SHORTED DRUG,,,,,,,,,ALTERNATE DRUG,,,,,,,,,NOTES
Date reported,Chemical name,Strength,Dosage form,Brand name,DIN/PIN/NPN,Manufacturer,Availability status,Estimated date of availability (if known),Last updated on,Alternate drug Trade/Brand name,Strength,Dosage form,Alternate drug DIN/PIN,Manufacturer,Maximum reimbursement price,Alternate full coverage start date,Alternate full coverage end date,Notes
45931,5-AMINOSALICYLIC ACID,400 MG,tablet,ASACOL,1997580,Allergan,discontinued – no longer available,,2025-10-01,Not yet determined,,,,,,,,
44868,5-AMINOSALICYLIC ACID,800 MG,tablet,ASACOL 800,2267217,Allergan,discontinued – no longer available,,2022-11-03,Other already-covered 400 mg strength full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44820,ACETAMINOPHEN,80 MG/ML,drops,TEMPRA INFANT DROPS,875988,Paladin,back-order–no date,,2026-01-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45504,ACETAMINOPHEN,500 MG,tablet,JAMP ACETAMINOPHEN,1939122,Jamp,back-order–with date,2026-04-24,2026-01-05,ACETAMINOPHEN,500 MG,caplet,1977474,Lab,.0348,2025-03-25,,
45504,ACETAMINOPHEN,500 MG,tablet,JAMP ACETAMINOPHEN,1939122,Jamp,back-order–with date,2026-04-24,2026-01-05,APO ACETAMINOPHEN,500 MG,tablet,545007,Apotex,.0850,2024-08-01,,
45504,ACETAMINOPHEN,500 MG,tablet,JAMP ACETAMINOPHEN,1939122,Jamp,back-order–with date,2026-04-24,2026-01-05,APO ACETAMINOPHEN,500 MG,capsule,2229977,Apotex,.0285,2024-08-01,,
45504,ACETAMINOPHEN,500 MG,tablet,JAMP ACETAMINOPHEN,1939122,Jamp,back-order–with date,2026-04-24,2026-01-05,NOVO-GESIC FORTE,500 MG,tablet,482323,Teva,.0308,2024-08-01,,
45699,ACETAMINOPHEN,325 MG,tablet,ACETAMINOPHEN 325MG TABLETS REGULAR STRENGTH,2252805,Cellchem,no information available,,2025-10-10,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45504,ACETAMINOPHEN,500 MG,tablet,ACETAMINOPHEN 500MG TABLETS EXTRA STRENGTH,2252813,Cellchem Pharma,no information available,,2025-03-24,ACETAMINOPHEN,500 MG,caplet,1977474,Lab,.0348,2025-03-25,,
43920,ACETAMINOPHEN,500 MG,tablet,ACETAMINOPHEN 500MG TABLETS EXTRA STRENGTH,2252813,Cellchem Pharma,no information available,,2024-10-29,NOVO-GESIC FORTE,500 MG,tablet,482323,Apotex,.0308,2024-07-31,,
43920,ACETAMINOPHEN,500 MG,tablet,ACETAMINOPHEN 500MG TABLETS EXTRA STRENGTH,2252813,Cellchem Pharma,no information available,,2024-07-31,APO ACETAMINOPHEN,500 MG,tablet,545007,Apotex,.0850,2024-07-31,,
43920,ACETAMINOPHEN,500 MG,tablet,ACETAMINOPHEN 500MG TABLETS EXTRA STRENGTH,2252813,Cellchem Pharma,no information available,,2024-07-31,APO ACETAMINOPHEN,500 MG,capsule,2229977,Apotex,.0285,2024-07-31,,
44820,ACETAMINOPHEN,160 MG/5 ML,liquid,ACETAMINOPHEN ORAL SOL FOR CHILDREN USP,1958836,Laboraoires T,no information available,,2023-05-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44820,ACETAMINOPHEN,80 MG/ML,drops,ACETAMINOPHEN SOLUTION ORAL GTTE,1905864,Laboraoires T,no information available,,2023-05-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44820,ACETAMINOPHEN,160 MG/5 ML,liquid,CHILDREN'S ACETAMINOPHEN ORAL SOLN,1901389,Jamp,no information available,,2023-05-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44208,ACETAMINOPHEN,650 MG,suppository,ABENOL,1919407,McNeil Consum,discontinued – no longer available,,2021-01-12,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44208,ACETAMINOPHEN,325 MG,tablet,ATASOL,293482,Church & Dwight,discontinued – no longer available,,2021-01-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44208,ACETAMINOPHEN,325 MG,tablet,TYLENOL REGULAR STRENGTH,627062,McNeil Consum,discontinued – no longer available,,2021-01-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45863,ACETAMINOPHEN WITH CODEINE,300 MG- 30 MG,tablet,TEVA-EMTEC-30,608882,Teva,back-order–with date,2026-03-20,2026-02-05,TRIATEC-30 ,300 MG - 30 MG,tablet,789828,Laboratoire,.1787,2025-07-25,,
43920,ACETAMINOPHEN WITH CODEINE,300 MG - 30 MG,tablet,ACET CODEINE 30,1999648,Teva,discontinued – no longer available,,2024-03-21,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43920,ACETAMINOPHEN WITH CODEINE,160-8 MG/5,Elixir,TYLENOL WITH CODEINE ELIXIR,2163942,Janssen Inc,discontinued – no longer available,,2020-03-30,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
43920,ACETAMINOPHEN/CODEINE/CAFFEINE,300-8-15 MG,caplets,WAMPOLE-ACETAMINOPHEN/CODEINE/CAFFEINE,2453703,Jamp,back-order–no date,,2026-01-08,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44208,ACETAMINOPHEN/CODEINE/CAFFEINE,300-8-15 MG,tablet,NOVO-GESIC-C8,615528,Teva,discontinued – no longer available,,2021-01-12,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
43920,ACETAMINOPHEN/CODEINE/CAFFEINE,325-15-30 MG,tablet,ATASOL 15,293504,Church & Dwight,discontinued – no longer available,,2020-03-30,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
43920,ACETAMINOPHEN/CODEINE/CAFFEINE,325-30-30 MG,tablet,ATASOL 30,293512,Church & Dwight,discontinued – no longer available,,2020-03-30,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44208,ACETAMINOPHEN/CODIENE/CAFFEINE,325-8-15 MG,tablet,ACETAMINOPHEN 325 MG WITH 15 MG CAFFEINE AND 8 MG CODEINE PHOSPH,706221,Vita Health,discontinued – no longer available,,2021-01-12,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44208,ACETAMINOPHEN/CODIENE/CAFFEINE,500-8-15 MG,tablet,ACETAMINOPHEN 325 MG WITH 15 MG CAFFEINE AND 8 MG CODEINE PHOSPH,708712,Vita Health,discontinued – no longer available,,2021-01-12,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44208,ACETAMINOPHEN/CODIENE/CAFFEINE,300-8-15 MG,tablet,"ACETAMINOPHEN, CAFFEINE + CODEINE",2025337,PMS,discontinued – no longer available,,2021-01-12,Not yet determined.,,,,,,,,
41683,ACETYLCYSTEINE,200 MG/ML,vial,MUCOMYST,2091526,Wellspring,discontinued – no longer available,,2023-11-02,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44000,ACETYLSALICYLIC AC/DIPYRIDAMOL,25 MG-200 MG,capsule,AGGRENOX,2242119,Boehringer,discontinued – no longer available,,2020-12-21,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
42716,ACETYLSALICYLIC ACID,325 MG,tablet,ENTERIC COATED ASA TABLETS,2010526,Jamp,discontinued – no longer available,,2024-02-03,ASPIRIN COATED FOR DELAYED RELEASE REGULAR STRENGTH,325 MG,tablet,2150417,Bayer,.0739,2018-07-17,,
45971,ACYCLOVIR,5%,ointment,APO-ACYCLOVIR OINTMENT,2477130,Apotex,back-order–with date,2026-03-27,2026-01-08,Not yet determined,,,,,,,,
45184,ACYCLOVIR,200 MG/ML,oral suspension,ZOVIRAX,886157,GlaxoSmithKline,discontinued – no longer available,,2024-05-28,Not yet determined,,,,,,,,
45034,ALENDRONATE SODIUM,70 MG,tablet,NRA-ALENDRONATE,2523116,Nora Pharma,no information available,,2023-04-18,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45034,ALENDRONATE SODIUM,70 MG,tablet,RIVA-ALENDRONATE,2270889,Riva,no information available,,2023-04-18,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44258,ALENDRONATE SODIUM,70 MG,tablet,ALENDRONATE-70,2303078,Pro Doc,no information available,,2021-03-03,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44035,ALENDRONATE SODIUM,10 MG,tablet,MINT-ALENDRONATE,2394863,Mint,discontinued – no longer available,,2020-08-21,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44035,ALENDRONATE SODIUM,10 MG,tablet,ACCEL-ALENDRONATE,2401126,Accel,discontinued – no longer available,,2020-07-24,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44035,ALENDRONATE SODIUM,10 MG,tablet,TEVA-ALENDRONATE,2247373,Teva,discontinued – no longer available,,2020-07-24,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44035,ALENDRONATE SODIUM,10 MG,tablet,APO-ALENDRONATE,2248728,Apotex,discontinued – no longer available,,2020-07-23,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44035,ALENDRONATE SODIUM,10 MG,tablet,SANDOZ ALENDRONATE,2288087,Sandoz,discontinued – no longer available,,2020-07-23,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45134,ALITRETINOIN,30 MG,capsule,TOCTINO,2337649,GlaxoSmithKline,discontinued – no longer available,,2024-06-06,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,30 MG,capsule,2477440,Dr Reddy's Lab,20.7920,2023-08-19,,
43377,ALPRAZOLAM,0.5 MG,tablet,JAMP-ALPRAZOLAM,2400138,Jamp,discontinued – no longer available,,2022-04-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43377,ALPRAZOLAM,0.5 MG,tablet,MYLAN-ALPRAZOLAM,2137542,Mylan,discontinued – no longer available,,2018-10-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43377,ALPRAZOLAM,0.25 MG,tablet,MYLAN-ALPRAZOLAM,2137534,Mylan,discontinued – no longer available,,2018-10-10,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45517,AMITRIPTYLINE HCL,10 MG,tablet,JAMP-AMITRIPTYLINE TABLETS,2435527,Jamp,back-order–no date,,2025-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45517,AMITRIPTYLINE HCL,10 MG,tablet,APO-AMITRIPTYLINE,2403137,Apotex,discontinued – no longer available,,2025-07-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45517,AMITRIPTYLINE HCL,10 MG,tablet,TEVA-AMITRIPTYLINE,2326043,Teva,discontinued – no longer available,,2024-08-13,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45649,AMOX TR/POTASSIUM CLAVULANATE,200-28.5/5,suspension,JAMP AMOXI CLAV SUSPENSION,2539411,Jamp,back-order–with date,2026-04-10,2026-02-05,CLAVULIN 200,200/28.5/5,suspension,2238831,GlaxoSmithKline,.1977,2024-12-23,,
43061,AMPICILLIN TRIHYDRATE,250 MG/5 ML,suspension,AMPICILLIN,283185,Unknown,discontinued – no longer available,,2018-09-10,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44984,ARIPIPRAZOLE,2 MG,tablet,TEVA-ARIPIPRAZOLE,2464144,Teva,discontinued – no longer available,,2023-04-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45862,ASCORBIC ACID,500 MG,tablet,VITAMIN C,2163268,Jamieson,discontinued – no longer available,,2025-07-24,VITAMIN C,500 MG,tablet,80092665,Jamieson,.0653,2025-07-24,,
45862,ASCORBIC ACID,1000 MG,tablet,VITAMIN C,760587,Pharmetics,discontinued – no longer available,,2025-07-24,VITAMIN C,1000 MG,tablet,80103481,WN Pharmaceuticals,.0750,2025-07-24,,
44327,ATENOLOL/CHLORTHALIDONE,50 MG - 25 MG,tablet,TENORETIC,2049961,Astrazeneca,discontinued – no longer available,,2021-05-28,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44327,ATENOLOL/CHLORTHALIDONE,100 MG - 25 MG,tablet,TENORETIC,2049988,Astrazeneca,discontinued – no longer available,,2021-05-28,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44071,ATROPINE SULFATE,1 %,drops,ATROPINE,2023695,Pharma Stullin,back-order–no date,,2026-02-19,ISOPTO ATROPINE,1 %,drops,35017,Alcon Canada,.9090,2020-08-28,,
45329,BACITRACIN ZINC/POLYMYX B SULFATE,500-10 K/G,ointment,POLYSPORIN STERILE OPHTHALMIC OINTMENT,2239157,J&J Inc,discontinued – no longer available,,2024-02-07,Not yet determined.,,,,,,,,
42544,BENZTROPINE MESYLATE,0.4 MG/ML,solution,PDP-BENZTROPINE,2219727,Pendopharm,discontinued – no longer available,,2018-09-10,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
45630,BETAHISTINE HCL,16 MG,tablet,PMS-BETAHISTINE,2330210,PMS,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45631,BETAHISTINE HCL,24 MG,tablet,PMS-BETAHISTINE,2330237,PMS,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45630,BETAHISTINE HCL,16 MG,tablet,ACT BETAHISTINE,2374757,Teva,discontinued – no longer available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45631,BETAHISTINE HCL,24 MG,tablet,ACT BETAHISTINE,2374765,Teva,discontinued – no longer available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45630,BETAHISTINE HCL,16 MG,tablet,BETAHISTINE,2466449,Sanis,discontinued – no longer available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45631,BETAHISTINE HCL,24 MG,tablet,BETAHISTINE,2466457,Sanis,discontinued – no longer available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45631,BETAHISTINE HCL,8 MG,tablet,NRA-BETAHISTINE,2544911,Nora Pharm,no information available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45630,BETAHISTINE HCL,16 MG,tablet,NRA-BETAHISTINE,2544938,Nora Pharma,no information available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45631,BETAHISTINE HCL,24 MG,tablet,NRA-BETAHISTINE,2544946,Nora Pharma,no information available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45631,BETAHISTINE HCL,8 MG,tablet,TEVA-BETAHISTINE,2280183,Teva,discontinued – no longer available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45630,BETAHISTINE HCL,16 MG,tablet,TEVA-BETAHISTINE,2280191,Teva,discontinued – no longer available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45631,BETAHISTINE HCL,24 MG,tablet,TEVA-BETAHISTINE,2280205,Teva,discontinued – no longer available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45819,BETAMETHASONE VALERATE,0.1%,cream,TEVA-ECTOSONE,535435,Teva,back-order–with date,2026-04-10,2026-01-08,Other already covered full benefit topical corticosteroids available at same potency. Consult the online LCA Data Files for details.,,,,,,,,
45819,BETAMETHASONE VALERATE,0.1%,cream,BETAMETHASONE VALERATE,2357844,Bausch ,discontinued – no longer available,,2025-06-11,Other already covered full benefit topical corticosteroids available at same potency. Consult the online LCA Data Files for details.,,,,,,,,
43857,BETAMETHASONE VALERATE,0.1%,cream,CELESTODERM V,2357844,PMS,discontinued – no longer available,,2024-01-02,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44137,BETAMETHASONE VALERATE,0.1%,cream,CELESTODERM V CRM 0.1%,27901,Schering,discontinued – no longer available,,2023-02-15,No alternative available and no coverage for compounding; discuss treatment options with prescriber - lotion and ointments are available in .05% and 0.1%,,,,,,,,
43048,BISACODYL,10 MG,suppository,BISACODYL,2458853,Cellchem Pharma,no information available,,2023-07-27,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44439,BOSENTAN,125 MG,tablet,APO-BOSENTAN,2399210,Apotex,discontinued – no longer available,,2021-10-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44439,BOSENTAN,62.5 MG,tablet,ACT BOSENTAN,2386194,Teva,discontinued – no longer available,,2021-09-21,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44439,BOSENTAN,125 MG,tablet,ACT BOSENTAN,2386208,Teva,discontinued – no longer available,,2021-09-21,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44439,BOSENTAN,62.5 MG,tablet,SANDOZ BOSENTAN,2386275,Sandoz,discontinued – no longer available,,2021-09-21,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44439,BOSENTAN,125 MG,tablet,SANDOZ BOSENTAN,2386283,Sandoz,discontinued – no longer available,,2021-09-21,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43942,BRIMONIDINE TARTRATE,0.2%,drops,APO-BRIMONIDINE,2260077,Apotex,discontinued – no longer available,,2022-09-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45665,BRIVARACETAM,10 MG,tablet,APO-BRIVARACETAM,2538679,Apotex,back-order–no date,,2025-12-15,BRIVLERA,10 MG,tablet,2452936,UCB Canada,4.6657,2025-01-08,,
43626,BROMAZEPAM,1.5 MG,tablet,APO-BROMAZEPAM,2177153,Apotex,discontinued – no longer available,,2019-06-10,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44810,BUDESONIDE,0.25 MG/2 ML,ampule,TARO-BUDESONIDE,2494264,Taro Pharma,back-order–no date,,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44755,BUDESONIDE,1 MG/2 ML,ampule,TARO-BUDESONIDE,2494280,Taro Pharma,back-order–no date,,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45870,BUDESONIDE,0.5 MG/2 ML,ampule,TARO-BUDESONIDE,2494272,Taro Pharma,back-order–with date,2026-07-10,2026-02-19,PULMICORT NEBUAMP 0.25 MG/ML,0.5 MG/2 ML,ampule,1978918,Astrazeneca,0.5824,2025-08-01,,
45194,BUDESONIDE,3 MG,capsule,BUDESONIDE,2483874,Tillotts,discontinued – no longer available,,2025-10-09,ENTOCORT,3 MG,capsule,2229293,Tillotts,2.3352,2023-09-25,,
45996,BUPRENORPHINE HCL/NALOXONE HCL,2 MG-0.5 MG,tablet,ACT BUPRENORPHINE/NALOXONE,2453908,Teva,back-order–no date,,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45996,BUPRENORPHINE HCL/NALOXONE HCL,8 MG-2 MG,tablet,ACT BUPRENORPHINE/NALOXONE,2453916,Teva,back-order–no date,,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45932,CALCITONIN,200/ML,vial,CALCIMAR,1926691,Sanofi,now available,,2026-01-22,CALCITONIN (US LABELLED – SALMON SYNTHETIC),200 USP Unit/ML,vial,66128579,unknown,30.78,2025-10-03,,
