Inhibitors of the Renin-Angiotensin-Aldosterone System (RAAS)
PDL Reference Documents
- Inhibitors of the Renin-Angiotensin-Aldosterone System (RAAS) - Feb 03, 2022
- Heart Failure - Jun 03, 2021
- ACE-Is, ARBs, DRI, and Sacubitril-Valsartan Scan - May 25, 2017
- ACE-Is, ARBs and DRIs DERP Scan Summary - Jan 29, 2015
- ACEI/ARB/DRI Scan Summary - Jan 30, 2014
- ACEI Derp Scan - Jan 30, 2014
- Class Update: ACEIs, ARBs, DRIs - Jan 26, 2012
Drug Use Review Documents
Newsletters
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 | New Drug Evaluation |
---|---|---|---|---|---|
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 | ||
enalapril maleate | VASOTEC | TABLET | Y | ||
fosinopril sodium | FOSINOPRIL SODIUM | TABLET | Y | ||
irbesartan | AVAPRO | TABLET | Y | ||
irbesartan | IRBESARTAN | TABLET | Y | ||
lisinopril | ZESTRIL | TABLET | Y | ||
lisinopril | LISINOPRIL | TABLET | Y | ||
lisinopril | PRINIVIL | TABLET | Y | ||
losartan potassium | COZAAR | TABLET | Y | ||
losartan potassium | LOSARTAN POTASSIUM | TABLET | Y | ||
olmesartan medoxomil | BENICAR | TABLET | Y | ||
olmesartan medoxomil | OLMESARTAN MEDOXOMIL | TABLET | Y | ||
quinapril HCl | ACCUPRIL | TABLET | Y | ||
quinapril HCl | QUINAPRIL HCL | TABLET | Y | ||
ramipril | ALTACE | CAPSULE | Y | ||
ramipril | RAMIPRIL | CAPSULE | Y | ||
telmisartan | MICARDIS | TABLET | Y | ||
telmisartan | TELMISARTAN | TABLET | Y | ||
valsartan | VALSARTAN | TABLET | Y | ||
valsartan | DIOVAN | TABLET | Y | ||
aliskiren hemifumarate | TEKTURNA | TABLET | N | ||
aliskiren hemifumarate | ALISKIREN | TABLET | N | ||
azilsartan medoxomil | EDARBI | TABLET | N | ||
captopril | CAPTOPRIL | TABLET | N | ||
enalapril maleate | EPANED | SOLUTION | N | ||
enalapril maleate | ENALAPRIL MALEATE | SOLUTION | N | ||
eprosartan mesylate | TEVETEN | TABLET | N | ||
lisinopril | QBRELIS | SOLUTION | N | ||
moexipril HCl | MOEXIPRIL HCL | TABLET | N | ||
perindopril erbumine | PERINDOPRIL ERBUMINE | TABLET | N | ||
sacubitril/valsartan | ENTRESTO | TABLET | N | PA Document | Sep 24, 2015 |
trandolapril | TRANDOLAPRIL | TABLET | N |