UWSP Student Health Service Pharmacy Formulary 1/22/2015
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1 UWSP Student Health Service Pharmacy Formulary 1/22/2015 UWSP Student Health Service Pharmacy Formulary 1/22/2015 Medication Name Strength DosageForm Route Acetaminophen 325 MG Tablet Oral Acetaminophen-Codeine # MG Tablet Oral Acetaminophen-Codeine # MG Tablet Oral AcetaZOLAMIDE 250 MG Tablet Oral Acyclovir 400 MG Tablet Oral Acyclovir 800 MG Tablet Oral Albuterol Sulfate (2.5 MG/3ML) 0.083% Nebulization Solution Inhalation Amitriptyline HCl 10 MG Tablet Oral Amitriptyline HCl 25 MG Tablet Oral Amoxicillin 250 MG Capsule Oral Amoxicillin 500 MG Capsule Oral Amoxicillin-Pot Clavulanate MG Tablet Oral Antacid Liquid MG/5ML Suspension Oral Antipyrine-Benzocaine MG/ML Solution Otic Anucort-HC 25 MG Suppository Rectal Apri MG-MCG Tablet Oral Aspirin 81 MG Tablet Chewable Oral Aspirin EC 325 MG Tablet Delayed Release Oral Assess Full Range Peak Meter Device Does not Atovaquone-Proguanil HCl MG Tablet Oral Aviane MG-MCG Tablet Oral Azithromycin 250 MG Tablet Oral Azithromycin 500 MG Tablet Oral Bacitracin 500 UNIT/GM Ointment External Benzonatate 100 MG Capsule Oral Benzoyl Peroxide 5% Gel External Betamethasone Dipropionate 0.05% Cream External Betamethasone Dipropionate Aug 0.05% Cream External Betasept Surgical Scrub 4% Liquid External Bismatrol 262 MG Tablet Chewable Oral Boric Acid Powder Does not BuPROPion HCl ER (SR) 150 MG Tablet Extended Release 12 Hour Oral BusPIRone HCl 15 MG Tablet Oral Camila 0.35 MG Tablet Oral CefTRIAXone Sodium 250 MG Solution Reconstituted Injection Cefuroxime Axetil 250 MG Tablet Oral Cefuroxime Axetil 500 MG Tablet Oral Cepacol Sore Throat MG Lozenge Mouth/Throat
2 Cephalexin 250 MG Capsule Oral Cephalexin 500 MG Capsule Oral CeraORS 75 Natural Packet Oral Cetirizine HCl 10 MG Tablet Oral Ciprofloxacin HCl 0.30% Solution Ophthalmic Ciprofloxacin HCl 250 MG Tablet Oral Ciprofloxacin HCl 500 MG Tablet Oral Clindamycin HCl 150 MG Capsule Oral Clindamycin Phosphate 1% Gel External ClonazePAM 0.5 MG Tablet Oral Clotrimazole 1% Cream External Clotrimazole 1% Cream Vaginal Clotrimazole 10 MG Troche Mouth/Throat Condoms Miscellaneous Does not Cough Drops Menthol Lozenge Mouth/Throat Cryselle MG-MCG Tablet Oral Cyclobenzaprine HCl 10 MG Tablet Oral Cyclobenzaprine HCl 5 MG Tablet Oral Deep Sea Nasal Spray 0.65% Solution Nasal Depo-Provera 150 MG/ML Suspension Intramuscular Dexamethasone 4 MG Tablet Oral Dexamethasone Sod Phosphate PF 10 MG/ML Solution Injection Dicloxacillin Sodium 250 MG Capsule Oral Dicloxacillin Sodium 500 MG Capsule Oral Dicyclomine HCl 20 MG Tablet Oral DiphenhydrAMINE HCl 25 MG Capsule Oral Domeboro 25% Packet External Doxycycline Hyclate 100 MG Tablet Oral Doxycycline Monohydrate 100 MG Tablet Oral Ella 30mg Tablet Oral Erythromycin 5 MG/GM Ointment Ophthalmic Eye Wash Solution Ophthalmic Famotidine 20 MG Tablet Oral Ferrous Gluconate 324 (37.5 Fe) MG Tablet Oral Ferrous Sulfate 325 (65 Fe) MG Tablet Oral Fluconazole 150 MG Tablet Oral Fluorouracil 5% Cream External FLUoxetine HCl 10 MG Tablet Oral FLUoxetine HCl 20 MG Capsule Oral Fluticasone Propionate 50 MCG/ACT Suspension Nasal Gianvi MG Tablet Oral GuaiFENesin 100 MG/5ML Liquid Oral Guaifenesin-DM MG/5ML Liquid Oral Herbal Snuff Hibiclens 4% Liquid External
