Alzheimer's Disease, Non-injectable Drugs
PDL Reference Documents
- Alzheimer's Disease Drugs (Monoclonal antibodies) - Oct 05, 2023
- Alzheimer's Disease - Oct 07, 2021
- Alzheimer's Disease - Sep 24, 2015
- Alzheimer's Disease - Sep 23, 2014
- Alzheimer's Disease Scan Summary - Sep 23, 2014
- Class Scan: Alzheimers Medications - Sep 26, 2013
- Class Scan: Alzheimer's Drugs - Feb 23, 2012
PDL Status Values
Y = preferred
N = non-preferred. Non-preferred drugs listed as N but without clinical drug use criteria are subject to the
Non-Preferred Drugs in Select PDL Classes prior authorization criteria.
New drugs will be listed as N until reviewed by the P&T Committee and are subject to the
New Drug Policy.
V = voluntary non-preferred. Non-preferred mental health drugs are listed as V and prior authorization is not required.
Null (i.e. blank) = indicates the class or specific drug has not been reviewed for PDL placement.
To request a Prior Authorization, please use this form.
| NDC | Brand Name | Generic Name | Form | Strength | PDL Status |
Rebate | Current Drug Use Criteria |
|---|---|---|---|---|---|---|---|
| 84054001060 | ZUNVEYL | benzgalantamine gluconate | TABLET DR | 10 mg | N | Y | |
| 84054001560 | ZUNVEYL | benzgalantamine gluconate | TABLET DR | 15 mg | N | Y | |
| 84054000560 | ZUNVEYL | benzgalantamine gluconate | TABLET DR | 5 mg | N | Y | |
| 65038005601 | ADLARITY | donepezil HCl | PATCH TDWK | 10 mg/24 hour | N | Y | |
| 65038005603 | ADLARITY | donepezil HCl | PATCH TDWK | 10 mg/24 hour | N | Y | |
| 65038005501 | ADLARITY | donepezil HCl | PATCH TDWK | 5 mg/24 hour | N | Y | |
| 65038005503 | ADLARITY | donepezil HCl | PATCH TDWK | 5 mg/24 hour | N | Y | |
| 29300025111 | DONEPEZIL HCL ODT | donepezil HCl | TAB RAPDIS | 10 mg | Y | Y | |
| 33342003007 | DONEPEZIL HCL ODT | donepezil HCl | TAB RAPDIS | 10 mg | Y | Y | |
| 29300025011 | DONEPEZIL HCL ODT | donepezil HCl | TAB RAPDIS | 5 mg | Y | Y | |
| 33342002907 | DONEPEZIL HCL ODT | donepezil HCl | TAB RAPDIS | 5 mg | Y | Y | |
| 62856024630 | ARICEPT | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 00904647861 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 13668010310 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 13668010330 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 13668010390 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 16571077903 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 16571077909 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 16571077910 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 16571077950 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 31722073805 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 31722073830 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 31722073890 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 33342002807 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 33342002810 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 33342002815 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 42543070301 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 43547027603 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 43547027609 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 43547027611 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 55111035705 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 55111035710 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 60687030301 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 60687030311 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 62332009330 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 62332009390 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 62332009391 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 64380090804 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 64380090807 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 71093012801 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 71093012803 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 71093012805 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 71093012806 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 82009012005 | DONEPEZIL HCL | donepezil HCl | TABLET | 10 mg | Y | Y | |
| 62856024730 | ARICEPT | donepezil HCl | TABLET | 23 mg | Y | Y | |
| 24979000406 | DONEPEZIL HCL | donepezil HCl | TABLET | 23 mg | Y | Y | |
| 24979000407 | DONEPEZIL HCL | donepezil HCl | TABLET | 23 mg | Y | Y | |
| 33342006107 | DONEPEZIL HCL | donepezil HCl | TABLET | 23 mg | Y | Y | |
| 33342006110 | DONEPEZIL HCL | donepezil HCl | TABLET | 23 mg | Y | Y | |
| 42799095401 | DONEPEZIL HCL | donepezil HCl | TABLET | 23 mg | Y | Y | |
| 42799095402 | DONEPEZIL HCL | donepezil HCl | TABLET | 23 mg | Y | Y | |
| 43547038203 | DONEPEZIL HCL | donepezil HCl | TABLET | 23 mg | Y | Y | |
| 43547038209 | DONEPEZIL HCL | donepezil HCl | TABLET | 23 mg | Y | Y | |
