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*Denotes a generic available in at least one dosage form or strength - page 2 / 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.

none

ethambutol

rifampin rifampin and isoniazid

cycloserine

Capastat Sulfate Myambutol* Mycobutin Paser Priftin Rifadin* Rifamate* Rifater Seromycin* Trecator

isoniazid pyrazinamide

none

cefuroxime cefotaxime ceftazidime cephalexin cefepime cefdinir

ceftriaxone cefditoren

ceftazidime cefpodoxime cefuroxime cefaclor cefadroxil cefazolin

Cedax Ceftin* Claforan* Fortaz* Keflex* Maxipime* Omnicef* Raniclor Rocephin* Spectracef* Suprax Tazicef* Vantin* Zinacef *

none

Infergen Pegasys

cefprozil chloramphenicol none

none

Alferon N Intron A PegIntron

none

clarithromycin clarithromycin ER erythromycin ethylsuccinate

azithromycin

Biaxin* Biaxin XL* E.E.S.* EryPed Erythrocin Lactobionate Erythrocin Stearate Ketek PCE Zithromax* Zmax

erythromycin base

erythromycin ethylsuccinate and sulfisoxazole

*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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