KP Wellness
1:55 PM - Public
Migraine & Cluster Headache Therapy
1 HEADACHE THERAPY
TIER 1
+ Acetaminophen/Caffeine/Butalbital
+ Aspirin/Caffeine/Butalbital
+ Dihydroergotamine Mesylate (D .H .E .45)
+ Naratriptan HCl
+ Sumatriptan Succinate Tablet
TIER 2
Cafergot (Ergotamine Tartrate/ Caffeine Tablet)
Ergomar (Ergotamine Tartrate)
+ Sumatriptan Succinate Nasal Spray
TIER 3
Sumatriptan Injection (Alsuma)
Almotriptan Malate (Axert)
Frovatriptan (Frova)
Rizatriptan (Maxalt)
Dihydroergotamine Mesylate Spray (Migranal)
Sumatriptan Injection (Sumavel DosePro)
sumatriptan and naproxen (Treximet)
Zolmitriptan (Zomig)
1 HEADACHE THERAPY
TIER 1
+ Acetaminophen/Caffeine/Butalbital
+ Aspirin/Caffeine/Butalbital
+ Dihydroergotamine Mesylate (D .H .E .45)
+ Naratriptan HCl
+ Sumatriptan Succinate Tablet
TIER 2
Cafergot (Ergotamine Tartrate/ Caffeine Tablet)
Ergomar (Ergotamine Tartrate)
+ Sumatriptan Succinate Nasal Spray
TIER 3
Sumatriptan Injection (Alsuma)
Almotriptan Malate (Axert)
Frovatriptan (Frova)
Rizatriptan (Maxalt)
Dihydroergotamine Mesylate Spray (Migranal)
Sumatriptan Injection (Sumavel DosePro)
sumatriptan and naproxen (Treximet)
Zolmitriptan (Zomig)
KP Wellness
1:54 PM - Public
3.4.2 ANTIVERTIGO & ANTIEMETIC DRUGS
TIER 1
+ Dronabinol (Marinol)
+ Ondansetron HCl (Zofran)
+ Ondansetron HCl Tablet, Rapid Dissolve
(Zofran ODT)
+ Prochlorperazine Maleate Tablet (Compazine)
+ Promethazine HCl (Phenergan)
+ Trimethobenzamide HCl Capsule (Tigan 250, 300 mg)
TIER 2
Antivert 50 mg (Meclizine HCl Tablet)
Emend (Aprepitant)
+ Granisetron HCl Tablet (Kytril)**
TIER 3
Dolasetron (Anzemet)
Nabilone Capsules (Cesamet)
Granisetron Patch (Sancuso)
Scopolamine (Scopace)
Scopolamine transdermal (Transderm-Scop)
Zuplenz
TIER 1
+ Dronabinol (Marinol)
+ Ondansetron HCl (Zofran)
+ Ondansetron HCl Tablet, Rapid Dissolve
(Zofran ODT)
+ Prochlorperazine Maleate Tablet (Compazine)
+ Promethazine HCl (Phenergan)
+ Trimethobenzamide HCl Capsule (Tigan 250, 300 mg)
TIER 2
Antivert 50 mg (Meclizine HCl Tablet)
Emend (Aprepitant)
+ Granisetron HCl Tablet (Kytril)**
TIER 3
Dolasetron (Anzemet)
Nabilone Capsules (Cesamet)
Granisetron Patch (Sancuso)
Scopolamine (Scopace)
Scopolamine transdermal (Transderm-Scop)
Zuplenz
KP Wellness
1:22 PM (edited) - Public
3.5 Antiparkinsonism Agents
TIER 1
+ Amantadine HCl (Symmetrel)
+ Benztropine Mesylate (Cogentin)
+ Bromocriptine Mesylate (Parlodel)
+ Carbidopa/Levodopa (Sinemet)
+ Carbidopa/Levodopa Tablet,
Rapid Dissolve (Parcopa)
+ Carbidopa/Levodopa Tablet, Sustained-Action
(Sinemet CR)
+ Pramipexole Di-HCl (Mirapex)
+ Ropinirole HCl (Requip)
+ Selegiline HCl (Eldepryl)
+ Trihexyphenidyl HCl (Artane)
TIER 2
Akineton (Biperiden HCl)
Apokyn (Apomorphine HCl)
Comtan (Entacapone)
Tasmar (Tolcapone)
TIER 3
Rasagiline (Azilect)
Pramipexole (Mirapex)
Ropinirole Hcl (Requip)
Carbidopa, Levodopa and Entacapone (Stalevo)
Selegiline Hydrochloride (Zelapar)
TIER 1
+ Amantadine HCl (Symmetrel)
+ Benztropine Mesylate (Cogentin)
+ Bromocriptine Mesylate (Parlodel)
+ Carbidopa/Levodopa (Sinemet)
+ Carbidopa/Levodopa Tablet,
Rapid Dissolve (Parcopa)
+ Carbidopa/Levodopa Tablet, Sustained-Action
(Sinemet CR)
+ Pramipexole Di-HCl (Mirapex)
+ Ropinirole HCl (Requip)
+ Selegiline HCl (Eldepryl)
+ Trihexyphenidyl HCl (Artane)
TIER 2
Akineton (Biperiden HCl)
Apokyn (Apomorphine HCl)
Comtan (Entacapone)
Tasmar (Tolcapone)
TIER 3
Rasagiline (Azilect)
Pramipexole (Mirapex)
Ropinirole Hcl (Requip)
Carbidopa, Levodopa and Entacapone (Stalevo)
Selegiline Hydrochloride (Zelapar)
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