healthpac formularydisclaimer: doses / routes of administration are the responsibility of the...

HealthPAC Formulary Current as of January 2014

Generic Name Brand Name Strength Class I Class II

Acetaminophen / Oxycodone Percocet 325/5 and 325/10 Analgesic Narcotic

Acetaminophen/Codeine #3 Tylenol #3 300 / 30 mg Analgesic Narcotic

Acetaminophen/Hydrocodone Norco 325/5 mg Analgesic Narcotic

Acetaminophen/Hydrocodone Norco 325/7.5 mg Analgesic Narcotic

Acetaminophen/Hydrocodone Norco 325/10 mg Analgesic Narcotic

Acetaminophen/Hydrocodone

bitartrateVicodin 500 mg - 5 mg Analgesic Narcotic

Acetic acid Vosol 15 ml drops Otic

Acetic acid/Hydrocortisone Vosol HC 2%-1% Otic

Acetylsalicylic acid (ASA) 81, 325 mg Analgesic Salicylates

Acyclovir Zovirax 200 mg Antimicrobials Antiviral



Albuterol HFA (IDP) tablet, MDI,

solution, UD

Proventil HFA

(IDP)90 mcg Respiratory Inhaler

Albuterol liquid Ventolin, Proventil 2 mg / 5 cc (120 ml) Respiratory

Albuterol solution neb Proventil 5 mg/ml (20 ml bottle) Respiratory Nebulizer soln

Albuterol Unit Dose Proventil 0.83 mg/ml Respiratory

Albuterol-ipratropium Inhaler Combivent MDI Respiratory

Alclometasone Cream Aclovate 45gm Anti-inflammatory Agents

Alclometasone Ointment Aclovate 45gm Anti-inflammatory Agents

Alendronate Fosamax 70 mg Osteoporosis

Alendronate Fosamax 35 mg Osteoporosis

Allopurinol Zyloprim 300 mg Gout

Allopurinol Zyloprim 100 mg Gout

Amantadine Symmetrel 50 mg / 5 ml (120 ml) Neurologic Parkinson

Amantadine Symmetrel 100 mg Neurologic Parkinson

Amiodarone Cordarone 400 mg Cardiovascular Antiarrythmic

Amiodarone Cordarone 200 mg Cardiovascular Antiarrythmic

Amitriptyline Elavil 50 mg Psychiatric Antidepressant




Disclaimer: Doses / routes of administration are the responsibility of the prescribing provider based on the medical home's practice guidelines. of 22




Amlodipine Norvasc 5 mg CardiovascularCalcium Channel

Blockers

Amlodipine Norvasc 2.5 mg CardiovascularCalcium Channel

Blockers

Amlodipine Norvasc 10 mg CardiovascularCalcium Channel

Blockers

Amoxicillin Amoxil 500 mg Antimicrobials Penicillins

Amoxicillin Amoxil 250 mg / 5 cc (150 cc) Antimicrobials Penicillins

Amoxicillin Amoxil 250 mg Antimicrobials Penicillins

Amoxicillin Amoxil 125 mg / 5 cc (80 cc) Antimicrobials Penicillins

Amoxicillin Amoxil 400 mg/ 5 cc Antimicrobials Penicillins

Amoxicillin-clavulanate Augmentin 500 mg-125 mg Antimicrobials Penicillins

Amoxicillin-clavulanate Augmentin 875 mg Antimicrobials Penicillins

Amoxicillin-clavulanate Augmentin 200 mg / 5 cc (100 ml) Antimicrobials Penicillins

