Combined Troop Medical Clinic Outpatient Formulary. The availability of formulary items is subject to change.

Similar documents
Professionalism & Service with Great Prices

Riesbeck's Pharmacy Reward Club Generic Medication List February 2018 $4 30 Day Supply

Riesbeck's Pharmacy Reward Club Generic Medication List October 2017

Glossary of Medications

Riesbeck's Pharmacy Reward Club Generic Medication List September 2017

Generic Drug List - Alphabetical

Everyday Low Cost Generics

Upper Peninsula Health Plan Advantage (HMO) (List of Covered Drugs)

PRESCRIPTION SAVINGS CLUB FLAT- PRICED GENERIC DRUG LIST (EMDEON) Effective August 20, 2014

90-Day Generic Drug Discount List Treatment Medication Strength Dose Quantity Price Allergy/Cold&Flu Benzonatate 100mg Tablet 42 $15.

Cash Wise Pharmacy $4 GENERIC MEDICATION FORMULARY. Cash Wise Pharmacy s $4 generic medication formulary is sorted by medical condition.

CMI Marketplace 2015 (List of Covered Drugs)

Palliative Care Drug Plan (Plan P) Formulary List of drugs PharmaCare covers

$4 Prescription Program May 5, 2008

Oakwood Healthcare Low Cost Drug List for OHSCare & BCN

$4 Prescription Program October 23, 2007

UWSP Student Health Service Pharmacy Formulary 1/22/2015

FORMULARY Revised January 2019

Fruth Pharmacy Prescription Savings Club Prescription Club October 2010 Generics item list 30 Day Qty

UWSP Student Health Service Pharmacy Formulary updated: 1/2017

RETAIL PRESCRIPTION PROGRAM DRUG LIST -- WALMART Revised 8/24/11

Hundreds of Choices. More Savings Every Day. 8 and $ 12 Generics Also Available. Based on 30-day supply at commonly prescribed doses

Allergy, Cough and Cold. Analgesic. Anti-Anxiety. Antibiotic

(D) Standard Indications Included (Refer to Appendix A for list of medications)

Special Generic Drug Pricing Program

Pharmacy Savings Program

Joint Base McGuire-Dix-Lakehurst Outpatient Formulary Alphabetical Listing by Therapeutic Category

PRIOR ADAP FORMULARY - RX OPTIONS

Formulary for the JHM Outpatient Medication Assistance Program (OMAP)

ANTI COLD / ANTI ALLERGIC / ANTI-ASTHMATICS GIT PRODUCTS

AMANTADINE 50 MG/5 ML SYRUP ACYCLOVIR 200 MG CAPSULES ACYCLOVIR 400 MG TABLETS ACYCLOVIR 800 MG TABLETS 30 90

FORMULARY NOTES ABOUT FORMULARY AND PHARMACY

Home Delivery Prescription Program Drug List

Ambetter 90-Day-Supply Maintenance Drug List

Product List Finished Dosage Forms (FDF) B2B Business

Club Members save even more with the $4 Plus Plan!

5/8/2017. Clinical Pharmacy Specialist Division of Kidney Disease and Hypertension

TennCare Program TN MAC Price Change List As of: 03/30/2017

ADDITIONAL DRUG LISTING FOR MEDICARE & MEDI-CAL MEMBERS

Alaska Medicaid 90 Day** Generic Prescription Medication List

DT Description Price Category Price change Percentage BNF 1.2 Mebeverine 135mg tablets (100) 759 M %

PHARMA-MEDIC SERVICES INC. POLICY MANUAL

PyeongChang 2018 Paralympic Winter Games Formulary

DT Description Price Category Price change

Table A1: Fifty Most Often Repeated Oral Drug Product Shortages (35 ingredients), Canada,

CATEGORIES: QUIZ 2. Drugs Categories. 1. What drug subcategory often ends with the suffix -asone?

Drugs That May Be Used by Certain Optometrists

Home Delivery Prescription Program Drug List

Amitriptyline Hydrochloride Heart Health & BP Amlodipine Besylate 5mg Norvasc Antibiotics Amoxicillin 500 mg Amoxil

CONTENTS SECTION 1 SECTION

FORMULARY Revised January 2018 NOTES ABOUT FORMULARY AND PHARMACY

While there is around a 3% increase shown in costs for Category M lines, I think this is due to the inclusion of more lines in Category M.

