Preferred Drug List Changes
The following changes have been made to the Nebraska PDL. Changes are effective July 19, 2024.
PDL changes effective 07/19/2024
Nebraska PDL Therapeutic Drug Class | Drug Name (Route) | PDL Status before 7/19/24 | PDL status on or after 7/19/24 |
|---|---|---|---|
ACNE AGENTS, TOPICAL | ADAPALENE / BENZOYL PEROXIDE (EPIDUO) (TOPICAL) | Non Preferred | Preferred |
ACNE AGENTS, TOPICAL | CLINDAMYCIN / BENZOYL PEROXIDE (BENZACLIN) (TOPICAL) | Non Preferred | Preferred |
ACNE AGENTS, TOPICAL | CLINDAMYCIN / BENZOYL PEROXIDE (DUAC) (TOPICAL) | Non Preferred | Preferred |
ACNE AGENTS, TOPICAL | ADAPALENE CREAM (TOPICAL) | Preferred | Non Preferred |
ANDROGENIC AGENTS | TESTIM (TRANSDERM.) | Non Preferred | Preferred |
ANTIBIOTICS, VAGINAL | CLINDESSE (VAGINAL) | Preferred | Non Preferred |
ANTICOAGULANTS | DABIGATRAN (ORAL) | Non Preferred | Preferred |
ANTICOAGULANTS | PRADAXA (ORAL) | Preferred | Non Preferred |
ANTIEMETIC/ANTIVERTIGO AGENTS | SCOPOLAMINE (TRANSDERM) | Non Preferred | Preferred |
ANTIEMETIC/ANTIVERTIGO AGENTS | TRANSDERM-SCOP (TRANSDERM) | Preferred | Non Preferred |
ANTIFUNGALS, TOPICAL | TOLNAFTATE POWDER OTC (TOPICAL) | Preferred | Non Preferred |
ANTIMIGRAINE AGENTS, OTHER | AIMOVIG (SUBCUTANEOUS) | Non Preferred | Preferred |
ANTIMIGRAINE AGENTS, OTHER | QULIPTA (ORAL) | Non Preferred | Preferred |
BETA-BLOCKERS | HEMANGEOL (ORAL) | Non Preferred | Preferred |
BLADDER RELAXANT PREPARATIONS | FESOTERODINE ER (ORAL) | Non Preferred | Preferred |
BLADDER RELAXANT PREPARATIONS | TOVIAZ (ORAL) | Preferred | Non Preferred |
GI MOTILITY, CHRONIC | TRULANCE (ORAL) | Non Preferred | Preferred |
GROWTH HORMONE | NUTROPIN AQ PEN (INJECTION) | Preferred | Non Preferred |
HIV / AIDS | PREZISTA (ORAL) | Non Preferred | Preferred |
HIV / AIDS | RITONAVIR TABLET (ORAL) | Non Preferred | Preferred |
PAH AGENTS, ORAL AND INHALED | SILDENAFIL SUSPENSION (ORAL) | Non Preferred | Preferred |
PAH AGENTS, ORAL AND INHALED | REVATIO SUSPENSION (ORAL) | Preferred | Non Preferred |
PRENATAL VITAMINS | PNV NO.15/IRON FUM & PS CMP/FA (ORAL) | Non Preferred | Preferred |
PRENATAL VITAMINS | PNV WITH CA,NO.74/IRON/FA OTC (ORAL) | Non Preferred | Preferred |
PRENATAL VITAMINS | PNV119/IRON FUMARATE/FA/DSS TABLET (ORAL) | Non Preferred | Preferred |
PRENATAL VITAMINS | PRENATAL MULTI OTC (ORAL) | Non Preferred | Preferred |
PRENATAL VITAMINS | SELECT-OB + DHA (ORAL) | Non Preferred | Preferred |
PRENATAL VITAMINS | TENDERA-OB OTC (ORAL) | Non Preferred | Preferred |
PRENATAL VITAMINS | TRICARE (ORAL) | Non Preferred | Preferred |
PRENATAL VITAMINS | VITAFOL FE+ (ORAL) | Non Preferred | Preferred |
PRENATAL VITAMINS | VITAFOL-OB (ORAL) | Non Preferred | Preferred |
PRENATAL VITAMINS | VITAFOL-OB+DHA (ORAL) | Non Preferred | Preferred |
PRENATAL VITAMINS | VITAFOL-ONE (ORAL) | Non Preferred | Preferred |
PRENATAL VITAMINS | COMPLETENATE CHEW TABLET (ORAL) | Preferred | Non Preferred |
PRENATAL VITAMINS | MARNATAL-F (ORAL) | Preferred | Non Preferred |
PRENATAL VITAMINS | PNV W-CA NO.40/IRON FUM/FA CMB NO.1 (ORAL) | Preferred | Non Preferred |
PROTON PUMP INHIBITORS | ESOMEPRAZOLE CAPSULES (ORAL) | Non Preferred | Preferred |
PROTON PUMP INHIBITORS | RABEPRAZOLE TABLETS (ORAL) | Non Preferred | Preferred |
PROTON PUMP INHIBITORS | DEXILANT (ORAL) | Preferred | Non Preferred |
TETRACYCLINES | TETRACYCLINE (ORAL) | Non Preferred | Preferred |
ULCERATIVE COLITIS AGENTS | PENTASA (ORAL) | Non Preferred | Preferred |
VASODILATORS, CORONARY | ISOSORBIDE DINTRATE/HYDRALAZINE (ORAL) | Non Preferred | Preferred |
VASODILATORS, CORONARY | BIDIL (ORAL) | Preferred | Non Preferred |