| 62856024530 | ARICEPT | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 00904647761 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 13668010210 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 13668010230 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 13668010290 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 16571077803 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 16571077809 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 16571077810 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 16571077850 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 31722073705 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 31722073730 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 31722073790 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 33342002707 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 33342002710 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 33342002715 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 42543070201 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 43547027503 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 43547027509 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 43547027511 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 55111035605 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 55111035610 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 60687029201 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 60687029211 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 62332009230 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 62332009290 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 62332009291 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 64380090704 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 64380090705 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 64380090707 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 71093012701 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 71093012703 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 71093012705 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 71093012706 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 82009011905 | DONEPEZIL HCL | donepezil HCl | TABLET | 5 mg | Y | Y | |
| 47335083683 | GALANTAMINE ER | galantamine HBr | CAP24H PEL | 16 mg | Y | Y | |
| 65862074530 | GALANTAMINE ER | galantamine HBr | CAP24H PEL | 16 mg | Y | Y | |
| 47335083783 | GALANTAMINE ER | galantamine HBr | CAP24H PEL | 24 mg | Y | Y | |
| 65862074630 | GALANTAMINE ER | galantamine HBr | CAP24H PEL | 24 mg | Y | Y | |
| 47335083583 | GALANTAMINE ER | galantamine HBr | CAP24H PEL | 8 mg | Y | Y | |
| 65862074430 | GALANTAMINE ER | galantamine HBr | CAP24H PEL | 8 mg | Y | Y | |
| 00054013749 | GALANTAMINE HYDROBROMIDE | galantamine HBr | SOLUTION | 4 mg/mL | N | Y | |
| 24979072404 | GALANTAMINE HBR | galantamine HBr | TABLET | 12 mg | Y | Y | |
| 57237005160 | GALANTAMINE HBR | galantamine HBr | TABLET | 12 mg | Y | Y | |
| 65862046060 | GALANTAMINE HBR | galantamine HBr | TABLET | 12 mg | Y | Y | |
| 24979072204 | GALANTAMINE HBR | galantamine HBr | TABLET | 4 mg | Y | Y | |
| 57237004960 | GALANTAMINE HBR | galantamine HBr | TABLET | 4 mg | Y | Y | |
| 65862045860 | GALANTAMINE HBR | galantamine HBr | TABLET | 4 mg | Y | Y | |
| 68084072911 | GALANTAMINE HBR | galantamine HBr | TABLET | 4 mg | Y | Y | |
| 68084072921 | GALANTAMINE HBR | galantamine HBr | TABLET | 4 mg | Y | Y | |
| 24979072304 | GALANTAMINE HBR | galantamine HBr | TABLET | 8 mg | Y | Y | |
| 57237005060 | GALANTAMINE HBR | galantamine HBr | TABLET | 8 mg | Y | Y | |
| 65862045960 | GALANTAMINE HBR | galantamine HBr | TABLET | 8 mg | Y | Y | |
| 16571085303 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 14 mg | Y | Y | |
| 16571085309 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 14 mg | Y | Y | |
| 16714096001 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 14 mg | Y | Y | |
| 16714096002 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 14 mg | Y | Y | |
| 59651040530 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 14 mg | Y | Y | |
| 59651040590 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 14 mg | Y | Y | |
| 65162078303 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 14 mg | Y | Y | |
| 65162078309 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 14 mg | Y | Y | |
| 68180024706 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 14 mg | Y | Y | |
| 68180024709 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 14 mg | Y | Y | |
| 68382054706 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 14 mg | Y | Y | |
| 68382054716 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 14 mg | Y | Y | |
| 69680016230 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 14 mg | Y | Y | |
| 70436005504 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 14 mg | Y | Y | |
| 70436005506 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 14 mg | Y | Y | |
| 16571085403 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 21 mg | Y | Y | |
| 16714096101 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 21 mg | Y | Y | |
| 59651040630 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 21 mg | Y | Y | |
| 65162078403 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 21 mg | Y | Y | |
| 68180024806 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 21 mg | Y | Y | |