45226,CALCIUM POLYSTYRENE SULFONATE,0,powder,JAMP CALCIUM POLYSTYRENE SULFONATE,2502631,Jamp,back-order–no date,,2026-02-05,RESONIUM CALCIUM,0,powder,2017741,Sanofi,.3811,2023-10-27,,
44104,CALCIUM SENNOSIDES A&B,8.5 MG/5 ML,liquid,SENOKOT SYRUP,367729,Purdue Pharma,discontinued – no longer available,,2021-08-19,JAMP SENNAQUIL,1.7 MG/ML,liquid,80024394,Jamp,.0335,2020-09-30,,
45034,CANDESARTAN CILEXETIL,32 MG,tablet,ACH-CANDESARTAN,2379295,Accord,back-order–no date,,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45034,CANDESARTAN CILEXETIL,32 MG,tablet,APO-CANDESARTAN,2399105,Apotex,back-order–no date,,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44980,CANDESARTAN CILEXETIL,16 MG,tablet,APO-CANDESARTAN,2365367,Apotex,back-order–no date,,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45034,CANDESARTAN CILEXETIL,32 MG,tablet,TARO-CANDESARTAN,2380714,Taro Pharma,back-order–with date,2026-04-10,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44980,CANDESARTAN CILEXETIL,16 MG,tablet,TARO-CANDESARTAN,2380706,Taro Pharma,back-order–with date,2026-03-20,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45034,CANDESARTAN CILEXETIL,32 MG,tablet,NRA-CANDESARTAN,2527030,Nora Pharma,no information available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45034,CANDESARTAN CILEXETIL,32 MG,tablet,AURO-CANDESARTAN,2445816,Auropharma,back-order–no date,,2023-07-10,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45475,CANDESARTAN CILEXETIL/HCTZ,16-12.5 MG,tablet,NRA-CANDESARTAN HCTZ,2531240,Nora,back-order–no date,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45475,CANDESARTAN CILEXETIL/HCTZ,16-12.5 MG,tablet,AURO-CANDESARTAN HCT,2421038,Auro,back-order–no date,,2024-07-02,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45096,CANDESARTAN CILEXETIL/HCTZ,32-12.5 MG,tablet,AURO-CANDESARTAN,2421046,Auropharma,back-order–no date,,2023-07-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43697,CANDESARTAN CILEXETIL/HCTZ,32-25 MG,tablet,AURO-CANDESARTAN HCT,2421054,Auropharma,back-order–no date,,2023-04-24,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43697,CANDESARTAN CILEXETIL/HCTZ,32-25 MG,tablet,ACCEL-CANDESARTAN/HCTZ,2463857,Accel,discontinued – no longer available,,2021-01-25,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45743,CARBIDOPA/LEVODOPA,25 MG-100 MG,tablet,AURO-LEVOCARB,2531607,Auro,back-order–with date,2026-04-10,2026-01-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43896,CARBIDOPA/LEVODOPA,25 MG-100 MG,tablet,TEVA-LEVOCARBIDOPA,2244495,Teva,back-order–no date,,2026-01-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43896,CARBIDOPA/LEVODOPA,25 MG-250 MG,tablet,TEVA-LEVOCARBIDOPA,2244496,Teva,back-order–no date,,2026-01-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43896,CARBIDOPA/LEVODOPA,25 MG - 250 MG,tablet,SINEMET,328219,Organon,discontinued – no longer available,,2022-09-28,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43558,CARBIDOPA/LEVODOPA,25 MG - 100 MG,tablet,SINEMET,513997,Organon,discontinued – no longer available,,2022-09-28,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43405,CARBIDOPA/LEVODOPA,10 MG-100 MG,tablet,MINT-LEVOCARB,2457954,Mint,discontinued – no longer available,,2020-02-26,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43405,CARBIDOPA/LEVODOPA,25 MG-100 MG,tablet,MINT-LEVOCARB,2457962,Mint,discontinued – no longer available,,2020-02-26,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43405,CARBIDOPA/LEVODOPA,25 MG-250 MG,tablet,MINT-LEVOCARB,2457970,Mint,discontinued – no longer available,,2020-02-26,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43558,CARBIDOPA/LEVODOPA,50 MG - 200 MG,tablet,SINEMET,870935,Merck,discontinued – no longer available,,2019-05-06,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43405,CARBIDOPA/LEVODOPA,10 MG-100 MG,tablet,SINEMET,355658,Merck,discontinued – no longer available,,2018-11-01,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
46050,CEFTAZIDIME,1 G,vial,"CEFTAZIDIME FOR INJECTION, USP",886971,Fresenius Kabi,back-order–no date,,2026-02-19,CEFTAZIDIME FOR INJECTION BP,1 G,vial,2437848,Sterimax,18.85,2026-01-28,,
44937,CEFTAZIDIME,1 G,vial,FORTAZ,2212218,GlaxoSmithKline,discontinued – no longer available,,2023-02-02,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44938,CEFTAZIDIME,2 G,vial,FORTAZ,2212226,GlaxoSmithKline,discontinued – no longer available,,2023-02-02,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,2023-01-12,,
45002,CETIRIZINE HCL,10 MG,tablet,JAMP-CETIRIZINE,2451778,Jamp,back-order–no date,,2026-01-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,DIN 2231603 APO-CETIRIZINE
45289,CHLORDIAZEPOXIDE HCL,5 MG,capsule,CHLORDIAZEPOXIDE,522724,AAPharma,discontinued – no longer available,,2024-07-08,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
45289,CHLORDIAZEPOXIDE HCL,10 MG,capsule,CHLORDIAZEPOXIDE,522988,AAPharma,discontinued – no longer available,,2024-07-08,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44665,CHLORDIAZEPOXIDE/CLIDINIUM BR,5 MG-2.5 MG,capsule,CHLORAX,618454,AA Pharma,discontinued – no longer available,,2024-04-01,LIBRAX,5 MG - 2.5 MG,capsule,115630,Bausch,.4959,2022-04-14,,
44202,CIPROFLOXACIN HCL,500 MG,tablet,SEPTA-CIPROFLOXACIN,2379635,Septa Pharma,no information available,,2023-01-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43924,CLARITHROMYCIN,500 MG,tablet,BIAXIN XL,2244756,Mylan,discontinued – no longer available,,2021-02-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44543,CLINDAMYCIN HCL,150 MG,capsule,NRA-CLINDAMYCIN,2493748,Nora Pharma,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44224,CLINDAMYCIN HCL,300 MG,capsule,NRA-CLINDAMYCIN,2493756,Nora Pharma,back-order–no date,,2025-12-15,other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44543,CLINDAMYCIN HCL,150 MG,capsule,M-CLINDAMYCIN,2479923,Mantra Pharma,no information available,,2021-12-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44543,CLINDAMYCIN HCL,300 MG,capsule,M-CLINDAMYCIN,2479931,Mantra Pharma,no information available,,2021-12-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44236,CLINDAMYCIN HCL,150 MG,capsule,MYLAN-CLINDAMYCIN,2258331,Mylan,discontinued – no longer available,,2021-02-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44224,CLINDAMYCIN HCL,300 MG,capsule,MYLAN-CLINDAMYCIN,2258358,Mylan,discontinued – no longer available,,2021-02-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44224,CLINDAMYCIN HCL,300 MG,capsule,APO-CLINDAMYCIN,2245233,Apotex,discontinued – no longer available,,2021-02-01,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43626,CLINDAMYCIN HCL,150 MG,capsule,APO-CLINDAMYCIN,2245232,Apotex,discontinued – no longer available,,2019-06-10,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
46056,CLINDAMYCIN PHOSPHATE,0.01,solution,TARO-CLINDAMYCIN,2266938,Taro Pharm,back-order–with date,2026-03-13,2026-02-19,Compounding allowed; no Special Authority required. See Notes for details.,,,,,,,,note on the Rx that they are using PIN 22123280 for the 1% solution during a manufacturer’s shortage/priced using compound policy pricing
44686,CLOBETASOL PROPIONATE,0.05%,ointment,NOVO-CLOBETASOL OINTMENT,2126192,Teva,discontinued – no longer available,,2025-12-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45986,COAL TAR,0.5%,shampoo,NEUTROGENA T/GEL THERAPEUTIC SHAMPOO,2240645,J & J,discontinued – no longer available,,2025-11-25,COAL-TAR SHAMPOO,0.5%,shampoo,2538954,Seaford Pharma,.0784,2025-11-25,,
45985,CODEINE PHOSPHATE,30 MG,tablet,TEVA-CODEINE,593451,Teva,back-order–with date,2026-05-06,2026-02-19,CODEINE 30,30 MG,tablet,2009757,Laboratoire Riva,.1664,2025-11-24,,
45985,CODEINE PHOSPHATE,15 MG,tablet,TEVA-CODEINE,593435,Teva,back-order–with date,2026-03-06,2026-02-19,Not yet determined,,,,,,,,
44208,CODEINE/ACETYLSALICYLIC/CAFFEINE,8-375-15 MG,tablet,A.C.+ C TABLETS,1922246,PMS,discontinued – no longer available,,2021-01-12,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44208,CODEINE/ACETYLSALICYLIC/CAFFEINE,8-375-15 MG,tablet,"ACETYLSALICYLIC ACID, CAFFEINE AND 8 MG CODEINE PHOSPHATE",95494,Cellchem Pharma,discontinued – no longer available,,2021-01-12,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
45404,COLLAGENASE,250 UNIT/G,ointment,SANTYL,2063670,Smith + Nephew,back-order–with date,2026-09-30,2026-02-05,COLLANGENASE SANTYL OINTMENT (US) 30G,250 UNIT/GM,ointment,66128469,Cardinal Health,3.4754,2025-03-05,,
44865,CYANOCOBALAMIN,1000 MCG/ML,vial,JAMP-CYANOCOBALAMIN,2420147,Jamp,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44865,CYANOCOBALAMIN,1000 MCG/ML,vial,B-12 1000 INJ,626112,Omega,dormant,,2023-08-29,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44865,CYANOCOBALAMIN,1000 MCG/ML,vial,"CYANOCOBALAMIN INJECTION, USP",2413795,Stides,no information available,,2023-06-19,CYANOCOBALAMIN INJECTION USP,1000 MCG/ML,ampule,2463393,Hikma Canada,.3308,2023-06-19,,
46010,CYCLOSPORINE,100 MG,capsule,SANDOZ CYCLOSPORINE,2242821,Sandoz,back-order–with date,2026-08-05,2026-02-19,NEORAL,100 MG,capsule,2150670,Novartis,7.5254,2025-12-19,,
46051,DESMOPRESSIN ACETATE,10 MCG,spray,DESMOPRESSIN SPRAY,2242465,AAPharma,back-order–with date,2026-03-04,2026-02-19,APO-DESMOPRESSIN,0.2 MG,tablet,2284049,Apotex,1.4273,2026-01-29,,
46051,DESMOPRESSIN ACETATE,10 MCG,spray,DESMOPRESSIN SPRAY,2242465,AAPharma,back-order–with date,2026-03-04,2026-02-19,APO-DESMOPRESSIN,0.1 MG,tablet,2284030,Apotex,.7138,2026-01-29,,
46051,DESMOPRESSIN ACETATE,10 MCG,spray,DESMOPRESSIN SPRAY,2242465,AAPharma,back-order–with date,2026-03-04,2026-02-19,PMS-DESMOPRESSIN,0.2 MG,tablet,2304376,PMS,1.4273,2026-01-29,,
46051,DESMOPRESSIN ACETATE,10 MCG,spray,DESMOPRESSIN SPRAY,2242465,AAPharma,back-order–with date,2026-03-04,2026-02-19,PMS-DESMOPRESSIN,0.1 MG,tablet,2304368,PMS,.7138,2026-01-29,,
45883,DESMOPRESSIN ACETATE,4 MCG/ML,ampule,BIPAZEN,2513579,KVR Pharmaceutical,back-order–with date,2026-05-15,2026-02-17,DDAVP INJ 4MCG/ML,4 MCG/ML,ampule,873993,Ferring Inc.,12.7081,2025-08-14,,
46051,DESMOPRESSIN ACETATE,10 MCG,spray,DDAVP SPRAY,836362,Ferring,discontinued – no longer available,,2026-01-29,APO-DESMOPRESSIN,0.2 MG,tablet,2284049,Apotex,1.4273,2026-01-29,,
46051,DESMOPRESSIN ACETATE,10 MCG,spray,DDAVP SPRAY,836362,Ferring,discontinued – no longer available,,2026-01-29,APO-DESMOPRESSIN,0.1 MG,tablet,2284030,Apotex,.7138,2026-01-29,,
46051,DESMOPRESSIN ACETATE,10 MCG,spray,DDAVP SPRAY,836362,Ferring,discontinued – no longer available,,2026-01-29,PMS-DESMOPRESSIN,0.2 MG,tablet,2304376,PMS,1.4273,2026-01-29,,
46051,DESMOPRESSIN ACETATE,10 MCG,spray,DDAVP SPRAY,836362,Ferring,discontinued – no longer available,,2026-01-29,PMS-DESMOPRESSIN,0.1 MG,tablet,2304368,PMS,.7138,2026-01-29,,
46073,DEXDROAMPHETAMINE SULFATE,10 MG,capsule,TEVA-DEXTROAMPHETAMINE SR,2448319,Teva,back-order–with date,2026-04-15,2026-02-20,DEXEDRINE SPANSULE,10 MG,capsule,1924559,Endo,1.3106,2026-02-20,,
46007,DEXTROAMPHETAMINE SULFATE,15 MG,capsule,ACT DEXTROAMPHETAMINE SR,2448327,Teva,back-order–with date,2026-03-13,2026-02-19,DEXEDRINE SPANSULE SRC,15 MG,capsule,1924567,Paladin Labs,1.5648,2025-12-16,,
45803,DEXTROAMPHETAMINE/AMPHETAMINE,10 MG,capsule,SANDOZ AMPHETAMINE XR,2457296,Sandoz,discontinued – no longer available,,2026-02-21,ADDERALL XR,10 MG,capsule,2248809,Takeda Canada,3.0560,2026-02-21,,
46073,DEXTROAMPHETAMINE/AMPHETAMINE,10 MG,capsule,APO-AMPHETAMINE XR,2445506,Apotex,back-order–no date,2026-02-23,2026-02-20,ADDERALL XR,10 MG,capsule,2248809,Takeda Canada,3.0560,2026-02-21,,
46073,DEXTROAMPHETAMINE/AMPHETAMINE,10 MG,capsule,APO-AMPHETAMINE XR,2445506,Apotex,back-order–no date,,2026-02-20,ADDERALL XR,10 MG,capsule,2248809,Takeda,3.0560,2026-02-21,,
43391,DEXTROAMPHETAMINE/AMPHETAMINE,10 MG,capsule,PMS-AMPHETAMINES XR,2440377,PMS,discontinued – no longer available,,2026-02-20,ADDERALL XR,10 MG,capsule,2248809,Takeda Canada,3.0560,2026-02-21,,
43389,DEXTROAMPHETAMINE/AMPHETAMINE,5 MG,capsule,PMS-AMPHETAMINES XR,2440369,PMS,discontinued – no longer available,,2026-01-29,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43336,DEXTROAMPHETAMINE/AMPHETAMINE,25 MG,capsule,PMS-AMPHETAMINES XR,2440407,PMS,discontinued – no longer available,,2026-01-29,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43304,DEXTROAMPHETAMINE/AMPHETAMINE,30 MG,capsule,PMS-AMPHETAMINES XR,2440415,PMS,discontinued – no longer available,,2026-01-29,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43272,DEXTROAMPHETAMINE/AMPHETAMINE,20 MG,capsule,PMS-AMPHETAMINES XR,2440393,PMS,discontinued – no longer available,,2026-01-29,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45803,DEXTROAMPHETAMINE/AMPHETAMINE,30 MG,capsule,SANDOZ AMPHETAMINE XR,2439298,Sandoz,discontinued – no longer available,,2026-01-29,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45800,DEXTROAMPHETAMINE/AMPHETAMINE,20 MG,capsule,SANDOZ AMPHETAMINE XR,2457326,Sandoz,discontinued – no longer available,,2026-01-29,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45803,DEXTROAMPHETAMINE/AMPHETAMINE,25 MG,capsule,SANDOZ AMPHETAMINE XR,2457334,Sandoz,discontinued – no longer available,,2026-01-29,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45803,DEXTROAMPHETAMINE/AMPHETAMINE,5 MG,capsule,SANDOZ AMPHETAMINE XR,2457288,Sandoz,discontinued – no longer available,,2026-01-29,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45803,DEXTROAMPHETAMINE/AMPHETAMINE,5 MG,capsule,TEVA-AMPHETAMINE XR,2439239,Teva,back-order–with date,2026-09-16,2026-01-29,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45803,DEXTROAMPHETAMINE/AMPHETAMINE,10 MG,capsule,TEVA-AMPHETAMINE XR,2439247,Teva,back-order–with date,2026-09-16,2026-01-29,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45803,DEXTROAMPHETAMINE/AMPHETAMINE,25 MG,capsule,TEVA-AMPHETAMINE XR,2439271,Teva,back-order–with date,2026-09-16,2026-01-29,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45803,DEXTROAMPHETAMINE/AMPHETAMINE,30 MG,capsule,TEVA-AMPHETAMINE XR,2439298,Teva,back-order–with date,2026-09-16,2026-01-29,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
46073,DEXTROAMPHETAMINE/AMPHETAMINE,10 MG,capsule,TEVA-AMPHETAMINE XR,2439247,Teva,back-order–no date,,2023-08-08,ADDERALL XR,10 MG,capsule,2248809,Takeda Canada,3.0560,2026-02-21,,
44645,"DEXTROSE/ELECTROLY,ORL",0.47-0.53 G,powder,GASTROLYTE,1931563,Sanofi-Aventis,discontinued – no longer available,,2024-06-26,HYDRALYTE ELECTROLYTE MAINTENANCE POWDER,10 x 4.9 G,grams,80026860,Mccaughey,.1967,2022-03-25,,
43980,DICLOFENAC SODIUM,0.1%,drops,APO-DICLOFENAC OPHTHALMIC,2441020,Apotex,back-order–no date,,2025-12-23,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,DIN 2475065 is available
43784,DICLOFENAC SODIUM,50 MG,tablet,TEVA-DICLOFENAC EC,808547,Teva,discontinued – no longer available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45386,DICLOFENAC SODIUM,100 MG,suppositories,SANDOZ-DICLOFENAC,2261936,Sandoz,discontinued – no longer available,,2024-04-04,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
43784,DICLOFENAC SODIUM,50 MG,tablet,DICLOFENAC EC,2352397,Sanis,discontinued – no longer available,,2021-08-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43277,DICYCLOMINE HCL,20 MG,tablet,BENTYLOL,2103095,Allergan,discontinued – no longer available,,2022-03-30,JAMP-DICYCLOMINE HCL,20 MG,tablet,2366088,Jamp,.7829,2018-06-26,,
43171,DICYCLOMINE HCL,10 MG,tablet,BENTYLOL,2103087,Allergan,discontinued – no longer available,,2020-02-27,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44355,DIFLUNISAL,250 MG,tablet,DIFLUNISAL,2039486,AA Pharma,discontinued – no longer available,,2021-06-08,Other limited coverage products are available,,,,,,,,
44355,DIFLUNISAL,500 MG,tablet,DIFLUNISAL,2039494,AA Pharma,discontinued – no longer available,,2021-06-08,Other limited coverage products are available,,,,,,,,
43915,DIGOXIN,0.25 MG,tablet,TOLOXIN,2335727,PMS,discontinued – no longer available,,2020-03-25,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
