Category Name



|MaineCare Brands Preferred Over Generic Version List |

|Category Name |Preferred Brand |Non-Preferred Generic |

|Ace Inhibitors |Monopril |Fosinopril Sodium |

|Antiarrhythmics |Norpace |Disopyramide Phosphate |

| |Norpace CR |Disopyramide PhosphateER |

| |Tambocor |Flecainide Acetate |

| |Rythmol |Propafenone HCL |

|Antiasthmatic-Nasal Steroids |Nasalide |Flunisolide |

|Antibiotics – Misc |Coly-Mycin-M |Colistimethate Sodium |

|Anticonvulsants |Mysoline |Primidone |

|Antiretrovirals |Videx-EC |Didanosine |

|Beta-Lactams/Clavulanate Combo’s |Augmentin ES-600 Susp. |Amoxicillin/Clavulanate |

|Cephalosporins |Vantin |Cefpodoxime Proxetil |

| |Claforan |Cefotaxime Sodium |

| |Fortaz |Tazicef, Tazidime |

|Contraceptives – Bi-Phasic Combo’s |Ortho-Novum 10/11 –28 |Necon 10/11-28 |

|Contraceptives – Injectable |Depo-Provera |Medroxyprogesterone Acetate IM |

|Contraceptives – Progestin Only |Nor-QD, Ortho Micronor |Norethindrone tab 0.35mg |

|Contraceptives – Tri-Phasic Combo’s |Tri-Levlen, Triphasil |Levonorgestrel-Eth Estra Tab 0.05-30/0.075-40/0.125-30mg-mcg |

| |Ortho-Novum 7/7/7 |Norethindrone-Eth Estradiol Tab 0.5-35/0.75-35/1-35mg-mcg |

| |Ortho Tri-Cyclen |Norgestimate-Eth Estrad Tab 0.18-35/0.215-35/0.25-35 mg-mcg |

|Contraceptives-Monophasic Combination O/C’s |Desogen, Ortho-Cept |Desogestrel & Ethinyl Estradiol tab 0.15mg-30mcg |

| |Demulen |Zovia |

| |Alesse, Levlite |Aviane, Lessina, Lutera |

| |Norinyl,Ortho-Novum |Norethindrone & Ethinyl Estradiol Tab 1mg-35mcg |

| |Lo/Ovral |Norgestrel & Ethinyl Estradiol Tab 0.3mg-30mcg |

| |Ortho-Cyclen |Norgestimate & Ethinyl Estradiol Tab 0.25mg-35mcg |

|Hepatitis Agents |Rebetol |Ribavirin |

|Immunosuppressants |Sandimmune |Cyclosporine |

|Miscellaneous |Purinethol |Mercaptopurine |

| |Vepesid |Etoposide |

|Migraine – Misc. |Cafergot |Ergotamine w/Caffeine Supp. 2-100mg |

|Narcotics – Long Acting |RMS |Morphine Sulfate Supp. |

|Neurologics –Misc. |Mestinon |Pyridostigmine bromide |

|Op.Quinolones |Ocuflox |Ofloxacin Ophth Sol 0.3% |

|Somatostatic Agents |Sandostatin |Octreotide Acetate |

|Stimulants |Dexedrine |Dextroamphetamine Sulf. Cap SR 24HR 15mg |

|Topical – Antifungals |Loprox |Ciclopirox Olamine Cream 0.77% |

| |Spectazole |Econazole Nitrate Cream 1% |

| |Nizoral |Ketoconazole Shampoo 2% |

|Topical – Corticosteroids |Diprolene |Augmented Betamethasone Dipropionate |

| |Cutivate |Fluticasone Propionate |

| |Ultravate |Halobetasol Propionate |

| |Locoid |Hydrocortisone Butyrate |

|Topical – Acne Preparations |Accutane |Isotretinoin Cap |

| |Retin-A |Tretinoin |

| |Cleocin-T |Clindamycin Phosphate |

|Topical – Emollients |Lac-Hydrin |Lactic Acid (Ammonium Lactate) |

|Urological – Misc. |Macrodantin |Nitrofurantoin Macrocrystals |

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