Other Dyslipidemia Drugs
PDL Reference Documents
- Bempedoic Acid Indication Update - Dec 07, 2023
- PCSK9 Modulators - Aug 04, 2022
- Non-Statin Dyslipidemia Drugs - Aug 05, 2021
- Non-statin Dyslipidemia Drugs - Aug 06, 2020
- Non-statin Lipid Lowering Agents - May 23, 2019
- PCSK9 Inhibitors - Jan 25, 2018
- Non-statin Lipid-lowering Agents - Nov 17, 2016
- PCSK9 Inhibitors - Nov 19, 2015
- Other Lipotropics - Sep 23, 2014
- Omega-3 Fatty Acids Prior Authorization Criteria - Mar 27, 2014
- Fish Oil Class Review - Jan 30, 2014
- Class Update: Other Lipid Lowering Agents - Sep 26, 2013
- Abbreviated Class Review: Non-Statin Lipid Lowering Agents - May 31, 2012
Drug Use Review Documents
Newsletters
- August 2022 - An Update in Lipid Lowering Therapies
- March 2019 - Non-statin Low-Density Lipoprotein Cholesterol (LDL-C) Lowering Therapy and Cardiovascular Outcomes
- May 2014 - New Cholesterol Guidelines: A Significant Shift in Cholesterol Management
- March 2014 - Evidence Based Review of Fish Oil: Going Beyond the Headlines
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.
| NDC | Brand Name | Generic Name | Form | Strength | PDL Status |
Rebate | Current Drug Use Criteria |
|---|---|---|---|---|---|---|---|
| 61755002101 | PRALUENT PEN | alirocumab | PEN INJCTR | 150 mg/mL | N | Y | PA Document |
| 61755002102 | PRALUENT PEN | alirocumab | PEN INJCTR | 150 mg/mL | N | Y | PA Document |
| 61755002000 | PRALUENT PEN | alirocumab | PEN INJCTR | 75 mg/mL | N | Y | PA Document |
| 61755002001 | PRALUENT PEN | alirocumab | PEN INJCTR | 75 mg/mL | N | Y | PA Document |
| 61755002002 | PRALUENT PEN | alirocumab | PEN INJCTR | 75 mg/mL | N | Y | PA Document |
| 72426011803 | NEXLETOL | bempedoic acid | TABLET | 180 mg | N | Y | PA Document |
| 72426081803 | NEXLIZET | bempedoic acid/ezetimibe | TABLET | 180 mg-10 mg | N | Y | PA Document |
| 24658027095 | CHOLESTYRAMINE LIGHT | cholestyramine | POWD PACK | 4 gram | Y | Y | |
| 42806026998 | CHOLESTYRAMINE LIGHT | cholestyramine | POWD PACK | 4 gram | Y | Y | |
| 42806027095 | CHOLESTYRAMINE LIGHT | cholestyramine | POWD PACK | 4 gram | Y | Y | |
| 42806027098 | CHOLESTYRAMINE LIGHT | cholestyramine | POWD PACK | 4 gram | Y | Y | |
| 49884046663 | CHOLESTYRAMINE LIGHT | cholestyramine | POWD PACK | 4 gram | Y | Y | |
| 49884046665 | CHOLESTYRAMINE LIGHT | cholestyramine | POWD PACK | 4 gram | Y | Y | |
| 67877042257 | CHOLESTYRAMINE LIGHT | cholestyramine | POWD PACK | 4 gram | Y | Y | |
| 67877042260 | CHOLESTYRAMINE LIGHT | cholestyramine | POWD PACK | 4 gram | Y | Y | |
| 68094090620 | CHOLESTYRAMINE LIGHT | cholestyramine | POWD PACK | 4 gram | Y | Y | |
| 68382052960 | CHOLESTYRAMINE LIGHT | cholestyramine | POWD PACK | 4 gram | Y | Y | |
| 00245003642 | PREVALITE | cholestyramine | POWD PACK | 4 gram | Y | Y | |
| 00245003660 | PREVALITE | cholestyramine | POWD PACK | 4 gram | Y | Y | |
| 00245003689 | PREVALITE | cholestyramine | POWD PACK | 4 gram | Y | Y | |
| 24658027197 | CHOLESTYRAMINE LIGHT | cholestyramine | POWDER | 4 gram | Y | Y | |
| 42806027193 | CHOLESTYRAMINE LIGHT | cholestyramine | POWDER | 4 gram | Y | Y | |
| 42806027197 | CHOLESTYRAMINE LIGHT | cholestyramine | POWDER | 4 gram | Y | Y | |
| 49884046667 | CHOLESTYRAMINE LIGHT | cholestyramine | POWDER | 4 gram | Y | Y | |
| 62135093754 | CHOLESTYRAMINE LIGHT | cholestyramine | POWDER | 4 gram | Y | Y | |
| 68094090610 | CHOLESTYRAMINE LIGHT | cholestyramine | POWDER | 4 gram | Y | Y | |
| 68382052942 | CHOLESTYRAMINE LIGHT | cholestyramine | POWDER | 4 gram | Y | Y | |
| 00245003623 | PREVALITE | cholestyramine | POWDER | 4 gram | Y | Y | |
| 49884093767 | QUESTRAN LIGHT | cholestyramine | POWDER | 4 gram | Y | Y | |
| 24658026695 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWD PACK | 4 gram | Y | Y | |
| 27241013421 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWD PACK | 4 gram | Y | Y | |
| 27241013436 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWD PACK | 4 gram | Y | Y | |
| 42806026598 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWD PACK | 4 gram | Y | Y | |