3 Hydrocodone-Acetaminophen MG Tablet Oral Hydrocortisone 1% Cream External Hydrocortisone 1% Ointment External Hydrocortisone Acetate 25 MG Suppository Rectal Hydrogen Peroxide 3% Miscellaneous External Hydroxychloroquine Sulfate 200 MG Tablet Oral HydrOXYzine HCl 10 MG Tablet Oral HydrOXYzine HCl 25 MG Tablet Oral Hypercare 20% Solution External Ibuprofen 200 MG Tablet Oral Ibuprofen 600 MG Tablet Oral Imiquimod 5% Cream External Insta-Glucose 40% Gel Oral Iron 325 (65 Fe) MG Tablet Oral Jolessa MG Tablet Oral Junel FE 1.5/ MG-MCG Tablet Oral Junel FE 1/ MG-MCG Tablet Oral Kariva /0.01 MG (21/5) Tablet Oral Kelnor 1/ MG-MCG Tablet Oral Ketoconazole 2% Cream External Ketoconazole 2% Shampoo External Ketorolac Tromethamine 30 MG/ML Solution Injection Ketotifen Fumarate 0.03% Solution Ophthalmic LamoTRIgine 100 MG Tablet Oral LamoTRIgine 25 MG Tablet Oral Levofloxacin 500 MG Tablet Oral Lidocaine HCl 2% Gel External Lidocaine Viscous 2% Solution Mouth/Throat Lomedia 24 FE 1-20 MG-MCG(24) Tablet Oral Loperamide HCl 2 MG Capsule Oral Loratadine 10 MG Tablet Oral Malarone MG Tablet Oral Meclizine HCl 25 MG Tablet Chewable Oral Mediplast 40% Miscellaneous External MedroxyPROGESTERone Acetate 10 MG Tablet Oral MedroxyPROGESTERone Acetate 150 MG/ML Suspension Intramuscular Mefloquine HCl 250 MG Tablet Oral Melatonin Maximum Strength 5 MG Tablet Oral MetroNIDAZOLE 0.75% Gel Vaginal MetroNIDAZOLE 500 MG Tablet Oral Minocycline HCl 100 MG Capsule Oral Minocycline HCl 50 MG Capsule Oral Misoprostol 200 MCG Tablet Oral Montelukast Sodium 10 MG Tablet Oral Mupirocin 2% Ointment External Naproxen Sodium 220 MG Tablet Oral
4 Naproxen Sodium 550 MG Tablet Oral Nasal Decongestant Spray 0.05% Solution Nasal Neomycin-Polymyxin-HC Suspension Otic Nicotine Polacrilex 2 MG Gum Mouth/Throat Nicotine Polacrilex 4 MG Gum Mouth/Throat Nicotine Step 1 21 MG/24HR Patch 24 Hour Transdermal Nicotine Step 2 14 MG/24HR Patch 24 Hour Transdermal Nicotine Step 3 7 MG/24HR Patch 24 Hour Transdermal Nitrofurantoin Monohyd Macro 100 MG Capsule Oral Nortrel 1/35 (28) 1-35 MG-MCG Tablet Oral NuvaRing MG/24HR Ring Vaginal Ocella MG Tablet Oral Ofloxacin 0.30% Solution Otic Omeprazole 20 MG Capsule Delayed Release Oral Ondansetron 4 MG Tablet Dispersible Oral Ortho Tri-Cyclen Lo 0.18/0.215/0.25 MG-25 MCG Tablet Oral Pantoprazole Sodium 20 MG Tablet Delayed Release Oral Penicillin V Potassium 500 MG Tablet Oral Pepto-Bismol 262 MG Tablet Chewable Oral Permethrin 5% Cream External Petrolatum Ointment External Phenazopyridine Phenazopyridine HCl 200 MG Tablet Oral Pill Splitter Miscellaneous Does not Plan B One-Step 1.5 MG Tablet Oral Pocket Chamber Device Does not Polymyxin B-Trimethoprim UNIT/ML-% Solution Ophthalmic Portia MG-MCG Tablet Oral PrednisoLONE Acetate 1% Suspension Ophthalmic PredniSONE 20 MG Tablet Oral PredniSONE 50 MG Tablet Oral Prenatal Plus 27-1 MG Tablet Oral Propranolol HCl 20 MG Tablet Oral QUEtiapine Fumarate 100 MG Tablet Oral QUEtiapine Fumarate 25 MG Tablet Oral Ranitidine HCl 150 MG Tablet Oral Reclipsen MG-MCG Tablet Oral Seasonique &0.01 MG Tablet Oral Selenium Sulfide 2.50% Lotion External Sertraline HCl 100 MG Tablet Oral Sertraline HCl 50 MG Tablet Oral Silver Sulfadiazine 1% Cream External Singulair 10 MG Tablet Oral SMZ-TMP DS MG Tablet Oral Sore Throat MG Lozenge Mouth/Throat
