NVIH Formulary
This document defines the medications included on the Northern Valley Indian Health (NVIH) CHS formulary. The formulary lists the medications which are covered for those Native American patients who have no other payment source and obtain their medications at the expense of NVIH. Coverage of specific medications on this formulary will change over time with some medications being added and others excluded. The decisions regarding which medications are covered will be made by the Pharmacy and Therapeutics Committee.
If a patient or a provider wishes to request that a medication be paid for by NVIH CHS funds and that medication is not included on the formulary, the request should be made to the CHS committee. The CHS committee has the authority to grant exceptions to the limitations of the formulary. Requests that medications be added to the formulary should be made to the Pharmacy and Therapeutics Committee.
You can sort the table by clicking on the column headings.
| Generic Name | Brand Name | Category | Sub Category | Comments |
|---|---|---|---|---|
| miconazole topical 2% cream | - None | derm | fungal | |
| silver sulfadiazine 1% cream 50gm | - None | derm | abx | |
| neosporin ointment | - None | derm | abx | |
| sodium fluoride 0.5mg chewable tablets | - None | vit | - none | |
| nitroglycerin 0.2mg/hr patches | - None | card | other | |
| sulfacetamide 10% ophth oint | - None | ophtho | abx | |
| penicillin VK 250mg/5ml suspension | - None | abx | pcn | |
| phenobarbital 20mg/5ml elixir | - None | neuro | seizure | |
| tri-vit/fluor 0.25mg/cc | - None | vit | - none | |
| mebendazole 100 chewable tablet | - None | abx | anti-parasitic | |
| prednisone 10mg tablets | - None | endo | steriod | |
| prednisone 5mg tablets | - None | endo | steriod | |
| pseudoephedrine 60mg tablets | - None | ent | - none | |
| aspirin 325mg tablets | - None | heme | anticoag | |
| bacitracin Topical Ointment | - None | abx | topical | |
| benzoyl peroxide topical 10% 45gm | - None | derm | acne | |
| benzoyl peroxide topical 5% 60gm | - None | derm | acne | |
| allopurinol 300mg | - None | endo | - none | |
| cefaclor 250mg capsule | - None | abx | ceph2 | |
| ferrous sulfate elixir 220mg/5ml | - None | heme | - none | |
| dicloxacillin 500mg capsules | - None | abx | pcn | |
| guaifenesin/codeine expectorant | - None | ent | - none | |
| doxepin 75mg capsules | - None | psych | tca | |
| erythromycin 200mg/5ml suspension | - None | abx | macrolides | |
| multivitamin | - None | vit | - none | |
| niacin 100mg tablets | - None | lipid | - none | |
| sodium fluoride 1mg chewable tablets | - None | vit | - none | |
| sulfacetamide 10% ophth soln | - None | ophtho | abx | |
| phenobarbital 100mg tablets | - None | neuro | seizure | |
| tetracycline 250mg capsules | - None | abx | tetracyclines | |
| trazodone 100mg tablets | - None | psych | - none | |
| prednisone 1mg tablets | - None | endo | steriod | |
| prednisone 5mg/5ml solution | - None | endo | steriod | |
| acetaminophen/hydrocodone 325/5 | - None | pain | narc | |
| pseudoephedrine syrup 30mg/5ml | - None | ent | - none | |
| aspirin 81mg enteric coated tablets | - None | heme | anticoag | |
| baclofen 10mg tablets | - None | pain | - none | |
| benzoyl peroxide topical 10% 60gm | - None | derm | acne | |
| benzoyl peroxide topical 5% 90gm | - None | derm | acne | |
| cefaclor 500mg capsule | - None | abx | ceph2 | |
| colchicine 0.6mg. tablets | - None | renal | - none | |
| gentamicin 0.3% Ophth solution | - None | ophtho | abx | |
| guaifenex LA 600mg tablets | - None | ent | - none | |
| hydrocortisone 1% cream | - None | derm | steriod | |
| doxepin 100mg capsules | - None | psych | tca | |
| salsalate 500mg tablets | - None | - none | - none | |
| isoniazid 300mg tablets | - None | abx | anti-TB | |
| niacin 500mg tablets | - None | lipid | - none | |
