Patient Protection and Affordable Care Act Preventive Drug List (2024)

In accordance with the Patient Protection and Affordable Care Act (PPACA), which is also called health care reform, certain preventive medicines are covered at 100 percent with no member out of pocket cost. All medicines, including over-the-counter items, require a prescription from the doctor and must be provided by a participating retail, or through the home delivery pharmacy.

Below is information about the medicines available. The list of medicines begins on page 2.

A summary of the categories includes:

• Low-dose aspirin to prevent cardiovascular disease for men age 45-79 and to prevent cardiovascular disease and preeclampsia for women age 13-79.
• Generic bowel prep medicines required for the preparation of a preventive colonoscopy screening.
• Generic breast cancer prevention medicines for women age 35 and older.
• Fluoride supplements for children ages 6 months through 5 years old.
• Folic acid supplements for women.
• Statins for primary prevention of cardiovascular diseases in adults: low to moderate intensity statins are recommended for adults who are between the ages of 40-75, have no history of cardiovascular disease (CVD), have one or more risk factors for CVD and have a calculated 10-year CVD event risk of 10% or greater. Lovastatin and pravastatin are covered.
• Smoking cessation: Generic, brand-name with no generic equivalent (single source) and over the counter smoking cessation medicines. The day supply limit applied to these FDA-approved tobacco cessation medicines is 180 days per member per 365 days. Brand smoking cessation medicines that do have a generic equivalent (multi-source) are covered with copayment/cost sharing, or according to your benefit design.
• Routine immunizations for children, adolescents and adults as recommended from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (covered under medical benefit)
• Iron supplementation for children ages 6 months to 1 year old who are at increased risk for iron deficiency anemia.
• Contraceptives: Generic contraceptives are covered with no cost share. Brand contraceptive products that do have a generic equivalent (multi-source) and brand name contraceptives with no generic equivalent (single-source) are covered with copayment/cost sharing.
• Pre-Exposure Prophylaxis (PrEP) for the prevention of HIV infection.

This list will be reviewed periodically and is subject to change

Generic prescription drugs are shown in lower-case boldface type. Most generic drugs are followed by a reference brand drug in (parentheses). Reference brands may not themselves be covered, please check your benefit. Some generic products have no reference brand. Brand prescription drugs are shown in all capital letters followed by the generic name. Generic medicines are available for many of the brand-name drugs listed though may not be available in all strengths.

ASPIRIN

• aspirin chew tab 81 mg
• aspirin tab delayed release 81 mg
• VAZALORE - ASPIRIN CAP 81 MG

BOWEL PREPARATION

• peg 3350-kcl-na bicarb-nacl-na sulfate for soln 236 gm (Golytely)
• peg 3350-kcl-sod bicarb-nacl for soln 420 gm

BREAST CANCER PRIMARY PREVENTION

• anastrozole tab 1 mg (Arimidex)
• tamoxifen citrate tab 10 mg (base equivalent)
• tamoxifen citrate tab 20 mg (base equivalent)

