Brand Name |
Generic Name |
|
|
A (top) |
|
|
|
ACCUPRIL |
QUINAPRIL |
|
|
ACETEST |
KETONE TESTING PRODUCTS |
|
|
ACTIFED |
PSEUDOEPHEDRINE/TRI PROLIDINE |
|
|
ACTIGALL |
URSODIOL |
|
|
ACTOS |
PIOGLITAZONE |
|
|
ACULAR |
KETOROLAC TROMETHAMINE, ophthalmic solution only |
|
|
ADALAT CC |
NIFEDIPINE |
|
|
ADDERALL |
AMPHETAMINES/DEXTROAMPHETAMINES |
|
|
ADDERALL XR |
AMPHETAMINES/DEXTROAMPHETAMINES |
|
|
ADVAIR |
FLUTICASONE/SALMETEROL |
|
|
AEROBID |
FLUNISOLIDE |
|
|
AEROCHAMBER * |
INHALER DEVICE |
|
|
AK-CON |
NAPHAZOLINE |
|
|
ALAWAY |
KETOTIFEN, OTC only |
|
|
ALDACTAZIDE |
SPIRONOLACTONE/HYDROCHLOROTHIAZIDE |
|
|
ALDACTONE |
SPIRONOLACTONE |
|
|
ALDARA |
IMIQUIMOD |
|
|
ALDOMET |
METHYLDOPA |
|
|
ALPHAGAN |
BRIMONIDINE TARTRATE |
|
|
ALTACE |
RAMIPRIL |
|
|
ALUPENT |
METAPROTERENOL |
|
|
AMARYL |
GLIMEPIRIDE |
|
|
AMBIEN (not CR) |
ZOLPIDEM |
|
|
AMOXIL |
AMOXICILLIN |
|
|
AMPHOJEL * |
ALUMINUM HYDROXIDE |
|
|
AMPICILLIN INJ |
AMPICILLIN |
|
|
ANAFRANIL |
CLOMIPRAMINE |
|
|
ANAPROX |
NAPROXEN SODIUM |
|
|
ANCEF, KEFZOL |
CEFAZOLIN |
|
|
ANCOBON |
FLUCYTOSINE |
|
|
ANTABUSE |
DISULFIRAM |
|
|
ANTIMINTH |
PYRANTEL |
|
|
ANTIVERT |
MECLIZINE |
|
|
ANZEMET |
DOLASETRON MESYLATE |
|
|
APRESOLINE |
HYDRALAZINE |
|
|
ARALEN |
CHLOROQUINE HCL |
|
|
ARISTOCORT |
TRIAMCINOLONE DIACETATE |
|
|
ARMOUR |
THYROID, DESSICATED |
|
|
ARTHROTEC |
DICLOFENAC/MISOPROSTOL |
|
|
ASACOL |
MESALAMINE Code 1 restricted to intolerance or unresponsive to sulfasalazine |
|
|
ASENDIN |
AMOXAPINE |
|
|
ASMANEX |
MOMETASONE nasal up to 4 YO only |
|
|
ASSESS * |
PEAK AIR FLOW METER |
|
|
ATARAX, VISTARIL |
HYDROXYZINE all forms |
|
|
ATIVAN * |
LORAZEPAM |
|
|
ATROPINE |
ATROPINE SULFATE all forms |
|
|
ATROVENT |
IPRATROPIUM |
|
|
ATROVENT NASAL SPRAY |
IPRATROPIUM NASAL SPRAY |
|
|
AUGMENTIN |
AMOXICILLIN/CLAVULANATE all forms except XR |
|
|
AURALGAN |
ANTIPYRINE/BENZOCAINE |
|
|
AVANDIA |
ROSIGLITAZONE |
|
|
AZMACORT |
TRIAMCINOLONE ACETONIDE |
|
|
AZULFIDINE |
SULFASALAZINE |
|
|
B (top) |
||
|
BACIGUENT * |
BACITRACIN |
|
|
BACTERIOSTATIC WATER |
BACTERIOSTATIC WATER FOR INJECTION ONLY |
|
|
BACTROBAN OINTMENT |
MUPIROCIN |
|
|
BAYER ASPIRIN * |
ASPIRIN all forms |
|
|
B-D SWABS |
ALCOHOL SWABS |
|
|
B-D SYRINGES, NEEDLES |
INSULIN SYRINGES, NEEDLES |
|
|
BENADRYL * |
DIPHENHYDRAMINE |
|
|
BENEMID |
PROBENECID |
|
|
BENTYL |
DICYCLOMINE |
|
|
BENZAC |
BENZOYL PEROXIDE |
|
|
BETADINE |
POVIDONE-IODINE 10% solution only |
|
|
BETAGAN |
LEVOBUNOLOL |
|
|
BETAPACE |
SOTALOL |
|
|
BETOPTIC |
BETAXOLOL |
|
|
BIAXIN |
CLARITHROMYCIN in individuals with HIV infection, for otitis media when other first line antibiotics cannot be used or treatment of H. pylori (maximum 2 weeks) |
|
|
BICILLIN L-A |
PENICILLIN G BENZATHINE |
|
|
BICNU |
CARMUSTINE |
|
|
BLEPHAMIDE |
SULFACETAMIDE/PREDNISOLONE AC |
|
|
BRETHINE |
TERBUTALINE SULFATE |
|
|
BUMEX |
BUMETANIDE |
|
|
BUROW’S OTIC |
ACETIC ACID/ALUMINUM ACETATE 2% ear solution only |
|
|
BURROW’S SOLUTION |
ALUMINUM ACETATE |
|
|
BUSPAR |
BUSPIRONE psych exempt |
|
|
C (top) |
||
|
CAFERGOT |
ERGOTAMINE TARTRATE/CAFFEINE |
|
|
CAFERGOT PB |
ERGOTAMINE/CAFFEINE/BELLADONNA/PHENOBARBITAL |
|
|
CALAMINE * |
CALAMINE |
|
|
CALAN |
VERAPAMIL |
|
|
CALCIMAR |
CALCITONIN all forms |
|
|
CAPOTEN |
CAPTOPRIL |
|
|
CARAFATE |
SUCRALFATE |
|
|
CARBATROL |
CARBAMAZEPINE |
|
|
CARDIZEM |
DILTIAZEM all forms |
|
|
CARNITOR |
LEVOCARNITINE |
|
|
CATAPRES |
CLONIDINE all forms |
|
|
CECLOR |
CEFACLOR |
|
|
CEFTIN |
CEFUROXINE Code 1 restricted to 2nd line for sinusitis, otitis media and CAP up to a maximum of 250mg dose |
|
|
CELEXA |
CITALOPRAM |
|
|
CELONTIN |
METHSUXIMIDE |
|
|
CEPHULAC |
LACTULOSE |
|
|
CHANTIX |
VARENICLINE |
|
|
CHLOR-TRIMETON * |
CHLORPHENIRAMINE |
|
|
CILOXAN |
CIPROFLOXACIN |
|
|
CIPRO |
CIPROFLOXACIN |
|
|
CIPRO-DEX OTIC |
CIPROFLOXACIN/DEXAMETHASONE |
|
|
CIPRO HC OTIC |
CIPROFLOXACIN HYDROCORTISONE OTIC |
|
|
CLARITIN * |
LORATIDINE |
|
|
CLEOCIN |
CLINDAMYCIN HCL |
|
|
CLEOCIN |
CLINDAMYCIN PHOSPHATE |
|
|
CLEOCIN |
CLINDAMYCIN TOPICAL |
|
|
CLINISTIX |
GLUCOSE TESTING (URINE) |
|
|
CLINORIL |
SULINDAC |
|
|
COAL TAR |
COAL TAR SOLUTION |
|
|
CODEINE |
CODEINE all forms |