5 Sore Throat Spray 1.40% Liquid Mouth/Throat Sprintec MG-MCG Tablet Oral SSD 1% Cream External SudoGest 30 MG Tablet Oral SudoGest 60 MG Tablet Oral SUMAtriptan Succinate 100 MG Tablet Oral SUMAtriptan Succinate 50 MG Tablet Oral SUMAtriptan Succinate 6 MG/0.5ML Solution Subcutaneous Tamiflu 75 MG Capsule Oral Terbinafine HCl 1% Cream External Terbinafine HCl 250 MG Tablet Oral Terconazole 0.80% Cream Vaginal Thera-M Tablet Oral TraZODone HCl 50 MG Tablet Oral Tretinoin 0.01% Gel External Tretinoin 0.03% Cream External Tri-Sprintec 0.18/0.215/0.25 MG-35 MCG Tablet Oral Triamcinolone Acetonide 0.10% Cream External Triamcinolone Acetonide 0.10% Ointment External Triamcinolone Acetonide 0.10% Paste Mouth/Throat Ulipristal Acetate 30 MG Tablet Oral Ultrathon Insect Repellent 34.34% Lotion External ValACYclovir HCl 1 GM Tablet Oral Ventolin HFA 108 (90 Base) MCG/ACT Aerosol Solution Inhalation Visc Lido2%/Benadryl/Maalox Vitamin D 1000 UNIT Tablet Oral Vivotif Berna Vaccine Capsule Delayed Release Oral White Petrolatum Gel Does not Zarah MG Tablet Oral
UWSP Student Health Service Pharmacy Formulary updated: 1/2017
UWSP Student Health Service Pharmacy Formulary updated: 1/2017 Medication Name Strength DosageForm Route Acetaminophen 325 MG Tablet Oral Acetaminophen-Codeine #2 300-15 MG Tablet Oral Acetaminophen-Codeine
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MEDICATION STRENGTH NOTES ANTIMICROBIALS-ANTIBIOTICS AMOXICILLIN CAPS 500 MG AMOXICILLIN SUSP 125 MG/5 ML 250 MG/5 ML 400 MG/5 ML AMOXICILLIN CHEW 250 MG AMOXICILLIN AND CLAVULANIC ACID CAPS (AUGMENTIN)
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Allergies & Cold and Flu Benzonatate 100mg 14 42 Ceron DM syrup 120ml 360ml Ceron drops* 30ml 90ml Dec-Chlorphen drops* 30ml 90ml Dec-Chlorphen DM syrup* 118ml 354ml Loratadine 10mg 30 90 Promethazine
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Allergy, Cold & Flu Antibiotic Treatments Arthritis & Pain Benzonatate 100mg cap 14 42 Diphenhydramine HCl Cap 50 MG 30 90 Diphenhydramine HCl Inj 50MG/ML 1 3 Diphenhydramine HCl Liquid 12.5 MG/5ML 720ml
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Allergy, Cold & Flu Antibiotic Treatments Arthritis & Pain Benzonatate 100mg cap 14 42 Diphenhydramine HCl Cap 50 MG 30 90 Diphenhydramine HCl Inj 50MG/ML 1 3 Diphenhydramine HCl Liquid 12.5 MG/5ML 720ml
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Acetaminophen 80mg/0.8mL Suspension Drops Acetaminophen 120mg Suppository Acetaminophen 160mg/5mL Suspension Acetaminophen 325mg Suppository Acetaminophen 325mg Tablet, Caplet, or Capsule Acetaminophen
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Allergies & Cold and Flu Benzonatate 100mg 14 Ceron DM syrup Ceron drops Dec-Chlorphen drops Dec-Chlorphen DM syrup 118ml* Loratadine 10mg Promethazine DM syrup Trivent DPC syrup * Antibiotic Treatments
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ANTI COLD / ANTI ALLERGIC / ANTI-ASTHMATICS GIT PRODUCTS
SR. NO 1 ANTI COLD / ANTI ALLERGIC / ANTI-ASTHMATICS Paracetamol 500 mg, Phenylephrine HCL 5 mg With Chlorpheniramine Maleate 2 mg & Caffeine 30 mg Tablets 2 Salbutamol Tablets BP 2 mg 3 Salbutamol Tablets
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Drug Category Allergy, Cold & Flu Antibiotic Treatments Arthritis & Pain Riesbeck's Benzonatate 100mg cap 14 42 Diphenhydramine HCl Cap 50 MG 30 90 Diphenhydramine HCl Liquid 12.5 MG/5ML 720ml 2160ml Hydroxyzine
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