Inhibitors of the Renin-Angiotensin-Aldosterone System (RAAS)
PDL Reference Documents
Drug Use Review Documents
Newsletters
- February 2026 - Chronic Kidney Disease Pharmacotherapy: Guideline Updates & Practical Application
- September 2025 - 2025 American College of Cardiology/American Heart Association Joint Committee Clinical Practice Guideline Update
- September 2021 - Updates in Heart Failure Therapy: New Drugs and Indications
PDL Status Values
Y = preferred
N = non-preferred. Non-preferred drugs listed as N but without clinical drug use criteria are subject to the
Non-Preferred Drugs in Select PDL Classes prior authorization criteria.
New drugs will be listed as N until reviewed by the P&T Committee and are subject to the
New Drug Policy.
V = voluntary non-preferred. Non-preferred mental health drugs are listed as V and prior authorization is not required.
Null (i.e. blank) = indicates the class or specific drug has not been reviewed for PDL placement.
To request a Prior Authorization, please use this form.
| Generic Name | Brand Name | Form | PDL Status |
Current Drug Use Criteria | Carveout ‐ Bill FFS |
New Drug Evaluation & Updates |
|---|---|---|---|---|---|---|
| benazepril HCl | BENAZEPRIL HCL | TABLET | Y | |||
| benazepril HCl | LOTENSIN | TABLET | Y | |||
| candesartan cilexetil | ATACAND | TABLET | Y | |||
| candesartan cilexetil | CANDESARTAN CILEXETIL | TABLET | Y | |||
| enalapril maleate | ENALAPRIL MALEATE | TABLET | Y | |||
| fosinopril sodium | FOSINOPRIL SODIUM | TABLET | Y | |||
| irbesartan | AVAPRO | TABLET | Y | |||
| irbesartan | IRBESARTAN | TABLET | Y | |||
| lisinopril | ZESTRIL | TABLET | Y | |||
| lisinopril | PRINIVIL | TABLET | Y | |||
| lisinopril | LISINOPRIL | TABLET | Y | |||
| losartan potassium | COZAAR | TABLET | Y | |||
| losartan potassium | LOSARTAN POTASSIUM | TABLET | Y | |||
| olmesartan medoxomil | OLMESARTAN MEDOXOMIL | TABLET | Y | |||
| olmesartan medoxomil | BENICAR | TABLET | Y | |||
| quinapril HCl | QUINAPRIL HCL | TABLET | Y | |||
| ramipril | RAMIPRIL | CAPSULE | Y | |||
| telmisartan | TELMISARTAN | TABLET | Y | |||
| valsartan | VALSARTAN | TABLET | Y | |||
| valsartan | DIOVAN | TABLET | Y | |||
| aliskiren hemifumarate | ALISKIREN | TABLET | N | |||
| aliskiren hemifumarate | TEKTURNA | TABLET | N | |||
| azilsartan medoxomil | EDARBI | TABLET | N | |||
| azilsartan medoxomil | AZILSARTAN MEDOXOMIL | TABLET | N | |||
| captopril | CAPTOPRIL | TABLET | N | |||
| enalapril maleate | ENALAPRIL MALEATE | SOLUTION | N | |||
| enalapril maleate | EPANED | SOLUTION | N | |||
| eprosartan mesylate | TEVETEN | TABLET | N | |||
| lisinopril | QBRELIS | SOLUTION | N | |||
| losartan potassium | ARBLI | ORAL SUSP | N | |||
| moexipril HCl | MOEXIPRIL HCL | TABLET | N | |||
| perindopril erbumine | PERINDOPRIL ERBUMINE | TABLET | N | |||
| sacubitril/valsartan | ENTRESTO SPRINKLE | PEL DSP CP | N | Pharmacy PA | ||
| sacubitril/valsartan | SACUBITRIL-VALSARTAN | TABLET | N | Pharmacy PA | ||
| sacubitril/valsartan | ENTRESTO | TABLET | N | Pharmacy PA | Sep 24, 2015 | |
| trandolapril | TRANDOLAPRIL | TABLET | N | |||
| valsartan | VALSARTAN | SOLUTION |