|
|
COGENTIN |
BENZTROPINE |
|
|
COLACE * |
DOCUSATE SODIUM |
|
|
COLBENEMID |
COLCHICINE/PROBENECID |
|
|
COLCHICINE |
COLCHICINE |
|
|
COLESTID |
COLESTIPOL bulk |
|
|
COLYTE |
PEG 3350/ELECTROLYTE SOLUTION |
|
|
COMBIVENT |
IPRATROPIUM/ALBUTEROL |
|
|
COMPAZINE |
PROCHLORPERAZINE MALEATE all forms |
|
|
COMTAN |
ENTACAPONE |
|
|
CONCEPTROL * |
NONOXYNOL 9 |
|
|
CONCERTA |
METHYLPHENIDATE restricted to QD |
|
|
CONDYLOX |
PODOFILOX gel only |
|
|
COREG (not CR) |
CARVEDILOL Code 1 restricted to treatment of CHF |
|
|
CORDARONE |
AMIODARONE |
|
|
CORTISPORIN |
HYDROCORTISONE/POLYMYXIN/NEOMYCIN eye and ear only |
|
|
CORTONE |
CORTISONE |
|
|
COSOPT |
DORZOLAMIDE/TIMOLOL |
|
|
COUMADIN |
WARFARIN SODIUM |
|
|
COZAAR |
LOSARTAN ST T/F or intolerance to ACE inhibitor |
|
|
CREON |
AMYLASE/LIPASE/PROTEASE/PANCREATIN |
|
|
CYCLOGYL |
CYCLOPENTOLATE |
|
|
CYTOMEL |
LIOTHYRONINE |
|
|
CYTOTEC |
MISOPROSTOL |
|
|
D (top) |
||
|
DALMANE * |
FLURAZEPAM |
|
|
DAPSONE |
DAPSONE |
|
|
DARAPRIM |
PYRIMETHAMINE |
|
|
DARVOCET-N 100 |
PROPOXYPHENE NAPSYLATE/ACETAMINOPHEN QL maximum 50 tablets per 30 days |
|
|
DDAVP |
DESMOPRESSIN ACETATE |
|
|
DECADRON |
DEXAMETHASONE |
|
|
DECADRON PHOSPHATE |
DEXAMETHASONE SODIUM PHOSPHATE |
|
|
DELTASONE |
PREDNISONE |
|
|
DEMADEX |
TORSEMIDE |
|
|
DEMEROL |
MEPERIDINE |
|
|
DEPAKENE |
VALPROIC ACID |
|
|
DEPAKOTE (not ER) |
DIVALPROEX SODIUM |
|
|
DEPO-ESTRADIOL |
ESTRADIOL CYPIONATE |
|
|
DEPO-PROVERA |
MEDROXYPROGESTERONE |
|
|
DEPO-TESTOSTERONE |
TESTOSTERONE all forms of injections |
|
|
DERMATOP |
PREDNICARBATE all forms |
|
|
DESOWEN |
DESONIDE |
|
|
DESYREL |
TRAZODONE |
|
|
DETROL, (not LA) |
TOLTERODINE TARTRATE |
|
|
DEXEDRINE |
D-AMPHETAMINE all forms |
|
|
DEXTROSE SOLUTION |
DEXTROSE/WATER |
|
|
DHT |
DIHYDROTACHYSTEROL |
|
|
DIABINESE |
CHLORPROPAMIDE |
|
|
DIAMOX |
ACETAZOLAMIDE |
|
|
DYAZIDE |
TRIAMTERENE/HYDROCHLOROTHIAZIDE all forms |
|
|
DIDRONEL |
ETIDRONATE |
|
|
DIFLUCAN |
FLUCONAZOLE |
|
|
DILANTIN |
PHENYTOIN SODIUM |
|
|
DILAUDID |
HYDROMORPHONE all forms |
|
|
DIMETAPP * |
PSEUDOEPHEDRINE/BROMPHENIRAMINE |
|
|
DIPROSONE |
BETAMETHASONE DIPROPIONATE all forms |
|
|
DISALCID |
SALSALATE |
|
|
DITROPAN |
OXYBUTYNIN |
|
|
DITROPAN XL |
OXYBUTYNIN SR, code 1 urologist |
|
|
DOLOPHINE |
METHADONE, ql maximum 90 day supply per fill |
|
|
DOMEBORO |
CALCIUM ACETATE/ALUMINUM SULFATE |
|
|
DONNATAL |
BELLADONA ALK/PB |
|
|
DRAMAMINE * |
DIMENHYDRINATE |
|
|
DRITHOCREME |
ANTHRALIN |
|
|
DULCOLAX * |
BISACODYL |
|
|
DYNAPEN |
DICLOXACILLIN |
|
|
DYRENIUM |
TRIAMTERENE |
|
|
E (top) |
||
|
E.E.S |
ERYTHROMYCIN ETHYLSUCCINATE |
|
|
EFFEXOR |
VENLAFAXINE, tablets only (XR requires TAR) |
|
|
EFUDEX |
FLUOROURACIL |
|
|
ELAVIL |
AMITRIPTYLINE |
|
|
ELDEPRYL |
SELEGILINE |
|
|
ELIMITE |
EPINASTINE |
|
|
EMPIRIN #2, #3 |
CODEINE PHOSPHATE/ASPIRIN |
|
|
EPIPEN |
EPINEPHRINE HYDROCHLORIDE |
|
|
ERGAMISOL |
LEVAMISOLE |
|
|
ERGOSTAT |
ERGOTAMINE |
|
|
ERGOTRATE |
ERGONOVINE |
|
|
ERY-TAB |
ERYTHROMYCIN BASE |
|
|
ERYTHROMYCIN ST |
ERYTHROMYCIN STEARATE |
|
|
ESTRACE |
ESTRADIOL |
|
|
EURAX |
CROTAMITON |
|
|
EVISTA |
RALOXIFENE |
|
|
EXCERDIN * |
ASPIRIN/ACETAMINOPHEN/CAFFEINE |
|
|
F (top) |
||
|
FELDENE |
PIROXICAM |
|
|
FEMSTAT * |
BUTOCONAZOLE |
|
|
FERGON |
FERROUS GLUCONATE |
|
|
FER-IN-SOL * |
FERROUS SULFATE |
|
|
FIORICET |
ACETAMINOPHEN/CAFFEINE/BUTALBITAL |
|
|
FLAGYL |
METRONIDAZOLE |
|
|
FLEET’S ENEMA * |
SODIUM PHOSPHATE/SODIUM BIPHOSPHATE |
|
|
FLEXERIL |
CYCLOBENZAPRINE QL maximum 50 tablets per
30 days |
|
|
FLOMAX |
TAMSULOSIN |
|
|
FLONASE |
FLUTICASONE PROPIONATE |
|
|
FLORINEF |
FLUDROCORTISONE |
|
|
FLOVENT |
FLUTICASONE |
|
|
FLOXIN otic & tablets |
OFLOXACIN Code 1 Restricted to use in the
treatment of PID, GC, UTI, polymicrobial skin and compromised febrile GI or
blood infections when other first line antibiotics cannot be used |
|
|
FML |
FLUOROMETHOLONE |
|
|
FOLIC ACID * |
FOLIC ACID |
|
|
FOSAMAX |
ALENDRONATE all |
|
|
FULVICIN |
GRISEOFULVIN |
|
|
FUNGIZONE |
AMPHOTERICIN B INJ |
|
|
FURADANTIN |
NITROFURANTOIN all forms |
|
|
FUROXONE |
FURAZOLIDONE |
|
|
G (top) |
||
|
GANTRISIN |
SULFISOXAZOLE |
|
|
GARAMYCIN |
GENTAMICIN all forms |