| 42806026695 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWD PACK | 4 gram | Y | Y | |
| 42806026698 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWD PACK | 4 gram | Y | Y | |
| 49884046564 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWD PACK | 4 gram | Y | Y | |
| 49884046565 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWD PACK | 4 gram | Y | Y | |
| 67877029809 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWD PACK | 4 gram | Y | Y | |
| 67877029860 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWD PACK | 4 gram | Y | Y | |
| 68094080620 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWD PACK | 4 gram | Y | Y | |
| 68382052860 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWD PACK | 4 gram | Y | Y | |
| 49884093664 | QUESTRAN | cholestyramine (with sugar) | POWD PACK | 4 gram | Y | Y | |
| 49884093665 | QUESTRAN | cholestyramine (with sugar) | POWD PACK | 4 gram | Y | Y | |
| 24658026693 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWDER | 4 gram | Y | Y | |
| 24658026697 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWDER | 4 gram | Y | Y | |
| 27241013451 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWDER | 4 gram | Y | Y | |
| 42806026793 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWDER | 4 gram | Y | Y | |
| 42806026797 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWDER | 4 gram | Y | Y | |
| 49884046566 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWDER | 4 gram | Y | Y | |
| 62135000856 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWDER | 4 gram | Y | Y | |
| 62559062037 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWDER | 4 gram | Y | Y | |
| 67877029837 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWDER | 4 gram | Y | Y | |
| 68094080610 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWDER | 4 gram | Y | Y | |
| 68382052842 | CHOLESTYRAMINE | cholestyramine (with sugar) | POWDER | 4 gram | Y | Y | |
| 49884093666 | QUESTRAN | cholestyramine (with sugar) | POWDER | 4 gram | Y | Y | |
| 67877042224 | CHOLESTYRAMINE LIGHT | cholestyramine/aspartame | POWDER | 4 gram | Y | Y | |
| 00904419160 | CHOLINE | choline | TABLET | 650 mg | N | Y | |
| 00115186430 | COLESEVELAM HCL | colesevelam HCl | POWD PACK | 3.75 gram | N | Y | |
| 00713093530 | COLESEVELAM HCL | colesevelam HCl | POWD PACK | 3.75 gram | N | Y | |
| 51660099530 | COLESEVELAM HCL | colesevelam HCl | POWD PACK | 3.75 gram | N | Y | |
| 67877052330 | COLESEVELAM HCL | colesevelam HCl | POWD PACK | 3.75 gram | N | Y | |
| 68462062030 | COLESEVELAM HCL | colesevelam HCl | POWD PACK | 3.75 gram | N | Y | |
| 00713088030 | WELCHOL | colesevelam HCl | POWD PACK | 3.75 gram | N | Y | |
| 00115132019 | COLESEVELAM HCL | colesevelam HCl | TABLET | 625 mg | N | Y | |
| 00713093681 | COLESEVELAM HCL | colesevelam HCl | TABLET | 625 mg | N | Y | |
| 27808019001 | COLESEVELAM HCL | colesevelam HCl | TABLET | 625 mg | N | Y | |
| 43598023018 | COLESEVELAM HCL | colesevelam HCl | TABLET | 625 mg | N | Y | |
| 60687038525 | COLESEVELAM HCL | colesevelam HCl | TABLET | 625 mg | N | Y | |
| 60687038595 | COLESEVELAM HCL | colesevelam HCl | TABLET | 625 mg | N | Y | |
| 67877050651 | COLESEVELAM HCL | colesevelam HCl | TABLET | 625 mg | N | Y | |
| 68382061928 | COLESEVELAM HCL | colesevelam HCl | TABLET | 625 mg | N | Y | |
| 68462043318 | COLESEVELAM HCL | colesevelam HCl | TABLET | 625 mg | N | Y | |
| 69452015825 | COLESEVELAM HCL | colesevelam HCl | TABLET | 625 mg | N | Y | |
| 00713087981 | WELCHOL | colesevelam HCl | TABLET | 625 mg | N | Y | |
| 65597070118 | WELCHOL | colesevelam HCl | TABLET | 625 mg | N | Y | |
| 00009026002 | COLESTID | colestipol HCl | GRANULES | 5 gram | N | Y | |
| 00009026017 | COLESTID | colestipol HCl | GRANULES | 5 gram | N | Y | |
| 59762026003 | COLESTIPOL HCL | colestipol HCl | GRANULES | 5 gram | N | Y | |
| 59762026001 | COLESTIPOL HCL | colestipol HCl | PACKET | 5 gram | N | Y | |
| 59762026002 | COLESTIPOL HCL | colestipol HCl | PACKET | 5 gram | N | Y | |
| 00009045003 | COLESTID | colestipol HCl | TABLET | 1 gram | N | Y | |
| 00115521116 | COLESTIPOL HCL | colestipol HCl | TABLET | 1 gram | N | Y | |
