Listed below are medications currently available and generally
accepted by the medical community for the treatment of the
seven (7) medical conditions associated with disease level
6. This list was compiled in consultation with a number
of HCV medical specialists and reflects medications that
may be recommended or prescribed for persons infected with
HCV.
*This list shall be periodically updated in consultation
with HCV medical specialists, at the Administrator's discretion.
|
Disease Level 6 Medication
List
|
|
LIVER
TRANSPLANT
|
THERAPEUTIC
CLASS |
GENERIC NAME
|
BRAND
NAME |
| Immunosuppressive Therapy
|
Azathioprine
Cyclosporine
Mycophenolate Mofetil
Prednisone
Tacrolimus
|
Imuran
Neoral/Sandimmune
CellCept
Apo-Prednisone
Prograf |
| Antifungals |
Caspofungin
Fluconazole
Itraconazole
Ketoconazole
Nystatin
Voraconazole |
Cancidas
Diflucan
Sporanox
Nizoral
Mycostatin/Nilstat
|
| Antivirals |
Acyclovir
Famciclovir
Ganciclovir
Oseltamivir Phosphate
Pegylated Interferon alfa-2b-Ribavirin
Ribavirin, Interferon, alfa 2bValacyclovir Hydrochloride
Zanamivir |
Zovirax
Famvir
Cytovene
Tamiflu
Pegetron
Rebetron
Valtrex
Relenza |
| Sulfonamides and Trimethoprim |
Sulfamethoxazole |
Bactrim DS |
| Bone Metabolism Regulator |
Risedronate Sodium Hemi-pentahydrate |
Actonel |
| Gastroduodenal Cytoprotective
Agents |
Aluminum Hydroxide
Cimetidine
Famotidine
Lansoprazole
Magnesium Hydroxide
Nizatidine
Omeprazole Magnesium
Pantoprazole Sodium
Ranitidine Hydrochloride
Sucralfate |
Gaviscon
Tagamet
Pepcid AC
Prevacid
Mylanta
Axid
Losec
Pantoloc
Zantac
Sulcrate
|
| Supplements |
Calcium Carbonate
Calcium Gluconate
Iron Dextran
Ferrous Fumarate
Magnesium
Magnesium Chloride
Multi-Vitamins
Potassium Chloride |
Caltrate
Calcium Gluconate
Dexiran/Infufer
Ferrous Sulphate/Palafer
Magnesium-Rougier/
Slow-Mag
Centrum
Slow-K |
| Pain Medications |
Acetaminophen/Caffeine/
Codeine Phosphate
Acetaminophen
Hydromorphone Hydrochloride
Morphine Sulphate
Pentazocine Hydrochloride |
Tylenol with Codeine
Tylenol
Dilaudid
Morphine
Talwin |
|
DECOMPENSATION
OF THE LIVER
|
Ascites |
DIURETICS
Furosemide
Hydrodiuril
Spironolactone |
Lasix
Hydrochlorothiazide
Aldactone |
Hepatic
Encephalopathy |
Lactulose |
Laxilose |
| Variceal Bleeding as a Result of Portal Hypertension |
Phytonadione
Somatostatin
ANTIHYPERTENSIVE
Acebutolol Hydrochloride
Atenolol
Carvedilol
Esmolol Hydrochloride
Hydrodiuril
Metoprolol Tartrate
Nadolol
Pindolol
Propranolol Hydrochloride
Terazosin Hydrochloride
Timolol Maleate |
Vitamin K Injections
Stilamin
Sectral
Tenormin
Coreg
Brevibloc
Hydrochlorothiazide
Lopresor
Corgard
Visken
Inderal
Hytrin
Timolide |
| Chemotherapy Treatment |
EXAMPLES
Cyclophosphamide
Dexamethasone
Doxorubicin Hydrochloride
Methotrexate
Prednisone
Vincristine Sulfate |
Cytoxan
Maxitrol
Adriamycin
Methotrexate
Apo-Prednisone
Oncotice |
| Medications Related
to Treatment |
Calcium Folinate
Chlorambucil
Dolasetron Mesylate
Epoetin alfa
Filgrastim
Granisetron Hydrochloride
Ondansetron Hydrochloride |
Leucovorin
Leukeran
Anzemet
Eprex
Neupogen
Kytril
Zofran |
| Immunosuppressive Agents |
Azathioprine
Chlorambucil
CORTICOSTERIODS
Betamethasone
Cortisone
Cyclophosphamide
Hydrocortisone
Interferon alfa 2B
Methylprednisolone
Triamcinolone |
Imuran
Leukeran
Celestoderm/Betnovate
Cortisone
Cytoxan
Cortoderm
Intron A
Solu-Medrol
Kenacomb/Viaderm
|
| Nonsteroidal Anti-Inflammatory
Agents |
Celecoxib
Diclofenac Sodium
Ibuprofen
Indomethacin
Ketoprofen
Ketorolac
Naproxen
Piroxicam
Rofecoxib
Tolmetin Sodium |
Celebrex
Voltaren
Motrin
Indocid
Orudis
Toradol
Naprosyn
Feldene
Vioxx
Tolectin |
| Dietary Supplements |
Calcium Carbonate
Calcitriol
Iron Dextran |
Caltrate
Rocaltrol
Dexiron |
| Erythropoiesis Regulating Hormone |
MEDICATIONS
Epoetin Alfa |
Eprex |
| Topical Anaesthetic for Dermal Analgesia |
Lidocaine-Prilocaine |
Emla Cream |