Antipyrene, Benzodine, Glycerine

dehydAuralgan 10 ml drops Otic

Atenolol Tenormin 50 mg Cardiovascular Beta Blockers



Azathioprine Imuran 50mg Immunosupressive

Azithromycin Zithromax 250 mg Antimicrobials Macrolides

Baclofen Lioresal 10 mg Analgesic Muscle Relaxant

Baclofen Lioresal 20 mg Analgesic Muscle Relaxant

Beclomethasone dipropinate Qvar 80 mcg Respiratory Steroid inhaler

Beclomethasone dipropinate Qvar 40 mcg Respiratory Steroid inhaler

Belladona alkaloids, phenobarbital Donnatal 16.2 mg GI Antispasmodics

Benztropine mesylate Cogentin 2 mg Neurologic Parkinson

Benztropine mesylate Cogentin 1 mg Neurologic Parkinson

Benztropine mesylate Cogentin 0.5 mg Neurologic Parkinson

Benztropine mesylate Cogentin 1 mg/cc (inj) Neurologic Parkinson

bismuth subsalicylate-metronidazole-

tetracyclineHelidac Helicobacter pylori agent




Brimonidine tartrate solution Alphagan 0.2% Ophthalmic Glaucoma

Brimonidine tartrate solution Alphagan 0.2% Ophthalmic Glaucoma

Brinzolamide Azopt 1% solution Ophthalmic Glaucoma

Bromocriptine Parlodel 2.5mg Hypoprolactinemic

Bupropion XL Wellbutrin XL 150 mg, 300 mg Psychiatric Antidepressant

Buproprion IR, SR Wellbutrin SR 150 mg Psychiatric Antidepressant





Buspirone HCI BuSpar 5 mg Psychiatric Other




Butalbital-APAP-Caffeine Fioricet 50/325/40 Analgesic Misc

Calcitriol Rocaltrol 0.25 mcg Vitamin

Calcitriol Rocaltrol 0.5mcg Vitamin

Calcium acetate Phoslo 667mg phosphate binder

Captopril Capoten 50 mg Cardiovascular ACE Inhibitor


Captopril Capoten 12.5 mg Cardiovascular ACE Inhibitor


Carbamazepine Tegretol 200 mg Psychiatric Mood Stabilizer

Carbamazepine Tegretol 100 mg Psychiatric Mood Stabilizer

Carbamazepine Tegretol 100 mg / 5 cc Psychiatric Mood Stabilizer

Carbidopa - levodopa Sinemet 25 - 250 mg Neurologic Parkinson



Carbidopa - levodopa LA Sinemet CR 50 - 200 mg Neurologic Parkinson

Carbidopa - levodopa LA Sinemet CR 25 - 100 mg Neurologic Parkinson

Carisoprodol Soma 250mg muscle relaxant

Carvedilol Coreg 6.25 mg Cardiovascular Beta Blockers






Carvedilol Coreg 25 mg Cardiovascular Beta Blockers

Cephalexin Keflex 250 mg / 5 ml (100 ml) Antimicrobials Cephalosporins

Cephalexin Keflex 250 mg Antimicrobials Cephalosporins

Cephalexin Keflex 125 mg / 5 ml (200 ml) Antimicrobials Cephalosporins

Cephalexin Keflex 500 mg Antimicrobials Cephalosporins

Chlorpromazine Thorazine 50 mg Psychiatric Antipsychotic





Chlorpromazine Thorazine 30 mg/ml Psychiatric Antipsychotic

Chlorpromazine Thorazine 100 mg/ml Psychiatric Antipsychotic

Chlorthalidone Thalitone 25mg Cardiovascular Diuretics

Chlorthalidone Thalitone 50 mg Cardiovascular Diuretics

Cimetidine Tagamet 400 mg GI H2 blockers

Ciprofloxacin Cipro 500 mg Antimicrobials Quinolones

Ciprofloxacin Cipro 250 mg Antimicrobials Quinolones

Ciprofloxacin eye drop Ciloxan 0.3% Ophthalmic

Citalopram Hydrobromide Celexa 40 mg Psychiatric Antidepressant



Citalopram Hydrobromide Celexa 10 mg / 5 cc Psychiatric Antidepressant

Clarithromycin Biaxin 500 mg Antimicrobials

Clindamycin Cleocin 150 mg Antimicrobials Misc

Clindamycin Cleocin 300 mg Antimicrobials Misc

Clindamycin topical gel, lotion Cleocin 1% Derm Acne

