(continued)
DRUG CLASS
EXCLUDED MEDICATIONS
PREFERRED ALTERNATIVES
Bowel Evacuants
CLENPIQ, PLENVU, SUFLAVE, SUTAB
magnesium sulfate/potassium sulfate/sodium sulfate solution, peg 3350/ascorbic acid powder packets
Constipation Agents
RELISTOR TABLETS
lubiprostone, MOVANTIK, SYMPROIC budesonide foam, hydrocortisone enema
Corticosteroids (Rectal Formulations)
CORTIFOAM
Gallstone Dissolution Agents
RELTONE
ursodiol
Gastroparesis Agents
GIMOTI
No alternatives recommended
Hemorrhoidal Preparations
HYDROCORTISONE/PRAMOXINE 25-18MG SUPPOSITORIES
hydrocortisone ac suppositories, pramoxine/ hydrocortisone cream
MICORT HC
hydrocortisone 2.5% rectal cream pramoxine/hydrocortisone cream
PROCTOFOAM-HC
Inflammatory Bowel Agents
DIPENTUM
balsalazide disodium, mesalamine dr, mesalamine er, sulfasalazine, PENTASA 250MG CAPSULES lubiprostone, prucalopride, LINZESS, TRULANCE
Irritable Bowel Syndrome and Chronic Constipation Agents
IBSRELA
Pancreatic Enzymes Proton Pump Inhibitors
PERTZYE
CREON, PANCREAZE, ZENPEP
dexlansoprazole dr, DEXILANT
esomeprazole magnesium dr capsules, lansoprazole dr capsules, omeprazole dr capsules, pantoprazole dr tablets, rabeprazole dr tablets esomeprazole magnesium dr, lansoprazole dr, omeprazole dr, pantoprazole dr, rabeprazole dr tablets
KONVOMEP, PRILOSEC SUSPENSION, RABEPRAZOLE DR SPRINKLE
Miscellaneous Gastrointestinal Agents
DARTISLA ODT YOSPRALA DR
glycopyrrolate tablets
HEMATOLOGICAL Antiplatelet Agents
aspirin plus omeprazole dr, esomeprazole magnesium dr, lansoprazole dr, pantoprazole dr or rabeprazole dr tablets
Erythropoiesis-Stimulating Agents
ARANESP, EPOGEN, MIRCERA
PROCRIT, RETACRIT
Factor Deficiency Agents and Related Products
IXINITY, RIXUBIS NOVOSEVEN RT
BENEFIX
SEVENFACT
NUWIQ, RECOMBINATE
ADVATE, ADYNOVATE, AFSTYLA, ALTUVIIIO, ELOCTATE, ESPEROCT, JIVI, KOVALTRY, NOVOEIGHT, XYNTHA, XYNTHA SOLOFUSE
REBINYN
ALPROLIX, IDELVION FULPHILA, ZIEXTENZO
Granulocyte Colony Stimulating Factors
FYLNETRA, NEULASTA, NYVEPRIA, ROLVEDON, RYZNEUTA, STIMUFEND, UDENYCA
FILKRI, GRANIX, NEUPOGEN, NYPOZI, RELEUKO, ZARXIO
NIVESTYM
Hematopoietic and Thrombopoietic Agents
APHEXDA
plerixafor
Hemophilia Agents
QFITLIA
For Hemophilia A with inhibitors: ALHEMO, HEMLIBRA For Hemophilia A without inhibitors: ALHEMO, HEMLIBRA, HYMPAVZI For Hemophilia B with inhibitors: ALHEMO For Hemophilia B without inhibitors: ALHEMO, HYMPAVZI
Hypoxia-Inducible Factor Prolyl Hydroxylase Inhibitors
VAFSEO
PROCRIT, RETACRIT
Iron Replacement Agents
MONOFERRIC
iron sucrose, sodium ferric gluconate complex
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