| 68382054806 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 21 mg | Y | Y | |
| 69680016330 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 21 mg | Y | Y | |
| 70436005604 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 21 mg | Y | Y | |
| 00904673561 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 28 mg | Y | Y | |
| 16571085503 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 28 mg | Y | Y | |
| 16571085509 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 28 mg | Y | Y | |
| 16714096201 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 28 mg | Y | Y | |
| 16714096202 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 28 mg | Y | Y | |
| 59651040730 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 28 mg | Y | Y | |
| 59651040790 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 28 mg | Y | Y | |
| 65162078503 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 28 mg | Y | Y | |
| 65162078509 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 28 mg | Y | Y | |
| 68180024902 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 28 mg | Y | Y | |
| 68180024906 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 28 mg | Y | Y | |
| 68180024909 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 28 mg | Y | Y | |
| 68382054906 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 28 mg | Y | Y | |
| 68382054916 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 28 mg | Y | Y | |
| 69680016430 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 28 mg | Y | Y | |
| 70436005704 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 28 mg | Y | Y | |
| 70436005706 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 28 mg | Y | Y | |
| 00904673461 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 7 mg | Y | Y | |
| 16571085203 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 7 mg | Y | Y | |
| 16714095901 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 7 mg | Y | Y | |
| 59651040430 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 7 mg | Y | Y | |
| 65162078203 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 7 mg | Y | Y | |
| 68180024606 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 7 mg | Y | Y | |
| 68382054606 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 7 mg | Y | Y | |
| 69680016130 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 7 mg | Y | Y | |
| 70436005404 | MEMANTINE HCL ER | memantine HCl | CAP SPR 24 | 7 mg | Y | Y | |
| 13925054012 | MEMANTINE HCL | memantine HCl | SOLUTION | 2 mg/mL | Y | Y | |
| 33342006628 | MEMANTINE HCL | memantine HCl | SOLUTION | 2 mg/mL | Y | Y | |
| 60505616205 | MEMANTINE HCL | memantine HCl | SOLUTION | 2 mg/mL | Y | Y | |
| 62135094305 | MEMANTINE HCL | memantine HCl | SOLUTION | 2 mg/mL | Y | Y | |
| 62135094324 | MEMANTINE HCL | memantine HCl | SOLUTION | 2 mg/mL | Y | Y | |
| 62135094337 | MEMANTINE HCL | memantine HCl | SOLUTION | 2 mg/mL | Y | Y | |
| 00591390087 | MEMANTINE HCL | memantine HCl | TAB DS PK | 5 mg (28)-10 mg (21) | Y | Y | |
| 00456320014 | NAMENDA | memantine HCl | TAB DS PK | 5 mg (28)-10 mg (21) | Y | Y | |
| 00591387544 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 00591387545 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 00591387560 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 00832111360 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 00904650606 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 00904650661 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 27241007105 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 27241007106 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 29300017205 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 29300017216 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 31722080860 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 33342029809 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 33342029815 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 47335032213 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 47335032286 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 50268058811 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 50268058813 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 53746016960 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 55111059705 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 55111059760 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 60687018411 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 60687018457 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 61442019305 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 62135089660 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 65162016906 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 68180023007 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 72578000405 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 72578000414 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 72603011901 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 72603011902 | MEMANTINE HCL | memantine HCl | TABLET | 10 mg | Y | Y | |