Clindamycin topical solution Cleocin-T 1% (60 ml) Derm Acne

Clobetasol lotion Temovate 0.05% Derm

Clobetasol propionate Temovate 0.05% crm (15 Gms) Derm Antiinflammatory

Clobetasol propionate Temovate 0.05% oint (30 Gms) Derm Antiinflammatory

Clobetasol propionate Temovate 0.05% oint (15 Gms) Derm Antiinflammatory

Clomipramine Anafranil 75 mg Psychiatric Antidepressant






Clonazepam (SCH IV) Klonopin 2 mg Psychiatric Benzos

Clonazepam (SCH IV) Klonopin 1 mg Psychiatric Benzos

Clonazepam (SCH IV) Klonopin 0.5 mg Psychiatric Benzos

Clonidine HCI tabs Catapres 0.1 mg CardiovascularCentral Alpha

Agonist


Agonist


Agonist

Clopidogrel Plavix 75 mgPlatetlet aggregation

inhibitor

Colchicine Colcrys 0.6 mg Gout

Conjugated Estrogen Cream Premarin 0.625 mg/g crm (43 Gm) Hormone Replacement

Cortisporin otic soln 1%-0.35%-10000u/mL (10 ml) Otic

Cortisporin otic susp drops (10 ml) Otic

Cromolyn inhaler Intal 14.2 Gm Respiratory

Cyclobenzaprine Flexeril 10 mg Analgesic Muscle Relaxant

Dextroamphetamine/amphetamine Adderall XR 10mg Psychiatric Stimulant




Diabetes supplies - glucometer Diabetes

Diabetes supplies - lancets Diabetes

Diabetes supplies - syringes/needles Diabetes

Diabetes supplies - test strips Diabetes

Diabetes supplies - testing control

solutionDiabetes

Diazepam (SCH IV) Valium 5 mg Psychiatric Benzos



Diclofenac Voltaren 50 mg Analgesic NSAID




Diclofenac Voltaren 75 mg Analgesic NSAID

Dicloxacillin Dynapen 500 mg Antimicrobials Penicillins

Dicloxacillin Dynapen 250 mg Antimicrobials Penicillins

Dicyclomine Bentyl 20 mg GI Antispasmodics

Dicyclomine Bentyl 10 mg GI Antispasmodics

Digoxin Lanoxin 0.25 mg Cardiovascular Glycosides

Digoxin Lanoxin 0.125 mg Cardiovascular Glycosides

Dilitiazem HCI Cardizem LA 180 mg CardiovascularCalcium Channel

Blockers

Diltiazem Cardizem 120 mg CardiovascularCalcium Channel

Blockers

Diltiazem

Cardizem CD,

Dilacor Xr, Cartia

XL, Dilt-CD

90 mg CardiovascularCalcium Channel

Blockers

Diltiazem

Cardizem CD,

Dilacor Xr, Cartia

XL, Dilt-CD

60 mg CardiovascularCalcium Channel

Blockers

Diltiazem SR Cardizem SR 300 mg CardiovascularCalcium Channel

Blockers


Blockers


Blockers


Blockers

Diltiazem CD Cardizem CD 360mg CardiovascularCalcium Channel

Blockers

Diltiazem CD Cardizem CD 90 mg CardiovascularCalcium Channel

Blockers


Blockers


Blockers





Blockers


Blockers


Blockers


Blockers

Diphenhydramine Benadryl 25, 50 mg capsules Cold, Cough, Allergy Antihistamine

Diphenhydramine Benadryl 12.5 mg/ 5ml Cold, Cough, Allergy Antihistamine

Diphenhydramine Benadryl 50 mg/cc (inj) Cold, Cough, Allergy Antihistamine

Diphenoxylate-atropine Lomotil 2.5 mg GI Antidiarrhea

Diphenoxylate-atropine (SCH V) Lomotil 2.5 / .025 / 5 (60 ml) GI Antidiarrhea

Dipyridamole Persantine 25 mg Cardiovascular Anticoagulants



Divalproex sodium Depakote DR 125 mg Psychiatric Mood Stabilizer



Divalproex sodium Depakote ER 250 mg Psychiatric Mood Stabilizer

Divalproex sodium Depakote ER 500 mg Psychiatric Mood Stabilizer

Doxazosin mesylate Cardura 8 mg Cardiovascular Alpha-1 blocker




Doxepin HCL Sinequan 50 mg Psychiatric Antidepressant