| 42799011501 | COLESTIPOL HCL | colestipol HCl | TABLET | 1 gram | N | Y | |
| 59762045001 | COLESTIPOL HCL | colestipol HCl | TABLET | 1 gram | N | Y | |
| 60687071511 | COLESTIPOL HCL | colestipol HCl | TABLET | 1 gram | N | Y | |
| 60687071521 | COLESTIPOL HCL | colestipol HCl | TABLET | 1 gram | N | Y | |
| 62559039512 | COLESTIPOL HCL | colestipol HCl | TABLET | 1 gram | N | Y | |
| 70710146707 | COLESTIPOL HCL | colestipol HCl | TABLET | 1 gram | N | Y | |
| 61755001001 | EVKEEZA | evinacumab-dgnb | VIAL | 1,200 mg/8 mL (150 mg/mL) | N | Y | PA Document |
| 61755001301 | EVKEEZA | evinacumab-dgnb | VIAL | 345 mg/2.3 mL (150 mg/mL) | N | Y | PA Document |
| 55513076091 | REPATHA SURECLICK | evolocumab | PEN INJCTR | 140 mg/mL | Y | Y | PA Document |
| 72511039301 | REPATHA SURECLICK | evolocumab | PEN INJCTR | 140 mg/mL | Y | Y | PA Document |
| 72511039302 | REPATHA SURECLICK | evolocumab | PEN INJCTR | 140 mg/mL | Y | Y | PA Document |
| 72511076001 | REPATHA SURECLICK | evolocumab | PEN INJCTR | 140 mg/mL | Y | Y | PA Document |
| 72511076002 | REPATHA SURECLICK | evolocumab | PEN INJCTR | 140 mg/mL | Y | Y | PA Document |
| 72511050101 | REPATHA SYRINGE | evolocumab | SYRINGE | 140 mg/mL | Y | Y | PA Document |
| 72511075001 | REPATHA SYRINGE | evolocumab | SYRINGE | 140 mg/mL | Y | Y | PA Document |
| 55513077091 | REPATHA PUSHTRONEX | evolocumab | WEAR INJCT | 420 mg/3.5 mL | Y | Y | PA Document |
| 72511077001 | REPATHA PUSHTRONEX | evolocumab | WEAR INJCT | 420 mg/3.5 mL | Y | Y | PA Document |
| 00591371305 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 00591371319 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 00591371330 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 00904710304 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 00904710310 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 16714081301 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 16714081302 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 16714081303 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 16729043310 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 31722062805 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 31722062830 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 31722062890 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 50228037905 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 50228037930 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 50228037990 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 50268029811 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 50268029812 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 51660020005 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 51660020030 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 51660020090 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 59651005205 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 59651005230 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 59651005290 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 60687037311 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 60687037321 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 67877049005 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 67877049030 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 67877049090 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 68382077305 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 68382077306 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 68382077316 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 68462022605 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 68462022630 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 68462022690 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 69238115403 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 69238115409 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 82009002405 | EZETIMIBE | ezetimibe | TABLET | 10 mg | Y | Y | |
| 78206017801 | ZETIA | ezetimibe | TABLET | 10 mg | Y | Y | |
| 62559046190 | FENOFIBRATE | fenofibrate | CAPSULE | 150 mg | N | Y | |
