Narcotic & Non-Narcotic Analgesics

KP Wellness

 1:19 PM  -  Public

3.3  Non-Narcotic Analgesics
3.3.1.1 NSAIDS
TIER 1
Diclofenac Potassium (Cataflam)
Diclofenac Sodium (Voltaren)
Diclofenac Sodium Tablet, Sustained-Release 24 Hour
(Voltaren-XR)
Etodolac (Lodine)
Etodolac Tablet, Sustained-Release 24 Hour
(Lodine XL)
Fenoprofen Calcium (Nalfon)
Flurbiprofen (Ansaid)
Ibuprofen (Motrin)
Indomethacin (Indocin)
Indomethacin Capsule, Sustained-Action (Indocin SR)
Ketoprofen (Orudis)
Ketoprofen Capsule, 24 Hour  Sustained-Release
(Oruvail 200 mg)
Ketorolac Tromethamine (Toradol)
Meclofenamate Sodium (Meclomen)
Meloxicam (Mobic)
Nabumetone (Relafen)
Naproxen (EC-Naprosyn)
Naproxen (Naprosyn)
Naproxen Sodium (Anaprox, Anaprox DS)
Oxaprozin (Daypro)
Piroxicam (Feldene)
Sulindac (Clinoril)
TIER 2
Tolmetin Sodium (Tolectin)
Tolmetin Sodium (Tolectin DS)
Voltaren Gel (Diclofenac Sodium Gel 1%)
TIER 3
Diclofenac Sodium, Misoprostol (Arthrotec)
Diclofenac potassium (Zipsor)
Diclofenac potassium for oral solution (Cambia)
Diclofenac epolamine patch 1.3% (Flector)
Diclofenac Sodium Topical Solution (Pennsaid)
Mefenamic Acid (Ponstel)
Naproxen Sodium (Naprelan)
Naproxen and Esomeprazole Magnesium Delayed Release Tablets (Vimovo)

3.3.1.2 NSAIDS–SPECIFIC COX-II INHIBITORS
TIER 3
Celebrex  
3.3.2 SALICYLATES
TIER 1
Salsalate (Salflex)

3.3.3  MISCELLANEOUS ANALGESICS
TIER 1
Pentazocine HCl/Acetaminophen (Talacen)
Pentazocine HCl/Naloxone HCl  (Talwin NX)
Tramadol HCl (Ultram)
Tramadol HCl/Acetaminophen (Ultracet)  
TIER 2
Butorphanol Tartrate Aerosol, Spray (Stadol) 
Tramadol HCl Tablet, Sustained-Release 24 Hour (Ultram ER) 
TIER 3
Nucynta 
Rybix  
Ryzolt  

3.3.4  NARCOTIC ANTAGONISTS/OPIOID DEPENDENCE
TIER 1
Buphrenorphine Hydrochloride
(Subutex) N SL
Naltrexone HCl (ReVia)
TIER 2
Suboxone (Buprenorphine HCl/ Naloxone HCl) 

KP Wellness

 1:04 PM  -  Public

3. Autonomic & CNS Drugs, Neurology & Psych 

3.1  Narcotic Analgesics
3.1.1 NARCOTICS
TIER 1
Codeine Sulfate (Codeine Sulfate)
Duragesic (Fentanyl Transdermal) 
Hydromorphone HCl Tablet (Dilaudid)
Levorphanol Tartrate (Levo-Dromoran)
Methadone HCl (Dolophine HCl)
Meperidine HCl (Demerol)
Morphine Sulfate Solution, Oral (MSIR 20 mg/ml)
Morphine Sulfate Solution, Oral (Roxanol)
Morphine Sulfate Tablet, Sustained-Action (MS Contin) SL
Oxycodone HCl (Roxicodone, OxyIR)
Oxycodone HCl Concentrate, Oral (OxyFAST)
TIER 2
Codeine Phosphate (Codeine  Phosphate)
Fentanyl Citrate Lollipop (Actiq)  
MSIR (Morphine Sulfate Capsule)
Opana ER (Oxymorphone HCl Tablet,  Sustained-Release 12 Hour)
OxyContin (Oxycodone HCl Tablet,  Sustained-Release 12 Hour)
Oxymorphone HCl Tablet,  Sustained-Release 12 Hour
(Opana ER) 
Oxymorphone Tablet (Opana) 
TIER 3
Morphine sulfate extended-release capsules (Avinza)
Morphine and naltrexone (Embeda)
Morphine Sulfate Extended-Release (Kadian)
Hydromorphone Hydrochloride Extended Release Tablets (Exalgo)
Fentanyl Transdermal (Duragesic) 
Fentanyl Buccal Tablet (Fentora)
Fentanyl Buccal Soluble Film (Onsolis)

3.1.2  COMBINATION NARCOTIC /ANALGESICS
TIER 1
Acetaminophen/Caffeine/Butalbital
(Fioricet)  
Aspirin/Caffeine/Butalbital (Fiorinal)
Codeine Phosphate/Acetaminophen
(Tylenol w/Codeine)  
Codeine Phosphate/Acetaminophen/ 
Caffeine/Butalbital (Fioricet  w/Codeine)  
Codeine Phosphate/Aspirin/Caffeine/ Butalbital
(Fiorinal w/Codeine 30 mg)
Dihydrocodeine Bit/Acetaminophen/ Caffeine
(Panlor SS, Panlor DC) 
Hydrocodone Bit/Acetaminophen (Vicodin) 
Hydrocodone Bit/Acetaminophen (Vicodin ES) 
Hydrocodone Bit/Acetaminophen (Vicodin HP) 
Hydrocodone Bit/Acetaminophen (Xodol) 
Hydrocodone Bit/Acetaminophen  Elixir, Tablet
(Lortab, Lorcet) 
Ibuprofen/Hydrocodone (Vicoprofen)
Oxycodone HCl/Acetaminophen (Tylox)  
Oxycodone HCl/Acetaminophen Tablet (Percocet) 
Oxycodone HCl/Ibuprofen (Combunox)
Oxycodone/Aspirin (Percodan)
TIER 2
Hydrocodone Bit/Acetaminophen Solution, Oral (Hycet) 
TIER 3
Acetaminophen and codeine phosphate (Cocet Plus)
Dihydrocodeine bitartrate, aspirin and caffeine (Synalgos-DC)