FLUORIDE

Dental Products & Combinations

• CREST COMPLETE – sodium fluoride paste 0.243%
• EQL TRAVEL TOOTHBRUSH/TOO – sodium monofluorophosphate paste 0.15%
• FLUORIDEX SENSITIVITY REL – sodium fluoride-potassium nitrate paste 1.1-5%
• FLUORIMAX 5000 SENSITIVE – sodium fluoride-potassium nitrate paste 1.1-5%
• GEL-KAM stannous fluoride gel 0.4%
• LISTERINE ESSENTIAL CARE – sod monofluorophosph-eucal-men-methyl sal-thymol gel 0.76%
• LISTERINE TOTAL CARE – sodium fluoride rinse 0.0221% (0.01% f)
• LISTERINE TOTAL CARE ZERO – sodium fluoride rinse 0.02%
• OMNI GEL – stannous fluoride gel 0.4%
• PARODONTAX – stannous fluoride paste 0.454%
• PREVIDENT FLUORIDE – sodium fluoride gel 1.1% (0.5% f)
• PREVIDENT RINSE – sodium fluoride rinse 0.2%
• PREVIDENT 5000 BOOSTER PLUS – sodium fluoride paste 1.1%
• PREVIDENT 5000 DRY MOUTH – sodium fluoride gel 1.1% (0.5% f)
• PREVIDENT 5000 ENAMEL PRO – sodium fluoride-potassium nitrate paste 1.1-5%
• PREVIDENT 5000 ORTHO DEFENSE – sodium fluoride paste 1.1%
• PREVIDENT 5000 PLUS – sodium fluoride cream 1.1%
• PREVIDENT 5000 SENSITIVE – sodium fluoride-potassium nitrate gel 1.1-5%
• SENSODYNE COMPLETE PROTECTION – stannous fluoride paste 0.454%
• SENSODYNE RAPID RELIEF – stannous fluoride paste 0.454%
• SENSODYNE REPAIR & PROTECT – stannous fluoride paste 0.454%
• sodium fluoride cream 1.1% (Prevident 5000 plus)
• sodium fluoride gel 1.1% (0.5% f) (Prevident fluoride)
• sodium fluoride paste 1.1% (Prevident 5000 boost)
• sodium fluoride rinse 0.02% (Listerine)
• sodium fluoride rinse 0.0221% (0.01% f) (Listerine)
• sodium fluoride rinse 0.05%
• stannous fluoride conc 0.63%
• stannous fluoride gel 0.4% (Gel-kam gel)
• STANNOUS FLUORIDE RINSE – stannous fluoride liq 0.1%

Supplements & Combinations

• FLORICAL – sodium fluoride w/ calcium carb cap 8.3-364 mg
• FLORICAL – sodium fluoride w/ calcium carb tab 8.3-364 mg
• FLORIVA – sodium fluoride-vitamin d liqd drops 0.25 mg/ml-400 unit/ml
• MONOCAL – sodium monofluorophosphate-calcium carb tab 22.75-625 mg
• SODIUM FLUORIDE – sodium fluoride tab 0.5 mg f (from 1.1 mg naf)
• SODIUM FLUORIDE – sodium fluoride tab 1 mg f (from 2.2 mg naf)
• sodium fluoride chew tab 0.25 mg f (from 0.55 mg naf)
• sodium fluoride chew tab 0.5 mg f (from 1.1 mg naf)
• sodium fluoride chew tab 1 mg f (from 2.2 mg naf)
• sodium fluoride soln 0.5 mg/ml f (from 1.1 mg/ml naf)

FOLIC ACID SUPPLEMENTS

• folic acid cap 0.8 mg
• folic acid tab 400 mcg
• folic acid tab 800 mcg

HUMAN IMMUNODEFICIENCY VIRUS PREEXPOSURE PROPHYLAXIS

HIV PrEP (generic list)

• emtricitabine-tenofovir disoproxil fumarate tab 200-300 mg (Truvada)

INFANT EYE OINTMENT (FOR NEWBORNS)

• erythromycin ophth oint 5 mg/gm*

* If used for prevention of gonococcal conjunctivitis in a newborn in an out-patient setting, please fill out the Copay Waiver Form to obtain this medication with $0 cost share

IRON SUPPLEMENTS

• carbonyl iron susp 15 mg/1.25 ml (elemental iron) (Icar pediatric)
• FER-IN-SOL – ferrous sulfate soln 75 mg/ml (15 mg/ml elemental fe)
• FERROUS SULFATE – ferrous sulfate liquid 220 mg/5ml (44 mg/5 ml elemental fe)
• FERROUS SULFATE – ferrous sulfate soln 220 mg/5ml (44 mg/5 ml elemental fe)
• ferrous sulfate elixir 220 mg/5 ml soln (44 mg/5 ml elemental fe)
• ferrous sulfate soln 75 mg/ml (Fer-in-sol) (15 mg/ml elemental fe) (Fer-In-Sol)
• ferrous sulfate syrup 300 mg/5 ml (60 mg/5 ml elemental fe)
• ICAR PEDIATRIC – carbonyl iron susp 15 mg/1.25 ml (elemental iron)
• IRON UP – polysaccharide iron complex liquid 15 mg/0.5 ml (fe equiv)
• NOVAFERRUM PEDIATRIC DROP – polysaccharide iron complex liquid 15 mg/ml (fe equiv)