Doxycycline Doryx Vibramycin 50 mg Antimicrobials Tetracyclines

Doxycycline Doryx Vibramycin 100 mg Antimicrobials Tetracyclines




Econazole Spectazole 1% crm 15 Gm (15 Gm) Antimicrobials Antifungals



Enalapril maleate Vasotec 5 mg Cardiovascular ACE Inhibitor


Enalapril maleate Vasotec 2.5 mg Cardiovascular ACE Inhibitor


Erythromycin eye ointment 5 mg / Gm (3.5 Gm) Ophthalmic

Erythromycin gel or solution Erygel 2% Derm Acne

Erythromycin stearate Ery-Tab 500 mg Antimicrobials Macrolides



Estradiol Estrace 2 mg Hormone Replacement

Estradiol Estrace 1 mg Hormone Replacement

Estradiol Estrace 0.5 mg Hormone Replacement

Ethambutol Myambutol 400 mg Antimicrobials Antitubercular

Ethambutol Myambutol 100 mg Antimicrobials Antitubercular

Famotidine Pepcid 20 mg GI H2 Antagonists

Famotidine Pepcid 40 mg GI H2 Antagonists

Finasteride Proscar 5 mg Genitourinary

5-alpha

reductase

inhibitor

Fluconazole Diflucan 200 mg Antimicrobials Antifungals



Fludrocortisone Florinef 0.2 mg Adrenals

Fludrocortisone Florinef 0.1 mg Endocrine

Flunisolide Nasarel 25 mcg/spray (0.025%) Cold, Cough, Allergy Nasal Steroids

Fluocinolone acetonide Synalar 0.025% cream Derm Antiinflammatory

Fluocinolone acetonide Synalar 0.01% cream Derm Antiinflammatory

Fluocinolone acetonide Synalar 0.025% ointment Derm Antiinflammatory

Fluocinolone acetonide Synalar 0.01% ointment Derm Antiinflammatory

Fluocinolone acetonide Synalar 0.025%, 0.01% solution, 60 ml Derm Antiinflammatory




Fluocinonide Lidex 0.05% gel (60gm) Derm Antiinflammatory

Fluocinonide Lidex 0.05% solution 60ml Derm Antiinflammatory

Fluocinonide Lidex 0.05% oint (60 gm) Derm Antiinflammatory



Fluocinonide Lidex 0.05% cream (60 gm) Derm Antiinflammatory

Fluocinonide Lidex 0.05% cream (30 gm) Derm Antiinflammatory

Fluoxetine Prozac 20 mg Psychiatric Antidepressant



Fluoxetine Prozac 20 mg / 5 ml Psychiatric Antidepressant

Fluphenazine Prolixin 5 mg / cc Psychiatric Antipsychotic

Fluphenazine Prolixin 0.5 mg/ml Psychiatric Antipsychotic

Fluphenazine Prolixin 2.5 mg Psychiatric Antipsychotic

Fluphenazine Prolixin 10 mg Psychiatric Antipsychotic

Fluphenazine Prolixin 1 mg Psychiatric Antipsychotic

Fluphenazine decanoate Prolixin 25 mg/cc (inj) Psychiatric Antipsychotic

Fluticasone propionate Flonase 50 mcg/spray Respiratory Nasal Inhaler

Folic Acid 800 MicorGrams Vitamin

Furosemide Lasix 80 mg Cardiovascular Diuretics



Gabapentin Neurontin 300 mg Neurologic Anticonvulsant




Gemfibrozil Lopid 600 mg CardiovascularCholesterol

Lowering Agents

Gentamicin eye drops Garamycin 0.3% (5 ml) Ophthalmic

Glipizide Glucotrol 5 mg Diabetes Sulfonylureas

Glipizide Glucotrol 10 mg Diabetes Sulfonylureas




Glyburide Micronase Diabeta 5 mg Diabetes Sulfonylureas

Glyburide Micronase Diabeta 2.5 mg Diabetes Sulfonylureas

Glyburide Micronase Diabeta 1.25 mg Diabetes Sulfonylureas

Griseofulvin micro liquid Grifulvin V 125 mg / 5 mL (120 ml) Antimicrobials Antifungals

Griseofulvin ultramicro Grisactin Fulvicin 250 mg Antimicrobials Antifungals

Griseofulvin ultramicro Grisactin Fulvicin 125 mg Antimicrobials Antifungals

Guaifenesin + Codeine Robitussin AC 100 mg - 10mg / 5 ml Cold, Cough, Allergy Antitussive