Drugs Categories. 4. Which suffix do alpha blocker generic drug names often end with?

CITY OF JOPLIN, MISSOURI

DT Description Price Category Price change Percentage BNF 1.2 Mebeverine 135mg tablets (100) 702 M %

Amitriptyline Hydrochloride Heart Health & BP Amlodipine Besylate 5mg Norvasc Antibiotics Amoxicillin 500 mg Amoxil

Rifamycins Drug interactions

BC Cancer Agency & Canadian Cancer Society Financial Support Drug Program (FSDP) for Cancer Patients. Drug Benefit List. Updated August 1, 2017

AMMONIA AROMATIC 15 % (W/V) SOLUTION FOR

TN Cover Rx Tennessee CoverRx MAC Price Change List As of: 04/26/2018

Drugs Categories. 4. Which suffix do erectile dysfunction generic drug names often end with?

ALLERGIC RHINITIS-NASAL

Table Of Contents: AHFS Pharmacologic-Therapeutic Classification 0:01 Front Matter 4:00 Antihistamine Drugs 4:04 First Generation Antihistamines

CRITERIA Trial of two generic formulary products from the following: atomoxetine or ADHD stimulant medication.

Nclex para la Enfermera Hispana

DT Description Price Category Price change Percentage

All Pharmacy and Prescribing Providers. Subject: State Maximum Allowable Cost (MAC) Updates

PHARMACOLOGY MILESTONES:

DRUG NAMING AND CLASSES

Drug Classification and Pharmacologic Actions

$0 Preferred Generics List

Penicillin VK Vcillin K 250gm/5ml Penicillin VK Vcillin K 250mg Sulfameth/Trimeth Bactrim 400/80mg Sulfameth/Trimeth Bactrim/Septra DS 800/160mg

Drug Classifications

Step Therapy Approval Criteria

Pharmacology. An Introduction. Henry Hitner, Ph.D. Barbara Nagle, Ph.D. Learn. Neuroscience, Physiology,

Pharma X Consultancy Inc. Inventory List

GENERIC DISCOUNT FORMULARY March 2015

acetylcysteine inhalation, solution 20% acyclovir Al hydroxide/asa/ca carbonate/mg hydroxide

Neuro Basics SLO Practice (online) Page 1 of 5

Essentials for Medication Safety

Al hydroxide/asa/ca carbonate/mg hydroxide

Active Pharmaceutical Ingredient (API) List List Updated March 1st, 2019

FLORIDA 2017 EHB BENCHMARK PLAN

General products list. NDC Product Description Strength Form Brand Name Therapeutic Class Class Size

Nebraska Medicaid Program NE Weekly MAC Price Change List For Period: 12/14/ /20/2017

PRODUCT LIST GENERAL - TABLETS

Drugs, Sleep & Wakefulness. Brian Koo Reena Mehra MD MS Kingman Strohl MD

Medication and Supplies Wish list for Donors

Who remembers Terfenadine? Once daily non-sedating anti-histamine. Drug Interactions: What is the CYP 450 system? What does the CYP 450 system do?

calcium chloride 100 mg/ml (10 %) intravenous solution,calcium chloride 100 mg/ml (10 %) $ 60.00

Synthesis of Essential Drugs

2018 Step Therapy Criteria

Step Therapy Criteria (Criteria for Step Therapy-2 [ST-2] Drugs)

CONTRAINDICATIONS TABLE

Adverse drug interactions in dental practice

Provider Toolkit PFFS/PPO

2018 MEDICARE LOCAL COVERAGE DETERMINATION (LCD) - L34313 CPT CODES: 86003, ALLERGY TESTING

Office of Medicaid Policy and Planning Over-the-Counter Drug Formulary ANALGESICS ANTACIDS ANTI-FLATULENTS

Transcription:

Combined Troop Medical Clinic Outpatient Formulary Alphabetical Listing by Therapeutic Category This document is current as of September 6, 2013. The availability of formulary items is subject to change.