SINGLE AGENT STATINS

Comprehensive (three statins)

• lovastatin tab 20 mg
• lovastatin tab 40 mg
• pravastatin sodium tab 10 mg
• pravastatin sodium tab 20 mg
• pravastatin sodium tab 40 mg
• pravastatin sodium tab 80 mg

TOBACCO CESSATION

• Brand/generic OTC nicotine gum, lozenges, patches
• Brand/generic Rx nicotine gum, lozenges, patches
• bupropion hcl (smoking deterrent) tab er 12hr 150 mg
• COMMIT – nicotine polacrilex lozenge 2 mg
• COMMIT – nicotine polacrilex lozenge 4 mg
• NICODERM CQ – nicotine td patch 24hr 7 mg/24hr
• NICODERM CQ – nicotine td patch 24hr 14 mg/24hr
• NICODERM CQ – nicotine td patch 24hr 21 mg/24hr
• NICORETTE – nicotine polacrilex gum 2 mg
• NICORETTE – nicotine polacrilex gum 4 mg
• NICORETTE – nicotine polacrilex lozenge 2 mg
• NICORETTE – nicotine polacrilex lozenge 4 mg
• NICORETTE MINI – nicotine polacrilex lozenge 2 mg
• NICORETTE MINI – nicotine polacrilex lozenge 4 mg
• NICORETTE STARTER KIT – nicotine polacrilex gum 2 mg
• NICORETTE STARTER KIT – nicotine polacrilex gum 4 mg
• NICOTINE TRANSDERMAL SYSTEM – nicotine td patch 24 hr kit 21-14-7 mg/24hr
• NICOTROL INHALER – nicotine inhaler system 10 mg (4 mg delivered)
• NICOTROL NS – nicotine nasal spray 10 mg/ml (0.5 mg/spray)
• varenicline tartrate tab 11 x 0.5 mg & 42 x 1 start pack
• varenicline tartrate tab 0.5 mg (base equiv)
• varenicline tartrate tab 1 mg (base equiv)

