Reach Out Formulary Alphabetical List DRUG NAME DOSAGE DRUG CLASS ALT NAME Acetaminophen 325 mg (MaPap, Q-Pap)

Transcription

1 Acetaminophen 325 mg (MaPap, Q-Pap) Analgesic Tylenol Acyclovir 400 mg Antiviral Zovirax AirDuo Respiclick 55 mg/14 Inhalation Fluticasone, Respiratory mg Powder salmeterol Albuterol Soln for Nebulizer 0.083% Solution Respiratory Albuterol Allopurinol 300 mg Anti-Gout Zyloprim Amitiza 24mcg Capsule GI Agent Lubiprostone Amitiza 8mcg Capsule GI Agent Lubiprostone Amitriptyline 10 mg Antidepressant, tricyclic Elavil Amitriptyline 25 mg Antidepressant, tricyclic Elavil Amitriptyline 50 mg Antidepressant, tricyclic Elavil Amitriptyline 150 mg Antidepressant, tricyclic Elavil Amlodipine 2.5 mg Antihypertensive, DHP CCB Norvasc Amlodipine 5 mg Antihypertensive, DHP CCB Norvasc Amlodipine 10 mg Antihypertensive, DHP CCB Norvasc Amoxicillin 125 mg/5 ml Suspension Anti-Infective Amoxil Amoxicillin 250 mg Capsule Anti-Infective Amoxil Amoxicillin 250 mg/5 ml Suspension Anti-Infective Amoxil Amoxicillin 400 mg/5 ml Suspension Anti-Infective Amoxil Amoxicillin 500 mg Capsule Anti-Infective Amoxil Amoxicillin 875 mg Anti-Infective Amoxil Amoxicillin/Clavulanate 400 mg/57 mg Suspension Anti-Infective Augmentin Revised 1/22/2019 Page 1

2 Amoxicillin/Clavulanate 500 mg/125 mg Anti-Infective Augmentin Amoxicillin/Clavulanate 600 mg/42.9 mg/5 ml Suspension Anti-Infective Augmentin Amoxicillin/Clavulanate 875 mg/125 mg Anti-Infective Augmentin Anoro Ellipta Inhaler Respiratory Umeclindimium, vilanterol Apidra Vial Diabetic, insulin Glulisine Apidra SoloStar 100 units/ml Pen Diabetic, insulin Glulisine Aricept 10 mg Anti-Dementia Donepezil Aripiprazole 2 mg, 5 mg, 10 Antipsychotic Abilify mg, 15 mg Arnuity Ellipta 200 mcg Inhalation Powder Respiratory Fluticasone Artificial Tears ophth ointment Ointment OTC Artificial Tears ophth solution Solution OTC Asmanex 200 mcg Inhaler Respiratory Mometasone, formoterol Aspirin 81mg Analgesic Aspirin 81mg chewable *clinic use only* Analgesic Aspirin 325mg Analgesic Atenolol 25 mg Tenormin Atenolol 50 mg Tenormin Atorvastatin 20 mg Cholesterol inhibitor Lipitor Atorvastatin 80 mg Cholesterol inhibitor Lipitor Ayr saline nasal gel Gel Respiratory Saline Revised 1/22/2019 Page 2

3 Ayr saline nasal rinse kit Rinse Respiratory Saline Azithromycin 100 mg/5 ml Suspension Anti-Infective Zithromax Azithromycin 200 mg/5 ml Suspension Anti-Infective Zithromax Azithromycin 250 mg Anti-Infective Zithromax Azithromycin 250 mg Z-pack Dose pack Anti-Infective Zithromax Azithromycin 500 mg Anti-Infective Zithromax Bacitracin (with Zinc) Ointment Anti-Infective Baclofen 10 mg Muscle relaxant Lioresal Basaglar KwikPen Pen Diabetic, insulin Glargine Benzonatate 100 mg Capsule Cough Suppressant Tessalon Perles Betamethasone valerate 0.1% Cream Steroid, Topical Bisacodyl 5 mg GI Agent, laxative Dulcolax Boniva 150 mg Osteoporosis Ibandronate Breo Ellipta 100/25 Inhaler Respiratory Fluticasone, vilanterol Bumetanide 1 mg Diuretic Bumex Bumetanide 2 mg Diuretic Bumex Buspirone 10 mg Anxiolytic Buspar Buspirone 15 mg Anxiolytic Buspar Bydureon 2 mg pen Pen Diabetic, injection Exenatide Calamine Lotion Lotion Topical Carbamazeprine 200 mg Anti-Convulsant Tegretol Carvedilol 3.125mg Coreg Carvedilol 6.25 mg Coreg Carvedilol 12.5 mg Coreg Revised 1/22/2019 Page 3

