FORMULARY: ALPHABETICAL LISTING...5 FORMULARY: ALPHABETICAL LISTING *Most current Formulary List...

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FORMULARY: ALPHABETICAL LISTING* *Most current Formulary List of Drugs can be found:

1. DUH intranet [click on DRH (Duke Regional Hospital), Departments and Services, Pharmacy, then Lincoln Community Health Center Formulary] https://intranet.dm.duke.edu/hospitals/drh/pharmacy/Document%20Library/LCHC%20Formulary.pdf

2. LCHC website (http://www.lincolnchc.org/secondary/drug-formulary.html) 3. PADC website (http://www.projectaccessdurham.org/), then click on the Lincoln Pharmacy formulary. 4. LCHC Intranet/ Pharmacy Department/ Formulary of Drugs

Use Ctrl-F to quickly search the listing for a specific item.

Rx Pathways Plan Pfizer drugs are available to uninsured patients who are at or below 400% of the federal

poverty level. Only a dispensing fee is charged. NOTE: These medications are labeled as “RxP”.

Patient Assistance Program Patients who meet specific eligibility requirements may receive formualry medications

through manufacturer-sponsored patient assistance programs (PAPs). Medications labeled as “PAP” are available to eligible patients through manufacturer-sponsored PAPs. These medications may not be readily available and may require up to an 8-week processing period.

HIV Patient Assistance Program EI Clinic may access medications through for qualified patients. For patients that do not

qualify for ADAP, HIV medications may be obtained from manufacturer programs. http://epi.publichealth.nc.gov/cd/hiv/docs/ADAPProgrammanual.pdf

Project Access Durham County Project Access Durham County (PADC) serves eligible low-income, uninsured Durham

residents who have specialty medical care needs. PADC enrolls members based on referrals from a primary care provider at Lincoln Community Health Center (LCHC). PADC patients are eligible for LCHC formulary medications.

Lab Monitoring Some formulary drugs require laboratory monitoring and are labeled as “LAB”.

Safety in Lactation Lactation safety data from American Academy of Pediatrics (www.aap.org)

Medicaid Preferred Drug List http://www.ncdhhs.gov/dma/pharmacy/PDL.pdf Medicaid Prior Authorizations https://www.nctracks.nc.gov/content/public/providers.html Hazardous Drugs Drugs identified by National Institute of Occupational Safety and Health as hazardous are

labeled as “HD”. Use caution when handling. (http://www.cdc.gov/niosh/docs/2014-138/pdfs/2014-138.pdf)

https://intranet.dm.duke.edu/hospitals/drh/pharmacy/Document%20Library/LCHC%20Formulary.pdf

http://www.projectaccessdurham.org/

http://epi.publichealth.nc.gov/cd/hiv/docs/ADAPProgrammanual.pdf

http://www.aap.org/

http://www.ncdhhs.gov/dma/pharmacy/PDL.pdf

https://www.nctracks.nc.gov/content/public/providers.html

http://www.cdc.gov/niosh/docs/2014-138/pdfs/2014-138.pdf

http://www.cdc.gov/niosh/docs/2014-138/pdfs/2014-138.pdf

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Medication Brand Name Therapeutic Category Pharmacologic Category

Package Size

Preg Cat Safety in Lactation

Crush/ Split Dose Adjust L=Liver

K=Kidney

Acetaminophen/Codeine Tab 300mg/30mg

Tylenol With Codeine #3

ANAGESICS AND ANTIPYRETICS

Opioid C ? + L

Acetaminophen Suspension 160mg/5mL

Tylenol Susp ANAGESICS AND ANTIPYRETICS

Miscellaneous 120 mL B + L

Acetaminophen Tablet 325mg

Tylenol ANAGESICS AND ANTIPYRETICS

Miscellaneous #100 tabs B + + L

Acetazolamide Tablet 500mg ER 12 hr

Diamox Sequels

CARDIOVASCULAR DRUGS

Carbonic Anhydrase Inhibitor

C - + K/L

Acyclovir Capsule 200mg Zovirax ANTI-INFECTIVES Diuretic B + - K/L

Acyclovir Suspension 200mg/5mL

Zovirax ANTI-INFECTIVES Antiviral B + K/L

Adalimumab Injection 40mg PAP,LAB

Humira RHEUMATOLOGY Tumor Necrosis Factor Blocking Agent

90 day supply PAP

B - - ?

Albendazole Tablet 200mg

Albenza ANTI-INFECTIVES Antihelmintic C ? + K

Albuterol MDI Proventil, Ventolin, ProAir

RESPIRATORY AGENTS Bronchodilator, Beta2-Adrenergic Agonist

6.7 gm C ?

Albuterol Nebulizer Solution 0.083%

Proventil, Ventolin

RESPIRATORY AGENTS Bronchodilator, Beta2-Adrenergic Agonist

#25 C ?

Alendronate Tablet 4mg Fosamax ENDOCRINE AND METABOLIC AGENTS

Biphosphonates, Osteoporosis

#4 tabs C - - K

Allopurinol Tablet 100mg Zyloprim ENDOCRINE AND METABOLIC AGENTS

Gout, Xanthine Oxidase Inhibitors

90 day supply available

C + + K

Allopurinol Tablet 300mg Zyloprim ENDOCRINE AND METABOLIC AGENTS

Gout, Xanthine Oxidase Inhibitors


C + + K

7


Package Size



K=Kidney

Amiodarone Tablet 200mg LAB

Cordarone CARDIOVASCULAR DRUGS

Antiarrhythmic D - + L

Amitriptyline Tablet 25mg Elavil ANTIDEPPRESSANT AGENTS

Tricyclic D - +

Amitriptyline Tablet 50mg Elavil ANTIDEPPRESSANT AGENTS

Tricyclic D - +

Amlodipine Tablets 5mg Norvasc CARDIOVASCULAR DRUGS

Calcium Channel Blocker

C ? + L

Amlodipine Tablets 10mg Norvasc CARDIOVASCULAR DRUGS


C ? + L

Amoxicillin Capsule 250mg

Amoxil ANTI-INFECTIVES Penicillin B + - K

Amoxicillin Suspension 250mg/5mL

Amoxil ANTI-INFECTIVES Penicillin B + K

Amoxicillin/Clavulanic Acid Tablets 875mg/125mg

Augmentin ANTI-INFECTIVES Penicillin B ? + K/L

Anastrozole Tablet 1mg PAP,LAB, HD

Arimidex ANTINEOPLASTIC AGENTS

Aromatase Inhibitor 90 day supply PAP

X -

Artificial Tear Drops Artificial Tears

EYE, EAR, NOSE, AND THROAT

Lubricant 15 mL 90 day supply available

+ +

Artificial Tear Ointment Duratears EYE, EAR, NOSE, AND THROAT

Lubricant 3.5 gm 90 day supply available

+ +

Aspirin Tablet 325 mg (enteric coated)