VACCINES

• ABRYSVO – rsv pre-fusion f a&b vac recomb for im soln 120 mcg/0.5 ml
• ACTHIB – haemophilus b polysaccharide conjugate vaccine for inj
• ADACEL – tet tox-diph-acell pertuss ad inj 5-2-15.5 lf-lf-mcg/0.5 ml
• AFLURIA QUADRIVALENT – influenza virus vac split quadrivalent susp pref syr 0.5 ml
• AFLURIA QUADRIVALENT – influenza virus vaccine split quadrivalent im inj
• AREXVY – rsvpref3 vaccine recomb adjuvanted for im susp 120 mcg/0.5 ml
• BEXSERO – meningococcal vac b (recomb omv adjuv) inj prefilled syringe
• BOOSTRIX – tet tox-diph-acell pertuss ad inj 5-2.5-18.5 lf-lf-mcg/0.5 ml
• BOOSTRIX - tet-diph-acell pertuss ad pref syr 5-2.5-18.5 lf-mcg/0.5 ml
• COMIRNATY - covi-19 mrna vac tris-pfizer im susp pref syr 30 mcg/0.3 ml
• COMIRNATY - covid-19 mrna vac tris-sucrose-pfizer im susp 30 mcg/0.3ml
• DAPTACEL – diph, acellular pert & tet tox inj 15 lf-23 mcg-5 lf/0.5 ml
• ENGERIX-B - hepatitis b vaccine (recombinant) susp pref syr 10 mcg/0.5 ml
• ENGERIX-B - hepatitis b vaccine (recombinant) susp pref syr 20 mcg/ml
• ENGERIX-B – hepatitis b vaccine (recombinant) susp 20 mcg/ml
• FLUAD QUADRIVALENT – influenza vac type a&b surface ant adj quad pref syr 0.5 ml
• FLUARIX QUADRIVALENT – influenza virus vac split quadrivalent susp pref syr 0.5 ml
• FLUBLOK QUADRIVALENT – influenza vac recomb ha quad pf soln pref syr 0.5 ml
• FLUCELVAX QUADRIVALENT – influenza vac tissue-cultured subunit quad susp pref syr 0.5 ml
• FLUCELVAX QUADRIVALENT – influenza vac tissue-cultured subunit quadrivalent im susp
• FLULAVAL QUADRIVALENT – influenza virus vac split quadrivalent susp pref syr 0.5 ml
• FLUMIST QUADRIVALENT – influenza virus vaccine live quadrivalent intranasal susp
• FLUZONE HIGH-DOSE PF – influenza vac split high-dose quad pf susp pref syr 0.7 ml
• FLUZONE QUADRIVALENT – influenza virus vac split quadrivalent susp pref syr 0.5 ml
• FLUZONE QUADRIVALENT – influenza virus vaccine split quadrivalent im inj
• GARDASIL 9 – human papillomavirus (hpv) 9-valent recomb vac im susp
• GARDASIL 9 – human papillomavirus (hpv) 9-valent recomb vac susp pref syr
• HAVRIX – hepatitis a vaccine inj susp 1440 el unit/ml
• HAVRIX – hepatitis a vaccine inj susp 720 el unit/0.5 ml
• HEPLISAV-B – hepatitis b vaccine recomb adjuvanted pref syr 20 mcg/0.5 ml
• HIBERIX – haemophilus b polysaccharide conjugate vac for inj 10 mcg
• INFANRIX – diph, acellular pert & tet tox inj 25 lf-58 mcg-10 lf/0.5 ml
• IPOL INACTIVATED IPV – poliovirus vaccine, ipv injection
• KINRIX - diph-tetanus-acell pert-polio, ipv vacc susp pref syr 0.5 ml
• MENACTRA – meningococcal (a, c, y, and w-135) conjugate vaccine inj
• MENQUADFI – meningococcal (a, c, y, and w-135) conjugate vaccine inj
• MENVEO – meningococcal (a, c, y, and w-135) oligo conj vac for inj
• MENVEO – meningococcal (a, c, y, and w-135) oligo conj vac im soln
• M-M-R II – measles-mumps-rubella virus vaccines for inj soln
• MODERNA COVID-19 VACCINE/6MO-11Y - covid-19 mrna vaccine 6mo-11yr-moderna im susp 25 mcg/0.25 ml
• PEDIARIX - diph-tet tox-acell pert-hep b-polio ipv vac susp pref syr
• PEDVAX HIB – haemophilus b polysaccharide conj vac im susp 7.5 mcg/0.5 ml
• PENTACEL – diph-ac per-tet tox ad-poliov-haemoph b poly vac for im susp
• PFIZER-BIONTECH COVID-19 VACCINE/5-11Y - covid-19 mrna vac tris-s 5-11y-pfizer im susp 10 mcg/0.3 ml
• PFIZER-BIONTECH COVID-19 VACCINE/6MO-4Y - covid-19 mrna vac tris-s 6mo-4y-pfizer im susp 3 mcg/0.3 ml
• PNEUMOVAX 23 – pneumococcal vaccine polyvalent inj 25 mcg/0.5 ml
• PNEUMOVAX 23/1 DOSE – pneumococcal vaccine polyvalent inj 25 mcg/0.5 ml
• PREHEVBRIO – hepatitis b vaccine 3-antigen (recombinant) susp 10 mcg/mL
• PREVNAR 13 – pneumococcal 13-valent conjugate vaccine inj
• PREVNAR 20 – pneumococcal 20-valent conjugate vaccine sus pref syr 0.5 ml
• PRIORIX - measles-mumps-rubella virus vaccines for subcutaneous susp
• PROQUAD – measles-mumps-rubella-varicella virus vaccines for susp
• QUADRACEL – diph-tetanus tox ad-acell pert & polio virus, ipv vac inj
• QUADRACEL – diph-tetanus-acell pert-polio, ipv vacc susp pref syr 0.5 ml
• RECOMBIVAX HB – hepatitis b vaccine (recombinant) susp 10 mcg/ml
• RECOMBIVAX HB - hepatitis b vaccine (recombinant) susp pref syr 10 mcg/ml
• RECOMBIVAX HB – hepatitis b vaccine (recombinant) susp 40 mcg/ml
• RECOMBIVAX HB – hepatitis b vaccine (recombinant) susp 5 mcg/0.5ml
• RECOMBIVAX HB - hepatitis b vaccine (recombinant) susp pref syr 5 mcg/0.5 ml
• RECOMBIVAX HB – hepatitis b vaccine (recombinant) susp 40 mcg/ml
• RECOMBIVAX HB – hepatitis b vaccine (recombinant) susp pref syr 5 mcg/0.5 ml
• RECOMBIVAX HB – hepatitis b vaccine (recombinant) susp pref syr 10 mcg/ml
• ROTARIX – rotavirus vaccine, live for oral susp
• ROTARIX – rotavirus vaccine, live oral susp
• ROTATEQ – rotavirus vaccine, live oral pentavalent soln
• SHINGRIX – zoster vac recombinant adjuvanted for im inj 50 mcg/0.5 ml
• SPIKEVAX COVID-19 VACCINE - covid-19 mrna vaccine-moderna im susp pref syr 50 mcg/0.5 ml
• SPIKEVAX COVID-19 VACCINE - covid-19 (sars-cov-2) mrna vacc-moderna im susp 50 mcg/0.5 ml
• TDVAX – tetanus-diphtheria toxoids (td) inj 2-2 lf/0.5 ml
• TENIVAC – tetanus-diphtheria toxoids (td) inj 5-2 lfu
• TRUMENBA – meningococcal group b vac (recomb) im susp prefilled syr
• TWINRIX – hep a-hep b vaccine susp pref syr 720-20 elu-mcg/ml
• VAQTA – hepatitis a vaccine inj susp 25 unit/0.5 ml
• VAQTA – hepatitis a vaccine inj susp 50 unit/ml
• VARIVAX – varicella virus vac live for subcutaneous inj 1350 pfu/0.5 ml
• VAXELIS – diph-tet tox-ac pert ad-polio ipv-hib-hep b rec susp pre syr
• VAXELIS – diph-tet tox-ac pert ad-polio ipv-hib-hepatitis b recmb susp
• VAXNEUVANCE - pneumococcal 15-valent conjugate vaccine sus pref syr 0.5 ml