| sodium fluoride 0.5mg drops | - None | vit | - none | |
| nitroglycerin 0.4mg/hr patches | - None | card | other | |
| penicillin VK 250mg tablets | - None | abx | pcn | |
| phenobarbital 30mg tablets | - None | neuro | seizure | |
| tetracycline 500mg capsules | - None | abx | tetracyclines | |
| trazodone 150mg tablets | - None | psych | - none | |
| prednisone 20mg tablets | - None | endo | steriod | |
| prenatal vitamin tablets | - None | vit | - none | |
| acetaminophen/hydrocodone 325/10 | - None | pain | narc | |
| rifampin 300mg | - None | abx | anti-TB | |
| artificial tears ophthalmic soln | - None | ophtho | ophtho | |
| baclofen 20mg tablets | - None | pain | - none | |
| benzoyl peroxide topical 10% 90gm | - None | derm | acne | |
| benzoyl peroxide topical 5% 45gm | - None | derm | acne | |
| bisacodyl 5mg EC tablets | - None | gi | - none | |
| acetaminophen/Codeine 30mg | - None | pain | narc | |
| fish oil | - None | card | - none | |
| gentamicin ophtho ointment | - None | ophtho | abx | |
| glucagon 1mg Emergency Kit | - None | dm | other | |
| guaifenesin 100mg/5ml syrup | - None | ent | - none | |
| hydrochlorothiazide 25mg tablets | - None | renal | diuretic | |
| doxepin 25mg capsules | - None | psych | tca | |
| silver sulfadiazine 1% cream 400gm | - None | derm | abx | |
| sodium Cl 0.04% nasal spray | - None | ent | - none | |
| nitroglycerin 0.6mg/hr patches | - None | card | other | |
| penicillin VK 500mg tablets | - None | abx | pcn | |
| phenobarbital 60mg tablets | - None | neuro | seizure | |
| trazodone 50mg tablets | - None | psych | - none | |
| triple antibiotic ointment | - None | derm | abx | |
| prednisone 50mg tablets | - None | endo | steriod | |
| promethazine/codeine syrup | - None | gi | - none | |
| aspirin 325mg enteric coated tablets | - None | heme | anticoag | |
| benzoyl peroxide topical 2.5% 60gm | - None | derm | acne | |
| bisacodyl 10mg suppositories | - None | gi | - none | |
| acetaminophen/Codeine Elixir 12.5mg/5ml | - None | pain | narc | |
| calcium 600mg w/ vit D tabs | - None | vit | - none | |
| allopurinol 100mg | - None | endo | - none | |
| ethosuximide 250mg | - None | neuro | seizure | |
| ferrous sulfate 325mg tablets | - None | heme | - none | |
| folic acid 1mg tablets | - None | vit | - none | |
| dapsone 100mg tablets | - None | abx | anti-TB | |
| dicloxacillin 250mg capsules | - None | abx | pcn | |
| guaifenesin DM cough syrup | - None | ent | - none | |
| hydrochlorothiazide 50mg tablets | - None | renal | diuretic | |
| doxepin 50mg capsules | - None | psych | tca | |
| erythromycin ophtho ointment | - None | ophtho | abx | |
| albuterol 5mg/ml solution | AccuNeb, Proventil, Ventolin, ProAir | pulm | beta-agonist | |
| albuterol 90mcg/spray MDI | AccuNeb, Proventil, Ventolin, ProAir | pulm | beta-agonist | |
| albuterol 2mg/5ml syrup | AccuNeb, Proventil, Ventolin, ProAir | pulm | beta-agonist | |
| pioglitazone 30mg | Actos | dm | tgz | |
| pioglitazone 15mg | Actos | dm | tgz | |
| pioglitazone 45mg | Actos | dm | tgz | |
| amphetamine/dextroamphetamine 12.5mg | Adderall | neuro | stim | |
| amphetamine/dextroamphetamine 5mg | Adderall | neuro | stim | |
| amphetamine/dextroamphetamine 15mg | Adderall | neuro | stim | |
| amphetamine/dextroamphetamine 7.5mg | Adderall | neuro | stim | |
| amphetamine/dextroamphetamine 20mg | Adderall | neuro | stim | |
| amphetamine/dextroamphetamine 10mg | Adderall | neuro | stim | |
| amphetamine/dextroamphetamine 30mg | Adderall | neuro | stim | |
| flunisolide inhaled | Aerobid | pulm | steriod | |
| spironolactone 100mg | Aldactone | renal | diuretic | |
| spironolactone 25mg | Aldactone | renal | diuretic | |
| spironolactone 50mg | Aldactone | renal | diuretic | |
| glimeprimide 4mg | Amaryl | derm | sulfonourea | |
| glimeprimide 2mg | Amaryl | derm | sulfonourea | |
| zolpidem 5mg | Ambien | psych | sleep | |
| zolpidem 10mg | Ambien | psych | sleep | |