Ecotin CARDIOVASCULAR DRUGS

Salicylate #100 tablets

D ? - K/L

Aspirin Tablet 81mg (enteric coated)

Ecotin CARDIOVASCULAR DRUGS

Salicylate #120 tabs D ? - K/L

8


Package Size



K=Kidney

Atenolol Tablet 50mg Tenormin CARDIOVASCULAR DRUGS

Beta Blocker 90 day supply available

D - - K

Atenolol Tablet 100mg Tenormin CARDIOVASCULAR DRUGS


D - - K

Atorvastatin Tablet 10mg LAB

Lipitor CARDIOVASCULAR DRUGS

Antihyperlipidemic, HMG-CoA Reductase Inhibitor

X - + L




X - + L




X - + L




X - + L

Atropine Ophth Soln 1% Atropine EYE, EAR, NOSE, AND THROAT

Mydriatic 15 mL C +

Azithromycin Suspension 200mg/5mL

Zithromax ANTI-INFECTIVES Macrolide B ? K/L

Azithromycin Tablet 250mg

Zithromax ANTI-INFECTIVES Macrolide B ? + K/L

Bacitracin Ointment 500 units/gm

SKIN AND MUCOUS MEMBRANE AGENTS

Antibiotic, Topical 15 gm B ?

Baclofen Tablet 10mg Lioresal SKELETAL MUSCLE RELAXANT

Skeletal Muscle Relaxant

C + + K

Beclomethasone 80mcg MDI

QVAR RESPIRATORY AGENTS Corticosteroids, Inhalant

8.7 gm C ?

9


Package Size



K=Kidney

Benzonatate Capsule 100mg

Tessalon Perles

RESPIRATORY AGENTS Antitussive #20 caps C ? -

Benzoyl Peroxide Gel 5% Panoxyl SKIN AND MUCOUS MEMBRANE AGENTS

Acne 42.5 gm C ?

Bisacodyl Tablet 5mg Dulcolax GASTROINTESTINAL DRUGS

Laxative, Diphenylmethane

C ? - K

Bismuth Subsalicylate Tablet 262mg

Pepto-Bismol GASTROINTESTINAL DRUGS

Antidiarrheal #30 tabs D ? +

Brimonidine 0.2% ophth drops

Alphagan EYE, EAR, NOSE, AND THROAT

Antiglaucoma, Alpha2 Agonist

10 mL B ?

Buprenorphine/Naloxone SL Tablet 2mg/ 0.5mg

Zubsolv ANAGESICS AND ANTIPYRETICS

Opioid C ? + K/L

Buprenorphine/Naloxone SL Tablet 8mg/ 2mg

Zubsolv ANAGESICS AND ANTIPYRETICS

Opioid C ? + K/L

Bupropion Tablet 100mg Wellbutrin ANTIDEPPRESSANT AGENTS

Dopamine Reuptake Inhibitor

C - + K/L

Buspirone Tablet 15mg Buspar ANXIOLYTICS, SEDATIVES, HYPNOTICS

Antianxiety Agent B - + K/L

Butalbital, Acetaminophen and Caffeine Tablet 50mg/325mg/40mg

Note: Fioricet changed strength April 2014 and no longer has a generic

MIGRAINE AGENTS Migraine Combinations

C - + K/L

Calcitriol Capsule 0.5mcg Rocaltrol NEPHROLOGY Vitamin D Analog C ? -

Calcium (elemental) Tablet 500mg

Calcium NUTRIENTS AND NUTRITIONAL AGENTS

Calcium Supplement #60 tabs per bottle

+ (? 1st trimester)

? + K

Calcium Acetate Capsule 667mg

PhosLo NEPHROLOGY Calcium, Phosphate Binder

C ? -

10


Package Size



K=Kidney

Carbamazepine Tablet 200mg LAB, HD

Tegretol ANTICONVULSANT AGENTS

Miscellaneous D + + K/L

Carbamide Peroxide Otic Drops 6.5%

Debrox EYE, EAR, NOSE, AND THROAT

Cerumenolytic 15 mL ? ?

Carbidopa/Levodopa Tablet 25mg/100mg

Sinemet ANTIPARKINSON AGENTS

Dopamine Agonist C - + K/L

Carvedilol Tablet 3.125mg Coreg CARDIOVASCULAR DRUGS

Beta Blocker w/ alpha blocking activity


C ? + L

Carvedilol Tablet 12.5mg Coreg CARDIOVASCULAR DRUGS



C ? + L

Carvedilol Tablet 25mg Coreg CARDIOVASCULAR DRUGS



C ? + L

Cefdinir Suspension 250mg/5mL

Omnicef ANTI-INFECTIVES Cephalosporin, 3rd gen

B ? K

Cefuroxime Tablet 250 mg Ceftin ANTI-INFECTIVES Cephalosporin, 2nd gen

Celecoxib Capsule 200mg RxP

Celebrex ANAGESICS AND ANTIPYRETICS

NSAID, COX-2 Inhibitor

C (D in 3rd trimester)

? - K/L

Cephalexin Capsule 250mg

Keflex ANTI-INFECTIVES Cephalosporin B ? - K

Cephalexin Suspension 250mg/5ml

Keflex ANTI-INFECTIVES Cephalosporin B ? K

Cetirizine Solution 1mg/mL

Zyrtec RESPIRATORY AGENTS Antihistamine 120 mL B - K

11


Package Size



K=Kidney

Cetirizine Tablet 10mg Zyrtec RESPIRATORY AGENTS Antihistamine #30 tablets 90 day supply available

B - + K

Chlorhexidine Oral Rinse 0.12%

Peridex EYE, EAR, NOSE, AND THROAT

Anti-infective 480 mL B ?

Ciprofloxacin Ophth Soln 0.3%

Cipro ANTI-INFECTIVES Quinolone 5 mL bottle

C (not likely

teratogen)

?

Ciprofloxacin Tablets 500mg

Cipro ANTI-INFECTIVES Quinolone C (not likely

teratogen)

? + K/L

Clarithromycin Tablet 500mg

Biaxin ANTI-INFECTIVES Macrolide C ? + K

Clindamycin Capsule 150mg

Cleocin ANTI-INFECTIVES Miscellaneous B ? + K

Clindamycin Solution 75mg/5mL

Cleocin ANTI-INFECTIVES Miscellaneous 100 mL B ? K

Clindamycin Topical Solution 1%

Cleocin-T ANTI-INFECTIVES Miscellaneous 60 mL B ?

Clobetasol Solution 0.05% Temovate SKIN AND MUCOUS MEMBRANE AGENTS

Corticosteroid 50mL C ?