| 00527122106 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 00591387044 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 00591387045 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 00591387060 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 00832111260 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 00904650506 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 00904650561 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 27241007006 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 29300017105 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 29300017116 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 31722080760 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 33342029709 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 33342029715 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 47335032186 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 50268058711 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 50268058713 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 53746017360 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 55111059660 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 60687017311 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 60687017357 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 61442019205 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 62135089560 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 65162017306 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 68180022907 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 72578000305 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 72578000314 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 72603011801 | MEMANTINE HCL | memantine HCl | TABLET | 5 mg | Y | Y | |
| 69238124803 | MEMANTINE HCL-DONEPEZIL HCL ER | memantine HCl/donepezil HCl | CAP SPR 24 | 14 mg-10 mg | Y | Y | |
| 69680018330 | MEMANTINE HCL-DONEPEZIL HCL ER | memantine HCl/donepezil HCl | CAP SPR 24 | 14 mg-10 mg | Y | Y | |
| 00456121430 | NAMZARIC | memantine HCl/donepezil HCl | CAP SPR 24 | 14 mg-10 mg | Y | Y | |
| 62559020730 | MEMANTINE HCL-DONEPEZIL HCL ER | memantine HCl/donepezil HCl | CAP SPR 24 | 21 mg-10 mg | Y | Y | |
| 00456122130 | NAMZARIC | memantine HCl/donepezil HCl | CAP SPR 24 | 21 mg-10 mg | Y | Y | |
| 69238124703 | MEMANTINE HCL-DONEPEZIL HCL ER | memantine HCl/donepezil HCl | CAP SPR 24 | 28 mg-10 mg | Y | Y | |
| 69680018530 | MEMANTINE HCL-DONEPEZIL HCL ER | memantine HCl/donepezil HCl | CAP SPR 24 | 28 mg-10 mg | Y | Y | |
| 00456122830 | NAMZARIC | memantine HCl/donepezil HCl | CAP SPR 24 | 28 mg-10 mg | Y | Y | |
| 00456120730 | NAMZARIC | memantine HCl/donepezil HCl | CAP SPR 24 | 7 mg-10 mg | Y | Y | |
| 00078050315 | EXELON | rivastigmine | PATCH TD24 | 13.3 mg/24 hour | Y | Y | |
| 00078050361 | EXELON | rivastigmine | PATCH TD24 | 13.3 mg/24 hour | Y | Y | |
| 00378907216 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 13.3 mg/24 hour | Y | Y | |
| 00378907293 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 13.3 mg/24 hour | Y | Y | |
| 00781731331 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 13.3 mg/24 hour | Y | Y | |
| 00781731358 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 13.3 mg/24 hour | Y | Y | |
| 16714011701 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 13.3 mg/24 hour | Y | Y | |
| 16714011702 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 13.3 mg/24 hour | Y | Y | |
| 51991089930 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 13.3 mg/24 hour | Y | Y | |
| 51991089999 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 13.3 mg/24 hour | Y | Y | |
| 65162074934 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 13.3 mg/24 hour | Y | Y | |
| 70710119801 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 13.3 mg/24 hour | Y | Y | |
| 70710119807 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 13.3 mg/24 hour | Y | Y | |
| 00078050115 | EXELON | rivastigmine | PATCH TD24 | 4.6 mg/24 hour | Y | Y | |
| 00078050161 | EXELON | rivastigmine | PATCH TD24 | 4.6 mg/24 hour | Y | Y | |
| 00378907016 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 4.6 mg/24 hour | Y | Y | |
| 00378907093 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 4.6 mg/24 hour | Y | Y | |
| 00781730431 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 4.6 mg/24 hour | Y | Y | |
| 00781730458 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 4.6 mg/24 hour | Y | Y | |
| 16714011501 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 4.6 mg/24 hour | Y | Y | |
| 16714011502 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 4.6 mg/24 hour | Y | Y | |
| 51991089730 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 4.6 mg/24 hour | Y | Y | |
| 51991089799 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 4.6 mg/24 hour | Y | Y | |
| 65162082534 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 4.6 mg/24 hour | Y | Y | |
| 70710119601 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 4.6 mg/24 hour | Y | Y | |
| 70710119607 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 4.6 mg/24 hour | Y | Y | |