4 Carvedilol 25 mg Coreg Cefdinir 125mg/5ml Suspension Anti-Infective Omnicef Cefdinir 250mg/5ml Suspension Anti-Infective Omnicef Cefdinir 300mg Capsule Anti-Infective Omnicef Ceftriaxone 250 mg Injectable Anti-Infective Rocephin Ceftriaxone 500 mg Injectable Anti-Infective Rocephin Celecoxib 100 mg Capsule Analgesic, NSAID Celebrex Cephalexin 250 mg Capsule Anti-Infective Keflex Cephalexin 500 mg Capsule Anti-Infective Keflex Cetirizine 10 mg (All Day Allergy) Antihistimine Zyrtec Chlorthalidone 25 mg Diuretic Hygroton Ciprofloxacin 0.3% opth solution Solution Anti-Infective, Topical Ciloxan Ciprofloxacin 250 mg Anti-Infective Cipro Ciprofloxacin 500 mg Anti-Infective Cipro Citalopram 20 mg Antidepressant, SSRI Celexa Clindamycin 150 mg Capsule Anti-Infective Cleocin Clonidine 0.1 mg Antihypertensive, alpha Catapres agonist Clonidine 0.2 mg Antihypertensive, alpha Catapres agonist Clopidogrel 75 mg Antithrombotic, antiplatelet Plavix Clotrimazole 1% Cream Antifungal, Topical Lotrimin Clotrimazole and Betamethasone Cream Antifungal, Topical Lotrisone Crestor 40 mg Cholesterol inhibitor Rosuvastatin Cyclobenzaprine 5 mg Muscle relaxant Flexeril Cyclobenzaprine 10 mg Muscle relaxant Flexeril Depo-Medrol 40 mg/ml Injectable Steroid Methylprednisolone Revised 1/22/2019 Page 4

5 Depo-Medrol 80 mg/ml Injectable Steroid Methylprednisolone Depo-Provera Injectable Contraceptive, Medroxyprogesterone injection Diclofenac Gel 1% Gel Analgesic, topical NSAID Voltaren Dicyclomine 10 mg Capsule GI Agent Bentyl Dicyclomine 20 mg GI Agent Bentyl Digoxin mg Cardiovascular Digox Diltiazem 180 mg Capsule Antihypertensive, non- DHP CCB Cardizem Diphenhydramine (Banophen) 12.5 mg/5 ml Diphenhydramine (Banophen) 25 mg Syrup Antihistamine Benadryl/ Banophen Antihistamine Benadryl Dipyridamole 50 mg Antithrombotic, antiplatelet Persantine Divalproex DR 250 mg Capsule Anti-Convulsant Depakote Divalproex DR 500 mg Capsule Anti-Convulsant Depakote Docusate Sodium 100 mg Capsule GI Agent, laxative Colace Doxycycline 100 mg Capsule Anti-Infective Vibramycin Dulera 100 mcg/5 mcg Inhaler Respiratory Duloxetine 30 mg Capsule Antidepressant, SNRI Cymbalta Duloxetine 60 mg Capsule Antidepressant, SNRI Cymbalta Earwax Drops (Debrox) Solution OTC Debrox Eliquis 2.5 mg Eliquis 5 mg Antithrombotic, Xa inhibitor Antithrombotic, Xa inhibitor Mometasone, formoterol Apixaban Apixaban Enalapril 10 mg Antihypertensive, ACEi Vasotec Enoxaparin 40 mg/0.4 ml Injectable Antithrombotic, LMWH Lovenox Revised 1/22/2019 Page 5

