Misc Analgesics
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 | Carveout ‐ Bill FFS |
Current Drug Use Criteria |
|---|---|---|---|---|---|---|---|---|
| 00143938601 | ACETAMINOPHEN | acetaminophen | PIGGYBACK | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 00143938610 | ACETAMINOPHEN | acetaminophen | PIGGYBACK | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 00264410090 | ACETAMINOPHEN | acetaminophen | PIGGYBACK | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 25021070587 | ACETAMINOPHEN | acetaminophen | PIGGYBACK | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 36000030660 | ACETAMINOPHEN | acetaminophen | PIGGYBACK | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 63323043400 | ACETAMINOPHEN | acetaminophen | PIGGYBACK | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 63323043441 | ACETAMINOPHEN | acetaminophen | PIGGYBACK | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 67457094010 | ACETAMINOPHEN | acetaminophen | PIGGYBACK | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 00264405080 | ACETAMINOPHEN | acetaminophen | PIGGYBACK | 500 mg/50 mL (10 mg/mL) | Y | N | ||
| 25021070582 | ACETAMINOPHEN | acetaminophen | PIGGYBACK | 500 mg/50 mL (10 mg/mL) | Y | N | ||
| 36000037240 | ACETAMINOPHEN | acetaminophen | PIGGYBACK | 650 mg/65 mL (10 mg/mL) | Y | N | ||
| 45802073200 | ACETAMINOPHEN | acetaminophen | SUPP.RECT | 120 mg | Y | N | ||
| 45802073230 | ACETAMINOPHEN | acetaminophen | SUPP.RECT | 120 mg | Y | N | ||
| 45802073233 | ACETAMINOPHEN | acetaminophen | SUPP.RECT | 120 mg | Y | N | ||
| 70677127001 | CHILDREN'S PAIN RELIEVER | acetaminophen | SUPP.RECT | 120 mg | Y | N | ||
| 51672211500 | FEVERALL | acetaminophen | SUPP.RECT | 120 mg | Y | N | ||
| 51672211502 | FEVERALL | acetaminophen | SUPP.RECT | 120 mg | Y | N | ||
| 51672211600 | FEVERALL | acetaminophen | SUPP.RECT | 325 mg | Y | N | ||
| 51672211602 | FEVERALL | acetaminophen | SUPP.RECT | 325 mg | Y | N | ||
| 45802073000 | ACETAMINOPHEN | acetaminophen | SUPP.RECT | 650 mg | Y | N | ||
| 45802073030 | ACETAMINOPHEN | acetaminophen | SUPP.RECT | 650 mg | Y | N | ||
| 45802073032 | ACETAMINOPHEN | acetaminophen | SUPP.RECT | 650 mg | Y | N | ||
| 45802073033 | ACETAMINOPHEN | acetaminophen | SUPP.RECT | 650 mg | Y | N | ||
| 51672211700 | FEVERALL | acetaminophen | SUPP.RECT | 650 mg | Y | N | ||
| 70677127101 | PAIN RELIEVER | acetaminophen | SUPP.RECT | 650 mg | Y | N | ||
| 51672211400 | FEVERALL | acetaminophen | SUPP.RECT | 80 mg | Y | N | ||
| 51672211402 | FEVERALL | acetaminophen | SUPP.RECT | 80 mg | Y | N | ||
| 00781315606 | ACETAMINOPHEN | acetaminophen | VIAL | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 00781315695 | ACETAMINOPHEN | acetaminophen | VIAL | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 00781927406 | ACETAMINOPHEN | acetaminophen | VIAL | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 00781927495 | ACETAMINOPHEN | acetaminophen | VIAL | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 24201010001 | ACETAMINOPHEN | acetaminophen | VIAL | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 24201010024 | ACETAMINOPHEN | acetaminophen | VIAL | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 24201011001 | ACETAMINOPHEN | acetaminophen | VIAL | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 24201011024 | ACETAMINOPHEN | acetaminophen | VIAL | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 31722020510 | ACETAMINOPHEN | acetaminophen | VIAL | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 31722020524 | ACETAMINOPHEN | acetaminophen | VIAL | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 31722020531 | ACETAMINOPHEN | acetaminophen | VIAL | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 55150030701 | ACETAMINOPHEN | acetaminophen | VIAL | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 55150030724 | ACETAMINOPHEN | acetaminophen | VIAL | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 72572005001 | ACETAMINOPHEN | acetaminophen | VIAL | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 72572005010 | ACETAMINOPHEN | acetaminophen | VIAL | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 72603017301 | ACETAMINOPHEN | acetaminophen | VIAL | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 72603017310 | ACETAMINOPHEN | acetaminophen | VIAL | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 72603017324 | ACETAMINOPHEN | acetaminophen | VIAL | 1,000 mg/100 mL (10 mg/mL) | Y | N | ||
| 45802070214 | ASPIRIN | aspirin | SUPP.RECT | 120 mg | Y | N | ||
| 45802070230 | ASPIRIN | aspirin | SUPP.RECT | 120 mg | Y | N | ||
| 45802070233 | ASPIRIN | aspirin | SUPP.RECT | 120 mg | Y | N | ||
| 45802070814 | ASPIRIN | aspirin | SUPP.RECT | 130 mg | Y | N | ||
| 45802070314 | ASPIRIN | aspirin | SUPP.RECT | 195 mg | Y | N | ||
| 45802070330 | ASPIRIN | aspirin | SUPP.RECT | 195 mg | Y | N | ||
| 45802070333 | ASPIRIN | aspirin | SUPP.RECT | 195 mg | Y | N | ||
