ FENOFIBRATE S SDZ

GEMFIBROZIL

Table: GEMFIBROZIL
Drug strength and dosage form DIN Brand name Manufacturer code
ST300MG Capsule 01979574 APO-GEMFIBROZIL APX
ST300MG Capsule 02241608 DOM-GEMFIBROZIL DPC
ST300MG Capsule 02239951 PMS-GEMFIBROZIL PMS
ST300MG Capsule 02241704 TEVA-GEMFIBROZIL TEV
ST600MG Tablet 01979582 APO-GEMFIBROZIL APX
ST600MG Tablet 02142074 TEVA-GEMFIBROZIL TEV

24:06.08 HMG-COA REDUCTASE INHIBITORS

ATORVASTATIN CALCIUM

Table: ATORVASTATIN CALCIUM
Drug strength and dosage form DIN Brand name Manufacturer code
ST10MG Tablet 02457741 ACH-ATORVASTATIN CALCIUM ACC
10MG Tablet 02478145 AG-ATORVASTATIN ANG
ST10MG Tablet 02295261 APO-ATORVASTATIN APX
ST10MG Tablet 02346486 ATORVASTATIN PDL
ST10MG Tablet 02348705 ATORVASTATIN SAN
ST10MG Tablet 02396424 ATORVASTATIN APX
ST10MG Tablet 02399377 ATORVASTATIN PMS
10MG Tablet 02475022 ATORVASTATIN RIV
ST10MG Tablet 02411350 ATORVASTATIN-10 SIV
ST10MG Tablet 02407256 AURO-ATORVASTATIN AUR
10MG Tablet 02481189 BIO-ATORVASTATIN BMI
ST10MG Tablet 02399482 DOM-ATORVASTATIN DPC
ST10MG Tablet 02391058 JAMP-ATORVASTATIN JMP
ST10MG Tablet 02230711 LIPITOR UNK
ST10MG Tablet 02454017 MAR-ATORVASTATIN MAR
10MG Tablet 02471167 M-ATORVASTATIN MAN
ST10MG Tablet 02479508 MINT-ATORVASTATIN MIN
ST10MG Tablet 02392933 MYLAN-ATORVASTATIN MYL
10MG Tablet 02476517 NRA-ATORVASTATIN UNK
10MG Tablet 02482886 PRIVA-ATORVASTATIN PHA
ST10MG Tablet 02417936 REDDY-ATORVASTATIN REC
ST10MG Tablet 02422751 RIVA-ATORVASTATIN RIV
ST10MG Tablet 02324946 SANDOZ ATORVASTATIN SDZ
ST10MG Tablet 02313707 TARO-ATORVASTATIN SUN
ST10MG Tablet 02310899 TEVA-ATORVASTATIN TEV
ST20MG Tablet 02457768 ACH-ATORVASTATIN CALCIUM ACC
20MG Tablet 02478153 AG-ATORVASTATIN ANG
ST20MG Tablet 02295288 APO-ATORVASTATIN APX
ST20MG Tablet 02346494 ATORVASTATIN PDL
ST20MG Tablet 02348713 ATORVASTATIN SAN
ST20MG Tablet 02396432 ATORVASTATIN APX
ST20MG Tablet 02399385 ATORVASTATIN PMS
20MG Tablet 02475030 ATORVASTATIN RIV
ST20MG Tablet 02411369 ATORVASTATIN-20 SIV
ST20MG Tablet 02407264 AURO-ATORVASTATIN AUR
20MG Tablet 02481197 BIO-ATORVASTATIN BMI
ST20MG Tablet 02399490 DOM-ATORVASTATIN DPC
ST20MG Tablet 02391066 JAMP-ATORVASTATIN JMP
ST20MG Tablet 02230713 LIPITOR UNK
ST20MG Tablet 02454025 MAR-ATORVASTATIN MAR
20MG Tablet 02471175 M-ATORVASTATIN MAN
ST20MG Tablet 02479516 MINT-ATORVASTATIN MIN
ST20MG Tablet 02392941 MYLAN-ATORVASTATIN MYL
20MG Tablet 02476525 NRA-ATORVASTATIN UNK
20MG Tablet 02482894 PRIVA-ATORVASTATIN PHA
ST20MG Tablet 02417944 REDDY-ATORVASTATIN REC
ST20MG Tablet 02422778 RIVA-ATORVASTATIN RIV
ST20MG Tablet 02324954 SANDOZ ATORVASTATIN SDZ
ST20MG Tablet 02313715 TARO-ATORVASTATIN SUN
ST20MG Tablet 02310902 TEVA-ATORVASTATIN TEV
ST40MG Tablet 02457776 ACH-ATORVASTATIN CALCIUM ACC
40MG Tablet 02478161 AG-ATORVASTATIN ANG
ST40MG Tablet 02295296 APO-ATORVASTATIN APX
ST40MG Tablet 02346508 ATORVASTATIN PDL
ST40MG Tablet 02348721 ATORVASTATIN SAN
ST40MG Tablet 02396440 ATORVASTATIN APX
ST40MG Tablet 02399393 ATORVASTATIN PMS
ST40MG Tablet 02411377 ATORVASTATIN-40 SIV
ST40MG Tablet 02407272 AURO-ATORVASTATIN AUR
40MG Tablet 02481200 BIO-ATORVASTATIN BMI
ST40MG Tablet 02399504 DOM-ATORVASTATIN DPC
ST40MG Tablet 02391074 JAMP-ATORVASTATIN JMP
ST40MG Tablet 02230714 LIPITOR UNK
ST40MG Tablet 02454033 MAR-ATORVASTATIN MAR
40MG Tablet 02471183 M-ATORVASTATIN MAN
ST40MG Tablet 02392968 MYLAN-ATORVASTATIN MYL
40MG Tablet 02476533 NRA-ATORVASTATIN UNK
40MG Tablet 02482908 PRIVA-ATORVASTATIN PHA
ST40MG Tablet 02417952 REDDY-ATORVASTATIN REC
ST40MG Tablet 02422786 RIVA-ATORVASTATIN RIV
ST40MG Tablet 02324962 SANDOZ ATORVASTATIN SDZ
ST40MG Tablet 02313723 TARO-ATORVASTATIN SUN
ST40MG Tablet 02310910 TEVA-ATORVASTATIN TEV
ST80MG Tablet 02457784 ACH-ATORVASTATIN CALCIUM ACC
80MG Tablet 02478188 AG-ATORVASTATIN ANG
ST80MG Tablet 02295318 APO-ATORVASTATIN APX
ST80MG Tablet 02346516 ATORVASTATIN PDL
ST80MG Tablet 02348748 ATORVASTATIN SAN
ST80MG Tablet 02396459 ATORVASTATIN APX
ST80MG Tablet 02399407 ATORVASTATIN PMS
80MG Tablet 02475057 ATORVASTATIN RIV
ST80MG Tablet 02411385 ATORVASTATIN-80 SIV
ST80MG Tablet 02407280 AURO-ATORVASTATIN AUR
80MG Tablet 02481219 BIO-ATORVASTATIN BMI
ST80MG Tablet 02391082 JAMP-ATORVASTATIN JMP
ST80MG Tablet 02243097 LIPITOR UNK
ST80MG Tablet 02454041 MAR-ATORVASTATIN MAR
80MG Tablet 02471191 M-ATORVASTATIN MAN
ST80MG Tablet 02479532 MINT-ATORVASTATIN MIN
ST80MG Tablet 02392976 MYLAN-ATORVASTATIN MYL
80MG Tablet 02476541 NRA-ATORVASTATIN UNK
80MG Tablet 02482916 PRIVA-ATORVASTATIN PHA
ST80MG Tablet 02417960 REDDY-ATORVASTATIN REC
ST80MG Tablet 02422794 RIVA-ATORVASTATIN RIV
ST80MG Tablet 02324970 SANDOZ ATORVASTATIN SDZ
ST80MG Tablet 02313758 TARO-ATORVASTATIN SUN
ST80MG Tablet 02310929 TEVA-ATORVASTATIN TEV

FLUVASTATIN SODIUM

Table: FLUVASTATIN SODIUM
Drug strength and dosage form DIN Brand name Manufacturer code
ST20MG Capsule 02299224 TEVA-FLUVASTATIN TEV
ST40MG Capsule 02299232 TEVA-FLUVASTATIN TEV
ST80MG Tablet (Extended Release) 02250527 LESCOL XL NVR

LOVASTATIN

Table: LOVASTATIN
Drug strength and dosage form DIN Brand name Manufacturer code
ST20MG Tablet 02248572 ACT LOVASTATIN TEV
ST20MG Tablet 02220172 APO-LOVASTATIN APX
ST20MG Tablet 02353229 LOVASTATIN SAN
ST20MG Tablet 02246013 PMS-LOVASTATIN PMS
ST40MG Tablet 02248573 ACT LOVASTATIN TEV
ST40MG Tablet 02220180 APO-LOVASTATIN APX
ST40MG Tablet 02353237 LOVASTATIN SAN
ST40MG Tablet 02246014 PMS-LOVASTATIN PMS

PRAVASTATIN SODIUM

Table: PRAVASTATIN SODIUM
Drug strength and dosage form DIN Brand name Manufacturer code
ST10MG Tablet 02440644 ACH-PRAVASTATIN ACC
ST10MG Tablet 02243506 APO-PRAVASTATIN APX
ST10MG Tablet 02458977 AURO-PRAVASTATIN AUR
10MG Tablet 02446251 BIO-PRAVASTATIN BMI
ST10MG Tablet 02249723 DOM-PRAVASTATIN DPC
ST10MG Tablet 02330954 JAMP-PRAVASTATIN JMP
ST10MG Tablet 02432048 MAR-PRAVASTATIN MAR
ST10MG Tablet 02317451 MINT-PRAVASTATIN MIN
10MG Tablet 02476274 M-PRAVASTATIN MAN
ST10MG Tablet 02247655 PMS-PRAVASTATIN PMS
ST10MG Tablet 02356546 PRAVASTATIN SAN
ST10MG Tablet 02389703 PRAVASTATIN SIV
ST10MG Tablet 02243824 PRAVASTATIN-10 PDL
10MG Tablet 02445379 PRIVA-PRAVASTATIN PHA
ST10MG Tablet 02284421 RAN-PRAVASTATIN RBY
ST10MG Tablet 02468700 SANDOZ PRAVASTATIN SDZ
ST10MG Tablet 02247008 TEVA-PRAVASTATIN TEV
ST20MG Tablet 02440652 ACH-PRAVASTATIN ACC
ST20MG Tablet 02243507 APO-PRAVASTATIN APX
ST20MG Tablet 02458985 AURO-PRAVASTATIN AUR
20MG Tablet 02446278 BIO-PRAVASTATIN BMI
ST20MG Tablet 02249731 DOM-PRAVASTATIN DPC
ST20MG Tablet 02330962 JAMP-PRAVASTATIN JMP
ST20MG Tablet 02432056 MAR-PRAVASTATIN MAR
ST20MG Tablet 02317478 MINT-PRAVASTATIN MIN
20MG Tablet 02476282 M-PRAVASTATIN MAN
ST20MG Tablet 02247656 PMS-PRAVASTATIN PMS
ST20MG Tablet 00893757 PRAVACHOL BMS
ST20MG Tablet 02356554 PRAVASTATIN SAN
ST20MG Tablet 02389738 PRAVASTATIN SIV
ST20MG Tablet 02243825 PRAVASTATIN-20 PDL
20MG Tablet 02445395 PRIVA-PRAVASTATIN PHA
ST20MG Tablet 02284448 RAN-PRAVASTATIN RBY
ST20MG Tablet 02468719 SANDOZ PRAVASTATIN SDZ
ST20MG Tablet 02247009 TEVA-PRAVASTATIN TEV
ST40MG Tablet 02440660 ACH-PRAVASTATIN ACC
ST40MG Tablet 02243508 APO-PRAVASTATIN APX
ST40MG Tablet 02458993 AURO-PRAVASTATIN AUR
40MG Tablet 02446286 BIO-PRAVASTATIN BMI
ST40MG Tablet 02249758 DOM-PRAVASTATIN DPC
ST40MG Tablet 02330970 JAMP-PRAVASTATIN JMP
ST40MG Tablet 02432064 MAR-PRAVASTATIN MAR
ST40MG Tablet 02317486 MINT-PRAVASTATIN MIN
40MG Tablet 02476290 M-PRAVASTATIN MAN
ST40MG Tablet 02247657 PMS-PRAVASTATIN PMS
ST40MG Tablet 02222051 PRAVACHOL BMS
ST40MG Tablet 02356562 PRAVASTATIN SAN
ST40MG Tablet 02389746 PRAVASTATIN SIV
ST40MG Tablet 02243826 PRAVASTATIN-40 PDL
40MG Tablet 02445409 PRIVA-PRAVASTATIN PHA
ST40MG Tablet 02284456 RAN-PRAVASTATIN RBY
ST40MG Tablet 02468727 SANDOZ PRAVASTATIN SDZ
ST40MG Tablet 02247010 TEVA-PRAVASTATIN TEV

ROSUVASTATIN CALCIUM

Table: ROSUVASTATIN CALCIUM
Drug strength and dosage form DIN Brand name Manufacturer code
ST5MG Tablet 02438917 ACH-ROSUVASTATIN ACC
5MG Tablet 02477033 AG-ROSUVASTATIN ANG
ST5MG Tablet 02337975 APO-ROSUVASTATIN APX
ST5MG Tablet 02442574 AURO-ROSUVASTATIN AUR
5MG Tablet 02444968 BIO-ROSUVASTATIN BMI
ST5MG Tablet 02265540 CRESTOR AZC
ST5MG Tablet 02386704 DOM-ROSUVASTATIN DPC
ST5MG Tablet 02391252 JAMP-ROSUVASTATIN JMP
ST5MG Tablet 02413051 MAR-ROSUVASTATIN MAR
ST5MG Tablet 02399164 MED-ROSUVASTATIN GMP
5MG Tablet 02477483 NRA-ROSUVASTATIN UNK
ST5MG Tablet 02378523 PMS-ROSUVASTATIN PMS
5MG Tablet 02445417 PRIVA-ROSUVASTATIN PHA
ST5MG Tablet 02380013 RIVA-ROSUVASTATIN RIV
ST5MG Tablet 02381176 ROSUVASTATIN PDL
ST5MG Tablet 02405628 ROSUVASTATIN SAN
ST5MG Tablet 02411628 ROSUVASTATIN SIV
ST5MG Tablet 02338726 SANDOZ ROSUVASTATIN SDZ
ST5MG Tablet 02382644 TARO-ROSUVASTATIN SUN
ST5MG Tablet 02354608 TEVA-ROSUVASTATIN TEV
ST10MG Tablet 02438925 ACH-ROSUVASTATIN ACC
10MG Tablet 02477041 AG-ROSUVASTATIN ANG
ST10MG Tablet 02337983 APO-ROSUVASTATIN APX
ST10MG Tablet 02442582 AURO-ROSUVASTATIN AUR
10MG Tablet 02444976 BIO-ROSUVASTATIN BMI
ST10MG Tablet 02247162 CRESTOR AZC
ST10MG Tablet 02386712 DOM-ROSUVASTATIN DPC
ST10MG Tablet 02391260 JAMP-ROSUVASTATIN JMP
ST10MG Tablet 02413078 MAR-ROSUVASTATIN MAR
ST10MG Tablet 02399172 MED-ROSUVASTATIN GMP
10MG Tablet 02477491 NRA-ROSUVASTATIN UNK
ST10MG Tablet 02378531 PMS-ROSUVASTATIN PMS
10MG Tablet 02445425 PRIVA-ROSUVASTATIN PHA
ST10MG Tablet 02380056 RIVA-ROSUVASTATIN RIV
ST10MG Tablet 02381184 ROSUVASTATIN PDL
ST10MG Tablet 02405636 ROSUVASTATIN SAN
ST10MG Tablet 02411636 ROSUVASTATIN SIV
ST10MG Tablet 02338734 SANDOZ ROSUVASTATIN SDZ
ST10MG Tablet 02382652 TARO-ROSUVASTATIN SUN
ST10MG Tablet 02354616 TEVA-ROSUVASTATIN TEV
ST20MG Tablet 02438933 ACH-ROSUVASTATIN ACC
20MG Tablet 02477068 AG-ROSUVASTATIN ANG
ST20MG Tablet 02337991 APO-ROSUVASTATIN APX
ST20MG Tablet 02442590 AURO-ROSUVASTATIN AUR
20MG Tablet 02444984 BIO-ROSUVASTATIN BMI
ST20MG Tablet 02247163 CRESTOR AZC
ST20MG Tablet 02386720 DOM-ROSUVASTATIN DPC
ST20MG Tablet 02391279 JAMP-ROSUVASTATIN JMP
ST20MG Tablet 02413086 MAR-ROSUVASTATIN MAR
ST20MG Tablet 02399180 MED-ROSUVASTATIN GMP
20MG Tablet 02477505 NRA-ROSUVASTATIN UNK
ST20MG Tablet 02378558 PMS-ROSUVASTATIN PMS
20MG Tablet 02445433 PRIVA-ROSUVASTATIN PHA
ST20MG Tablet 02380064 RIVA-ROSUVASTATIN RIV
ST20MG Tablet 02381192 ROSUVASTATIN PDL
ST20MG Tablet 02405644 ROSUVASTATIN SAN
ST20MG Tablet 02411644 ROSUVASTATIN SIV
ST20MG Tablet 02338742 SANDOZ ROSUVASTATIN SDZ
ST20MG Tablet 02382660 TARO-ROSUVASTATIN SUN
ST20MG Tablet 02354624 TEVA-ROSUVASTATIN TEV
ST40MG Tablet 02438941 ACH-ROSUVASTATIN ACC
40MG Tablet 02477076 AG-ROSUVASTATIN ANG
ST40MG Tablet 02338009 APO-ROSUVASTATIN APX
ST40MG Tablet 02442604 AURO-ROSUVASTATIN AUR
40MG Tablet 02444992 BIO-ROSUVASTATIN BMI
ST40MG Tablet 02247164 CRESTOR AZC
ST40MG Tablet 02391287 JAMP-ROSUVASTATIN JMP
ST40MG Tablet 02413108 MAR-ROSUVASTATIN MAR
ST40MG Tablet 02399199 MED-ROSUVASTATIN GMP
40MG Tablet 02477513 NRA-ROSUVASTATIN UNK
ST40MG Tablet 02378566 PMS-ROSUVASTATIN PMS
ST40MG Tablet 02380102 RIVA-ROSUVASTATIN RIV
ST40MG Tablet 02381206 ROSUVASTATIN PDL
ST40MG Tablet 02405652 ROSUVASTATIN SAN
ST40MG Tablet 02411652 ROSUVASTATIN SIV
ST40MG Tablet 02338750 SANDOZ ROSUVASTATIN SDZ
ST40MG Tablet 02382679 TARO-ROSUVASTATIN SUN
ST40MG Tablet 02354632 TEVA-ROSUVASTATIN TEV