6 Enoxaparin 80 mg/0.8 ml Injectable Antithrombotic, LMWH Lovenox Enoxaparin 100 mg/1 ml Injectable Antithrombotic, LMWH Lovenox Enoxaparin 150 mg/1 ml Injectable Antithrombotic, LMWH Lovenox Epi-Pen 0.15 mg (pediatric) *clinic use only* Syringe Antidote Epinephrine Epi-Pen 0.3 mg *clinic use only* Syringe Antidote Epinephrine Erythromycin Ophth 0.5% Ointment Anti-Infective, Topical Ilotycin Famotidine 20 mg GI Agent Pepcid Farxiga 5 mg Diabetic, oral Dapagliflozin Fenofibrate 160 mg Cholesterol inhibitor Tricor Ferrous Sulfate 325 mg Vitamin/Mineral Iron Fiasp FlexTouch 100 units/ml Pen Diabetic, insulin Aspart Fluconazole 150 mg Antifungal Diflucan Fluconazole 200 mg Antifungal Diflucan Fluoxetine 10 mg Capsule Antidepressant, SSRI Prozac Fluoxetine 20 mg Capsule Antidepressant, SSRI Prozac Fluticasone Propionate 50 mcg Nasal Spray Respiratory Flonase Folic Acid 1 mg Vitamin/Mineral Vitamin B Furosemide 20 mg Diuretic Lasix Furosemide 40 mg Diuretic Lasix Gemfibrozil 600 mg Cholesterol inhibitor Lopid Glimepiride 4 mg Diabetic, oral Amaryl Glipizide 5 mg Diabetic, oral Glucotrol Glipizide 10 mg Diabetic, oral Glucotrol Glyburide 5 mg Diabetic, oral Micronase Glyxambi 10 mg/5 mg Empagliflozin, Diabetic, oral linagliptin Revised 1/22/2019 Page 6

7 Griseofulvin 125 mg/5 ml Suspension Anti-Infective Gris-Peg Hemorrhoidal Ointment Ointment GI Agents, hemorrhoid Prep-H Humalog Vial Diabetic, insulin Lispro Humalog KwikPens 100 units/ml Pen Diabetic, insulin Lispro Humalog Mix 75/25 Vial Diabetic, insulin Lispro Humulin 70/30 Vial Diabetic, insulin NPH/Regular Humulin N Vial Diabetic, insulin Insulin NPH Humulin R Vial Diabetic, insulin Insulin Regular Hydralazine 10 mg Cardiovascular Apresoline Hydralazine 25 mg Cardiovascular Apresoline Hydralazine 50 mg Cardiovascular Apresoline Hydralazine 100 mg Cardiovascular Apresoline Hydrochlorothiazide 12.5 mg Diuretic Microzide Hydrochlorothiazide 25 mg Diuretic Microzide Hydrocortisone 1% Cream Cream Steroid, Topical Cortizone Hydrocortisone 1% Ointment Ointment Steroid, Topical Cortizone Hydrocortisone 2.5% Cream Cream Steroid, Topical Cortizone Hydrocortisone 2.5% Lotion Lotion Steroid, Topical Cortizone Hydrocortisone 2.5% Ointment Ointment Steroid, Topical Cortizone Hydroxychloroquine 200 mg Anti-Infective, malaria Plaquenil Hydroxyzine HCl 25 mg Antihistamine Atarax Hydroxyzine HCl 50 mg Antihistamine Atarax Hydroxyzine Pamoate 25 mg Capsule Antihistamine Vistaril Hydroxyzine Pamoate 50 mg Capsule Antihistamine Vistaril Ibuprofen 400 mg Analgesic, NSAID Motrin Ibuprofen 600 mg Analgesic, NSAID Motrin Revised 1/22/2019 Page 7