| 00078050215 | EXELON | rivastigmine | PATCH TD24 | 9.5 mg/24 hour | Y | Y | |
| 00078050261 | EXELON | rivastigmine | PATCH TD24 | 9.5 mg/24 hour | Y | Y | |
| 00378907116 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 9.5 mg/24 hour | Y | Y | |
| 00378907193 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 9.5 mg/24 hour | Y | Y | |
| 00781730931 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 9.5 mg/24 hour | Y | Y | |
| 00781730958 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 9.5 mg/24 hour | Y | Y | |
| 16714011601 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 9.5 mg/24 hour | Y | Y | |
| 16714011602 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 9.5 mg/24 hour | Y | Y | |
| 51991089830 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 9.5 mg/24 hour | Y | Y | |
| 51991089899 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 9.5 mg/24 hour | Y | Y | |
| 65162082634 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 9.5 mg/24 hour | Y | Y | |
| 70710119701 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 9.5 mg/24 hour | Y | Y | |
| 70710119707 | RIVASTIGMINE | rivastigmine | PATCH TD24 | 9.5 mg/24 hour | Y | Y | |
| 00781261406 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 1.5 mg | Y | Y | |
| 00904710761 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 1.5 mg | Y | Y | |
| 33342008909 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 1.5 mg | Y | Y | |
| 33342008915 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 1.5 mg | Y | Y | |
| 55111035205 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 1.5 mg | Y | Y | |
| 55111035260 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 1.5 mg | Y | Y | |
| 60687077701 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 1.5 mg | Y | Y | |
| 60687077711 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 1.5 mg | Y | Y | |
| 62135090060 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 1.5 mg | Y | Y | |
| 62332006360 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 1.5 mg | Y | Y | |
| 62756014513 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 1.5 mg | Y | Y | |
| 62756014586 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 1.5 mg | Y | Y | |
| 65862064860 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 1.5 mg | Y | Y | |
| 72241001103 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 1.5 mg | Y | Y | |
| 33342009009 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 3 mg | Y | Y | |
| 33342009015 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 3 mg | Y | Y | |
| 55111035305 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 3 mg | Y | Y | |
| 55111035360 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 3 mg | Y | Y | |
| 62135090160 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 3 mg | Y | Y | |
| 62332006460 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 3 mg | Y | Y | |
| 62756014613 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 3 mg | Y | Y | |
| 62756014686 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 3 mg | Y | Y | |
| 65862064960 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 3 mg | Y | Y | |
| 72241001203 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 3 mg | Y | Y | |
| 00781261606 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 4.5 mg | Y | Y | |
| 33342009109 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 4.5 mg | Y | Y | |
| 33342009115 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 4.5 mg | Y | Y | |
| 55111035405 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 4.5 mg | Y | Y | |
| 55111035460 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 4.5 mg | Y | Y | |
| 62135090260 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 4.5 mg | Y | Y | |
| 62332006560 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 4.5 mg | Y | Y | |
| 62756014713 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 4.5 mg | Y | Y | |
| 62756014786 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 4.5 mg | Y | Y | |
| 65862065060 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 4.5 mg | Y | Y | |
| 72241001303 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 4.5 mg | Y | Y | |
| 00781261706 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 6 mg | Y | Y | |
| 33342009209 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 6 mg | Y | Y | |
| 33342009215 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 6 mg | Y | Y | |
| 55111035505 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 6 mg | Y | Y | |
| 55111035560 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 6 mg | Y | Y | |
| 62135090360 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 6 mg | Y | Y | |
| 62332006660 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 6 mg | Y | Y | |
| 62756014813 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 6 mg | Y | Y | |
| 62756014886 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 6 mg | Y | Y | |
| 65862065160 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 6 mg | Y | Y | |
| 72241001403 | RIVASTIGMINE | rivastigmine tartrate | CAPSULE | 6 mg | Y | Y |