| 00574703412 | ASPIRIN | aspirin | SUPP.RECT | 300 mg | Y | N | ||
| 00574703450 | ASPIRIN | aspirin | SUPP.RECT | 300 mg | Y | N | ||
| 45802070414 | ASPIRIN | aspirin | SUPP.RECT | 300 mg | Y | N | ||
| 45802070430 | ASPIRIN | aspirin | SUPP.RECT | 300 mg | Y | N | ||
| 45802070433 | ASPIRIN | aspirin | SUPP.RECT | 300 mg | Y | N | ||
| 45802070114 | ASPIRIN | aspirin | SUPP.RECT | 60 mg | Y | N | ||
| 45802070130 | ASPIRIN | aspirin | SUPP.RECT | 60 mg | Y | N | ||
| 45802070133 | ASPIRIN | aspirin | SUPP.RECT | 60 mg | Y | N | ||
| 00574703650 | ASPIRIN | aspirin | SUPP.RECT | 600 mg | Y | N | ||
| 45802070514 | ASPIRIN | aspirin | SUPP.RECT | 600 mg | Y | N | ||
| 00143972401 | CLONIDINE HCL | clonidine HCl/PF | VIAL | 1,000 mcg/10 mL (100 mcg/mL) | Y | N | ||
| 39822200001 | CLONIDINE HCL | clonidine HCl/PF | VIAL | 1,000 mcg/10 mL (100 mcg/mL) | Y | N | ||
| 67457021810 | DURACLON | clonidine HCl/PF | VIAL | 1,000 mcg/10 mL (100 mcg/mL) | Y | N | ||
| 00143972301 | CLONIDINE HCL | clonidine HCl/PF | VIAL | 5,000 mcg/10 mL | Y | N | ||
| 00143927301 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | AMPUL | 1 mg/mL | Y | N | ||
| 00143927310 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | AMPUL | 1 mg/mL | Y | N | ||
| 61990041100 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | AMPUL | 1 mg/mL | Y | N | ||
| 61990041101 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | AMPUL | 1 mg/mL | Y | N | ||
| 61990041102 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | AMPUL | 1 mg/mL | Y | N | ||
| 81284041100 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | AMPUL | 1 mg/mL | Y | N | ||
| 81284041105 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | AMPUL | 1 mg/mL | Y | N | ||
| 81284041110 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | AMPUL | 1 mg/mL | Y | N | ||
| 24201046301 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | SPRAY/PUMP | 0.5 mg/pump actuation (4 mg/mL) | Y | N | ||
| 24201046308 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | SPRAY/PUMP | 0.5 mg/pump actuation (4 mg/mL) | Y | N | ||
| 69097050327 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | SPRAY/PUMP | 0.5 mg/pump actuation (4 mg/mL) | Y | N | ||
| 69097050331 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | SPRAY/PUMP | 0.5 mg/pump actuation (4 mg/mL) | Y | N | ||
| 72888009618 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | SPRAY/PUMP | 0.5 mg/pump actuation (4 mg/mL) | Y | N | ||
| 72888009619 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | SPRAY/PUMP | 0.5 mg/pump actuation (4 mg/mL) | Y | N | ||
| 72888009634 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | SPRAY/PUMP | 0.5 mg/pump actuation (4 mg/mL) | Y | N | ||
| 73352009618 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | SPRAY/PUMP | 0.5 mg/pump actuation (4 mg/mL) | Y | N | ||
| 73352009619 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | SPRAY/PUMP | 0.5 mg/pump actuation (4 mg/mL) | Y | N | ||
| 76282068043 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | SPRAY/PUMP | 0.5 mg/pump actuation (4 mg/mL) | Y | N | ||
| 76282068044 | DIHYDROERGOTAMINE MESYLATE | dihydroergotamine mesylate | SPRAY/PUMP | 0.5 mg/pump actuation (4 mg/mL) | Y | N | ||
| 67457017750 | RIMSO-50 | dimethyl sulfoxide | SOLUTION | 50 % | Y | N | ||
| 81279010420 | ERGOMAR | ergotamine tartrate | TAB SUBL | 2 mg | Y | N | ||
| 00409228821 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | CARTRIDGE | 15 mg/mL | Y | N | ||
| 00004692006 | TORADOL | ketorolac tromethamine | CARTRIDGE | 15 mg/mL | Y | N | ||
| 00004692106 | TORADOL | ketorolac tromethamine | CARTRIDGE | 15 mg/mL | Y | N | ||
| 00074228754 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | CARTRIDGE | 30 mg/mL | Y | N | ||
| 00004692206 | TORADOL | ketorolac tromethamine | CARTRIDGE | 30 mg/mL | Y | N | ||
| 76045020900 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | SYRINGE | 30 mg/mL | Y | N | ||
| 76045020910 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | SYRINGE | 30 mg/mL | Y | N | ||
| 76045010500 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | SYRINGE | 60 mg/2 mL | Y | N | ||
| 76045010520 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | SYRINGE | 60 mg/2 mL | Y | N | ||