Clonidine Tablet 0.1mg Catapres CARDIOVASCULAR DRUGS

Alpha2 Adrenergic Agonist


C ? + K




C ? + K

12


Package Size



K=Kidney




C ? + K

Clopidogrel Tablet 75mg Plavix CARDIOVASCULAR DRUGS

Antiplatelet B ? + L

Colchicine Tablet 0.6mgHD

Colcrys ENDOCRINE AND METABOLIC AGENTS

Gout C ? + K/L

Cyanocobalamin Tablets 500mcg

Vitamin B12 NUTRIENTS AND NUTRITIONAL AGENTS

Vitamin #130 tabs C + +

Cyclobenzaprine Tablets 5mg

Flexeril SKELETAL MUSCLE RELAXANT

Centrally Acting B ? + L

Dextroamphetamine /Amphetamine Tabs 10mg

Adderall STIMULANT ADHD, Narcolepsy C - + K

Diazepam Tablets 5mg Valium ANXIOLYTICS, SEDATIVES, HYPNOTICS

Benzodiazepine D - + L

Dicyclomine Capsules 10mg

Bentyl GASTROINTESTINAL DRUGS

Anticholinergic B - -

Digoxin Tablets 0.125mg LAB

Lanoxin CARDIOVASCULAR DRUGS

Antiarrhythmic C + + K

Digoxin Tablets 0.25mg LAB

Lanoxin CARDIOVASCULAR DRUGS

Antiarrhythmic C + + K

Diltiazem HCl XR 180mg Capsule

Cardizem CD CARDIOVASCULAR DRUGS


C + -

Diltiazem HCl XR 240mg Capsule

Cardizem CD CARDIOVASCULAR DRUGS


C + -

Diphenhydramine Capsule 25mg

Benadryl ANTIDOTE Antihistamine B - -

Diphenhydramine Capsule 50mg

Benadryl ANTIDOTE Antihistamine B - -

13


Package Size



K=Kidney

Diphenhydramine Elixer 12.5ml/5mL

Benadryl ANTIDOTE Antihistamine B -

Diphenoxylate/Atropine Sulf Tablets 2.5/0.025mg

Lomotil; Lonox

GASTROINTESTINAL DRUGS

Antidiarrheal C - - K/L

Disulfiram Tablet 250mg Antabuse ANTIDOTE Aldehyde Dehydrogenase Inhibitor

C ? +

Divalproex Sodium Tablet 250mg LAB, HD

Depakote ANTICONVULSANT AGENTS

Miscellaneous X ? - L

Docusate Sodium Capsule 100mg

Colace GASTROINTESTINAL DRUGS

Stool Softener #100 caps C ? - (taste may not be

acceptable)

Donepezil Tablet 10mg Aricept ALZHEIMER DISEASE Acetylcholinesterase Inhibitor (Central)

C ? +

Dorzolamide 2% Trusopt EYE, EAR, NOSE, AND THROAT

Antiglaucoma, Carbonic Anhydrase Inhibitor

10 mL C -

Doxazosin Tablet 2mg Cardura CARDIOVASCULAR DRUGS

Alpha1 Blocker 90 day supply available

C ? + L

Doxazosin Tablet 8mg Cardura CARDIOVASCULAR DRUGS

Alpha1 Blocker 90 day supply available

C ? + L

Doxepin Capsule 25mg Sinequan ANTIDEPPRESSANT AGENTS

Tricyclic C - -

Doxepin Capsule 50mg Sinequan ANTIDEPPRESSANT AGENTS

Tricyclic C - -

Doxycycline Tablet 100mg Vibramycin ANTI-INFECTIVES Tetracycline D ? +

14


Package Size



K=Kidney

Duloxetine Capsule 20mg PAP

Cymbalta ANTIDEPPRESSANT AGENTS

Serotonin/ Norepinephrine Reuptake Inhibitor

120 day supply PAP

C ? - (may open & mix w/

applesauce, NOT

chocolate)

K/L




120 day supply PAP


applesauce, NOT

chocolate)

K/L




120 day supply PAP


applesauce, NOT

chocolate)

K/L

Electrolyte Solution Pedialyte/ Infalyte

ELECTROLYTE SUPPLEMENT

Treatment of Dehydration

1,000 mL ? ?

Eletriptan Tablet 40mg RxP

Relpax MIGRAINE AGENTS Serotonin 5-HT1 Receptor Agonist

6 tabs per box

C ? + L

Enoxaparin SQ Injection 100mg PAP, LAB

Lovenox CARDIOVASCULAR DRUGS

Anticoagulant B + K



Anticoagulant B + K



Anticoagulant B + K



Anticoagulant B + K

15


Package Size



K=Kidney



Anticoagulant B + K



Anticoagulant B + K



Anticoagulant B + K

Epinephrine IM Injection 0.15mg/0.15mL

EpiPen ANTIDOTE Alpha/Beta Adrenergic Agonist

2 Auto-Injectors

C -

Epinephrine IM Injection 0.3mg/0.3mL

EpiPen ANTIDOTE Alpha/Beta Adrenergic Agonist

2 Auto-Injectors

C -

Erythromycin 5mg/gm Ilotycin EYE, EAR, NOSE, AND THROAT

Anti-infective 3.5 gm B +

Estrogens, conjugated Cream 0.625mg/gmHD

Premarin SKIN AND MUCOUS MEMBRANE AGENTS

Estrogen 30 gm X -

Estrogens, conjugated Tablet 0.625mgHD

Premarin ENDOCRINE AND METABOLIC AGENTS

Estrogen X - +

Estrogens, conjugated Tablet 1.25mgHD

Premarin ENDOCRINE AND METABOLIC AGENTS

Estrogen X - +

Ezetimibe tablet 10mg PAP

Zetia CARDIOVASCULAR DRUGS

Antihyperlipidemic, 2-Azetidinone

90 day supply PAP

C ? + L

Ferrous Sulfate Drops 75mg/mL (15mg/mL elemental)

ANTIANEMIA AGENTS Iron Preparations 50mL + +

Ferrous Sulfate Elixer 220mg/5mL (44mg/5mL elemental)

ANTIANEMIA AGENTS Iron Preparations 480mL + +

Ferrous Sulfate Tablet 325mg (65mg elemental)

ANTIANEMIA AGENTS Iron Preparations #100 tabs + + +

16


Package Size



K=Kidney

Finasteride Tablet 5mgHD Proscar ENDOCRINE AND METABOLIC AGENTS

Androgen Hormone Inhibitor, 5 Alpha-Reductase Inhibitor

X - - (hazardous agent)

L

Fluconazole Tablet 200mg Diflucan ANTI-INFECTIVES Antifungal C (single dose vag candida),

D all other indications

+ + K

Fluocinonide Cream 0.05%

Lidex SKIN AND MUCOUS MEMBRANE AGENTS

Corticosteroid 30 gm C -

Fluoxetine Capsule 20mg Prozac ANTIDEPPRESSANT AGENTS

Selective Serotonin Reuptake Inhibitor

C (- in 3rd trimester)

- - L

Fluticasone Propionate MDI 110mcg/puff PAP

Flovent RESPIRATORY AGENTS Corticosteroids, Inhalant

90 day supply PAP

C ?