| hyoscyamine Sulfate 0.125mg tablets | Anaspaz, Levbid, Levbid | gi | - none | |
| meclizine 25mg tablets | Antivert | neuro | - none | |
| mesalamine 400mg tablets | Asacol | gi | - none | |
| hydroxyzine 10mg/5ml Syrup | Atarax, Vistaril | allergy | h1-blocker | |
| hydroxyzine HCl 10mg tablets | Atarax, Vistaril | allergy | h1-blocker | |
| hydroxyzine HCl 25mg tablets | Atarax, Vistaril | allergy | h1-blocker | |
| lorazepam 0.5mg tablets | Ativan | psych | benzo | |
| lorazepam 1mg tablets | Ativan | psych | benzo | |
| ipatropium MDI | Atrovert | pulm | - none | |
| ipratropium 0.02% Soln | Atrovert | pulm | - none | |
| amoxicillin/clavulanate 200mg/5ml Suspension | Augmentin | abx | pcn/lactam | |
| amoxicillin/clavulanate 400/57mg chewable tablet | Augmentin | abx | pcn/lactam | |
| amoxicillin/clavulanate 875/125mg tablets | Augmentin | abx | pcn/lactam | |
| rosiglitazone 4mg tablets | Avandia | dm | tgz | |
| rosiglitazone 8mg tablets | Avandia | dm | tgz | |
| rosiglitazone 2mg tablets | Avandia | dm | tgz | |
| sulfamethoxazole/trimethoprim DS | Bactrim, Septra | abx | - none | |
| sulfamethoxazole/trimethoprim susp | Bactrim, Septra | abx | - none | |
| diphenhydramine 25mg capsules | Benadryl | allergy | h1-blocker | |
| diphenhydramine 12.5mg/5ml Elixir | Benadryl | allergy | h1-blocker | |
| dicyclomine 20mg tablets | Bentyl | gi | - none | |
| timolol 0.5% ophth Soln | Betimol, Timoptic | ophtho | b-blocker | |
| clarithromycin 500mg tablet | Biaxin | abx | other | only for H. pylori treatment |
| bumetanide 1mg tablets | Bumex | renal | diuretic | |
| buspirone 7.5mg tablets | Buspar | psych | - none | |
| buspirone 10mg tablets | Buspar | psych | - none | |
| buspirone 30mg tablets | Buspar | psych | - none | |
| buspirone 5mg tablets | Buspar | psych | - none | |
| exenatide 10mcg/0.04ml | Byetta | derm | other | |
| exenatide 5mcg/0.02ml | Byetta | derm | other | |
| verapamil 240mg CR tablets | Calan | card | ccb | |
| verapamil 80mg tablets | Calan | card | ccb | |
| verapamil 120mg CR tablets | Calan | card | ccb | |
| verapamil 180mg CR tablets | Calan | card | ccb | |
| captopril 25mg tablets | Capoten | card | ace | |
| captopril 50mg tablets | Capoten | card | ace | |
| sucralfate 1gm tablets | Carafate | gi | - none | |
| doxazosin 8mg | Cardura | card | a-blocker | |
| doxazosin 1mg | Cardura | card | a-blocker | |
| doxazosin 2mg | Cardura | card | a-blocker | |
| doxazosin 4mg | Cardura | card | a-blocker | |
| clonidine HCl 0.3mg tablets | Catapress | card | a-blocker | |
| clonidine HCl 0.1mg tablets | Catapress | card | a-blocker | |
| clonidine HCl 0.2mg tablets | Catapress | card | a-blocker | |
| citalopram 20mg | Celexa | psych | ssri | |
| citalopram 40mg | Celexa | psych | ssri | |
| citalopram 10mg | Celexa | psych | ssri | |
| acetaminophen Children's Drops 160mg/ml | Children’s Tylenol | pain | - none | |
| chlorpheniramine 4mg tablets | Chlor-Trimetron | allergy | h1-blocker | |
| chlorpheniramine 8mg SA capsuless | Chlor-Trimetron | allergy | h1-blocker | |
| cefaclor 250mg capsule | Chlor-Trimetron | abx | ceph2 | |
| ciprofloxacin 500mg tablets | Cipro | abx | fluroq | |
| loratidine 1mg/ml | Claritin | allergy | h1-blocker | |
| loratidine 10mg tablets | Claritin | allergy | h1-blocker | |
| clindamycin HCl 150mg capsules | Cleocin | abx | other | |
| clindamycin 1% Topical Solution | Cleocin | derm | acne | |
| clobetasol 0.05% cream 15gm | Clobex | derm | steroid high | |
| clobetasol 0.05% cream 30gm | Clobex | derm | steroid high | |
| clobetasol 0.05% cream 60gm | Clobex | derm | steroid high | |
| benztropine 1mg tablet | Cogentin | neuro | - none | |
| benztropine 2mg tablet | Cogentin | neuro | - none | |
| benztropine 0.5mg tablet | Cogentin | neuro | - none | |
| docusate sodium 50mg/5ml liquid | Colace | gi | - none | |
| docusate sodium 100mg capsules | Colace | gi | - none | |