Recommendation on Contraceptives by Health Resources and Services Administration (HRSA)

Eligible benefit plans include coverage under the Affordable Care Act for the following contraceptives to be covered at $0. To determine cost share for medications not listed below, log onto your account at MyPrime.com. Please refer to your benefit materials for coverage details and the plan website for current information as this publication is subject to change. This list will be reviewed periodically and is subject to change.

Generic prescription drugs are shown in lower-case boldface type. Most generic drugs are followed by a reference brand drug in (parentheses). Reference brands may not themselves be covered, please check your benefit. Some generic products have no reference brand. Brand prescription drugs are shown in all capital letters followed by the generic name. Generic medicines are available for many of the brand-name drugs listed though may not be available in all strengths.

CONTRACEPTIVES

Barrier Method Types

Cervical Caps

• FEMCAP – cervical cap 22 mm
• FEMCAP – cervical cap 26 mm
• FEMCAP – cervical cap 30 mm

Diaphragms

• CAYA – diaphragm arc-spring
• OMNIFLEX DIAPHRAGM – diaphragms
• WIDE-SEAL SILICONE DIAPHR – diaphragm wide seal 60 mm
• WIDE-SEAL SILICONE DIAPHR – diaphragm wide seal 65 mm
• WIDE-SEAL SILICONE DIAPHR – diaphragm wide seal 70 mm
• WIDE-SEAL SILICONE DIAPHR – diaphragm wide seal 75 mm
• WIDE-SEAL SILICONE DIAPHR – diaphragm wide seal 80 mm
• WIDE-SEAL SILICONE DIAPHR – diaphragm wide seal 85 mm
• WIDE-SEAL SILICONE DIAPHR – diaphragm wide seal 90 mm
• WIDE-SEAL SILICONE DIAPHR – diaphragm wide seal 95 mm

Female Condom

• FC2 FEMALE CONDOM – condoms - female

Male Condom

• ALL MALE CONDOMS

Spermicide

• ENCARE – nonoxynol-9 vaginal suppos 100 mg
• OPTIONS GYNOL II VAGINAL – nonoxynol-9 gel 3%
• VCF VAGINAL CONTRACEPTIVE – nonoxynol-9 film 28
• VCF VAGINAL CONTRACEPTIVE – nonoxynol-9 foam 12.5%
• VCF VAGINAL CONTRACEPTIVE – nonoxynol-9 gel 4%

