Antianginals

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PDL Reference Documents

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.

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NDC Brand Name Generic Name Form Strength PDL
Status		 Rebate Carveout
‐ Bill FFS		 Current Drug Use Criteria
24338001009 BIDIL isosorbide dinit/hydralazine TABLET 20 mg-37.5 mg N Y N  
50742024690 ISOSORBIDE DINIT-HYDRALAZINE isosorbide dinit/hydralazine TABLET 20 mg-37.5 mg N Y N  
52536000609 ISOSORBIDE DINIT-HYDRALAZINE isosorbide dinit/hydralazine TABLET 20 mg-37.5 mg N Y N  
72319001203 ISOSORBIDE DINIT-HYDRALAZINE isosorbide dinit/hydralazine TABLET 20 mg-37.5 mg N Y N  
00143176510 ISOSORBIDE DINITRATE isosorbide dinitrate TAB SUBL 2.5 mg N Y N  
00143177101 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 10 mg Y Y N  
00143177110 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 10 mg Y Y N  
00781155601 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 10 mg Y Y N  
00781155610 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 10 mg Y Y N  
00904661961 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 10 mg Y Y N  
16714000801 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 10 mg Y Y N  
49884002101 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 10 mg Y Y N  
49884002110 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 10 mg Y Y N  
50268044811 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 10 mg Y Y N  
50268044815 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 10 mg Y Y N  
51079002923 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 10 mg Y Y N  
63739056910 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 10 mg Y Y N  
68001037400 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 10 mg Y Y N  
68084008201 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 10 mg Y Y N  
68084008211 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 10 mg Y Y N  
70710114901 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 10 mg Y Y N  
72888008200 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 10 mg Y Y N  
72888008201 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 10 mg Y Y N  
00143177201 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 20 mg Y Y N  
00143177210 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 20 mg Y Y N  
00781169501 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 20 mg Y Y N  
00781169510 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 20 mg Y Y N  
00904662061 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 20 mg Y Y N  
16714000901 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 20 mg Y Y N  
49884002201 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 20 mg Y Y N  
49884002210 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 20 mg Y Y N  
50268044911 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 20 mg Y Y N  
50268044915 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 20 mg Y Y N  
68001037500 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 20 mg Y Y N  
68084008301 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 20 mg Y Y N  
68084008311 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 20 mg Y Y N  
70710115001 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 20 mg Y Y N  
72888008300 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 20 mg Y Y N  
72888008301 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 20 mg Y Y N  
16714001001 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 30 mg Y Y N  
49884000901 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 30 mg Y Y N  
49884000910 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 30 mg Y Y N  
68001056200 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 30 mg Y Y N  
70710115101 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 30 mg Y Y N  
72888008400 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 30 mg Y Y N  
72888008401 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 30 mg Y Y N  
70710115201 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 40 mg Y Y N  
72888008501 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 40 mg Y Y N  
00143176901 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 5 mg Y Y N  
