Medication class Medication name Contraceptives ALL PRESCRIPTION FORMULATIONS Dental caries prevention PEDIATRIC MULTIVITAMINS WITH FLUORIDE - ALL PRESCRIPTION FORMULATIONS SODIUM FLUORIDE Diagnostic agents and supplies BLOOD GLUCOSE STRIPS - ALL FORMULATIONS CONTROL SOLUTIONS INSULIN DELIVERY DEVICES INSULIN SYRINGES, INFUSION SETS, AND NEEDLES - ALL FORMULATIONS KETONE BLOOD TEST STRIPS - ALL FORMULATIONS LANCETS, LANCET DEVICES URINE TESTING STRIPS - ALL FORMULATIONS Diuretics ALDACTAZIDE AMILORIDE/HYDROCHLOROTHIAZIDE CHLORTHALIDONE DIURIL HYDROCHLOROTHIAZIDE INDAPAMIDE SPIRONOLACTONE/HYDROCHLOROTHIAZIDE THALITONE TRIAMTERENE/HYDROCHLOROTHIAZIDE Hereditary angioedema agents CINRYZE HAEGARDA ORLADEYO TAKHZYRO Immunizations ALL FORMULATIONS Immunosuppressive agents ASTAGRAF XL CELLCEPT CYCLOSPORINE CAPS ENVARSUS XR EVEROLIMUS GENGRAF 17

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