| 62559030690 | LIPOFEN | fenofibrate | CAPSULE | 150 mg | N | Y | |
| 62559046090 | FENOFIBRATE | fenofibrate | CAPSULE | 50 mg | N | Y | |
| 62559030590 | LIPOFEN | fenofibrate | CAPSULE | 50 mg | N | Y | |
| 00115152310 | FENOFIBRATE | fenofibrate | TABLET | 120 mg | N | Y | |
| 00378439177 | FENOFIBRATE | fenofibrate | TABLET | 120 mg | N | Y | |
| 00115552202 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 00115552210 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 00904712804 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 27241011703 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 27241011705 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 42858066045 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 50268031311 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 50268031315 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 59651057690 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 60219552205 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 60219552209 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 60687086411 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 60687086421 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 62135083890 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 62332055590 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 62332055591 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 63304090190 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 68180023209 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 69315029005 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 69315029009 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 69367025405 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 69367025409 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 70756021551 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 70756021590 | FENOFIBRATE | fenofibrate | TABLET | 160 mg | Y | Y | |
| 00115152210 | FENOFIBRATE | fenofibrate | TABLET | 40 mg | N | Y | |
| 00378439077 | FENOFIBRATE | fenofibrate | TABLET | 40 mg | N | Y | |
| 00115551110 | FENOFIBRATE | fenofibrate | TABLET | 54 mg | Y | Y | |
| 27241011603 | FENOFIBRATE | fenofibrate | TABLET | 54 mg | Y | Y | |
| 42858045445 | FENOFIBRATE | fenofibrate | TABLET | 54 mg | Y | Y | |
| 50268031211 | FENOFIBRATE | fenofibrate | TABLET | 54 mg | Y | Y | |
| 50268031215 | FENOFIBRATE | fenofibrate | TABLET | 54 mg | Y | Y | |
| 59651057590 | FENOFIBRATE | fenofibrate | TABLET | 54 mg | Y | Y | |
| 60219551109 | FENOFIBRATE | fenofibrate | TABLET | 54 mg | Y | Y | |
| 60687085311 | FENOFIBRATE | fenofibrate | TABLET | 54 mg | Y | Y | |
| 60687085321 | FENOFIBRATE | fenofibrate | TABLET | 54 mg | Y | Y | |
| 62135083790 | FENOFIBRATE | fenofibrate | TABLET | 54 mg | Y | Y | |
| 62332055490 | FENOFIBRATE | fenofibrate | TABLET | 54 mg | Y | Y | |
| 63304090090 | FENOFIBRATE | fenofibrate | TABLET | 54 mg | Y | Y | |
| 68180023109 | FENOFIBRATE | fenofibrate | TABLET | 54 mg | Y | Y | |
| 69315028909 | FENOFIBRATE | fenofibrate | TABLET | 54 mg | Y | Y | |
| 69367025709 | FENOFIBRATE | fenofibrate | TABLET | 54 mg | Y | Y | |
| 70756021451 | FENOFIBRATE | fenofibrate | TABLET | 54 mg | Y | Y | |
| 70756021490 | FENOFIBRATE | fenofibrate | TABLET | 54 mg | Y | Y | |
| 00378306605 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 00378306677 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 00904716104 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 00904716161 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 00904748004 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 31722059690 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 43547043109 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 51079060801 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 51079060820 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 60687062901 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 60687062911 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 60687062921 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 62332036171 