ACNE PRODUCTS Acne Products Adrenergic Agonist Agent Alpha 1 Blocker Alfuzosin... Prazosin... Tamsulosin... Terazosin... Alpha 2 -Adrenergic Agonist CloNIDine... Alpha/Beta Agonist EPINEPHrine (Systemic, Oral Inhalation)... Guaifenesin and Pseudoephedrine... Pseudoephedrine... Amebicide Aminoquinoline (Antimalarial) Hydroxychloroquine... Primaquine... Analgesic Combination (Opioid) Acetaminophen and Codeine... Acetaminophen and Tramadol... Hydrocodone and Acetaminophen... Oxycodone and Acetaminophen... Analgesic, Miscellaneous Acetaminophen... Acetaminophen and Tramadol... Analgesic, Opioid OxyCODONE... Analgesic, Topical Lidocaine (Topical)... Analgesic, Urinary Phenazopyridine... Androgen Testosterone... Anesthetic/Corticosteroid Pramoxine and Hydrocortisone... Anesthetic, Topical Phenol... Angiotensin II Receptor Blocker Losartan... Losartan and Hydrochlorothiazide... Telmisartan... Telmisartan and Hydrochlorothiazide... Valsartan... Angiotensin-Converting Enzyme (ACE) Inhibitor Lisinopril... Lisinopril and Hydrochlorothiazide... Antacid Aluminum Hydroxide, Magnesium Hydroxide, and Simethicone... Antianginal Agent Atenolol... Metoprolol... Antianxiety Agent, Miscellaneous BusPIRone... Antiarrhythmic Agent, Class II Antiarrhythmic Agent, Class IV Antibiotic, Aminoglycoside Gentamicin (Ophthalmic)... Antibiotic, Cephalosporin (First Generation) Cephalexin... Antibiotic/Corticosteroid, Ophthalmic Neomycin, Polymyxin B, and Dexamethasone... Tobramycin and Dexamethasone... Antibiotic/Corticosteroid, Otic Antibiotic, Lincosamide Clindamycin (Systemic)... Clindamycin (Topical)... Antibiotic, Macrolide Azithromycin (Systemic)... Clarithromycin... Erythromycin (Ophthalmic)... Antibiotic, Miscellaneous Nitrofurantoin... Rifampin... Sulfamethoxazole and Trimethoprim... Antibiotic, Ophthalmic Bacitracin, Neomycin, and Polymyxin B... Erythromycin (Ophthalmic)... Gatifloxacin... Gentamicin (Ophthalmic)... Moxifloxacin (Ophthalmic)... Antibiotic, Oral Rinse Chlorhexidine Gluconate... Antibiotic, Otic Ofloxacin (Otic)... Antibiotic, Penicillin Amoxicillin... Amoxicillin and Clavulanate... Penicillin V Potassium... Antibiotic, Quinolone Ciprofloxacin (Systemic)... Gatifloxacin... Levofloxacin (Systemic)... Moxifloxacin (Ophthalmic)... Ofloxacin (Otic)... Antibiotic, Sulfonamide Derivative Sulfamethoxazole and Trimethoprim... Antibiotic, Tetracycline Derivative Doxycycline... Minocycline... Antibiotic, Topical Bacitracin, Neomycin, and Polymyxin B... Chlorhexidine Gluconate... MetroNIDAZOLE (Topical)... Mupirocin... Silver Sulfadiazine... Anticholinergic Agent Dicyclomine... Ipratropium and Albuterol... Ipratropium (Oral Inhalation)... Tiotropium... Tolterodine... Anticholinergic Agent, Long-Acting Tiotropium... Anticonvulsant, Hydantoin Phenytoin... Anticonvulsant, Miscellaneous Gabapentin... Antidepressant, Alpha-2 Antagonist Mirtazapine...