90 day supply PAP

C ?



90 day supply PAP

C ?

Fluticasone Propionate Nasal Spray 50mcg/spray

Flonase EYE, EAR, NOSE, AND THROAT

Corticosteroid 16 gm C ?

Fluticasone Propionate/Salmeterol Diskus 100/50 PAP

Advair Diskus RESPIRATORY AGENTS Beta2 Adrenergic Agonist/ Corticosteroid, Inhalant

90 day supply PAP

C ?

17


Package Size



K=Kidney



90 day supply PAP

C ?



90 day supply PAP

C ?

Folic Acid Tablet 1mg NUTRIENTS AND NUTRITIONAL AGENTS

Vitamin 90 day supply available

A + +

Furosemide Tablet 40mg Lasix CARDIOVASCULAR DRUGS

Diuretic, Loop 90 day supply available

C ? + K/L

Gabapentin Capsule 100mg

Neurontin ANAGESICS AND ANTIPYRETICS

Anticonvulsant, Neuropathic pain (unlabeled)

C ? - K

Gabapentin Capsule 300mg

Neurontin ANAGESICS AND ANTIPYRETICS

Anticonvulsant, Neuropathic pain (unlabeled)

C ? - K

Gemfibrozil Tablet 600mg Lopid CARDIOVASCULAR DRUGS

Antihyperlipidemic, Fibric Acid

C ? + K

Gentamicin Sulfate Ophth Soln 3mg/mL

Garamycin EYE, EAR, NOSE, AND THROAT

Aminoglycoside 5 mL C ?

Glipizide ER Tablet 10mg Glucotrol XL ENDOCRINE AND METABOLIC AGENTS

Antidiabetic, Sulfonylurea

C ? - L

Glipizide ER Tablet 5mg Glucotrol XL ENDOCRINE AND METABOLIC AGENTS

Antidiabetic, Sulfonylurea

C ? - L

Glycerin 1 gm suppository Pedia-Lax Rectal


Laxative, Osmotic A + +

18


Package Size



K=Kidney

Glycerin 1 gm suppository Sani-Supp Adult Rectal


Laxative, Osmotic A + +

Griseofulvin Susp 125mg/5mL

Grifulvin ANTI-INFECTIVES Antifungal C ?

Guaifenesin Tablet 200mg Humibid RESPIRATORY AGENTS Expectorant #100 tabs C + +

Haloperidol Tablet 1mg Haldol ANTIPSYCHOTIC AGENTS

Typical, D2 Antagonist

C - +

Haloperidol Tablet 2mg Haldol ANTIPSYCHOTIC AGENTS


C - +

Hydralazine Tablet 25mg Apresoline CARDIOVASCULAR DRUGS

Vasodilator 90 day supply available

C + + K

Hydralazine Tablet 50mg Apresoline CARDIOVASCULAR DRUGS

Vasodilator 90 day supply available

C + + K

Hydrochlorothiazide Tablet 25mg

Hydrodiuril CARDIOVASCULAR DRUGS

Diuretic, Thiazide 90 day supply available

B (D is used in

pregnancy-induced

HTN)

+ + K

Hydrochlorothiazide Tablet 50mg

Hydrodiuril CARDIOVASCULAR DRUGS

Diuretic, Thiazide 90 day supply available

B (D is used in

pregnancy-induced

HTN)

+ + K

Hydrocodone and Aceta-minophen Tab 5mg/325mg

Norco ANAGESICS AND ANTIPYRETICS

Opioid C ? + L

Hydrocortisone Cream 1% SKIN AND MUCOUS MEMBRANE AGENTS


19


Package Size



K=Kidney

Hydrocortisone Cream 2.5 %



Hydrocortisone Ointment 1%


Corticosteroid 30 gm

Hydrocortisone Suppository 25mg

Anusol-HC SKIN AND MUCOUS MEMBRANE AGENTS

Corticosteroid #12 per box

C ?

Hydrocortisone, Nystatin, Diphenhydramine Susp

Duke's Mouthwash


Corticosteroid, Antifungal, Antihistamine

120 mL per bottle

? -

Hydroxychloroquine Tablet 200mg

Plaquenil ANTI-INFECTIVES Antimalarial C + + K/L

Hydroxyzine HCL Syrup 10mg/5mL

Atarax ANXIOLYTICS, SEDATIVES, HYPNOTICS

Antihistamine C - K/L

Hydroxyzine HCL Tablet 25mg


Antihistamine C - + K/L

Hydroxyzine HCL Tablet 50mg


Antihistamine C - + K/L

Ibuprofen Suspension 100mg/5mL

Motrin ANAGESICS AND ANTIPYRETICS

NSAID B (D in 3rd trimester)

+ K

Ibuprofen Tablet 400mg Motrin ANAGESICS AND ANTIPYRETICS


+ + (taste may be

unacceptable)

K

Imipramine Tablet 10mg Tofranil ANTIDEPPRESSANT AGENTS

Tricyclic D - +

Imipramine Tablet 25mg Tofranil ANTIDEPPRESSANT AGENTS

Tricyclic D - +

20


Package Size



K=Kidney

Imiquimod Cream 5% Aldara SKIN AND MUCOUS MEMBRANE AGENTS

#12 single-use packets

C ?

Indomethacin Capsule 25mg

Indocin ANAGESICS AND ANTIPYRETICS


+ - K

Indomethacin Capsule 50mg

Indocin ANAGESICS AND ANTIPYRETICS


+ - K

Insulin Aspart 100units/mL, Rapid-Acting

NovoLog ENDOCRINE AND METABOLIC AGENTS

Antidiabetic, Insulin B/C +

Insulin Lispro 100units/mL, Rapid-Acting

Humalog ENDOCRINE AND METABOLIC AGENTS

Antidiabetic, Insulin Insured only

B/C +

Insulin Regular 100units/mL, Short-Acting

Novolin Regular

ENDOCRINE AND METABOLIC AGENTS


Insulin Aspart Protamine/ Insulin Aspart, Combination

NovoLog Mix 70/30



Insulin Lispro Protamine/ Insulin Lispro 100units/mL, Combination

Humalog Mix 75/25


Antidiabetic, Insulin Insured only

B/C +

Insulin NPH and Insulin Regular 100units/mL, Combination

Novolin 70/30 ENDOCRINE AND METABOLIC AGENTS


Insulin NPH 100units/mL, Intermediate-Acting

Novolin NPH ENDOCRINE AND METABOLIC AGENTS


Insulin Detemir 100units/mL, Long-Acting

Levemir ENDOCRINE AND METABOLIC AGENTS


Insulin Glargine 100units/mL PAP, Long-Acting

Lantus ENDOCRINE AND METABOLIC AGENTS

Antidiabetic, Insulin 90 day supply PAP

B/C +

21


Package Size



K=Kidney

Insulin Glulisine 100units/mL PAP, Rapid-Acting

Apidra ENDOCRINE AND METABOLIC AGENTS

Antidiabetic, Insulin 90 day supply PAP

B/C +

Ipratropium Bromide MDI 17mcg/actuation PAP

Atrovent RESPIRATORY AGENTS Bronchodilator, Anticholinergic

MDI: 90 day supply PAP

B ?