| 00338006910 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 00409379301 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 00409379319 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 00409379325 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 00641604101 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 00641604125 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 25021070001 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 31722030501 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 31722030510 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 31722030525 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 62332059901 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 62332059925 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 63323016100 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 63323016101 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 63323016112 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 63323016116 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 63323016121 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 63323016141 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 65145014601 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 65145014625 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 68462075501 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 68462075525 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 70512084201 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 70512084225 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 72266023401 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 72266023425 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 72572035401 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 72572035410 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 72603015301 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 72603015325 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 15 mg/mL | Y | N | ||
| 00338007225 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 00409379501 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 00409379519 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 00409379525 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 00641604201 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 00641604225 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 25021070101 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 31722030601 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 31722030625 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 62332060001 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 62332060025 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 63323016200 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 63323016201 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 63323016212 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 63323016216 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 63323016223 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 63323016243 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 65145014501 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 65145014525 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 68462075601 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 68462075625 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 70512084301 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 70512084325 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 72266011801 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 72266011825 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 72572035501 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 72572035525 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 72603016101 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 72603016125 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 30 mg/mL (1 mL) | Y | N | ||
| 00409379601 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 00409379619 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 00409379625 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 25021070102 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 31722030702 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 31722030725 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 62332060102 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 62332060125 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 63323016202 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 63323016203 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 63323016214 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 63323016225 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 63323016226 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 63323016245 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 65145014701 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 65145014725 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 68462075702 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 68462075725 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 70512084401 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 70512084425 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 72266011901 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 72266011925 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 72603017201 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 72603017225 | KETOROLAC TROMETHAMINE | ketorolac tromethamine | VIAL | 60 mg/2 mL | Y | N | ||
| 50458009801 | ELMIRON | pentosan polysulfate sodium | CAPSULE | 100 mg | Y | N |