8 Ibuprofen 800 mg Analgesic, NSAID Motrin Ibuprofen Children's Oral Susp Suspension 100 mg/5 ml Analgesic, NSAID Motrin Indomethacin 25 mg Capsule Anti-Gout Indocin Indomethacin 50 mg Capsule Anti-Gout Indocin Ipratropium & Albuterol Soln Vial Respiratory Duo-Neb Nebulizer Ipratropium 0.02% Soln Nebulizer Isoniazid 300 mg Vial Respiratory Anti-Infective, tuberculosis Laniazid Isosorbide Mononitrate ER 30 mg Cardiovascular Imdur Jentadueto 2.5 mg/1000 mg Diabetic, oral Jentadueto 2.5 mg/500 mg Diabetic, oral Ketoconazole 2% Cream Cream Antifungal, Topical Xolegel Ketoconazole 2% Shampoo Solution Antifungal, Topical Ketotifen 2% ophthalmic (Eye Linagliptin, Linagliptin, itch relief) Solution Topical Zaditor Lactulose Solution Syrup GI Agent Enulose Lamotrigine 25 mg Anti-Convulsant Lamictal Lamotrigine 100 mg Anti-Convulsant Lamictal Lamotrigine 150 mg Anti-Convulsant Lamictal Lantus Vial Diabetic, insulin Glargine Lantus Solostar Pen Diabetic, insulin Glargine Levetiracetam 500 mg Anti-Convulsant Keppra Levofloxacin 500 Anti-Infective Levaquin Levofloxacin 750 Anti-Infective Levaquin Levothyroxine 100 mcg Thyroid Synthroid Revised 1/22/2019 Page 8

9 Lidocaine Patches 5% Patch Analgesic Lidoderm Lidocaine/prilocaine 2.5%/2.5% *clinic use only* Cream Analgesic Linzess 145 mcg Capsule GI Agent Linaclotide Linzess 290 mcg Capsule GI Agent Linaclotide Lisinopril 2.5 mg Antihypertensive, ACEi Zestril Lisinopril 5 mg Antihypertensive, ACEi Zestril Lisinopril 10 mg Antihypertensive, ACEi Zestril Lisinopril 20 mg Antihypertensive, ACEi Zestril Lisinopril 40 mg Antihypertensive, ACEi Zestril Loperamide 2mg GI Agent, antidiarrheal Imodium Loratadine 10 mg Antihistamine Claritin Loratadine Children's Liquid Syrup Antihistamine Claritin Losartan 50 mg Antihypertensive, ARB Cozaar Losartan 100 mg Antihypertensive, ARB Cozaar Lovastatin 20 mg Cholesterol inhibitor Mevacor Lovastatin 40 mg Cholesterol inhibitor Mevacor Magnesium Citrate 296 Ml Solution GI Agent, laxative Magnesium hydroxide Solution GI Agent, laxative Milk of Magnesia Meclizine 12.5 mg Antihistamine Antivert Meclizine 25 mg Antihistamine Antivert Medroxyprogesterone 10 mg Contraceptive, oral Provera Meloxicam 7.5 mg Analgesic, NSAID Mobic Metformin 500 mg Diabetic, oral Glucophage Revised 1/22/2019 Page 9

10 Multivitamin Vitamin/Mineral Metformin 1000 mg Diabetic, oral Glucophage Methimazole 10 mg Thyroid Tapazole Methocarbamol 500 mg Muscle relaxant Robaxin Methylprednisolone 4 mg Dose pack Steroid Medrol Metoclopramide 10 mg GI Agent Reglan Metoprolol Succinate ER 50 mg Lopressor Metoprolol Succinate ER 100 mg Lopressor Metoprolol Tartrate 25 mg Lopressor Metoprolol Tartrate 50 mg Lopressor Metoprolol Tartrate 100 mg Lopressor Metronidazole 250 mg Anti-Infective Flagyl Metronidazole 500 mg Anti-Infective Flagyl Mexiletine 150 mg Capsule Cardiovascular Mexitil Minocycline 50 mg Capsule Anti-Infective Minocin Minoxidil 10 mg Antihypertensive Loniten Montelukast 10 mg Respiratory Singulair Mucus Relief DM Respiratory Guaifenesin, dextromethorphan Thera-M, Therems Mupirocin 2% topical Ointment Anti-Infective, Topical Bactroban Naproxen 500 mg Analgesic, NSAID Naprosyn Narcan 4 mg *clinic use only* Nasal Spray Opioid antagonist Naloxone Neomycin & Polymyxin B Sulfate Otic solution Neomycin & Polymyxin B Sulfate Otic suspension Solution Anti-Infective, Topical Cortisporin Suspension Anti-Infective, Topical Cortisporin Revised 1/22/2019 Page 10