00143176910 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 5 mg Y Y N  
00781163501 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 5 mg Y Y N  
00781163510 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 5 mg Y Y N  
16714000701 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 5 mg Y Y N  
49884002001 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 5 mg Y Y N  
49884002010 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 5 mg Y Y N  
50268044711 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 5 mg Y Y N  
50268044715 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 5 mg Y Y N  
68001037300 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 5 mg Y Y N  
70710114801 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 5 mg Y Y N  
72888008100 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 5 mg Y Y N  
72888008101 ISOSORBIDE DINITRATE isosorbide dinitrate TABLET 5 mg Y Y N  
13668010601 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 120 mg N Y N  
23155062801 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 120 mg N Y N  
42799096001 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 120 mg N Y N  
50742017701 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 120 mg N Y N  
59651054101 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 120 mg N Y N  
62135058890 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 120 mg N Y N  
62175012886 ISOSORBIDE MONONITRATE isosorbide mononitrate TAB ER 24H 30 mg N Y N  
00904644961 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 30 mg N Y N  
13668010401 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 30 mg N Y N  
13668010410 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 30 mg N Y N  
23155051901 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 30 mg N Y N  
23155051905 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 30 mg N Y N  
42799095801 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 30 mg N Y N  
42799095802 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 30 mg N Y N  
50742017501 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 30 mg N Y N  
50742017505 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 30 mg N Y N  
59651053901 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 30 mg N Y N  
59651053905 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 30 mg N Y N  
60687078301 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 30 mg N Y N  
60687078311 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 30 mg N Y N  
62135058690 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 30 mg N Y N  
62175011986 ISOSORBIDE MONONITRATE isosorbide mononitrate TAB ER 24H 60 mg N Y N  
00904645061 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 60 mg N Y N  
13668010501 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 60 mg N Y N  
13668010510 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 60 mg N Y N  
23155017801 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 60 mg N Y N  
23155017805 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 60 mg N Y N  
42799095901 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 60 mg N Y N  
42799095902 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 60 mg N Y N  
50742017601 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 60 mg N Y N  
50742017605 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 60 mg N Y N  
59651054001 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 60 mg N Y N  
59651054005 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 60 mg N Y N  
60687079401 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 60 mg N Y N  
60687079411 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 60 mg N Y N  
62135058790 ISOSORBIDE MONONITRATE ER isosorbide mononitrate TAB ER 24H 60 mg N Y N  
00228263111 ISOSORBIDE MONONITRATE isosorbide mononitrate TABLET 10 mg Y Y N  
81665010210 ISOSORBIDE MONONITRATE isosorbide mononitrate TABLET 10 mg Y Y N  
00228262011 ISOSORBIDE MONONITRATE isosorbide mononitrate TABLET 20 mg Y Y N  
81665010310 ISOSORBIDE MONONITRATE isosorbide mononitrate TABLET 20 mg Y Y N  
00713056431 NITROGLYCERIN nitroglycerin OINT. (G) 0.4 % (w/w) Y N  
21922004805 NITROGLYCERIN nitroglycerin OINT. (G) 0.4 % (w/w) Y N  
52817083530 NITROGLYCERIN nitroglycerin OINT. (G) 0.4 % (w/w) Y N  
