KP Wellness
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4.4 Coagulation Therapy
4.4.1 ANTICOAGULANTS
TIER 1
+ Warfarin Sodium (Coumadin)
TIER 2
+ Coumadin (Warfarin Sodium)
4.4.2 ANTIPLATELET DRUGS
TIER 1
+ Cilostazol (Pletal)
+ Dipyridamole (Persantine)
+ Ticlopidine HCl (Ticlid)
TIER 2
Plavix (Clopidogrel Bisulfate)
TIER 3
Aspirin, Extended-Release Dipyridamole (Aggrenox)
Prasugrel Tablets (Effient)
4.4.3 HEPARIN
TIER 1
+ Heparin Sodium (Heparin)
TIER 2
+ Fondaparinux Sodium (Arixtra)*
+ Enoxaparin (Lovenox)*
TIER 3
Dalteparin (Fragmin)
Tinzaparin (Innohep)
4.4.4 VITAMIN K
TIER 2
Mephyton (Phytonadione)
4.4.5 HEMOSTATICS
TIER 1
+ Aminocaproic Acid Syrup (Amicar)
+ Aminocaproic Acid Tablet (Amicar 500 mg)
TIER 2
Amicar 1000 mg (Aminocaproic Acid Tablet)
Humate-P (AHF, Human/VHF, Human)
Novoseven (Factor VIIA, Recomb (BHK Cells)
Promacta (Eltrombopag Olamine)
4.4.6 MISCELLANEOUS COAGULATION AGENTS
TIER 1
Pentoxifylline Tablet, Sustained-Action (Trental)
TIER 2
Advate (Antihemoph.FVIII Plas/Alb Free)
Alphanate (Antihemophilic Factor, Human)
Alphanine SD (Factor IX)
Bebulin VH Immuno (Factor IX Complex Human)
Benefix (Factor IX Human Recombinant)
Corifact (Factor XIII)
Feiba (Anti-Inhibitor Coagulant Comp.)
Helixate FS (Antihemophilic Factor, Hum Rec)
Hemofil-M (Antihemophilic Factor, Human)
Koate-DVI (Antihemophilic Factor, Human)
Kogenate FS (Antihemophilic Factor, Hum Rec)
Konyne 80 (Anti-Inhibitor Coagulant Comp.)
Monoclate-P (Antihemophilic Factor, Human)
Mononine (Factor IX)
Profilnine SD (Anti-Inhibitor Coagulant Comp.)
Recombinate (Antihemophilic Factor, Hum Rec)
Xyntha (Antihemoph.FVIII Plas/Alb Free)
4.4.1 ANTICOAGULANTS
TIER 1
+ Warfarin Sodium (Coumadin)
TIER 2
+ Coumadin (Warfarin Sodium)
4.4.2 ANTIPLATELET DRUGS
TIER 1
+ Cilostazol (Pletal)
+ Dipyridamole (Persantine)
+ Ticlopidine HCl (Ticlid)
TIER 2
Plavix (Clopidogrel Bisulfate)
TIER 3
Aspirin, Extended-Release Dipyridamole (Aggrenox)
Prasugrel Tablets (Effient)
4.4.3 HEPARIN
TIER 1
+ Heparin Sodium (Heparin)
TIER 2
+ Fondaparinux Sodium (Arixtra)*
+ Enoxaparin (Lovenox)*
TIER 3
Dalteparin (Fragmin)
Tinzaparin (Innohep)
4.4.4 VITAMIN K
TIER 2
Mephyton (Phytonadione)
4.4.5 HEMOSTATICS
TIER 1
+ Aminocaproic Acid Syrup (Amicar)
+ Aminocaproic Acid Tablet (Amicar 500 mg)
TIER 2
Amicar 1000 mg (Aminocaproic Acid Tablet)
Humate-P (AHF, Human/VHF, Human)
Novoseven (Factor VIIA, Recomb (BHK Cells)
Promacta (Eltrombopag Olamine)
4.4.6 MISCELLANEOUS COAGULATION AGENTS
TIER 1
Pentoxifylline Tablet, Sustained-Action (Trental)
TIER 2
Advate (Antihemoph.FVIII Plas/Alb Free)
Alphanate (Antihemophilic Factor, Human)
Alphanine SD (Factor IX)
Bebulin VH Immuno (Factor IX Complex Human)
Benefix (Factor IX Human Recombinant)
Corifact (Factor XIII)
Feiba (Anti-Inhibitor Coagulant Comp.)
Helixate FS (Antihemophilic Factor, Hum Rec)
Hemofil-M (Antihemophilic Factor, Human)
Koate-DVI (Antihemophilic Factor, Human)
Kogenate FS (Antihemophilic Factor, Hum Rec)
Konyne 80 (Anti-Inhibitor Coagulant Comp.)
Monoclate-P (Antihemophilic Factor, Human)
Mononine (Factor IX)
Profilnine SD (Anti-Inhibitor Coagulant Comp.)
Recombinate (Antihemophilic Factor, Hum Rec)
Xyntha (Antihemoph.FVIII Plas/Alb Free)
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