1986-1990 HEPATITIS C CLAIMS CENTRE
HCV MEDICATION LIST FOR MEDICAL CONDITIONS ASSOCIATED
WITH DISEASE LEVEL 6*

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
TRANSPLANTATION

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
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 BLEEDINGAS 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