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 62332036190 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 63304044905 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 63304044990 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 65862076990 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 68180038902 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 68180038909 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 69097045805 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 69315028805 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 69315028809 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 82009006090 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 00074318990 | TRICOR | fenofibrate nanocrystallized | TABLET | 145 mg | Y | Y | |
| 00378306577 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 48 mg | Y | Y | |
| 31722059590 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 48 mg | Y | Y | |
| 43547043009 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 48 mg | Y | Y | |
| 50268033811 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 48 mg | Y | Y | |
| 50268033812 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 48 mg | Y | Y | |
| 51079059901 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 48 mg | Y | Y | |
| 51079059920 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 48 mg | Y | Y | |
| 60687061811 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 48 mg | Y | Y | |
| 60687061821 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 48 mg | Y | Y | |
| 62332036071 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 48 mg | Y | Y | |
| 62332036090 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 48 mg | Y | Y | |
| 63304044805 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 48 mg | Y | Y | |
| 63304044890 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 48 mg | Y | Y | |
| 65862076890 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 48 mg | Y | Y | |
| 68180038809 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 48 mg | Y | Y | |
| 69097045905 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 48 mg | Y | Y | |
| 69315028709 | FENOFIBRATE | fenofibrate nanocrystallized | TABLET | 48 mg | Y | Y | |
| 00074317390 | TRICOR | fenofibrate nanocrystallized | TABLET | 48 mg | Y | Y | |
| 60505312103 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 130 mg | Y | Y | |
| 60505312109 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 130 mg | Y | Y | |
| 63304044430 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 130 mg | Y | Y | |
| 63304044490 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 130 mg | Y | Y | |
| 68180013106 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 130 mg | Y | Y | |
| 13668043901 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 134 mg | Y | Y | |
| 27241011904 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 134 mg | Y | Y | |
| 42858013401 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 134 mg | Y | Y | |
| 43975030510 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 134 mg | Y | Y | |
| 59651020201 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 134 mg | Y | Y | |
| 62135089490 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 134 mg | Y | Y | |
| 62332008531 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 134 mg | Y | Y | |
| 68462058101 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 134 mg | Y | Y | |
| 69367026801 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 134 mg | Y | Y | |
| 13668043801 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 200 mg | Y | Y | |
| 27241012004 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 200 mg | Y | Y | |
| 42858020001 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 200 mg | Y | Y | |
| 43975030610 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 200 mg | Y | Y | |
| 59651020301 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 200 mg | Y | Y | |
| 60687071311 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 200 mg | Y | Y | |
| 60687071321 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 200 mg | Y | Y | |