SIMVASTATIN

Table: SIMVASTATIN
Drug strength and dosage form DIN Brand name Manufacturer code
5MG Tablet 02480050 AG-SIMVASTATIN ANG
ST5MG Tablet 02247011 APO-SIMVASTATIN APX
ST5MG Tablet 02405148 AURO-SIMVASTATIN AUR
ST5MG Tablet 02253747 DOM-SIMVASTATIN DPC
ST5MG Tablet 02281619 DOM-SIMVASTATIN DPC
ST5MG Tablet 02375591 JAMP-SIMVASTATIN JMP
ST5MG Tablet 02375036 MAR-SIMVASTATIN MAR
ST5MG Tablet 02372932 MINT-SIMVASTATIN MIN
ST5MG Tablet 02469979 PHARMA-SIMVASTATIN PMS
ST5MG Tablet 02269252 PMS-SIMVASTATIN PMS
ST5MG Tablet 02247827 SANDOZ SIMVASTATIN SDZ
ST5MG Tablet 02386291 SIMVASTATIN SIV
ST5MG Tablet 02329131 TARO-SIMVASTATIN SUN
ST5MG Tablet 02250144 TEVA-SIMVASTATIN TEV
10MG Tablet 02480069 AG-SIMVASTATIN ANG
ST10MG Tablet 02247012 APO-SIMVASTATIN APX
ST10MG Tablet 02405156 AURO-SIMVASTATIN AUR
10MG Tablet 02484455 BIO-SIMVASTATIN BMI
ST10MG Tablet 02253755 DOM-SIMVASTATIN DPC
ST10MG Tablet 02281627 DOM-SIMVASTATIN DPC
ST10MG Tablet 02375605 JAMP-SIMVASTATIN JMP
ST10MG Tablet 02375044 MAR-SIMVASTATIN MAR
ST10MG Tablet 02372940 MINT-SIMVASTATIN MIN
ST10MG Tablet 02469987 PHARMA-SIMVASTATIN PMS
ST10MG Tablet 02269260 PMS-SIMVASTATIN PMS
10MG Tablet 02485745 PRIVA-SIMVASTATIN PHA
ST10MG Tablet 02247828 SANDOZ SIMVASTATIN SDZ
ST10MG Tablet 02386305 SIMVASTATIN SIV
ST10MG Tablet 02247221 SIMVASTATIN-10 PDL
ST10MG Tablet 02329158 TARO-SIMVASTATIN SUN
ST10MG Tablet 02250152 TEVA-SIMVASTATIN TEV
ST10MG Tablet 00884332 ZOCOR FRS
20MG Tablet 02480077 AG-SIMVASTATIN ANG
ST20MG Tablet 02247013 APO-SIMVASTATIN APX
ST20MG Tablet 02405164 AURO-SIMVASTATIN AUR
20MG Tablet 02484463 BIO-SIMVASTATIN BMI
ST20MG Tablet 02253763 DOM-SIMVASTATIN DPC
ST20MG Tablet 02281635 DOM-SIMVASTATIN DPC
ST20MG Tablet 02375613 JAMP-SIMVASTATIN JMP
ST20MG Tablet 02375052 MAR-SIMVASTATIN MAR
ST20MG Tablet 02372959 MINT-SIMVASTATIN MIN
ST20MG Tablet 02469995 PHARMA-SIMVASTATIN PMS
ST20MG Tablet 02269279 PMS-SIMVASTATIN PMS
20MG Tablet 02485753 PRIVA-SIMVASTATIN PHA
ST20MG Tablet 02247830 SANDOZ SIMVASTATIN SDZ
ST20MG Tablet 02386313 SIMVASTATIN SIV
ST20MG Tablet 02247222 SIMVASTATIN-20 PDL
ST20MG Tablet 02329166 TARO-SIMVASTATIN SUN
ST20MG Tablet 02250160 TEVA-SIMVASTATIN TEV
ST20MG Tablet 00884340 ZOCOR FRS
40MG Tablet 02480085 AG-SIMVASTATIN ANG
ST40MG Tablet 02247014 APO-SIMVASTATIN APX
ST40MG Tablet 02405172 AURO-SIMVASTATIN AUR
40MG Tablet 02484471 BIO-SIMVASTATIN BMI
ST40MG Tablet 02253771 DOM-SIMVASTATIN DPC
ST40MG Tablet 02281643 DOM-SIMVASTATIN DPC
ST40MG Tablet 02375621 JAMP-SIMVASTATIN JMP
ST40MG Tablet 02375060 MAR-SIMVASTATIN MAR
ST40MG Tablet 02372967 MINT-SIMVASTATIN MIN
ST40MG Tablet 02470004 PHARMA-SIMVASTATIN PMS
ST40MG Tablet 02269287 PMS-SIMVASTATIN PMS
40MG Tablet 02485761 PRIVA-SIMVASTATIN PHA
ST40MG Tablet 02247831 SANDOZ SIMVASTATIN SDZ
ST40MG Tablet 02386321 SIMVASTATIN SIV
ST40MG Tablet 02247223 SIMVASTATIN-40 PDL
ST40MG Tablet 02329174 TARO-SIMVASTATIN SUN
ST40MG Tablet 02250179 TEVA-SIMVASTATIN TEV
ST40MG Tablet 00884359 ZOCOR FRS
80MG Tablet 02480093 AG-SIMVASTATIN ANG
ST80MG Tablet 02247015 APO-SIMVASTATIN APX
ST80MG Tablet 02405180 AURO-SIMVASTATIN AUR
ST80MG Tablet 02253798 DOM-SIMVASTATIN DPC
ST80MG Tablet 02281651 DOM-SIMVASTATIN DPC
ST80MG Tablet 02375648 JAMP-SIMVASTATIN JMP
ST80MG Tablet 02375079 MAR-SIMVASTATIN MAR
ST80MG Tablet 02372975 MINT-SIMVASTATIN MIN
80MG Tablet 02470012 PHARMA-SIMVASTATIN PMS
ST80MG Tablet 02269295 PMS-SIMVASTATIN PMS
ST80MG Tablet 02247833 SANDOZ SIMVASTATIN SDZ
ST80MG Tablet 02386348 SIMVASTATIN SIV
ST80MG Tablet 02247224 SIMVASTATIN-80 PDL
ST80MG Tablet 02329182 TARO-SIMVASTATIN SUN
ST80MG Tablet 02250187 TEVA-SIMVASTATIN TEV

24:06.24 

ALIROCUMAB

Limited use benefit (prior approval required).

Initial Coverage (12 weeks):

  • For adult patients with heterozygous familial hypercholesterolemia (HeFH) who require additional lowering of low-density lipoprotein cholesterol (LDL-C) if the following clinical criteria are met:
  • definite or probable diagnosis of HeFH using the Simon Broome or Dutch Lipid Network criteria or genetic testing;
  • and

Patient is unable to reach an LDL-C target of < 2.0 mmol/L for secondary CVD prevention, or at least a 50% reduction in LDL-C from untreated baseline for primary prevention despite:

  • confirmed adherence to a high-dose statin (e.g., atorvastatin 80 mg or rosuvastatin 40 mg) in combination with ezetimibe for a total of at least 3 months of continuous treatment;
  • or
  • patient is unable to tolerate at least two statins, with at least one statin initiated at the lowest daily starting dose; and
  • for each statin (two statins in total), dose reduction was attempted to resolve intolerable myopathy or creatine kinase > 5 times the upper limit of normal rather than statin discontinuation; and
  • for each statin (two statins in total), intolerable myopathy or creatine kinase > 5 times the upper limit of normal was reversed upon statin discontinuation, but reoccurred with statin rechallenge where clinically appropriate; and
  • confirmed adherence to ezetimibe for a total of at least 3 months continuous treatment; and
  • other known determinants of intolerable symptoms or abnormal biomarkers have been ruled out;
  • or
  • patient developed confirmed and documented rhabdomyolysis;
  • or
  • patient has a contraindication to statins; and
  • confirmed adherence to ezetimibe for a total of at least 3 months continuous treatment.

Continued coverage (6 months):

  • patient is adherent to therapy; and
  • patient has achieved a reduction in LDL-C of at least 40% from baseline.
  • Note: Annual coverage is limited to 26 prefilled syringes or prefilled pens per year.
Table: ALIROCUMAB
Drug strength and dosage form DIN Brand name Manufacturer code
75MG Solution 02453754 PRALUENT SAC
75MG Solution 02453819 PRALUENT SAC
150MG Solution 02453762 PRALUENT SAC
150MG Solution 02453835 PRALUENT SAC

EVOLOCUMAB

Limited use benefit (prior approval required).

Initial coverage criteria (Initial approval for 12 weeks):

For adult patients with heterozygous familial hypercholesterolemia (HeFH) who require additional lowering of low-density lipoprotein cholesterol (LDL-C) if the following clinical criteria are met:

  • definite or probable diagnosis of HeFH using the Simon Broome or Dutch Lipid Network criteria or genetic testing; and
  • patient is unable to reach an LDL-C target of < 2.0 mmol/L for secondary CVD prevention, or at least a 50% reduction in LDL-C from untreated baseline for primary prevention despite:
  • confirmed adherence to a high-dose statin (e.g., atorvastatin 80 mg or rosuvastatin 40 mg) in combination with ezetimibe for a total of at least 3 months of continuous treatment;
  • or
  • patient is unable to tolerate at least two statins, with at least one statin initiated at the lowest daily starting dose; and
  • for each statin (two statins in total), dose reduction was attempted to resolve intolerable myopathy or creatine kinase > 5 times the upper limit of normal rather than statin discontinuation; and
  • for each statin (two statins in total), intolerable myopathy or creatine kinase > 5 times the upper limit of normal was reversed upon statin discontinuation, but reoccurred with statin rechallenge where clinically appropriate; and
  • confirmed adherence to ezetimibe for a total of at least 3 months continuous treatment; and
  • other known determinants of intolerable symptoms or abnormal biomarkers have been ruled out;
  • or
  • patient developed confirmed and documented rhabdomyolysis;
  • or
  • patient has a contraindication to statins; and
  • confirmed adherence to ezetimibe for a total of at least 3 months continuous treatment.

Note: Annual coverage is limited to 26 prefilled autoinjectors (140 mg every 2 weeks) or 12 automated Mini-Dosers with prefilled cartridges (420 mg once a month).

Renewal coverage criteria (Renewal for 6 months):

  • patient is adherent to therapy; and
  • patient has achieved a reduction in LDL-C of at least 40% from baseline.

Note: Annual coverage is limited to 26 prefilled Autoinjectors (140 mg every 2 weeks) or 12 automated Mini-Dosers with prefilled cartridges (420 mg once a month).

Table: EVOLOCUMAB
Drug strength and dosage form DIN Brand name Manufacturer code
120MG Solution 02459779 REPATHA AMG
140MG Solution 02446057 REPATHA AMG

24:08.16 CENTRAL ALPHA-AGONISTS

CLONIDINE HYDROCHLORIDE

Table: CLONIDINE HYDROCHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST0.025MG Tablet 02304163 TEVA-CLONIDINE TEV
ST0.1MG Tablet 02462192 MINT-CLONIDINE MIN
ST0.1MG Tablet 02046121 TEVA-CLONIDINE TEV
ST0.2MG Tablet 00868957 APO-CLONIDINE APX
ST0.2MG Tablet 02462206 MINT-CLONIDINE MIN
ST0.2MG Tablet 02046148 TEVA-CLONIDINE TEV
ST pDIN For Extemporaneous Mixture 99503021 CLONIDINE ORAL LIQUID UNK

METHYLDOPA

Table: METHYLDOPA
Drug strength and dosage form DIN Brand name Manufacturer code
ST125MG Tablet 00360252 METHYLDOPA AAP
ST250MG Tablet 00360260 METHYLDOPA AAP
ST500MG Tablet 00426830 METHYLDOPA AAP

24:08.20 DIRECT VASODILATORS

DIAZOXIDE

Table: DIAZOXIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST100MG Capsule 00503347 PROGLYCEM FRS

HYDRALAZINE HYDROCHLORIDE

Table: HYDRALAZINE HYDROCHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST10MG Tablet 00441619 APO-HYDRALAZINE APX
ST10MG Tablet 02457865 JAMP-HYDRALAZINE JMP
ST10MG Tablet 02468778 MINT-HYDRALAZINE MIN
ST25MG Tablet 00441627 APO-HYDRALAZINE APX
ST25MG Tablet 02457873 JAMP-HYDRALAZINE JMP
ST25MG Tablet 02468786 MINT-HYDRALAZINE MIN
ST50MG Tablet 00441635 APO-HYDRALAZINE APX
ST50MG Tablet 02457881 JAMP-HYDRALAZINE JMP
ST50MG Tablet 02468794 MINT-HYDRALAZINE MIN

MINOXIDIL

Table: MINOXIDIL
Drug strength and dosage form DIN Brand name Manufacturer code
ST2.5MG Tablet 00514497 LONITEN PFI
ST10MG Tablet 00514500 LONITEN PFI

24:12.08 NITRATES AND NITRITES

ISOSORBIDE DINITRATE

Table: ISOSORBIDE DINITRATE
Drug strength and dosage form DIN Brand name Manufacturer code
ST5MG Tablet 00670944 ISDN AAP
ST10MG Tablet 00441686 ISDN AAP
ST10MG Tablet 00786667 PMS-ISOSORBIDE PMS
ST30MG Tablet 00441694 ISDN AAP

ISOSORBIDE-5-MONONITRATE

Table: ISOSORBIDE-5-MONONITRATE
Drug strength and dosage form DIN Brand name Manufacturer code
ST60MG Tablet (Extended Release) 02272830 APO-ISMN APX
ST60MG Tablet (Extended Release) 02126559 IMDUR UNK
ST60MG Tablet (Extended Release) 02301288 PMS-ISMN PMS
ST60MG Tablet (Extended Release) 02311321 PRO-ISMN PDL

NITROGLYCERIN

Table: NITROGLYCERIN
Drug strength and dosage form DIN Brand name Manufacturer code
ST0.2MG Patch 02162806 MINITRAN VAE
ST0.2MG Patch 02407442 MYLAN-NITRO MYL
ST0.2MG Patch 01911910 NITRO-DUR FRS
ST0.2MG Patch 00584223 TRANSDERM-NITRO NVR
ST0.2MG Patch 02230732 TRINIPATCH PAL
ST0.4MG Patch 02163527 MINITRAN VAE
ST0.4MG Patch 02407450 MYLAN-NITRO MYL
ST0.4MG Patch 01911902 NITRO-DUR FRS
ST0.4MG Patch 00852384 TRANSDERM-NITRO NVR
ST0.4MG Patch 02230733 TRINIPATCH PAL
ST0.6MG Patch 02163535 MINITRAN VAE
ST0.6MG Patch 02407469 MYLAN-NITRO MYL
ST0.6MG Patch 01911929 NITRO-DUR FRS
ST0.6MG Patch 02046156 TRANSDERM-NITRO NVR
ST0.6MG Patch 02230734 TRINIPATCH PAL
ST0.8MG Patch 02407477 MYLAN-NITRO MYL
ST0.8MG Patch 02011271 NITRO-DUR FRS
0.4MG Pump 02243588 MYLAN-NITRO MYL
0.4MG Pump 02231441 NITROLINGUAL PUMPSPRAY SAC
0.4MG Pump 02238998 RHO-NITRO PUMPSPRAY SDZ
ST0.3MG Tablet 00037613 NITROSTAT PFI
ST0.6MG Tablet 00037621 NITROSTAT PFI

24:12.12 PHOSPHODIESTERASE INHIBITORS

SILDENAFIL CITRATE

Limited use benefit (prior approval required).

Must be initiated by a Pulmonary Hypertension specialist

Patients with World Health Organization (WHO) class III pulmonary artery hypertension (PAH), either idiopathic (i.e. primary) or associated with a congenital or systemic condition (e.g. connective tissue disease) and confirmed by right heart catheterization.

Table: SILDENAFIL CITRATE
Drug strength and dosage form DIN Brand name Manufacturer code
ST20MG Tablet 02418118 APO-SILDENAFIL R APX
ST20MG Tablet 02412179 PMS-SILDENAFIL R PMS
ST20MG Tablet 02279401 REVATIO UNK
ST20MG Tablet 02319500 TEVA-SILDENAFIL R TEV

TADALAFIL

Limited use benefit (prior approval required).