Haloperidol Haldol 5 mg Psychiatric Antipsychotic



Haloperidol Haldol 0.5 mg Psychiatric Antipsychotic

Haloperidol Haldol 2 mg / cc (15 cc) Psychiatric Antipsychotic

Haloperidol Haldol 2 mg / cc (120 cc) Psychiatric Antipsychotic



Haloperidol decanoate Haldol 50 mg/cc (inj) Psychiatric Antipsychotic

Haloperidol decanoate Haldol 100 mg/cc (inj) Psychiatric Antipsychotic

Hydralazine Apresoline 50 mg CardiovascularOther

Vasodilators


Vasodilators


Vasodilators


Vasodilators

Hydrochlorothiazide Esidrix 25 mg Cardiovascular Diuretics

Hydrochlorothiazide Esidrix 50 mg Cardiovascular Diuretics

Hydrochlorothiazide Microzide 12.5 mg cap Cardiovascular Diuretics

Hydrocortisone HC 2.5% lotion Derm Antiinflammatory

Hydrocortisone HC 5mg Derm Antiinflammatory






Hydrocortisone cream Cortizone 2.5% Derm Antiinflammatory

Hydrocortisone ointment Cortizone 2.50% Derm Antiinflammatory

Hydrocortisone Suppositories Cortizone 25mg GI Antiinflammatory

Hydroxychloroquine Plaquenil 200 mg Rheumatology

Hydroxyzine HCL Atarax 25 mg Cold, Cough, Allergy Antihistamine


Hydroxyzine HCL Atarax 10 mg / 5 cc (120 ml) Cold, Cough, Allergy Antihistamine


Ibuprofen Motrin 400 mg Analgesic NSAID



Imipramine Tofranil 50 mg Psychiatric Antidepressant



Indomethacin Indocin 50 mg Analgesic NSAID

Indomethacin Indocin 25 mg Analgesic NSAID

Insulin 70/30 Humulin, Novolin U100 (10 ml) Diabetes Insulin Product

Insulin glargine Lantus 100 IU/mL Diabetes Insulin Product

Insulin Lispro Humalog 100U/mL Diabetes Insulin Product

Insulin NPH Humulin N U100 (10 ml) Diabetes Insulin Product

Insulin Regular Humulin R U100 (10 ml) Diabetes Insulin Product

Ipratropium bromide 0.02% Atrovent Inh Sol 500 mcg (3 cc/amp) Respiratory Nebulizer soln