| amiodarone 200 tablet | Cordarone, Pacerone | card | anti-arrhythmics | |
| carvedilol 25mg | Coreg | card | b-blocker | |
| carvedilol 3.125mg | Coreg | card | b-blocker | |
| carvedilol 6.25mg | Coreg | card | b-blocker | |
| carvedilol 12.5mg | Coreg | card | b-blocker | |
| neomycin/Polymyxin/HC otic suspension | Cortisporin Otic | abx | other | |
| warfarin 2mg tablets | Coumadin | heme | anticoag | |
| warfarin 5mg tablets | Coumadin | heme | anticoag | |
| warfarin 2.5mg tablets | Coumadin | heme | anticoag | |
| warfarin 6mg tablets | Coumadin | heme | anticoag | |
| warfarin 10mg tablets | Coumadin | heme | anticoag | |
| warfarin 3mg tablets | Coumadin | heme | anticoag | |
| warfarin 7.5mg tablets | Coumadin | heme | anticoag | |
| warfarin 1mg tablets | Coumadin | heme | anticoag | |
| warfarin 4mg tablets | Coumadin | heme | anticoag | |
| losartan 50mg | Cozaar | card | arb | |
| losartan 100mg | Cozaar | card | arb | |
| losartan 25mg | Cozaar | card | arb | |
| desmopressin acetate 10mcg/spray nasal | DDAVP | renal | - none | |
| desmopressin acetate 0.1mg tablets | DDAVP | renal | - none | |
| valproic acid 250mg capsule | Depakote | neuro | seizure | |
| divalproex sodium 250mg EC tablets | Depakote | neuro | seizure | |
| medroxyprogesterone acetate 150mg/ml injection | Depo-Provera | endo | - none | |
| dextroamphetamine 10mg extended release | Dexedrine | psych | stim | |
| dextroamphetamine 15mg extended release | Dexedrine | psych | stim | |
| dextroamphetamine 10mg | Dexedrine | psych | stim | |
| dextroamphetamine 15mg extended release | Dexedrine | psych | stim | |
| dextroamphetamine 5mg | Dexedrine | psych | stim | |
| glyburide 2.5mg tablets | Diabeta, Micronase | dm | sulfonourea | |
| glyburide 5mg tablets | Diabeta, Micronase | dm | sulfonourea | |
| glyburide 1.25mg tablets | Diabeta, Micronase | dm | sulfonourea | |
| triamterene/HCTZ 37.5/25 capsules | Diazide, Maxide | renal | diuretic | |
| triamterene/HCTZ 75/50 capsules | Diazide, Maxide | renal | diuretic | |
| fluconazole 150mg tablets | Diflucan | abx | antifungal | |
| phenytoin 100mg capsules | Dilantin | neuro | seizure | |
| phenytoin 125mg/5ml suspension | Dilantin | neuro | seizure | |
| oxybutynin 5mg tablets short acting | Ditropan | urol | - none | |
| amitriptyline HCl 100mg | Elavil | psych | tca | |
| amitriptyline HCl 75mg | Elavil | psych | tca | |
| amitriptyline HCl 150mg | Elavil | psych | tca | |
| amitriptyline HCl 25mg | Elavil | psych | tca | |
| amitriptyline HCl 50mg | Elavil | psych | tca | |
| permethrin 5% rinse | Elimite | derm | anti-parasitic | |
| epinephrine 0.3mg syringe | EpiPen | allergy | - none | |
| epinephrine 0.15mg syringe | EpiPen Jr. | allergy | - none | |
| erythromycin base 250mg tablets EC | Ery-Tab | abx | macrolides | |
| erythromycin base 500mg tablets | Ery-Tab | abx | macrolides | |
| acetaminophen 500mg tablets | ES Tylenol | pain | - none | |
| estradiol 1mg tablets | Estrace | endo | hrt | |
| estradiol 2mg tablets | Estrace | endo | hrt | |
| piroxicam 20mg capsules | Feldene | nsaid | - none | |
| butalbital/APAP/Caffeine 50/325/40mg tablet | Fioricet | neuro | ha | |
| butalbital/APAP/Caffeine 50/500/40mg tablet | Fioricet | neuro | ha | |
| metronidazole 250mg tablets | Flagyl | abx | other | |
| metronidazole 500mg tablets | Flagyl | abx | other | |
| sodium phosphate enema | Fleets | gi | - none | |
| cyclobenzaprine 10mg tablets | Flexeril | pain | other | |
| tamsulosin 0.4mg | Flomax | urol | - none | |
| fluticasone 50mcg nasal spray | Flonase | allergy | steriod | |
| alendronate 70mg tablets | Fosamox | endo | - none | |
| simethicone 80mg chew tablets | Gas-EX | gi | - none | |
| metformin 500mg tablets | Glucophage | dm | - none | |
| metformin 850mg tablets | Glucophage | dm | - none | |
| metformin 1000mg tablets | Glucophage | dm | - none | |