Must be initiated by a Pulmonary Hypertension specialist

Patients with World Health Organization (WHO) class III pulmonary artery hypertension (PAH), either idiopathic (i.e. primary) or associated with a congenital or systemic condition (e.g. connective tissue disease) and confirmed by right heart catheterization.

Table: TADALAFIL
Drug strength and dosage form DIN Brand name Manufacturer code
ST20MG Tablet 02338327 ADCIRCA LIL
ST20MG Tablet 02421933 APO-TADALAFIL PAH APX

24:12.92 MISCELLANEOUS VASODILATING AGENTS

AMBRISENTAN

Limited use benefit (prior approval required).

Maximum dose covered is 10 mg once daily.

Patients with World Health Organization (WHO) class III pulmonary artery hypertension (PAH), either idiopathic (i.e. primary) or associated with a congenital or systemic condition (e.g. connective tissue disease) and confirmed by right heart catheterization; and

  • who have failed to respond to sildenafil or tadalafil; or
  • who have contraindications to sildenafil or tadalafil.
Table: AMBRISENTAN
Drug strength and dosage form DIN Brand name Manufacturer code
ST5MG Tablet 02307065 VOLIBRIS GSK
ST10MG Tablet 02307073 VOLIBRIS GSK

BOSENTAN MONOHYDRATE

Limited use benefit (prior approval required).

Maximum dose covered is 125 mg twice daily

Patients with World Health Organization (WHO) class III pulmonary artery hypertension (PAH), either idiopathic (i.e. primary) or associated with a congenital or systemic condition (e.g. connective tissue disease) and confirmed by right heart catheterization; and

  • who have failed to respond to sildenafil or tadalafil; or
  • who have contraindications to sildenafil or tadalafil.
Table: BOSENTAN MONOHYDRATE
Drug strength and dosage form DIN Brand name Manufacturer code
ST62.5MG Tablet 02399202 APO-BOSENTAN APX
ST62.5MG Tablet 02383012 PMS-BOSENTAN PMS
ST62.5MG Tablet 02386275 SANDOZ BOSENTAN SDZ
ST62.5MG Tablet 02398400 TEVA-BOSENTAN TEV
ST62.5MG Tablet 02244981 TRACLEER JSO
ST125MG Tablet 02383020 PMS-BOSENTAN PMS
ST125MG Tablet 02386283 SANDOZ BOSENTAN SDZ
ST125MG Tablet 02244982 TRACLEER JSO

DIPYRIDAMOLE

Table: DIPYRIDAMOLE
Drug strength and dosage form DIN Brand name Manufacturer code
ST25MG Tablet 00895644 APO-DIPYRIDAMOLE APX
ST50MG Tablet 00571245 APO-DIPYRIDAMOLE APX
ST50MG Tablet 00895652 APO-DIPYRIDAMOLE APX
ST75MG Tablet 00601845 APO-DIPYRIDAMOLE APX
ST75MG Tablet 00895660 APO-DIPYRIDAMOLE APX

DIPYRIDAMOLE, ACETYLSALICYLIC ACID

Table: DIPYRIDAMOLE, ACETYLSALICYLIC ACID
Drug strength and dosage form DIN Brand name Manufacturer code
ST200MG & 25MG Capsule (Immediate And Extended Release) 02471051 TARO-DIPYRIDAMOLE/ ASA TAR

24:20.00 ALPHA ADRENERGIC BLOCKING AGENTS

DOXAZOSIN MESYLATE

Table: DOXAZOSIN MESYLATE
Drug strength and dosage form DIN Brand name Manufacturer code
ST1MG Tablet 02240588 APO-DOXAZOSIN APX
ST1MG Tablet 02244527 PMS-DOXAZOSIN PMS
ST1MG Tablet 02242728 TEVA-DOXAZOSIN TEV
ST2MG Tablet 02240589 APO-DOXAZOSIN APX
ST2MG Tablet 02244528 PMS-DOXAZOSIN PMS
ST2MG Tablet 02242729 TEVA-DOXAZOSIN TEV
ST4MG Tablet 02240590 APO-DOXAZOSIN APX
ST4MG Tablet 02244529 PMS-DOXAZOSIN PMS
ST4MG Tablet 02242730 TEVA-DOXAZOSIN TEV

PRAZOSIN HYDROCHLORIDE

Table: PRAZOSIN HYDROCHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST1MG Tablet 00882801 APO-PRAZO APX
ST1MG Tablet 01934198 TEVA-PRAZOSIN TEV
ST2MG Tablet 00882828 APO-PRAZO APX
ST2MG Tablet 01934201 TEVA-PRAZOSIN TEV
ST5MG Tablet 00882836 APO-PRAZO APX
ST5MG Tablet 01934228 TEVA-PRAZOSIN TEV

TERAZOSIN HYDROCHLORIDE

Table: TERAZOSIN HYDROCHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST1MG Tablet 02234502 APO-TERAZOSIN APX
ST1MG Tablet 02243746 DOM-TERAZOSIN DPC
ST1MG Tablet 02243518 PMS-TERAZOSIN PMS
ST1MG Tablet 02237476 TERAZOSIN PDL
ST1MG Tablet 02350475 TERAZOSIN SAN
ST1MG Tablet 02230805 TEVA-TERAZOSIN TEV
ST2MG Tablet 02234503 APO-TERAZOSIN APX
ST2MG Tablet 02243747 DOM-TERAZOSIN DPC
ST2MG Tablet 02243519 PMS-TERAZOSIN PMS
ST2MG Tablet 02237477 TERAZOSIN PDL
ST2MG Tablet 02350483 TERAZOSIN SAN
ST2MG Tablet 02230806 TEVA-TERAZOSIN TEV
ST5MG Tablet 02234504 APO-TERAZOSIN APX
ST5MG Tablet 02243748 DOM-TERAZOSIN DPC
ST5MG Tablet 02243520 PMS-TERAZOSIN PMS
ST5MG Tablet 02237478 TERAZOSIN PDL
ST5MG Tablet 02350491 TERAZOSIN SAN
ST5MG Tablet 02230807 TEVA-TERAZOSIN TEV
ST10MG Tablet 02234505 APO-TERAZOSIN APX
ST10MG Tablet 02243749 DOM-TERAZOSIN DPC
ST10MG Tablet 02243521 PMS-TERAZOSIN PMS
ST10MG Tablet 02237479 TERAZOSIN PDL
ST10MG Tablet 02350505 TERAZOSIN SAN
ST10MG Tablet 02230808 TEVA-TERAZOSIN TEV

24:24.00 BETA ADRENERGIC BLOCKING AGENTS

ACEBUTOLOL HYDROCHLORIDE

Table: ACEBUTOLOL HYDROCHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST100MG Tablet 02164396 ACEBUTOLOL PDL
ST100MG Tablet 02147602 APO-ACEBUTOLOL APX
ST100MG Tablet 02204517 TEVA-ACEBUTOLOL TEV
ST200MG Tablet 02164418 ACEBUTOLOL PDL
ST200MG Tablet 02147610 APO-ACEBUTOLOL APX
ST200MG Tablet 02204525 TEVA-ACEBUTOLOL TEV
ST400MG Tablet 02164426 ACEBUTOLOL PDL
ST400MG Tablet 02147629 APO-ACEBUTOLOL APX
ST400MG Tablet 02204533 TEVA-ACEBUTOLOL TEV

ATENOLOL

Table: ATENOLOL
Drug strength and dosage form DIN Brand name Manufacturer code
25MG Tablet 02369176 AG-ATENOLOL ANG
ST25MG Tablet 02326701 ATENOLOL PDL
ST25MG Tablet 02392194 BIO-ATENOLOL BMI
ST25MG Tablet 02367556 JAMP-ATENOLOL JMP
ST25MG Tablet 02371979 MAR-ATENOLOL MAR
ST25MG Tablet 02368013 MINT-ATENOL MIN
ST25MG Tablet 02246581 PMS-ATENOLOL PMS
ST25MG Tablet 02277379 RIVA-ATENOLOL RIV
ST25MG Tablet 02368633 SEPTA-ATENOLOL SPT
ST25MG Tablet 02373963 TARO-ATENOLOL SUN
ST25MG Tablet 02266660 TEVA-ATENOLOL TEV
ST50MG Tablet 02255545 ACT ATENOLOL ACG
50MG Tablet 02369184 AG-ATENOLOL ANG
ST50MG Tablet 00773689 APO-ATENOL APX
ST50MG Tablet 00828807 ATENOLOL PDL
ST50MG Tablet 02238316 ATENOLOL SIV
ST50MG Tablet 02466465 ATENOLOL SAN
ST50MG Tablet 02392178 BIO-ATENOLOL BMI
ST50MG Tablet 02229467 DOM-ATENOLOL DPC
ST50MG Tablet 02367564 JAMP-ATENOLOL JMP
ST50MG Tablet 02371987 MAR-ATENOLOL MAR
ST50MG Tablet 02368021 MINT-ATENOL MIN
ST50MG Tablet 02237600 PMS-ATENOLOL PMS
ST50MG Tablet 02242094 RIVA-ATENOLOL RIV
ST50MG Tablet 02368641 SEPTA-ATENOLOL SPT
ST50MG Tablet 02267985 TARO-ATENOLOL SUN
ST50MG Tablet 02039532 TENORMIN AZC
ST50MG Tablet 02171791 TEVA-ATENOLOL TEV
ST100MG Tablet 02255553 ACT ATENOLOL ACG
100MG Tablet 02369192 AG-ATENOLOL ANG
ST100MG Tablet 00773697 APO-ATENOL APX
ST100MG Tablet 00828793 ATENOLOL PDL
ST100MG Tablet 02238318 ATENOLOL SIV
ST100MG Tablet 02466473 ATENOLOL SAN
ST100MG Tablet 02392186 BIO-ATENOLOL BMI
ST100MG Tablet 02229468 DOM-ATENOLOL DPC
ST100MG Tablet 02367572 JAMP-ATENOLOL JMP
ST100MG Tablet 02371995 MAR-ATENOLOL MAR
ST100MG Tablet 02368048 MINT-ATENOL MIN
ST100MG Tablet 02237601 PMS-ATENOLOL PMS
ST100MG Tablet 02242093 RIVA-ATENOLOL RIV
ST100MG Tablet 02368668 SEPTA-ATENOLOL SPT
ST100MG Tablet 02267993 TARO-ATENOLOL SUN
ST100MG Tablet 02039540 TENORMIN AZC
ST100MG Tablet 02171805 TEVA-ATENOLOL TEV

ATENOLOL, CHLORTHALIDONE

Table: ATENOLOL, CHLORTHALIDONE
Drug strength and dosage form DIN Brand name Manufacturer code
ST50MG & 25MG Tablet 02248763 AA-ATENIDONE AAP
ST50MG & 25MG Tablet 02049961 TENORETIC AZC
ST100MG & 25MG Tablet 02248764 AA-ATENIDONE APX
ST100MG & 25MG Tablet 02049988 TENORETIC AZC

BISOPROLOL FUMARATE

Table: BISOPROLOL FUMARATE
Drug strength and dosage form DIN Brand name Manufacturer code
ST5MG Tablet 02256134 APO-BISOPROLOL APX
ST5MG Tablet 02383055 BISOPROLOL SIV
ST5MG Tablet 02391589 BISOPROLOL SAN
ST5MG Tablet 02465612 MINT-BISOPROLOL MIN
ST5MG Tablet 02302632 PMS-BISOPROLOL PMS
ST5MG Tablet 02306999 PRO-BISOPROLOL PDL
5MG Tablet 02471264 RIVA-BISOPROLOL RIV
ST5MG Tablet 02247439 SANDOZ BISOPROLOL SDZ
ST5MG Tablet 02494035 SANDOZ BISOPROLOL SDZ
ST5MG Tablet 02267470 TEVA-BISOPROLOL TEV
ST10MG Tablet 02256177 APO-BISOPROLOL APX
ST10MG Tablet 02383063 BISOPROLOL SIV
ST10MG Tablet 02391597 BISOPROLOL SAN
ST10MG Tablet 02465620 MINT-BISOPROLOL MIN
ST10MG Tablet 02302640 PMS-BISOPROLOL PMS
ST10MG Tablet 02307006 PRO-BISOPROLOL PDL
10MG Tablet 02471272 RIVA-BISOPROLOL RIV
ST10MG Tablet 02247440 SANDOZ BISOPROLOL SDZ
ST10MG Tablet 02494043 SANDOZ BISOPROLOL SDZ
ST10MG Tablet 02267489 TEVA-BISOPROLOL TEV

CARVEDILOL

Table: CARVEDILOL
Drug strength and dosage form DIN Brand name Manufacturer code
ST3.125MG Tablet 02247933 APO-CARVEDILOL APX
ST3.125MG Tablet 02418495 AURO-CARVEDILOL AUR
ST3.125MG Tablet 02248752 CARVEDILOL SIV
ST3.125MG Tablet 02324504 CARVEDILOL PDL
ST3.125MG Tablet 02364913 CARVEDILOL SAN
ST3.125MG Tablet 02248748 DOM-CARVEDILOL DPC
ST3.125MG Tablet 02368897 JAMP-CARVEDILOL JMP
ST3.125MG Tablet 02245914 PMS-CARVEDILOL PMS
ST3.125MG Tablet 02268027 RAN-CARVEDILOL RBY
ST3.125MG Tablet 02252309 TEVA-CARVEDILOL TEV
ST6.25MG Tablet 02247934 APO-CARVEDILOL APX
ST6.25MG Tablet 02418509 AURO-CARVEDILOL AUR
ST6.25MG Tablet 02248753 CARVEDILOL SIV
ST6.25MG Tablet 02324512 CARVEDILOL PDL
ST6.25MG Tablet 02364921 CARVEDILOL SAN
ST6.25MG Tablet 02248749 DOM-CARVEDILOL DPC
ST6.25MG Tablet 02368900 JAMP-CARVEDILOL JMP
ST6.25MG Tablet 02245915 PMS-CARVEDILOL PMS
ST6.25MG Tablet 02268035 RAN-CARVEDILOL RBY
ST6.25MG Tablet 02252317 TEVA-CARVEDILOL TEV
ST12.5MG Tablet 02247935 APO-CARVEDILOL APX
ST12.5MG Tablet 02418517 AURO-CARVEDILOL AUR
ST12.5MG Tablet 02248754 CARVEDILOL SIV
ST12.5MG Tablet 02324520 CARVEDILOL PDL
ST12.5MG Tablet 02364948 CARVEDILOL SAN
ST12.5MG Tablet 02248750 DOM-CARVEDILOL DPC
ST12.5MG Tablet 02368919 JAMP-CARVEDILOL JMP
ST12.5MG Tablet 02245916 PMS-CARVEDILOL PMS
ST12.5MG Tablet 02268043 RAN-CARVEDILOL RBY
ST12.5MG Tablet 02252325 TEVA-CARVEDILOL TEV
ST25MG Tablet 02247936 APO-CARVEDILOL APX
ST25MG Tablet 02418525 AURO-CARVEDILOL AUR
ST25MG Tablet 02248755 CARVEDILOL SIV
ST25MG Tablet 02324539 CARVEDILOL PDL
ST25MG Tablet 02364956 CARVEDILOL SAN
ST25MG Tablet 02248751 DOM-CARVEDILOL DPC
ST25MG Tablet 02368927 JAMP-CARVEDILOL JMP
ST25MG Tablet 02245917 PMS-CARVEDILOL PMS
ST25MG Tablet 02268051 RAN-CARVEDILOL RBY
ST25MG Tablet 02252333 TEVA-CARVEDILOL TEV

HYDROCHLOROTHIAZIDE, PINDOLOL

Table: HYDROCHLOROTHIAZIDE, PINDOLOL
Drug strength and dosage form DIN Brand name Manufacturer code
ST10MG & 25MG Tablet 00568627 VISKAZIDE UNK
ST10MG & 50MG Tablet 00568635 VISKAZIDE UNK

LABETALOL HYDROCHLORIDE

Table: LABETALOL HYDROCHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST100MG Tablet 02489406 RIVA-LABETALOL RIV
ST100MG Tablet 02106272 TRANDATE PAL
ST200MG Tablet 02489414 RIVA-LABETALOL RIV
ST200MG Tablet 02106280 TRANDATE PAL