|
|
GAVISCON * |
SODIUM BICARBONATE/MAGNESIUM TRISILICATE/ALUMINUM HYRDROXIDE/ALGINIC ACID |
|
|
GLUCAGON |
GLUCAGON 1mg emergency kit |
|
|
GLUCOPHAGE |
METFORMIN |
|
|
GLUCOTROL |
GLIPIZIDE |
|
|
GLYCERIN * |
GLYCERIN suppositories |
|
|
GOLYTELY/COLYTE |
PEG 3350/ELECTROLYTE SOLUTION |
|
|
H (top) |
||
|
HEPARIN |
HEPARIN SODIUM |
|
|
HIPREX |
METHENAMINE HIPPURATE |
|
|
HUMALOG |
INSULIN all forms, vials only |
|
|
HUMULIN |
INSULIN all forms, vials only |
|
|
HYDERGINE |
ERGOLOID MESYLATES |
|
|
HYDROCORTISONE * |
HYDROCORTISONE all forms |
|
|
HYDRODIURIL |
HYDROCHLOROTHIAZIDE |
|
|
HYTRIN |
TERAZOSIN |
|
|
HYZAAR |
LOSARTAN/HYDROCHLOROTHIAZIDE ST T/F or intolerance to ACE inhibitor |
|
|
I (top) |
||
|
ILETIN |
INSULIN all forms, vials only |
|
|
ILOTYCIN |
ERYTHROMYCIN OPHTHALMIC |
|
|
IMITREX |
SUMATRIPTAN QL 2 syringes/30days - 9 tablets per 30 days - 2 spray cartons per 30 days |
|
|
IMODIUM * |
LOPERAMIDE |
|
|
IMURAN |
AZATHIOPRINE |
|
|
INDERAL, INDERAL LA |
PROPRANOLOL all forms |
|
|
INDOCIN |
INDOMETHACIN |
|
|
INFED |
IRON DEXTRAN COMPLEX |
|
|
INH |
ISONIAZID |
|
|
INTAL |
CROMOLYN all forms |
|
|
IOPIDINE |
APRACLONIDINE |
|
|
ISOPTO ALKALINE |
HYDROXYPROPYLMETHYLCELLULOSE |
|
|
ISOPTO CARBACHOL |
CARBACHOL |
|
|
ISOPTO CARPINE |
PILOCARPINE HYDROCHLORIDE |
|
|
ISOPTO HOMATROPINE |
HOMATROPINE HYDROBROMIDE |
|
|
ISORDIL |
ISOSORBIDE DINITRATE |
|
|
K (top) |
||
|
KAOPECTOLIN |
KAOLIN/PECTIN |
|
|
KAYEXALATE |
SODIUM POLYSTYRENE SULFONATE |
|
|
K-DUR |
POTASSIUM CHLORIDE all forms |
|
|
KEFLEX |
CEPHALEXIN |
|
|
KEFZOL |
CEFAZOLIN |
|
|
KENALOG |
TRIAMCINOLONE ACETONIDE all forms |
|
|
KEPPRA |
LEVETIRACETAM |
|
|
KETO-DIASTIX |
GLUCOSE/KETONE TEST COMBO (URINE) |
|
|
KLONOPIN * |
CLONAZEPAM |
|
|
K-Y JELLY * |
GLYCERIN/HYDROXYETHYLCELLULOSE |
|
|
KYTRIL |
GRANISETRON QL 6 per Rx |
|
|
L (top) |
||
|
LAMICTAL |
LAMOTRIGINE QL use ˝ tablet doses when
appropriate |
|
|
LAMISIL AT * |
TERBINAFINE t250MG TAB & 1% CREAM |
|
|
LAMPRENE |
CLOFAZIMINE |
|
|
LANOXIN |
DIGOXIN |
|
|
LANTUS |
INSULIN all forms, vials only |
|
|
LARODOPA |
LEVODOPA |
|
|
LASIX |
FUROSEMIDE |
|
|
LEUCOVORIN CALCIUM |
LEUCOVORIN |
|
|
LEVAQUIN |
LEVOFLOXACIN Code 1 50 years or older and lower respiratory infection |
|
|
LEVOXYL |
LEVOTHROXINE SODIUM |
|
|
LIDEX |
FLUOCINONIDE |
|
|
LIORESAL |
BACLOFEN Code 1 restricted to use in spasticity resulting from MS or spinal cord injury |
|
|
LIPITOR |
ATORVASTATIN 80MG only; QL use 1/2 tablet per day when appropriate |
|
|
LODINE |
ETODOLAC Code 1 intolerance to 1st or 2nd line NSAIDS |
|
|
LOMOTIL |
DIPHENOXYLATE/ATROPINE SULFATE |
|
|
LONITEN |
MINOXIDIL |
|
|
LOPID |
GEMFIBROZIL |
|
|
LOPRESSOR |
METOPROLOL TARTRATE |
|
|
LORCET |
HYDROCODONE BITARTRATE/ACETAMINOPHEN 10/650, QL maximum 120 tablets per 30 days |
|
|
LORTAB 10/500 |
HYDROCODONE/APAP 10/500 |
|
|
LOTENSIN HCT/LOTENSIN |
BENAZEPRIL/HYDROCHLOROTHIAZIDE & BENAZEPRIL |
|
|
LOTRIMIN * |
CLOTRIMAZOLE |
|
|
LOVENOX |
ENOXAPARIN QL maximum 14 days |
|
|
LUDIOMIL |
MAPROTILINE psych exempt |
|
|
LUNELLE |
MEDROXYPROGESTERONE/ESTRADIOL CYPIONATE |
|
|
LURIDE |
SODIUM FLUORIDE |
|
|
M (top) |
||
|
MAALOX * |
MAGNESIUM HYDROXIDE/ALUMINUM HYDROXIDE |
|
|
MACROBID |
NITROFURANTOIN/NITROFURAN MACROCRYSTALS |
|
|
MAG-OXIDE * |
MAGNESIUM OXIDE Code 1 restricted to renal failure |
|
|
MANDELAMINE |
METHENAMINE MANDELATE |
|
|
MAVIK |
TRANDOLAPRIL |
|
|
MAXAIR |
PIRBUTEROL |
|
|
MEDROL |
METHYLPREDNISOLONE all forms |
|
|
MEPHYTON * |
PHYTONADIONE |
|
|
MEPRON |
ATOVAQUONE Code 1 restricted to use for treatment of mild to moderate P. carinii pneumonia in patients who are intolerant to TMP/SMX |
|
|
MESTINON |
PYRIDOSTIGMINE |
|
|
METADATE CD |
METHYLPHENIDATE |
|
|
METHERGINE |
METHYLERGONOVINE |
|
|
METHOTREXATE |
METHOTREXATE |
|
|
METROGEL |
METRONIZOLE topical only |
|
|
MEVACOR |
LOVASTATIN |
|
|
MEXITIL |
MEXILETINE |
|
|
MICRONASE |
GLYBURIDE |
|
|
MIDRIN * |
ISOMETHEPTENE/DICHL0RALPHENAZONE/ACETAMINOPHEN |
|
|
MILK OF MAGNESIA * |
MAGNESIUM HYDROXIDE |
|
|
MINIPRESS |
PRAZOSIN |
|
|
MINOCIN |
MINOCYCLINE |
|
|
MINTEZOL |
THIABENDAZOLE |
|
|
MIRALAX POWDER |
PEG 3350 |
|
|
MIRAPEX |
PRAMIPEXOLE DIHYDROCHLORIDE |