| 62135089990 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 200 mg | Y | Y | |
| 62332008631 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 200 mg | Y | Y | |
| 68462058201 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 200 mg | Y | Y | |
| 69367026901 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 200 mg | Y | Y | |
| 60505312003 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 43 mg | Y | Y | |
| 63304044330 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 43 mg | Y | Y | |
| 68180013006 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 43 mg | Y | Y | |
| 13668044001 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 67 mg | Y | Y | |
| 27241011804 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 67 mg | Y | Y | |
| 42858006701 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 67 mg | Y | Y | |
| 43975044410 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 67 mg | Y | Y | |
| 59651020101 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 67 mg | Y | Y | |
| 62135089390 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 67 mg | Y | Y | |
| 62332008431 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 67 mg | Y | Y | |
| 68462058001 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 67 mg | Y | Y | |
| 69367027001 | FENOFIBRATE | fenofibrate,micronized | CAPSULE | 67 mg | Y | Y | |
| 00115132510 | FENOFIBRIC ACID | fenofibric acid (choline) | CAPSULE DR | 135 mg | Y | Y | |
| 00115155510 | FENOFIBRIC ACID | fenofibric acid (choline) | CAPSULE DR | 135 mg | Y | Y | |
| 42385094590 | FENOFIBRIC ACID | fenofibric acid (choline) | CAPSULE DR | 135 mg | Y | Y | |
| 42571034890 | FENOFIBRIC ACID | fenofibric acid (choline) | CAPSULE DR | 135 mg | Y | Y | |
| 59651021790 | FENOFIBRIC ACID | fenofibric acid (choline) | CAPSULE DR | 135 mg | Y | Y | |
| 62332024590 | FENOFIBRIC ACID | fenofibric acid (choline) | CAPSULE DR | 135 mg | Y | Y | |
| 69315028209 | FENOFIBRIC ACID | fenofibric acid (choline) | CAPSULE DR | 135 mg | Y | Y | |
| 00115155410 | FENOFIBRIC ACID | fenofibric acid (choline) | CAPSULE DR | 45 mg | Y | Y | |
| 42385094490 | FENOFIBRIC ACID | fenofibric acid (choline) | CAPSULE DR | 45 mg | Y | Y | |
| 42571034790 | FENOFIBRIC ACID | fenofibric acid (choline) | CAPSULE DR | 45 mg | Y | Y | |
| 59651021690 | FENOFIBRIC ACID | fenofibric acid (choline) | CAPSULE DR | 45 mg | Y | Y | |
| 62332024490 | FENOFIBRIC ACID | fenofibric acid (choline) | CAPSULE DR | 45 mg | Y | Y | |
| 69315028109 | FENOFIBRIC ACID | fenofibric acid (choline) | CAPSULE DR | 45 mg | Y | Y | |
| 00074316190 | TRILIPIX | fenofibric acid (choline) | CAPSULE DR | 45 mg | Y | Y | |
| 16571078406 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 16571078450 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 16714010102 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 16714010105 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 24658026005 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 24658026018 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 24658026060 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 31722012805 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 31722012860 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 42806026005 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 42806026060 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 50268035011 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 50268035015 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 60687022401 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 60687022411 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 62135016060 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 65862062405 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 65862062460 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 69097082103 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 69097082112 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 72603020601 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 72603020602 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 76282022505 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 76282022518 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 76282022560 | GEMFIBROZIL | gemfibrozil | TABLET | 600 mg | N | Y | |
