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First Fill prescription drug list

These drugs are approved for use with SAIF's voluntary First Fill pharmacy benefit. Some have quantity limits.

Acetaminophen*
Amoxicillin
Cephalexin
Ciprofloxacin
Codeine/apap 300-30 and 300-60
Cyclobenzaprine
Erythromycin
Hydrocodone apap 5-325 mg
Ibuprofen*
Morphine Sulphate 15 mg
Morphine Suplhate 30 mg
Naproxen*
Oxycodone 5 mg
Oxycodone/apap 5-325 mg
Tramadol
Penicillin
Silver sulfadiazine cream
Temazepam
Tetracycline
Zolpidem

*Over-the-counter and prescription strength medications are covered with a provider's prescription.

 

From saif.com

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