|
|
MOBIC |
MELOXICAM |
|
|
MONISTAT |
MICONAZOLE NITRATE |
|
|
MONOPRIL |
FOSINOPRIL |
|
|
MOTRIN |
IBUPROFEN all forms |
|
|
MS CONTIN |
MORPHINE EXTENDED RELEASE all forms |
|
|
MUCOMYST |
ACETYLCYSTEINE |
|
|
MYAMBUTOL |
ETHAMBUTOL |
|
|
MYCOBUTIN |
RIFABUTIN Code 1 for use in prevention of MAC disease in advanced HIV infection |
|
|
MYCOLOG II |
NYSTATIN/TRIAMCINOLONE |
|
|
MYCOSTATIN |
NYSTATIN |
|
|
MYOCHRYSINE |
GOLD SODIUM THIOMALATE |
|
|
MYSOLINE |
PRIMIDONE |
|
|
N (top) |
||
|
NAPHCON-A * |
NAPHAZOLINE HYDROCHLORIDE/PHENIRAMINE |
|
|
NAPROSYN |
NAPROXEN |
|
|
NASONEX |
MOMETASONE FUROATE For children under 4 YO only |
|
|
NATACYN |
NATAMYCIN |
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NEBCIN |
TOBRAMYCIN |
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NEOSPORIN |
NEOMYCIN/POLYMYXIN/BACITRACIN |
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NEO-SYNEPHRINE |
PHENYLEPHRINE |
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NEPHRO-VITE * |
NEPHRO-VITE Code 1 restricted to renal failure |
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NEURONTIN |
GABAPENTIN |
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NIACIN * |
NIACIN all forms |
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NICORETTE * |
NICOTINE POLACRILEX QL 12 weeks / 365 days and smoking cessation class certificate |
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NICOTROL * |
NICOTINE PATCH QL 12 weeks / 365 days and smoking cessation class certificate |
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NITROGLYCERIN |
NITROGLYCERIN all tablets, capsules, and ointment |
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NIZORAL |
KETOCONAZOLE |
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NOCTEC |
CHLORAL HYDRATE |
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NOLVADEX |
TAMOXIFEN |
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HYDROCODONE/APAP 10/325 |
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NORMODYNE |
LABETOLOL **CODE 1 restricted to use during pregnancy |
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NORPACE |
DISOPYRAMIDE |
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NORPLANT |
LEVONORGESTREL long acting |
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NORPRAMIN |
DESIPRAMINE |
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NORVASC |
AMLODIPINE |
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NUVARING |
ETONOGESTREL/ETHINYL ESTRADIOL |
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O (top) |
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OMNICEF, susp only |
CEFDINIR |
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OMNIPEN-N |
AMPICILLIN SODIUM injection only |
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OPTIPRANOLOL |
METIPRANOLOL |
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ORTHO-DIAPHRAGM |
DIAPHRAGM |
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ORTHO EVRA |
NORELGESTROMIN/ETHINYL ESTRADIOL |
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ORTHO-GYNOL * |
OCTOXYNOL 9 |
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ORUDIS |
KETOPROFEN |
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OSCAL * |
CALCIUM all forms that have a generic available |
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OSCAL-D * |
CALCIUM/VITAMIN D all forms that have a generic available |
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OVIDE |
MALATHION |
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P (top) |
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PAMELOR |
NORTRIPTYLINE |
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PANCREASE |
AMYLASE/LIPASE/PROTEASE |
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PAXIL |
PAROXETINE, generic only |
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PEDIAZOLE |
ERYTHROMYCIN/SULFISOXAZOLE |
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PEN VK |
PENICILLIN V POTASSIUM |
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PENTAM 300 |
PENTAMIDINE **CODE 1 HIV history of PCP or with CD4(T4) lymphocycte count < 200 cells/mm3 |
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PEPCID |
