Product Name for Replacement*
- Select - Angeliq® (drospirenone and estradiol) tablets Betaseron® (interferon beta-1b) lyophilized powde Beyaz® (drospirenone/ethinyl estradiol/levomefolate calcium and levomefolate calcium) tablets Cipro IV® (ciprofloxacin) injection, Cipro® (ciprofloxacin) tablets/oral suspension Climara® (estradiol) transdermal system Climara Pro® (estradiol/levonorgestrel) transdermal system Kerendia® (finerenone) tablets LAMPIT® (nifurtimox) Tablets Menostar® (estradiol) transdermal system Natazia® (estradiol valerate and estradiol valerate/dienogest) tablets Nexavar® (sorafenib) tablets Nubeqa® (darolutamide) tablets Safyral® (drospirenone/ethinyl estradiol/levomefolate calcium and levomefolate calcium) tablets Stivarga® (regorafenib) tablets Vitrakvi™ (larotrectinib) tablets Yasmin® (drospirenone/ethinyl estradiol) tablets Yaz® (drospirenone/ethinyl estradiol) tablets
Dosage
- Select - Stivarga (3-bottle pack containing 28 tablets each) Stivarga (1 bottle containing 21 tablets) Stivarga (4-bottle pack containing 21 tablets each
Dosage
- Select - Vitrakvi 25 mg Capsules Vitrakvi 100 mg Capsules Vitrakvi Oral Solution - 100 mL Vitrakvi Oral Solution - 50 mL (1 bottle pack) Vitrakvi Oral Solution - 50 mL (2-bottle pack)
Dosage
- Select - Nubeqa Tablets
Dosage
- Select - Nexavar Tablets (NDC: 50419-488-58) Nexavar Tablets (NDC: 50419-489-01)
Dosage
- Select - Safyral Tablets
Dosage
- Select - Beyaz Tablets
Dosage
- Select - Natazia Tablets
Dosage
- Select - Yasmin Tablets
Dosage
- Select - Yaz Tablets
Dosage
- Select - Menostar Transdermal System
Dosage
- Select - Angeliq Tablets, 0.5 mg / 1 mg Angeliq Tablets, 0.25 mg / 0.5 mg
Dosage
- Select - Kerendia Tablets (30-tablet bottle) 10 mg Kerendia Tablets (30-tablet bottle) 20 mg Kerendia Tablets (90-tablet bottle) 10 mg Kerendia Tablets (90-tablet bottle) 20 mg
Dosage
- Select - Lampit Tablets 30 mg Lampit Tablets 120 mg
Dosage
- Select - Cipro Tablets 500 mg Cipro Tablets 250 mg Cipro Suspension 10% Cipro Suspension 5%
Dosage
- Select - Climara Transdermal System, 0.025 mg per day Climara Transdermal System, 0.0375 mg per day Climara Transdermal System, 0.05 mg per day Climara Transdermal System, 0.06 mg per day Climara Transdermal System, 0.075 mg per day Climara Transdermal System, 0.1 mg per day
Dosage
- Select - Climara Pro Transdermal System
Dosage
- Select - Betaseron for Injection (14-vial pack) Betaseron for Injection (single vial )
Quantity of bottles/patches/packs Needing Replacement