43530,DILTIAZEM HCL,120 MG,tablet,SANDOZ DILTIAZEM CD,2243338,Sandoz,discontinued – no longer available,,2021-08-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43530,DILTIAZEM HCL,120 MG,tablet,ACT DILTIAZEM CD,2370611,Teva,discontinued – no longer available,,2019-10-29,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
43165,DILTIAZEM HCL,120 MG,tablet,PMS-DILTIAZEM CD,2355752,PMS,discontinued – no longer available,,2019-07-10,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43129,DILTIAZEM T,360 MG,capsule,SANDOZ DILTIAZEM T,2245922,Sandoz,discontinued – no longer available,,2019-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45390,DIMENHYDRINATE,50 MG,suppositories,CONFAB DIMENHYDRINATE,392553,Lab,no information available,,2024-04-08,GRAVOL SUPPOSITORIES,100 MG,suppositories,13609,Church + Dwight,.7722,2024-04-08,,
43252,DIMENHYDRINATE,50 MG,tablet,APO DIMENHYDRINATE,363766,Apotex,discontinued – no longer available,,2018-10-29,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
42934,DIPHENHYDRAMINE HCL,12.5 MG/5 ML,elixir,PMS-DIPHENHYDRAMINE ELIXIR,792705,PMS,discontinued – no longer available,,2018-09-10,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,DIN 2019698 BENADRYL CHILDRENS LIQUID 6.25MG/5ML 
45853,DISOPYRAMIDE,100 MG,capsule,RYTHMODAN,2224801,Cheplapharm,back-order–no date,,2026-02-19,DR. REDDY’S DISOPYRAMIDE PHOSPHATE 100 MG CAPSULES – US LABELLED,100 MG,,,Dr. Reddy's,1.4000,2025-07-16,,
43775,DOCUSATE SODIUM,60 MG/15 ML,syrup,PMS-DOCUSATE SODIUM,703508,PMS,discontinued – no longer available,,2026-01-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43775,DOCUSATE SODIUM,60 MG/15 ML,syrup,SOFLAX SYRUP 4MG/ML,2006758,PMS,discontinued – no longer available,,2024-01-02,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45987,DORZOLAMIDE HCL,2%,drops,DORZOLAMIDE,2522373,Jamp,back-order–no date,,2026-02-19,TRUSOPT,2%,drops,2216205,Elvium,6.6168,2025-11-26,,
45813,DORZOLAMIDE HCL,2%,drops,JAMP-DORZOLAMIDE,2453347,Jamp,back-order–no date,,2026-02-05,TRUSOPT,2%,drops,2216205,Elivium,6.6168,2025-11-26,,
45813,DORZOLAMIDE HCL,2%,drops,SANDOZ DORZOLAMIDE,2316307,Sandoz,discontinued – no longer available,,2025-12-15,TRUSOPT,2%,drops,2216205,Elvium,6.6168,2025-11-26,,
45813,DORZOLAMIDE HCL,2%,drops,MED-DORZOLAMIDE,2457210,Generic Medica,discontinued – no longer available,,2025-11-26,TRUSOPT,2%,drops,2216205,Elvium,6.6168,2025-11-26,,
46015,DORZOLAMIDE HCL/TIMOLOL,2% - 0.5%,drops,DORZOLAMIDE-TIMOLOL,2522020,Jamp,back-order–no date,,2026-02-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43115,DORZOLAMIDE HCL/TIMOLOL,2% - 0.5%,drops,ACT DORZOTIMOLOL,2404389,Teva,discontinued – no longer available,,2026-02-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
46015,DORZOLAMIDE HCL/TIMOLOL,2% - 0.5%,drops,APO-DORZO-TIMOP,2299615,Apotex,back-order–with date,2026-04-10,2026-02-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
46015,DORZOLAMIDE HCL/TIMOLOL,2% - 0.5%,drops,DORZOLAMIDE AND TIMOLOL EYE DROPS BP,2489635,Hikma,discontinued – no longer available,,2026-02-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
46015,DORZOLAMIDE HCL/TIMOLOL,2% - 0.5%,drops,JAMP DORZOLAMIDE-TIMOLOL,2457539,Jamp,back-order–no date,,2026-02-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
46015,DORZOLAMIDE HCL/TIMOLOL,2% - 0.5%,drops,MED-DORZOLAMIDE-TIMOLOL,2437686,Generic Medica,back-order–no date,,2026-02-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43606,DORZOLAMIDE HCL/TIMOLOL,2% - 0.5%,drops,MINT-DORZOLAMIDE/TIMOLOL,2443090,Mint,discontinued – no longer available,,2026-02-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43115,DORZOLAMIDE HCL/TIMOLOL,2% - 0.5%,drops,PMS-DORZOLAMIDE-TIMOLOL,2442426,PMS,discontinued – no longer available,,2026-02-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
46015,DORZOLAMIDE HCL/TIMOLOL,2% - 0.5%,drops,RIVA-DORZOLAMIDE/TIMOLOL,2441659,Riva,back-order–no date,,2026-02-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43914,DORZOLAMIDE HCL/TIMOLOL,2% - 0.5%,drops,TEVA-DORZOTIMOL,2320525,Teva,discontinued – no longer available,,2026-02-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45301,DOXYCYCLINE MONOHYDRATE,100 MG,tablet,DOXYCIN,860751,Riva,no information available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45575,EDARAVONE,105 MG/5 ML,oral suspension,RADICAVA,2532611,Mitsubisi,discontinued – no longer available,,2024-10-10,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
43341,ERGOCALCIFEROL,"50,000 UNIT",capsule,OSTO-D2,2301911,Paladin,discontinued – no longer available,,2024-01-25,D-TABS,10000 UNIT,tablet,821772,Riva,.2155,2024-01-25,,
43341,ERGOCALCIFEROL,"50,000 UNIT",capsule,OSTO-D2,2301911,Paladin,discontinued – no longer available,,2023-08-28,JAMP-VITAMIN D,50000 UNIT,capsule,2449110,Jamp,1.0260,2023-08-28,,
45912,ESOMEPRAZOLE MAG TRIHYDRATE,20 MG,tablet,ESOMEPRAZOLE,2520699,Jamp,back-order–no date,,2026-02-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45912,ESOMEPRAZOLE MAG TRIHYDRATE,20 MG,tablet,TEVA-ESOMEPRAZOLE,2423855,Teva,back-order–with date,2026-04-15,2025-11-18,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45912,ESOMEPRAZOLE MAG TRIHYDRATE,20 MG,tablet,M-ESOMEPRAZOLE,2520109,Mantra,discontinued – no longer available,,2025-09-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45244,ESTRADIOL,50 MCG/24 H,patch,OESCLIM,2243724,Searchlight,back-order–no date,,2026-01-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
46055,ETHINYL ESTRADIOL/DROSPIRENONE,0.02-3(28),tablet,MYA,2415380,Apotex,now available,,2026-02-19,YAZ,0.02-3(28),tablet,2321157,Bayer Inc.,.6372,2026-02-02,2026-02-27,
46055,ETHINYL ESTRADIOL/DROSPIRENONE,0.02-3(28),tablet,DROSPIRENONE AND ETHINYL ESTRADIOL,2462060,Glenmark,back-order–no date,,2026-02-17,YAZ,0.02-3(28),tablet,2321157,Bayer Inc.,.6372,2026-02-02,,
46035,ETONOGESTREL/ETHINYL ESTRADIOL,.12-.015 MG,vaginal ring,HALOETTE,2520028,Searchlight,back-order–with date,2026-07-31,2026-02-05,NUVARING,.12-.015 MG,vaginal ring,2253186,Organon,21.3405,2026-01-13,,
45422,EVOLOCUMAB,420 MG/3.5,w/i,REPATHA,2459779,Amgen,discontinued – no longer available,,2024-05-10,Not yet determined.,,,,,,,,
43726,FAMOTIDINE,20 MG,tablet,APO-FAMOTIDINE,1953842,Apotex,discontinued – no longer available,,2020-04-16,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44008,FENTANYL CITRATE,50 MCG/NL,ampule,FENTANYL,2237197,Technilab Inc,no information available,,2020-10-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44008,FENTANYL CITRATE,50 MCG/NL,ampule,SUBLIMAZE,751251,Janssen Pharma,discontinued – no longer available,,2020-10-08,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
46076,FERROUS FUMARATE,300(100)5,suspension,PALAFER,1923439,GlaxoSmithKline,back-order–with date,2026-03-06,2026-02-23,LIQUID IRON,200 ML,suspension,80093351,Jamieson,.0840,2026-02-23,,
43923,FERROUS SULFATE,15 MG/ML,drops,PEDIAFER SOLUTION USP,2232202,Sandoz,discontinued – no longer available,,2020-04-06,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
41491,FERROUS SULFATE,160(50)MG,tablet,SLOW FE,623520,Novartis,discontinued – no longer available,,2018-09-10,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44349,FLUCONAZOLE,150 MG,capsule,PRIVA-FLUCONAZOLE,2433702,Strides Phamra,no information available,,2021-06-03,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43242,FLUNISOLIDE,25 MCG,spray,APO-FLUNISOLIDE NASAL SPRAY,2239288,Apotex,discontinued – no longer available,,2018-10-29,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
45840,FLUOXETINE HCL,10 MG,capsule,JAMP-FLUOXETINE,2401894,Jamp,back-order–no date,,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45840,FLUOXETINE HCL,10 MG,capsule,PMS-FLUOXETINE,2177579,AAPharma,back-order–with date,2026-03-13,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45840,FLUOXETINE HCL,10 MG,capsule,ACH-FLUOXETINE,2393441,Accord,back-order–no date,,2026-02-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45840,FLUOXETINE HCL,10 MG,capsule,SANDOZ FLUOXETINE,2479486,Sandoz,discontinued – no longer available,,2025-12-16,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45840,FLUOXETINE HCL,10 MG,capsule,NRA-FLUOXETINE,2503875,Nora,discontinued – no longer available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45840,FLUOXETINE HCL,10 MG,capsule,PROZAC,2018985,Eli Lilly,discontinued – no longer available,,2025-07-02,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
45840,FLUOXETINE HCL,10 MG,capsule,M-FLUOXETINE,2529432,Mantra,discontinued – no longer available,,2025-07-02,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43633,FLUPHENAZINE DECANOATE,100 MG/ML,ampule,MODECATE CONCENTRATE,755575,B-M Squibb,discontinued – no longer available,,2019-06-17,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
46021,FOLIC ACID,5 MG,tablet,JAMP-FOLIC ACID,2366061,Jamp,now available,,2026-02-05,FOLIC ACID,5 MG  ,tablet,426849,AAPharma,.0468,2025-02-25,2026-02-13,
44825,FRAMYCETIN/ESCULOSIDE/HC/DIB,10-10-5-5,suppository,PROCTOSEDYL SUPPOSITORIES,1988573,Hoechst-Rousse,discontinued – no longer available,,2022-09-21,Other already-covered full benefit ointment versions available. Consult the online LCA Data Files for details.,,,,,,,,
43005,GABAPENTIN,100 MG,capsule,GABAPENTIN CAPSULES USP,2416840,Accord,discontinued – no longer available,,2018-09-10,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45349,GALANTAMINE HBR,8 MG,capsule,MAR-GALANTAMINE ER,2420821,Marcan,discontinued – no longer available,,2024-04-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45349,GALANTAMINE HBR,8 MG,capsule,PMS-GALANTAMINE ER,2398370,PMS,discontinued – no longer available,,2024-04-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45349,GALANTAMINE HBR,16 MG,capsule,MAR-GALANTAMINE ER,2398389,Marcan,discontinued – no longer available,,2024-02-27,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45349,GALANTAMINE HBR,16 MG,capsule,PMS-GALANTAMINE ER,2398389,PMS,discontinued – no longer available,,2024-02-27,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43542,GEMFIBROZIL,300 MG,capsule,TEVA-GEMFIBROZIL,2241704,Teva,discontinued – no longer available,,2024-04-01,TEVA-GEMFIBROZIL,600 MG,tablet,2142074,Teva,1.5101,2019-03-18,,
45378,GLICLAZIDE,60 MG,tablet,TARO-GLICLAZIDE MR,2439328,Taro,back-order–with date,2026-03-04,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45378,GLICLAZIDE,60 MG,tablet,SANDOZ GLICLAZIDE MR,2461331,Sandoz,discontinued – no longer available,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45454,GLICLAZIDE,30 MG,tablet,SANDOZ GLICLAZIDE MR,2461323,Sandoz,discontinued – no longer available,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45378,GLICLAZIDE,60 MG,tablet,GLICLAZIDE MR,2524864,Sanis,discontinued – no longer available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45378,GLICLAZIDE,60 MG,tablet,MINT-GLICLAZIDE MR,2423294,Mint,discontinued – no longer available,,2025-04-16,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45454,GLICLAZIDE,30 MG,tablet,JAMP GLICLAZIDE-MR,2429764,Jamp,discontinued – no longer available,,2024-08-08,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45015,GLUCAGON,1 MG,vial,GLUCAGEN,2333619,Paladin,discontinued – no longer available,,2025-10-09,GLUCAGON KIT 1 MG VIAL (US-LABELLED),1 MG,vial,9858279,Amphastar,302.4000,2024-01-12,,
45015,GLUCAGON,1 MG,vial,GLUCAGEN HYPOKIT,2333627,Paladin,discontinued – no longer available,,2025-10-09,GLUCAGON KIT 1 MG VIAL (US-LABELLED),1 MG,vial,9858279,Amphastar,302.4000,2024-01-12,,
45015,GLUCAGON,1 MG,vial,GLUCAGON,2243297,Eli Lilly,discontinued – no longer available,,2024-03-13,GLUCAGON KIT 1 MG VIAL (US-LABELLED),1 MG,vial,9858279,Amphastar,302.4000,2024-01-12,,
45621,GLYCERIN,2100 MG,suppositories,SUPPOSITOIRES A LA GLYCERINE POUR ADULTES,2020394 ,Rougier,discontinued – no longer available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45820,GRAMICIDIN D/POLYMYX B SULF,0.025-10 K,drops,POLYSPORIN EYE AND EAR DROPS STERILE,2239156,J & J,back-order–no date,,2026-01-22,SOOTHE ANTIBIOTIC DROPS ,0.25-10 K,drops,2552418 ,Bausch,1.2320,2025-06-12,,
40963,GRAMICIDIN D/POLYMYX B SULF,0.025 MG-10 K,drops,OPTIMYXIN OTO/OPHT GTTE,701785,Sandoz,discontinued – no longer available,,2018-09-10,POLYSPORIN EYE AND EAR DROPS STERILE,0.025-10 K,drops,2239156,J & J Inc,1.1318,2014-01-24,,
42921,HEP B VIR VACC RECOMB,20 MCG/ML,vial,ENGERIX B INJ SUS,1919431,GlaxoSmithKline,discontinued – no longer available,,2026-01-26,ENGERIX-B,20 MCG/1 ML,vial,2487039,GlaxoSmithKline,35.64,2019-12-12,,
42921,HEP B VIR VACC RECOMB,20 MCG/ML,vial,ENGERIX B INJ SUS,1919431,GlaxoSmithKline,discontinued – no longer available,,2022-03-30,RECOMBIVAX HB     -(PRESERVATIVE FREE),10 MCG/ML,vial,2243676,Merk,23.89,2017-07-06,,
42921,HEP B VIR VACC RECOMB,20 MCG/ML,vial,ENGERIX B INJ SUS,1919431,GlaxoSmithKline,discontinued – no longer available,,2021-05-11,ENGERIX-B,10 MCG/0.5 ML,vial,2487020,GlaxoSmithKline,12.31,2019-11-26,,
43473,HEPARIN SODIUM (BEEF),1000/ML,vial,HEPARIN INJ 10000UNIT/ML(BEEF LUNG),562270,Organon,discontinued – no longer available,,2024-01-22,HEPARIN SODIUM INJECTION USP,5000/0.5,syringe,2456958,Sterinova,11.6980,2022-08-25,,
43473,HEPARIN SODIUM (BEEF),1000/ML,vial,HEPARIN INJ 10000UNIT/ML(BEEF LUNG),562270,Organon,discontinued – no longer available,,2021-08-30,HEPARIN SODIUM INJECTION USP,"10,000/ML",vial,2382326,Pfizer,5.6680,2021-08-30,,
43473,HEPARIN SODIUM (BEEF),1000/ML,vial,HEPARIN INJ 10000UNIT/ML(BEEF LUNG),562270,Organon,discontinued – no longer available,,2019-01-15,"HEPARIN SODIUM INJECTION, USP",5000/0.5 ML,vial,2392453,Fresenius Kabi,8.2296,2019-01-15,,
43473,HEPARIN SODIUM (BEEF),1000/ML,vial,HEPARIN INJ 10000UNIT/ML(BEEF LUNG),562270,Organon,discontinued – no longer available,,2019-01-08,"HEPARIN SODIUM INJECTION, USP",10000/ML,vial,2264307,Fresenius Kabi,7.3656,2019-01-08,,
43972,HEPARIN SODIUM (PORCINE),"10,000/ML",vial,HEPARIN SODIUM INJECTION USP         (SINGLE USE VIAL-PRESERVATI,2303094,Sandoz,discontinued – no longer available,,2020-07-16,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
42328,HEPARIN SODIUM (PORCINE),10 UNIT/ML,vial,HEPARIN LOCK FLUSH SOLUTION INJECTION USP,725323,Hospira,discontinued – no longer available,,2019-11-15,HEPARIN I.V.FLUSH SYRINGE (DEVICE),10 UNITS/ML,syringe,66128148,Medefil,.4260,2019-11-15,,
42440,HYDROCORTISONE,1 %,lotion,EMO CORT LOTION,192600,GlaxoSmithKline,discontinued – no longer available,,2018-09-10,JAMP-HYDROCORTISONE LOTION,1%,lotion,80057191,Jamp,.1419,2016-03-11,,
42636,HYDROCORTISONE,2.5%,lotion,EMO CORT LOTION,595802,GlaxoSmithKline,discontinued – no longer available,,2018-09-10,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
43479,HYDROCORTISONE ACETATE,10%,foam,CORTIFOAM,579335,Paladin,discontinued – no longer available,,2020-04-17,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44201,HYDROCORTISONE ACETATE/URE(TP),1% - 10%,cream,UREMOL HC,503134,GlaxoSmithKline,discontinued – no longer available,,2024-10-21,JAMP-HYDROCORTISONE ACETATE 1% UREA 10% CREAM,1%-10%,cream,80061501,Jamp,.1999,2021-06-08,,
41324,HYDROCORTISONE ACETATE/URE(TP),1% - 10%,lotion,UREMOL HC,560022,GlaxoSmithKline,discontinued – no longer available,,2024-10-21,JAMP-HYDROCORTISONE ACETATE 1% UREA 10% CREAM,1%-10%,cream,80061501,Jamp,.1999,2021-06-08,,
44201,HYDROCORTISONE ACETATE/URE(TP),1% - 10%,cream,CALMURID,364134,Unknown,discontinued – no longer available,,2022-08-03,JAMP-HYDROCORTISONE ACETATE 1% UREA 10% CREAM,1%-10%,cream,80061501,Jamp,.1603,2021-06-08,,
44201,HYDROCORTISONE ACETATE/URE(TP),0.5%,cream,SENTIAL CRM,733083,Unknown,discontinued – no longer available,,2021-06-08,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
