Nitrofurantoin Monohyd Macro 1 + PA1 1 Formulary Enhancement N/A CAPSULE 100 MG Oral 2 + QL eletriptan 20 Relpax TABLET 20 MG Oral NF Formulary Update 9 mg,1 + QL 9 2 + QL eletriptan 40 Relpax TABLET 40 MG Oral NF Formulary Update 9 mg, 1 + QL 9 sevelamer Renvela TABLET 800 MG Oral 2 NF Formulary Update carbonate 800 mg, 1 vigabatrin 50 Sabril PACKET 500 MG Oral 2 NF Formulary Update mg/ml, 2 efavirenz 50 Sustiva CAPSULE 50 MG Oral 2 NF Formulary Update mg, 1 Symdeko Tablet Therapy Pack 100-150 NF 2 + PA1 + LA Formulary Enhancement N/A & 150 MG Oral scopolamine Transderm-Scop (1.5 MG) Patch 72 2 NF Formulary Update 0.0139 mg/hr, Hour 1 MG/3DAYS Transdermal 1 Trientine HCl CAPSULE 250 MG Oral NF 1 Formulary Enhancement N/A Trisenox SOLUTION 10 MG/10ML 2 + BD NF CMS Required Deletion N/A Intravenous Videx EC CAPSULE DELAYED NF 2 Formulary Enhancement N/A RELEASE 125 MG Oral Vigamox SOLUTION 0.5 % moxifloxacin 5 2 NF Formulary Update Ophthalmic mg/ml, 1 Zenpep CAPSULE DELAYED RELEASE PARTICLES NF 2 Formulary Enhancement N/A UNIT Oral
Nitrofurantoin Monohyd Macro CAPSULE 100 MG Oral 1 + PA1 1 Formulary Enhancement N/A Relpax TABLET 20 MG Oral 2 + QL 9 NF Formulary Update eletriptan 20 mg,1 + QL 9 Relpax TABLET 40 MG Oral 2 + QL 9 NF Formulary Update eletriptan 40 mg, 1 + QL 9 Renvela TABLET 800 MG Oral 2 NF Formulary Update sevelamer carbonate 800 mg, 1 Sabril PACKET 500 MG Oral 2 NF Formulary Update vigabatrin 50 mg/ml, 2 Sustiva CAPSULE 50 MG Oral 2 NF Formulary Update efavirenz 50 mg, 1 Symdeko Tablet Therapy Pack 100-150 & 150 MG Oral NF 2 + PA1 + LA Formulary Enhancement N/A Transderm-Scop (1.5 MG) Patch 72 Hour 1 MG/3DAYS Transdermal 2 NF Formulary Update scopolamine 0.0139 mg/hr, 1 Trientine HCl CAPSULE 250 MG Oral NF 1 Formulary Enhancement N/A Trisenox SOLUTION 10 MG/10ML Intravenous 2 + BD NF CMS Required Deletion N/A Videx EC CAPSULE DELAYED RELEASE 125 MG Oral NF 2 Formulary Enhancement N/A Vigamox SOLUTION 0.5 % Ophthalmic 2 NF Formulary Update moxifloxacin 5 mg/ml, 1 Zenpep CAPSULE DELAYED RELEASE PARTICLES UNIT Oral NF 2 Formulary Enhancement N/A
AgeWell-MMP_2018_Addendum_Eff_07012018.docx