Vaginal pH Regulator Gel

• PHEXXI - lactic acid-citric acid-potassium bitartrate gel 1.8-1-0.4%

Sponge

• TODAY SPONGE – nonoxynol-9 vaginal sponge 1000 mg

Emergency Method Types

Emergency Ella

• ELLA – ulipristal acetate tab 30 mg

Emergency Progestin

• Aftera - levonorgestrel tab 1.5 mg (Plan B One-Step)
• Afterpill - levonorgestrel tab 1.5 mg (Plan B One-Step)
• Curae - levonorgestrel tab 1.5 mg (Plan B One-Step)
• Econtra one-step - levonorgestrel tab 1.5 mg (Plan B One-Step)
• Her style - levonorgestrel tab 1.5 mg (Plan B One-Step)
• levonorgestrel tab 1.5 mg (Plan B One-Step)
• My choice - levonorgestrel tab 1.5 mg (Plan B One-Step)
• My way - levonorgestrel tab 1.5 mg (Plan B One-Step)
• New day - levonorgestrel tab 1.5 mg (Plan B One-Step)
• Opcicon one-step - levonorgestrel tab 1.5 mg (Plan B One-Step)
• Option 2 - levonorgestrel tab 1.5 mg (Plan B One-Step)
• PLAN B ONE-STEP - levonorgestrel tab 1.5 mg
• React - levonorgestrel tab 1.5 mg (Plan B One-Step)
• Take action - levonorgestrel tab 1.5 mg (Plan B One-Step)

CONTRACEPTIVES

Hormonal Method Types

Injectable Progestin (continued)

• DEPO-PROVERA CONTRACEPTIVE – medroxyprogesterone acetate im susp 150 mg/ml
• DEPO-PROVERA CONTRACEPTIVE – medroxyprogesterone acetate im susp prefilled syr 150 mg/ml
• DEPO-SUBQ PROVERA 104 – medroxyprogesterone acetate susp pref syr 104 mg/0.65 ml
• medroxyprogesterone acetate im susp 150 mg/ml (Depo-provera contraceptive)
• medroxyprogesterone acetate im susp prefilled syr 150 mg/ml (Depo-provera contraceptive)