43220,HYDROCORTISONE CREAM,1%,cream,CELL-HYDROCORTISONE CREAM,80073687,Cellchem Pharma,no information available,,2019-12-27,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43220,HYDROCORTISONE CREAM,1%,cream,M-HC,80066164,Mantra Pharma,no information available,,2018-06-06,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45786,HYDROCORTISONE/EMOLLIENT BASE,2.5 %,cream,SANDOZ HYDROCORTISONE,2469421,Sandoz,discontinued – no longer available,,2025-12-16,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44328,HYDROCORTISONE/PRAMOXINE /ZINC,10-20-10 MG,suppository,ANUGESIC-HC SUPPOSITORIES,476242,McNeil Consum,discontinued – no longer available,,2021-07-13,LCA Cat 774 HYDROCORTISONE/PRAMOX ONT 0.5%/ 1% (DINs 505781 and 2234466) are viable alternatives to the suppositories,,,,,,,,
43510,HYDROMORPHONE HCL,3 MG,capsule,APO-HYDROMORPHONE CR,2476614,Apotex,discontinued – no longer available,,2024-04-01,HYDROMORPH CONTIN-CONTROLLED RELEASE,3 MG,capsule,2125323,Purdue Pharma,.8305,2019-02-14,,
43893,HYDROMORPHONE HCL,4.5 MG,capsule,APO-HYDROMORPHONE CR,2476622,Apotex,discontinued – no longer available,,2024-04-01,HYDROMORPH CONTIN-CONTROLLED RELEASE,4.5 MG,capsule,2359502,Purdue Pharma,1.0022,2020-03-03,,
43515,HYDROMORPHONE HCL,9 MG,capsule,APO-HYDROMORPHONE CR,2476649,Apotex,discontinued – no longer available,,2024-04-01,HYDROMORPH CONTIN-CONTROLLED RELEASE,9 MG,capsule,2359510,Purdue Pharma,1.6373,2019-02-19,,
43700,HYDROMORPHONE HCL,12 MG,capsule,APO-HYDROMORPHONE CR,2476657,Apotex,discontinued – no longer available,,2024-04-01,HYDROMORPH CONTIN-CONTROLLED RELEASE,12 MG,capsule,2125366,Purdue Pharma,2.1578,2019-08-23,,
43893,HYDROMORPHONE HCL,18 MG,capsule,APO-HYDROMORPHONE CR,2476665,Apotex,discontinued – no longer available,,2024-04-01,HYDROMORPH CONTIN-CONTROLLED RELEASE,18 MG,capsule,2243562,Purdue Pharma,3.1131,2020-03-03,,
43700,HYDROMORPHONE HCL,24 MG,capsule,APO-HYDROMORPHONE CR,2476673,Apotex,discontinued – no longer available,,2024-04-01,HYDROMORPH CONTIN-CONTROLLED RELEASE,24 MG,capsule,2125382,Purdue Pharma,3.6029,2019-08-23,,
43494,HYDROMORPHONE HCL,6 MG,capsule,APO-HYDROMORPHONE CR,2476630,Apotex,discontinued – no longer available,,2024-04-01,HYDROMORPH CONTIN-CONTROLLED RELEASE CAP,6 MG,capsule,2125331,Purdue Pharma,1.2409,2019-01-29,,
43867,HYDROMORPHONE HCL,30 MG,capsule,APO-HYDROMORPHONE CR,2476681,Apotex,discontinued – no longer available,,2024-04-01,HYDROMORPH CONTIN-CONTROLLED RELEASE CAP,30 MG,capsule,2125390,Purdue Pharma,4.3157,2020-02-06,,
43907,HYDROXYCHLOROQUINE SULFATE,200 MG,tablet,MYLAN-HYDROXYCHLOROQUINE,2252600,Mylan,discontinued – no longer available,,2020-05-13,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
42290,HYOSCINE HYDROBROMIDE,0.4 MG/ML,ampule,SCOPOLAMINE HYDROBROMIDE INJECTION,541869,Pfizer,discontinued – no longer available,,2024-04-01,SCOPOLAMINE HYDROBROMIDE INJECTION,0.4 MG/ML,vial,2242810,Omega,6.8931,2015-10-13,,
42335,HYOSCINE HYDROBROMIDE,0.6 MG/ML,ampule,SCOPOLAMINE HYDROBROMIDE INJECTION,541877,Pfizer,discontinued – no longer available,,2024-04-01,SCOPOLAMINE HYDROBROMIDE INJECTION                              ,0.6 MG/ML,vial,2242811,Omega,7.4520,2015-11-27,,
45288,IBUPROFEN,200 MG,tablet,IBUPROFEN TABLETS,2368072,Vita Health,discontinued – no longer available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43585,IBUPROFEN,600 MG,tablet,TEVA-PROFEN,629359,Teva,discontinued – no longer available,,2021-01-06,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45574,INDOMETHACIN,50 MG,suppositories,ODAN-INDOMETHACIN,2231799,Odan,discontinued – no longer available,,2024-10-09,Other already-covered full benefit versions available - diclofenac supp is Regular Benefit,,,,,,,,
45574,INDOMETHACIN,100 MG,suppositories,ODAN-INDOMETHACIN,2231800,Odan,discontinued – no longer available,,2024-10-09,Other already-covered full benefit versions available - diclofenac supp is Regular Benefit,,,,,,,,
43606,"INSULIN GLARGINE,HUM.REC.ANLOG",100/ML,insulin pen,BASAGLAR,2444852,Eli Lilly,discontinued – no longer available,,2019-05-21,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,60 Unit pen terminated and replaced by 80 Unit pen DIN 2461528
44176,INSULIN NPH S-S/REG INSULIN HM,50-50 ML,vial,HUMULIN 50/50 INJ,889121,Eli Lilly,discontinued – no longer available,,2020-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44176,"INSULIN REG-ISOPHANE, NPH HUMAN",10-90 ML,vial,HUMULIN 10/90 INJ,889113,Eli Lilly,discontinued – no longer available,,2020-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44176,"INSULIN REG-ISOPHANE, NPH HUMAN",20-80/ML,cartridge,HUMULIN 20/80,1962655,Eli Lilly,discontinued – no longer available,,2020-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44176,"INSULIN REG-ISOPHANE, NPH HUMAN",10-90/ML,cartridge,NOVOLIN GE 10/90,2024292,Novo Nordisk,discontinued – no longer available,,2020-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44176,"INSULIN REG-ISOPHANE, NPH HUMAN",20-80/ML,cartridge,NOVOLIN GE 20/80,2024306,Novo Nordisk,discontinued – no longer available,,2020-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
42712,IODOQUINOL,650 MG,tablet,DIODOQUIN,1997750,Glenwood,discontinued – no longer available,,2018-09-10,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
43608,IRBESARTAN,75 MG,tablet,JAMP-IRBESARTAN,2418193,Jamp,back-order–no date,,2025-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43615,IRBESARTAN,150 MG,tablet,JAMP-IRBESARTAN,2418207,Jamp,back-order–no date,,2025-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43556,IRBESARTAN,300 MG,tablet,JAMP-IRBESARTAN,2418215,Jamp,back-order–no date,,2025-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43745,IRBESARTAN,150-12.5 MG,tablet,JAMP-IRBESARTAN AND HYDROCHLOROTHIAZIDE,2418223,Jamp,back-order–no date,,2025-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43745,IRBESARTAN,300-12.5 MG,tablet,JAMP-IRBESARTAN AND HYDROCHLOROTHIAZIDE,2418231,Jamp,back-order–no date,,2025-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43745,IRBESARTAN,300-25 MG,tablet,JAMP-IRBESARTAN AND HYDROCHLOROTHIAZIDE,2418258,Jamp,back-order–no date,,2025-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43556,IRBESARTAN,300 MG,tablet,MINT-IRBESARTAN,2423006,Mint,back-order–no date,,2024-04-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43608,IRBESARTAN,75 MG,tablet,AURO-IRBESARTAN,2406098,Auropharma,back-order–no date,,2023-04-24,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43745,IRBESARTAN,150 MG,tablet,AURO-IRBESARTAN,2406101,Auropharma,back-order–no date,,2023-04-24,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43556,IRBESARTAN,300 MG,tablet,AURO-IRBESARTAN,2406128,Auropharma,back-order–no date,,2023-04-24,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43745,IRBESARTAN,150-12.5 MG,tablet,AURO-IRBESARTAN HCT,2447878,Auropharma,back-order–no date,,2023-04-24,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43745,IRBESARTAN,300-12.5 MG,tablet,AURO-IRBESARTAN HCT,2447886,Auropharma,back-order–no date,,2023-04-24,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43745,IRBESARTAN,300 MG-25 MG,tablet,AURO-IRBESARTAN HCT,2447894,Auropharma,back-order–no date,,2023-04-24,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43608,IRBESARTAN,75 MG,tablet,IRBESARTAN,2365197,Pro Doc,no information available,,2021-01-25,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43745,IRBESARTAN,150 MG,tablet,IRBESARTAN,2365200,Pro Doc,no information available,,2021-01-25,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43556,IRBESARTAN,300 MG,tablet,IRBESARTAN,2365219,Pro Doc,no information available,,2021-01-25,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43732,IRON DEXTRAN COMPLEX,50 MG/ML,vial,DEXIRON,2205963,Fresenius Medical,discontinued – no longer available,,2025-01-15,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
46055,KETOROLAC TROMETHAMINE,0.5%,drops,KETOROLAC,2245821,AAPharma,back-order–with date,2026-07-08,2026-02-02,ACULAR,0.5%,drops,1968300,Abbvie,3.9741,2026-02-02,,
45925,LANSOPRAZOLE,15 MG,capsule,LANSOPRAZOLE,2433001,PMS,back-order–no date,,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45925,LANSOPRAZOLE,15 MG,capsule,LANSOPRAZOLE,2385767,Sivem,back-order–with date,2026-03-06,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45925,LANSOPRAZOLE,15 MG,capsule,SANDOZ LANSOPRAZOLE,2385643,Sandoz,back-order–no date,,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45925,LANSOPRAZOLE,15 MG,capsule,TARO-LANSOPRAZOLE,2402610,Taro,back-order–no date,,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45925,LANSOPRAZOLE,15 MG,capsule,TEVA-LANSOPRAZOLE,2280515,Teva,discontinued – no longer available,,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44021,LANSOPRAZOLE-AMOXICILLIN-CLARITHROMYCIN,30-500-500,package,HP-PAC,2238525,Mylan,discontinued – no longer available,,2024-11-15,Other already-covered full benefit PPI versions available,,,,,,,,
45958,LATANOPROST,50 MCG/ML,drops,SANDOZ LATANOPROST/TIMOLOL,2367335,Sandoz,back-order–no date,,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45958,LATANOPROST,50 MCG/ML,drops,TEVA-LATANOPROST,2254786,Teva,back-order–no date,,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45958,LATANOPROST,50 MCG/ML,drops,MED-LATANOPROST,2426935,Generic Medica,back-order–no date,,2025-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45958,LATANOPROST,50 MCG/ML,drops,RIVA-LATANOPROST,2341085,Riva,back-order–no date,,2025-11-27,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45958,LATANOPROST,50 MCG/ML,drops,LATANOPROST OPHTHALMIC SOLUTION,2489570,Hikma,discontinued – no longer available,,2025-10-28,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45741,LATANOPROST/TIMOLOL MALEATE,50 MCG-5/ML,drops,TEVA-LATANOPROST-TIMOLOL,2436256,Teva,back-order–no date,,2026-01-13,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45741,LATANOPROST/TIMOLOL MALEATE,50 MCG-5/ML,drops,M-LATANOPROST-TIMOLOL,2514516,Mantra,back-order–no date,,2025-04-16,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45741,LATANOPROST/TIMOLOL MALEATE,50 MCG-5/ML,drops,LATANOPROST AND TIMOLOL OPHTHALMIC SOLUTION,2489368,Hikma,discontinued – no longer available,,2020-04-28,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45741,LATANOPROST/TIMOLOL MALEATE,50 MCG-5/ML,drops,MED-LATANOPROST-TIMOLOL,2454505,Generic Medica,discontinued – no longer available,,2020-04-28,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43620,LATANOPROST/TIMOLOL MALEATE,50 MCG-5/ML,drops,SANDOZ LATANOPROST/TIMOLOL,2394685,Sandoz,discontinued – no longer available,,2020-04-28,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43214,LEVETIRACETAM,250 MG,tablet,LEVETIRACETAM,2399776,Accord,back-order–no date,,2026-01-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43924,LEVETIRACETAM,500 MG,tablet,LEVETIRACETAM,2399784,Accord,back-order–no date,,2026-01-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43924,LEVETIRACETAM,750 MG,tablet,LEVETIRACETAM,2399792,Accord,back-order–no date,,2026-01-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43924,LEVETIRACETAM,250 MG,tablet,LEVETIRACETAM,2454653,PMS,discontinued – no longer available,,2021-12-06,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43924,LEVETIRACETAM,500 MG,tablet,LEVETIRACETAM,2454661,PMS,discontinued – no longer available,,2021-12-06,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43924,LEVETIRACETAM,500 MG,tablet,PRO-LEVETIRACETAM,2311380,Pro Doc,no information available,,2020-04-03,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43924,LEVETIRACETAM,750 MG,tablet,PRO-LEVETIRACETAM,2311399,Pro Doc,no information available,,2020-04-03,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45856,LEVOTHYROXINE SODIUM,50 MCG,tablet,EUTHYROX,2264331,Emd Serono,discontinued – no longer available,,2025-11-03,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45856,LEVOTHYROXINE SODIUM,50 MCG,tablet,LEVOTEC,2237214,Technilab,discontinued – no longer available,,2025-11-03,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43213,LIDOCAINE HCL,2%,solution,XYLOCAINE VISCOUS,1686,Aspen,discontinued – no longer available,,2022-04-07,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
46034,LIOTHYRONINE SODIUM,25 MCG,tablet,TEVA-LIOTHYRONINE,2494345,Teva,back-order–with date,2026-03-20,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44207,LISINOPRIL,5 MG,tablet,JAMP-LISINOPRIL,2361531,Jamp,discontinued – no longer available,,2022-05-17,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44207,LISINOPRIL,10 MG,tablet,JAMP-LISINOPRIL,2361558,Jamp,discontinued – no longer available,,2022-05-17,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44232,LISINOPRIL,20 MG,tablet,JAMP-LISINOPRIL,2361566,Jamp,discontinued – no longer available,,2022-05-17,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44207,LISINOPRIL,10 MG,tablet,ACT LISINOPRIL,2271451,Teva,discontinued – no longer available,,2021-03-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44232,LISINOPRIL,20 MG,tablet,ACT LISINOPRIL,2271478,Teva,discontinued – no longer available,,2021-03-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44207,LISINOPRIL,10 MG,tablet,SANDOZ LISINOPRIL,2289202,Sandoz,discontinued – no longer available,,2021-03-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44232,LISINOPRIL,20 MG,tablet,SANDOZ LISINOPRIL,2289229,Sandoz,discontinued – no longer available,,2021-03-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44207,LISINOPRIL,10 MG,tablet,TEVA-LISINOPRIL (TYPE P),2285088,Teva,discontinued – no longer available,,2021-03-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44232,LISINOPRIL,20 MG,tablet,TEVA-LISINOPRIL (TYPE P),2285096,Teva,discontinued – no longer available,,2021-03-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44207,LISINOPRIL,5 MG,tablet,SANDOZ LISINOPRIL,2289199,Sandoz,discontinued – no longer available,,2021-02-08,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44207,LISINOPRIL,5 MG,tablet,ACT LISINOPRIL,2271443,Teva,discontinued – no longer available,,2021-01-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44207,LISINOPRIL,5 MG,tablet,TEVA-LISINOPRIL (TYPE P),2285061,Teva,discontinued – no longer available,,2021-01-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45427,LITHIUM CARBONATE,300 MG,capsule,APO-LITHIUM CARBONATE,2242838,Apotex,back-order–no date,,2026-02-19,CARBOLITH,300 MG,capsule,236683,Bausch,.1280,2024-05-15,,
45427,LITHIUM CARBONATE,300 MG,capsule,LITHANE,406775,Searchlight,back-order–no date,,2026-02-19,CARBOLITH,300 MG,capsule,236683,Bausch,.1280,2024-05-15,,
45427,LITHIUM CARBONATE,300 MG,capsule,PMS-LITHIUM CARBONATE,2216140,PMS,back-order–no date,,2026-02-19,CARBOLITH,300 MG,capsule,236683,Bausch,.1280,2024-05-15,,
45427,LITHIUM CARBONATE,300 MG,capsule,APO-LITHIUM CARBONATE,2242838,Apotex,back-order–no date,,2026-02-19,LITHANE,300 MG,tablet,406775,Searchllight,.2043,2024-06-04,,
45427,LITHIUM CARBONATE,300 MG,capsule,PMS-LITHIUM CARBONATE,2216140,PMS,back-order–no date,,2026-02-19,LITHANE,300 MG,tablet,406775,Searchlight,.2043,2024-05-22,,Lithmax is a sustained-release product
45427,LITHIUM CARBONATE,300 MG,capsule,APO-LITHIUM CARBONATE,2242838,Apotex,back-order–no date,,2026-02-19,LITHMAX,300 MG,tablet,2266695,AAPharma,.3111,2024-05-22,,Lithmax is a sustained-release product
45427,LITHIUM CARBONATE,300 MG,capsule,LITHANE,406775,Searchlight,back-order–no date,,2026-02-19,LITHMAX,300 MG,tablet,2266695,AAPharma,.3111,2024-05-22,,Lithmax is a sustained-release product
45427,LITHIUM CARBONATE,300 MG,capsule,PMS-LITHIUM CARBONATE,2216140,PMS,back-order–no date,,2026-02-19,LITHMAX,300 MG,tablet,2266695,AAPharma,.3111,2024-05-22,,Lithmax is a sustained-release product
45429,LITHIUM CARBONATE,150 MG,capsule,LITHANE,2013231,Searchlight,back-order–no date,,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44531,LITHIUM CARBONATE,600 MG,capsule,PMS-LITHIUM CARBONATE,2216159,PMS,discontinued – no longer available,,2024-05-15,CARBOLITH        ,600 MG,capsule,2011239,Bausch,.2504,2024-05-16,,
42978,LITHIUM CITRATE,8 MMOL/5 ML,solution,PMS-LITHIUM CITRATE,2074834,PMS,discontinued – no longer available,,2018-09-10,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