Ipratropium Bromide Nebulizer Soln 0.02%

Atrovent RESPIRATORY AGENTS Bronchodilator, Anticholinergic

25 vials per box

B ?

Isosorbide Dinitrate Tablet 10mg

Isordil CARDIOVASCULAR DRUGS

Vasodilator C ? +



Vasodilator C ? +



Vasodilator C ? +

Ketoconazole 2% Shampoo

Nizoral SKIN AND MUCOUS MEMBRANE AGENTS

Antifungal 120 mL C ?

Ketorolac 0.5% Ophth Soln

Acular EYE, EAR, NOSE, AND THROAT

Corticosteroid 5 mL C ?

Ketotifen 0.025% Ophth Soln

Zaditor EYE, EAR, NOSE, AND THROAT

Antihistamine, Mast Cell Stabilizer

5 mL C ?

Lactulose Syrup 10gm/15mL

Duphalac Syrup


Constipation, Chronic

B ?

Lamotrigine Tablet 25mg Lamictal ANTICONVULSANT AGENTS

Miscellaneous C - + L

Lamotrigine Tablet 100mg Lamictal ANTICONVULSANT AGENTS

Miscellaneous C - + L

Latanoprost Ophth Sol 0.005%

Xalatan EYE, EAR, NOSE, AND THROAT

Antiglaucoma, Prostaglandin Inhibitor

2.5 mL C ?

22


Package Size



K=Kidney

Leuprolide IM Injection 11.25mg PAP,LAB, HD

Lupron ENDOCRINE AND METABOLIC AGENTS

Gonadotropin Releasing Hormone Agonist

90 day supply PAP

X -

Leuprolide IM Injection 22mg PAP,LAB, HD



90 day supply PAP

X -

Leuprolide IM Injection 30mg PAP,LAB, HD



90 day supply PAP

X -

Levofloxacin Tablet 500mg

Levaquin ANTI-INFECTIVES Anti-Infective C ? + K

Levothyroxine 0.088 mg Tablet LAB

Levoxyl ENDOCRINE AND METABOLIC AGENTS

Thyroid A + +



Thyroid A + +



Thyroid A + +



Thyroid A + +



Thyroid A + +



Thyroid A + +



Thyroid A + +

Lidocaine (Viscous) Oral Solution 2%

Xylocaine EYE, EAR, NOSE, AND THROAT

Analgesic 100 mL B +

Lisinopril Tablet 5mg LAB Zestril CARDIOVASCULAR DRUGS

ACE-Inhibitor 90 day supply available

D ? + K

23


Package Size



K=Kidney

Lisinopril Tablet 10mg LAB

Zestril CARDIOVASCULAR DRUGS


D ? + K




D ? + K




D ? + K

Lisinopril/HCTZ Tablet 20/12.5mg LAB

Zestoretic CARDIOVASCULAR DRUGS

ACE-Inhibitor/ Diuretic, Thiazide


D ? + K

Lisinopril/HCTZ Tablet 20/12.5mg LAB

Zestoretic CARDIOVASCULAR DRUGS

ACE-Inhibitor/ Diuretic, Thiazide


D ? + K

Lithium Carbonate Capsule 300mg LAB

Eskalith ANTIPSYCHOTIC AGENTS

Bipolar Disorder 90 day supply available

D - - K

Loperamide Tablet 2mg Imodium GASTROINTESTINAL DRUGS

Antidiarrheal #12 tabs C + +

Loratadine Tablet 10mg Claritin RESPIRATORY AGENTS Antihistamine #30 tabs 90 day supply available

B + + K

Losartan Tablet 25mg Cozaar CARDIOVASCULAR DRUGS

Angiotensin Receptor Blocker

D ? + L



D ? + L



D ? + L

24


Package Size



K=Kidney

Lubiprostone Capsule 24mcg PAP

Amitiza GASTROINTESTINAL DRUGS

Constipation, IBS 90 day supply PAP

C ? - L

Lurasidone Tablet 20mg PAP

Latuda ANTIPSYCHOTIC AGENTS

Atypical, mixed serotonin-dopamine antagonist

90 day supply PAP

B ? + K/L




90 day supply PAP

B ? + K/L




90 day supply PAP

B ? + K/L




90 day supply PAP

B ? + K/L




90 day supply PAP

B ? + K/L

Magnesium Oxide Tablet 400mg (240mg elemental)

MagOx NUTRIENTS AND NUTRITIONAL AGENTS

Hypomagnesemia #120 A + + L

Magnesium/Aluminum/ Simethicone Suspension

Maalox Max Strength


Antacid 480 mL C ? K

Meclizine Tablet 12.5mg Antivert ANTIEMETIC/ANTI-VERTIGO AGENTS

Anticholinergic, Antihistamine

B ? +

Medroxyprogesterone Acetate Tablet 10mgHD

Provera ENDOCRINE AND METABOLIC AGENTS

Contraceptive Hormone, Progestin

X + + L

Megestrol Acetate Susp 40mg/mLHD

Megace ENDOCRINE AND METABOLIC AGENTS

Progestin D ? K

Melatonin Tablet 3mg ANXIOLYTICS, SEDATIVES, HYPNOTICS

Neurohormone, indole

#120 - -

25


Package Size



K=Kidney

Memantine extended release tablet 7mg PAP

Namenda XR ALZHEIMER DISEASE N-Methyl-D-Aspartate Receptor Antagonist

90 day supply PAP

B ? - K



90 day supply PAP

B ? - K



90 day supply PAP

B ? - K



90 day supply PAP

B ? - K

Metformin Tablet 1000mg LAB

Glucophage ENDOCRINE AND METABOLIC AGENTS

Antidiabetic, Biguanide


B ? + K/L

Methimazole Tablet 10mg Tapazole ENDOCRINE AND METABOLIC AGENTS

Thyroid D + +

Methocarbamol Tablet 500mg

Robaxin SKELETAL MUSCLE RELAXANT

Centrally Acting C ? + L

Methotrexate Tablet 2.5mg LAB, HD

Rheumatrex RHEUMATOLOGY Disease Modifying Antirheumatic Drug (DMARD)

X - + K/L

Methyldopa Tablet 250mg

Aldomet CARDIOVASCULAR DRUGS

Alpha Adrenergic Inhibitor, Alpha2 Adrenergic Agonist

B + + K/L

Methylphenidate HCl Tablet 5mg

Ritalin STIMULANT ADHD, Narcolepsy C ? +

Metoclopramide Tablet 10mg

Reglan GASTROINTESTINAL DRUGS

Prokinetic B ? + K

26


Package Size



K=Kidney

Metoprolol Tartrate Tablet 25mg

Lopressor CARDIOVASCULAR DRUGS


C ? + L

Metoprolol Tartrate Tablet 50mg

Lopressor CARDIOVASCULAR DRUGS


C ? + L

Metronidazole Gel 0.05% Metrogel SKIN AND MUCOUS MEMBRANE AGENTS

Miscellaneous 45 gm B ?

