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*Denotes a generic available in at least one dosage form or strength - page 6 / 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.

Aricept

Alzheimer’s Agents

galantamine galantamine

Cognex Exelon Namenda Razadyne* Razadyne ER*

Lexapro Luvox CR

clomipramine

citalopram

venlafaxine

amitriptyline and chlordiazepoxide

Anafranil* Aplenzin Celexa* Cymbalta Effexor* Effexor XR Emsam Limbitrol*

desipramine nortriptyline tranylcypromine paroxetine paroxetine

fluoxetine

mirtazapine

fluoxetine fluoxetine

trimipramine

Marplan Nardil Norpramin* Pamelor*

Parnate* Paxil* Paxil CR* Pexeva Pristiq Prozac* Prozac Weekly Remeron* Sarafem* Selfemra* Surmontil*

imipramine imipramine

Symbyax Tofranil* Tofranil-PM* Venlafaxine ER

protriptyline bupropion bupropion bupropion sertraline amitriptyline amoxapine doxepin fluvoxamine maprotiline nefazodone

Vivactil* Wellbutrin* Wellbutrin SR* Wellbutrin XL* Zoloft*

perphenazine and amitriptyline

trazodone

*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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