11 Nifedipine XL 30 mg Antihypertensive, DHP CCB Procardia Nitrofurantoin 100 mg Capsule Anti-Infective Macrobid Nitroglycerin 0.4 mg SL Cardiovascular Nitroglycerin Nix Lice Killing Crème Rinse Suspension Anti-Infective, parasite Permethrin Norethindrone (Heather) Contraceptive, oral Nora-Be Novolin N -see Humulin N Vial Diabetic, insulin NPH Novolog * sample* or see Humalog Vial Diabetic, insulin Aspart Nystatin Cream 100,000 units Cream Antifungal, Topical Nyamyc Nystatin Ointment 100,000 units Ointment Antifungal, Topical Nyamyc Nystatin Oral Suspension Suspension Antifungal Mycostatin Nystatin Powder 100,000 units Powder Antifungal, Topical Nyamyc Olopatadine 0.2% ophth Solution Antihistamine Patanase Omeprazole 20 mg Capsule GI Agent Prilosec Ondansetron 4 mg Anti-Emetic Zofran Ondansetron 4 mg ODT -ODT Anti-Emetic Zofran Ondansetron 8 mg ODT -ODT Anti-Emetic Zofran Osphena 60 mg Contraceptive, oral Ospemifene Oxybutynin 5 mg Urinary Tract Disorder Ditropan Pantoprazole 20 mg GI Agent Protonix Pantoprazole 40 mg GI Agent Protonix Penicillin VK 125 mg/5 ml Solution Anti-Infective Penicillin VK 250 mg Anti-Infective Penicillin VK 250 mg/5 ml Solution Anti-Infective Penicillin VK 500 mg Anti-Infective Permethrin 5% Cream Anti-Infective, parasite Elimite Revised 1/22/2019 Page 11

12 Phenazopyridine 100 mg Urinary Tract Disorder Pyridium Phenazopyridine 200 mg Urinary Tract Disorder Pyridium Phenytoin Sodium ER 100 mg Capsule Anti-Convulsant Dilantin Polyethylene Glycol 3350 Powder Powder GI Agent, laxative Miralax Polymixin B & Trimethoprim Ophth solution Solution Anti-Infective, Topical Potassium Chloride ER 10 meq Potassium Chloride ER 20 meq Cardiovascular Cardiovascular Prednisolone Oral Solution 15 mg/ 5 ml Suspension Steroid Prelone Prednisone 5 mg Steroid Deltasone Prednisone 10 mg Steroid Deltasone Prednisone 20 mg Steroid Deltasone Prednisone Oral Solution 5 Prednisone Suspension Steroid mg/5 ml Intensol Proctozone HC Rectal Cream Cream Steroid, Topical Hydrocortisone Promethazine 6.25 mg Syrup Anti-Emetic Phenergan Promethazine 25 mg Anti-Emetic Phenergan Propranolol 10 mg Inderal Propranolol 20 mg Inderal Propranolol 80 mg Inderal Propranolol ER 60 mg Capsule Inderal Revised 1/22/2019 Page 12

13 Propranolol ER 80 mg Capsule Inderal Quetiapine Fumarate 25 mg Antipsychotic Seroquel Quetiapine Fumarate 100 mg Antipsychotic Seroquel Senexon-S GI Agent, laxative Senna, docusate Senna Laxative Tabs GI Agent, laxative Senna Sertraline 50 mg Antidepressant, SSRI Zoloft Sertraline 100 mg Antidepressant, SSRI Zoloft Silver Sulfadiazine 1% cream Cream Topical Silvadene Ranitidine 150 mg GI Agent Zantac Ranitidine 300 mg GI Agent Zantac Relistor 150 mg GI Agent Methylnaltrexone Risperidone 3 mg Antipsychotic Risperdal Robitussin DM Syrup (see Robafen) Syrup Cough Suppressant Robafen DM Robitussin Plain Syrup (see Robafen) Syrup Cough Suppressant Robafen Seebri Neohaler 15.6 Inhalation Powder Respiratory Glycopyrrolate Simvastatin 10 mg Cholesterol inhibitor Zocor Simvastatin 20 mg Cholesterol inhibitor Zocor Simvastatin 40 mg Cholesterol inhibitor Zocor Solu Medrol 125 mg/ml Injectable Steroid Methylprednisolone Spiriva Handihaler 18 mcg Capsule Respiratory Tiotropium Spiriva Respimat 1.25 mcg Tiotropium Inhaler Respiratory bromide Spironolactone 25 mg Diuretic Aldactone Revised 1/22/2019 Page 13

