**All**A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Product Name | Implementation Date | Guideline |
---|---|---|

EDURANT | 07/01/12 | The limits are 1 tablet per day. |

EFFEXOR XR® | 07/01/05 | The limits are 1 capsule per day, except Effexor XR 75mg which has a limit of 3 capsules per day. |

ELIQUIS | 07/01/13 | The limits are 2 tablets per day for Eliquis 2.5mg and 4 tablets per day for Eliqus 5 mg. |

EMBEDA™ | 09/09/09 | The limits are 2 capsules per day. |

EMEND® | 11/12/08 | The limits are 4 capsules per 30 days for Emend 80mg, 2 capsules per 30 days for Emend 125mg, and 2 packs (6 capsules) per 30 days for Emend 125mg/80mg packs. |

EMTRIVA | 07/01/12 | The limits are 1 capsule or 24 mL per day. |

ENBREL® | 05/17/99 | Enbrel may be subject to step therapy requirements. Patients must have trial and failure of a first-line DMARD. The limits are 8 doses of Enbrel 25mg or 4 doses of Enbrel 50mg per 28 days. |

ENDOCET® | 01/01/00 | The limits for are 12 tablets per day for Endocet 5-325mg , 8 tablets per day for 7.5-325mg and 7.5-500mg, and 6 tablets per day for 10-325mg and 10-650mg. |

EPIDUO® | 01/01/11 | Prior authorization for medical necessity may be required. |

EPIVIR | 07/01/12 | The limits are 2 tablets for Epivir 150 mg, 1 tablet for Epivir 300 mg or 32 mL per day for Epivir solution. |

EPZICOM | 07/01/12 | The limits are 1 tablet per day. |

ERIVEDGE™ | 07/01/12 | Prior authorization for medical necessity is required. The limits are 1 capsule per day. |

ESBRIET® | 10/20/14 | Prior authorization for medical necessity is required. |

ESGIC | 04/01/13 | The limits are 6 tablets or capsules per day. |

ESGIC PLUS | 04/01/13 | The limits are 6 tablets or capsules per day. |