Rx Formulary

ADHD

AMPHETAMINE SALTS 10,15,20,30MG: Adderall Tablets
CLONIDINE 0.1, 0.2, 0.3MG: Catapres
GUANFACINE 1,2MG: Tenex
METHYLPHENIDATE 5,10,20MG: Ritalin Tablets

ALZHEIMER’S

DONEPEZIL 5,10MG: Aricept
MEMANTINE 5,10MG: Namenda

ANTIBIOTICS

AMOXICILLIN 250,500MG: Amoxil
AMOXICILLIN/CLAV 500/125mg, 875/125MG: Augmentin
AZITHROMYCIN 250,500MG: Zithromax Z-pak
CEPHALEXIN 250,500MG: Keflex
CIPROFLOXACIN 250,500,750MG: Cipro
CLARITHROMYCIN 500MG: Biaxin
CLINDAMYCIN 150,300MG: Cleocin
DOXYCYCLINE 50,100MG: Vibratab
LEVOFLOXACIN 250,500,750MG: Levaquin
METRONIDAZOLE 250,500MG: Flagyl
MINOCYCLINE 50,100MG: Minocin
NITROFURANTOIN MONO 100MG: Macrobid
PENICILLIN 250,500MG: Pen-Vee K
SULFA/TRIMETH SS & DS: Septra/Bactrim

ANTIBIOTICS - PEDIATRIC (Liquids)

AMOXICILLIN 250MG/5ML (sizes: 80ML,100ML,150ML): Amoxil
AMOXICILLIN 400MG/5ML (sizes: 75ML,100ML): Amoxil
AMOXICILLIN/Clav 400MG/5ML (sizes: 50ML,75ML,100ML): Augmentin
AMOXICILLIN/Clav ES 600MG/5ML (sizes: 75ML,125ML,200ML) Augmentin ES
AZITHROMYCIN 100MG/5ML (size: 15ML): Zithromax
AZITHROMYCIN 200MG/5ML (sizes: 15ML,22.5ML,30ML): Zithromax
CEFDINIR 125MG/5ML (sizes: 60ML,100ML): Omnicef
CEFDINIR 250MG/5ML (sizes: 60ML,100ML): Omnicef
FLUCONAZOLE 10MG/ML - 35ML: Diflucan
FLUCONAZOLE 40MG/ML - 35ML: Diflucan

ANTIBIOTICS - TOPICAL

BENZOYL PEROXIDE 5% CLEANSER
CLINDAMYCIN 1% SOLUTION: Cleocin T Solution
MUPIROCIN 2% OINTMENT: Bactroban Ointment
SILVER SULFADIAZINE 1%: Silvadene Cream

ANTICHOLINERGIC

BENZTROPINE 0.5,1,2MG: Cogentin
HYOSCYAMINE 0.125MG: Levsin Oral or SL

ANTICOAGULANT / ANTIPLATELET

ASPIRIN 81,325MG
CLOPIDOGREL 75MG: Plavix
WARFARIN 1,2,2.5,3,4,5,6,7.5,10MG: Coumadin

ANTICONVULSANTS

DIVALPROEX SODIUM ER tablet 250, 500MG: Depakote ER
DIVALPROEX SODIUM tablet 125, 250, 500MG: Depakote
GABAPENTIN 100,300,400,600,800MG: Neurontin
LAMOTRIGINE 25,100,150,200MG: Lamictal
LEVETIRACETAM Tablets 250,500,750,1000mg: Keppra
OXCARBAZEPINE 150,300MG: Trileptal
PHENYTOIN 100MG: Dilantin
PRIMIDONE 50,250MG: Mysoline
TOPIRAMATE 25,50,100,200MG: Topamax

ANTIDEPRESSANTS

AMITRIPTYLINE 10,25,50MG: Elavil
BUPROPION SR 100,150,200MG: Wellbutrin SR
BUPROPION XL 150,300MG: Wellbutrin XL
CITALOPRAM 10,20,40MG: Celexa
DULOXETINE 20,30,60MG: Cymbalta
ESCITALOPRAM 10,20MG: Lexapro
FLUOXETINE 10,20,40MG: Prozac
MIRTAZAPINE 15,30,45MG: Remeron
NORTRIPTYLINE 10,25,50MG: Pamelor
PAROXETINE 10,20,30,40MG: Paxil
SERTRALINE 25,50,100MG: Zoloft
TRAZODONE 50,100,150MG: Desyrel
VENLAFAXINE ER 37.5,75,150MG Capsules: Effexor XR

