bestmed medicine formulary non-cdl

BESTMED MEDICINE FORMULARY
NON-CDL - CHRONIC CONDITIONS

Benefits are subject to the following:
 Pre-authorisation
 Bestmed guidelines
 Bestmed protocols
 Mediscor Reference Price (MRP)
The MRP sets a maximum price for a generic medicine product, of which the cost is normally lower than that
of the original or ethical product. This means that, should you choose to use the original medicine product
and a generic alternative for the product is available, you will be responsible for paying the difference
between the price of the chosen original medicine product and that of the MRP.
This formulary is effective from 1 January 2014.
This formulary is subject to change without notice.


MAJOR DEPRESSION
MEDICINE NAME
Beat4
Pace1
Pace2
Pace3
Pace4
A
MEDICINE NAME
Beat4
Pace1
Pace2
Pace3
Pace4
CITRAZ 5MG TAB
YES
ADCO-PAROXETINE 20MG TAB
YES
CLOMIDEP 25MG
YES
A-LENNON FLUOXETINE 20MG
YES
CLORIX 150MG TAB
YES
ANAFRANIL 10MG TAB
YES
CLORIX 300MG TAB
YES
ANAFRANIL 25MG TAB
YES
D
ANAFRANIL SR 75MG TAB
YES
DEPAROC 20MG TAB
YES
APEX-PAROXETINE 20MG TAB
YES
DEPNIL 150MG TAB
YES
AROPAX 20MG TAB
YES
DEPNIL 300MG TAB
YES
ASPEN ESCITALOPRAM 10MG
YES
DEPRAMIL 20MG TAB
YES
AURO-CITALOPRAM 20MG TAB
YES
DEPRAMIL 40MG TAB
YES
AURO PAROXETINE 20MG TAB
YES
DEPROZAN CAP
YES
AUSTELL-CITALOPRAM 10MG
YES
DRL CITALOPRAM 20MG TAB
YES
AUSTELL-CITALOPRAM 20MG
YES
DRL CITALOPRAM 40MG TAB
YES
AUSTELL-CITALOPRAM 40MG
YES
E
AUSTELL-PAROXETINE 20MG
YES
EQUINORM 10MG
YES
AUSTELL-PAROXETINE 30MG
YES
EQUINORM 25MG
YES
ESCITALOPRAM 10MG BE-TAB
YES
ESCITALOPRAM 20MG BE-TAB
YES
B
BIO CITALOPRAM 20MG TAB
YES
C
ETHIPRAMINE 10MG TAB
YES
CILATE 20MG TAB
YES
ETHIPRAMINE 25MG TAB
YES
CILIFT 20MG TAB
YES
F
CILORAM 20MG TAB
YES
FLUOXETINE ACTOR 20MG CAP
YES
CIPRALEX 10MG TAB
YES
FLUTINOL 20MG CAP
YES
CIPRAMIL 20MG TAB
YES
G
CITALOHEXAL 20MG TAB
YES
GLENMARK CITALOPRAM 20MG T
YES
CITALOPRAM ACTOR 20MG
YES
GULF AMITRIPTYLINE 25MG TAB
YES
CIPRALEX 10MG TAB
YES
H
CITALOPRAM-WINTHROP 20MG
YES
HEXAL-PAROXETINE 20MG TAB
CITALOPRAM-WINTHROP 40MG
YES
L
CITRAZ 10MG TAB
YES
LANTANON 10MG TAB
YES
CITRAZ 20MG TAB
YES
LANTANON 30MG TAB
YES
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YES
LEXAMIL 10MG TABS
YES
SANDOZ CITALOPRAM 40MG
YES
LEXAMIL 20MG TABS
YES
SANDOZ DOTHIEPIN 25MG CAP
YES
LEXAMIL 5MG TAB
YES
SANDOZ DOTHIEPIN 75MG TAB
YES
LILLY-FLUOXETINE 20MG
YES
SANDOZ FLUOXETINE 20MG CA
YES
LORIEN 20MG CAP
YES
SANDOZ PAROXETINE 20MG
YES
LORIEN 20MG TAB
YES
SANDOZ SULPIRIDE 50MG CAP
YES
SEDARIN 20MG TAB
YES
M
MERCK-CITALOPRAM 20MG
YES
SERRAPRESS 20MG
YES
MERCK-CITALOPRAM 40MG
YES
SERRAPRESS 30MG
YES
MYLAN ESCITALOPRAM 10MG
YES
SIMAYLA CITALOPRAM 10MG
YES
MYLAN ESCITALOPRAM 20MG
YES
SIMAYLA CITALOPRAM 20MG
YES
SIMAYLA CITALOPRAM 40MG
YES
YES
N
NEXITO 10MG TAB
YES
SURMONTIL 50MG CAP
NUZAK 20MG CAP
YES
T
P
TALOMIL 20MG TAB
YES
PARAX 20MG TAB
YES
TEXINE 20MG TAB
YES
PARAX 40MG TAB
YES
THADEN 25MG CAP
YES
PARNATE 10MG TAB
YES
THADEN 75MG TAB
YES
PAROXETINE UNICORN 20MG TAB
YES
TOFRANIL 10MG TAB
YES
PAXIL 20MG TAB
YES
TOFRANIL 25MG TAB
YES
PROHEXAL 20MG CAP
YES
TREPILINE 10MG TAB
YES
PROHEXAL 20T
YES
TREPILINE 25MG TAB
YES
PROHEXAL 40T
YES
TRIZAC 20MG CAP
YES
PROTHIADEN 25MG CAP
YES
TRYPTANOL 25MG TAB
YES
PROTHIADEN 75MG TAB
YES
TYDAMINE 25MG TAB
YES
PROZAC 20MG CAP
YES
TYDAMINE 50MG CAP
YES
PROZAC 20MG TAB
YES
X
PROZAC 20MG/5ML LIQ
YES
XET 20MG TAB
R
YES
Z
RAN-CITALOPRAM 20MG TAB
YES
ZITOLEX 10MG TAB
YES
RAN-CITALOPRAM 40MG TAB
YES
ZITOLEX 20MG TAB
YES
RANFLOCS 20
YES
ZYDUS ESCITALOPRAM 10MG T
YES
REZAK 20MG CAP
YES
ZYDUS-FLUOXETINE 20MG
YES
S
ZYDUS-PAROXETINE 20MG
YES
SANDOZ AMITRIPTYLINE 25
YES
ZYTOMIL 10MG TAB
YES
SANDOZ CITALOPRAM 20MG
YES
ZYTOMIL 20MG TAB
YES
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