Metronidazole Tablet 500mg

Flagyl ANTI-INFECTIVES Miscellaneous B ? + K,L

Miconazole Cream 2% Micatin SKIN AND MUCOUS MEMBRANE AGENTS

Antifungal 30 gm + ?

Mirtazapine Tablet 30mg Remeron ANTIDEPPRESSANT AGENTS

Alpha2 Antagonist C ? + K,L

Moisturizing Cream Eucerin SKIN AND MUCOUS MEMBRANE AGENTS

Moisturizing 120 gm + +

Montelukast Tablet 10mg Singulair RESPIRATORY AGENTS Leukotriene Inhibitor

B ? + L

Multivitamin Drops with Iron

Poly-vi-sol NUTRIENTS AND NUTRITIONAL AGENTS

Vitamin 50 mL + +

Multivitamin Tablet, Adult

Centrum NUTRIENTS AND NUTRITIONAL AGENTS

Vitamin #100 tabs + + +

Multivitamin tablet, Children

Flinstones NUTRIENTS AND NUTRITIONAL AGENTS

Vitamin #100 tabs + + +

Mupirocin 2% Ointment Bactroban SKIN AND MUCOUS MEMBRANE AGENTS

Antibiotic, Topical 22 gm B ?

Naloxone 2mg/ 2mL Narcan ANTIDOTE Opioid antagonist C ?

Naltrexone Tablets 50mg ReVia; Vivitrol

ANTIDOTE Opioid antagonist C ?

27


Package Size



K=Kidney

Naphazoline/Pheniramine Ophth Soln 0.025%/0.3%

Vasocon-A EYE, EAR, NOSE, AND THROAT

Vasoconstrictor/ Antihistamine

15 mL C ?

Naproxen Sodium Tablet 500mg

Naprosyn ANAGESICS AND ANTIPYRETICS


+ +

Nasal Aspirator DEVICE + +

Nasal Irrigation Kit Neti Pot DEVICE + +

Neomycin/Polymyxin B/Hydrocortisone Otic Susp

Cortisporin Otic


Anti-infective, Corticosteroid

Otic 10mL ? ?

Nicotine Gum 2mg Nicorette Gum

SMOKING CESSATION Nicotine Product 110 pieces

C - K/L

Nicotine Gum 4mg Nicorette Gum

SMOKING CESSATION Nicotine Product 110 pieces

C - K/L

Nicotine Transdermal Patch 14mg

Nicoderm CQ SMOKING CESSATION Nicotine Product #14 patches

D - K/L



D - K/L



D - K/L

Nifedipine XL Tablet 30mg Procardia XL CARDIOVASCULAR DRUGS


C - - L



C - - L



C - - L

Nitrofurantoin Capsule 100mg

Macrobid ANTI-INFECTIVES Urinary B +? K/L

Nitroglycerin SL Tablet 0.4mg

Nitrostat CARDIOVASCULAR DRUGS

Vasodilator #100 tabs C ?

28


Package Size



K=Kidney

Nitroglycerin Transdermal Patch 0.2mg/hr

Transderm Nitro


Vasodilator #30 patches

C ? -


Transderm Nitro



C ? -


Transderm Nitro



C ? -

Norethindrone Tablet 0.35mgHD

Nor-Q-D ENDOCRINE AND METABOLIC AGENTS

Contraceptive Hormone, Progestin

#28 tabs X - (may start 6 wks

after pregnancy)

+ L

Norethindrone/ E. Estradiol (triphasic) Tablet 0.5-0.75-1mg/0.035mgHD

Ortho-Novum 7/7/7


Contraceptive Hormone, Combination

#28 tabs X/D - + L

Norgestrol / E. Estradiol for postcoital contraceptionHD

LCHC version of Plan B


Postcoital contraception, Combination (4 tab w/in 72 hrs unprotected sex, followed by 4 tabs 12 hrs later)

#8 tabs X - + L

Norgestrol / E. Estradiol Tablet 0.3mg/0.03mgHD

Lo-Ovral ENDOCRINE AND METABOLIC AGENTS

Contraceptive Hormone, Combination

#28 tabs X - + L

Nortriptyline Tablet 25mg Pamelor ANTIDEPPRESSANT AGENTS

Tricyclic D + + K/L

Nystatin Cream 100,000 units/gm

Mycostatin ANTI-INFECTIVES Antifungal 15 gm C ?

Nystatin Suspension 100,000 units/mL

Nilstat ANTI-INFECTIVES Antifungal 60 mL bottle

C ?

29


Package Size



K=Kidney

Omega-3 Fatty Acids (180 EPA / 120 DHA)

Fish Oil NUTRIENTS AND NUTRITIONAL AGENTS

Vitamins #100 caps C ? - L

Omeprazole Capsule 20mg

Prilosec GASTROINTESTINAL DRUGS

Proton Pump Inhibitor

C ? - L

Ondansetron Tablet 4mg Zofran ANTIEMETIC/ANTI-VERTIGO AGENTS

5-HT3 Receptor Antagonist

B ? + L

Oxazepam Capsule 15mg Serax ANXIOLYTICS, SEDATIVES, HYPNOTICS

Benzodiazepine D - -

Oxybutynin Chloride Tablet 5mg

Ditropan GENITOURINARY AGENTS

Antispasmodic, Urinary

B ? + K/L

Oxymetazoline Nasal Spray 0.05%

Afrin RESPIRATORY AGENTS Decongestant (topical)

15 mL C ?