FAMOTIDINE |
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PEPTO-BISMOL * |
BISMUTH SUBSALICYLATE |
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PERCOCET |
OXYCODONE/ACETAMINOPHEN QL maximum 100 per 30 days |
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PERCODAN |
OXYCODONE/ASPIRIN QL maximum 100 per 30 days |
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PERSANTINE |
DIPYRIDAMOLE |
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PHENERGAN |
PROMETHAZINE all forms except cough and cold combinations |
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PHENOBARBITAL * |
PHENOBARBITAL all forms |
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PHOSLO |
CALCIUM ACETATE |
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PHOSPHOLINE |
ECHOTHIOPHATE IODIDE |
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PLAQUENIL |
HYDROXYCHLOROQUINE |
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PLAN B |
LEVONORGESTREL |
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PLAVIX |
CLOPIDOGREL Code 1 for stent replacement or intolerance or failure to aspirin |
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POLY-PRED |
NEOMYCIN/POLYMYXIN/PREDNISOLONE |
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POLYSPORIN OPHT |
POLYMYXIN B SULFATE/BACITRACIN drops and ointment |
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POLYTRIM |
POLYMYXIN/TRIMETHOPRIM |
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POLY-VI-FLOR |
MULTIVITAMINS W/FLUORIDE restricted to children 8 yrs old and younger |
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PRAVACHOL |
PRAVASTATIN |
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PRED FORTE, PRED MILD |
PREDNISOLONE ACETATE |
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PREDNISONE |
PREDNISONE |
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PRELONE |
PREDNISOLONE |
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PRENAVITE |
PRENATAL VITAMINS |
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PREVEN |
LEVONORGESTREL/ETHINYL ESTRADIOL |
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PRILOSEC OTC |
OMEPRAZOLE QL maximum 2 TABLETS PER DAY |
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PRIMAQUINE |
PRIMAQUINE |
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PRINIVIL |
LISINOPRIL |
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PRINIZIDE |
LISINOPRIL/HYDROCHLOROTHIAZIDE |
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PROAIR HFA |
ALBUTEROL HFA |
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PROGESTERONE INJ |
PROGESTERONE |
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PROLOPRIM |
TRIMETHOPRIM |
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PRONESTYL |
PROCAINAMIDE |
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PROPINE |
DIPIVEFRIN |
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PROPYLTHIOURACIL |
PROPYLTHIOURACIL, PTU |
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PROSCAR |
FINASTERIDE 5 mg |
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PROSTIGMIN |
NEOSTIGMINE BROMIDE |
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PROVENTIL |
ALBUTEROL all generic forms |
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PROVERA |
MEDROXYPROGESTERONE |
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PROZAC |
FLUOXETINE restricted to 10mg & 20mg capsules only |
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PULMICORT |
BUDESONIDE TAR for nebs if 6 YO or older |
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PYRAZINAMIDE |
PYRAZINAMIDE |
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PYRIDIUM |
PHENAZOPYRIDINE |
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Q (top) |
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QUESTRAN |
CHOLESTYRAMINE/SUCROSE bulk only |
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QUINAGLUTE |
QUINIDINE GLUCONATE |
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QUINIDIN |
QUINIDINE SULFATE |
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QVAR |
BECLOMETHASONE DIPROPIONATE |
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R (top) |