00281032608 NITRO-BID nitroglycerin OINT. (G) 2 % N Y N  
00281032630 NITRO-BID nitroglycerin OINT. (G) 2 % N Y N  
00281032660 NITRO-BID nitroglycerin OINT. (G) 2 % N Y N  
21922005405 NITROGLYCERIN nitroglycerin OINT. (G) 2 % N Y N  
21922005447 NITROGLYCERIN nitroglycerin OINT. (G) 2 % N Y N  
21922005459 NITROGLYCERIN nitroglycerin OINT. (G) 2 % N Y N  
50742051301 NITRO-DUR nitroglycerin PATCH TD24 0.1 mg/hour Y Y N  
50742051330 NITRO-DUR nitroglycerin PATCH TD24 0.1 mg/hour Y Y N  
00378910216 NITROGLYCERIN PATCH nitroglycerin PATCH TD24 0.1 mg/hour Y Y N  
00378910293 NITROGLYCERIN PATCH nitroglycerin PATCH TD24 0.1 mg/hour Y Y N  
43598089630 NITROGLYCERIN PATCH nitroglycerin PATCH TD24 0.1 mg/hour Y Y N  
50742051401 NITRO-DUR nitroglycerin PATCH TD24 0.2 mg/hour Y Y N  
50742051430 NITRO-DUR nitroglycerin PATCH TD24 0.2 mg/hour Y Y N  
00378910416 NITROGLYCERIN PATCH nitroglycerin PATCH TD24 0.2 mg/hour Y Y N  
00378910493 NITROGLYCERIN PATCH nitroglycerin PATCH TD24 0.2 mg/hour Y Y N  
43598089511 NITROGLYCERIN PATCH nitroglycerin PATCH TD24 0.2 mg/hour Y Y N  
43598089530 NITROGLYCERIN PATCH nitroglycerin PATCH TD24 0.2 mg/hour Y Y N  
50742051501 NITRO-DUR nitroglycerin PATCH TD24 0.3 mg/hour Y Y N  
50742051530 NITRO-DUR nitroglycerin PATCH TD24 0.3 mg/hour Y Y N  
50742051601 NITRO-DUR nitroglycerin PATCH TD24 0.4 mg/hour Y Y N  
50742051630 NITRO-DUR nitroglycerin PATCH TD24 0.4 mg/hour Y Y N  
00378911216 NITROGLYCERIN PATCH nitroglycerin PATCH TD24 0.4 mg/hour Y Y N  
00378911293 NITROGLYCERIN PATCH nitroglycerin PATCH TD24 0.4 mg/hour Y Y N  
43598089411 NITROGLYCERIN PATCH nitroglycerin PATCH TD24 0.4 mg/hour Y Y N  
43598089430 NITROGLYCERIN PATCH nitroglycerin PATCH TD24 0.4 mg/hour Y Y N  
50742051701 NITRO-DUR nitroglycerin PATCH TD24 0.6 mg/hour Y Y N  
50742051730 NITRO-DUR nitroglycerin PATCH TD24 0.6 mg/hour Y Y N  
00378911616 NITROGLYCERIN PATCH nitroglycerin PATCH TD24 0.6 mg/hour Y Y N  
00378911693 NITROGLYCERIN PATCH nitroglycerin PATCH TD24 0.6 mg/hour Y Y N  
43598089330 NITROGLYCERIN PATCH nitroglycerin PATCH TD24 0.6 mg/hour Y Y N  
50742051801 NITRO-DUR nitroglycerin PATCH TD24 0.8 mg/hour Y Y N  
50742051830 NITRO-DUR nitroglycerin PATCH TD24 0.8 mg/hour Y Y N  
28595070501 GONITRO nitroglycerin POWD PACK 400 mcg N Y N  
28595070536 GONITRO nitroglycerin POWD PACK 400 mcg N Y N  
28595012012 NITROGLYCERIN nitroglycerin SPRAY 400 mcg/spray N Y N  
28595012049 NITROGLYCERIN nitroglycerin SPRAY 400 mcg/spray N Y N  
45802021001 NITROGLYCERIN nitroglycerin SPRAY 400 mcg/spray N Y N  
45802021002 NITROGLYCERIN nitroglycerin SPRAY 400 mcg/spray N Y N  
66993024141 NITROGLYCERIN nitroglycerin SPRAY 400 mcg/spray N Y N  
66993024150 NITROGLYCERIN nitroglycerin SPRAY 400 mcg/spray N Y N  
21724010041 NITROLINGUAL nitroglycerin SPRAY 400 mcg/spray N Y N  
21724010050 NITROLINGUAL nitroglycerin SPRAY 400 mcg/spray N Y N  
28595055012 NITROLINGUAL nitroglycerin SPRAY 400 mcg/spray N Y N  
28595055049 NITROLINGUAL nitroglycerin SPRAY 400 mcg/spray N Y N  
43547098510 NITROGLYCERIN nitroglycerin TAB SUBL 0.3 mg Y Y N  
43598043501 NITROGLYCERIN nitroglycerin TAB SUBL 0.3 mg Y Y N  
59651065700 NITROGLYCERIN nitroglycerin TAB SUBL 0.3 mg Y Y N  
59762492101 NITROGLYCERIN nitroglycerin TAB SUBL 0.3 mg Y Y N  
68462063801 NITROGLYCERIN nitroglycerin TAB SUBL 0.3 mg Y Y N  
69339017301 NITROGLYCERIN nitroglycerin TAB SUBL 0.3 mg Y Y N  
70756001311 NITROGLYCERIN nitroglycerin TAB SUBL 0.3 mg Y Y N  
72888013801 NITROGLYCERIN nitroglycerin TAB SUBL 0.3 mg Y Y N  
00071041724 NITROSTAT nitroglycerin TAB SUBL 0.3 mg Y Y N  
58151030901 NITROSTAT nitroglycerin TAB SUBL 0.3 mg Y Y N  
43547098604 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
43547098610 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
43598043601 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
43598043611 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
43598043635 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
59651065800 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
59651065804 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
59651065825 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
59762330401 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
