APPENDIX C. EXCLUSIONS BASED ON MEDICATIONS
SP medications are reviewed by the Physician and the SP is excluded from CV Fitness if he or she is
taking any of the following medications. Medications are reviewed quarterly and updated if necessary.
Last updated 01-01-2005
Class
Code Class Name Generic Drug Name
CARDIOTONICS/*Cardiac Glycosides*
312000 Digoxin DIGITEK
312000 Digoxin DIGOXIN
312000 Digoxin DIGOXIN PEDIATRIC
312000 Digoxin DIGOXIN-TAB
312000 Digoxin LANOXICAPS
312000 Digoxin LANOXIN
312000 Digoxin THSC DIGOXIN
ANTIANGINAL AGENTS/Nitrates**
321000 Amyl Nitrite Inhal AMYL NITRITE
321000 Amyl Nitrite Inhal AMYL NITRITE INHAL
321000 Nitroglycerin TD Patch HR HR DEPONIT
321000 Isosorbide Dinitrate CR DILATRATE SR
321000 Isosorbide Mononitrate SR HR IMDUR
321000 Isosorbide Mononitrate ISMO
321000 Isosorbide Dinitrate CR ISOCHRON
321000 Isosorbide Dinitrate SL ISORDIL
321000 Isosorbide Dinitrate ISORDIL TITRADOSE
321000 Isosorbide Dinitrate ISOSORBIDE DINITRATE
321000 Isosorbide Dinitrate CR ISOSORBIDE DINITRATE CR
321000 Isosorbide Dinitrate CR ISOSORBIDE DINITRATE ER
321000 Isosorbide Dinitrate CR ISOSORBIDE DINITRATE SA
321000 Isosorbide Dinitrate SL ISOSORBIDE DINITRATE SL
321000 Isosorbide Dinitrate CR ISOSORBIDE DINITRATE SR
321000 Isosorbide Dinitrate CR ISOSORBIDE DINITRATE TD
321000 Isosorbide Dinitrate CR ISOSORBIDE DINITRATE TR
321000 Isosorbide Mononitrate ISOSORBIDE MONONITRATE
321000 Isosorbide Mononitrate SR HR ISOSORBIDE MONONITRATE ER
321000 Isosorbide Mononitrate SR HR ISOSORBIDE MONONITRATE SR 24HR
321000 Nitroglycerin TD Patch HR HR MINITRAN
321000 Isosorbide Mononitrate MONOKET