14 Spironolactone 100 mg Diuretic Aldactone Sprintec Contraceptive, oral Ethinyl estradiol/ norgestimate Strattera 80 mg Capsule ADD, selective NRI Atomoxetine Sucralfate 1 gram GI Agent Carafate Sulfamethoxazole and Trimethoprim 200 mg/40 mg/5 ml Sulfamethoxazole and Trimethoprim DS 800 mg/160 mg Suspension Anti-Infective Bactrim Anti-Infective Bactrim Sumatriptan 25 mg Anti-Migraine Imitrex Sumatriptan 100 mg Anti-Migraine Imitrex Symbicort 80mcg/4.5 mcg Budesonide, Inhaler Respiratory formoterol Synjardi 5 mg/1000 mg Empagliflozin, Diabetic, oral Synjardi 10 mg/1000 mg Empagliflozin, Diabetic, oral Synjardi 25 mg/1000 mg Empagliflozin, Diabetic, oral Synthroid 25 mcg Thyroid Levothyroxine Tamsulosin 0.4 mg Urinary Tract Disorder Flomax Telmisartan 80 mg Antihypertensive, ARB Micardis Terazosin 2 mg Capsule Antihypertensive, alpha Hytrin 1 Terazosin 5 mg Capsule Antihypertensive, alpha Hytrin 1 Terbinafine 250 mg Antifungal Lamisil Terconazole Vaginal Cream 0.4% Cream Antifungal, Topical Terazol Revised 1/22/2019 Page 14

15 Toujeo (glargine) Pen Diabetic, insulin Glargine Tradjenta 5 mg Diabetic, oral Linagliptin Trazodone 50 mg Antidepressant, atypical Oleptro Trazodone 100 mg Antidepressant, Oleptro Trazodone 150 mg atypical Antidepressant, atypical Tri- Sprintec Contraceptive, oral Triamcinolone Acetonide 0.025% Oleptro Ethinyl estradiol/ norgestimate Cream Steroid, Topical Kenalog Triamcinolone Acetonide 0.1% Cream Steroid, Topical Kenalog Triamcinolone Acetonide 0.1% Ointment Steroid, Topical Kenalog Triamcinolone Acetonide 0.5% Cream Steroid, Topical Kenalog Triamterene/HCTZ 37.5 mg/ 25 mg Triamterene/HCTZ 75 mg/ 50 mg Trintellix 10 mg Triple Antibiotic Ointment 28 grams Diuretic Maxzide Diuretic Maxzide Ointment Antidepressant, serotonin modulator Anti-Infective, Topical Vortioxetine Bacitracin, neomycin, polymxin B Aclidinium bromide Tudorza Pressair 400mcg Inhaler Respiratory Uloric 40 mg Anti-Gout Febuxostat Utibron Neohaler 27.5 Indacaterol, Inhaler Respiratory mcg/15.6 mcg glycopyrrolate Valacyclovir 500 mg Antiviral Valtrex Revised 1/22/2019 Page 15

16 Valacyclovir 1000 mg Antiviral Valtrex Ventolin HFA Inhaler Respiratory Albuterol Verapamil ER 240 mg Vitamin D (ergocalciferol) 50,000 units Warfarin Sodium 1 mg Warfarin Sodium 5 mg Xarelto 20 mg Xigduo XR 2.5 mg/1000 mg Xigduo XR 5 mg/1000 mg Xigduo XR 10 mg/1000 mg Xigduo XR 10 mg/500 mg Capsule Antihypertensive, non- DHP CCB Vitamin/Mineral Antithrombotic, vitamin K antagonist Antithrombotic, vitamin K antagonist Antithrombotic, Xa inhibitor Diabetic, oral Diabetic, oral Diabetic, oral Diabetic, oral Calan, Isoptin Coumadin, Jantoven Coumadin, Jantoven Rivaroxaban Dapagliflozin, Dapagliflozin, Dapagliflozin, Dapagliflozin, Revised 1/22/2019 Page 16