Ipratropium MDI Atrovent 18mcg/dose MDI (14gm) Respiratory Asthma

Isoniazid INH 300 mg Antimicrobials Antitubercular

Isoniazid INH 100 mg Antimicrobials Antitubercular

Isoniazid INH 10 mg / ml Antimicrobials Antitubercular

Isosorbide dinitrate Isordil 5 mg CardiovascularNitrate

Vasodilators


Vasodilators





Vasodilators


Vasodilators

Isosorbide mononitrate IR, SR Imdur 60 mg CardiovascularNitrate

Vasodilators


Vasodilators


Vasodilators


Vasodilators


Vasodilators

Ketoconazole Nizoral 200 mg (tabs) Antimicrobials Antifungals

Ketoconazole Nizoral 2% crm (60 Gm) Antimicrobials Antifungals



Ketoconazole Nizoral 2% shampoo Antimicrobials Antifungals

Ketotifen Alaway 0.025% Ophthalmic

Labetalol HCL Trandate 200 mg Cardiovascular Beta Blockers



Lactulose Duphalac 10g/15 ml syrup GI Laxatives

Lamotrigine Lamictal 25 mg tab Neurologic Anticonvulsant




Latanoprost Xalatan 0.005% Ophthalmic

Levetiracetam Keppra 500 mg Neurologic



Levofloxacin Levaquin 500 mg Antimicrobials




Levothyroxine Levoxyl 0.3 mg Endocrine Thyroid












Lisinopril Prinivil, Zestril 5 mg Cardiovascular ACE Inhibitor



Lisinopril Prinivil, Zestril 2.5 mg Cardiovascular ACE Inhibitor



Lithium carbonate Eskalith CR 300 mg Psychiatric Mood Stabilizer

Lithium carbonate Eskalith CR 150 mg Psychiatric Mood Stabilizer

Lithium carbonate Eskalith SR 300 mg Psychiatric Mood Stabilizer

Lithium carbonate Eskalith SR 450 mg Psychiatric Mood Stabilizer

Loratidine Claritin 10mg Antihistamine

Lorazepam (SCH IV) Ativan 2.0 mg Psychiatric Benzos



Losartan Cozaar 25 mg CardiovascularAngiotensin II

Blocker

Losartan Cozaar 50mg CardiovascularAngiotensin II

Blocker

Losartan Cozaar 100 mg CardiovascularAngiotensin II

Blocker




Lovastatin Mevacor 10, 20, 40 mg CardiovascularCholesterol

Lowering Agents

Loxapin Loxitane 5, 10, 25, 50 mg Psychiatric Antipsychotic

Meclizine Antivert 25mg tabs Neurologic Misc

Medroxyprogesterone Provera 5 mg Hormone Replacement

Medroxyprogesterone Provera 2.5 mg Hormone Replacement

Medroxyprogesterone Provera 10 mg Hormone Replacement

Mesalamine Asacol 400 mg GI

Anti-

inflammatory

bowelMetformin Glucophage 500 mg Diabetes Biquanides

Metformin Glucophage 850 mg Diabetes Biquanides

Metformin Glucophage 1000 mg Diabetes Biquanides

Methadone 5 mg Analgesic Narcotic

Methadone 10 mg Analgesic Narcotic

Methimazole Tapazole 5 mg Endocrine Thyroid

Methimazole Tapazole 10 mg Endocrine Thyroid

Methocarbamol Robaxin 500 mg Analgesic Muscle Relaxant

Methocarbamol Robaxin 750 mg Analgesic Muscle Relaxant

Methotrexate Rheumatrex 2.5 mg Chemotherapy

Methyldopa Aldomet 500 mg CardiovascularCentral Alpha

Agonist

Methyldopa Aldomet 250 mg CardiovascularCentral Alpha

Agonist

Methylphenidate long-acting Ritalin LA 10mg Psychiatric Stimulant




Methylphenidate short acting Ritalin 10mg Psychiatric Stimulant



Metoclopramide Reglan 10 mg GI Antiemetic

Metoclopramide hcl Reglan 5 mg GI Antiemetic

Metolazone Zaroxolyn 5 mg Cardiovascular Diurectics




Metolazone Zaroxolyn 10 mg Cardiovascular Diurectics

Metolazone Zaroxolyn 2.5 mg Cardiovascular Diurectics

Metoprolol succinate Toprol XL 50 mg Cardiovascular Beta Blockers



Metoprolol tartrate Lopressor 50 mg Cardiovascular Beta Blockers



Metronidazole Flagyl 250 mg Antimicrobials Misc

Metronidazole Flagyl 500 mg Antimicrobials Misc

Metronidazole cream Metrocream 0.075% Antimicrobials Misc

Metronidazole cream Metrocream 0.75% Derm Acne

Metronidazole topical gel Metrogel 0.75% Derm Acne

Miralax polyethylene glycol 238g GI

Miralax polyethylene glycol 510g GI

Mirtazapine Remeron 45 mg Psychiatric Antidepressant



Misoprostol Cytotec 100mg GI

Misoprostol Cytotec 200mg GI

Montelukast Singulair 5 mg chew Respiratory

Montelukast Singulair 10 mg Respiratory

Morphine sulfate Liquid MS 20mg/ 5 ml Analgesic Narcotic

Morphine sulfate short acting MS 15,30mg Analgesic Narcotic

Morphine sulfate SR Oramorph SR 15 mg Analgesic Narcotic




Mupirocin Bactroban 2%ointment Antibiotic

Nabumetone Relafen 750 mg Analgesic NSAID

Naproxen Naprosyn 250 mg Analgesic NSAID






Niacin IR & ER tabs only 500 mg Cardiovascular



Nicotine Patches- 28 weeks NicoDerm 7mg Smoking deterrents



Nifedipine SRProcardia, Adalat

CC, Nifediac90 mg Cardiovascular

Calcium Channel

Blockers



Calcium Channel

Blockers



Calcium Channel

Blockers

Nitrofurantoin macrocryst Macrodantin 50 mg Antimicrobials Misc

Nitrofurantoin macrocryst Macrodantin 100 mg Antimicrobials Misc

Nitrofurantoin monohydrate Macrobid 100 mg Antimicrobials Misc