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REGLAN |
METOCLOPRAMIDE |
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RELAFEN |
NABUMETONE |
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RELENZA |
ZANAMIVIR QL 5 day course x 2 |
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REMERON |
MIRTAZAPINE |
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RENAGEL |
SEVELAMER Code 1 restriction failure/intolerance with Phoslo |
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REQUIP |
ROPINIROLE Not XL |
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RESTORIL * |
TEMAZEPAM 15mg and 30mg strengths only |
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RETROVIR |
ZIDOVUDINE |
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RID * |
PIPERONYL BUTOXIDE/PYRETHRINS |
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RIFADIN |
RIFAMPIN |
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RIFAMATE |
RIFAMPIN/ISONIAZID |
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RIFATER |
RIFAMPIN/ ISONIAZID/PYRAZINAMIDE |
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RILUTEK |
RILUZOLE Code1 treatment of ALS only |
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RIOPAN * |
MAGALDRATE/SIMETHICONE |
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RITALIN |
METHYLPHENIDATE all forms |
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ROBAXIN |
METHOCARBAMOL QL maximum of 50 tabs in 30 days |
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ROBINUL |
GLYCOPYRROLATE |
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ROBITUSSIN * |
GUAIFENESIN |
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ROBITUSSIN DM * |
GUAIFENESIN/DEXTROMETHORPHAN |
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ROBITUSSIN A-C * |
GUAIFENESIN/CODEINE |
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ROCALTROL |
CALCITRIOL |
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ROCEPHIN |
CEFTRIAXONE |
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ROXANOL |
MORPHINE all forms of generic |
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ROXICODONE |
OXYCODONE |
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RYTHMOL |
PROPAFENONE |
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S (top) |
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SANTYL |
COLLAGENASE |
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SELSUN |
SELENIUM SULFIDE |
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SENOKOT * |
SENNA |
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SEPTRA, SEPTRA DS |
SULFAMETHOXAZOLE/TRIMETHOPRIM all forms |
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SEREVENT |
SALMETEROL |
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SERZONE |
NEFAZODONE |
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SILVADENE |
SILVER SULFADIAZINE |
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SINEMET |
CARBIDOPA/LEVODOPA |
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SINEQUAN |
DOXEPIN |
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SINGULAIR |
MONTELUKAST ST dx asthma in pts already on ICS or Advair; dx allergic rhinitis with T/F of NSA + nasal steroid |
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SODIUM CHLORIDE |
SODIUM CHLORIDE all forms |
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SOLGANAL |
AUROTHIOGLUCOSE |
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SOLU-MEDROL |
METHYLPREDNISOLONE SODIUM SUCCINATE |
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SPECTAZOLE 1% CREAM |
ECONAZOLE NITRATE 1% CREAM |
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SPIRIVA |
TIOTROPIUM |
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SSKI |
POTASSIUM IODIDE |
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STILPHOSTROL |
DIETHYLSTILBESTROL |
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STRATTERA |
ATOMEXETINE, ql one capsule per day |
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STREPTOMYCIN |
STREPTOMYCIN |
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STROMECTOL |
IVERMECTIN Code 1 restricted to treatment of resistant lice / scabies |
