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 |