Nitroglycerine SL Nitrostat 0.4 mg CardiovascularNitrate

Vasodilators

Nortriptyline Pamelor 75 mg Psychiatric Antidepressant




Nystatin (cream or ointment) Derm Antifungals

Nystatin oral suspension 100,000 units/ml Antimicrobials Antifungals

Olanzapine Zyprexa 5 mg Psychiatric Antipsychotic

Olanzapine Zyprexa 2.5mg Psychiatric Antipsychotic

Omeprazole Prilosec 20 mg GI PPI

Oseltamivir Tamiflu 75mg Antimicrobials Antiviral

Oseltamivir Tamiflu 12mg/ml Antimicrobials Antiviral

Oxybutynin Ditropan 5 mg Genitourinary

Paroxetine Paxil 40 mg Psychiatric Antidepressant







Paroxetine Paxil 10 mg / 5 ml Psychiatric Antidepressant

Penicillin VK 500 mg Antimicrobials Penicillins

Penicillin VK 250 mg / 5 cc (100 cc) Antimicrobials Penicillins

Penicillin VK Veetids 250 mg Antimicrobials Penicillins



Pentoxifylline ER Trental 400 mg Hemorrheologic Agents

Permethrin cream Elimite 5% (60 Gm) DermScabicide and

Lice

Perphenazine Trilafon 8 mg Psychiatric Antipsychotic



Perphenazine Trilafon 16 mg / 5 cc (120 ml) Psychiatric Antipsychotic


Phenazopyridine HCL Pyridium 200 mg Genitourinary

Phenazopyridine HCL Pyridium 100 mg Genitourinary

Phenobarbital (SCH IV) 30 mg Neurologic Anticonvulsant




Phenytoin Dilantin 100 mg Neurologic Anticonvulsant

Phenytoin Dilantin 50 mg Neurologic Anticonvulsant

Pioglitazone hydrochloride Actos 15 mg DiabetesThiazolidinedion

es


es


es

Polyethylene glycol electrolyte

solutionMix Golytely 240g GI Prep

Polymyxin b- trimethoprim Polytrim 10 mL drops Ophthalmic

Polymyxin b- trimethoprim Polytrim 3.5 gm ointment Ophthalmic




Potassium chloride 10% (480 cc) CardiovascularPotassium

Supplement

Potassium chloride tabsK-Tab, K-Dur,

Slow-K, Klor-con8 mEq Cardiovascular

Potassium

Supplement



Potassium

Supplement



Potassium

Supplement

Pravastatin Pravachol 20, 40, 80 mg tabs CardiovascularCholesterol

Lowering Agents

Praziquantel Biltricide 600mg Anthelmintics

Prazosin Minipress 1 mg Cardiovascular Alpha-blockers



Prednisolone Prelone 15mg/5ml oral sol Endocrine Glucocorticoids

Prednisolone ophth solu or susp 1% Ophthalmic

Prednisone Deltasone 1 mg Endocrine Glucocorticoids

Prednisone Deltasone 2.5 mg Endocrine Glucocorticoids





Primidone Mysoline 50 mg Neurologic Anticonvulsant

Primidone Mysoline 250 mg Neurologic Anticonvulsant

Probenecid Benemid 500 mg Gout

Prochlorperazine Compazine 25 mg supp GI Antiemetic

Prochlorperazine Compazine 10 mg GI Antiemetic

Prochlorperazine Compazine 5 mg GI Antiemetic

Promethazine HCI Phenergan 50 mg GI Antiemetic

Promethazine HCIPhenergan

suppositor25 mg supp GI Antiemetic

Promethazine HCI Phenergan 25 mg GI Antiemetic

Promethazine HCI Phenergan 12.5 mg supp GI Antiemetic




Promethazine HCI Phenergan syrup 6.25 / 5 ml (120 ml) GI Antiemetic

Promethazine HCI Phenergan 12.5 mg GI Antiemetic

Promethazine/VC/DM Cold, Cough, Allergy Antitussive

Propranolol HCL Inderal 80 mg Cardiovascular Beta Blockers





Propylthiouracil PTU 50 mg Endocrine Thyroid

Pyrazinamide 500 mg Antimicrobials Antitubercular

Pyridoxine Vitamin B5 25mg Vitamin

Pyridoxine Vitamin B6 100mg Vitamin

Quetiapine fumarate Seroquel 100 mg Psychiatric Antipsychotic






Ranitidine Zantac 300 mg GI H2 blockers

Ranitidine Zantac 150 mg GI H2 blockers

Rifampin Rifadin 300 mg Antimicrobials Antitubercular

Rifampin Rifadin 150 mg Antimicrobials Antitubercular

Risperidone Risperdal 1 mg Psychiatric Antipsychotic

Risperidone Risperdal 1 mg/ml solution Psychiatric Antipsychotic

Risperidone Risperdal 0.5 mg Psychiatric Antipsychotic




Salmeterol xinafoate Serevent Diskus 50 mcg Respiratory Asthma

Salsalate 750 mg Analgesic Salicyclates

Salsalate 500 mg Analgesic Salicyclates

Selenium sulfide lotion Selsun 2.50% Derm Anti-seborrhea

Sertraline Zoloft 20 mg/ml Psychiatric Antidepressant




Sertraline Zoloft 25 mg Psychiatric Antidepressant



Silver sulfadiazineFlint SSD,

Silvadene1% crm Derm Other

Simvastatin Zocor 40 mg CardiovascularCholesterol

Lowering Agents


Lowering Agents


Lowering Agents

Spironolactone Aldactone 25 mg Cardiovascular Diuretics

Spironolactone Aldactone 50 mg Cardiovascular Diuretics

Spironolatone Aldactone 100 mg Cardiovascular Diuretics

Sucralfate Carafate 1 Gm GI

Sulfacetamide sodium eye drop sol Sulamyd 10% Ophthalmic

Sulfacetamide sodium eye ointment Sulamyd 10% Ophthalmic

Sulfamethxzl Trimethoprim Septra 80 / 400 mg Antimicrobials Sulfas

Sulfamethxzl Trimethoprim Bactrim 40mg / 5ml - 200mg / 5-ml (60 ml) Antimicrobials Sulfas