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SUDAFED * |
PSEUDOEPHEDRINE HCL all forms |
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SULAMYD |
SULFACETAMIDE SODIUM all forms |
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SULFADIAZINE |
SULFADIAZINE powder only |
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SUMYCIN |
TETRACYCLINE |
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SUPRAX |
CEFIXIME Code 1 for otitis media when first line cannot be used or intolerant to Augmentin (suspension only); GC (tablets) |
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SURFAK * |
DOCUSATE CALCIUM |
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SYMBICORT INHALER |
BUDESONIDE/FORMOTEROL |
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SYNALAR |
FLUOCINOLONE ACETONIDE |
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SYNTHROID |
LEVOTHYROXINE |
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SYSTANE |
ARTIFICIAL TEARS |
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T (top) |
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TAGAMET |
CIMETIDINE |
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TAMBOCOR |
FLECAINIDE ACETATE |
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TAMIFLU |
OSELTAMIVIR QL 5 day course x 2 |
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TAPAZOLE |
METHIMAZOLE |
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TAVIST-1 * |
CLEMASTINE FUMARATE |
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TEGRETOL, TEGRETOL XR |
CARBAMAZEPINE |
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TENEX |
GUANFACINE |
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TENORMIN |
ATENOLOL |
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TERAZOL * |
TERCONAZOLE |
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THEO-DUR |
THEOPHYLLINE all forms |
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TIGAN |
TRIMETHOBENZAMIDE |
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TIMOPTIC |
TIMOLOL |
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TINACTIN |
TOLNAFTATE |
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TOBRADEX |
TOBRAMYCIN SULFATE/DEXAMETHASONE |
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TOFRANIL |
IMIPRAMINE HYDROCHLORIDE |
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TOPAMAX |
TOPIRAMATE; use higher strength tablets as appropriate |
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TRANDATE |
LABETOLOL Code 1 restricted to use in pregnancy |
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TRENTAL |
PENTOXIFYLLINE Code 1 restricted to use over 65 years of age diagnosed with intermittent claudication, or diabetics of any age diagnosed with intermittent claudication |
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TRILEPTAL |
OXCARBAZEPINE |
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TRI-VI-FLOR |
TRIPLE VITAMINS W/FLUORIDE restricted to children 8 yrs old and younger |
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TRI-VI-FLOR/IRON |
TRIPLE VITS W/FLUORIDE & IRON restricted to children 8 yrs old and younger |
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TROJAN * |
CONDOMS, MALE |
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TRUETRACK & TRUETEST MONITORS |
GLUCOSE MONITORS |
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TRUETRACK & TRUETEST TEST STRIPS |
GLUCOSE TEST STRIPS |
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TRUSOPT |
DORZOLAMIDE |
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TYLENOL * |
ACETAMINOPHEN all forms |
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TYLENOL W/CODEINE |
CODEINE PHOSPHATE/ACETAMINOPHEN 15 & 30 mg codeine only; QL maximum 120 tablets per 30 days |
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U (top) |
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UNIRETIC |
MOEXIPRIL/HYDROCHLOROTHIAZIDE |
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UNIVASC |
MOEXIPRIL |
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URECHOLINE |
BETHANECHOL CHLORIDE |
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V (top) |