43448,LOSARTAN POTASSIUM,50 MG,tablet,APO-LOSARTAN,2353504,Apotex,back-order–no date,,2026-01-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43488,LOSARTAN POTASSIUM,100 MG,tablet,APO-LOSARTAN,2353512,Apotex,back-order–no date,,2026-01-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43448,LOSARTAN POTASSIUM,25 MG,tablet,APO-LOSARTAN,2379058,Apotex,back-order–no date,,2026-01-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44455,LOSARTAN POTASSIUM,25 MG,tablet,LOSARTAN,2388790,Sivem,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44455,LOSARTAN POTASSIUM,50 MG,tablet,LOSARTAN,2388804,Sivem,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44459,LOSARTAN POTASSIUM,100 MG,tablet,LOSARTAN,2388812,Sivem,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43448,LOSARTAN POTASSIUM,100 MG,tablet,MINT-LOSARTAN,2405768,Mint,back-order–no date,,2024-01-04,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43448,LOSARTAN POTASSIUM,25 MG,tablet,MINT-LOSARTAN,2405733,Mint,back-order–no date,,2023-08-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43448,LOSARTAN POTASSIUM,50 MG,tablet,MINT-LOSARTAN,2405741,Mint,back-order–no date,,2023-08-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43448,LOSARTAN POTASSIUM,25 MG,tablet,SEPTA-LOSARTAN,2424967,Septa Pharma,no information available,,2023-01-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43448,LOSARTAN POTASSIUM,50 MG,tablet,SEPTA-LOSARTAN,2424975,Septa Pharma,no information available,,2023-01-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43448,LOSARTAN POTASSIUM,100 MG,tablet,SEPTA-LOSARTAN,2424983,Septa Pharma,no information available,,2023-01-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43448,LOSARTAN POTASSIUM,25 MG,tablet,ACT LOSARTAN,2354829,Teva,discontinued – no longer available,,2022-03-14,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43448,LOSARTAN POTASSIUM,50 MG,tablet,ACT LOSARTAN,2354837,Teva,discontinued – no longer available,,2022-03-14,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43448,LOSARTAN POTASSIUM,100 MG,tablet,ACT LOSARTAN,2354845,Teva,discontinued – no longer available,,2022-03-14,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44543,LOSARTAN POTASSIUM/HCTZ,100 MG - 25 MG,tablet,LOSARTAN HCT,2388987,Sivem,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43497,LOSARTAN POTASSIUM/HCTZ,100 MG - 25 MG,tablet,JAMP-LOSARTAN HCTZ,2408252,Jamp,discontinued – no longer available,,2025-04-16,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44543,LOSARTAN POTASSIUM/HCTZ,100 MG - 25 MG,tablet,MINT-LOSARTAN/HCTZ DS,2389673,Mint,back-order–no date,,2024-04-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43497,LOSARTAN POTASSIUM/HCTZ,50-12.5 MG,tablet,ACT LOSARTAN/HCT,2388251,Teva,discontinued – no longer available,,2022-02-08,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44543,LOSARTAN POTASSIUM/HCTZ,100 MG - 25 MG,tablet,ACT LOSARTAN/HCT,2388286,Teva,discontinued – no longer available,,2022-02-08,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43497,LOSARTAN POTASSIUM/HCTZ,100 MG - 25 MG,tablet,ACT LOSARTAN/HCT,2388286,Teva,discontinued – no longer available,,2022-02-08,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43497,LOSARTAN POTASSIUM/HCTZ,50-12.5 MG,tablet,APO-LOSARTAN/HCTZ,2371235,Apotex,discontinued – no longer available,,2022-02-08,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43497,LOSARTAN POTASSIUM/HCTZ,100 MG - 25 MG,tablet,APO-LOSARTAN/HCTZ,2371251,Apotex,discontinued – no longer available,,2022-02-08,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43497,LOSARTAN POTASSIUM/HCTZ,50-12.5 MG,tablet,TEVA-LOSARTAN/HCTZ,2358263,Teva,discontinued – no longer available,,2022-02-08,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44543,LOSARTAN POTASSIUM/HCTZ,100 MG - 25 MG,tablet,TEVA-LOSARTAN/HCTZ,2377152,Teva,discontinued – no longer available,,2022-02-08,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43497,LOSARTAN/HYDROCHLOROTHIAZIDE,50 MG - 12.5 MG,tablet,LOSARTAN HCT,2388960,Sivem,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44543,LOSARTAN/HYDROCHLOROTHIAZIDE,100 MG/12.5 MG,tablet,LOSARTAN HCT,2388979,Sivem,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43497,LOSARTAN/HYDROCHLOROTHIAZIDE,50 MG - 12.5 MG,tablet,JAMP-LOSARTAN HCTZ,2408244,Jamp,discontinued – no longer available,,2025-04-16,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43497,LOSARTAN/HYDROCHLOROTHIAZIDE,50 MG - 12.5 MG,tablet,MINT-LOSARTAN/HCTZ,2389657,Mint,back-order–no date,,2024-04-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44543,LOSARTAN/HYDROCHLOROTHIAZIDE,100 MG/12.5 MG,tablet,MINT-LOSARTAN/HCTZ,2389665,Mint,back-order–no date,,2024-04-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44543,LOSARTAN/HYDROCHLOROTHIAZIDE,100 MG/12.5 MG,tablet,TEVA-LOSARTAN/HCTZ,2377144,Teva,discontinued – no longer available,,2022-04-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43495,LOSARTAN/HYDROCHLOROTHIAZIDE,100 MG/12.5 MG,tablet,ACT LOSARTAN/HCT,2388278,Teva,discontinued – no longer available,,2022-02-08,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43495,LOSARTAN/HYDROCHLOROTHIAZIDE,100 MG/12.5 MG,tablet,APO-LOSARTAN/HCTZ,2371243,Apotex,discontinued – no longer available,,2020-06-16,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45506,LOXAPINE SUCCINATE,5 MG,tablet,XYLAC,2230837,Pendopharm,discontinued – no longer available,,2024-09-18,LOXAPINE 2.5 MG COMPOUNDED CAPSULES,2.5 MG,capsule,22123398,Unknown,.4200,2024-07-30,,
46042,MAGNESIUM GLUCOHEPTONATE,25 MG/5 ML,liquid,ROUGIER MAGNESIUM,26697,Rougier,back-order–no date,,2026-02-19,MAGNESIUM-ODAN 5MG/ML LIQUID,5 MG/ML,liquid,80004109,Odan,.0269,2026-01-20,,
42964,MEFENAMIC ACID,250 MG,capsule,PONSTAN,155225,AA Pharma,discontinued – no longer available,,2023-04-01,MEFENAMIC,250 MG,capsule,2229452,AA Pharma,.4906,2017-08-17,,
43901,METFORMIN HCL,500 MG,tablet,SEPTA-METFORMIN,2379767,Septa Pharma,no information available,,2023-01-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43901,METFORMIN HCL,850 MG,tablet,SEPTA-METFORMIN,2379775,Septa Pharma,no information available,,2023-01-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43901,METFORMIN HCL,850 MG,tablet,PRO-METFORMIN,2314894,Pro Doc,discontinued – no longer available,,2020-03-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43901,METFORMIN HCL,500 MG,tablet,PRO-METFORMIN,2314908,Pro Doc,discontinued – no longer available,,2020-03-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
42396,METHENAMINE MANDELATE,500 MG,tablet,MANDELAMINE,499013,Erfa,back-order–no date,,2025-12-11,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
45835,METHOTREXATE,10 MG,tablet,"METHOTREXATE TABLETS, USP",2182750,Pfizer,back-order–no date,,2025-12-15,JAMP METHOTREXATE TABLETS,10 MG,tablet,2553740,Jamp,3.0226,2025-06-27,,
43983,METHOTREXATE SODIUM NO/PRESERVATIVE,25 MG/ML,vial,METHOTREXATE SODIUM INJECTION,2099705,Teva,back-order–no date,,2025-12-15,METHOTREXATE INJECTION USP,25 MG/ML,vial,2182971,Pfizer,6.0750,2021-02-18,,
43983,METHOTREXATE SODIUM NO/PRESERVATIVE,25 MG/ML,vial,METHOTREXATE SODIUM INJECTION,2099705,Teva,back-order–no date,,2025-12-15,METHOTREXATE INJECTION USP,25 MG/ML,vial,2182971,Pfizer,6.0750,2021-02-18,,
43983,METHOTREXATE SODIUM NO/PRESERVATIVE,25 MG/ML,vial,METHOTREXATE SODIUM INJECTION,2099705,Teva,back-order–no date,,2025-12-15,METHOTREXATE INJECTION USP,25 MG/ML,vial,2182971,Pfizer,6.0750,2021-02-18,,
43983,METHOTREXATE SODIUM NO/PRESERVATIVE,25 MG/ML,vial,METHOTREXATE SODIUM INJECTION,2099705,Teva,back-order–no date,,2025-12-15,METHOTREXATE INJECTION USP,25 MG/ML,vial,2182971,Pfizer,6.0750,2021-02-18,,
43983,METHOTREXATE SODIUM NO/PRESERVATIVE,25 MG/ML,vial,METHOTREXATE SODIUM INJECTION,2099705,Teva,back-order–no date,,2025-12-15,METHOTREXATE INJECTION USP,25 MG/ML,vial,2182971,Pfizer,6.0750,2021-02-18,,
43983,METHOTREXATE SODIUM NO/PRESERVATIVE,25 MG/ML,vial,METHOTREXATE SODIUM INJECTION,2099705,Teva,back-order–no date,,2025-12-15,METHOTREXATE INJECTION USP,25 MG/ML,vial,2182971,Pfizer,6.0750,2021-02-18,,
43983,METHOTREXATE SODIUM NO/PRESERVATIVE,25 MG/ML,vial,METHOTREXATE SODIUM INJECTION,2099705,Teva,back-order–no date,,2025-12-15,METHOTREXATE INJECTION USP,50 MG/2 ML,vial,2182955,Pfizer,6.0750,2021-02-18,,
43983,METHOTREXATE SODIUM NO/PRESERVATIVE,25 MG/ML,vial,METHOTREXATE SODIUM INJECTION,2099705,Teva,back-order–no date,,2025-12-15,METHOTREXATE INJECTION USP,50 MG/2 ML,vial,2182955,Pfizer,6.0750,2021-02-18,,
43983,METHOTREXATE SODIUM NO/PRESERVATIVE,25 MG/ML,vial,METHOTREXATE SODIUM INJECTION,2099705,Teva,back-order–no date,,2025-12-15,METHOTREXATE INJECTION USP,50 MG/2 ML,vial,2182955,Pfizer,6.0750,2021-02-18,,
43983,METHOTREXATE SODIUM NO/PRESERVATIVE,25 MG/ML,vial,METHOTREXATE SODIUM INJECTION,2099705,Teva,back-order–no date,,2025-12-15,METHOTREXATE INJECTION USP,50 MG/2 ML,vial,2182955,Pfizer,6.0750,2021-02-18,,
43983,METHOTREXATE SODIUM NO/PRESERVATIVE,25 MG/ML,vial,METHOTREXATE SODIUM INJECTION,2099705,Teva,back-order–no date,,2025-12-15,METHOTREXATE INJECTION USP,50 MG/2 ML,vial,2182955,Pfizer,6.0750,2021-02-18,,
43983,METHOTREXATE SODIUM NO/PRESERVATIVE,25 MG/ML,vial,METHOTREXATE SODIUM INJECTION,2099705,Teva,back-order–no date,,2025-12-15,METHOTREXATE INJECTION USP,50 MG/2 ML,vial,2182955,Pfizer,6.0750,2021-02-18,,
43983,METHOTREXATE SODIUM NO/PRESERVATIVE,25 MG/ML,vial,METHOTREXATE SODIUM INJECTION,2182971,Pfizer,available to hospitals only,,2025-10-09,METHOTREXATE INJECTION USP,50 MG/2 ML,vial,2182955,Pfizer,6.0750,2021-02-18,,
43983,METHOTREXATE SODIUM NO/PRESERVATIVE,25 MG/ML,vial,METHOTREXATE SODIUM INJECTION,2182971,Pfizer,available to hospitals only,,2025-10-09,METHOTREXATE INJECTION USP,50 MG/2 ML,vial,2182955,Pfizer,6.0750,2021-02-18,,
43983,METHOTREXATE SODIUM NO/PRESERVATIVE,25 MG/ML,vial,METHOTREXATE SODIUM INJECTION,2182971,Pfizer,available to hospitals only,,2025-10-09,METHOTREXATE INJECTION USP,50 MG/2 ML,vial,2182955,Pfizer,6.0750,2021-02-18,,
43983,METHOTREXATE SODIUM NO/PRESERVATIVE,25 MG/ML,vial,METHOTREXATE SODIUM INJECTION,2182971,Pfizer,available to hospitals only,,2025-10-09,METHOTREXATE INJECTION USP,50 MG/2 ML,vial,2182955,Pfizer,6.0750,2021-02-18,,
43983,METHOTREXATE SODIUM NO/PRESERVATIVE,25 MG/ML,vial,METHOTREXATE SODIUM INJECTION,2182971,Pfizer,available to hospitals only,,2025-10-09,METHOTREXATE INJECTION USP,50 MG/2 ML,vial,2182955,Pfizer,6.0750,2021-02-18,,
43983,METHOTREXATE SODIUM NO/PRESERVATIVE,25 MG/ML,vial,METHOTREXATE SODIUM INJECTION,2182971,Pfizer,available to hospitals only,,2025-10-09,METHOTREXATE INJECTION USP,50 MG/2 ML,vial,2182955,Pfizer,6.0750,2021-02-18,,
43608,METHYLPREDNISOLONE SODIUM SUCCINATE,500 MG,vial,METHYLPREDNISOLONE SODIUM SUCCINATE FOR INJECTION,2231895,Teva,discontinued – no longer available,,2023-04-05,SOLU-MEDROL,500 MG,vial,30678,Pfizer,50.1163,2019-05-23,,
42695,METHYLPREDNISOLONE SODIUM SUCCINATE,1000 MG,vial,METHYLPREDNISOLONE SODIUM SUCCINATE FOR INJECTION,2241229,Teva,discontinued – no longer available,,2023-04-05,SOLU-MEDROL,1000 MG/8 ML,vial,2367971,Pfizer,76.5184,2016-11-21,,
42576,METHYLPREDNISOLONE SODIUM SUCCINATE,125 MG/ML,vial,METHYLPREDNISOLONE SODIUM SUCCINATE FOR INJECTION,2231894,Teva,discontinued – no longer available,,2023-04-01,SOLU-MEDROL,125 MG/ML,vial,2367955,Pfizer,20.3990,2016-07-26,,
44510,METHYLPREDNISOLONE SODIUM SUCCINATE/PF,40 MG/ML,vial,METHYLPREDNISOLONE SODIUM SUCCINATE FOR INJECTION,2231893,Teva,discontinued – no longer available,,2023-04-01,SOLU-MEDROL,40 MG/ML,vial,2367947,Pfizer,8.3905,2021-11-10,,
43538,METOPROLOL TARTRATE,200 MG,tablet,APO-METOPROLOL SR,2285177,AAPharma,back-order–no date,,2025-05-06,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44112,METYRAPONE,250 MG,tablet,METOPIRONE,74241,Unknown,discontinued – no longer available,,2020-10-08,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44901,MICONAZOLE NITRATE,400 MG-2%,kit,MONISTAT 3 DUAL-PAK,2126249,Insight Pharma,back-order–no date,,2023-10-03,CANESTEN COMBI 3 DAY,200 MG-1%,combo pkg,2264099,Bayer,15.0984,2022-12-06,,
44901,MICONAZOLE NITRATE,400 MG-2%,kit,MONISTAT 3 DUAL-PAK,2126249,Insight Pharma,back-order–no date,,2023-10-03,MICONAZOLE 3 DAY OVULE TREATMENT,400 MG,supp.vag,2171775,Vita Health,6.95,2022-12-06,,
44901,MICONAZOLE NITRATE,400 MG,supp.vag,MONISTAT 3 VAGINAL OVULES,2126605,Insight Pharma,back-order–no date,,2022-12-06,CANESTEN COMBI 3 DAY,200 MG-1%,combo pkg,2264099,Bayer,15.0984,2022-12-06,,
44901,MICONAZOLE NITRATE,400 MG,supp.vag,MONISTAT 3 VAGINAL OVULES,2126605,Insight Pharma,back-order–no date,,2022-12-06,MICONAZOLE 3 DAY OVULE TREATMENT,400 MG,supp.vag,2171775,Vita Health,6.95,2022-12-06,,
44692,MICONAZOLE NITRATE,400 MG-2%,kit,MONISTAT 3 DUAL-PAK,2126249,Insight,discontinued – no longer available,,2022-05-16,Other already-covered full benefit versions available. ,,,,,,,,DIN 2126605 and other fully covered forms of clotrimazole such as DIN 812366
44634,MIDAZOLAM HCL,5 MG/ML,ampule,MIDAZOLAM INJECTION,2423766,Pfizer,discontinued – no longer available,,2022-11-07,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,Plan B was added due to shortage on Lorazepam 4MG/ML
42873,MONOBASIC SODIUM PHOSPHATE/SODIUM BICARBONATE/POTASSIUM BICARBONATE,500/469/123 MG,tablet,PHOSPHATE NOVARTIS,80027202,Novartis,discontinued – no longer available,,2020-10-03,JAMP-SODIUM PHOSPHATE,500/469/123 MG,tablet,80047562,Jamp,1.5131,2017-08-09,,
43475,MORPHINE SULFATE,20 MG,capsule,M-EDIAT,2320436,Valeo,discontinued – no longer available,,2024-04-01,MS.IR,20 MG,tablet,2014238,Purdue Pharma,.4833,2019-01-10,,
43475,MORPHINE SULFATE,5 MG,capsule,M-EDIAT,2320398,Valeo,discontinued – no longer available,,2024-04-01,STATEX,5 MG,tablet,594652,Paladin,.1392,2019-01-10,,
43475,MORPHINE SULFATE,10 MG,capsule,M-EDIAT,2320428,Valeo,discontinued – no longer available,,2024-04-01,STATEX,10 MG,tablet,594644,Paladin,.2151,2019-01-10,,
43475,MORPHINE SULFATE,10 MG,capsule,M-EDIAT,2320428,Valeo,discontinued – no longer available,,2024-03-04,MS.IR,10 MG,tablet,2014211,Purdue,.2095,2024-03-04,,
44677,MORPHINE SULFATE,20 MG,suppository,M.O.S.- 20,624276,Valeant,discontinued – no longer available,,2022-04-26,"For PharmaCare coverage, patients may switch to oral morphine or oxycodone suppositories, depending on patient needs. A consultation between the pharmacist and prescriber is recommended to ensure appropriate therapy",,,,,,,,
44677,MORPHINE SULFATE,20 MG,suppository,MS IR SUP,2014262,Purdue,discontinued – no longer available,,2022-04-26,"For PharmaCare coverage, patients may switch to oral morphine or oxycodone suppositories, depending on patient needs. A consultation between the pharmacist and prescriber is recommended to ensure appropriate therapy",,,,,,,,
44677,MORPHINE SULFATE,20 MG,suppository,MS IR SUP,1909452,Unknown,discontinued – no longer available,,2022-04-26,"For PharmaCare coverage, patients may switch to oral morphine or oxycodone suppositories, depending on patient needs. A consultation between the pharmacist and prescriber is recommended to ensure appropriate therapy",,,,,,,,
44677,MORPHINE SULFATE,20 MG,suppository,STATEX SUPPOSITORIES,596965,Paladin,discontinued – no longer available,,2022-04-26,"For PharmaCare coverage, patients may switch to oral morphine or oxycodone suppositories, depending on patient needs. A consultation between the pharmacist and prescriber is recommended to ensure appropriate therapy",,,,,,,,
43600,MORPHINE SULFATE,30 MG,capsule,M-EDIAT,2320444,Valeo,discontinued – no longer available,,2019-05-15,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
45714,MULTIVITAMIN,MULTI,tablet,CENTRUM JUNIOR COMPLETE,80020794,Pfizer,discontinued – no longer available,,2026-01-12,IRONKIDS ESSENTIALS MULTIVITAMIN GUMMIES,MULTI,gummies,80073172,Life Science,.0774,2026-01-12,,
46034,MULTIVITAMIN,MULTI,tablet,FLINTSTONES MULTIPLE VITAMINS WITH EXTRA C,2247975,Bayer,discontinued – no longer available,,2026-01-12,IRONKIDS ESSENTIALS MULTIVITAMIN GUMMIES ,MULTI,gummies,80073172,Life Science,.0774,2026-01-12,,
