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*Denotes a generic available in at least one dosage form or strength - page 5 / 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

methenamine

Furadantin Hiprex*

nitrofurantoin and nitrofurantoin macrocrystals nitrofurantoin macrocrystals

Macrobid*

Macrodantin* Monurol Primsol

methenamine, methylene blue, benzoic acid, phenyl salicylate, hyoscyamine

Prosed/DS*

methenamine, methylene blue, phenyl salicylate, sodium phosphate, hyoscyamine

Urelle*

methenamine

methenamine and sodium phosphate

Urex* Urimar-T Urin D.S. Uroqid-Acid No. 2*

methenamine, methylene blue, phenyl salicylate, sodium phosphate, hyoscyamine

Uta*

methenamine and sodium phosphate

Utac*

methenamine, methylene blue, phenyl salicylate, sodium phosphate, hyoscyamine

Utira C*

trimethoprim

*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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