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VALISONE |
BETAMETHASONE VALERATE all forms |
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VALIUM * |
DIAZEPAM |
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VANCOCIN |
VANCOMYCIN all forms Code 1 failure to first line antibiotics or intolerance |
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VASERETIC |
ENALAPRIL/HYDROCHLOROTHIAZIDE |
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VASOCON-A * |
NAPHAZOLINE HYDROCHLORIDE/ANTAZOLINE |
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VASOTEC |
ENALAPRIL |
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VENTOLIN HFA |
ALBUTEROL HFA |
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VERMOX |
MEBENDAZOLE |
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VIBRAMYCIN |
DOXYCYCLINE HYCLATE |
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VICODIN & VICODIN ES |
HYDROCODONE BITARTRATE/ACETAMINOPHEN 5/500 & 7.5/750 QL maximum. 120 tabs per 30 days |
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VIDEX |
DIDANOSINE |
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VIGAMOX |
MOXIFLOXACIN, ophthalmic only |
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VIROPTIC |
TRIFLURIDINE |
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VISTARIL / ATARAX |
HYDROXYZINE all forms |
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VITAMIN B-1 * |
THIAMINE |
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VITAMIN B-6 * |
PYRIDOXINE |
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VITAMIN B-12 * |
CYANCOCOBALAMIN |
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VITAMIN D * |
ERGOCALCIFEROL |
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VITAMIN E * |
ALPHA-TOCOPHERYL |
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VIVACTIL |
PROTRIPTYLINE |
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VOLTAREN |
DICLOFENAC SODIUM |
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VOSOL |
ACETIC ACID |
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VOSOL HC |
ACETIC ACID/HYDROCORTISONE |
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W (top) |
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WATER |
BACTERIOSTATIC WATER |
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WATER FOR INJECTION |
WATER FOR INJECTION, WFI |
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WELLBUTRIN /SR /XR |
BUPROPION all forms |
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WYCILLIN |
PENICILLIN G PROCAINE |
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WYDASE |
HYALURONIDASE |
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X (top) |
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XALATAN |
LATANOPROST |
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XYLOCAINE |
LIDOCAINE except transdermal patch |
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Z (top) |
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ZADITOR, OTC |
KETOTIFEN, OTC |
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ZANTAC |
RANITIDINE |
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ZARONTIN |
ETHOSUXIMIDE |
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ZAROXOLYN |
METOLAZONE |
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ZESTRIL/ZESTORETIC |
LISINOPRIL & LISINOPRIL/HYDROCHLOROTHIAZIDE |
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ZITHROMAX |
AZITHROMYCIN |
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ZOCOR |
SIMVASTATIN |
|
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ZOFRAN |
ONDANSETRON QL 12 / Rx |
|
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ZOLOFT |
SERTRALINE |
|
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ZOSTRIX * |
CAPSAICIN |
|
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ZOVIRAX |
ACYCLOVIR all forms |
|
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ZYBAN |
BUPROPION QL 12 weeks per year and smoking cessation class certificate |
|
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ZYLOPRIM |
ALLOPURINOL |
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ZYRTEC OTC |
CETIRIZINE |
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