METOPROLOL TARTRATE

Table: METOPROLOL TARTRATE
Drug strength and dosage form DIN Brand name Manufacturer code
ST25MG Tablet 02246010 APO-METOPROLOL APX
ST25MG Tablet 02252252 DOM-METOPROLOL-L DPC
ST25MG Tablet 02356813 JAMP-METOPROLOL-L JMP
ST25MG Tablet 02296713 METOPROLOL PDL
ST25MG Tablet 02248855 PMS-METOPROLOL-L PMS
ST25MG Tablet 02315300 RIVA-METOPROLOL L RIV
ST25MG Tablet 02261898 TEVA-METOPROLOL TEV
ST50MG Tablet 00618632 APO METOPROLOL APX
ST50MG Tablet 00749354 APO METOPROLOL (TYPE L) APX
ST50MG Tablet 02172550 DOM-METOPROLOL-B DPC
ST50MG Tablet 02231121 DOM-METOPROLOL-L DPC
ST50MG Tablet 02356821 JAMP-METOPROLOL-L JMP
ST50MG Tablet 00648019 METOPROLOL PDL
ST50MG Tablet 02350394 METOPROLOL SAN
ST50MG Tablet 02442124 METOPROLOL-L SIV
ST50MG Tablet 02145413 PMS-METOPROLOL-B PMS
ST50MG Tablet 02230803 PMS-METOPROLOL-L PMS
ST50MG Tablet 02315319 RIVA-METOPROLOL L RIV
ST50MG Tablet 00648035 TEVA-METOPROLOL TEV
ST50MG Tablet 00842648 TEVA-METOPROLOL TEV
ST100MG Tablet 00618640 APO METOPROLOL APX
ST100MG Tablet 00751170 APO-METOPROLOL (TYPE L) APX
ST100MG Tablet 02172569 DOM-METOPROLOL-B DPC
ST100MG Tablet 02231122 DOM-METOPROLOL-L DPC
ST100MG Tablet 02356848 JAMP-METOPROLOL-L JMP
ST100MG Tablet 00648027 METOPROLOL PDL
ST100MG Tablet 02350408 METOPROLOL SAN
ST100MG Tablet 02442132 METOPROLOL-L SIV
ST100MG Tablet 02145421 PMS-METOPROLOL-B PMS
ST100MG Tablet 02230804 PMS-METOPROLOL-L PMS
ST100MG Tablet 02315327 RIVA-METOPROLOL L RIV
ST100MG Tablet 00648043 TEVA-METOPROLOL TEV
ST100MG Tablet 00842656 TEVA-METOPROLOL TEV
ST100MG Tablet (Extended Release) 02285169 APO-METOPROLOL SR APX
ST100MG Tablet (Extended Release) 00658855 LOPRESOR SR NVR
ST100MG Tablet (Extended Release) 02351404 METOPROLOL SR PDL
ST100MG Tablet (Extended Release) 02303396 SANDOZ METOPROLOL SR SDZ
ST200MG Tablet (Extended Release) 02285177 APO-METOPROLOL SR APX
ST200MG Tablet (Extended Release) 00534560 LOPRESOR SR NVR
ST200MG Tablet (Extended Release) 02303418 SANDOZ METOPROLOL SR SDZ
ST pDIN For Extemporaneous Mixture 99503015 METOPROLOL ORAL LIQUID UNK

NADOLOL

Table: NADOLOL
Drug strength and dosage form DIN Brand name Manufacturer code
ST40MG Tablet 00782505 NADOLOL AAP
ST80MG Tablet 00782467 NADOLOL AAP
ST160MG Tablet 00782475 NADOLOL AAP

PINDOLOL

Table: PINDOLOL
Drug strength and dosage form DIN Brand name Manufacturer code
ST5MG Tablet 00755877 APO-PINDOL APX
ST5MG Tablet 00869007 TEVA-PINDOLOL TEV
ST5MG Tablet 00417270 VISKEN UNK
ST10MG Tablet 00755885 APO-PINDOL APX
ST10MG Tablet 00869015 TEVA-PINDOLOL TEV
ST10MG Tablet 00443174 VISKEN UNK
ST15MG Tablet 00755893 APO-PINDOL APX
ST15MG Tablet 02238047 DOM-PINDOLOL DPC
ST15MG Tablet 00869023 TEVA-PINDOLOL TEV

PROPRANOLOL (HEMANGIOL)

Limited use benefit (prior approval required).

For the treatment of proliferating infantile hemangioma requiring systemic therapy and at least one of the following:

  • life or function-threatening hemangioma; or
  • ulcerated hemangioma with pain and/or lack of response to simple wound care measures; or
  • hemangioma with a risk of permanent scarring or disfigurement.
Table: PROPRANOLOL (HEMANGIOL)
Drug strength and dosage form DIN Brand name Manufacturer code
3.75MG Solution 02457857 HEMANGIOL PFD

PROPRANOLOL HYDROCHLORIDE

Table: PROPRANOLOL HYDROCHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST60MG Capsule (Sustained Release) 02042231 INDERAL LA PFI
ST80MG Capsule (Sustained Release) 02042258 INDERAL LA PFI
ST120MG Capsule (Sustained Release) 02042266 INDERAL LA PFI
ST160MG Capsule (Sustained Release) 02042274 INDERAL LA PFI
ST10MG Tablet 00496480 TEVA-PROPRANOLOL TEV
ST20MG Tablet 00740675 TEVA-PROPRANOLOL TEV
ST40MG Tablet 00496499 TEVA-PROPRANOLOL TEV
ST80MG Tablet 00582271 PMS-PROPRANOLOL PMS
ST80MG Tablet 00496502 TEVA-PROPRANOLOL TEV
ST120MG Tablet 00504335 APO PROPRANOLOL APX
ST120MG Tablet 00582298 PMS-PROPRANOLOL PMS
ST pDIN For Extemporaneous Mixture 99503014 PROPRANOLOL ORAL LIQUID UNK

SOTALOL HYDROCHLORIDE

Table: SOTALOL HYDROCHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST80MG Tablet 02210428 APO-SOTALOL APX
ST80MG Tablet 02238634 DOM-SOTALOL DPC
ST80MG Tablet 02368617 JAMP-SOTALOL JMP
ST80MG Tablet 02238326 PMS-SOTALOL PMS
ST80MG Tablet 02316528 PRO-SOTALOL PDL
80MG Tablet 02272164 RIVA-SOTALOL RIV
ST160MG Tablet 02167794 APO-SOTALOL APX
ST160MG Tablet 02238635 DOM-SOTALOL DPC
ST160MG Tablet 02368625 JAMP-SOTALOL JMP
ST160MG Tablet 02238327 PMS-SOTALOL PMS
ST160MG Tablet 02316536 PRO-SOTALOL PDL
ST pDIN For Extemporaneous Mixture 99503023 SOTALOL ORAL LIQUID UNK

TIMOLOL MALEATE

Table: TIMOLOL MALEATE
Drug strength and dosage form DIN Brand name Manufacturer code
ST5MG Tablet 00755842 TIMOLOL APX
ST10MG Tablet 00755850 TIMOLOL APX
ST20MG Tablet 00755869 TIMOLOL APX

24:28.08 DIHYDROPYRIDINES

AMLODIPINE BESYLATE

Table: AMLODIPINE BESYLATE
Drug strength and dosage form DIN Brand name Manufacturer code
ST2.5MG Tablet 02297477 ACT AMLODIPINE ACG
ST2.5MG Tablet 02326795 AMLODIPINE PDL
ST2.5MG Tablet 02385783 AMLODIPINE SIV
ST2.5MG Tablet 02419556 AMLODIPINE BESYLATE ACC
ST2.5MG Tablet 02392127 BIO-AMLODIPINE BMI
ST2.5MG Tablet 02326825 DOM-AMLODIPINE DPC
ST2.5MG Tablet 02357186 JAMP-AMLODIPINE JMP
2.5MG Tablet 02468018 M-AMLODIPINE MAN
ST2.5MG Tablet 02371707 MAR-AMLODIPINE MAR
2.5MG Tablet 02476452 NRA-AMLODIPINE UNK
2.5MG Tablet 02469022 PHARMA-AMLODIPINE PMS
ST2.5MG Tablet 02295148 PMS-AMLODIPINE PMS
2.5MG Tablet 02444445 PRIVA-AMLODIPINE PHA
ST2.5MG Tablet 02398877 RAN-AMLODIPINE RBY
ST2.5MG Tablet 02331489 RIVA-AMLODIPINE RIV
ST2.5MG Tablet 02330474 SANDOZ AMLODIPINE SDZ
ST2.5MG Tablet 02357704 SEPTA-AMLODIPINE SPT
ST5MG Tablet 02297485 ACT AMLODIPINE ACG
5MG Tablet 02369230 AG-AMLODIPINE ANG
ST5MG Tablet 02326809 AMLODIPINE PDL
ST5MG Tablet 02331284 AMLODIPINE SAN
ST5MG Tablet 02385791 AMLODIPINE SIV
ST5MG Tablet 02429217 AMLODIPINE JMP
ST5MG Tablet 02419564 AMLODIPINE BESYLATE ACC
ST5MG Tablet 02273373 APO-AMLODIPINE APX
ST5MG Tablet 02397072 AURO-AMLODIPINE AUR
ST5MG Tablet 02392135 BIO-AMLODIPINE BMI
ST5MG Tablet 02326833 DOM-AMLODIPINE DPC
ST5MG Tablet 02357194 JAMP-AMLODIPINE JMP
5MG Tablet 02468026 M-AMLODIPINE MAN
ST5MG Tablet 02371715 MAR-AMLODIPINE MAR
ST5MG Tablet 02362651 MINT-AMLODIPINE MIN
ST5MG Tablet 02272113 MYLAN-AMLODIPINE MYL
ST5MG Tablet 00878928 NORVASC UNK
5MG Tablet 02476460 NRA-AMLODIPINE UNK
ST5MG Tablet 02469030 PHARMA-AMLODIPINE PMS
ST5MG Tablet 02284065 PMS-AMLODIPINE PMS
5MG Tablet 02444453 PRIVA-AMLODIPINE PHA
ST5MG Tablet 02321858 RAN-AMLODIPINE RBY
ST5MG Tablet 02331497 RIVA-AMLODIPINE RIV
ST5MG Tablet 02284383 SANDOZ AMLODIPINE SDZ
ST5MG Tablet 02357712 SEPTA-AMLODIPINE SPT
ST5MG Tablet 02250497 TEVA-AMLODIPINE TEV
ST10MG Tablet 02297493 ACT AMLODIPINE ACG
10MG Tablet 02369249 AG-AMLODIPINE ANG
ST10MG Tablet 02326817 AMLODIPINE PDL
ST10MG Tablet 02331292 AMLODIPINE SAN
ST10MG Tablet 02385805 AMLODIPINE SIV
ST10MG Tablet 02429225 AMLODIPINE JMP
ST10MG Tablet 02419572 AMLODIPINE BESYLATE ACC
ST10MG Tablet 02273381 APO-AMLODIPINE APX
ST10MG Tablet 02397080 AURO-AMLODIPINE AUR
ST10MG Tablet 02392143 BIO-AMLODIPINE BMI
ST10MG Tablet 02326841 DOM-AMLODIPINE DPC
ST10MG Tablet 02357208 JAMP-AMLODIPINE JMP
10MG Tablet 02468034 M-AMLODIPINE MAN
ST10MG Tablet 02371723 MAR-AMLODIPINE MAR
ST10MG Tablet 02362678 MINT-AMLODIPINE MIN
ST10MG Tablet 02272121 MYLAN-AMLODIPINE MYL
ST10MG Tablet 00878936 NORVASC UNK
10MG Tablet 02476479 NRA-AMLODIPINE UNK
ST10MG Tablet 02469049 PHARMA-AMLODIPINE PMS
ST10MG Tablet 02284073 PMS-AMLODIPINE PMS
10MG Tablet 02444461 PRIVA-AMLODIPINE PHA
ST10MG Tablet 02321866 RAN-AMLODIPINE RBY
ST10MG Tablet 02331500 RIVA-AMLODIPINE RIV
ST10MG Tablet 02284391 SANDOZ AMLODIPINE SDZ
ST10MG Tablet 02357720 SEPTA-AMLODIPINE SPT
ST10MG Tablet 02250500 TEVA-AMLODIPINE TEV
ST pDIN For Extemporaneous Mixture 99503003 AMLODIPINE ORAL LIQUID UNK

AMLODIPINE BESYLATE, ATORVASTATIN CALCIUM

Table: AMLODIPINE BESYLATE, ATORVASTATIN CALCIUM
Drug strength and dosage form DIN Brand name Manufacturer code
ST5MG & 10MG Tablet 02411253 APO-AMLODIPINE-ATORVASTATIN APX
ST5MG & 10MG Tablet 02273233 CADUET UNK
ST5MG & 10MG Tablet 02362759 GD-AMLODIPINE-ATORVASTATIN UNK
ST5MG & 10MG Tablet 02404222 PMS-AMLODIPINE-ATORVASTATIN PMS
ST5MG & 20MG Tablet 02411261 APO-AMLODIPINE-ATORVASTATIN APX
ST5MG & 20MG Tablet 02273241 CADUET UNK
ST5MG & 20MG Tablet 02362767 GD-AMLODIPINE-ATORVASTATIN UNK
ST5MG & 20MG Tablet 02404230 PMS-AMLODIPINE-ATORVASTATIN PMS
ST5MG & 40MG Tablet 02411288 APO-AMLODIPINE-ATORVASTATIN APX
ST5MG & 40MG Tablet 02273268 CADUET UNK
ST5MG & 40MG Tablet 02362775 GD-AMLODIPINE-ATORVASTATIN UNK
ST5MG & 80MG Tablet 02411296 APO-AMLODIPINE-ATORVASTATIN APX
ST5MG & 80MG Tablet 02273276 CADUET UNK
ST5MG & 80MG Tablet 02362783 GD-AMLODIPINE-ATORVASTATIN UNK
ST10MG & 10MG Tablet 02411318 APO-AMLODIPINE-ATORVASTATIN APX
ST10MG & 10MG Tablet 02273284 CADUET UNK
ST10MG & 10MG Tablet 02362791 GD-AMLODIPINE-ATORVASTATIN UNK
ST10MG & 10MG Tablet 02404249 PMS-AMLODIPINE-ATORVASTATIN PMS
ST10MG & 20MG Tablet 02411326 APO-AMLODIPINE-ATORVASTATIN APX
ST10MG & 20MG Tablet 02273292 CADUET UNK
ST10MG & 20MG Tablet 02362805 GD-AMLODIPINE-ATORVASTATIN UNK
ST10MG & 20MG Tablet 02404257 PMS-AMLODIPINE-ATORVASTATIN PMS
ST10MG & 40MG Tablet 02411334 APO-AMLODIPINE-ATORVASTATIN APX
ST10MG & 40MG Tablet 02273306 CADUET UNK
ST10MG & 40MG Tablet 02362813 GD-AMLODIPINE-ATORVASTATIN UNK
ST10MG & 80MG Tablet 02411342 APO-AMLODIPINE-ATORVASTATIN APX
ST10MG & 80MG Tablet 02273314 CADUET UNK
ST10MG & 80MG Tablet 02362821 GD-AMLODIPINE-ATORVASTATIN UNK

AMLODIPINE BESYLATE, TELMISARTAN

Table: AMLODIPINE BESYLATE, TELMISARTAN
Drug strength and dosage form DIN Brand name Manufacturer code
ST5MG & 40MG Tablet 02371022 TWYNSTA BOE
ST5MG & 80MG Tablet 02371049 TWYNSTA BOE
ST10MG & 40MG Tablet 02371030 TWYNSTA BOE
ST10MG & 80MG Tablet 02371057 TWYNSTA BOE

FELODIPINE

Table: FELODIPINE
Drug strength and dosage form DIN Brand name Manufacturer code
ST2.5MG Tablet (Extended Release) 02452367 APO-FELODIPINE APX
ST2.5MG Tablet (Extended Release) 02057778 PLENDIL AZC
ST5MG Tablet (Extended Release) 02452375 APO-FELODIPINE APX
ST5MG Tablet (Extended Release) 00851779 PLENDIL AZC
ST5MG Tablet (Extended Release) 02280264 SANDOZ FELODIPINE SDZ
ST5MG Tablet (Extended Release) 09857203 SANDOZ-FELODIPINE SDZ
ST10MG Tablet (Extended Release) 02452383 APO-FELODIPINE APX
ST10MG Tablet (Extended Release) 00851787 PLENDIL AZC
ST10MG Tablet (Extended Release) 02280272 SANDOZ FELODIPINE SDZ
ST10MG Tablet (Extended Release) 09857204 SANDOZ-FELODIPINE SDZ

NIFEDIPINE

Table: NIFEDIPINE
Drug strength and dosage form DIN Brand name Manufacturer code
ST5MG Capsule 00725110 NIFEDIPINE AAP
ST5MG Capsule 02235897 PMS-NIFEDIPINE PMS
ST10MG Capsule 00755907 NIFEDIPINE AAP
ST10MG Capsule 02235898 PMS-NIFEDIPINE PMS
ST20MG Tablet (Extended Release) 02237618 ADALAT XL BAY
ST30MG Tablet (Extended Release) 02155907 ADALAT XL BAY
ST30MG Tablet (Extended Release) 02349167 MYLAN-NIFEDIPINE MYL
ST30MG Tablet (Extended Release) 02421631 NIFEDIPINE PDL
ST30MG Tablet (Extended Release) 02418630 PMS-NIFEDIPINE PMS
ST60MG Tablet (Extended Release) 02155990 ADALAT XL BAY
ST60MG Tablet (Extended Release) 02321149 MYLAN-NIFEDIPINE MYL
ST60MG Tablet (Extended Release) 02421658 NIFEDIPINE PDL
ST60MG Tablet (Extended Release) 02416301 PMS-NIFEDIPINE PMS

NIMODIPINE

Table: NIMODIPINE
Drug strength and dosage form DIN Brand name Manufacturer code
ST30MG Tablet 02325926 NIMOTOP BAY