59762330403 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
68462063901 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
68462063925 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
68462063945 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
69339017401 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
69339017402 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
69339017441 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
70756001402 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
70756001405 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
70756001411 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
72603026601 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
72603026604 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
72888013901 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
72888013932 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
72888013933 NITROGLYCERIN nitroglycerin TAB SUBL 0.4 mg Y Y N  
58151031001 NITROSTAT nitroglycerin TAB SUBL 0.4 mg Y Y N  
58151031052 NITROSTAT nitroglycerin TAB SUBL 0.4 mg Y Y N  
58151031094 NITROSTAT nitroglycerin TAB SUBL 0.4 mg Y Y N  
43547098710 NITROGLYCERIN nitroglycerin TAB SUBL 0.6 mg Y Y N  
43598043701 NITROGLYCERIN nitroglycerin TAB SUBL 0.6 mg Y Y N  
59651065900 NITROGLYCERIN nitroglycerin TAB SUBL 0.6 mg Y Y N  
59762048901 NITROGLYCERIN nitroglycerin TAB SUBL 0.6 mg Y Y N  
68462064001 NITROGLYCERIN nitroglycerin TAB SUBL 0.6 mg Y Y N  
69339017501 NITROGLYCERIN nitroglycerin TAB SUBL 0.6 mg Y Y N  
70756001611 NITROGLYCERIN nitroglycerin TAB SUBL 0.6 mg Y Y N  
72888014001 NITROGLYCERIN nitroglycerin TAB SUBL 0.6 mg Y Y N  
58151031101 NITROSTAT nitroglycerin TAB SUBL 0.6 mg Y Y N  
27241012602 RANOLAZINE ER ranolazine TAB ER 12H 1,000 mg N Y N  
27241012605 RANOLAZINE ER ranolazine TAB ER 12H 1,000 mg N Y N  
29300029716 RANOLAZINE ER ranolazine TAB ER 12H 1,000 mg N Y N  
31722066960 RANOLAZINE ER ranolazine TAB ER 12H 1,000 mg N Y N  
42385096460 RANOLAZINE ER ranolazine TAB ER 12H 1,000 mg N Y N  
42571032560 RANOLAZINE ER ranolazine TAB ER 12H 1,000 mg N Y N  
45963041906 RANOLAZINE ER ranolazine TAB ER 12H 1,000 mg N Y N  
50228042460 RANOLAZINE ER ranolazine TAB ER 12H 1,000 mg N Y N  
50268072311 RANOLAZINE ER ranolazine TAB ER 12H 1,000 mg N Y N  
50268072313 RANOLAZINE ER ranolazine TAB ER 12H 1,000 mg N Y N  
59651001060 RANOLAZINE ER ranolazine TAB ER 12H 1,000 mg N Y N  
63304001860 RANOLAZINE ER ranolazine TAB ER 12H 1,000 mg N Y N  
67877052660 RANOLAZINE ER ranolazine TAB ER 12H 1,000 mg N Y N  
68462032060 RANOLAZINE ER ranolazine TAB ER 12H 1,000 mg N Y N  
69367029460 RANOLAZINE ER ranolazine TAB ER 12H 1,000 mg N Y N  
70756070460 RANOLAZINE ER ranolazine TAB ER 12H 1,000 mg N Y N  
72319002202 RANOLAZINE ER ranolazine TAB ER 12H 1,000 mg N Y N  
72578006514 RANOLAZINE ER ranolazine TAB ER 12H 1,000 mg N Y N  
00904750604 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
27241012502 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
27241012505 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
29300029616 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
31722066860 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
42385096360 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
42571032460 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
50228042360 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
50268072211 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
50268072215 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
59651000960 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
60687054911 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
60687054921 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
63304001760 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
63739022901 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
67877052560 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
68462031960 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
69367029360 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
70756070360 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
72319002102 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
72578006414 RANOLAZINE ER ranolazine TAB ER 12H 500 mg N Y N  
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