ANTIESTROGEN

ANASTROZOLE 1MG: Arimidex
LETROZOLE 2.5MG: Femara
TAMOXIFEN 10,20MG: Nolvadex

ANTIFUNGAL

CLOTRIMAZOLE 1%: Lotrimin
FLUCONAZOLE 150MG: Diflucan
MICONAZOLE 2%: Micatin
NYSTATIN CREAM: Mycostatin
NYSTATIN oral suspension
NYSTATIN POWDER: Nystop
TERBINAFINE 250MG: Lamisil

ANTIVIRAL

ACYCLOVIR 400,800MG: Zovirax
VALACYCLOVIR 500,1000MG: Valtrex

CARDIAC

AMIODARONE 200MG: Cordarone
CARVEDILOL 3.125, 6.25, 12.5, 25MG: Coreg
DILTIAZEM CD 120,180,240,300MG: Cardizem CD
FLECAINIDE 50,100MG: Tambocor
FUROSEMIDE 20,40,80MG: Lasix
ISOSORBIDE MN 30,60MG: Imdur
LABETALOL 100,200MG: Normodyne
METOPROLOL SUCCINATE ER – 25,50,100MG: Toprol XL
METOPROLOL TARTRATE – 25,50,100MG: Lopressor
NITROGLYCERIN 0.4MG: Nitrostat
SOTALOL 80,120MG: Betapace

CONTRACEPTIVES & HORMONAL CARE

Simpesse (Levonorgestrel: 0.15mg/EE: 30mcg & 10mcg)
ESTRADIOL CREAM (0.1mg/g): Estrace
LEVONORGESTREL-ETHINYL ESTRADIOL: Nordette, Orsythia
MEDROXYPROGESTERONE 150MG/ML Vial/Syringe: Depo-Provera
NORETHINDRONE: Ortho Micronor
NORETHINDRONE-ETHINYL ESTRADIOL: Microgestin/Microgestin FE/Nortrel
NORGESTREL-ETHINYL ESTRADIOL: Cryselle
TRI-ESTARYLLA: Tri-Sprintec

COUGH

BENZONATATE 100,200MG: Tessalon
GUAIFENESIN/CODEINE: Robitussin AC
PROMETHAZINE/CODEINE: Phenergan/codeine

DERMATOLOGY

BETAMETHASONE DIP augmented cream: Diprolene
CLOTRIMAZOLE/BETAMETHASONE cream: Lotrisone
HYDROCORTISONE 2.5% ointment
HYDROXYZINE 10,25,50MG: Atarax
METHYLPREDNISOLONE 4mg Dosepack: Medrol
MOMETASONE cream/ointment: Elocon
PERMETHRIN crème rinse: NIX crème rinse
PREDNISONE 5,10,20,50MG: Sterapred DS
TRIAMCINOLONE cream/ointment: Kenalog

DIABETES TYPE-2

ACARBOSE 25,50,100MG: Precose
BLOOD GLUCOSE: MONITOR/STRIPS/LANCETS
GLIMEPIRIDE 1,2,4MG: Amaryl
GLIPIZIDE 5,10,MG: Glucotrol
GLIPIZIDE XL 2.5,5,10MG: Glucotrol-XL
METFORMIN 500,850,1000MG: Glucophage
METFORMIN ER 500MG: Glucophage XR
PEN NEEDLES 100’
PIOGLITAZONE 15,30,45MG: Actos
SYRINGES 30,50,100 Units

