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