Some Drugs Strength-Specific on Preferred Drug List (PDL)


There are a few drugs currently that are either preferred or non-preferred depending on the strength of the medication. Please be aware that these drugs are only preferred if in the strengths indicated in the table below. Providers are asked to keep this in mind when prescribing these medications, as using a non-preferred strength will require a PA that may delay the process and access to medication.

DRUG

PREFERRED STRENGTHS

NON-PREFERRED STRENGTHS

Fenofibrate

48 mg & 145 mg

40 mg, 43 mg, 50 mg, 54 mg, 67 mg, 120 mg, 130 mg, 134 mg, 150 mg, 160 mg, 200 mg

Olopatadine drops

0.1 %

0.2 %

Gabapentin

100 mg, 300 mg, 400 mg

* Capsule form only

600 mg & 800 mg

* Tablet form only

Fentanyl

12 mcg/hr, 25 mcg/hr, 50 mcg/hr, 75 mcg/hr, 100 mcg/hr

37.5 mcg/hr, 62.5 mcg/hr, 87.5 mcg/hr

Temazepam

15 mg & 30 mg

7.5 mg & 22.5 mg