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| All drugs are listed by catagory and alphabetically, starting with their generic names followed by the brand names in parenthesis. Click on a high-lighted item in green to see a detailed description of the drug. To search for a specific drug, hold down both the control key (command key on the Mac) and the F key, then type in the drug name.
For a list of specific medical criterias, see the bottom of this page. | ||
| Antiretroviral | ||
| Nucleoside/tide Reverse Transcriptase Inhibitor (NRTI) abacavir (Ziagen) abacavir/lamivudine/zidovudine (Trizivir) didanosine (ddI, Videx) emtricitabine (Emtriva) lamivudine (Epivir, 3TC) lamivudine/zidovudine (Combivir) stavudine (d4T, Zerit) tenofovir (Viread) zalcitabine (ddC, HIVID) zidovudine (AZT, Retrovir) |
Protease Inhibitor (PI) amprenavir (Agenerase) atazanavir (Reyataz) fosamprenavir (Lexiva) indinavir (Crixivan) lopinavir/ritonavir (Kaletra) nelfinavir (Viracept) ritonavir (Norvir) saquinavir (Fortavase) saquinavir (Invirase) |
Non-nucleoside Reverse Transcriptase Inhibitor (NnRTI) delavirdine (Rescriptor) efavirenz (Sustiva) nevirapine (Viramune) Other hydroxyurea (Hydrea) |
| HIV Drug Resistance Tests: None. | ||
| Opportunistic Infection (OI) Treatment & Prophylaxis | ||
| Public Health Service Recommanded OI drugs acyclovir (Zovirax) azithromycin (Zithromax) clarithromycin (Biaxin) famciclovir (Famvir) fluconazole (Diflucan) foscarnet (Foscavir) ganciclovir (Cytovene) itraconazole (Sporanox) leucovorin pyrimethamine (Daraprim) sulfadiazine TMP/SMX (Bactrim, Septra) |
Other OI drugs amikacin (Amikin) amphotericin B atovaquone (Mepron) ciprofloxacin (Cipro) clindamycin (Cleocin) clofazimine (Lamprene) clotrimazole (Mycelex) dapsone erythropoietin (Procrit) |
ethambutol (Myambutol) filgrastim (G-CSF, Neupogen) ketoconazole (Nizoral) metronidazole (Flagyl) nystatin (Mycostatin) pentamidine (NebuPent, Pentam) primaquine rifabutin (Mycobutin) trimethoprim (Proloprim) valacyclovir (Valtrex) valganciclovir (Valcyte) |
| isoniazid, pyrazinamide, and rifampin are covered through the TB Program. | ||
| Diabetic | ||
| metformin (Glucophage) | ||
| Hyperlipidemia | ||
| atorvastatin (Lipitor) | gemfibrozil (Lopid) | pravastatin (Pravachol) |
| Wasting | ||
| megestrol acetate (Megace) |
||
| Other | ||
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Centrum Silver Cerovite Silver Nizoral Cream Prenatal-S sertraline (Zoloft) Tegrin Shampoo Enterix-B (HBV) Haverix (HAV) Twinrix (HAV and HBV) |
Contraceptives Condoms with/without nonoxynol 9 Spermicidal Foam VCF Spermicidal Film Depo-Provera Norplant Ovulation thermometer Fertility Awareness book, charts, videotape |
"All Methods" counseling pamphlet Oral Contraceptives Loestrin Fe Micronor Nordette Ortho-Cyclen Ortho Novum Triphasil |
| Medical Criteria | ||
Prior approval required for:
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Last
modified: 12/15/2006 |
