Attach9_Specialty Clinical Services List.docx

MEDICATIONS REQUIRING SPECIALTY CLINICAL SERVICES*

ADRENOCORTICOTROPHIC HORMONE

ACTH

ACTHAR H.P.

AGENTS TO TREAT MULTIPLE SCLEROSIS

AVONEX

BETASERON

COPAXONE

EXTAVIA

GILENYA

REBIF

AMPYRA

ANTINEOPLASTIC AGENTS

ALKERAN

CYCLOPHOSPHAMIDE

METHOTREXATE

VIDAZA

ERIVEDGE

HEXALEN

LEUKERAN

TRETINOIN CAPSULE

TABLOID

XELODA

TEMODAR

JAKAFI

ZYTIGA

THALIDOMID

ZOLINZA

AFINITOR

HYCAMTIN

CAPRELSA

GLEEVEC

NEXAVAR

SPRYCEL

SUTENT

INLYTA

TARCEVA

IRESSA

TASIGNA

TYKERB

VANDETANIB

HYDROXYUREA

VOTRIENT

MATULANE

LYSODREN

MERCAPTOPURINE

XALKORI

ZELBORAF

ELIGARD

LEUPROLIDE ACETATE

LUPRON

NILANDRON

CASODEX

FLUTAMIDE

ZOLADEX

FIRMAGON

THERACYS

ETOPOSIDE

REVLIMID

SYLATRON

8-MOP

AGENTS FOR CYSTIC FIBROSIS

TOBI

CAYSTON

PULMOZYME

HYPERTONIC SALINE FOR INHALATION

AMYOTROPHIC LATERAL SCLEROSIS AGENT

RILUTEK

DISEASE MODIFYING ANTI-RHEUMATIC DRUGS

METHOTREXATE

RHEUMATREX

KINARET

SIMPONI

ORENCIA

ENBREL

HUMIRA

CIMZIA

SULFASALAZINE

AZATHIOPRINE

LEFLUNOMIDE

ANTIDIURETIC AND VASOPRESSOR HORMONE

DDAVP

DESMOPRESSIN ACETATE

MINIRIN

ANTIHEMOPHILIC FACTOR

BIOCLATE

FEIBA NF

FEIBA VH IMMUNO

GENARC

HELIXATE FS

HEMOFIL M

HUMATE-P

KOATE-DVI

KOATE-HP

KOGENATE FS

MONOCLATE-P

RECOMBINATE

XYNTHA

ALPHANINE HEAT-TREAT/SOLV S

ALPHANINE SD

ALPHANINE SD HEAT TREAT/SOL

BEBULIN

BEBULIN VH IMMUNO

BENEFIX

MONONINE

ANTI-NARCOLEPSY & ANTI-CATAPLEXY

XYREM

ANTIPARKINSONISM DRUGS

APOKYN

ANTIPSORIATIC AGENTS

AMEVIVE

ANTISERA

BAYHEP B

H-BIG

HEP-B-GAMMAGEE

HYPERHEP

NABI-HB

RHOPHYLAC

VARICELLA-ZOSTER IMM GLOBUL

WINRHO SD

WINRHO SDF

ANTIVIRALS, HIV-SPECIFIC

APTIVUS

PREZISTA

TRUVADA

COMBIVIR

EPZICOM

LAMIVUDINE-ZIDOVUDINE

TRIZIVIR

SELZENTRY

FUZEON

EDURANT

INTELENCE

NEVIRAPINE

RESCRIPTOR

SUSTIVA

VIRAMUNE

VIRAMUNE XR

ABACAVIR

DIDANOSINE

EMTRIVA

EPIVIR

LAMIVUDINE

RETROVIR

STAVUDINE

VIDEX EC

ZERIT

ZIAGEN

ZIDOVUDINE

VIREAD

CRIXIVAN

INVIRASE

LEXIVA

NORVIR

REYATAZ

VIRACEPT

KALETRA

ISENTRESS

ATRIPLA

COMPLERA

C1 ESTERASE INHIBITOR

BERINERT

CHEMOTHERAPY RESCUE/ANTIDOTE AGENT

LEUCOVORIN CALCIUM

MESNEX

CXCR4 CHEMOKINE RECEPTOR ANTAGONIS

MOZOBIL

DRUGS TO TREAT HEREDITARY TYROSINEMIA

ORFADIN

DRUGS TO TX GAUCHER DISEASE

ZAVESCA

BLOOD CELL STIMULATING AGENTS

ARANESP

EPOGEN

PROCRIT

MOZOBIL

NPLATE

PROMACTA

LEUKINE

NEULASTA

NEUMEGA

GASTRIC ENZYME

SUCRAID

GROWTH HORMONE

GENOTROPIN

HUMATROPE

GROWTH HORMONE RECEPTOR ANTAGONIST

SOMAVERT

GROWTH HORMONE RELEASING HORMONE (GHRH) & ANALOG

EGRIFTA

HEPATITIS B TREATMENT AGENT

EPIVIR HBV

HEPATITIS C TREATMENT AGENT

COPEGUS

INFERGEN

PEGASYS

PEGINTRON

PEGINTRON REDIPEN

REBETOL

RIBAPAK

RIBASPHERE

RIBATAB

RIBAVIRIN

INCIVEK

VICTRELIS

IMMUNOMODULATOR

ACTIMMUNE

INTRON A

IMMUNOSUPPRESSIVE

CELLCEPT

CYCLOSPORINE

CYCLOSPORINE MODIFIED

GENGRAF

HECORIA

MYCOPHENOLATE MOFETIL

MYFORTIC

NEORAL

PROGRAF

RAPAMUNE

SANDIMMUNE

SANGCYA

TACROLIMUS

ZORTRESS

INSULIN-LIKE GROWTH FACTOR-1 (IGF-1) HORMONE

INCRELEX

KIDNEY STONE AGENT

CYSTAGON

NON-ANTINEOPLASTIC PITUITARY SUPPRESSANTS

LUPRON DEPOT

LUPRON DEPOT-3 MONTH

SUPPRELIN LA

VANTAS

CETROTIDE

LUPRON DEPOT-PEDS

CHELATING AGENTS

EXJADE

FERRIPROX

MONOCLONAL ANTIBODIES TO IMMUNOGLOBULIN E (IGE

XOLAIR

MONOCLONAL ANTIBODY-HUMAN INTERLEUKIN 12/23 INHI

STELARA

MOVEMENT DISORDERS (DRUG THERAPY

XENAZINE

AGENTS TO TREAT PHENYLKETONURIA

KUVAN

PROGESTATIONAL AGENT

GESTEROL-50

PROGESTERONE

PROGESTERONE 50 IN OIL

PROGESTERONE IN OIL

PROGESTERONE-50 IN OIL

ROGEST 50

AGENTS TO TREAT PULMONARY HYPERTENSION

ADCIRCA

REVATIO

LETAIRIS

TRACLEER

TYVASO

VENTAVIS

SOMATOSTATIC AGENT

OCTREOTIDE ACETATE

SANDOSTATIN

SANDOSTATIN LAR

SOMATULINE DEPOT

*This list provides therapy classes with examples of medications that require specialty clinical services. The therapy classes and medications listed are subjected to change.

DRAFT 31 July 2012