44286,NAPROXEN,500 MG,tablet,PMS-NAPROXEN EC,2294710,PMS,discontinued – no longer available,,2021-04-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43055,NAPROXEN,500 MG,suppository,PMS-NAPROXEN,2017237,PMS,discontinued – no longer available,,2018-09-10,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
43290,NAPROXEN SODIUM,220 MG,tablet,NAPROXEN,2362430,PMS,discontinued – no longer available,,2024-07-17,ALEVE CAPLETS,220 MG,tablet,2301733,Apotex,.2217,2024-07-17,,
45128,NIACIN,500 MG,tablet,NIACIN TAB,557412,Jamp,back-order–no date,,2026-01-08,NIACIN ,500 MG,caplet,309737,Jamieson Lab,.0924,2024-07-04,,
45349,NIACIN,500 MG,tablet,NIACIN TAB,557412,Jamp,back-order–no date,,2026-01-08,NIACIN ,500 MG,tablet,1939130,Odan,.0827,2024-02-27,,
41687,NIACIN,100 MG,tablet,NIACIN TAB,268585,Valeant,discontinued – no longer available,,2018-09-10,NIACIN ,100 MG ,tablet,405264,Swiss Herbal,0.0341,2014-02-17,,
43578,NIFEDIPINE,20 MG,tablet,ADALAT XL,2237618,Teva,discontinued – no longer available,,2022-05-03,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
43594,NIFEDIPINE,60 MG,tablet,ADALAT XL,2155990,Teva,discontinued – no longer available,,2022-05-03,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43314,NITROGLYCERIN,2%,ointment,NITROL,1926454,Paladin,discontinued – no longer available,,2018-08-02,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44130,NORETHINDRONE AC-ETH ESTRADIOL,1 MG - 50 MCG,tablet,NORLESTRIN 1/50TAB,24007,Unknown,discontinued – no longer available,,2020-10-26,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44130,NORETHINDRONE AC-ETH ESTRADIOL,2.5-0.05 MG,tablet,NORLESTRIN 2.5/50TAB,24015,Unknown,discontinued – no longer available,,2020-10-26,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44130,NORETHINDRONE-ETHIN ESTRADIOL,7-9-5,tablet,SYNPHASIC 21 TABLETS,2162636,Hoffmann-LaRoche,no information available,,2020-10-26,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44061,NORETHINDRONE-ETHINYL ESTRADIOL,0.25-0.035,tablet,CYCLEN TABLETS (21 DAY),1968440,Janssen Inc,discontinued – no longer available,,2020-09-30,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44061,NORETHINDRONE-ETHINYL ESTRADIOL,7 days x3 21,tablet,TRI-CYCLEN,2028700,Janssen Inc,discontinued – no longer available,,2020-09-30,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43944,NORETHINDRONE-ETHINYL ESTRADIOL,7 days x3 28,tablet,TRI-CYCLEN,2029421,Janssen Inc,discontinued – no longer available,,2020-08-18,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44130,NORETHINDRONE-MESTRANOL,500-100 MCG,tablet,ORTHO-NOVUM 0.5MG TAB,22632,Unknown,discontinued – no longer available,,2020-10-26,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44130,NORETHINDRONE-MESTRANOL,1 MG - 80 MCG,tablet,ORTHO-NOVUM 1/80 TAB,22659,Unknown,discontinued – no longer available,,2020-10-26,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44130,NORETHINDRONE-MESTRANOL,2 MG-0.1 MG,tablet,ORTHO-NOVUM 2MG TAB,22640,Unknown,discontinued – no longer available,,2020-10-26,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
46050,NORGESTIMATE-ETHINYL ESTRADIOL,1 MG - 35 MCG,tablet,BREVICAON 1/35,2189062,Pfizer,back-order–with date,2026-06-10,2026-01-28,SELECT 1/35,1 MG-35 MCG,tablet,2199297,Pfizer,.4247,2026-01-28,,
44061,NORGESTIMATE-ETHINYL ESTRADIOL,0.25-0.035,tablet,CYCLEN TABLETS (28 DAY),1992872,Janssen Inc,discontinued – no longer available,,2020-10-07,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45953,NYSTATIN/METRONIDAZOLE,100 K-500,cream,FLAGYSTATIN,1926845,Sanofi,discontinued – no longer available,,2025-10-23,Not yet determined.,,,,,,,,
44091,OLANZAPINE,5 MG,tablet,JAMP OLANZAPINE ODT,2406624,Jamp,back-order–with date,2026-03-11,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45797,OLANZAPINE,15 MG,tablet,ZYPREXA ZYDIS,2243088,Cheplapharm,back-order–with date,2026-03-25,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45763,OLANZAPINE,20 MG,tablet,ZYPREXA ZYDIS,2243089,Cheplapharm,back-order–no date,,2025-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45693,OLANZAPINE,5 MG,tablet,NRA-OLANZAPINE ODT,2536188,Nora,no information available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44091,OLANZAPINE,5 MG,tablet,AURO-OLANZAPINE ODT,2448726,Auropharma,back-order–no date,,2023-08-02,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43300,OLANZAPINE,10 MG,tablet,AURO-OLANZAPINE ODT,2448734,Auropharma,back-order–no date,,2023-04-25,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44095,OLANZAPINE,15 MG,tablet,AURO-OLANZAPINE ODT,2448742,Auropharma,back-order–no date,,2023-04-25,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44095,OLANZAPINE,20 MG,tablet,AURO-OLANZAPINE ODT,2448750,Auropharma,back-order–no date,,2023-04-25,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44095,OLANZAPINE,15 MG,tablet,OLANZAPINE ODT,2338661,Pro Doc,no information available,,2020-09-21,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44091,OLANZAPINE,5 MG,tablet,OLANZAPINE ODT,2338645,Pro Doc,no information available,,2020-09-17,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43300,OLANZAPINE,10 MG,tablet,OLANZAPINE ODT,2338653,Pro Doc,no information available,,2019-12-27,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43528,OLMESARTAN MEDOXOMIL,20 MG,tablet,ACT OLMESARTAN HCT,2442191,Teva,discontinued – no longer available,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43528,OLMESARTAN MEDOXOMIL,40 MG,tablet,ACT OLMESARTAN HCT,2442205,Teva,discontinued – no longer available,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44972,OLMESARTAN MEDOXOMIL,20 MG,tablet,NRA-OLMESARTAN,2499258,Nora Pharma,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44972,OLMESARTAN MEDOXOMIL,20 MG,tablet,PRZ-OLMESARTAN,2505185,Pharmaris,no information available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43529,OLMESARTAN MEDOXOMIL/HCTZ,20 MG-12.5 MG,tablet,ACT OLMESARTAN HCT,2443112,Teva,discontinued – no longer available,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43529,OLMESARTAN MEDOXOMIL/HCTZ,40 MG-12.5 MG,tablet,ACT OLMESARTAN HCT,2443120,Teva,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43409,OLMESARTAN MEDOXOMIL/HCTZ,40 MG-25 MG,tablet,ACT OLMESARTAN HCT,2443139,Teva,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44641,OMEPRAZOLE,20 MG,tablet,LOSEC,2190915,Cheplapharm,discontinued – no longer available,,2022-03-21,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43521,ONDANSETRON,8 MG,tablet,VPI-ONDANSETRON ODT,2444682,VPI Pharma,discontinued – no longer available,,2019-08-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43579,ONDANSETRON,4 MG,tablet,VPI-ONDANSETRON ODT,2444674,VPI Pharma,discontinued – no longer available,,2019-07-18,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43573,ONDANSETRON HCL,8 MG,tablet,CCP-ONDANSETRON,2458802,Cellchem Pharma,no information available,,2019-12-27,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43573,ONDANSETRON HCL,4 MG,tablet,RAN-ONDANSETRON,2312247,Ranbaxy,discontinued – no longer available,,2019-05-06,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43573,ONDANSETRON HCL,8 MG,tablet,RAN-ONDANSETRON,2312255,Ranbaxy,discontinued – no longer available,,2019-05-06,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43586,ONDANSETRON HCL,4 MG,tablet,TEVA-ONDANSETRON,2264056,Teva,discontinued – no longer available,,2019-05-01,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43573,ONDANSETRON HCL,8 MG,tablet,TEVA-ONDANSETRON,2264064,Teva,discontinued – no longer available,,2019-05-01,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
46029,OSELTAMIVIR PHOSPHATE,6 MG/ML,suspension,NAT-OSELTAMIVIR,2499894,Natco,back-order–with date,2026-03-06,2026-02-19,TAMIFLU,6 MG/ML,suspension,2381842,Hoffman,.3570,2026-01-07,,
44902,OXYCODONE HCL,10 MG,suppositories,SUPEUDOL 10,392480,Sandoz,back-order–no date,,2026-02-19,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
45411,PAMIDRONATE DISODIUM90,90 MG/10 ML,vial,PAMIDRONATE DISODIUM FOR INJECTION,2249685,Omega,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43661,PANTOPRAZOLE,40 MG,tablet,PANTOPRAZOLE,2318695,Pro Doc,no information available,,2019-12-27,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43661,PANTOPRAZOLE,40 MG,tablet,M-PANTOPRAZOLE,2467372,Mantra Pharma,no information available,,2019-07-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
46030,PANTOPRAZOLE MAGNESIUM,40 MG,tablet,MYLAN-PANTOPRAZOLE T,2408570,Mylan,back-order–no date,,2026-02-19,TECTA,40 MG,tablet,2267233,Takeda,.8921,2026-02-03,,
45909,PANTOPRAZOLE MAGNESIUM,40 MG,tablet,PANTOPRAZOLE MAGNESIUM,2519534,Sivem,back-order–no date,,2026-02-19,TECTA,40 MG,tablet,2267233,Takeda,.8921,2026-02-03,,
46056,PANTOPRAZOLE MAGNESIUM,40 MG,tablet,PANTOPRAZOLE T,2466147,Sanis,back-order–no date,,2026-02-19,TECTA,40 MG,tablet,2267233,Takeda,.8921,2026-02-03,,
45909,PANTOPRAZOLE MAGNESIUM,40 MG,tablet,TEVA-PANTOPRAZOLE MAGNESIUM,2440628,Teva,back-order–with date,2026-04-03,2026-02-19,TECTA,40 MG ,tablet,2267233,Takeda,.8921,2026-02-03,,
46056,PANTOPRAZOLE MAGNESIUM,40 MG,tablet,PANTOPRAZOLE MAGNESIUM,2441853,Altius Healthcare,back-order–with date,2026-04-10,2026-02-05,TECTA,40 MG,tablet,2267233,Takeda,.8921,2026-02-03,,
46072,PERAMPANEL,12 MG,tablet,TARO-PERAMPANEL,2522683,Taro,back-order–with date,2026-03-04,2026-02-19,FYCOMPA,12 MG,tablet,2404567,Eisai Limited,11.2179,2026-02-19,,
44364,PHENYLEPHRINE HCL,10 MG/ML,ampule,NEO-SYNEPHRINE INJ LIQ,1928546,Unknown,discontinued – no longer available,,2021-06-17,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44426,PHENYTOIN SODIUM EXTENDED,100 MG,capsule,NOVO-PHENYTOIN,37435,Teva,discontinued – no longer available,,2021-11-02,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44642,PIRFENIDONE,267 MG,capsule,ESBRIET,2393751,Hoffmann-LaRoche,discontinued – no longer available,,2023-09-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44510,PIRFENIDONE,267 MG,tablet,ESBRIET,2464489,Hoffmann-LaRoche,discontinued – no longer available,,2022-09-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44600,PNEUMOCOCCAL 23-VAL P-SAC VAC,25 MCG/0.5,vial,PNEUMOVAX 23,431648,Merck,discontinued – no longer available,,2023-04-27,PNEUMOVAX 23,25 MCG/0.5,syringe,2436442,Merck,34.92,2022-02-08,,
45440,PODOFILOX,0.5%,solution,CONDYLINE,1945149,Sanofi,discontinued – no longer available,,2024-05-28,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
45440,PODOFILOX,0.5%,solution,WARTEC,2074788,Stiefel Lab,discontinued – no longer available,,2024-05-28,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
43314,POTASSIUM CHLORIDE,20 MEQ/15 ML,liquid,PMS-POTASSIUM CHLORIDE,2238604,PMS,back-order–no date,,2026-02-19,JAMP POTASSIUM CHLORIDE LIQUID,20 MEQ/15 ML,liquid,80024835,Jamp,.0437,2018-08-08,,
43314,POTASSIUM CHLORIDE,20 MEQ/15 ML,liquid,PMS-POTASSIUM CHLORIDE,2238604,PMS,back-order–no date,,2026-02-19,POTASSIUM CHLORIDE LIQUID ODAN,20 MEQ/15 ML,liquid,80046782,Odan,.0437,2020-04-07,,
45581,POTASSIUM CHLORIDE,1500 MG,tablet,ODAN K-20 TAB 1500MG (20 MEQ),80004415,Odan,discontinued – no longer available,,2025-04-16,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45581,POTASSIUM CHLORIDE,1500 MG,tablet,ODAN K-20 TAB 1500MG (20 MEQ),80004415,Odan,discontinued – no longer available,,2025-04-16,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45581,POTASSIUM CHLORIDE,1500 MG,tablet,EURO-K20 TABLET (SUSTAINED RELEASE),2242261,Sandoz,discontinued – no longer available,,2024-12-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45581,POTASSIUM CHLORIDE,1500 MG,tablet,EURO-K20 TABLET (SUSTAINED RELEASE),2242261,Sandoz,discontinued – no longer available,,2024-12-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45610,POTASSIUM CHLORIDE,1500 MG,tablet,K-DUR (20 MEQ),713376,Merck,discontinued – no longer available,,2024-12-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45610,POTASSIUM CHLORIDE,1500 MG,tablet,K-DUR (20 MEQ),713376,Merck,discontinued – no longer available,,2024-12-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
41789,PRAZOSIN HCL,5 MG,tablet,MINIPRESS,560979,Erfa,discontinued – no longer available,,2025-10-28,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
41789,PRAZOSIN HCL,2 MG,tablet,MINIPRESS,560960,Erfa,discontinued – no longer available,,2025-10-28,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
41789,PRAZOSIN HCL,5 MG,tablet,MINIPRESS,560979,Erfa,discontinued – no longer available,,2025-10-28,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45370,PRENATAL MULTIVITAMIN,MULTI,tablet,CENTRUM MATERNA,80001842,WyethAyerst,discontinued – no longer available,,2024-03-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,NPN 80045822
45370,PRENATAL MULTIVITAMIN,MULTI,tablet,COMPLETE MULTI-PRE AND POST NATAL,2229535,Wampoli,discontinued – no longer available,,2024-03-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,NPN 80045822
45370,PRENATAL MULTIVITAMIN,MULTI,tablet,PRENATAL AND POSTPARTUM VITAMINS AND MINERALS,80005770,Pharmetics,discontinued – no longer available,,2024-03-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,NPN 80045822
45370,PRENATAL MULTIVITAMIN,MULTI,tablet,PRENATAL/POSTPARTUM VITAMIN AND MINERAL SUPPLEMENT,2241235,Stanley,discontinued – no longer available,,2024-03-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,NPN 80045822
43270,PROCYCLIDINE HCL,2.5 MG,tablet,PDP-PROCYCLIDINE,649392,PendoPharm,discontinued – no longer available,,2018-10-04,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
46009,PROGESTERONE,50 MG/ML,vial,"PROGESTERONE INJECTION, USP",2531828,Hikma Canada,back-order–with date,2026-03-11,2026-02-19,PROGESTERONE INJECTION USP 50MG/ML (US LABELLED),50 MG/ML,injection,66128596,UNKNOWN,6.329,2025-12-18,,
45118,PROGESTERONE,50 MG/ML,vial,ACT PROGESTERONE INJECTION,2446820,Teva,discontinued – no longer available,,2025-12-18,PROGESTERONE INJECTION USP 50MG/ML (US LABELLED),50 MG/ML,injection,66128596,UNKNOWN,6.329,2025-12-18,,
44319,PROGESTERONE,65 MCG/24 HR,iud,PROGESTASERT,327379,Unknown,discontinued – no longer available,,2021-05-03,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
45183,PROPRANOLOL HCL,60 MG,capsule,INDERAL-LA,2042231,Pfizer,discontinued – no longer available,,2024-12-31,LUPIN-PROPRANOLOL LA,60 MG,capsule,2491893,Lupin Pharma,.9995,2023-09-14,,Feb 6/24 per call to manufacturer discontinued
45167,PROPRANOLOL HCL,80 MG,capsule,INDERAL-LA,2042258,Pfizer,discontinued – no longer available,,2024-12-31,LUPIN-PROPRANOLOL LA,80 MG,capsule,2491907,Lupin Pharma,1.1284,2023-08-29,,Feb 6/24 per call to manufacturer discontinued
45160,PROPRANOLOL HCL,120 MG,capsule,INDERAL-LA,2042266,Pfizer,discontinued – no longer available,,2024-12-31,LUPIN-PROPRANOLOL LA,120 MG,capsule,2491915,Lupin Pharma,1.7366,2023-08-22,,Feb 6/24 per call to manufacturer discontinued
45426,PROPRANOLOL HCL,160 MG,capsule,INDERAL-LA,2042274,Pfizer,discontinued – no longer available,,2024-12-31,LUPIN-PROPRANOLOL LA,160 MG ,capsule,2491923,Lupin Pharma,2.0541,2023-09-14,,Feb 6/24 per call to manufacturer discontinued
45589,PROPYLENE GLYCOL/PEG 400,0.3%-0.4%,drops,SYSTANE LUBRICANT EYE DROPS,2248967,Alcon,discontinued – no longer available,,2024-10-24,Not yet determined.,,,,,,,,
44053,PROPYLTHIOURACIL,100 MG,tablet,PROPYL-THYRACIL,10219,Paladin,discontinued – no longer available,,2021-01-01,PTU - AUSTRALIA (PROPYLTHIOURACIL) ,50 MG,tablet,9858122,Phebra Canada Inc.,.5400,2020-07-17,,
44027,PROPYLTHIOURACIL,50 MG,tablet,PROPYL-THYRACIL,10200,Paladin,discontinued – no longer available,,2021-01-01,PTU - AUSTRALIA (PROPYLTHIOURACIL)                  ,50 MG,tablet,9858122,Phebra Canada Inc.,.5400,2020-07-17,,
45832,QUETIAPINE FUMARATE,150 MG,tablet,SANDOZ QUETIAPINE XRT,2407698,Sandoz,back-order–no date,,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45614,QUETIAPINE FUMARATE,50 MG,tablet,TEVA-QUETIAPINE XR,2395444,Teva,back-order–with date,2026-03-06,2026-02-19,SEROQUEL XR,50 MG,tablet,2300184,Cheplapharm,1.2201,2025-05-08,,
45833,QUETIAPINE FUMARATE,300 MG,tablet,TEVA-QUETIAPINE XR,2395479,Teva,back-order–with date,2026-04-01,2026-01-22,SEROQUEL XR,300 MG,tablet,2300206,Cheplapharm,4.7695,2025-06-25,,