DIURETICS

BUMETANIDE 0.5,1,2MG: Bumex
CHLORTHALIDONE 25,50MG: Thalitone
FUROSEMIDE 20,40,80MG: Lasix
HCTZ 12.5,25MG: HydroDiuril
POTASSIUM CHLORIDE ER 10,20 MEQ : KlorCON
SPIRONOLACTONE 25,50,100MG: Aldactone
TRIAMTERENE/HCTZ 37.5/25, 75/50MG Tabs: Maxzide

EMERGENCY CONTRACEPTION

*Note: this medication requires a prescription in order to be obtained at the pharmacy at no cost.
MY WAY (generic Plan B)*

GASTRO

DICYCLOMINE 10,20MG: Bentyl
ESOMEPRAZOLE 20,40MG: Nexium
FAMOTIDINE 20,40MG: Pepcid
GAVILYTE-G, GAVILYTE-N: Golytely, Nulytely Colonoscopy Preps
MECLIZINE 12.5,25MG: Antivert
METOCLOPRAMIDE 5,10MG: Reglan
OMEPRAZOLE 10,20,40MG: Prilosec
ONDANSETRON 4,8MG: Zofran Tabs
ONDANSETRON-ODT 4,8MG: Zofran-ODT
PANTOPRAZOLE 20,40MG: Protonix
PROCHLORPERAZINE 5,10MG: Compazine
PROMETHAZINE 12.5,25MG: Phenergan
SIMETHICONE 125MG chewable, 20mg/0.3ml infant drops: Gas-X
SUCRALFATE 1GM Tablets: Carafate
SULFASALAZINE 500MG, ER 500MG: Azulfidine

GOUT

ALLOPURINOL 100,300MG: Zyloprim
INDOMETHACIN 25,50MG: Indocin
NAPROXEN 250,375,500MG: Naprosyn
PREDNISONE 5,10,20,50MG: Sterapred DS

HEENT - ALLERGY

AZELASTINE 0.1% nasal spray: Astelin
CETIRIZINE 10MG, 1mg/ml LIQUID: Zyrtec
FLUTICASONE nasal spray: Flonase
IPRATROPIUM nasal spray 0.03%,0.06%: Atrovent
LEVOCETIRIZINE 5MG: Xyzal
LORATADINE 10MG: Claritin
MONTELUKAST 4,5,10MG: Singulair

HEENT - EAR

NEO/POLY/DEX EYE drops: Maxitrol ophthalmic
OFLOXACIN EYE drops: Ocuflox

HEENT - EYE

CIPROFLOXACIN eye drops: Ciloxan
GENTAMICIN eye drops: Garamycin
KETOTIFEN eye drops: Zatidor/Alaway
NEO/POLY/DEX eye ointment: Maxitrol ointment
OFLOXACIN eye drops: Ocuflox
POLYMYXIN/TRIMETHOPRIM eye drops: PolyTrim
TOBRAMYCIN eye drops: Tobrex

HEENT - GLAUCOMA

BRIMONIDINE 0.2% eye drops: Alphagan
DORZOLAMIDE + TIMOLOL eye drops: CoSopt
DORZOLAMIDE eye drops: Trusopt
LATANOPROST eye drops: Xalatan
TIMOLOL eye drops: Timoptic plain

HEENT - MOUTH

LIDOCAINE VISCOUS 2%: Xylocaine viscous

HYPERLIPIDEMIA

ATORVASTATIN 10,20,40,80MG: Lipitor
EZETIMIBE 10MG: Zetia
FENOFIBRATE 48,145,160MG: Tricor
GEMFIBROZIL 600MG: Lopid
OMEGA-3-ACID ETHYL ESTERS: Lovaza
PRAVASTATIN 10,20,40,80MG: Pravachol
ROSUVASTATIN 5,10,20,40MG: Crestor
SIMVASTATIN 5,10,20,40MG: Zocor

HYPERTENSION - ACE/ARBs

BENAZEPRIL 5,10,20,40MG: Lotensin
IRBESARTAN 75,150,300MG: Avapro
IRBESARTAN/HCTZ: Avalide
LISINOPRIL 2.5,5,10,20,30,40MG: Prinivil/Zestril
LISINOPRIL/HCTZ (all strengths): Zestoretic
LOSARTAN 25,50,100MG: Cozaar
LOSARTAN/HCTZ 50/12.5,100/12.5,100/25MG: Hyzaar
OLMESARTAN 5,20,40MG: Benicar
QUINAPRIL 5,10,20,40MG: Accupril
RAMIPRIL 1.25,2.5,5,10MG: Altace
TELMISARTAN 20,40,80MG: Micardis
VALSARTAN 40,80,160,320MG: Diovan