24:28.92 MISCELLANEOUS CALCIUM-CHANNEL BLOCKING AGENTS

DILTIAZEM HYDROCHLORIDE

Table: DILTIAZEM HYDROCHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST120MG Capsule (Controlled Delivery) 02230997 APO-DILTIAZ CD APX
ST120MG Capsule (Controlled Delivery) 02231472 DILTIAZEM CD PDL
ST120MG Capsule (Controlled Delivery) 02400421 DILTIAZEM CD SAN
ST120MG Capsule (Controlled Delivery) 02355752 PMS-DILTIAZEM CD PMS
ST180MG Capsule (Controlled Delivery) 02230998 APO-DILTIAZ CD APX
ST180MG Capsule (Controlled Delivery) 02231474 DILTIAZEM CD PDL
ST180MG Capsule (Controlled Delivery) 02400448 DILTIAZEM CD SAN
ST180MG Capsule (Controlled Delivery) 02355760 PMS-DILTIAZEM CD PMS
ST240MG Capsule (Controlled Delivery) 02230999 APO-DILTIAZ CD APX
ST240MG Capsule (Controlled Delivery) 02231475 DILTIAZEM CD PDL
ST240MG Capsule (Controlled Delivery) 02400456 DILTIAZEM CD SAN
ST240MG Capsule (Controlled Delivery) 02355779 PMS-DILTIAZEM CD PMS
ST300MG Capsule (Controlled Delivery) 02229526 APO-DILTIAZ CD APX
ST300MG Capsule (Controlled Delivery) 02231057 DILTIAZEM CD PDL
ST300MG Capsule (Controlled Delivery) 02400464 DILTIAZEM CD SAN
ST300MG Capsule (Controlled Delivery) 02355787 PMS-DILTIAZEM CD PMS
ST120MG Capsule (Extended Release) 02370611 ACT DILTIAZEM CD TEV
ST120MG Capsule (Extended Release) 02370441 ACT DILTIAZEM T TEV
ST120MG Capsule (Extended Release) 02097249 CARDIZEM CD VAE
ST120MG Capsule (Extended Release) 02445999 DILTIAZEM CD SIV
ST120MG Capsule (Extended Release) 02325306 DILTIAZEM TZ PDL
ST120MG Capsule (Extended Release) 02465353 MAR-DILTIAZEM T MAR
ST120MG Capsule (Extended Release) 02243338 SANDOZ DILTIAZEM CD SDZ
ST120MG Capsule (Extended Release) 02245918 SANDOZ DILTIAZEM T SDZ
ST120MG Capsule (Extended Release) 02271605 TEVA-DILTIAZEM VAE
ST120MG Capsule (Extended Release) 02242538 TEVA-DILTIAZEM CD TEV
ST120MG Capsule (Extended Release) 02231150 TIAZAC VAE
ST180MG Capsule (Extended Release) 02370638 ACT DILTIAZEM CD TEV
ST180MG Capsule (Extended Release) 02370492 ACT DILTIAZEM T TEV
ST180MG Capsule (Extended Release) 02446006 DILTIAZEM CD SIV
ST180MG Capsule (Extended Release) 02325314 DILTIAZEM TZ PDL
ST180MG Capsule (Extended Release) 02465361 MAR-DILTIAZEM T MAR
ST180MG Capsule (Extended Release) 02243339 SANDOZ DILTIAZEM CD SDZ
ST180MG Capsule (Extended Release) 02245919 SANDOZ DILTIAZEM T SDZ
ST180MG Capsule (Extended Release) 02271613 TEVA-DILTIAZEM VAE
ST180MG Capsule (Extended Release) 02242539 TEVA-DILTIAZEM CD TEV
ST180MG Capsule (Extended Release) 02231151 TIAZAC VAE
ST240MG Capsule (Extended Release) 02370646 ACT DILTIAZEM CD TEV
ST240MG Capsule (Extended Release) 02370506 ACT DILTIAZEM T TEV
ST240MG Capsule (Extended Release) 02446014 DILTIAZEM CD SIV
ST240MG Capsule (Extended Release) 02325322 DILTIAZEM TZ PDL
ST240MG Capsule (Extended Release) 02465388 MAR-DILTIAZEM T MAR
ST240MG Capsule (Extended Release) 02243340 SANDOZ DILTIAZEM CD SDZ
ST240MG Capsule (Extended Release) 02245920 SANDOZ DILTIAZEM T SDZ
ST240MG Capsule (Extended Release) 02271621 TEVA-DILTIAZEM VAE
ST240MG Capsule (Extended Release) 02242540 TEVA-DILTIAZEM CD TEV
ST240MG Capsule (Extended Release) 02231152 TIAZAC VAE
ST300MG Capsule (Extended Release) 02370654 ACT DILTIAZEM CD TEV
ST300MG Capsule (Extended Release) 02370514 ACT DILTIAZEM T TEV
ST300MG Capsule (Extended Release) 02446022 DILTIAZEM CD SIV
ST300MG Capsule (Extended Release) 02325330 DILTIAZEM TZ PDL
ST300MG Capsule (Extended Release) 02465396 MAR-DILTIAZEM T MAR
ST300MG Capsule (Extended Release) 02243341 SANDOZ DILTIAZEM CD SDZ
ST300MG Capsule (Extended Release) 02245921 SANDOZ DILTIAZEM T SDZ
ST300MG Capsule (Extended Release) 02271648 TEVA-DILTIAZEM VAE
ST300MG Capsule (Extended Release) 02242541 TEVA-DILTIAZEM CD TEV
ST300MG Capsule (Extended Release) 02231154 TIAZAC VAE
ST360MG Capsule (Extended Release) 02370522 ACT DILTIAZEM T TEV
ST360MG Capsule (Extended Release) 02325349 DILTIAZEM TZ PDL
ST360MG Capsule (Extended Release) 02465418 MAR-DILTIAZEM T MAR
ST360MG Capsule (Extended Release) 02245922 SANDOZ DILTIAZEM T SDZ
ST360MG Capsule (Extended Release) 02271656 TEVA-DILTIAZEM VAE
ST360MG Capsule (Extended Release) 02231155 TIAZAC VAE
ST30MG Tablet 00771376 AA-DILTIAZ AAP
ST30MG Tablet 00862924 TEVA-DILTIAZEM TEV
ST60MG Tablet 00771384 AA-DILTIAZ AAP
ST60MG Tablet 00862932 TEVA-DILTIAZEM TEV
ST120MG Tablet (Extended Release) 02256738 TIAZAC XC VAE
ST180MG Tablet (Extended Release) 02256746 TIAZAC XC VAE
ST240MG Tablet (Extended Release) 02256754 TIAZAC XC VAE
ST300MG Tablet (Extended Release) 02256762 TIAZAC XC VAE
ST360MG Tablet (Extended Release) 02256770 TIAZAC XC VAE

VERAPAMIL HYDROCHLORIDE

Table: VERAPAMIL HYDROCHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
120MG Capsule (Sustained Release) 02100479 VERELAN RGL
ST180MG Capsule (Sustained Release) 02100487 VERELAN RGL
ST240MG Capsule (Sustained Release) 02100495 VERELAN RGL
ST80MG Tablet 00782483 APO-VERAP APX
ST80MG Tablet 02237921 MYLAN-VERAPAMIL MYL
ST120MG Tablet 00782491 APO-VERAP APX
ST120MG Tablet 02237922 MYLAN-VERAPAMIL MYL
ST120MG Tablet (Extended Release) 02246893 APO-VERAP SR APX
ST120MG Tablet (Extended Release) 01907123 ISOPTIN SR BGP
ST120MG Tablet (Extended Release) 02210347 MYLAN-VERAPAMIL SR MYL
ST180MG Tablet (Extended Release) 02246894 APO-VERAP SR APX
ST180MG Tablet (Extended Release) 01934317 ISOPTIN SR BGP
ST180MG Tablet (Extended Release) 02450488 MYLAN-VERAPAMIL MYL
ST240MG Tablet (Extended Release) 02246895 APO-VERAP SR APX
ST240MG Tablet (Extended Release) 02240321 DOM-VERAPAMIL SR DPC
ST240MG Tablet (Extended Release) 00742554 ISOPTIN SR BGP
ST240MG Tablet (Extended Release) 02450496 MYLAN-VERAPAMIL MYL
ST240MG Tablet (Extended Release) 02237791 PMS-VERAPAMIL SR PMS

24:32.04 ANGIOTENSIN-CONVERTING ENZYME INHIBITORS

BENAZEPRIL HYDROCHLORIDE

Table: BENAZEPRIL HYDROCHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST5MG Tablet 02290332 BENAZEPRIL AAP
ST10MG Tablet 02290340 BENAZEPRIL AAP
ST20MG Tablet 02273918 BENAZEPRIL AAP

CAPTOPRIL

Table: CAPTOPRIL
Drug strength and dosage form DIN Brand name Manufacturer code
ST6.25MG Tablet 01999559 APO-CAPTO APX
ST12.5MG Tablet 00893595 APO-CAPTO APX
ST12.5MG Tablet 01942964 TEVA-CAPTOPRIL TEV
ST25MG Tablet 00893609 APO-CAPTO APX
ST25MG Tablet 01942972 TEVA-CAPTOPRIL TEV
ST50MG Tablet 00893617 APO-CAPTO APX
ST50MG Tablet 01942980 TEVA-CAPTOPRIL TEV
ST100MG Tablet 00893625 APO-CAPTO APX
ST100MG Tablet 02230206 PMS-CAPTOPRIL PMS
ST100MG Tablet 01942999 TEVA-CAPTOPRIL TEV

CILAZAPRIL

Table: CILAZAPRIL
Drug strength and dosage form DIN Brand name Manufacturer code
ST1MG Tablet 02291134 APO-CILAZAPRIL APX
ST1MG Tablet 02283778 MYLAN-CILAZAPRIL MYL
ST1MG Tablet 02280442 PMS-CILAZAPRIL PMS
ST2.5MG Tablet 02291142 APO-CILAZAPRIL APX
ST2.5MG Tablet 01911473 INHIBACE CHE
ST2.5MG Tablet 02283786 MYLAN-CILAZAPRIL MYL
ST2.5MG Tablet 02280450 PMS-CILAZAPRIL PMS
ST5MG Tablet 02291150 APO-CILAZAPRIL APX
ST5MG Tablet 01911481 INHIBACE CHE
ST5MG Tablet 02283794 MYLAN-CILAZAPRIL MYL
ST5MG Tablet 02280469 PMS-CILAZAPRIL PMS

CILAZAPRIL, HYDROCHLOROTHIAZIDE

Table: CILAZAPRIL, HYDROCHLOROTHIAZIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST5MG & 12.5MG Tablet 02284987 APO-CILAZAPRIL/HCTZ APX
ST5MG & 12.5MG Tablet 02181479 INHIBACE PLUS CHE
ST5MG & 12.5MG Tablet 02313731 TEVA-CILAZAPRIL/HCTZ TEV

ENALAPRIL MALEATE

Table: ENALAPRIL MALEATE
Drug strength and dosage form DIN Brand name Manufacturer code
ST2.5MG Tablet 02291878 ACT ENALAPRIL TEV
ST2.5MG Tablet 02020025 APO-ENALAPRIL APX
ST2.5MG Tablet 02400650 ENALAPRIL SAN
ST2.5MG Tablet 02442957 ENALAPRIL SIV
ST2.5MG Tablet 02459450 MAR-ENALAPRIL MAR
ST2.5MG Tablet 02311402 PRO-ENALAPRIL PDL
ST2.5MG Tablet 02352230 RAN-ENALAPRIL RBY
ST2.5MG Tablet 02300796 RIVA-ENALAPRIL RIV
ST2.5MG Tablet 02299933 SANDOZ ENALAPRIL SDZ
ST2.5MG Tablet 02300117 TARO-ENALAPRIL TAR
ST5MG Tablet 02291886 ACT ENALAPRIL TEV
ST5MG Tablet 02019884 APO-ENALAPRIL APX
ST5MG Tablet 02400669 ENALAPRIL SAN
ST5MG Tablet 02442965 ENALAPRIL SIV
ST5MG Tablet 02459469 MAR-ENALAPRIL MAR
ST5MG Tablet 02311410 PRO-ENALAPRIL PDL
ST5MG Tablet 02352249 RAN-ENALAPRIL RBY
ST5MG Tablet 02300818 RIVA-ENALAPRIL RIV
ST5MG Tablet 02299941 SANDOZ ENALAPRIL SDZ
ST5MG Tablet 02300125 TARO-ENALAPRIL TAR
ST5MG Tablet 00708879 VASOTEC FRS
ST10MG Tablet 02291894 ACT ENALAPRIL TEV
ST10MG Tablet 02019892 APO-ENALAPRIL APX
ST10MG Tablet 02400677 ENALAPRIL SAN
ST10MG Tablet 02442973 ENALAPRIL SIV
ST10MG Tablet 02444771 MAR-ENALAPRIL IDE
ST10MG Tablet 02311429 PRO-ENALAPRIL PDL
ST10MG Tablet 02352257 RAN-ENALAPRIL RBY
ST10MG Tablet 02300826 RIVA-ENALAPRIL RIV
ST10MG Tablet 02299968 SANDOZ ENALAPRIL SDZ
ST10MG Tablet 02300133 TARO-ENALAPRIL TAR
ST10MG Tablet 00670901 VASOTEC FRS
ST20MG Tablet 02291908 ACT ENALAPRIL TEV
ST20MG Tablet 02019906 APO-ENALAPRIL APX
ST20MG Tablet 02400685 ENALAPRIL SAN
ST20MG Tablet 02442981 ENALAPRIL SIV
ST20MG Tablet 02444798 MAR-ENALAPRIL IDE
ST20MG Tablet 02311437 PRO-ENALAPRIL PDL
ST20MG Tablet 02352265 RAN-ENALAPRIL RBY
ST20MG Tablet 02300834 RIVA-ENALAPRIL RIV
ST20MG Tablet 02299976 SANDOZ ENALAPRIL SDZ
ST20MG Tablet 02300141 TARO-ENALAPRIL TAR
ST20MG Tablet 00670928 VASOTEC FRS
ST pDIN For Extemporaneous Mixture 99503013 ENALAPRIL ORAL LIQUID UNK

ENALAPRIL MALEATE, HYDROCHLOROTHIAZIDE

Table: ENALAPRIL MALEATE, HYDROCHLOROTHIAZIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST5MG & 12.5MG Tablet 02352923 ENALAPRIL MALEATE/HCTZ AAP
ST10MG & 25MG Tablet 02352931 ENALAPRIL MALEATE/HCTZ AAP
ST10MG & 25MG Tablet 00657298 VASERETIC FRS

FOSINOPRIL SODIUM

Table: FOSINOPRIL SODIUM
Drug strength and dosage form DIN Brand name Manufacturer code
ST10MG Tablet 02266008 APO-FOSINOPRIL APX
ST10MG Tablet 02303000 FOSINOPRIL PDL
ST10MG Tablet 02332566 FOSINOPRIL RBY
ST10MG Tablet 02459388 FOSINOPRIL SAN
ST10MG Tablet 02331004 JAMP-FOSINOPRIL JMP
ST10MG Tablet 02255944 PMS-FOSINOPRIL PMS
ST10MG Tablet 02294524 RAN-FOSINOPRIL RBY
ST10MG Tablet 02247802 TEVA-FOSINOPRIL TEV
ST20MG Tablet 02266016 APO-FOSINOPRIL APX
ST20MG Tablet 02303019 FOSINOPRIL PDL
ST20MG Tablet 02332574 FOSINOPRIL RBY
ST20MG Tablet 02459396 FOSINOPRIL SAN
ST20MG Tablet 02331012 JAMP-FOSINOPRIL JMP
ST20MG Tablet 02255952 PMS-FOSINOPRIL PMS
ST20MG Tablet 02294532 RAN-FOSINOPRIL RBY
ST20MG Tablet 02247803 TEVA-FOSINOPRIL TEV

LISINOPRIL

Table: LISINOPRIL
Drug strength and dosage form DIN Brand name Manufacturer code
ST5MG Tablet 02217481 APO-LISINOPRIL APX
ST5MG Tablet 09853685 APO-LISINOPRIL APX
ST5MG Tablet 02394472 AURO-LISINOPRIL AUR
ST5MG Tablet 02361531 JAMP-LISINOPRIL JMP
ST5MG Tablet 02386232 LISINOPRIL SIV
ST5MG Tablet 02292203 PMS-LISINOPRIL PMS
ST5MG Tablet 02310961 PRO-LISINOPRIL PDL
ST5MG Tablet 02294230 RAN-LISINOPRIL RBY
ST5MG Tablet 02289199 SANDOZ LISINOPRIL SDZ
ST5MG Tablet 02285061 TEVA-LISINOPRIL (TYPE P) TEV
ST5MG Tablet 02285118 TEVA-LISINOPRIL (TYPE Z) TEV
ST5MG Tablet 02049333 ZESTRIL AZC
ST10MG Tablet 02217503 APO-LISINOPRIL APX
ST10MG Tablet 09853960 APO-LISINOPRIL APX
ST10MG Tablet 02394480 AURO-LISINOPRIL AUR
ST10MG Tablet 02361558 JAMP-LISINOPRIL JMP
ST10MG Tablet 02386240 LISINOPRIL SIV
ST10MG Tablet 02292211 PMS-LISINOPRIL PMS
ST10MG Tablet 00839396 PRINIVIL FRS
ST10MG Tablet 02310988 PRO-LISINOPRIL PDL
ST10MG Tablet 02294249 RAN-LISINOPRIL RBY
ST10MG Tablet 02289202 SANDOZ LISINOPRIL SDZ
ST10MG Tablet 02285088 TEVA-LISINOPRIL (TYPE P) TEV
ST10MG Tablet 02285126 TEVA-LISINOPRIL (TYPE Z) TEV
ST10MG Tablet 02049376 ZESTRIL AZC
ST20MG Tablet 02217511 APO-LISINOPRIL APX
ST20MG Tablet 09854010 APO-LISINOPRIL APX
ST20MG Tablet 02394499 AURO-LISINOPRIL AUR
ST20MG Tablet 02361566 JAMP-LISINOPRIL JMP
ST20MG Tablet 02386259 LISINOPRIL SIV
ST20MG Tablet 02292238 PMS-LISINOPRIL PMS
ST20MG Tablet 00839418 PRINIVIL FRS
ST20MG Tablet 02310996 PRO-LISINOPRIL PDL
ST20MG Tablet 02294257 RAN-LISINOPRIL RBY
ST20MG Tablet 02289229 SANDOZ LISINOPRIL SDZ
ST20MG Tablet 02285096 TEVA-LISINOPRIL (TYPE P) TEV
ST20MG Tablet 02285134 TEVA-LISINOPRIL (TYPE Z) TEV
ST20MG Tablet 02049384 ZESTRIL AZC