| glipizide XL 5mg | Glucotrol | dm | sulfonourea | |
| glipizide 10mg | Glucotrol | dm | sulfonourea | |
| glipizide XL 10mg | Glucotrol | dm | sulfonourea | |
| glipizide 5mg | Glucotrol | dm | sulfonourea | |
| glipizide XL 2.5mg | Glucotrol | dm | sulfonourea | |
| clotrimazole 1% vaginal cream | Gyne-Lotrimin | gyn | fungal | |
| insulin lispro 100units/ml 10ml vial | Humalog | dm | insulin | |
| insulin lispro 100units/ml 3ml cart | Humalog | dm | insulin | |
| insulin lispro protamine/lispro 75/25 10ml vial | Humalog 75/25 | dm | insulin | |
| insulin lispro protamine/lispro 75/25 3ml syringes | Humalog 75/25 | dm | insulin | |
| terazosin 5mg capsules | Hytrin | card | a-blocker | |
| terazosin 10mg capsules | Hytrin | card | a-blocker | |
| terazosin 1mg capsules | Hytrin | card | a-blocker | |
| terazosin 2mg capsules | Hytrin | card | a-blocker | |
| isosorbide mononitrate 120mg ER tablets | Imdur | card | nitrate | |
| isosorbide mononitrate 30mg ER tablets | Imdur | card | nitrate | |
| isosorbide mononitrate 60mg ER tablets | Imdur | card | nitrate | |
| loperimide 2mg capsules | Immodium | gi | - none | |
| propranolol 10mg tablets | Inderal | card | b-blocker | |
| propranolol 20mg tablets | Inderal | card | b-blocker | |
| propranolol 40mg tablets | Inderal | card | b-blocker | |
| propranolol 80mg tablets | Inderal | card | b-blocker | |
| acetaminophen Infant Drops 100mg/ml | Infant Tylenol | pain | - none | |
| isosorbide dinitrate 10mg tablets | Isordil | card | nitrate | |
| cephalexin 500mg capsules | Keflex | abx | ceph1 | |
| cephalexin 250mg/5ml suspension | Keflex | abx | ceph1 | |
| cephalexin 250mg capsules | Keflex | abx | ceph1 | |
| triamcinolone 0.1% cream | Kenalog | derm | steriod | |
| clonazepam 0.5mg tablets | Klonopin | psych | benzo | |
| clonazepam 1mg tablets | Klonopin | psych | benzo | |
| clonazepam 2mg tablets | Klonopin | psych | benzo | |
| digoxin 125mcg tablets | Lanoxin | card | anti-arrhythmics | |
| digoxin 250mcg tablets | Lanoxin | card | anti-arrhythmics | |
| insulin glargine 100units/ml 10ml vial | Lantus | dm | insulin | |
| insulin glargine 100units/ml 3ml cartridge | Lantus | dm | insulin | |
| furosemide 20mg tablets | Lasix | renal | diuretic | |
| furosemide 40mg tablets | Lasix | renal | diuretic | |
| furosemide 80mg tablets | Lasix | renal | diuretic | |
| insulin detemir 100units/ml 10ml | Levamir | dm | insulin | |
| levofloxacin 500mg tablets | Levaquin | abx | fluroq | restricted to pneumonia |
| fluocinonide 0.05% cream | Lidex, Vanos | derm | steroid | |
| fluocinonide 0.05% ointment | Lidex, Vanos | derm | steroid | |
| fluocinonide 0.05% solution | Lidex, Vanos | derm | steroid | |
| lithium 150mg tablets | Lithobid | psych | - none | |
| lithium 600mg controlled release tablets | Lithobid | psych | - none | |
| lithium 300mg tablets | Lithobid | psych | - none | |
| lithium 300mg controlled release tablets | Lithobid | psych | - none | |
| lithium 450mg controlled release tablets | Lithobid | psych | - none | |
| ethinyl estradiol/norgestrel tablets | Lo/Ovral | endo | ocp | |
| diphenoxylate/atropine tablets | Lomotil | gi | - none | |
| gemfibrozil 600mg tablets | Lopid | lipid | fibrate | |
| metoprolol 50mg tablets | Lopressor, Toprol | card | b-blocker | |
| metoprolol 25mg tablets | Lopressor, Toprol | card | b-blocker | |
| metoprolol 100mg tablets | Lopressor, Toprol | card | b-blocker | |
| benazepril 10mg tablets | Lotensin | card | ace | |
| benazepril 20mg tablets | Lotensin | card | ace | |
| benazepril 40mg tablets | Lotensin | card | ace | |
| benazepril 5mg tablets | Lotensin | card | ace | |
| clotrimazole 1% topical cream | Lotrimin, Mycelex | derm | fungal | |
| clotrimazole 1% topical solution | Lotrimin, Mycelex | derm | fungal | |
| nitrofurantoin 50mg caps | Macrobid | abx | other | |
| nitrofurantoin 50mg caps | Macrobid | abx | other | |