CENTRAL NERVOUS SYSTEM STIMULANT Antidepressant, Dopamine-Reuptake Inhibitor BuPROPion... Antidepressant, Selective Serotonin Reuptake Inhibitor Citalopram... FLUoxetine... PARoxetine... Sertraline... Antidepressant, Serotonin/Norepinephrine Reuptake Inhibitor Venlafaxine... Antidepressant, Serotonin Reuptake Inhibitor/Antagonist TraZODone... Antidepressant, Tricyclic (Tertiary Amine) Amitriptyline... Doxepin (Systemic)... Antidiabetic Agent, Biguanide MetFORMIN... Antidiabetic Agent, Dipeptidyl Peptidase IV (DPP-IV) Inhibitor SitaGLIPtin... Antidiabetic Agent, Sulfonylurea GlipiZIDE... GlyBURIDE... Antidiabetic Agent, Thiazolidinedione Pioglitazone... Antidiarrheal Bismuth... Loperamide... Antiemetic Ondansetron... Antiflatulent Aluminum Hydroxide, Magnesium Hydroxide, and Simethicone... Antifungal Agent, Oral Fluconazole... Terbinafine (Systemic)... Antifungal Agent, Parenteral Fluconazole... Antifungal Agent, Topical Betamethasone and Clotrimazole... Clotrimazole (Topical)... Ketoconazole (Topical)... Naftifine... Nystatin and Triamcinolone... Nystatin (Topical)... Tolnaftate... Antifungal Agent, Vaginal Clotrimazole (Topical)... Nystatin (Topical)... Terconazole... Antigout Agent Allopurinol... Colchicine... Anti-inflammatory, Locally Applied Carbamide Peroxide... Antilipemic Agent, 2-Azetidinone Ezetimibe and Simvastatin... Antilipemic Agent, Fibric Acid Fenofibrate... Gemfibrozil... Antilipemic Agent, HMG-CoA Reductase Inhibitor AtorvaSTATin... Ezetimibe and Simvastatin... Pravastatin... Simvastatin... Antilipemic Agent, Miscellaneous Niacin... Antimanic Agent RisperiDONE... Antimigraine Agent Rizatriptan... SUMAtriptan... ZOLMitriptan... Antiplatelet Agent Aspirin... Antiprotozoal, Nitroimidazole Antipsychotic Agent, Atypical ARIPiprazole... QUEtiapine... RisperiDONE... Antitubercular Agent Isoniazid... Rifampin... Antitussive Benzonatate... Antitussive/Decongestant/Expectorant Guaifenesin, Pseudoephedrine, and Codeine... Antiviral Agent Acyclovir (Systemic)... ValACYclovir... Antiviral Agent, Oral ValACYclovir... Antiviral Agent, Topical Acyclovir (Topical)... Barbiturate Butalbital, Acetaminophen, and Caffeine... Benzodiazepine ALPRAZolam... ClonazePAM... Diazepam... LORazepam... Temazepam... Beta 2 -Adrenergic Agonist Ipratropium and Albuterol... Beta 2 -Adrenergic Agonist, Long-Acting Salmeterol... Beta 2 Agonist Albuterol... Levalbuterol... Salmeterol... Beta-Adrenergic Blocker, Nonselective Beta-Blocker, Beta-1 Selective Atenolol... Metoprolol... Beta-Blocker With Alpha-Blocking Activity Carvedilol... Bisphosphonate Derivative Alendronate... Calcineurin Inhibitor Calcium Channel Blocker Calcium Channel Blocker, Dihydropyridine Calcium Channel Blocker, Nondihydropyridine Calcium Salt Central Nervous System Stimulant Dextroamphetamine and Amphetamine...

