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*Denotes a generic available in at least one dosage form or strength - page 21 / 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.

Phisohex

acetic acid and oxyquinoline silver sulfadiazine silver sulfadiazine

AVC Relagard* Silvadene* SSD* Sulfamylon

acetic acid, ricinoleic acid and oxyquinoline

silver nitrate

Capex Shampoo Derma-Smooth/FS

alclometasone hydrocortisone diflorasone

hydrocortisone acetate and urea

clobetasol hydrocortisone

fluticasone prednicarbate

desonide betamethasone dipropionate and propylene glycol betamethasone dipropionate and propylene glycol mometasone

hydrocortisone

hydrocortisone butyrate

Aclovate* Anusol-HC* Apexicon* Apexicon E Carmol HC* Clobex Cloderm Cordran Cormax* Cortenema* Cortifoam Cutivate* Dermatop* Desonate Desowen*

Diprolene*

Diprolene AF*

Elocon* Halog Hytone* Kenalog Locoid* Locoid Lipocream Luxiq Nucort

hydrocortisone acetate and aloe vera

Nuzon*

clobetasol

triamcinolone

hydrocortisone hydrocortisone

Olux* Olux-E Oralone in Orabase* Pandel Proctocort* Proctocream-HC*

*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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