| nitrofurantoin 100mg caps | Macrobid | abx | other | |
| lovastatin 10mg tablets | Mevacor | lipid | statin | |
| lovastatin 20mg tablets | Mevacor | lipid | statin | |
| lovastatin 40mg tablets | Mevacor | lipid | statin | |
| telmisartan 40mg | Micardis | card | arb | step therapy |
| telmisartan 80mg | Micardis | card | arb | step therapy |
| potassium chloride 20mEq | Micro-K | renal | - none | |
| prazosin 1mg capsules | Minipress | card | a-blocker | |
| prazosin 2mg capsules | Minipress | card | a-blocker | |
| prazosin 5mg capsules | Minipress | card | a-blocker | |
| minocycline 100mg capsules | Minocin, Solodyn | abx | tetracyclines | |
| minocycline 50mg capsules | Minocin, Solodyn | abx | tetracyclines | |
| ibuprofen 400mg tablets | Motrin | nsaid | - none | |
| ibuprofen 600mg tablets | Motrin | nsaid | - none | |
| ibuprofen 800mg tablets | Motrin | nsaid | - none | |
| ibuprofen suspension 100mg/5ml | Motrin | nsaid | - none | |
| nystatin/triamcinolone cream 30gm | Mycolog | derm | fungal | |
| nystatin/triamcinolone cream 45gm | Mycolog | derm | fungal | |
| nystatin/triamcinolone cream 15gm | Mycolog | derm | fungal | |
| nystatin cream 100,000U/gm | Mycostatin | derm | fungal | |
| nystatin ointment 100,000U/gm | Mycostatin | derm | fungal | |
| nystatin oral suspension 100,000U/gm | Mycostatin | derm | fungal | |
| alum/Mag/Simth 400/400/40mg | Mylanta II | gi | - none | |
| simethicone 40mg/0.6ml drops | Mylicon Drops | gi | - none | |
| naproxen 500mg tablets | Naprosyn | nsaid | - none | |
| gabapentin 300 capsules | Neurontin | pain | - none | |
| nitroglycerin 0.4mg Sublingual tablets | Nitrostat, Nitroquick | card | other | |
| permethrin 1% rinse | Nix | derm | anti-parasitic | |
| ketoconazole 2% cream 30gm | Nizoral | derm | fungal | |
| ketoconazole 2% cream 60gm | Nizoral | derm | fungal | |
| ketoconazole 2% shampoo | Nizoral | derm | fungal | |
| ketoconazole 2% cream 15gm | Nizoral | derm | fungal | |
| amlodipine 10mg tablets | Norvasc | card | ccb | |
| amlodipine 2.5mg tablets | Norvasc | card | ccb | |
| amlodipine 5mg tablets | Norvasc | card | ccb | |
| insulin aspart 100unit/ml 3ml cartridge | Novalog | dm | insulin | |
| insulin aspart 100unit/ml 10ml vial | Novalog | dm | insulin | |
| insulin aspart protamine/aspart 70/30 3ml cartridge | Novalog 70/30 | dm | insulin | |
| insulin aspart protamine/aspart 70/30 vial | Novalog 70/30 | dm | insulin | |
| insulin human 70/30 100units/ml 10ml vial | Novolin 70/30, Humulin 70/30 | dm | insulin | |
| insulin human 70/30 100units/ml 3ml cart | Novolin 70/30, Humulin 70/30 | dm | insulin | |
| insulin human NPH 100units/ml 10ml vial | Novolin N, Humulin N | dm | insulin | |
| insulin human NPH 100units/ml 3ml cart | Novolin N, Humulin N | dm | insulin | |
| insulin human regular 100units/ml 10ml vial | Novolin R, Humulin R | dm | insulin | |
| insulin human regular 100units/ml 3ml cart | Novolin R, Humulin R | dm | insulin | |
| ofloxacin 0.3% ophtho solution | Ocuflox | ophtho | abx | |
| ethinyl estradiol/norethindrone - 28 tablets | Ortho-Novum | endo | ocp | |
| nortriptyline HCl 10mg capsules | Pamelor | psych | tca | |
| nortriptyline HCl 25mg capsules | Pamelor | psych | tca | |
| nortriptyline HCl 50mg capsules | Pamelor | psych | tca | |
| nortriptyline HCl 75mg capsules | Pamelor | psych | tca | |
| bromocriptine 2.5mg tablets | Parlodel | endo | endo | |
| paroxetine 30mg tablets | Paxil | psych | ssri | |
| paroxetine 40mg tablets | Paxil | psych | ssri | |
| paroxetine 10mg tablets | Paxil | psych | ssri | |
| paroxetine 20mg tablets | Paxil | psych | ssri | |
| prednisolone 15mg/5ml soln | PediaPred | endo | steriod | |
| erythromycin/sulfisoxazole 200/600 susp | Pediazole | abx | macrolides | |
| famotidine 20mg | Pepcid | gi | h2-blocker | |
| bismuth subsalicylate chewable tablets | Pepto Bismal | gi | - none | |