CONTRACEPTIVE Contraceptive Ethinyl Estradiol and Desogestrel... Ethinyl Estradiol and Drospirenone... Ethinyl Estradiol and Ethynodiol Diacetate... Ethinyl Estradiol and Etonogestrel... Ethinyl Estradiol and Levonorgestrel... Ethinyl Estradiol and Norelgestromin... Ethinyl Estradiol and Norethindrone... Ethinyl Estradiol and Norgestimate... Ethinyl Estradiol and Norgestrel... Levonorgestrel... MedroxyPROGESTERone... Norethindrone... Corticosteroid, Inhalant (Oral) Fluticasone (Oral Inhalation)... Corticosteroid, Nasal Fluticasone (Nasal)... Mometasone (Nasal)... Corticosteroid, Ophthalmic Corticosteroid, Otic Corticosteroid, Rectal Hydrocortisone (Topical)... Corticosteroid, Systemic Betamethasone... MethylPREDNISolone... PredniSONE... Corticosteroid, Topical Betamethasone... Betamethasone and Clotrimazole... Clobetasol... Desonide... Fluocinonide... Hydrocortisone (Topical)... Nystatin and Triamcinolone... Triamcinolone (Topical)... Cough Preparation Decongestant Pseudoephedrine... Diuretic, Loop Furosemide... Diuretic, Potassium-Sparing Hydrochlorothiazide and Triamterene... Diuretic, Thiazide Hydrochlorothiazide... Hydrochlorothiazide and Triamterene... Lisinopril and Hydrochlorothiazide... Losartan and Hydrochlorothiazide... Telmisartan and Hydrochlorothiazide... Electrolyte Supplement, Oral Magnesium Oxide... Electrolyte Supplement, Parenteral Estrogen and Progestin Combination Ethinyl Estradiol and Desogestrel... Ethinyl Estradiol and Drospirenone... Ethinyl Estradiol and Ethynodiol Diacetate... Ethinyl Estradiol and Etonogestrel... Ethinyl Estradiol and Levonorgestrel... Ethinyl Estradiol and Norelgestromin... Ethinyl Estradiol and Norethindrone... Ethinyl Estradiol and Norgestimate... Ethinyl Estradiol and Norgestrel... Estrogen Derivative Estrogens (Conjugated/Equine, Systemic)... Ethanolamine Derivative Expectorant Guaifenesin and Pseudoephedrine... GABA Analog Gabapentin... Gastrointestinal Agent, Miscellaneous Sucralfate... Genitourinary Irrigant Histamine H 1 Antagonist Histamine H 1 Antagonist, First Generation Histamine H 1 Antagonist, Second Generation Histamine H 2 Antagonist Ranitidine... Hypnotic, Miscellaneous Zolpidem... Hypoglycemic Agent, Oral Imidazoline Derivative Immunosuppressant Agent AzaTHIOprine... Inhalation, Miscellaneous Inhalation Devices... Iron Salt Ferrous Sulfate... Irrigant Keratolytic Agent Laxative, Osmotic Polyethylene Glycol 3350... Laxative, Saline Magnesium Citrate... Leukotriene-Receptor Antagonist Montelukast... Local Anesthetic Benzocaine... Dibucaine... Lidocaine (Topical)... Lubricant, Ocular Magnesium Salt Magnesium Citrate... Magnesium Oxide... Miscellaneous Product Diabetic Supplies... Nonsteroidal Anti-inflammatory Drug (NSAID) Diclofenac (Systemic)... Diclofenac (Topical)... Nonsteroidal Anti-inflammatory Drug (NSAID), Oral Diclofenac (Systemic)... Ibuprofen...

XANTHINE OXIDASE INHIBITOR Indomethacin... Meloxicam... Naproxen... Nonsteroidal Anti-inflammatory Drug (NSAID), Parenteral Ibuprofen... Indomethacin... Nonsteroidal Anti-inflammatory Drug (NSAID), Topical Diclofenac (Topical)... Norepinephrine Reuptake Inhibitor, Selective AtoMOXetine... Nutritional Supplement Fluoride... Ophthalmic Agent, Miscellaneous Artificial Tears... Carboxymethylcellulose... Ophthalmic Agent, Vasoconstrictor Otic Agent, Analgesic Antipyrine and Benzocaine... Otic Agent, Anti-infective Acetic Acid... Otic Agent, Cerumenolytic Antipyrine and Benzocaine... Carbamide Peroxide... Pharmaceutical Aid White Petrolatum... Phenothiazine Derivative Phosphodiesterase-5 Enzyme Inhibitor Sildenafil... Piperazine Derivative Piperidine Derivative Progestin Levonorgestrel... MedroxyPROGESTERone... Norethindrone... Proton Pump Inhibitor Esomeprazole... Omeprazole... Respiratory Fluoroquinolone Levofloxacin (Systemic)... Retinoic Acid Derivative Salicylate Aspirin... Selective 5-HT 3 Receptor Antagonist Ondansetron... Serotonin 5-HT 1B, 1D Receptor Agonist Rizatriptan... SUMAtriptan... ZOLMitriptan... Skeletal Muscle Relaxant Carisoprodol... Cyclobenzaprine... Methocarbamol... Skin and Mucous Membrane Agent Imiquimod... Skin and Mucous Membrane Agent, Miscellaneous Emollients... Smoking Cessation Aid BuPROPion... Nicotine... Sodium Salt Stool Softener Docusate... Substituted Benzimidazole Esomeprazole... Omeprazole... Thyroid Product Levothyroxine... Topical Skin Product Acetic Acid... Calamine... Emollients... Imiquimod... Lactic Acid and Ammonium Hydroxide... White Petrolatum... Zinc Oxide... Topical Skin Product, Acne Clindamycin (Topical)... Transient Receptor Potential Vanilloid 1 (TRPV1) Agonist Vitamin Prenatal Vitamins... Vitamin B Complex Combinations... Vitamin, Fat Soluble Vitamin, Water Soluble Ascorbic Acid... Folic Acid... Niacin... Xanthine Oxidase Inhibitor Allopurinol...