HYPERTENSION – Beta Blockers

ATENOLOL 25,50,100MG: Tenormin
CARVEDILOL 3.125, 6.25, 12.5, 25MG: Coreg
LABETALOL 100,200MG: Normodyne
METOPROLOL 25,50,100MG: Lopressor
METOPROLOL ER 25,50,100MG: Toprol-XL
NEBIVOLOL 2.5,5,10,20MG: Bystolic
PROPRANOLOL 10,20,40,80MG: Inderal

HYPERTENSION - CCBs

AMLODIPINE 2.5,5,10MG: Norvasc
DILTIAZEM CD 120,180,240,300MG: Cardizem CD
NIFEDIPINE 30,60,90MG Tablets: Procardia XL
VERAPAMIL ER 120,180,240MG: Calan SR

HYPERTENSION – Sympatholytic

CLONIDINE 0.1, 0.2, 0.3MG: Catapres
GUANFACINE 1,2MG: Tenex

HYPOTENSION (Low Blood Pressure)

MIDODRINE 5,10MG: Proamatine

LAXATIVES

BISACODYL 5MG: Dulcolax
DOCUSATE 100MG Caps: Colace
LACTULOSE Syrup: Chronulac
MILK OF MAGNESIA
POLYETHYLENE GLYCOL: Miralax
SENNA 8.6MG

MEN’S HEALTH

ALFUZOSIN 10MG: Uroxatral
DUTASTERIDE 0.5MG: Avodart
FINASTERIDE 5MG: Proscar
SILDENAFIL 25,50,100MG (max 8 per month): Viagra
TADALAFIL 10,20MG (max 8 per month): Cialis
TADALAFIL 5MG: Cialis (BPH dose)
TAMSULOSIN 0.4MG: Flomax
TERAZOSIN 1,2,5,10MG: Hytrin

MENTAL HEALTH

ALPRAZOLAM 0.25,0.5,1MG: Xanax
ARIPIPRAZOLE 2,5,10,15,20,30MG: Abilify
BUSPIRONE 5,10,15,30MG: Buspar
CHLORDIAZEPOXIDE 5,10,25MG: Librium
CLONAZEPAM 0.5,1,2MG: Klonopin
DIAZEPAM 2,5,10MG: Valium
HYDROXYZINE PAMOATE 25,50MG: Vistaril
LITHIUM 150,300MG: LithoBid, Eskalith
LORAZEPAM 0.5,1MG: Ativan
OLANZAPINE 2.5,5,7.5,10MG: Zyprexa
PRAZOSIN 1,2MG: Minipress
QUETIAPINE 25,50,100,200,300MG: Seroquel
RISPERIDONE 0.25,0.5,1,2,3,4MG: Risperdal

MIGRAINE

PROPRANOLOL 10,20,40,80MG: Inderal
RIZATRIPTAN 5,10MG: Maxalt
RIZATRIPTAN ODT 5,10MG: Maxalt MLT
SUMATRIPTAN 25,50,100MG: Imitrex
TOPIRAMATE 25,50,100,200MG: Topamax

MUSCLE RELAXANTS

BACLOFEN 10,20MG: Lioresal
CYCLOBENZAPRINE 5,10MG: Flexeril
METHOCARBAMOL 500,750MG: Robaxin
ORPHENADRINE ER 100mg: Norflex
TIZANIDINE 2,4MG: Zanaflex

OAB (Overactive Bladder)

OXYBUTYNIN 5MG: Ditropan
OXYBUTYNIN ER 5,10,15MG: Ditropan XL
SOLIFENACIN 5,10MG: Vesicare

OSTEOPOROSIS

ALENDRONATE 35,70MG: Fosamax
CALCIUM CARBONATE: OS-CAL
CALCIUM CITRATE: Citracal
IBANDRONATE 150MG: Boniva
VITAMIN D 50,000 IU: Drisdol

