KP Wellness
12:52 PM - Public
2. Antineoplastic & Immunosuppressant Drugs
2.1 Antineoplastic & Immunosuppressant Drugs
2.1.1 ALKYLATING AGENTS
TIER 1
Cyclophosphamide (Cytoxan)
TIER 2
Alkeran (Melphalan Tablet)
CeeNu (Lomustine)
Leukeran (Chlorambucil)
Myleran (Busulfan)
Temodar (Temozolamide)
2.1.2 ANTIMETABOLITES
TIER 1
Mercaptopurine (Purinethol)
Methotrexate Sodium (Methotrexate)
TIER 2
Rheumatrex, Trexall (Methotrexate Sodium)
Xeloda (Capecitabine)
2.1.3 ANDROGENS, ESTROGENS, HORMONES & RELATED DRUGS
2.1.3.1 ANDROGENS
TIER 2
Oxandrolone (Oxandrin)
2.1.3.3 HORMONES
TIER 1
Megestrol Acetate (Megace)
TIER 3
Megestrol Acetate (Megace)
2.1.3.4 ANTIESTROGENS
TIER 1
Anastrozole (Arimidex)
Letrozole (Femara)
Tamoxifen (Nolvadex)
TIER 2
Exemestane (Aromasin)
Fareston (Toremifene Citrate)
2.1.3.5 ANTIANDROGENS
TIER 1
Bicalutamide (Casodex)
Flutamide (Eulexin)
TIER 2
Nilandron (Nilutamide)
2.1.5 IMMUNOSUPPRESSANT DRUGS
TIER 1
Azathioprine (Imuran)
Cyclosporine, Modified (Gengraf)
Mycophenolate Mofetil Capsule, Tablet (CellCept)
Tacrolimus Anhydrous (Prograf)
TIER 2
CellCept (Mycophenolate Mofetil HCl
Suspension, Reconstituted, Oral)
Myfortic (Mycophenolate Sodium)
Neoral (Cyclosporine, Modified)
Rapamune (Sirolimus)
Sandimmune (Cyclosporine)
TIER 3
Azathioprine (Azasan)
2.1 Antineoplastic & Immunosuppressant Drugs
2.1.1 ALKYLATING AGENTS
TIER 1
Cyclophosphamide (Cytoxan)
TIER 2
Alkeran (Melphalan Tablet)
CeeNu (Lomustine)
Leukeran (Chlorambucil)
Myleran (Busulfan)
Temodar (Temozolamide)
2.1.2 ANTIMETABOLITES
TIER 1
Mercaptopurine (Purinethol)
Methotrexate Sodium (Methotrexate)
TIER 2
Rheumatrex, Trexall (Methotrexate Sodium)
Xeloda (Capecitabine)
2.1.3 ANDROGENS, ESTROGENS, HORMONES & RELATED DRUGS
2.1.3.1 ANDROGENS
TIER 2
Oxandrolone (Oxandrin)
2.1.3.3 HORMONES
TIER 1
Megestrol Acetate (Megace)
TIER 3
Megestrol Acetate (Megace)
2.1.3.4 ANTIESTROGENS
TIER 1
Anastrozole (Arimidex)
Letrozole (Femara)
Tamoxifen (Nolvadex)
TIER 2
Exemestane (Aromasin)
Fareston (Toremifene Citrate)
2.1.3.5 ANTIANDROGENS
TIER 1
Bicalutamide (Casodex)
Flutamide (Eulexin)
TIER 2
Nilandron (Nilutamide)
2.1.5 IMMUNOSUPPRESSANT DRUGS
TIER 1
Azathioprine (Imuran)
Cyclosporine, Modified (Gengraf)
Mycophenolate Mofetil Capsule, Tablet (CellCept)
Tacrolimus Anhydrous (Prograf)
TIER 2
CellCept (Mycophenolate Mofetil HCl
Suspension, Reconstituted, Oral)
Myfortic (Mycophenolate Sodium)
Neoral (Cyclosporine, Modified)
Rapamune (Sirolimus)
Sandimmune (Cyclosporine)
TIER 3
Azathioprine (Azasan)
KP Wellness
12:49 PM - Public
2.1.6 MISCELLANEOUS ANTINEOPLASTIC DRUGS
TIER 1
Etoposide (VePesid)
Hydroxyurea (Hydrea)
Leuprolide Acetate (Lupron 1 mg/0 .2 ml)
Octreotide Acetate (Octreotide Acetate)
TIER 2
Afinitor (Everolimus)
Droxia (Hydroxyurea)
Emcyt (Estramustine Phosphate Sodium)
Gleevec (Imatinib Mesylate)
Hexalen (Altretamine)
Hycamtin (Topotecan HCl Capsule)
Lysodren (Mitotane)
Matulane (Procarbazine HCl)
Nexavar (Sorafenib Tosylate)
Revlimid (Lenalidomide)
Sandostatin (Octreotide Acetate Vial)
Somatuline Depot (Lanreotide Acetate)
Sprycel (Dasatinib)
Sutent (Sunitinib Malate)
Tarceva (Erlotinib HCl)
Tasigna (Nilotinib HCl)
Thalomid (Thalidomide)
Tretinoin (Vesanoid)
Tykerb (Lapatinib Ditosylate)
Votrient (Pazopanib Hydrochloride)
Zolinza (Vorinostat)
2.2 Adjunctive Agents
2.2.1 ADJUNCTIVE AGENTS
TIER 1
Leucovorin Calcium (Leucovorin Calcium 5, 25 mg)
TIER 2
Aranesp (Darbepoetin Alfa)
Epogen (Epoetin Alfa)
Leucovorin Calcium 10, 15 mg (Leucovorin Calcium)
Leukine (Sargramostim)
Neupogen (Filgrastim)
Procrit (Epoetin Alfa)
TIER 1
Etoposide (VePesid)
Hydroxyurea (Hydrea)
Leuprolide Acetate (Lupron 1 mg/0 .2 ml)
Octreotide Acetate (Octreotide Acetate)
TIER 2
Afinitor (Everolimus)
Droxia (Hydroxyurea)
Emcyt (Estramustine Phosphate Sodium)
Gleevec (Imatinib Mesylate)
Hexalen (Altretamine)
Hycamtin (Topotecan HCl Capsule)
Lysodren (Mitotane)
Matulane (Procarbazine HCl)
Nexavar (Sorafenib Tosylate)
Revlimid (Lenalidomide)
Sandostatin (Octreotide Acetate Vial)
Somatuline Depot (Lanreotide Acetate)
Sprycel (Dasatinib)
Sutent (Sunitinib Malate)
Tarceva (Erlotinib HCl)
Tasigna (Nilotinib HCl)
Thalomid (Thalidomide)
Tretinoin (Vesanoid)
Tykerb (Lapatinib Ditosylate)
Votrient (Pazopanib Hydrochloride)
Zolinza (Vorinostat)
2.2 Adjunctive Agents
2.2.1 ADJUNCTIVE AGENTS
TIER 1
Leucovorin Calcium (Leucovorin Calcium 5, 25 mg)
TIER 2
Aranesp (Darbepoetin Alfa)
Epogen (Epoetin Alfa)
Leucovorin Calcium 10, 15 mg (Leucovorin Calcium)
Leukine (Sargramostim)
Neupogen (Filgrastim)
Procrit (Epoetin Alfa)
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