LISINOPRIL, HYDROCHLOROTHIAZIDE

Table: LISINOPRIL, HYDROCHLOROTHIAZIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST10MG & 12.5MG Tablet 02362945 LISINOPRIL/HCTZ (TYPE Z) SAN
ST10MG & 12.5MG Tablet 02302365 SANDOZ LISINOPRIL HCT SDZ
ST10MG & 12.5MG Tablet 02302136 TEVA-LISINOPRIL/HCTZ (TYPE P) TEV
ST10MG & 12.5MG Tablet 02301768 TEVA-LISINOPRIL/HCTZ (TYPE Z) TEV
ST10MG & 12.5MG Tablet 02103729 ZESTORETIC AZC
ST20MG & 12.5MG Tablet 02362953 LISINOPRIL/HCTZ (TYPE Z) SAN
ST20MG & 12.5MG Tablet 02302373 SANDOZ LISINOPRIL HCT SDZ
ST20MG & 12.5MG Tablet 02302144 TEVA-LISINOPRIL/HCTZ (TYPE P) TEV
ST20MG & 12.5MG Tablet 02301776 TEVA-LISINOPRIL/HCTZ (TYPE Z) TEV
ST20MG & 12.5MG Tablet 02045737 ZESTORETIC AZC
ST20MG & 25MG Tablet 02362961 LISINOPRIL/HCTZ (TYPE Z) SAN
ST20MG & 25MG Tablet 02302381 SANDOZ LISINOPRIL HCT SDZ
ST20MG & 25MG Tablet 02302152 TEVA-LISINOPRIL/HCTZ (TYPE P) TEV
ST20MG & 25MG Tablet 02301784 TEVA-LISINOPRIL/HCTZ (TYPE Z) TEV
ST20MG & 25MG Tablet 02045729 ZESTORETIC AZC

PERINDOPRIL ERBUMINE

Table: PERINDOPRIL ERBUMINE
Drug strength and dosage form DIN Brand name Manufacturer code
2MG Tablet 02481677 AG-PERINDOPRIL ANG
ST2MG Tablet 02289261 APO-PERINDOPRIL APX
ST2MG Tablet 02459817 AURO-PERINDOPRIL AUR
ST2MG Tablet 02123274 COVERSYL SEV
ST2MG Tablet 02477009 JAMP PERINDOPRIL JMP
ST2MG Tablet 02474824 MAR-PERINDOPRIL MAR
ST2MG Tablet 02476762 MINT-PERINDOPRIL MIN
2MG Tablet 02482924 M-PERINDOPRIL ERBUMINE MAN
2MG Tablet 02489015 NRA-PERINDOPRIL UNK
ST2MG Tablet 02479877 PERINDOPRIL ERBUMINE SIV
ST2MG Tablet 02481634 PERINDOPRIL ERBUMINE SAN
2MG Tablet 02488949 PERINDOPRIL ERBUMINE PDL
ST2MG Tablet 02470675 PMS-PERINDOPRIL PMS
2MG Tablet 02483238 PRIVA-PERINDOPRIL ERBUMINE PHA
2MG Tablet 02472015 RIVA-PERINDOPRIL RIV
ST2MG Tablet 02470225 SANDOZ PERINDOPRIL ERBUMINE SDZ
ST2MG Tablet 02464985 TEVA-PERINDOPRIL TEV
4MG Tablet 02481685 AG-PERINDOPRIL ANG
ST4MG Tablet 02289288 APO-PERINDOPRIL APX
ST4MG Tablet 02459825 AURO-PERINDOPRIL AUR
ST4MG Tablet 02123282 COVERSYL SEV
ST4MG Tablet 02477017 JAMP PERINDOPRIL JMP
ST4MG Tablet 02474832 MAR-PERINDOPRIL MAR
ST4MG Tablet 02476770 MINT-PERINDOPRIL MIN
4MG Tablet 02482932 M-PERINDOPRIL ERBUMINE MAN
4MG Tablet 02489023 NRA-PERINDOPRIL UNK
ST4MG Tablet 02479885 PERINDOPRIL ERBUMINE SIV
ST4MG Tablet 02481642 PERINDOPRIL ERBUMINE SAN
4MG Tablet 02488957 PERINDOPRIL ERBUMINE PDL
ST4MG Tablet 02470683 PMS-PERINDOPRIL PMS
4MG Tablet 02483246 PRIVA-PERINDOPRIL ERBUMINE PHA
4MG Tablet 02472023 RIVA-PERINDOPRIL RIV
ST4MG Tablet 02470233 SANDOZ PERINDOPRIL ERBUMINE SDZ
ST4MG Tablet 02464993 TEVA-PERINDOPRIL TEV
8MG Tablet 02481693 AG-PERINDOPRIL ANG
ST8MG Tablet 02289296 APO-PERINDOPRIL APX
ST8MG Tablet 02459833 AURO-PERINDOPRIL AUR
ST8MG Tablet 02246624 COVERSYL SEV
ST8MG Tablet 02477025 JAMP PERINDOPRIL JMP
ST8MG Tablet 02474840 MAR-PERINDOPRIL MAR
ST8MG Tablet 02476789 MINT-PERINDOPRIL MIN
8MG Tablet 02482940 M-PERINDOPRIL ERBUMINE MAN
8MG Tablet 02489031 NRA-PERINDOPRIL UNK
ST8MG Tablet 02479893 PERINDOPRIL ERBUMINE SIV
ST8MG Tablet 02481650 PERINDOPRIL ERBUMINE SAN
8MG Tablet 02488965 PERINDOPRIL ERBUMINE PDL
ST8MG Tablet 02470691 PMS-PERINDOPRIL PMS
8MG Tablet 02483254 PRIVA-PERINDOPRIL ERBUMINE PHA
8MG Tablet 02472031 RIVA-PERINDOPRIL RIV
ST8MG Tablet 02470241 SANDOZ PERINDOPRIL ERBUMINE SDZ
ST8MG Tablet 02465000 TEVA-PERINDOPRIL TEV

PERINDOPRIL ERBUMINE, INDAPAMIDE

Table: PERINDOPRIL ERBUMINE, INDAPAMIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST4MG & 1.25MG Tablet 02246569 COVERSYL PLUS SEV
ST4MG & 1.25MG Tablet 02470438 SANDOZ PERINDOPRIL ERBUMINE/ INDAPAMIDE SDZ
ST4MG & 1.25MG Tablet 02464020 TEVA-PERINDOPRIL/INDAPAMIDE TEV
ST8MG & 2.5MG Tablet 02453061 APO-PERINDOPRIL-INDAPAMIDE APX
ST8MG & 2.5MG Tablet 02321653 COVERSYL PLUS HD SEV
ST8MG & 2.5MG Tablet 02408201 MYLAN-PERINDOPRIL/INDAPAMIDE MYL
ST8MG & 2.5MG Tablet 02470446 SANDOZ PERINDOPRIL ERBUMINE/ INDAPAMIDE HD SDZ
ST8MG & 2.5MG Tablet 02464039 TEVA-PERINDOPRIL/INDAPAMIDE TEV

QUINAPRIL

Table: QUINAPRIL
Drug strength and dosage form DIN Brand name Manufacturer code
ST5MG Tablet 01947664 ACCUPRIL PFI
ST5MG Tablet 02248499 APO-QUINAPRIL APX
ST5MG Tablet 02340550 PMS-QUINAPRIL PMS
ST10MG Tablet 01947672 ACCUPRIL PFI
ST10MG Tablet 02248500 APO-QUINAPRIL APX
ST10MG Tablet 02340569 PMS-QUINAPRIL PMS
ST20MG Tablet 01947680 ACCUPRIL PFI
ST20MG Tablet 02248501 APO-QUINAPRIL APX
ST20MG Tablet 02340577 PMS-QUINAPRIL PMS
ST40MG Tablet 01947699 ACCUPRIL PFI
ST40MG Tablet 02248502 APO-QUINAPRIL APX
ST40MG Tablet 02340585 PMS-QUINAPRIL PMS

QUINAPRIL, HYDROCHLOROTHIAZIDE

Table: QUINAPRIL, HYDROCHLOROTHIAZIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST10MG & 12.5MG Tablet 02237367 ACCURETIC PFI
ST10MG & 12.5MG Tablet 02408767 APO-QUINAPRIL/HCTZ APX
ST10MG & 12.5MG Tablet 02473291 AURO-QUINAPRIL HCTZ AUR
ST20MG & 12.5MG Tablet 02237368 ACCURETIC PFI
ST20MG & 12.5MG Tablet 02408775 APO-QUINAPRIL/HCTZ APX
ST20MG & 12.5MG Tablet 02473305 AURO-QUINAPRIL HCTZ AUR
ST20MG & 25MG Tablet 02237369 ACCURETIC PFI
ST20MG & 25MG Tablet 02408783 APO-QUINAPRIL/HCTZ APX
ST20MG & 25MG Tablet 02473321 AURO-QUINAPRIL HCTZ AUR

RAMIPRIL

Table: RAMIPRIL
Drug strength and dosage form DIN Brand name Manufacturer code
ST1.25MG Capsule 02221829 ALTACE VAE
ST1.25MG Capsule 02251515 APO-RAMIPRIL APX
ST1.25MG Capsule 02387387 AURO-RAMIPRIL AUR
ST1.25MG Capsule 02331101 JAMP-RAMIPRIL JMP
ST1.25MG Capsule 02420457 MAR-RAMIPRIL MAR
ST1.25MG Capsule 02469057 PHARMA-RAMIPRIL PMS
ST1.25MG Capsule 02295369 PMS-RAMIPRIL PMS
ST1.25MG Capsule 02310023 PRO-RAMIPRIL PDL
ST1.25MG Capsule 02299372 RAMIPRIL RIV
ST1.25MG Capsule 02308363 RAMIPRIL SIV
ST1.25MG Capsule 02310503 TARO-RAMIPRIL SUN
2.5MG Capsule 02477572 AG-RAMIPRIL ANG
ST2.5MG Capsule 02221837 ALTACE VAE
ST2.5MG Capsule 02251531 APO-RAMIPRIL APX
ST2.5MG Capsule 02387395 AURO-RAMIPRIL AUR
ST2.5MG Capsule 02287951 DOM-RAMIPRIL DPC
ST2.5MG Capsule 02331128 JAMP-RAMIPRIL JMP
ST2.5MG Capsule 02420465 MAR-RAMIPRIL MAR
ST2.5MG Capsule 02421305 MINT-RAMIPRIL MIN
2.5MG Capsule 02486172 NRA-RAMIPRIL UNK
ST2.5MG Capsule 02469065 PHARMA-RAMIPRIL PMS
ST2.5MG Capsule 02247917 PMS-RAMIPRIL PMS
2.5MG Capsule 02483416 PRIVA-RAMIPRIL PHA
ST2.5MG Capsule 02310066 PRO-RAMIPRIL PDL
ST2.5MG Capsule 02255316 RAMIPRIL RIV
ST2.5MG Capsule 02287927 RAMIPRIL SIV
ST2.5MG Capsule 02374846 RAMIPRIL SAN
ST2.5MG Capsule 02310511 TARO-RAMIPRIL SUN
ST2.5MG Capsule 02247945 TEVA-RAMIPRIL TEV
5MG Capsule 02477580 AG-RAMIPRIL ANG
ST5MG Capsule 02221845 ALTACE VAE
ST5MG Capsule 02251574 APO-RAMIPRIL APX
ST5MG Capsule 02387409 AURO-RAMIPRIL AUR
ST5MG Capsule 02287978 DOM-RAMIPRIL DPC
ST5MG Capsule 02331136 JAMP-RAMIPRIL JMP
ST5MG Capsule 02420473 MAR-RAMIPRIL MAR
ST5MG Capsule 02421313 MINT-RAMIPRIL MIN
5MG Capsule 02486180 NRA-RAMIPRIL UNK
ST5MG Capsule 02469073 PHARMA-RAMIPRIL PMS
ST5MG Capsule 02247918 PMS-RAMIPRIL PMS
5MG Capsule 02483424 PRIVA-RAMIPRIL PHA
ST5MG Capsule 02310074 PRO-RAMIPRIL PDL
ST5MG Capsule 02255324 RAMIPRIL RIV
ST5MG Capsule 02287935 RAMIPRIL SIV
ST5MG Capsule 02374854 RAMIPRIL SAN
ST5MG Capsule 02310538 TARO-RAMIPRIL SUN
ST5MG Capsule 02247946 TEVA-RAMIPRIL TEV
10MG Capsule 02477599 AG-RAMIPRIL ANG
ST10MG Capsule 02221853 ALTACE VAE
ST10MG Capsule 02251582 APO-RAMIPRIL APX
ST10MG Capsule 02387417 AURO-RAMIPRIL AUR
ST10MG Capsule 02287986 DOM-RAMIPRIL DPC
ST10MG Capsule 02331144 JAMP-RAMIPRIL JMP
ST10MG Capsule 02420481 MAR-RAMIPRIL MAR
ST10MG Capsule 02421321 MINT-RAMIPRIL MIN
10MG Capsule 02486199 NRA-RAMIPRIL UNK
ST10MG Capsule 02469081 PHARMA-RAMIPRIL PMS
ST10MG Capsule 02247919 PMS-RAMIPRIL PMS
10MG Capsule 02483432 PRIVA-RAMIPRIL PHA
ST10MG Capsule 02310104 PRO-RAMIPRIL PDL
ST10MG Capsule 02255332 RAMIPRIL RIV
ST10MG Capsule 02287943 RAMIPRIL SIV
ST10MG Capsule 02374862 RAMIPRIL SAN
ST10MG Capsule 02310546 TARO-RAMIPRIL SUN
ST10MG Capsule 02247947 TEVA-RAMIPRIL TEV
ST15MG Capsule 02325381 APO-RAMIPRIL APX
ST15MG Capsule 02440334 JAMP-RAMIPRIL JMP
ST15MG Capsule 02420503 MAR-RAMIPRIL MAR
ST15MG Capsule 02421348 MINT-RAMIPRIL MIN
ST15MG Capsule 02343932 PMS-RAMIPRIL PMS
ST15MG Capsule 02425548 TARO-RAMIPRIL SUN
ST1.25MG Tablet 02291398 SANDOZ RAMIPRIL SDZ
ST2.5MG Tablet 02291401 SANDOZ RAMIPRIL SDZ
ST5MG Tablet 02291428 SANDOZ RAMIPRIL SDZ
ST10MG Tablet 02291436 SANDOZ RAMIPRIL SDZ

RAMIPRIL, HYDROCHLOROTHIAZIDE

Table: RAMIPRIL, HYDROCHLOROTHIAZIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST2.5MG & 12.5MG Tablet 02283131 ALTACE HCT VAE
ST2.5MG & 12.5MG Tablet 02354004 APO-RAMIPRIL/HCTZ APX
ST2.5MG & 12.5MG Tablet 02449439 TARO-RAMIPRIL HCTZ SUN
ST5MG & 12.5MG Tablet 02283158 ALTACE HCT VAE
ST5MG & 12.5MG Tablet 02354012 APO-RAMIPRIL/HCTZ APX
ST5MG & 12.5MG Tablet 02449447 TARO-RAMIPRIL HCTZ SUN
ST5MG & 25MG Tablet 02283174 ALTACE HCT VAE
ST5MG & 25MG Tablet 02354020 APO-RAMIPRIL/HCTZ APX
ST5MG & 25MG Tablet 02449463 TARO-RAMIPRIL HCTZ SUN
ST10MG & 12.5MG Tablet 02283166 ALTACE HCT VAE
ST10MG & 12.5MG Tablet 02342154 PMS-RAMIPRIL-HCTZ PMS
ST10MG & 12.5MG Tablet 02449455 TARO-RAMIPRIL HCTZ SUN
ST10MG & 25MG Tablet 02283182 ALTACE HCT VAE
ST10MG & 25MG Tablet 02354039 APO-RAMIPRIL/HCTZ APX
ST10MG & 25MG Tablet 02342170 PMS-RAMIPRIL-HCTZ PMS
ST10MG & 25MG Tablet 02449471 TARO-RAMIPRIL HCTZ SUN

TRANDOLAPRIL

Table: TRANDOLAPRIL
Drug strength and dosage form DIN Brand name Manufacturer code
ST0.5MG Capsule 02471868 AURO-TRANDOLAPRIL AUR
ST0.5MG Capsule 02231457 MAVIK BGP
ST0.5MG Capsule 02357755 PMS-TRANDOLAPRIL PMS
ST0.5MG Capsule 02325721 SANDOZ TRANDOLAPRIL SDZ
ST0.5MG Capsule 02415429 TEVA-TRANDOLAPRIL TEV
ST1MG Capsule 02471876 AURO-TRANDOLAPRIL AUR
ST1MG Capsule 02231459 MAVIK BGP
ST1MG Capsule 02357763 PMS-TRANDOLAPRIL PMS
ST1MG Capsule 02325748 SANDOZ TRANDOLAPRIL SDZ
ST1MG Capsule 02415437 TEVA-TRANDOLAPRIL TEV
1MG Capsule 02488698 TRANDOLAPRIL PDL
ST2MG Capsule 02471884 AURO-TRANDOLAPRIL AUR
ST2MG Capsule 02231460 MAVIK BGP
ST2MG Capsule 02357771 PMS-TRANDOLAPRIL PMS
ST2MG Capsule 02325756 SANDOZ TRANDOLAPRIL SDZ
ST2MG Capsule 02415445 TEVA-TRANDOLAPRIL TEV
2MG Capsule 02488701 TRANDOLAPRIL PDL
ST4MG Capsule 02471892 AURO-TRANDOLAPRIL AUR
ST4MG Capsule 02239267 MAVIK BGP
ST4MG Capsule 02357798 PMS-TRANDOLAPRIL PMS
ST4MG Capsule 02325764 SANDOZ TRANDOLAPRIL SDZ
ST4MG Capsule 02415453 TEVA-TRANDOLAPRIL TEV
4MG Capsule 02488728 TRANDOLAPRIL PDL

