F:\nanderson\web site\np schedules\npschedulese.vp

New Brunswick Prescription Drug Program Formulary:
Appendix IV - Special Authorization
New Brunswick Prescription Drug Program
Formulary: Appendix IV - Special Authorization
Drugs Excluded
Bimatroprost (Lumigan) A-13Botulinum Toxin Type A (Botox) A-13Buserelin Acetate (Suprefact) A-14Capecitabine (Xeloda) A-15Celecoxib (Celebrex) A-16Ciprofloxacine (Cipro and generic brands) A-16Ciprofloxacin/hydrocortisone (Cipro HC Otic solution) A-16Clozapine (Clozaril and generic brands) A-17Cyproterone Acetate (Androcur and generic brands) A-17Delta-9-Tetrahydrocannabinol (Marinol) A-18Etanercept (Enbrel) A-20Fentanyl (Duragesic) A-21Filgrastim (Neupogen-Amgen) A-22Fludarabine (Fludara) A-23Flutamide (Euflex and generic brands) A-23Gabapentin (Neurontin and generic brands) A-24Ganciclovir (Cytovene) A-25Goserelin Acetate (Zoladex) A-26Imatinib (Gleevec) A-26Imiquimod (Aldara) A-27Infliximab (Remicade) A-27Interferon Alfa-2B Ribavirin (Rebetron) A-29Lamivudine (Heptovir) A-29Lamotrigine (Lamictal and generic brands) A-29Latanoprost (Xalatan) A-30Latanoprost/Timolol (Xalacom) A-30Leflunomide (Arava) A-30Leuprolide (Lupron and Lupron Depot) A-30Levetiracetam (Keppra) A-31Linezolid (Zyvoxam) A-31Nafarelin Acetate (Synarel) A-32Naltrexone (Revia) A-32Nilutamide (Anadron) A-33Octreotide Acetate (Sandostatin and Sandostatin Lar) A-34Ondansetron (Zofran) A-35Oxcarbazepine (Trileptal) A-35Oxycodone (Oxy IR and Oxycontin CR) A-35 and A-36Peginterferon Alfa-2A (Pegasys) A-36Peginterferon Alfa-2B+Ribavirin (Pegetron) A-36Quetiapine (Seroquel) A-38Rifabutin (Mycobutin) A-39Riluzole (Rilutek) A-39Rivastigmine (Exelon) A-40Sevelamer (Renagel) A-42 Nurses Association of New BrunswickNurse Practitioner Schedules - Revised October 2005 New Brunswick Prescription Drug Program Formulary:
Appendix IV - Special Athorization
Drugs Excluded con’t
Sirolimus (Rapamune) A-42Somatropine (Humatrope) (Saizen) A-43Tacrolimus (Protopic) A-43Thyrotropin Alpha (Thyrogen) A-44Tizanidine (Zanaflex) A-45Tobramycin (Tobi) A-45Travoprost (Travatan) A-45Tretinoin (Vesanoid) A-46Tryptophan (Tryptan and generic brands) A-46Ursodiol (Urso) (Urso DS) A-46Valganciclovir (Valcyte) A-46Vigabatrin (Sabril) A-47 Drugs Limited/For Maintenance
Anastrozole (Arimidex) A-12Atovaquone (Mepron) A-12Bosentan (Tracleer) A-13Bupropion Hydrochloride (Wellbutrin SR) A-14Calcitonin Salmon (Miacalcin, Apo-Calcitonin) A-15Desmopressin (DDAVP) A-18Dipyridamole Extended Release/ASA Immediate Release (Aggrenox) A-18Donepezil (Aricept) A-18Entacapone (Comtan) A-19Epoetin Alfa (Eprex) A-20Exemestane (Aromasin) A-20Finasteride (Proscar) A-23Galantamine (Reminyl) A-24Insulin Aspart (Novorapid) A-28Insulin Lispro (Humalog) A-28Letrozole (Femara) A -30Raloxifene (Evista) A-38Risperidone (Risperdal) (Risperdal M) A-40Tamsulosin Hydrochloride (Flomax) A-43• Controlled Drugs except as permitted by the Controlled Drugs and Substances Act Nurse Practitioner Schedules - Revised October 2005

Source: http://www.nanb.nb.ca/PDF/Publications/General_Publications/ScheduleAnnexeIVE.pdf