45833,QUETIAPINE FUMARATE,200 MG,tablet,MINT-QUETIAPINE XR,2522209,Mint,back-order–with date,2026-04-10,2026-01-08,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45614,QUETIAPINE FUMARATE,50 MG,tablet,MINT-QUETIAPINE XR,2522187,Mint,back-order–with date,2026-05-01,2026-01-08,SEROQUEL XR,50 MG,tablet,2300184,Cheplapharm,1.2201,2025-05-08,,
45833,QUETIAPINE FUMARATE,400 MG,tablet,MINT-QUETIAPINE XR,2522225,Mint,back-order–with date,2026-05-01,2026-01-08,SEROQUEL XR,400 MG,tablet,2300214,Cheplapharm,6.4747,2025-06-25,,
45833,QUETIAPINE FUMARATE,200 MG,tablet,ACH-QUETIAPINE FUMARATE XR,2450887,Accord,back-order–no date,,2026-01-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45833,QUETIAPINE FUMARATE,200 MG,tablet,APO-QUETIAPINE XR,2457245,Apotex,back-order–no date,,2026-01-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45833,QUETIAPINE FUMARATE,200 MG,tablet,QUETIAPINE FUMARATE XR,2516632,Sanis,back-order–no date,,2026-01-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45833,QUETIAPINE FUMARATE,200 MG,tablet,QUETIAPINE XR,2519623,Jamp,back-order–no date,,2026-01-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45833,QUETIAPINE FUMARATE,200 MG,tablet,QUETIAPINE XR,2417375,Sivem,back-order–no date,,2026-01-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45833,QUETIAPINE FUMARATE,200 MG,tablet,SANDOZ QUETIAPINE XRT,2407701,Sandoz,back-order–no date,,2026-01-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45833,QUETIAPINE FUMARATE,300 MG,tablet,MINT-QUETIAPINE XR,2516640,Mint,back-order–no date,,2026-01-05,SEROQUEL XR,300 MG,tablet,2300206,Cheplapharm,4.7695,2025-06-25,,
45833,QUETIAPINE FUMARATE,300 MG,tablet,QUETIAPINE FUMARATE XR,2516640,Sanis,back-order–no date,,2026-01-05,SEROQUEL XR,300 MG,tablet,2300206,Cheplapharm,4.7695,2025-06-25,,
45833,QUETIAPINE FUMARATE,400 MG,tablet,QUETIAPINE FUMARATE XR,2516659,Sanis,back-order–no date,,2026-01-05,SEROQUEL XR,400 MG,tablet,2300214,Cheplapharm,6.4747,2025-06-25,,
45614,QUETIAPINE FUMARATE,50 MG,tablet,QUETIAPINE XR,2519607,Jamp,back-order–no date,,2026-01-05,SEROQUEL XR,50 MG,tablet,2300184,Cheplapharm,1.2201,2025-05-08,,
45833,QUETIAPINE FUMARATE,300 MG,tablet,QUETIAPINE XR,2519747,Jamp,back-order–no date,,2026-01-05,SEROQUEL XR,300 MG,tablet,2300206,Cheplapharm,4.7695,2025-06-25,,
45833,QUETIAPINE FUMARATE,400 MG,tablet,QUETIAPINE XR,2519763,Jamp,back-order–no date,,2026-01-05,SEROQUEL XR,400 MG,tablet,2300214,Cheplapharm,6.4747,2025-06-25,,
45614,QUETIAPINE FUMARATE,50 MG,tablet,QUETIAPINE XR,2417359,Sivem,back-order–no date,,2026-01-05,SEROQUEL XR,50 MG,tablet,2300184,Cheplapharm,1.2201,2025-05-08,,
45833,QUETIAPINE FUMARATE,300 MG,tablet,QUETIAPINE XR,2417383,Sivem,back-order–no date,,2026-01-05,SEROQUEL XR,300 MG,tablet,2300206,Cheplapharm,4.7695,2025-06-25,,
45833,QUETIAPINE FUMARATE,400 MG,tablet,QUETIAPINE XR,2417391,Sivem,back-order–no date,,2026-01-05,SEROQUEL XR,400 MG,tablet,2300214,Cheplapharm,6.4747,2025-06-25,,
45708,QUETIAPINE FUMARATE,50 MG,tablet,SANDOZ QUETIAPINE XRT,2407671,Sandoz,back-order–no date,,2026-01-05,SEROQUEL XR,50 MG,tablet,2300184,Cheplapharm,1.2201,2025-05-08,,
45833,QUETIAPINE FUMARATE,300 MG,tablet,SANDOZ QUETIAPINE XRT,2407728,Sandoz,back-order–no date,,2026-01-05,SEROQUEL XR,300 MG,tablet,2300206,Cheplapharm,4.7695,2025-06-25,,
45833,QUETIAPINE FUMARATE,400 MG,tablet,SANDOZ QUETIAPINE XRT,2407736,Sandoz,back-order–no date,,2026-01-05,SEROQUEL XR,400 MG,tablet,2300214,Cheplapharm,6.4747,2025-06-25,,
45833,QUETIAPINE FUMARATE,400 MG,tablet,TEVA-QUETIAPINE XR,2395487,Teva,back-order–no date,,2026-01-05,SEROQUEL XR,400 MG,tablet,2300214,Cheplapharm,6.4747,2025-06-25,,
45832,QUETIAPINE FUMARATE,150 MG,tablet,QUETIAPINE XR,2417367,Sivem,discontinued – no longer available,,2025-12-23,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45833,QUETIAPINE FUMARATE,400 MG,tablet,ACH-QUETIAPINE FUMARATE XR,2417391,Accord,discontinued – no longer available,,2025-12-23,SEROQUEL XR,400 MG,tablet,2300214,Cheplapharm,6.4747,2025-06-25,,
45614,QUETIAPINE FUMARATE,50 MG,tablet,ACH-QUETIAPINE FUMARATE XR,2450860,Accord,back-order–no date,,2025-12-23,SEROQUEL XR,50 MG,tablet,2300184,Cheplapharm,1.2201,2025-05-08,,
45833,QUETIAPINE FUMARATE,300 MG,tablet,ACH-QUETIAPINE FUMARATE XR,2450895,Accord,back-order–no date,,2025-12-23,SEROQUEL XR,300 MG,tablet,2300206,Cheplapharm,4.7695,2025-06-25,,
45614,QUETIAPINE FUMARATE,50 MG,tablet,APO-QUETIAPINE XR,2457229,Apotex,back-order–no date,,2025-12-23,SEROQUEL XR,50 MG,tablet,2300184,Cheplapharm,1.2201,2025-05-08,,
45833,QUETIAPINE FUMARATE,300 MG,tablet,APO-QUETIAPINE XR,2457253,Apotex,back-order–no date,,2025-12-23,SEROQUEL XR,300 MG,tablet,2300206,Cheplapharm,4.7695,2025-06-25,,
45833,QUETIAPINE FUMARATE,400 MG,tablet,APO-QUETIAPINE XR,2457261,Apotex,back-order–no date,,2025-12-23,SEROQUEL XR,400 MG,tablet,2300214,Cheplapharm,6.4747,2025-06-25,,
45832,QUETIAPINE FUMARATE,150 MG,tablet,MINT-QUETIAPINE XR,2522195,Mint,back-order–with date,2026-04-10,2025-12-11,Compounding allowed only with prior approval of Special Authority Request. See Notes for details,,,,,,,,
45832,QUETIAPINE FUMARATE,150 MG,tablet,ACH-QUETIAPINE FUMARATE XR,2450879,Accord,back-order–no date,,2025-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45832,QUETIAPINE FUMARATE,150 MG,tablet,APO-QUETIAPINE XR,2457237,Apotex,back-order–no date,,2025-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45832,QUETIAPINE FUMARATE,150 MG,tablet,QUETIAPINE XR,2519615,Jamp,back-order–no date,,2025-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45832,QUETIAPINE FUMARATE,150 MG,tablet,NRA-QUETIAPINE XR,2510685,Nora,no information available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45833,QUETIAPINE FUMARATE,200 MG,tablet,NRA-QUETIAPINE XR,2510693,Nora,no information available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45832,QUETIAPINE FUMARATE,150 MG,tablet,QUETIAPINE FUMARATE XR,2516624,Sanis,discontinued – no longer available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45614,QUETIAPINE FUMARATE,50 MG,tablet,NRA-QUETIAPINE XR,2510677,Nora,no information available,,2025-10-09,SEROQUEL XR,50 MG,tablet,2300184,Cheplapharm,1.2201,2025-05-08,,
45833,QUETIAPINE FUMARATE,300 MG,tablet,NRA-QUETIAPINE XR,2450895,Nora,no information available,,2025-10-09,SEROQUEL XR,300 MG,tablet,2300206,Cheplapharm,4.7695,2025-06-25,,
45833,QUETIAPINE FUMARATE,400 MG,tablet,NRA-QUETIAPINE XR,2510715,Nora,no information available,,2025-10-09,SEROQUEL XR,400 MG,tablet,2300214,Cheplapharm,6.4747,2025-06-25,,
45614,QUETIAPINE FUMARATE,50 MG,tablet,QUETIAPINE FUMARATE XR,2516616,Sanis,discontinued – no longer available,,2025-10-09,SEROQUEL XR,50 MG,tablet,2300184,Cheplapharm,1.2201,2025-05-08,,
43213,QUETIAPINE FUMARATE,200 MG,tablet,BIO-QUETIAPINE,2447223,Biomed,no information available,,2025-09-25,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45833,QUETIAPINE FUMARATE,200 MG,tablet,M-QUETIAPINE FUMARATE XR,2527944,Mantra,no information available,,2025-09-25,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43213,QUETIAPINE FUMARATE,200 MG,tablet,PRO-QUETIAPINE,2317362,Pro Doc,no information available,,2025-09-25,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45832,QUETIAPINE FUMARATE,150 MG,tablet,M-QUETIAPINE FUMARATE XR,2527936,Mantra,no information available,,2025-09-06,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45833,QUETIAPINE FUMARATE,300 MG,tablet,M-QUETIAPINE FUMARATE XR,2527944,Mantra,no information available,,2025-06-25,SEROQUEL XR,300 MG,tablet,2300206,Cheplapharm,4.7695,2025-06-25,,
45833,QUETIAPINE FUMARATE,400 MG,tablet,M-QUETIAPINE FUMARATE XR,2527960,Mantra,no information available,,2025-06-25,SEROQUEL XR,400 MG,tablet,2300214,Cheplapharm,6.4747,2025-06-25,,
45614,QUETIAPINE FUMARATE,50 MG,tablet,M-QUETIAPINE FUMARATE XR,2527928,Mantra,no information available,,2025-05-08,SEROQUEL XR,50 MG,tablet,2300184,Cheplapharm,1.2201,2025-05-08,,
44678,QUINAPRIL HCL,20 MG,tablet,ACCUPRIL,1947680,Pfizer,discontinued – no longer available,,2024-04-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45211,RABEPRAZOLE SODIUM,20 MG,tablet,JAMP RABEPRAZOLE,2415291,Jamp,back-order–no date,,2026-01-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45245,RABEPRAZOLE SODIUM,10 MG,tablet,JAMP RABEPRAZOLE,2415283,Jamp,back-order–no date,,2026-01-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44923,RABEPRAZOLE SODIUM,10 MG,tablet,PMS-RABEPRAZOLE EC,2310805,PMS,back-order–no date,,2025-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45211,RABEPRAZOLE SODIUM,20 MG,tablet,PMS-RABEPRAZOLE EC,2310813,PMS,back-order–no date,,2025-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44923,RABEPRAZOLE SODIUM,10 MG,tablet,TARO-RABEPRAZOLE,2298074,Taro Pharma,discontinued – no longer available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45211,RABEPRAZOLE SODIUM,20 MG,tablet,TARO-RABEPRAZOLE,2298082,Taro Pharma,discontinued – no longer available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44923,RABEPRAZOLE SODIUM,10 MG,tablet,TEVA-RABEPRAZOLE EC,2296632,Teva,discontinued – no longer available,,2025-03-31,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43922,RAMIPRIL,1.25 MG,tablet,PRO-RAMIPRIL - 1.25,2310023,Pro Doc,no information available,,2019-04-01,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43922,RAMIPRIL,10 MG,tablet,PRO-RAMIPRIL - 10,2310104,Pro Doc,no information available,,2019-04-01,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43922,RAMIPRIL,2.5 MG,tablet,PRO-RAMIPRIL - 2.5,2310066,Pro Doc,no information available,,2019-04-01,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43922,RAMIPRIL,5 MG,tablet,PRO-RAMIPRIL - 5,2310074,Pro Doc,no information available,,2019-04-01,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43726,RANITIDINE HCL,150 MG,tablet,JAMP-RANITIDINE,2463717,Jamp,back-order–no date,,2026-01-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43726,RANITIDINE HCL,300 MG,tablet,JAMP-RANITIDINE,2463725,Jamp,back-order–no date,,2026-01-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44404,RANITIDINE HCL,150 MG,tablet,PMS-RANITIDINE,2242453,PMS,back-order–no date,,2026-01-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44404,RANITIDINE HCL,300 MG,tablet,PMS-RANITIDINE,2242454,PMS,back-order–no date,,2026-01-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43894,RANITIDINE HCL,15 MG/ML,solution,APO-RANITIDINE,2280833,Apotex,back-order–no date,,2025-12-23,No alternative available and no coverage for compounding; discuss treatment options with prescriber,,,,,,,,
44082,RANITIDINE HCL,150 MG,tablet,APO-RANITIDINE,733059,Apotex,back-order–no date,,2025-12-23,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44404,RANITIDINE HCL,300 MG,tablet,APO-RANITIDINE,733067,Apotex,back-order–no date,,2025-12-23,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43726,RANITIDINE HCL,150 MG,tablet,RANITIDINE,2385953,Sivem,discontinued – no longer available,,2022-09-28,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43726,RANITIDINE HCL,300 MG,tablet,RANITIDINE,2385961,Sivem,discontinued – no longer available,,2022-09-28,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43894,RANITIDINE HCL,15 MG/ML,solution,TEVA-RANITIDINE SOLUTION,2242940,Teva,discontinued – no longer available,,2022-09-14,No alternative available and no coverage for compounding; discuss treatment options with prescriber,,,,,,,,
44082,RANITIDINE HCL,150 MG,tablet,RANITIDINE,2353016,Sanis,discontinued – no longer available,,2022-01-18,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43803,RANITIDINE HCL,25 MG/ML,vial,RANITIDINE INJECTION USP,2256711,Sandoz,discontinued – no longer available,,2020-11-27,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
43803,RANITIDINE HCL,25 MG/ML,vial,ZANTAC,2212366,GlaxoSmithKline,discontinued – no longer available,,2020-04-20,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
43664,RIFAMPIN,150 MG,capsule,RIFADIN,2091887,Sanofi-Aventis,discontinued – no longer available,,2023-04-01,ROFACT,150 MG,tablet,393444,Valeant,1.4820,2019-07-31,,
43664,RIFAMPIN,300 MG,capsule,RIFADIN,2092808,Sanofi-Aventis,discontinued – no longer available,,2021-05-28,Other already-covered full benefit version available.,,,,,,,,
45980,RILUZOLE,50 MG,tablet,APO-RILUZOLE,2352583,Apotex,back-order–with date,2026-03-27,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45700,RISEDRONATE SODIUM,30 MG,tablet,TEVA-RISEDRONATE,2298384,Teva,discontinued – no longer available,,2026-01-05,Other already-covered full benefit versions available. Pharmacies should use the 35 MG format,,,,,,,,
45251,RISPERIDONE,1 MG/ML,solution,RISPERDAL ORAL SOLUTION,2236950,Janssen Inc,discontinued – no longer available,,2026-03-07,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45209,RISPERIDONE,1 MG/ML,solution,JAMP-RISPERIDONE,2454319,Jamp,back-order–with date,2026-07-10,2026-01-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44705,RISPERIDONE,0.5 MG,tablet,ACT RISPERIDONE,2282593,Teva,discontinued – no longer available,,2022-05-24,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
42849,RISPERIDONE,0.5 MG,tablet,MYLAN-RISPERIDONE ODT,2413485,Mylan,discontinued – no longer available,,2021-12-08,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
42886,RISPERIDONE,1 MG,tablet,MYLAN-RISPERIDONE ODT,2413493,Mylan,discontinued – no longer available,,2021-12-08,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
42909,RISPERIDONE,2 MG,tablet,MYLAN-RISPERIDONE ODT,2413507,Mylan,discontinued – no longer available,,2021-12-08,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
42962,RISPERIDONE,3 MG,tablet,MYLAN-RISPERIDONE ODT,2413515,Mylan,discontinued – no longer available,,2021-12-08,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
42912,RISPERIDONE,4 MG,tablet,MYLAN-RISPERIDONE ODT,2413523,Mylan,discontinued – no longer available,,2021-12-08,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
45806,RIVASTIGMINE TARTRATE,1.5 MG,capsule,EXELON,2242115,Knight Therape,back-order–no date,,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45806,RIVASTIGMINE TARTRATE,1.5 MG,capsule,JAMP RIVASTIGMINE,2485362,Jamp,back-order–with date,2026-07-10,2026-02-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45806,RIVASTIGMINE TARTRATE,1.5 MG,capsule,SANDOZ RIVASTIGMINE,2324563,Sandoz,discontinued – no longer available,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45806,RIVASTIGMINE TARTRATE,1.5 MG,capsule,MED-RIVASTIGMINE,2401614,Generic Medica,discontinued – no longer available,,2025-08-27,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45806,RIVASTIGMINE TARTRATE,1.5 MG,tablet,PMS-RIVASTIGMINE,2306034,PMS,discontinued – no longer available,,2025-08-27,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43152,SAL ACID/PODOPHYL RES/CANTH,30-5-1%,liquid,CANTHACUR-PS,589500,Paladin,discontinued – no longer available,,2021-04-01,CANTHARONE LIQUID,0.7%,liquid,80023975,Odan,11.9400,2018-02-22,,
45203,SALBUTAMOL SULFATE,100 MCG,inhaler,AIROMIR,2232570,Bausch Health,back-order–no date,,2025-03-31,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44019,SALMETEROL XINAFOATE,25 MCG,inhaler,SEREVENT- AEM 25MCG/AEM,2136139,Glaxosmythkline,discontinued – no longer available,,2020-07-24,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44019,SALMETEROL XINAFOATE,50 MCG,inhaler,SEREVENT,2136147,Glaxosmythkline,discontinued – no longer available,,2020-07-24,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44019,SALMETEROL XINAFOATE,50 MCG,inhaler,SEREVENT DISKHALER DISK,2214261,Glaxosmythkline,discontinued – no longer available,,2020-07-24,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45464,SAPROPTERIN DIHYDROCHLORIDE,500 MG,powder pack,REDDY-SAPROPTERIN,2535610,Dr. Reddy's,back-order–no date,,2026-02-19,KUVAN,500 MG,powder pack,2482215,Biomarin,165.00,2024-06-21,,
45300,SEMAGLUTIDE,0.25/.50,pen,OZEMPIC,2471477,Novo Norkisk,no information available,,2025-10-09,Not yet determined,,,,,,,,