Pancreatic Enzymes Capsule Lipase/Protease/Amylase 12k/38k/60k PAP

Creon GASTROINTESTINAL DRUGS

Pancreatic Enzymes 90 day supply PAP

C ? - (can be opened and given with

applesauce or pudding)

K






K

30


Package Size



K=Kidney






K

Paricalcitol Capsule 1mcg PAP

Zemplar NEPHROLOGY Vitamin D Analog 90 day supply PAP

C ? -



C ? -



C ? -

Peak Flow Meter DEVICE + +

Penicillin VK Suspension 250mg/5mL

Pen-Vee K ANTI-INFECTIVES Penicillin VK B ? K

Penicillin VK Tablet 500mg

Veetids ANTI-INFECTIVES Penicillin VK B ? + K

Permethrin Cream 5% Elimite SKIN AND MUCOUS MEMBRANE AGENTS

Antiparasitic Agent, Scabicidal

60 gm B ?

Phenazopyridine Tablet 100mg

Pyridium GENITOURINARY AGENTS

Analgesic, Urinary B ? + K

Phenobarbital Tablet 30mg

ANTICONVULSANT AGENTS

Barbiturate D - + K/L

Phenytoin Sodium Chewable tablet 50g LAB

Dilantin Infatabs

ANTICONVULSANT AGENTS

Hydantoin D + + L

Phenytoin Sodium Capsule 100mg LAB

Dilantin ANTICONVULSANT AGENTS

Hydantoin D + - L

31


Package Size



K=Kidney

Pill Box DEVICE + +

Pilocarpine Ophth Soln 4%

Pilocar EYE, EAR, NOSE, AND THROAT

Antiglaucoma, Cholinergic Agent

15 mL C ?

Pioglitazone Tablet 15mg LAB

Actos ENDOCRINE AND METABOLIC AGENTS

Antidiabetic, Thiazolidinedione

C ? + L

Pioglitazone Tablet 30mg LAB

Actos ENDOCRINE AND METABOLIC AGENTS

Antidiabetic, Thiazolidinedione

C ? + L

Piperonyl Butoxide and Pyrethrum Extract Kit

Rid Shampoo SKIN AND MUCOUS MEMBRANE AGENTS

Antiparasitic Agent, Pediculocide

120 mL C ?

Plan B : see Norgestrol / E. Estradiol

x - L

Polyethylene Glycol MiraLax GASTROINTESTINAL DRUGS

Laxative, Osmotic 255 gm C ?

Polyethylene Glycol with Electrolytes

GoLytely GASTROINTESTINAL DRUGS

Laxative, Osmotic (for Bowel Prep)

4,000 mL C ?

Polymyxin/Trimethoprim Ophth Soln 10,000 units-1mg/mL

Polytrim EYE, EAR, NOSE, AND THROAT

Anti-infective 10 mL C ?

Potassium Chloride Liquid 20 mEq/15mL

ELECTROLYTE SUPPLEMENT

Treatment of Hypokalemia

K

Potassium Chloride Tablet 8mEq

Klor-Con ELECTROLYTE SUPPLEMENT

Treatment of Hypokalemia

C ? - K

Prazosin Capsule 1mg Minipress CARDIOVASCULAR DRUGS

Alpha 1 Blocker, Antihypertensive

C ? - L



C ? - L



C ? - L

Prednisolone Acetate Ophth Soln 1%

Pred Forte EYE, EAR, NOSE, AND THROAT

Corticosteroid 15 mL C ?

32


Package Size



K=Kidney

Prednisolone Syrup 15mg/mL

Prelone ENDOCRINE AND METABOLIC AGENTS

Glucocorticoids C + K/L

Prednisone Tablet 20mg Deltasone ENDOCRINE AND METABOLIC AGENTS

Glucocorticoids C + + K/L

Prednisone Tablet 5mg Deltasone ENDOCRINE AND METABOLIC AGENTS

Glucocorticoids 90 day supply available

C + + K/L

Pregabalin Capsule 150mg RxP

Lyrica ANAGESICS AND ANTIPYRETICS

Anticonvulsant, Analgesic

C ? - K

Pregabalin Capsule 75mg RxP

Lyrica ANAGESICS AND ANTIPYRETICS

Anticonvulsant, Analgesic

C ? - K

Prenatal Vitamins Natalins RX NUTRIENTS AND NUTRITIONAL AGENTS

Vitamin #100 tablets

+ + +

Promethazine Suppository 25mg

Phenergan ANTIEMETIC/ANTI-VERTIGO AGENTS

Antidopaminergic, Phenothiazine

C - L

Promethazine Tablet 25mg

Phenergan ANTIEMETIC/ANTI-VERTIGO AGENTS

Antidopaminergic, Phenothiazine

C - L

Propranolol Tablet 10mg Inderal CARDIOVASCULAR DRUGS


C + + K/L

Propranolol Tablet 40mg Inderal CARDIOVASCULAR DRUGS


C + + K/L

Pseudoephedrine Syrup 30mg/5mL

Sudafed RESPIRATORY AGENTS Decongestant (Alpha/Beta Adrenergic Agonist)

C + K

Pseudoephedrine Tablet 30mg


#24 tabs C + + K

33


Package Size



K=Kidney

Pseudoephedrine Tablet 60mg


C + + K

Psyllium Hydrophilic Powder

Metamucil GASTROINTESTINAL DRUGS

Laxative, Bulk 284 gm + ?

Quetiapine 25mg LAB Seroquel ANTIPSYCHOTIC AGENTS

Atypical, Serotonin/Dopamine Receptor Antagonist

C - + K



C - + K



C - + K



C - + K



C - + K

Quetiapine extended release tablet 50mg PAP, LAB

Seroquel XR ANTIPSYCHOTIC AGENTS


90 day supply PAP

C - - K

34


Package Size



K=Kidney




90 day supply PAP

C - - K




90 day supply PAP

C - - K




90 day supply PAP

C - - K




90 day supply PAP

C - - K

Ranitidine Syrup 15mg/mL

Zantac GASTROINTESTINAL DRUGS

Histamine H2 Antagonist

B ? K/L

Ranitidine Tablet 150mg Zantac GASTROINTESTINAL DRUGS



B ? + K/L

Ranitidine Tablet 300mg Zantac GASTROINTESTINAL DRUGS



B ? + K/L

Risperidone 0.5mg LAB Risperdal ANTIPSYCHOTIC AGENTS


C - + K/L

35


Package Size



K=Kidney

Risperidone 1mg LAB Risperdal ANTIPSYCHOTIC AGENTS


C - + K/L

Risperidone 2mg LAB Risperdal ANTIPSYCHOTIC AGENTS


C - + K/L

Saline Nose Spray Saline Spray EYE, EAR, NOSE, AND THROAT

Irrigation 45 mL + +

Selenium Sulfide Lotion 2.5%

Selsun SKIN AND MUCOUS MEMBRANE AGENTS

Tinea Versicolor; Dandruff; Seborrheic Dermatitis

120 mL C ?

Sertraline Tablet 50mg Zoloft ANTIDEPPRESSANT AGENTS



+ + L

Sertraline Tablet 100mg Zoloft ANTIDEPPRESSANT AGENTS



+ + L

Silver Sulfadiazine Silvadene SKIN AND MUCOUS MEMBRANE AGENTS

Anti-infective 20 gm B -

Simethicone Drops 40mg/0.6mL

Mylicon GASTROINTESTINAL DRUGS

Antiflatulent 30 mL C but + ?