24:32.08 ANGIOTENSIN II RECEPTOR ANTAGONISTS

AZILSARTAN MEDOXOMIL

Table: AZILSARTAN MEDOXOMIL
Drug strength and dosage form DIN Brand name Manufacturer code
ST40MG Tablet 02381389 EDARBI VAE
ST80MG Tablet 02381397 EDARBI VAE

CANDESARTAN CILEXETIL

Table: CANDESARTAN CILEXETIL
Drug strength and dosage form DIN Brand name Manufacturer code
ST4MG Tablet 02379260 ACH-CANDESARTAN ACC
ST4MG Tablet 02365340 APO-CANDESARTAN APX
ST4MG Tablet 02239090 ATACAND AZC
ST4MG Tablet 02445786 AURO-CANDESARTAN AUR
ST4MG Tablet 02388901 CANDESARTAN SAN
ST4MG Tablet 02391171 PMS-CANDESARTAN PMS
ST4MG Tablet 02326957 SANDOZ CANDESARTAN SDZ
ST4MG Tablet 02380684 TARO-CANDESARTAN SUN
ST8MG Tablet 02379279 ACH-CANDESARTAN ACC
ST8MG Tablet 02365359 APO-CANDESARTAN APX
ST8MG Tablet 02239091 ATACAND AZC
ST8MG Tablet 02445794 AURO-CANDESARTAN AUR
ST8MG Tablet 02377934 CANDESARTAN PDL
ST8MG Tablet 02388707 CANDESARTAN SIV
ST8MG Tablet 02388928 CANDESARTAN SAN
ST8MG Tablet 02386518 JAMP-CANDESARTAN JMP
ST8MG Tablet 02476916 MINT-CANDESARTAN MIN
ST8MG Tablet 02391198 PMS-CANDESARTAN PMS
ST8MG Tablet 02326965 SANDOZ CANDESARTAN SDZ
ST8MG Tablet 02380692 TARO-CANDESARTAN SUN
ST8MG Tablet 02366312 TEVA-CANDESARTAN TEV
ST16MG Tablet 02379287 ACH-CANDESARTAN ACC
ST16MG Tablet 02365367 APO-CANDESARTAN APX
ST16MG Tablet 02239092 ATACAND AZC
ST16MG Tablet 02445808 AURO-CANDESARTAN AUR
ST16MG Tablet 02377942 CANDESARTAN PDL
ST16MG Tablet 02388715 CANDESARTAN SIV
ST16MG Tablet 02388936 CANDESARTAN SAN
ST16MG Tablet 02386526 JAMP-CANDESARTAN JMP
ST16MG Tablet 02476924 MINT-CANDESARTAN MIN
ST16MG Tablet 02391201 PMS-CANDESARTAN PMS
ST16MG Tablet 02326973 SANDOZ CANDESARTAN SDZ
ST16MG Tablet 02380706 TARO-CANDESARTAN SUN
ST16MG Tablet 02366320 TEVA-CANDESARTAN TEV
ST32MG Tablet 02379295 ACH-CANDESARTAN ACC
ST32MG Tablet 02399105 APO-CANDESARTAN APX
ST32MG Tablet 02311658 ATACAND AZC
ST32MG Tablet 02445816 AURO-CANDESARTAN AUR
ST32MG Tablet 02422069 CANDESARTAN PDL
ST32MG Tablet 02435845 CANDESARTAN SAN
ST32MG Tablet 02386534 JAMP-CANDESARTAN JMP
ST32MG Tablet 02391228 PMS-CANDESARTAN PMS
ST32MG Tablet 02417340 SANDOZ CANDESARTAN SDZ
ST32MG Tablet 02380714 TARO-CANDESARTAN SUN
ST32MG Tablet 02366339 TEVA-CANDESARTAN TEV

CANDESARTAN CILEXETIL, HYDROCHLOROTHIAZIDE

Table: CANDESARTAN CILEXETIL, HYDROCHLOROTHIAZIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST16MG & 12.5MG Tablet 02244021 ATACAND PLUS AZC
ST16MG & 12.5MG Tablet 02421038 AURO-CANDESARTAN HCT AUR
ST16MG & 12.5MG Tablet 02394812 CANDESARTAN-HCT SIV
ST16MG & 12.5MG Tablet 02392275 CANDESARTAN-HCTZ PDL
ST16MG & 12.5MG Tablet 02394804 CANDESARTAN-HCTZ SAN
ST16MG & 12.5MG Tablet 02473240 JAMP CANDESARTAN-HCT JMP
ST16MG & 12.5MG Tablet 02391295 PMS-CANDESARTAN HCTZ PMS
ST16MG & 12.5MG Tablet 02327902 SANDOZ CANDESARTAN PLUS SDZ
ST16MG & 12.5MG Tablet 02395541 TEVA-CANDESARTAN/HCTZ TEV
ST32MG & 12.5MG Tablet 02332922 ATACAND PLUS AZC
ST32MG & 12.5MG Tablet 02421046 AURO-CANDESARTAN HCT AUR
ST32MG & 12.5MG Tablet 02473259 JAMP CANDESARTAN-HCT JMP
ST32MG & 12.5MG Tablet 02420732 SANDOZ CANDESARTAN PLUS SDZ
ST32MG & 12.5MG Tablet 02395568 TEVA-CANDESARTAN/HCTZ TEV
ST32MG & 25MG Tablet 02332957 ATACAND PLUS AZC
ST32MG & 25MG Tablet 02421054 AURO-CANDESARTAN HCT AUR
ST32MG & 25MG Tablet 02473267 JAMP CANDESARTAN-HCT JMP
ST32MG & 25MG Tablet 02420740 SANDOZ CANDESARTAN PLUS SDZ

EPOSARTAN MESYLATE

Table: EPOSARTAN MESYLATE
Drug strength and dosage form DIN Brand name Manufacturer code
ST400MG Tablet 02240432 TEVETEN BGP
ST600MG Tablet 02243942 TEVETEN BGP

EPOSARTAN MESYLATE, HYDROCHLOROTHIAZIDE

Table: EPOSARTAN MESYLATE, HYDROCHLOROTHIAZIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST600MG & 12.5MG Tablet 02253631 TEVETEN PLUS BGP

IRBESARTAN

Table: IRBESARTAN
Drug strength and dosage form DIN Brand name Manufacturer code
75MG Tablet 02474395 AG-IRBESARTAN ANG
ST75MG Tablet 02386968 APO-IRBESARTAN APX
ST75MG Tablet 02406098 AURO-IRBESARTAN AUR
ST75MG Tablet 02237923 AVAPRO SAC
75MG Tablet 02446146 BIO-IRBESARTAN BMI
ST75MG Tablet 02365197 IRBESARTAN PDL
ST75MG Tablet 02372347 IRBESARTAN SAN
ST75MG Tablet 02385287 IRBESARTAN SIV
ST75MG Tablet 02418193 JAMP-IRBESARTAN JMP
ST75MG Tablet 02422980 MINT-IRBESARTAN MIN
ST75MG Tablet 02317060 PMS-IRBESARTAN PMS
ST75MG Tablet 02328461 SANDOZ IRBESARTAN SDZ
ST75MG Tablet 02406810 TARO-IRBESARTAN SUN
ST75MG Tablet 02316390 TEVA-IRBESARTAN TEV
150MG Tablet 02474409 AG-IRBESARTAN ANG
ST150MG Tablet 02386976 APO-IRBESARTAN APX
ST150MG Tablet 02406101 AURO-IRBESARTAN AUR
ST150MG Tablet 02237924 AVAPRO SAC
150MG Tablet 02446154 BIO-IRBESARTAN BMI
ST150MG Tablet 02365200 IRBESARTAN PDL
ST150MG Tablet 02372371 IRBESARTAN SAN
ST150MG Tablet 02385295 IRBESARTAN SIV
ST150MG Tablet 02418207 JAMP-IRBESARTAN JMP
ST150MG Tablet 02422999 MINT-IRBESARTAN MIN
ST150MG Tablet 02317079 PMS-IRBESARTAN PMS
ST150MG Tablet 02328488 SANDOZ IRBESARTAN SDZ
ST150MG Tablet 02406829 TARO-IRBESARTAN SUN
ST150MG Tablet 02316404 TEVA-IRBESARTAN TEV
300MG Tablet 02474417 AG-IRBESARTAN ANG
ST300MG Tablet 02386984 APO-IRBESARTAN APX
ST300MG Tablet 02406128 AURO-IRBESARTAN AUR
ST300MG Tablet 02237925 AVAPRO SAC
300MG Tablet 02446162 BIO-IRBESARTAN BMI
ST300MG Tablet 02365219 IRBESARTAN PDL
ST300MG Tablet 02372398 IRBESARTAN SAN
ST300MG Tablet 02385309 IRBESARTAN SIV
ST300MG Tablet 02418215 JAMP-IRBESARTAN JMP
ST300MG Tablet 02423006 MINT-IRBESARTAN MIN
ST300MG Tablet 02317087 PMS-IRBESARTAN PMS
ST300MG Tablet 02328496 SANDOZ IRBESARTAN SDZ
ST300MG Tablet 02406837 TARO-IRBESARTAN SUN
ST300MG Tablet 02316412 TEVA-IRBESARTAN TEV

IRBESARTAN, HYDROCHLOROTHIAZIDE

Table: IRBESARTAN, HYDROCHLOROTHIAZIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST150MG & 12.5MG Tablet 02447878 AURO-IRBESARTAN HCT AUR
ST150MG & 12.5MG Tablet 02241818 AVALIDE SAC
ST150MG & 12.5MG Tablet 02385317 IRBESARTAN HCT SIV
ST150MG & 12.5MG Tablet 02372886 IRBESARTAN/HCTZ SAN
ST150MG & 12.5MG Tablet 02365162 IRBESARTAN-HCTZ PDL
ST150MG & 12.5MG Tablet 02418223 JAMP-IRBESARTAN AND HYDROCHLOROTHIAZIDE JMP
ST150MG & 12.5MG Tablet 02392992 MINT-IRBESARTAN/HCTZ MIN
ST150MG & 12.5MG Tablet 02328518 PMS-IRBESARTAN-HCTZ PMS
ST150MG & 12.5MG Tablet 02363208 RAN-IRBESARTAN HCTZ RBY
ST150MG & 12.5MG Tablet 02337428 SANDOZ IRBESARTAN HCT SDZ
ST150MG & 12.5MG Tablet 02330512 TEVA-IRBESARTAN HCTZ TEV
ST300MG & 12.5MG Tablet 02447886 AURO-IRBESARTAN HCT AUR
ST300MG & 12.5MG Tablet 02241819 AVALIDE SAC
ST300MG & 12.5MG Tablet 02385325 IRBESARTAN HCT SIV
ST300MG & 12.5MG Tablet 02372894 IRBESARTAN/HCTZ SAN
ST300MG & 12.5MG Tablet 02365170 IRBESARTAN-HCTZ PDL
ST300MG & 12.5MG Tablet 02418231 JAMP-IRBESARTAN AND HYDROCHLOROTHIAZIDE JMP
ST300MG & 12.5MG Tablet 02393018 MINT-IRBESARTAN/HCTZ MIN
ST300MG & 12.5MG Tablet 02328526 PMS-IRBESARTAN-HCTZ PMS
ST300MG & 12.5MG Tablet 02363216 RAN-IRBESARTAN HCTZ RBY
ST300MG & 12.5MG Tablet 02337436 SANDOZ IRBESARTAN HCT SDZ
ST300MG & 12.5MG Tablet 02330520 TEVA-IRBESARTAN HCTZ TEV
ST300MG & 25MG Tablet 02387662 APO-IRBESARTAN/HCTZ APX
ST300MG & 25MG Tablet 02447894 AURO-IRBESARTAN HCT AUR
ST300MG & 25MG Tablet 02385333 IRBESARTAN HCT SIV
ST300MG & 25MG Tablet 02372908 IRBESARTAN/HCTZ SAN
ST300MG & 25MG Tablet 02365189 IRBESARTAN-HCTZ PDL
ST300MG & 25MG Tablet 02418258 JAMP-IRBESARTAN AND HYDROCHLOROTHIAZIDE JMP
ST300MG & 25MG Tablet 02393026 MINT-IRBESARTAN/HCTZ MIN
ST300MG & 25MG Tablet 02328534 PMS-IRBESARTAN-HCTZ PMS
ST300MG & 25MG Tablet 02363224 RAN-IRBESARTAN HCTZ RBY
ST300MG & 25MG Tablet 02337444 SANDOZ IRBESARTAN HCT SDZ
ST300MG & 25MG Tablet 02330539 TEVA-IRBESARTAN HCTZ TEV

LOSARTAN POTASSIUM

Table: LOSARTAN POTASSIUM
Drug strength and dosage form DIN Brand name Manufacturer code
100MG Capsule 99113701 LOSARTAN (PQ) UNK
25MG Tablet 02441195 AG-LOSARTAN ANG
ST25MG Tablet 02379058 APO-LOSARTAN APX
ST25MG Tablet 02403323 AURO-LOSARTAN AUR
25MG Tablet 02445964 BIO-LOSARTAN BMI
ST25MG Tablet 02182815 COZAAR FRS
ST25MG Tablet 02398834 JAMP-LOSARTAN JMP
ST25MG Tablet 02388790 LOSARTAN SIV
ST25MG Tablet 02388863 LOSARTAN SAN
ST25MG Tablet 02394367 LOSARTAN PDL
ST25MG Tablet 02405733 MINT-LOSARTAN MIN
ST25MG Tablet 02309750 PMS-LOSARTAN PMS
ST25MG Tablet 02313332 SANDOZ LOSARTAN SDZ
ST25MG Tablet 02424967 SEPTA-LOSARTAN SPT
ST25MG Tablet 02380838 TEVA-LOSARTAN TEV
50MG Tablet 02441209 AG-LOSARTAN ANG
ST50MG Tablet 02353504 APO-LOSARTAN APX
ST50MG Tablet 02403331 AURO-LOSARTAN AUR
50MG Tablet 02445972 BIO-LOSARTAN BMI
ST50MG Tablet 02182874 COZAAR FRS
ST50MG Tablet 02398842 JAMP-LOSARTAN JMP
ST50MG Tablet 02388804 LOSARTAN SIV
ST50MG Tablet 02388871 LOSARTAN SAN
ST50MG Tablet 02394375 LOSARTAN PDL
ST50MG Tablet 02405741 MINT-LOSARTAN MIN
ST50MG Tablet 02309769 PMS-LOSARTAN PMS
ST50MG Tablet 02313340 SANDOZ LOSARTAN SDZ
ST50MG Tablet 02424975 SEPTA-LOSARTAN SPT
ST50MG Tablet 02357968 TEVA-LOSARTAN TEV
100MG Tablet 02441217 AG-LOSARTAN ANG
ST100MG Tablet 02353512 APO-LOSARTAN APX
ST100MG Tablet 02403358 AURO-LOSARTAN AUR
100MG Tablet 02445980 BIO-LOSARTAN BMI
ST100MG Tablet 02182882 COZAAR FRS
ST100MG Tablet 02398850 JAMP-LOSARTAN JMP
ST100MG Tablet 02388812 LOSARTAN SIV
ST100MG Tablet 02388898 LOSARTAN SAN
ST100MG Tablet 02394383 LOSARTAN PDL
ST100MG Tablet 02405768 MINT-LOSARTAN MIN
ST100MG Tablet 02309777 PMS-LOSARTAN PMS
ST100MG Tablet 02313359 SANDOZ LOSARTAN SDZ
ST100MG Tablet 02424983 SEPTA-LOSARTAN SPT
ST100MG Tablet 02357976 TEVA-LOSARTAN TEV

LOSARTAN POTASSIUM, HYDROCHLOROTHIAZIDE

Table: LOSARTAN POTASSIUM, HYDROCHLOROTHIAZIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST50MG & 12.5MG Tablet 02371235 APO-LOSARTAN/HCTZ APX
ST50MG & 12.5MG Tablet 02423642 AURO-LOSARTAN HCT AUR
ST50MG & 12.5MG Tablet 02230047 HYZAAR FRS
ST50MG & 12.5MG Tablet 02408244 JAMP-LOSARTAN HCTZ JMP
ST50MG & 12.5MG Tablet 02388960 LOSARTAN HCT SIV
ST50MG & 12.5MG Tablet 02427648 LOSARTAN/HCTZ SAN
ST50MG & 12.5MG Tablet 02394391 LOSARTAN-HCTZ PDL
ST50MG & 12.5MG Tablet 02389657 MINT-LOSARTAN/HCTZ MIN
ST50MG & 12.5MG Tablet 02392224 PMS-LOSARTAN-HCTZ PMS
ST50MG & 12.5MG Tablet 02313375 SANDOZ LOSARTAN HCT SDZ
ST50MG & 12.5MG Tablet 02428539 SEPTA-LOSARTAN HCTZ SPT
ST50MG & 12.5MG Tablet 02358263 TEVA-LOSARTAN/HCTZ TEV
ST100MG & 12.5MG Tablet 02371243 APO-LOSARTAN/HCTZ APX
ST100MG & 12.5MG Tablet 02423650 AURO-LOSARTAN HCT AUR
ST100MG & 12.5MG Tablet 02297841 HYZAAR FRS
ST100MG & 12.5MG Tablet 02388979 LOSARTAN HCT SIV
ST100MG & 12.5MG Tablet 02427656 LOSARTAN/HCTZ SAN
ST100MG & 12.5MG Tablet 02394405 LOSARTAN-HCTZ PDL
ST100MG & 12.5MG Tablet 02389665 MINT-LOSARTAN/HCTZ MIN
ST100MG & 12.5MG Tablet 02392232 PMS-LOSARTAN-HCTZ PMS
ST100MG & 12.5MG Tablet 02362449 SANDOZ LOSARTAN HCT SDZ
ST100MG & 12.5MG Tablet 02377144 TEVA-LOSARTAN/HCTZ TEV
ST100MG & 25MG Tablet 02371251 APO-LOSARTAN/HCTZ APX
ST100MG & 25MG Tablet 02423669 AURO-LOSARTAN HCT AUR
ST100MG & 25MG Tablet 02241007 HYZAAR DS FRS
ST100MG & 25MG Tablet 02408252 JAMP-LOSARTAN HCTZ JMP
ST100MG & 25MG Tablet 02388987 LOSARTAN HCT SIV
ST100MG & 25MG Tablet 02427664 LOSARTAN/HCTZ SAN
ST100MG & 25MG Tablet 02394413 LOSARTAN-HCTZ PDL
ST100MG & 25MG Tablet 02389673 MINT-LOSARTAN/HCTZ MIN
ST100MG & 25MG Tablet 02392240 PMS-LOSARTAN-HCTZ PMS
ST100MG & 25MG Tablet 02313383 SANDOZ LOSARTAN HCT SDZ
ST100MG & 25MG Tablet 02428547 SEPTA-LOSARTAN HCTZ SPT
ST100MG & 25MG Tablet 02377152 TEVA-LOSARTAN/HCTZ TEV

