GASTROINTESTINAL DRUGS

KP Wellness

11:24 AM  -  Public

8.1  Ulcer Therapy
8.1.1  H2 ANTAGONISTS
TIER 1
Cimetidine Tablet, Liquid (Tagamet)
Famotidine Suspension, Oral (Pepcid)
Ranitidine HCl Syrup (Zantac Syrup)
TIER 2
Nizatidine Solution, Oral (Axid Oral Solution)

8.1.2 PROSTAGLANDINS
TIER 1
Misoprostol (Cytotec)

8.1.3  OTHER ULCER THERAPY
TIER 1
Sucralfate Tablet (Carafate)
TIER 2
Helidac (Tetracycline HCl/Bismuth  Subsalicylate/Metronidazole)
Prevpac (Lansoprazole/Amoxicillin  Trihydrate/Clarithromycin)
Pylera (Bismuth/Metronidazole/Tetracycline)
TIER 3
Sucralfate (Carafate Oral Suspension)

8.1.4  PROTON PUMP INHIBITORS
TIER 1
Omeprazole (Prilosec)
Pantoprazole (Protonix)
TIER 3
Rabeprazole Sodium (Aciphex)
Dexlansoprazole (Dexilant)
Lansoprazole Capsule,  Delayed-Release (Prevacid)
Lansoprazole Tablet, Rapid Dissolve,  Delayed-Release (Prevacid Solutab)
Esomeprazole Magnesium (Nexium Capsule)
Nexium Suspension
Omeprazole/Sodium Bicarbonate  Capsule
Prevacid Capsule, Delayed-Release  (Enteric-Coated)
Omeprazole (Prilosec Rx 10, 20 mg)
Omeprazole and Sodium Bicarbonate (Zegerid Capsule)
Zegerid Packet 

KP Wellness

11:24 AM  -  Public

8.2  Antidiarrheals & Antispasmodics
8.2.1 ANTIDIARRHEALS
TIER 1
Diphenoxylate HCl/Atropine Sulfate (Lomotil)
Paregoric (Paregoric)
TIER 3
Difenoxin and Atropine (Motofen)

8.2.2 ANTISPASMODICS
TIER 1
Dicyclomine HCl Tablet (Bentyl)
Glycopyrrolate (Robinul, Robinul Forte)
Hyoscyamine Sulfate (Levsin, Levsin/SL)
Hyoscyamine Sulfate Capsule, Sustained-Release  12 Hour (Levsinex)
Hyoscyamine Sulfate Drops (Gastrosed)
Hyoscyamine Sulfate Tablet, Rapid Dissolve (Nulev)
Hyoscyamine Sulfate Tablet, Sustained-Release  12 Hour (Levbid)
TIER 3
Mepenzolate Bromide (Cantil)
Hyoscyamine Sulfate (Symax Duotab)

8.2.3  COMBINATION ANTICHOLINERGICS
TIER 1
Belladonna Alkaloids/Phenobarbital (Donnatal)
Clidinium Bromide/Chlordiazepoxide (Librax)
TIER 3
Donnatal Tablet, Sustained-Action 

KP Wellness

11:22 AM  -  Public

8.3  Miscellaneous Gastrointestinal Agents
8.3.1  BILE ACIDS
TIER 1
Ursodiol (Actigall)
Ursodiol 250 mg (URSO 250)
Ursodiol 500 mg (URSO Forte)

8.3.2  DIGESTIVE ENZYMES
TIER 2
Creon (Lipase/Protease/Amylase)
Sucraid (Sacrosidase)
Zenpep (Lipase/Protease/Amylase)
TIER 3
Pancrelipase (Pancreaze)

8.3.3  MISCELLANEOUS GASTROINTESTINAL AGENTS
TIER 1
Balsalazide Disodium (Colazal)
Hydrocortisone (Cortenema)
Hydrocortisone Acetate Suppository, Rectal (Anusol-HC)
Hydrocortisone Acetate/Pramoxine HCl (Analpram-HC)
Hydrocortisone Cream (ProctoCream-HC 2 .5%,  Anusol-HC 2 .5%)
Lactulose (Cephulac, Chronulac)
Mesalamine Enema (Rowasa)
Mesalamine w/Cleansing Wipes (Rowasa Kit)
Metoclopramide HCl (Reglan)
Sulfasalazine Tablet (Azulfidine)
Sulfasalazine Tablet, Enteric-Coated (Azulfidine)
TIER 2
Apriso (Mesalamine)
Budesonide Capsule,  Sustained-Release (Entocort EC)**
Canasa (Mesalamine)
Cortifoam (Hydrocortisone Acetate  Foam)
Lialda (Mesalamine)
Lotronex (Alosetron HCl)
Relistor (Methylnaltrexone Bromide)
TIER 3
Lubiprostone (Amitiza)
Mesalazin (Asacol)
Asacol HD - delayed release tablets
Olsalazine Sodium Capsules (Dipentum)
Cromolyn Sodium (Gastrocrom)
Lactulose (Kristalose)
Metoclopramide HCl Orally Disintegrating Tablets (Metozolv ODT)
Sodium biphosphate and sodium phosphate (Osmoprep)
Mesalamine (Pentasa)
Sodium Phosphate Monobasic Monohydrate, Sodium Phosphate Dibasic Anhydrous (Visicol) 

KP Wellness

11:22 AM  -  Public

8.3.4  ANTIVERTIGO & ANTIEMETIC AGENTS
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 Transdermal System (Sancuso)
Scopolamine (Scopace)
Scopolamine transdermal (Transderm-Scop)
Ondansetron (Zuplenz)

8.3.5  BOWEL EVACUANTS
TIER 1
Polyethylene Glycol 3350 Powder (Glycolax)
+ Sod Chloride/NaHCO3/KCl/PEGs (Nulytely w/Flavor Packs)
+ Sodium Sulfate/Sodium/Sodium Bicarbonate/
Potassium Chloride/Polyethylene Glycols (Colyte)
+ Sodium Sulfate/Sodium/Sodium Bicarbonate/
Potassium Chloride/Polyethylene Glycols  Solution,
Reconstituted, Oral (GoLYTELY)
TIER 2
GoLYTELY (Sodium Sulfate/Sodium/
Sodium Bicarbonate/Potassium Chloride/
Polyethylene Glycols Packet)
TIER 3
Halflytely  (Bowel Prep Kits for Colonoscopy)
Moviprep (Colonoscopy Prep)