Sitagliptin Tablet 25mg PAP

Januvia ENDOCRINE AND METABOLIC AGENTS

Anti-diabetic, Dipeptidyl Peptidase IV (DPP-IV) Inhib

90 day supply PAP

B ? - K/L




90 day supply PAP

B ? - K/L

36


Package Size



K=Kidney




90 day supply PAP

B ? - K/L

Sodium Polystyrene Sulfonate Susp 15gm/60mL

Kayexalate NEPHROLOGY Treatment of Hyperkalemia

60 mL per bottle

C ?

Spacer Aerochamber DEVICE + +

Spacer, with mask Aerochamber, DEVICE + +

Spironolactone Tablet 25mg

Aldactone CARDIOVASCULAR DRUGS

Diuretic, Potassium Sparing

D + + K

Spironolactone/HCTZ Tablet 25mg/25mg

Aldactazide CARDIOVASCULAR DRUGS

Diuretic, Potassium Sparing / Thiazide

D + + K

Sulfamethoxazole/ Trimethoprim Suspension 200mg-40mg/5mL

Septra Suspension

ANTI-INFECTIVES Sulfonamide C +

Sulfamethoxazole/ Trimethoprim Tablet 800mg/160mg

Septra DS ANTI-INFECTIVES Sulfonamide C + K/L

Sulfasalazine Tablet 500mg

Sulfazine, Azulfadine

ANTI-INFECTIVES Sulfonamide D - + K/L

Sulfur/Salicylic Acid Shampoo 2%/2%

Sebulex SKIN AND MUCOUS MEMBRANE AGENTS

Dandruff 120 mL C -

Syringes 31ga 5/16" 0.5mL

Monoject DEVICE + +

Syringes 31ga 5/16" 1mL Monoject DEVICE

Tablet Cutter DEVICE + +

Tamoxifen Tablet 10mg LAB, HD

Nolvadex ANTINEOPLASTIC AGENTS

Anti-estrogen D - -

37


Package Size



K=Kidney

Tamsulosin 0.4mg Capsule

Flomax Alpha1 Blocker B + -

Terbinafine Cream 1% LAB

Lamisil AT ANTI-INFECTIVES Antifungal 15 gm B ?

Terbinafine Tablet 250mg LAB

Lamisil ANTI-INFECTIVES Antifungal B - + K/L

Terconazole Vaginal Cream 0.8%

Terazol-3 SKIN AND MUCOUS MEMBRANE AGENTS

Antifungal 20 gm C -

Thiamine Tablet 100mg Various NUTRIENTS AND NUTRITIONAL AGENTS

Nutritional Supplement

#100 tabs A + +

Timolol Maleate Ophth Soln 0.5%

Timoptic EYE, EAR, NOSE, AND THROAT

Antiglaucoma, Beta-Adrenergic Blocker

5mL C +

Tiotropium Bromide Cap for inhalation 18mcg PAP

Spiriva RESPIRATORY AGENTS Bronchodilator, Anticholinergic

90 day supply PAP

C - -

Tolterodine Tartrate extended release tablet 4mg RxP

Detrol LA GENITOURINARY AGENTS

Anticholinergic, Urinary

C - - K/L

Topiramate Tablet 100mg LAB, HD

Topamax ANTICONVULSANT AGENTS

Miscellaneous D ? - (taste may not be

acceptable)

K/L

Topiramate Tablet 25mg LAB, HD

Topamax ANTICONVULSANT AGENTS

Miscellaneous D ? - (taste may not be

acceptable)

K/L

Tramadol Tablet 50mg Ultram ANAGESICS AND ANTIPYRETICS

Nonopioid Analgesic C - + K/L

Trazadone Tablet 50mg Desyrel ANTIDEPPRESSANT AGENTS

Serotonin Reuptake Inhibitor/Antagonist

C - + K/L

38


Package Size



K=Kidney

Tretinoin Cream 0.05%HD Retin-A SKIN AND MUCOUS MEMBRANE AGENTS

Acne 45 gm D -

Triamcinolone Acetonide Cream 0.1%

Aristocort; Kenalog


Steroid 15 gm, 80 gm

C ?

Triamcinolone Acetonide Dental Paste 0.1%

Oralone SKIN AND MUCOUS MEMBRANE AGENTS

Steroid 5 gm C ?

Trifluoperazine Tablet 2mg

Stelazine ANTIPSYCHOTIC AGENTS


C - + L

Trihexphenidyl Tablet 2mg

Artane ANTIPARKINSON AGENTS

Anticholinergic C - + K/L

Triprolidine/ Pseudoephedrine Tablet 2.5mg/60mg

Actifed RESPIRATORY AGENTS Antihistamine and Decongestant (Alpha/Beta Adrenergic Agonist)

#24 tabs - (1st trimester),

C

? +

Varenicline Tablet Starter Pack RxP

Chantix SMOKING CESSATION Partial Nicotine Agonist

C - + K

VareniclineTablet Continuing Pack RxP

Chantix SMOKING CESSATION Partial Nicotine Agonist

C - + K

Verapamil SR Tablet 180mg

Calan SR CARDIOVASCULAR DRUGS


C - + split/- crush K/L

Verapamil SR Tablet 240mg

Calan SR CARDIOVASCULAR DRUGS


C - + split/- crush K/L

Vitamin D3 Tablet 400 IU NUTRIENTS AND NUTRITIONAL AGENTS

Vitamin #100 tabs C Avoid high doses

Vitamin D3 Tablet 1,000 IU

NUTRIENTS AND NUTRITIONAL AGENTS

Vitamin #100 tabs C Avoid high doses

Vitamin D3 Tablet 50,000 IU

NUTRIENTS AND NUTRITIONAL AGENTS

Vitamin C Avoid high doses

-

39


Package Size



K=Kidney

Warfarin Tablet 5mg LAB Coumadin CARDIOVASCULAR DRUGS

Anticoagulant - (1st trimester),

C

Use caution

+ K/L

Zinc Oxide Ointment 20% Desitin SKIN AND MUCOUS MEMBRANE AGENTS

Ointment 30 gm + +

Zinc Oxide Ointment 20% Desitin SKIN AND MUCOUS MEMBRANE AGENTS

Ointment 30 gm + +

Updated: Dec 7th, 2016

Date post:	07-Feb-2020
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FORMULARY: ALPHABETICAL LISTING*...5 FORMULARY: ALPHABETICAL LISTING* *Most current Formulary List...

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FORMULARY: ALPHABETICAL LISTING...5 FORMULARY: ALPHABETICAL LISTING *Most current Formulary List...