| promethazine 25mg tablet | Phenergan | gi | - none | |
| promethazine 50mg tablet | Phenergan | gi | - none | |
| promethazine 50mg suppositories | Phenergan | gi | - none | |
| promethazine 12.5mg suppositories | Phenergan | gi | - none | |
| hydroxychloroquine 200mg tablets | Plaquenil | rheum | - none | |
| clopidogrel 75mg tablet | Plavix | heme | anticoag | |
| polymixin b/trimethoprim ophthal | Polytrim | ophtho | abx | |
| pravastatin 10mg tablets | Pravachol | lipid | statin | |
| pravastatin 20mg tablets | Pravachol | lipid | statin | |
| pravastatin 40mg tablets | Pravachol | lipid | statin | |
| estrogen, conjugated 1.25mg | Premarin | endo | hrt | |
| estrogen, conjugated 0.625mg | Premarin | endo | hrt | |
| omeprazole 20mg capsules | Prilosec | gi | ppi | |
| omeprazole 10mg capsules | Prilosec | gi | ppi | |
| nifedipine SR 60mg tablets | Procardia, Adalat | card | ccb | |
| nifedipine SR 30mg tablets | Procardia, Adalat | card | ccb | |
| hydrocortisone rectal 25mg suppositories | Proctosol, Cortiform | gi | steriod | |
| finasteride 5mg | Proscar | urol | - none | |
| medroxyprogesterone 2.5mg | Provera | endo | - none | |
| medroxyprogesterone 10mg | Provera | endo | - none | |
| medroxyprogesterone 5mg | Provera | endo | - none | |
| fluoxetine 10mg tablet | Prozac | psych | tca | |
| fluoxetine 20mg tablet | Prozac | psych | tca | |
| phenazopyridine 100mg | Pyridium | urol | - none | |
| metoclopramide 10mg tablets | Reglan | gi | - none | |
| metoclopramide 5mg/5ml syrup | Reglan | gi | - none | |
| mirtazapine 30mg | Remeron | psych | - none | |
| mirtazapine 45mg | Remeron | psych | - none | |
| mirtazapine 15mg | Remeron | psych | - none | |
| temazepam 30mg capsules | Restoril | psych | benzo | |
| temazepam 15mg capsules | Restoril | psych | benzo | |
| methylphenidate 5mg tablet | Ritalin | rheum | stim | |
| methylphenidate 20mg CR tablet | Ritalin | rheum | stim | |
| methylphenidate 10mg tablet | Ritalin | rheum | stim | |
| methylphenidate 20mg tablet | Ritalin | rheum | stim | |
| methocarbamol 500mg tablets | Robaxin | pain | - none | |
| ceftriaxone 1Gm. Vial | Rocephin | abx | ceph3 | in-house severe infection |
| selenium sulfide shampoo 2.5% | Selsun | derm | - none | |
| carbidopa/levodopa 25/250 tablets | Sinemet | neuro | - none | |
| carbidopa/levodopa CR 25/250 tablets | Sinemet | neuro | - none | |
| carbidopa/levodopa 10/100 tablets | Sinemet | neuro | - none | |
| carbidopa/levodopa 25/100 tablets | Sinemet | neuro | - none | |
| montelukast 4mg chewable tablet | Singular | allergy | leukotriene | Step therapy required |
| montelukast 10mg tablet | Singular | allergy | leukotriene | Step therapy required |
| montelukast 5mg chewable tablet | Singular | allergy | leukotriene | Step therapy required |
| carisoprodol 350mg tablets | Soma | pain | - none | |
| amantadine 100mg capsules | Symmetrel | abx | viral | |
| levothyroxine 100mcg tablets | Synthroid | endo | - none | |
| levothyroxine 150mcg tablets | Synthroid | endo | - none | |
| levothyroxine 50mcg tablets | Synthroid | endo | - none | |
| levothyroxine 112mcg tablets | Synthroid | endo | - none | |
| levothyroxine 175mcg tablets | Synthroid | endo | - none | |
| levothyroxine 75mcg tablets | Synthroid | endo | - none | |
| levothyroxine 125mcg tablets | Synthroid | endo | - none | |
| levothyroxine 200mcg tablets | Synthroid | endo | - none | |
| levothyroxine 88mcg tablets | Synthroid | endo | - none | |
| levothyroxine 137mcg tablets | Synthroid | endo | - none | |
| levothyroxine 25mcg tablets | Synthroid | endo | - none | |
| methimazole 10mg | Tapazole | endo | - none | |
| methimazole 5mg | Tapazole | endo | - none | |
| carbamazepine 100mg/5ml suspension | Tegretol | neuro | seizure | |
| carbamazepine 200mg tablets | Tegretol | neuro | seizure | |
| carbamazepine 100mg Chewable tablets | Tegretol | neuro | seizure | |
| atenolol 50mg tablets | Tenormin | card | b-blocker | |