Oral Combined

• desogest-eth estrad & eth estrad tab 0.15-0.02/ 0.01 mg (21/5)
• desogestrel & ethinyl estradiol tab 0.15 mg-30 mcg
• drospirenone-ethinyl estradiol tab 3-0.02 mg (Yaz)
• drospirenone-ethinyl estradiol tab 3-0.03 mg (Yasmin 28)
• drospirenone-ethinyl estrad-levomefolate tab 3-0.02-0.451 mg (Beyaz)
• drospirenone-ethinyl estrad-levomefolate tab 3-0.03-0.451 mg (Safyral)
• ethynodiol diacetate & ethinyl estradiol tab 1 mg-35 mcg
• ethynodiol diacetate & ethinyl estradiol tab 1 mg-50 mcg
• levonorgestrel & ethinyl estradiol tab 0.1 mg-20 mcg
• levonorgestrel-ethinyl estradiolfe tab 0.1 mg-20 mcg (21) (Balcoltra)
• levonorgestrel & ethinyl estradiol tab 0.15 mg-30 mcg
• levonorgestrel-eth estra tab 0.05-30/0.075- 40/0.125-30mg-mcg
• levonor-eth est tab 0.15-0.02/0.025/0.03 mg &eth est 0.01 mg (Quartette)
• levonorg-eth est tab 0.1-0.02mg(84) & eth est tab 0.01mg(7) (Loseasonique)
• levonorg-eth est tab 0.15-0.03mg(84) & eth est tab 0.01mg(7) (Seasonique)
• levonorgestrel & ethinyl estradiol (91-day) tab 0.15-0.03 mg
• LO LOESTRIN FE – norethin-eth estradiol-fe tab 1 mg-10 mcg (24)/10 mcg (2)
• NATAZIA – estradiol valerate-dienogest tab 3 mg /2-2 mg/2-3 mg/1 mg
• NEXTSTELLIS – drospirenone-estetrol tab 3-14.2 mg
• norethindrone ac-ethinyl estrad-fe tab 1-20/1-30/1-35 mg-mcg
• norethindrone & ethinyl estradiol-fe chew tab 0.4 mg-35 mcg
• norethindrone & ethinyl estradiol-fe chew tab 0.8 mg-25 mcg (Generess fe)
• norethindrone & ethinyl estradiol tab 0.4 mg-35 mcg
• norethindrone & ethinyl estradiol tab 0.5 mg-35 mcg
• norethindrone & ethinyl estradiol tab 1 mg-35 mcg
• norethindrone ace & ethinyl estradiol tab 1 mg-20 mcg
• norethindrone ace & ethinyl estradiol tab 1.5 mg-30 mcg
• norethindrone ace & ethinyl estradiol-fe tab 1 mg-20 mcg
• norethindrone ace & ethinyl estradiol-fe tab 1 mg-20 mcg (24)
• norethindrone ace & ethinyl estradiol-fe tab 1.5 mg-30 mcg
• norethindrone ace-ethinyl estradiol-fe cap 1 mg-20 mcg (24) (Taytulla)
• norethindrone ace-eth estradiolfe chew tab 1 mg-20 mcg (24) (Minastrin 24 fe)
• norethindrone-eth estradiol tab 0.5-35/0.75-35/1-35 mg-mcg
• norethindrone-eth estradiol tab 0.5-35/1-35/0.5-35 mg-mcg
• norgestimate & ethinyl estradiol tab 0.25 mg-35 mcg
• norgestimate-eth estrad tab 0.18-25/0.215-25/0.25-25 mg-mcg
• norgestimate-eth estrad tab 0.18-35/0.215-35/0.25-35 mg-mcg
• norgestrel & ethinyl estradiol tab 0.3 mg-30 mcg
• TYBLUME – levonorgestrel & ethinyl estradiol chew tab 0.1 mg-20 mcg
• VELIVET - desogest-ethin est tab 0.1-0.025/0.125-0.025/0.15- 0.025 mg-mg

Oral Extended Continuous

• levonorgestrel-ethinyl estradiol (continuous) tab 90-20 mcg

Oral Progestin

• Jencycla - norethindrone tab 0.35 mg
• Lyleq - norethindrone tab 0.35 mg
• Lyza - norethindrone tab 0.35 mg
• Nora-be - norethindrone tab 0.35 mg
• norethindrone tab 0.35 mg
• Norlyroc - norethindrone tab 0.35 mg
• Sharobel - norethindrone tab 0.35 mg
• SLYND – drospirenone tab 4 mg

Transdermal Combined

• TWIRLA – levonorgestrel-ethinyl estradiol td ptwk 120-30 mcg/24hr
• Xulane - norelgestromin-ethinyl estradiol td ptwk 150-35 mcg /24hr
• Zafemy - norelgestromin-ethinyl estradiol td ptwk 150-35 mcg /24hr

Vaginal Combined Ring

• Eluryng - etonogestrel-ethinyl estradiol va ring 0.120-0.015 mg/24hr (Nuvaring)
• etonogestrel-ethinyl estradiol va ring 0.120-0.015 mg/24hr (Nuvaring)
• Haloette - etonogestrel-ethinyl estradiol va ring 0.120-0.015 mg/24hr (Nuvaring)
• NUVARING – etonogestrel-ethinyl estradiol va ring 0.120-0.015 mg/24hr

Implantable Method Types

Implantable Progestin (Rods)

• NEXPLANON – etonogestrel subdermal implant 68 mg

IUD Copper

• PARAGARD INTRAUTERINE COPPER – copper iud

IUD Progestin

• KYLEENA – levonorgestrel releasing iud 17.5 mcg/day (19.5 mg total)
• LILETTA – levonorgestrel releasing iud 19.5 mcg/day (52 mg total)
• MIRENA – levonorgestrel releasing iud 20 mcg/day (52 mg total)
• SKYLA – levonorgestrel releasing iud 14 mcg/day (13.5 mg total)

Last updated on: 07/01/2024