| 00071073720 | LOPID | gemfibrozil | TABLET | 600 mg | N | Y | |
| 00071073730 | LOPID | gemfibrozil | TABLET | 600 mg | N | Y | |
| 00054062127 | ICOSAPENT ETHYL | icosapent ethyl | CAPSULE | 0.5 gram | N | Y | PA Document |
| 00480012649 | ICOSAPENT ETHYL | icosapent ethyl | CAPSULE | 0.5 gram | N | Y | PA Document |
| 31722029824 | ICOSAPENT ETHYL | icosapent ethyl | CAPSULE | 0.5 gram | N | Y | PA Document |
| 43598074672 | ICOSAPENT ETHYL | icosapent ethyl | CAPSULE | 0.5 gram | N | Y | PA Document |
| 69238259707 | ICOSAPENT ETHYL | icosapent ethyl | CAPSULE | 0.5 gram | N | Y | PA Document |
| 70710173804 | ICOSAPENT ETHYL | icosapent ethyl | CAPSULE | 0.5 gram | N | Y | PA Document |
| 00054050823 | ICOSAPENT ETHYL | icosapent ethyl | CAPSULE | 1 gram | N | Y | PA Document |
| 00480012789 | ICOSAPENT ETHYL | icosapent ethyl | CAPSULE | 1 gram | N | Y | PA Document |
| 31722029912 | ICOSAPENT ETHYL | icosapent ethyl | CAPSULE | 1 gram | N | Y | PA Document |
| 42806056012 | ICOSAPENT ETHYL | icosapent ethyl | CAPSULE | 1 gram | N | Y | PA Document |
| 43598026704 | ICOSAPENT ETHYL | icosapent ethyl | CAPSULE | 1 gram | N | Y | PA Document |
| 60505403301 | ICOSAPENT ETHYL | icosapent ethyl | CAPSULE | 1 gram | N | Y | PA Document |
| 60687076411 | ICOSAPENT ETHYL | icosapent ethyl | CAPSULE | 1 gram | N | Y | PA Document |
| 60687076421 | ICOSAPENT ETHYL | icosapent ethyl | CAPSULE | 1 gram | N | Y | PA Document |
| 69238259808 | ICOSAPENT ETHYL | icosapent ethyl | CAPSULE | 1 gram | N | Y | PA Document |
| 70710159207 | ICOSAPENT ETHYL | icosapent ethyl | CAPSULE | 1 gram | N | Y | PA Document |
| 72603012901 | ICOSAPENT ETHYL | icosapent ethyl | CAPSULE | 1 gram | N | Y | PA Document |
| 00078100060 | LEQVIO | inclisiran sodium | SYRINGE | 284 mg/1.5 mL | N | Y | PA Document |
| 00078100098 | LEQVIO | inclisiran sodium | SYRINGE | 284 mg/1.5 mL | N | Y | PA Document |
| 00904419860 | INOSITOL | inositol | TABLET | N | Y | ||
| 10122041028 | JUXTAPID | lomitapide mesylate | CAPSULE | 10 mg | N | Y | |
| 76431011001 | JUXTAPID | lomitapide mesylate | CAPSULE | 10 mg | N | Y | |
| 10122042028 | JUXTAPID | lomitapide mesylate | CAPSULE | 20 mg | N | Y | |
| 76431012001 | JUXTAPID | lomitapide mesylate | CAPSULE | 20 mg | N | Y | |
| 10122043028 | JUXTAPID | lomitapide mesylate | CAPSULE | 30 mg | N | Y | |
| 10122040528 | JUXTAPID | lomitapide mesylate | CAPSULE | 5 mg | N | Y | |
| 76431010501 | JUXTAPID | lomitapide mesylate | CAPSULE | 5 mg | N | Y | |
| 00904063360 | NIACIN | niacin | CAPSULE ER | 125 mg | N | Y | |
| 50111019401 | NIACIN | niacin | CAPSULE ER | 125 mg | N | Y | |
| 50111019403 | NIACIN | niacin | CAPSULE ER | 125 mg | N | Y | |
| 50111019601 | NIACIN | niacin | CAPSULE ER | 125 mg | N | Y | |
| 50111019603 | NIACIN | niacin | CAPSULE ER | 125 mg | N | Y | |
| 00904062970 | NIACIN | niacin | CAPSULE ER | 250 mg | N | Y | |
| 00904062980 | NIACIN | niacin | CAPSULE ER | 250 mg | N | Y | |
| 50111019901 | NIACIN | niacin | CAPSULE ER | 250 mg | N | Y | |
| 50111019903 | NIACIN | niacin | CAPSULE ER | 250 mg | N | Y | |
| 00904063060 | NIACIN | niacin | CAPSULE ER | 400 mg | N | Y | |
| 50111020201 | NIACIN | niacin | CAPSULE ER | 400 mg | N | Y | |
| 00904063180 | NIACIN | niacin | CAPSULE ER | 500 mg | N | Y | |
| 49483001801 | NIACIN | niacin | CAPSULE ER | 500 mg | N | Y | |
| 00093739486 | NIACIN ER | niacin | TAB ER 24H | 1,000 mg | N | Y | |
| 00093739498 | NIACIN ER | niacin | TAB ER 24H | 1,000 mg | N | Y | |
| 33342018910 | NIACIN ER | niacin | TAB ER 24H | 1,000 mg | N | Y | |
| 47335061381 | NIACIN ER | niacin | TAB ER 24H | 1,000 mg | N | Y | |
| 59651002018 | NIACIN ER | niacin | TAB ER 24H | 1,000 mg | N | Y | |
| 59651002090 | NIACIN ER | niacin | TAB ER 24H | 1,000 mg | N | Y | |
| 62135049890 | NIACIN ER | niacin | TAB ER 24H | 1,000 mg | N | Y | |
