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Formulary and Therapeutic Interchanges

3rd Quarter, 2022 (updated October 24, 2022)

Heritage Health - Nebraska Total Care 

Suggested Interchanges
Class Non-Preferred Preferred Alternatives
ANTIDIABETICS

Basaglar,
Insulin Glar, Toujeo Max, Toujeo Solo

Admelog
Solo

Novolog

Rybelsus

Lantus,
Lantus Solos

Humalog,
Humalog Jr, Humalog Kwik, Insulin Lisp, Insulin Lispro Kwik

Insulin
Aspart, Insulin Aspart Kwik

Ozempic*

ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ANOREXIANTS

Dexmethylphenidate ER,
Focalin

 Adhansia Xr, Aptensio Xr,  Jornay Pm, 
Quillichew, Quillivant

Amphet/dextr,
Mydayis

Strattera

Intuniv

Dexmethylphenidate, Focalin
Xr

Concerta, Methylin,
Methylphenidate, Quillichew,

Adderall, Adderall Xr

Atomoxetine

Guanfacine

ANTIASTHMATIC AND BRONCHODILATOR AGENTS

Budes/formot,

Proair
Respi, Proventil, Ventolin Hfa

Flutic/salme,
Wixela Inhub

Fluticas
Hfa

Budesonide

Symbicort

Albuterol

Advair
Disku, Advair Hfa

Spiriva

Flovent
Hfa

Pulmicort

ANTIDEPRESSANTS

Forfivo Xl,

Trintellix

Desvenlafaxine

Viibryd

Bupropion Hcl

Fluoxetine

Venlafaxine

Escitalopram

GASTROINTESTINAL AGENTS - MISC.

Delzicol, Mesalamine, Pentasa

Cimzia Prefl, Cimzia Start

Lubiprostone

Sevelamer

Apriso, Lialda, Canasa

Amitiza

Renvela

*This brand product has a generic equivalent recommended as an alternative.