PAIN - OPIOIDS (Must Follow Clinic Opioid Policy)

ACETAMINOPHEN W/CODEINE #3: Tylenol #3
HYDROCODONE/APAP 5/325, 7.5/325, 10/325: Norco
MORPHINE ER 15,30MG: MS Contin
OXYCODONE 5,10,15MG IR Tablets: OXY-IR
TRAMADOL 50MG: Ultram

PAIN MANAGEMENT

CELECOXIB 100, 200MG: Celebrex
DICLOFENAC 1% Gel: Voltaren Gel
DICLOFENAC 50,75MG: Voltaren Tablets
GABAPENTIN 100,300,400,600,800MG: Neurontin
IBUPROFEN 200,400,600,800MG: Motrin
MELOXICAM 7.5,15MG: Mobic
NAPROXEN 250,375,500MG: Naprosyn
PREGABALIN 50,75,100,150MG: Lyrica

PARKINSON’S

BENZTROPINE 0.5,1,2MG: Cogentin
CARBIDOPA/LEVODOPA 25/100MG: Sinemet
PRAMIPEXOLE 0.125,0.25,0.5,0.75,1,1.5MG: Mirapex
ROPINIROLE 0.25,0.5,1,2,3,4MG: Requip

RESPIRATORY

ALBUTEROL 2.5MG/3ML Neb Soln: Ventolin Soln
ALBUTEROL HFA 8GM MAX: Ventolin
ALBUTEROL/IPRATROPIUM 0.5/3 mg/3ml Soln: Duoneb
IPRATROPIUM 0.02% Neb Soln: Atrovent Soln

RHEUMATOID ARTHRITIS

FOLIC ACID 1MG
HYDROXYCHLOROQUINE 200MG: Plaquenil
METHOTREXATE 2.5MG

RLS

PRAMIPEXOLE 0.125,0.25,0.5,0.75,1,1.5MG: Mirapex
ROPINIROLE 0.25,0.5,1,2,3,4MG: Requip

SLEEP AIDS

AMITRIPTYLINE 10,25,50MG: Elavil
DOXEPIN 10,25MG: Sinequan
MIRTAZAPINE 15,30,45MG: Remeron
TEMAZEPAM 15,30MG: Restoril
TRAZODONE 50,100,150MG: Desyrel
ZOLPIDEM 5,10MG: Ambien

THYROID

LEVOTHYROXINE (All Strengths): Synthroid
METHIMAZOLE 5,10 MG: Tapazole

UTI PAIN

PHENAZOPYRIDINE 100, 200MG (Max 6 Tablets): Pyridium

VITAMINS/SUPPLEMENTS

MELATONIN 3,5 MG (one daily)
CALCIUM CARBONATE: OS-CAL
CALCIUM CITRATE: Citracal
CHILDREN’S CHEWABLE MULTIVITAMIN
DAILY-VITE MULTIVITAMIN
FERREX 150: Iron Polysaccharide Supplement
FERROUS SULFATE 325MG: Iron Supplement
FOLIC ACID 1MG
MAGNESIUM OXIDE 400MG
MULTIVITAMIN W/ FLUORIDE 0.25,0.5,1MG: Floriva
SODIUM FLUORIDE 0.25,0.5,1MG: Ludent
VITAMIN B-1 100MG
VITAMIN B-12 500, 1000, 2,500MG
VITAMIN B-2 100MG
VITAMIN B-6 50MG
VITAMIN C 500MG
VITAMIN D 1000,2000,5000IU
VITAMIN D 400IU/mL Drops
VITAMIN E 200,400 IU

WOMEN’S HEALTH

CLOTRIMAZOLE VAG CREAM: Gyne-Lotrimin cream
ESTRADIOL 0.5,1,2MG: Estrace
FLUCONAZOLE 150MG: Diflucan
MICONAZOLE VAG CREAM/SUPPS: Monistat
PRENATAL VITAMINS: PNV Prenatal Plus
See “CONTRACEPTIVES” for birth control options