Sulfamethxzl Trimethoprim DS Septra 160 / 800 mg Antimicrobials Sulfas

Sulfasalazine Azulfidine 500 mg GI

Anti-

inflammatory

bowelSulindac Clinoril 200 mg Analgesic NSAID

Sulindac Clinoril 150 mg Analgesic NSAID

Sumatriptan Imitrex 50 mg Neurologic Migraine



Tamoxifen Soltamox 10mg Hormone Replacement

Tamsulosin Flomax 0.4 mg Genitourinary Alpha-blockers

Temazepam (SCH IV) Restoril 30 mg Psychiatric Hypnotic

Temazepam (SCH IV) Restoril 15 mg Psychiatric Hypnotic

Terazosin HCL Hytrin 5 mg Genitourinary







Testosterone Inj Depo Testosterone 100 mg/ml Hormone Replacement

Testosterone Inj Depo Testosterone 200mg/ml Hormone Replacement

Tetracycline Sumycin 500 mg Antimicrobials Tetracyclines

Tetracycline Sumycin 250 mg Antimicrobials Tetracyclines

Theophylline Theo-Dur 300 mg Respiratory

Theophylline Theo-Dur 200 mg Respiratory

Thiothixene Navane 5 mg Psychiatric Antipsychotic





Thiothixene Navane 5 mg/ml Psychiatric Antipsychotic

Ticlopidine Ticlid 250mgplatelet aggregation

inhibitorTimolol Maleate eye drops 0.5% Ophthalmic Glaucoma

Timolol Maleate eye drops 0.25% Ophthalmic Glaucoma

Tobramycin ophthal soln. 0.30% Ophthalmic

Tramadol Ultram, Rybix 50 mg Analgesic Misc

Trazodone Desyrel 50 mg Psychiatric Antidepressant



Tretinoin Retin-A0.01%, 0.025%, 0.05%, 0.1%

cream, gelDerm Acne

Triamcinolone cream, ointment, or

lotionKenalog, Aristocort 0.10% Derm Antiinflammatory

Triamcinolone cream, ointment, or

lotionKenalog, Aristocort 0.025% Derm Antiinflammatory

Triamterene hctz Maxzide 37.5/25 mg Cardiovascular Diuretics

Triamterene hctz Maxzide 75 / 50 mg Cardiovascular Diuretics

Trifluoperazine Stelazine 5 mg Psychiatric Antipsychotic






Trihexyphenidyl Artane 5 mg Neurologic Parkinson

Trihexyphenidyl Artane 2 mg / 5 cc Neurologic Parkinson

Trihexyphenidyl Artane 2 mg Neurologic Parkinson

ursodiol Actigall 300mg GI

Venlafaxine Effexor IR 25 mg Psychiatric Antidepressant

Venlafaxine XR Effexor XR 75 mg Psychiatric Antidepressant

Venlafaxine XR Effexor XR 37.5 mg Psychiatric Antidepressant

Venlafaxine XR Effexor XR 100 mg Psychiatric Antidepressant

Verapamil Isoptin 120 mg CardiovascularCalcium Channel

Blockers

Verapamil LA Isoptin 180 mg CardiovascularCalcium Channel

Blockers

Verapamil SR Calan SR 240 mg CardiovascularCalcium Channel

Blockers


Blockers


Blockers

Vitamin B6 50 mg Vitamin

Vitamin D Calciferol 50,000 units Vitamin

Vitamin K Phytonadione 5mg tab Vitamin

Warfarin sodium Coumadin 1 mg Cardiovascular Anticoagulants



Warfarin sodium Coumadin 2.5 mg Cardiovascular Anticoagulants





Warfarin sodium Coumadin 7.5 mg Cardiovascular Anticoagulants

Zolpidem Ambien 5, 10 mg tabs Psychiatric Hypnotic


healthpac formularydisclaimer: doses / routes of administration are the responsibility of the...

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