OLMESARTAN MEDOXOMIL

Table: OLMESARTAN MEDOXOMIL
Drug strength and dosage form DIN Brand name Manufacturer code
40MG Capsule 99113716 OLMESARTAN (QC) UNK
ST20MG Tablet 02442191 ACT OLMESARTAN TEV
20MG Tablet 02475731 AG-OLMESARTAN ANG
ST20MG Tablet 02453452 APO-OLMESARTAN APX
ST20MG Tablet 02443864 AURO-OLMESARTAN AUR
ST20MG Tablet 02469812 GLN-OLMESARTAN GLK
ST20MG Tablet 02461641 JAMP-OLMESARTAN JMP
ST20MG Tablet 02481057 OLMESARTAN SAN
20MG Tablet 02488744 OLMESARTAN PDL
ST20MG Tablet 02318660 OLMETEC FRS
ST20MG Tablet 02461307 PMS-OLMESARTAN PMS
ST20MG Tablet 02443414 SANDOZ OLMESARTAN SDZ
ST40MG Tablet 02442205 ACT OLMESARTAN TEV
40MG Tablet 02475758 AG-OLMESARTAN ANG
ST40MG Tablet 02453460 APO-OLMESARTAN APX
ST40MG Tablet 02443872 AURO-OLMESARTAN AUR
40MG Tablet 02469820 GLN-OLMESARTAN GLK
ST40MG Tablet 02461668 JAMP-OLMESARTAN JMP
ST40MG Tablet 02481065 OLMESARTAN SAN
40MG Tablet 02488752 OLMESARTAN PDL
ST40MG Tablet 02318679 OLMETEC FRS
ST40MG Tablet 02461315 PMS-OLMESARTAN PMS
ST40MG Tablet 02443422 SANDOZ OLMESARTAN SDZ

OLMESARTAN MEDOXOMIL, HYDROCHLOROTHIAZIDE

Table: OLMESARTAN MEDOXOMIL, HYDROCHLOROTHIAZIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST20MG & 12.5MG Tablet 02468948 ACH-OLMESARTAN HCTZ ACC
ST20MG & 12.5MG Tablet 02443112 ACT OLMESARTAN HCT TEV
ST20MG & 12.5MG Tablet 02453606 APO-OLMESARTAN/HCTZ APX
ST20MG & 12.5MG Tablet 02476487 AURO-OLMESARTAN HCTZ AUR
ST20MG/12.5MG Tablet 02319616 OLMETEC PLUS FRS
ST40MG & 12.5MG Tablet 02468956 ACH-OLMESARTAN HCTZ ACC
ST40MG & 12.5MG Tablet 02443120 ACT OLMESARTAN HCT TEV
ST40MG & 12.5MG Tablet 02453614 APO-OLMESARTAN/HCTZ APX
ST40MG & 12.5MG Tablet 02476495 AURO-OLMESARTAN HCTZ AUR
ST40MG & 25MG Tablet 02468964 ACH-OLMESARTAN HCTZ ACC
ST40MG & 25MG Tablet 02443139 ACT OLMESARTAN HCT TEV
ST40MG & 25MG Tablet 02453622 APO-OLMESARTAN/HCTZ APX
ST40MG & 25MG Tablet 02476509 AURO-OLMESARTAN HCTZ AUR
ST40MG/12.5MG Tablet 02319624 OLMETEC PLUS FRS
ST40MG/25MG Tablet 02319632 OLMETEC PLUS FRS

TELMISARTAN

Table: TELMISARTAN
Drug strength and dosage form DIN Brand name Manufacturer code
80MG Capsule 99113746 TELMISARTAN (QC) UNK
ST40MG Tablet 02420082 APO-TELMISARTAN APX
ST40MG Tablet 02453568 AURO-TELMISARTAN AUR
ST40MG Tablet 02240769 MICARDIS BOE
ST40MG Tablet 02486369 MINT-TELMISARTAN MIN
ST40MG Tablet 02391236 PHARMA-TELMISARTAN PMS
ST40MG Tablet 02375958 SANDOZ TELMISARTAN SDZ
ST40MG Tablet 02388944 TELMISARTAN SAN
ST40MG Tablet 02390345 TELMISARTAN SIV
ST40MG Tablet 02395223 TELMISARTAN PDL
ST40MG Tablet 02407485 TELMISARTAN ACC
ST40MG Tablet 02320177 TEVA-TELMISARTAN TEV
ST80MG Tablet 02420090 APO-TELMISARTAN APX
ST80MG Tablet 02453576 AURO-TELMISARTAN AUR
ST80MG Tablet 02240770 MICARDIS BOE
ST80MG Tablet 02391244 PHARMA-TELMISARTAN PMS
ST80MG Tablet 02375966 SANDOZ TELMISARTAN SDZ
ST80MG Tablet 02388952 TELMISARTAN SAN
ST80MG Tablet 02390353 TELMISARTAN SIV
ST80MG Tablet 02395231 TELMISARTAN PDL
ST80MG Tablet 02407493 TELMISARTAN ACC
ST80MG Tablet 02432900 TELMISARTAN PMS
ST80MG Tablet 02320185 TEVA-TELMISARTAN TEV

TELMISARTAN, HYDROCHLOROTHIAZIDE

Table: TELMISARTAN, HYDROCHLOROTHIAZIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST80MG & 12.5MG Tablet 02419114 ACH-TELMISARTAN HCTZ ACC
ST80MG & 12.5MG Tablet 02456389 AURO-TELMISARTAN HCTZ AUR
ST80MG & 12.5MG Tablet 02244344 MICARDIS PLUS BOE
ST80MG & 12.5MG Tablet 02401665 PMS-TELMISARTAN-HCTZ PMS
ST80MG & 12.5MG Tablet 02393557 SANDOZ TELMISARTAN HCT SDZ
ST80MG & 12.5MG Tablet 02390302 TELMISARTAN HCTZ SIV
ST80MG & 12.5MG Tablet 02395355 TELMISARTAN/HCTZ SAN
ST80MG & 12.5MG Tablet 02395525 TELMISARTAN-HCTZ PDL
ST80MG & 12.5MG Tablet 02433214 TELMISARTAN-HCTZ PMS
ST80MG & 12.5MG Tablet 02330288 TEVA-TELMISARTAN HCTZ TEV
ST80MG & 25MG Tablet 02419122 ACH-TELMISARTAN HCTZ ACC
ST80MG & 25MG Tablet 02420031 APO-TELMISARTAN/HCTZ APX
ST80MG & 25MG Tablet 02456397 AURO-TELMISARTAN HCTZ AUR
ST80MG & 25MG Tablet 02318709 MICARDIS PLUS BOE
ST80MG & 25MG Tablet 02393565 SANDOZ TELMISARTAN HCT SDZ
ST80MG & 25MG Tablet 02390310 TELMISARTAN HCTZ SIV
ST80MG & 25MG Tablet 02395363 TELMISARTAN/HCTZ SAN
ST80MG & 25MG Tablet 02395533 TELMISARTAN-HCTZ PDL
ST80MG & 25MG Tablet 02433222 TELMISARTAN-HCTZ PMS
ST80MG & 25MG Tablet 02379252 TEVA-TELMISARTAN HCTZ TEV

VALSARTAN

Table: VALSARTAN
Drug strength and dosage form DIN Brand name Manufacturer code
ST40MG Tablet 02371510 APO-VALSARTAN APX
ST40MG Tablet 02414201 AURO-VALSARTAN AUR
ST40MG Tablet 02270528 DIOVAN NVR
ST40MG Tablet 02356740 SANDOZ VALSARTAN SDZ
ST40MG Tablet 02363062 TARO-VALSARTAN SUN
ST40MG Tablet 02356643 TEVA-VALSARTAN TEV
ST40MG Tablet 02366940 VALSARTAN SAN
ST40MG Tablet 02367726 VALSARTAN PDL
ST40MG Tablet 02384523 VALSARTAN SIV
ST80MG Tablet 02371529 APO-VALSARTAN APX
ST80MG Tablet 02414228 AURO-VALSARTAN AUR
ST80MG Tablet 02244781 DIOVAN NVR
ST80MG Tablet 02356759 SANDOZ VALSARTAN SDZ
ST80MG Tablet 02363100 TARO-VALSARTAN SUN
ST80MG Tablet 02356651 TEVA-VALSARTAN TEV
ST80MG Tablet 02366959 VALSARTAN SAN
ST80MG Tablet 02367734 VALSARTAN PDL
ST80MG Tablet 02384531 VALSARTAN SIV
ST160MG Tablet 02371537 APO-VALSARTAN APX
ST160MG Tablet 02414236 AURO-VALSARTAN AUR
ST160MG Tablet 02244782 DIOVAN NVR
ST160MG Tablet 02356767 SANDOZ VALSARTAN SDZ
ST160MG Tablet 02363119 TARO-VALSARTAN SUN
ST160MG Tablet 02356678 TEVA-VALSARTAN TEV
ST160MG Tablet 02366967 VALSARTAN SAN
ST160MG Tablet 02367742 VALSARTAN PDL
ST160MG Tablet 02384558 VALSARTAN SIV
ST320MG Tablet 02371545 APO-VALSARTAN APX
ST320MG Tablet 02414244 AURO-VALSARTAN AUR
ST320MG Tablet 02289504 DIOVAN NVR
ST320MG Tablet 02356775 SANDOZ VALSARTAN SDZ
ST320MG Tablet 02356686 TEVA-VALSARTAN TEV
ST320MG Tablet 02366975 VALSARTAN SAN
ST320MG Tablet 02367750 VALSARTAN PDL
ST320MG Tablet 02384566 VALSARTAN SIV

VALSARTAN, HYDROCHLOROTHIAZIDE

Table: VALSARTAN, HYDROCHLOROTHIAZIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST80MG & 12.5MG Tablet 02382547 APO-VALSARTAN/HCTZ APX
ST80MG & 12.5MG Tablet 02408112 AURO-VALSARTAN HCT AUR
ST80MG & 12.5MG Tablet 02241900 DIOVAN-HCT NVR
ST80MG & 12.5MG Tablet 02356694 SANDOZ VALSARTAN HCT SDZ
ST80MG & 12.5MG Tablet 02356996 TEVA-VALSARTAN/HCTZ TEV
ST80MG & 12.5MG Tablet 02367009 VALSARTAN HCT SAN
ST80MG & 12.5MG Tablet 02384736 VALSARTAN HCT SIV
ST80MG & 12.5MG Tablet 02367769 VALSARTAN-HCTZ PDL
ST160MG & 12.5MG Tablet 02382555 APO-VALSARTAN/HCTZ APX
ST160MG & 12.5MG Tablet 02408120 AURO-VALSARTAN HCT AUR
ST160MG & 12.5MG Tablet 02241901 DIOVAN-HCT NVR
ST160MG & 12.5MG Tablet 02356708 SANDOZ VALSARTAN HCT SDZ
ST160MG & 12.5MG Tablet 02357003 TEVA-VALSARTAN/HCTZ TEV
ST160MG & 12.5MG Tablet 02367017 VALSARTAN HCT SAN
ST160MG & 12.5MG Tablet 02384744 VALSARTAN HCT SIV
ST160MG & 12.5MG Tablet 02367777 VALSARTAN-HCTZ PDL
ST160MG & 25MG Tablet 02382563 APO-VALSARTAN/HCTZ APX
ST160MG & 25MG Tablet 02408139 AURO-VALSARTAN HCT AUR
ST160MG & 25MG Tablet 02246955 DIOVAN-HCT NVR
ST160MG & 25MG Tablet 02356716 SANDOZ VALSARTAN HCT SDZ
ST160MG & 25MG Tablet 02357011 TEVA-VALSARTAN/HCTZ TEV
ST160MG & 25MG Tablet 02367025 VALSARTAN HCT SAN
ST160MG & 25MG Tablet 02384752 VALSARTAN HCT SIV
ST160MG & 25MG Tablet 02367785 VALSARTAN-HCTZ PDL
ST320MG & 12.5MG Tablet 02382571 APO-VALSARTAN/HCTZ APX
ST320MG & 12.5MG Tablet 02408147 AURO-VALSARTAN HCT AUR
ST320MG & 12.5MG Tablet 02308908 DIOVAN-HCT NVR
ST320MG & 12.5MG Tablet 02356724 SANDOZ VALSARTAN HCT SDZ
ST320MG & 12.5MG Tablet 02357038 TEVA-VALSARTAN/HCTZ TEV
ST320MG & 12.5MG Tablet 02367033 VALSARTAN HCT SAN
ST320MG & 12.5MG Tablet 02384760 VALSARTAN HCT SIV
ST320MG & 25MG Tablet 02382598 APO-VALSARTAN/HCTZ APX
ST320MG & 25MG Tablet 02408155 AURO-VALSARTAN HCT AUR
ST320MG & 25MG Tablet 02308916 DIOVAN-HCT NVR
ST320MG & 25MG Tablet 02356732 SANDOZ VALSARTAN HCT SDZ
ST320MG & 25MG Tablet 02357046 TEVA-VALSARTAN/HCTZ TEV
ST320MG & 25MG Tablet 02367041 VALSARTAN HCT SAN

24:32.20 MINERALOCORTICOIDE (ALDOSTERONE) RECEPTOR ANTAGONISTS

ENALAPRIL MALEATE

Table: ENALAPRIL MALEATE
Drug strength and dosage form DIN Brand name Manufacturer code
ST2.5MG Tablet 02474786 JAMP ENALAPRIL JMP
ST5MG Tablet 02474794 JAMP ENALAPRIL JMP
ST10MG Tablet 02474808 JAMP ENALAPRIL JMP
ST20MG Tablet 02474816 JAMP ENALAPRIL JMP

EPLERENONE

Limited use benefit (prior approval required).

For the treatment of patients with New York Heart Association (NYHA) class II chronic heart failure with left ventricular systolic dysfunction (with ejection fraction ≤ 35%), as an adjunct to standard therapy.

Note: Patients must be on optimal therapy with an angiotensin-converting-enzyme (ACE) inhibitor or an angiotensin-receptor blocker (ARB), and a beta-blocker (unless contraindicated) at the recommended dose or maximal tolerated dose.

Table: EPLERENONE
Drug strength and dosage form DIN Brand name Manufacturer code
25MG Tablet 02323052 INSPRA UNK
25MG Tablet 02471442 MINT-EPLERENONE MIN
50MG Tablet 02323060 INSPRA UNK
50MG Tablet 02471450 MINT-EPLERENONE MIN

HYDROCHLOROTHIAZIDE, SPIRONOLACTONE

Table: HYDROCHLOROTHIAZIDE, SPIRONOLACTONE
Drug strength and dosage form DIN Brand name Manufacturer code
ST pDIN For Extemporaneous Mixture 99503009 ALDACTAZIDE ORAL LIQUID UNK

SPIRONOLACTONE

Table: SPIRONOLACTONE
Drug strength and dosage form DIN Brand name Manufacturer code
ST25MG Tablet 00028606 ALDACTONE PFI
ST25MG Tablet 00613215 TEVA-SPIRONOLACTONE TEV
ST100MG Tablet 00285455 ALDACTONE PFI
ST100MG Tablet 00613223 TEVA-SPIRONOLACTONE TEV
ST pDIN For Extemporaneous Mixture 99503001 SPIRONOLACTONE ORAL LIQUID UNK

24:32.92 

VALSARTAN, SACUBITRIL

Limited use benefit (prior approval required).

For the treatment of New York Heart Association (NYHA) class II or III heart failure if the following criteria are met:

  • must be initiated by a physician experienced in the treatment of heart failure; and
  • left ventricular ejection fraction < 40%; and
  • NYHA class II to III symptoms despite at least four weeks of treatment with an angiotensin-converting enzyme inhibitor (ACEI) or an angiotensin II receptor antagonist (ARB); or If your patient has a contraindication or intolerance to ACEI or ARBs; and
  • must be used in combination with a beta blocker and an aldosterone antagonist (if tolerated); or If your patient has a contraindication or intolerance to beta blockers or aldosterone antagonists.
Table: VALSARTAN, SACUBITRIL
Drug strength and dosage form DIN Brand name Manufacturer code
26MG & 24MG Tablet 02446928 ENTRESTO NVR
51MG & 49MG Tablet 02446936 ENTRESTO NVR
103MG & 97MG Tablet 02446944 ENTRESTO NVR
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