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*Denotes a generic available in at least one dosage form or strength - page 14 / 26

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This PDL reference tool is to aid a prescribing physician with generic availability and preferred product status. A "substitution allowed" physician signature on a prescription should not require a PA to be obtained if a generic agent is available.

AzaSite Bactroban Nasal Blephamide Blephamide S.O.P. Bleph-10* Neosporin*

sulfacetamide neomycin, polymyxin B and gramicidin

Poly-Pred Tobrex* Vigamox

tobramycin

Astelin Astepro Optivar* Pataday Patanase Patanol

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azelastine

Nasalcrom OTC* Zaditor OTC*

cromolyn sodium

Alamast Alocril Alomide Bepreve** Crolom* Elestat Emadine

ciprofloxacin

neomycin, polymyxin B and hydrocortisone

ofloxacin

neomycin, polymyxin B and dexamethasone

ofloxacin

doxycycline polymyxin B and trimethoprim

tobramycin and dexamethasone

bacitracin bacitracin and polymyxin B erythromycin base gentamicin neomycin, bacitracin and polymyxin B neomycin, bacitracin, polymyxin B and hydrocortisone

Besivance Cetraxal** Ciloxan* Cipro HC Ciprodex Coly-Mycin S Cortisporin*

Cortisporin-TC Floxin*

Iquix Maxitrol*

Ocuflox* Pediotic Periostat*

Polytrim* Pred-G Quixin TobraDex*

Zylet Zymar

*Denotes a generic available in at least one dosage form or strength **Will be reviewed at a future time when eligible

Effective 4/1/2010

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