| 62175032246 | NIACIN ER | niacin | TAB ER 24H | 1,000 mg | N | Y | |
| 65162032309 | NIACIN ER | niacin | TAB ER 24H | 1,000 mg | N | Y | |
| 68180022301 | NIACIN ER | niacin | TAB ER 24H | 1,000 mg | N | Y | |
| 68180022303 | NIACIN ER | niacin | TAB ER 24H | 1,000 mg | N | Y | |
| 00093739286 | NIACIN ER | niacin | TAB ER 24H | 500 mg | N | Y | |
| 33342018710 | NIACIN ER | niacin | TAB ER 24H | 500 mg | N | Y | |
| 47335053981 | NIACIN ER | niacin | TAB ER 24H | 500 mg | N | Y | |
| 50268058411 | NIACIN ER | niacin | TAB ER 24H | 500 mg | N | Y | |
| 50268058413 | NIACIN ER | niacin | TAB ER 24H | 500 mg | N | Y | |
| 59651001818 | NIACIN ER | niacin | TAB ER 24H | 500 mg | N | Y | |
| 59651001890 | NIACIN ER | niacin | TAB ER 24H | 500 mg | N | Y | |
| 62135049790 | NIACIN ER | niacin | TAB ER 24H | 500 mg | N | Y | |
| 62175032046 | NIACIN ER | niacin | TAB ER 24H | 500 mg | N | Y | |
| 65162032109 | NIACIN ER | niacin | TAB ER 24H | 500 mg | N | Y | |
| 68180022101 | NIACIN ER | niacin | TAB ER 24H | 500 mg | N | Y | |
| 68180022103 | NIACIN ER | niacin | TAB ER 24H | 500 mg | N | Y | |
| 00093739386 | NIACIN ER | niacin | TAB ER 24H | 750 mg | N | Y | |
| 00093739398 | NIACIN ER | niacin | TAB ER 24H | 750 mg | N | Y | |
| 47335061481 | NIACIN ER | niacin | TAB ER 24H | 750 mg | N | Y | |
| 59651001918 | NIACIN ER | niacin | TAB ER 24H | 750 mg | N | Y | |
| 59651001990 | NIACIN ER | niacin | TAB ER 24H | 750 mg | N | Y | |
| 68180022201 | NIACIN ER | niacin | TAB ER 24H | 750 mg | N | Y | |
| 50268058211 | NIACIN | niacin | TABLET | 100 mg | N | Y | |
| 50268058215 | NIACIN | niacin | TABLET | 100 mg | N | Y | |
| 00904227080 | NIACIN | niacin | TABLET | 50 mg | N | Y | |
| 00904227260 | NIACIN | niacin | TABLET | 500 mg | N | Y | |
| 71269025010 | SLO-NIACIN | niacin | TABLET ER | 250 mg | N | Y | |
| 50268058311 | NIACIN | niacin | TABLET ER | 500 mg | N | Y | |
| 50268058315 | NIACIN | niacin | TABLET ER | 500 mg | N | Y | |
| 64980010301 | NIADELAY | niacin | TABLET ER | 500 mg | N | Y | |
| 71269050010 | SLO-NIACIN | niacin | TABLET ER | 500 mg | N | Y | |
| 71269050099 | SLO-NIACIN | niacin | TABLET ER | 500 mg | N | Y | |
| 00904434760 | NIACIN | niacin | TABLET ER | 750 mg | N | Y | |
| 71269075010 | SLO-NIACIN | niacin | TABLET ER | 750 mg | N | Y | |
| 00904420160 | NIACINAMIDE | niacinamide | TABLET | 100 mg | N | Y | |
| 83035185601 | VITAMIN B3 | niacinamide | TABLET | 250 mg | Y | ||
| 83035185401 | VITAMIN B3 | niacinamide | TABLET | 50 mg | Y | ||
| 83035185701 | VITAMIN B3 | niacinamide | TABLET | 500 mg | N | Y | |
| 71860010101 | TRYNGOLZA | olezarsen sodium | AUTO INJCT | 80 mg/0.8 mL | Y | ||
| 00904670606 | OMEGA-3 ACID ETHYL ESTERS | omega-3 acid ethyl esters | CAPSULE | 1 gram | Y | Y | PA Document |
| 00904749506 | OMEGA-3 ACID ETHYL ESTERS | omega-3 acid ethyl esters | CAPSULE | 1 gram | Y | Y | PA Document |
| 24658035012 | OMEGA-3 ACID ETHYL ESTERS | omega-3 acid ethyl esters | CAPSULE | 1 gram | Y | Y | PA Document |
| 31722093612 | OMEGA-3 ACID ETHYL ESTERS | omega-3 acid ethyl esters | CAPSULE | 1 gram | Y | Y | PA Document |
| 42806055212 | OMEGA-3 ACID ETHYL ESTERS | omega-3 acid ethyl esters | CAPSULE | 1 gram | Y | Y | PA Document |
| 60505317007 | OMEGA-3 ACID ETHYL ESTERS | omega-3 acid ethyl esters | CAPSULE | 1 gram | Y | Y | PA Document |
| 60687084611 | OMEGA-3 ACID ETHYL ESTERS | omega-3 acid ethyl esters | CAPSULE | 1 gram | Y | Y | PA Document |
| 60687084665 | OMEGA-3 ACID ETHYL ESTERS | omega-3 acid ethyl esters | CAPSULE | 1 gram | Y | Y | PA Document |
| 62135078012 | OMEGA-3 ACID ETHYL ESTERS | omega-3 acid ethyl esters | CAPSULE | 1 gram | Y | Y | PA Document |
| 64380076111 | OMEGA-3 ACID ETHYL ESTERS | omega-3 acid ethyl esters | CAPSULE | 1 gram | Y | Y | PA Document |
| 65162003416 | OMEGA-3 ACID ETHYL ESTERS | omega-3 acid ethyl esters | CAPSULE | 1 gram | Y | Y | PA Document |
| 69452017522 | OMEGA-3 ACID ETHYL ESTERS | omega-3 acid ethyl esters | CAPSULE | 1 gram | Y | Y | PA Document |
| 70756042322 | OMEGA-3 ACID ETHYL ESTERS | omega-3 acid ethyl esters | CAPSULE | 1 gram | Y | Y | PA Document |