| atenolol 100mg tablets | Tenormin | card | b-blocker | |
| atenolol 25mg tablets | Tenormin | card | b-blocker | |
| diltiazem 120mg SR capsules | Tiazac, Cardizem | card | ccb | |
| diltiazem 360mg SR capsules | Tiazac, Cardizem | card | ccb | |
| diltiazem 180mg SR capsules | Tiazac, Cardizem | card | ccb | |
| diltiazem 60mg tablets | Tiazac, Cardizem | card | ccb | |
| diltiazem 240mg SR capsules | Tiazac, Cardizem | card | ccb | |
| diltiazem 90mg SR capsules | Tiazac, Cardizem | card | ccb | |
| diltiazem 300mg SR capsules | Tiazac, Cardizem | card | ccb | |
| imipramine HCl 10mg tablets | Tofranil | psych | tca | |
| imipramine HCl 25mg tablets | Tofranil | psych | tca | |
| imipramine HCl 50mg tablets | Tofranil | psych | tca | |
| pentoxifylline 400mg SA tablets | Trental | heme | - none | |
| methotrexate 2.5mg tablets | Trexall | rheum | - none | |
| amoxicillin 125mg/5ml Susp | Trimox | abx | pcn | |
| amoxicillin 250mg capsules | Trimox | abx | pcn | |
| amoxicillin 250mg/5ml Susp | Trimox | abx | pcn | |
| amoxicillin 500mg capsules | Trimox | abx | pcn | |
| acetaminophen 120mg suppositories | Tylenol | pain | - none | |
| acetaminophen 325mg tablets | Tylenol | pain | - none | |
| tramadol 50mg tablets | Ultram | pain | - none | |
| diazepam 2mg tablets | Valium | psych | benzo | |
| diazepam 5mg tablets | Valium | psych | benzo | |
| diazepam 10mg tablets | Valium | psych | benzo | |
| beclomethazone MDI | Vanceril, Beclovent | pulm | steriod | |
| enalapril 10mg tablets | Vasotec | card | ace | |
| enalapril 20mg tablets | Vasotec | card | ace | |
| enalapril 2.5mg tablets | Vasotec | card | ace | |
| enalapril 5mg tablets | Vasotec | card | ace | |
| doxycycline 100mg tablets | Vibramycin | abx | tetracyclines | |
| hydrocodone/APAP 5/500 tablets | Vicodin | pain | narc | |
| acetaminophen/hydrocodone 750/7.5 | Vicodin | pain | narc | |
| pyridoxine 50mg tablets | Vitamin B6 | vit | - none | |
| diclofenac Sodium 50mg EC tablets | Voltaren | nsaid | - none | |
| bupropion 150mg extended tablets | Wellbutrin, Zyban | psych | - none | |
| bupropion 150mg extended tablets | Wellbutrin, Zyban | psych | - none | |
| alprazolam 2mg | Xanax | psych | benzo | |
| alprazolam 0.25mg | Xanax | psych | benzo | |
| alprazolam 0.50mg | Xanax | psych | benzo | |
| alprazolam 1mg | Xanax | psych | benzo | |
| ranitidine 15mg/ml syrup | Zantac | gi | h2-blocker | |
| ranitidine 300mg | Zantac | gi | h2-blocker | |
| ranitidine 150mg | Zantac | gi | h2-blocker | |
| metolazone 10mg | Zaroxylin | renal | diuretic | |
| metolazone 2.5mg | Zaroxylin | renal | diuretic | |
| metolazone 5mg | Zaroxylin | renal | diuretic | |
| lisinopril 20mg tablets | Zestril/Prinivil | card | ace | |
| lisinopril 30mg tablets | Zestril/Prinivil | card | ace | |
| lisinopril 40mg tablets | Zestril/Prinivil | card | ace | |
| lisinopril 10mg tablets | Zestril/Prinivil | card | ace | |
| lisinopril 5mg tablets | Zestril/Prinivil | card | ace | |
| azithromycin 200mg/5ml. Susp. | Zithromax | abx | macrolides | |
| azithromycin 250mg tablets | Zithromax | abx | macrolides | |
| azithromycin 500mg tablets | Zithromax | abx | macrolides | |
| simvastatin 20mg tablets | Zocor | lipid | statin | |
| simvastatin 40mg tablets | Zocor | lipid | statin | |
| simvastatin 80mg tablets | Zocor | lipid | statin | |
| simvastatin 10mg tablets | Zocor | lipid | statin | |
| sertaline 100mg tablets | Zoloft | psych | ssri | |
| sertaline 25mg tablets | Zoloft | psych | ssri | |
| sertaline 50mg tablets | Zoloft | psych | ssri | |
| capsaicin 0.25% cream | Zostrix Cream | derm | - none | |
| acyclovir 200mg | Zovirax | abx | viral | |
| acyclovir 400mg | Zovirax | abx | viral | |
| acyclovir 800mg | Zovirax | abx | viral | |
| cetirizine 10mg tablets | Zyrtec | allergy | h1-blocker | |
| cetirizine 1mg/1ml syrup | Zyrtec | allergy | h1-blocker |