44104,SENNA,1.7 MG/ML,syrup,SENNA LAX LIQUID,2144379,PMS,discontinued – no longer available,,2025-03-11,JAMP SENNAQUIL,1.7 MG/ML,liquid,80024394,Jamp,.0929,2020-09-30,,
45163,SERTRALINE,25 MG,capsule,NRA-SERTRALINE,2456434,Nora,back-order–no date,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45163,SERTRALINE,25 MG,capsule,JAMP-SERTRALINE,2357143,Jamp,discontinued – no longer available,,2024-12-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45194,SILDENAFIL CITRATE,100 MG,tablet,RIVA-SILDENAFIL,2452413,Riva,no information available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44040,SODIUM CHLORIDE,5%,ointment,ODAN-SODIUM CHLORIDE OPHTHALMIC OINTMENT 5%,80046696,Odan,back-order–no date,,2025-10-09,MURO 128 SOLN,5%,drops,750824,Bausch + Lomb,.8352,2020-01-28,,
44039,SODIUM CHLORIDE,5%,ointment,CORDEMA OINTMENT 5%,751162,Unknown,discontinued – no longer available,,2020-07-28,ODAN-SODIUM CHLORIDE OPHTHALMIC OINTMENT 5%,5%,ointment,80046696,Odan,2.9314,2020-07-28,,
43020,SODIUM CHLORIDE FOR INHALATION,0.9%,Vial-Neb,SODIUM CHLORIDE INHALATION SOLUTION USP 0.9%,2058235,Mylan,discontinued – no longer available,,2022-01-26,0.9% SODIUM CHLORIDE INJECTION USP,0.9%,Vial,2150204,Omega,.3726,2021-02-22,,
43020,SODIUM CHLORIDE FOR INHALATION,0.9%,Vial-Neb,SODIUM CHLORIDE INHALATION SOLUTION USP 0.9%,2058235,Mylan,discontinued – no longer available,,2022-01-26,BALLARD UNIT DOSE  - NAS ORL.9%,0.9%,Vial-Neb,2215977,Halyard Health,0.0228,2017-10-12,,released product also discontinued
45211,SOLIFENACIN SUCCINATE,10 MG,tablet,PMS-SOLIFENACIN,2417731,PMS,back-order–no date,,2026-01-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45330,SOLIFENACIN SUCCINATE,10 MG,tablet,M-SOLIFENACIN SUCCINATE,2529718,Mantra,no information available,,2024-02-08,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45845,SPIRONOLACTONE,100 MG,tablet,MINT-SPIRONOLACTONE,2488159,Mint,back-order–with date,2026-04-03,2026-02-19,ALDACTONE,100 MG,tablet,285455,Pfizer,.6923,2025-07-07,,
45845,SPIRONOLACTONE,100 MG,tablet,TEVA-SPIRONOLACTONE,613223,Teva,back-order–with date,2026-03-18,2026-02-19,ALDACTONE,100 MG,tablet,285455,Pfizer,.6923,2025-07-07,,
45845,SPIRONOLACTONE,25 MG,tablet,MINT-SPIRONOLACTONE,2488140,Mint,back-order–with date,2026-04-03,2026-01-08,ALDACTONE,25 MG,tablet,28606,Pfizer,.2906,2025-07-07,,
44889,SPIRONOLACTONE,100 MG,tablet,ALDACTONE,285455,Pfizer,back-order–no date,,2026-01-05,limited supply available October 2025. Consider dispensing reduced quantities to conserve inventory. 100mg tablets can be split and quartered.,,,,,,,,
44889,SPIRONOLACTONE,25 MG,tablet,ALDACTONE,28606,Pfizer,back-order–no date,,2026-01-05,limited supply available October 2025. Consider dispensing reduced quantities to conserve inventory. 100mg tablets can be split and quartered.,,,,,,,,
45845,SPIRONOLACTONE,25 MG,tablet,JAMP SPIRONOLACTONE,2518821,Jamp,back-order–with date,2026-04-08,2025-12-30,ALDACTONE,25 MG,tablet,28606,Pfizer,.2906,2025-07-07,,
45845,SPIRONOLACTONE,100 MG,tablet,JAMP SPIRONOLACTONE,2518848,Jamp,back-order–with date,2026-04-08,2025-12-30,ALDACTONE,100 MG,tablet,285455,Pfizer,.6923,2025-07-07,,
45845,SPIRONOLACTONE,25 MG,tablet,TEVA-SPIRONOLACTONE,613215,Teva,back-order–with date,2026-04-08,2025-12-30,ALDACTONE ,25 MG,tablet,28606,Pfizer,.2906,2025-07-07,,
45918,SUCRALFATE,1 G,tablet,TEVA-SUCRALFATE,2045702,Teva,discontinued – no longer available,,2026-01-05,SULCRATE,1 G,tablet,2100622,Abbvie,.8000,2025-09-18,,
45916,SUCRALFATE,1 G,tablet,APO-SUCRALFATE,2125250,Apotex,back-order–no date,,2025-12-23,SULCRATE,1 G,tablet,2100622,Abbvie,.8000,2025-09-18,,
42859,SULFAMETHOXAZOLE/TRIMETHOPRIM,200-40 MG/5,suspension,TEVA-TRIMEL,726540,Teva,back-order–no date,,2025-12-15,"Exceptional, last resort coverage of compounding would be considered where no alternative medications or the commercial tablets could be used (e.g. PJP prophylaxis dosing, desensitization regimens). Pharmacies may fax a Compound Costing Worksheet with the prescription to Special Authority for these situations. Prescriptions outside of these examples would require the prescriber to also submit a Special Authority either via eForms (Select medication “Other – Compounded Prescription Item) OR a completed Compound Coverage Request (Form 5479)",,,,,,,,
45245,TAMSULOSIN HCL,0.4 MG,tablet,FLOMAX CR,2270102,Boehringer,discontinued – no longer available,,2024-02-13,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45225,TAZAROTENE,0.05%,crean,TAZORAC,2243894,Allergan Inc,discontinued – no longer available,,2023-10-26,Not yet determined,,,,,,,,
43451,TELMISARTAN,40 MG,tablet,AURO-TELMISARTAN,2453568,Auropharma,back-order–no date,,2025-12-23,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44659,TELMISARTAN/AMLODIPINE,80 MG-5 MG,tablet,APO-TELMISARTAN-AMLODIPINE,2473488,Apotex,back-order–no date,,2026-01-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44742,TELMISARTAN/AMLODIPINE,80 MG-10 MG,tablet,APO-TELMISARTAN-AMLODIPINE,2473496,Apotex,back-order–no date,,2026-01-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
42478,TEMAZEPAM,30 MG,tablet,TEMAZEPAM,2225972,AA Pharma,discontinued – no longer available,,2023-04-01,RESTORIL,30 MG,tablet,604461,AA Pharma,.3218,2019-01-14,,
43462,TEMAZEPAM,15 MG,tablet,TEVA-TEMAZEPAM,2230095,Teva,discontinued – no longer available,,2023-04-01,RESTORIL,15 MG,tablet,604453,AA Pharma,.2658,2018-12-28,,
45663,TESTOSTERONE CYPIONATE,100 MG/ML,vial,DEPO-TESTOSTERONE INJ,30783,Pfizer,back-order–no date,,2026-01-12,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44060,TESTOSTERONE CYPIONATE,100 MG/ML,vial,"TESTOSTERONE PROPIONATE INJECTION, USP",1977571,Sterimax,never launched,,2021-01-07,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45490,TESTOSTERONE ENANTHATE,200 MG/ML,vial,DELATESTRYL,29246,Bausch Health,discontinued – no longer available,,2024-09-18,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45008,TESTOSTERONE ENANTHATE,200 MG/ML,vial,TESTOSTERONE ENANTHATE INJ 200MG/ML,716936,Taro Pharma,discontinued – no longer available,,2023-09-19,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44162,TESTOSTERONE PROPIONATE,100 MG/ML,vial,TESTOSTERONE PROPIONATE INJ,716944,Taro Pharma,discontinued – no longer available,,2021-01-07,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45523,TETRABENAZINE,25 MG,tablet,TETRABENAZINE TABLETS,2410338,Sterimas,no information available,,2025-10-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43496,THEOPHYLLINE ANHYDROUS,80 MG/15 ML,liquid,THEOLAIR,1966219,Valeant,discontinued – no longer available,,2022-11-15,ELIXIR DE THEOPHYLLINE,80 MG/15 ML,elixir,627410,Laboratoire Atlas,.0131,2019-01-31,,
45797,TIMOLOL MALEATE,0.5%,drops,JAMP-TIMOLOL,2447800,Jamp,back-order–with date,2026-03-04,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
46045,TIMOLOL MALEATE,0.5%,solution,TIMOLOL MALEATE-EX,2242276,Sandoz,back-order–with date,2026-08-05,2026-02-19,TIMOPTIC-XE,0.5%,solution,2171899,Elvium,9.8485,2026-01-23,,
45797,TIMOLOL MALEATE,0.5%,drops,APO-TIMOP,755834,Apotex,back-order–with date,2026-07-10,2026-01-22,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45987,TIMOLOL MALEATE/TRAVOPROST,0.5-0.004%,drops,APO-TRAVOPROST-TIMOP PQ,2415305,Apotex,back-order–with date,2026-04-15,2026-01-22,DUOTRAV PQ,0.5-0.004%,drops,2278251,Novartis,12.2472,2025-11-26,,
45721,TOBRAMYCIN,300 MG/5 ML,ampule,TEVA-TOBRAMYCIN,2389622,Teva,back-order–with date,2026-03-06,2026-02-19,TOBI,300 MG/5 ML,ampule,2239630,BGP Pharma,12.7724,2025-03-05,,
46014,TRANEXAMIC ACID,100 MG/ML,ampule,CYKLOKAPRON,2064413,Pfizer,back-order–no date,,2026-02-17,TRANEXAMIC ACID INJECTION,100 MG/ML,vial,2497328,Jamp,4.0742,2025-12-23,,
46014,TRANEXAMIC ACID,100 MG/ML,ampule,CYKLOKAPRON,2064413,Pfizer,back-order–no date,,2026-02-17,TRANEXAMIC ACID INJECTION,100 MG/ML,vial,2246365,Sandoz,4.0743,2025-12-23,,
46014,TRANEXAMIC ACID,100 MG/ML,ampule,CYKLOKAPRON,2064413,Pfizer,back-order–no date,,2026-02-17,TRANEXAMIC ACID INJECTION,100 MG/ML,vial,2392763,Omega,4.0212,2025-12-23,,
42479,TRETINOIN,0.1 %,cream,RETIN-A,870021,Valeant,discontinued – no longer available,,2024-04-01,RETIN-A MICRO,0.1%,gel,2243914,Valeant,1.6139,2016-04-28,,
45945,TRIAMCINOLONE ACETONIDE,40 MG/ML,vial,TRIAMCINOLONE ACETONIDE INJECTABLE SUSPENSION USP,1977563,Sterimax,available on allocation only,2026-05-01,2026-01-22,KENALOG-40 INJECTION,40 MG/ML,vial,1999869,B-M Squibb,9.3960,2025-10-15,,
45945,TRIAMCINOLONE ACETONIDE,40 MG/ML,vial,KENALOG-40 INJECTION,1999869,B-M Squibb,back-order–with date,2026-05-01,2026-01-08,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44257,TRIFLUOPERAZINE HCL,1 MG,tablet,TRIFLUOPERAZINE,345539,AA Pharma,back-order–no date,,2025-12-15,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
44257,TRIFLUOPERAZINE HCL,2 MG,tablet,TRIFLUOPERAZINE,312754,AA Pharma,back-order–no date,,2025-12-15,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
43587,TRIFLURIDINE,1%,drops,VIROPTIC,687456,Bausch + Lomb,discontinued – no longer available,,2022-03-14,No alternative available and no coverage for compounding; discuss treatment options with prescriber.,,,,,,,,
43621,VALACYCLOVIR HCL,500 MG,tablet,SANDOZ VALACYCLOVIR,2347091,Sandoz,back-order–no date,,2026-02-19,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43621,VALACYCLOVIR HCL,500 MG,tablet,JAMP-VALACYCLOVIR,2441454,Jamp,discontinued – no longer available,,2025-03-26,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45904,VALGANCICLOVIR HCL,50 MG/ML,solution,AURO-VALGANCICLOVIR,2535483,Auro,back-order–with date,2026-03-04,2026-02-19,VALCYTE,50 MG/ML,solution,2306085,Cheplapharm,3.8688,2025-09-04,,
43292,VALSARTAN,40 MG,tablet,TEVA-VALSARTAN,2356643,Teva,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43292,VALSARTAN,320 MG,tablet,TEVA-VALSARTAN,2356686,Teva,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43536,VALSARTAN/HYDROCHLOROTHIAZIDE,320-12.5 MG,tablet,TEVA-VALSARTAN/HCTZ,2357038,Teva,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44284,VARENICLINE TARTRATE,0.5 MG,tablet,TEVA-VARENICLINE,2426226,Teva,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44349,VARENICLINE TARTRATE,1 MG,tablet,TEVA-VARENICLINE,2426234,Teva,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44284,VARENICLINE TARTRATE,0.5 MG,tablet,TEVA-VARENICLINE (starter pack),2426781,Teva,back-order–no date,,2025-12-15,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43417,VENLAFAXINE HCL,37.5 MG,tablet,VENLAFAXINE XR,2339242,Pro Doc,no information available,,2019-12-27,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43417,VENLAFAXINE HCL,75 MG,tablet,VENLAFAXINE XR,2339250,Pro Doc,no information available,,2019-12-27,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43417,VENLAFAXINE HCL,150 MG,tablet,VENLAFAXINE XR,2339269,Pro Doc,no information available,,2019-12-27,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43417,VENLAFAXINE HCL,150 MG,tablet,ACT VENLAFAXINE XR,2304333,Teva,discontinued – no longer available,,2019-07-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43417,VENLAFAXINE HCL,150 MG,tablet,PMS-VENLAFAXINE XR,2278561,PMS,discontinued – no longer available,,2019-07-09,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43417,VENLAFAXINE HCL,75 MG,tablet,ACT VENLAFAXINE XR,2304325,Teva,discontinued – no longer available,,2019-03-26,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43417,VENLAFAXINE HCL,37.5 MG,tablet,PMS-VENLAFAXINE XR,2278545,PMS,discontinued – no longer available,,2019-02-26,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43417,VENLAFAXINE HCL,75 MG,tablet,PMS-VENLAFAXINE XR,2278553,PMS,discontinued – no longer available,,2019-01-17,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44096,VERAPAMIL HCL,240 MG,tablet,ISOPTIN SR,742554,Mylan,back-order–no date,,2026-01-08,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
42153,VERAPAMIL HCL,120 MG,tablet,APO-VERAP SR,2246893,Apotex,back-order–no date,,2025-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
42153,VERAPAMIL HCL,180 MG,tablet,APO-VERAP SR,2246894,Apotex,back-order–no date,,2025-12-11,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44615,ZINC OXIDE,15%,cream,ZINC OXIDE CREAM,2215799,HJ Sutton,no information available,,2025-07-08,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,DIN 572519
44358,ZOLEDRONIC ACID,4 MG/5 ML,vial,ZOLEDRONIC ACID FOR INJECTION,2444739,Juno Pharma,discontinued – no longer available,,2024-02-06,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44076,ZOLEDRONIC ACID,4 MG/5 ML,vial,ZOLEDRONIC ACID FOR INJECTION,2407639,Teva,discontinued – no longer available,,2023-10-30,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44358,ZOLEDRONIC ACID,4 MG/5 ML,vial,ZOLEDRONIC ACID FOR INJECTION CONCENTRATE,2422425,Dr Reddy,discontinued – no longer available,,2023-10-30,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
44838,ZOLEDRONIC ACID/MANNITOL+WATER,5 MG/100 ML,piggyback,TARO-ZOLEDRONIC ACID,2415100,Taro Pharma,discontinued – no longer available,,2025-10-10,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45551,ZOLMITRIPTAN,2.5 MG,tablet,MINT-ZOLMITRIPTAN,2419521,Mint,back-order–no date,,2026-02-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45551,ZOLMITRIPTAN,2.5 MG,tablet,NAT-ZOLMITRIPTAN,2421534,Natco,back-order–with date,2026-12-25,2026-02-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45551,ZOLMITRIPTAN,2.5 MG,tablet,NRA-ZOLMITRIPTAN,2489392,Nora,back-order–no date,,2026-02-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45551,ZOLMITRIPTAN,2.5 MG,tablet,SANDOZ ZOLMITRIPTAN,2362988,Sandoz,back-order–no date,,2026-02-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45551,ZOLMITRIPTAN,2.5 MG,tablet,TEVA-ZOLMITRIPTAN,2313960,Teva,back-order–no date,,2026-02-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45551,ZOLMITRIPTAN,2.5 MG,tablet,ZOLMITRIPTAN,2442655,Sanis,back-order–no date,,2026-02-05,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43090,ZOLMITRIPTAN,2.5 MG,tablet,JAMP-ZOLMITRIPTAN ODT,2428237,Jamp,back-order–no date,,2026-01-08,ZOMIG RAPIMELT,2.5 MG,tablet,2243045,Xediton Pharma,18.1340,2024-08-13,,
43090,ZOLMITRIPTAN,2.5 MG,tablet,SANDOZ ZOLMITRIPTAN ODT,2362996,Sandoz,back-order–no date,,2026-01-08,ZOMIG RAPIMELT,2.5 MG,tablet,2243045,Xediton Pharma,18.1340,2024-08-13,,
43090,ZOLMITRIPTAN,2.5 MG,tablet,SEPTA-ZOLMITRIPTAN-ODT,2428474,Septa Pharma,back-order–no date,,2026-01-08,ZOMIG RAPIMELT,2.5 MG,tablet,2243045,Xediton Pharma,18.1340,2024-08-13,,
45168,ZOLMITRIPTAN,2.5 MG,tablet,TEVA ZOLMITRIPTAN ODT,2342545,Teva,back-order–no date,,2026-01-08,ZOMIG RAPIMELT,2.5 MG,tablet,2243045,Xediton Pharma,18.1340,2024-08-13,,
43090,ZOLMITRIPTAN,2.5 MG,tablet,ZOLMITRIPTAN ODT,2442671,Sandoz,back-order–no date,,2026-01-08,ZOMIG RAPIMELT,2.5 MG,tablet,2243045,Xediton Pharma,18.1340,2024-08-13,,
43487,ZOLMITRIPTAN,2.5 MG,tablet,APO-ZOLMITRIPTAN,2380951,Apotex,discontinued – no longer available,,2025-11-13,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43753,ZOLMITRIPTAN,2.5 MG,tablet,CCP-ZOLMITRIPTAN,2458780,Cellchem Pharma,no information available,,2025-11-13,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45551,ZOLMITRIPTAN,2.5 MG,tablet,JAMP ZOLMITRIPTAN,2477106,Jamp,discontinued – no longer available,,2025-11-13,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
45551,ZOLMITRIPTAN,2.5 MG,tablet,JAMP-ZOLMITRIPTAN,2421623,Jamp,discontinued – no longer available,,2025-11-13,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43487,ZOLMITRIPTAN,2.5 MG,tablet,MAR-ZOLMITRIPTAN,2399458,Marcan,discontinued – no longer available,,2025-11-13,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43487,ZOLMITRIPTAN,2.5 MG,tablet,PMS-ZOLMITRIPTAN,2324229,PMS,discontinued – no longer available,,2025-11-13,Other already-covered full benefit versions available. Consult the online LCA Data Files for details.,,,,,,,,
43941,ZOLMITRIPTAN,2.5 MG,tablet,PMS-ZOLMITRIPTAN ODT,2324768,PMS,discontinued – no longer available,,2024-08-13,ZOMIG RAPIMELT,2.5 MG,tablet,2243045,Xediton Pharma,18.1340,2024-08-13,,
