Formulary Drug Listing Sorted by Generic NameEffective July 2008 |
|
|
|
|
Generic Name |
Brand Name |
|
A (top) |
|
|
ACETAMINOPHEN all forms * |
TYLENOL |
|
ACETAZOLAMIDE, tablet only |
DIAMOX |
|
ACETIC ACID |
VOSOL |
|
ACETIC ACID/ALUMINUM ACETATE all forms * |
BUROW’S OTIC |
|
ACETIC ACID/HYDRCORTISONE |
VOSOL HC |
|
ACETYLCYSTEINE |
MUCOMYST |
|
ACYCLOVIR all forms |
ZOVIRAX |
|
ALBUTEROL |
VENTOLIN HFA, PROAIR HFA |
|
ALCOHOL SWABS |
B-D SWABS |
|
ALENDRONATE, all |
FOSAMAX |
|
ALLOPURINOL |
ZYLOPRIM |
|
ALPHA-TOCOPHERYL |
VITAMIN E |
|
ALUMINUM HYDROXIDE * |
AMPHOJEL |
|
AMIODARONE |
CORDARONE |
|
AMITRIPTYLINE |
ELAVIL |
|
AMITRIPTYLINE HCL/PERPHENAZINE psych exempt |
TRIAVIL |
|
AMLODIPINE |
NORVASC |
|
AMOXAPINE |
ASENDIN |
|
AMOXICILLIN |
AMOXIL |
|
AMOXICILLIN/CLAVULANATE all forms except XR |
AUGMENTIN |
|
AMPHETAMINES/DEXTROAMPHETAMINES |
ADDERALL & |
|
AMPHOTERICIN B INJ |
FUNGIZONE |
|
AMPICILLIN SODIUM injection only |
OMNIPEN-N |
|
AMYLASE/LIPASE/PROTEASE |
PANCREASE |
|
AMYLASE/LIPASE/PROTEASE/PANCREATIN |
CREON |
|
ANTHRALIN |
DRITHOCREME |
|
ANTIPYRINE/BENZOCAINE |
AURALGAN |
|
ASPIRIN * |
BAYER |
|
ASPIRIN/ACETAMINOPHEN/CAFFEINE * |
EXCEDRIN MIGRAINE |
|
ATENOLOL |
TENORMIN |
|
ATOMEXETINE ql of 1 tablet per day |
STRATTERA |
|
ATOVAQUONE Code 1 restricted to use for
treatment of mild to moderate |
MEPRON |
|
ATROPINE SULFATE all forms |
ATROPINE |
|
AUROTHIOGLUCOSE |
SOLGANAL |
|
AZATHIOPRINE |
IMURAN |
|
AZITHROMYCIN |
ZITHROMAX |
|
B (top) |
||
|
BACITRACIN * |
BACIGUENT |
|
|
BACLOFEN Code 1 restricted to use in spasticity resulting from MS or spinal cord injury |
LIORESAL |
|
|
BACTERIOSTATIC WATER FOR INJECTION |
BACTERIOSTATIC WATER |
|
|
BECLOMETHASONE all forms of inhalers |
QVAR, VANCERIL, VANCENASE |
|
|
BELLADONNA ALKALOIDS/PHENOBARBITAL |
DONNATAL |
|
|
BENAZEPRIL |
LOTENSIN |
|
|
BENAZEPRIL/HYDROCHLOROTHIAZIDE |
LOTENSIN HCT |
|
|
BENZOYL PEROXIDE |
BENZAC |
|
|
BENZTROPINE |
COGENTIN |
|
|
BETAMETHASONE DIPROPIONATE all forms |
DIPROSONE |
|
|
BETAMETHASONE VALERATE all forms |
VALISONE |
|
|
BETAXOLOL |
BETOPTIC |
|
|
BETHANECHOL CHLORIDE |
URECHOLINE |
|
|
BISACODYL all forms * |
DULCOLAX |
|
|
BISMUTH SUBSALICYLATE * |
PEPTO-BISMOL |
|
|
BREATH FLOW METER * |
ASSESS |
|
|
BRIMONIDINE TARTRATE |
ALPHAGAN |
|
|
BROMOCRIPTINE MESYLATE |
PARLODEL |
|
|
BUDESONIDE |
PULMICORT |
|
|
BUDESONIDE/FORMOTEROL |
SYMBICORT INHALER |
|
|
BUMETANIDE |
BUMEX |
|
|
BUPROPION Zyban maximum 12 weeks per year and smoking cessation class certificate |
WELLBUTRIN /ZYBAN |
|
|
BUSPIRONE psych exempt |
BUSPAR |
|
|
BUTOCONAZOLE |
FEMSTAT |
|
|
C (top) |
||
|
CALAMINE * |
CALAMINE |
|
|
CALCITONIN all forms |
CALCIMAR |
|
|
CALCITRIOL |
ROCALTROL |
|
|
CALCIUM all forms that have a generic available * |
OSCAL |
|
|
CALCIUM ACETATE |
PHOSLO |
|
|
CALCIUM ACETATE/ALUMINUM SULFATE all forms * |
DOMEBORO |
|
|
CALCIUM/VITAMIN D all forms that have a generic available * |
OSCAL-D |
|
|
CAPSAICIN * |
ZOSTRIX |
|
|
CAPTOPRIL |
CAPOTEN |
|
|
CAPTOPRIL/HYDROCHLOROTHIAZIDE |
CAPOTOZIDE |
|
|
CARBACHOL |
ISOPTO CARBACHOL |
|
|
CARBAMAZEPINE |
CARBATROL, TEGRETOL, TEGRETOL XR |
|
|
CARBIDOPA/LEVODOPA |
SINEMET |
|
|
CARMUSTINE |
BICNU |
|
|
CARVEDILOL Code 1 restricted to treatment of CHF |
COREG |
|
|
CEFAZOLIN |
ANCEF, KEFZOL |
|
|
CEFIXIME Code 1 for otitis media when first line cannot be used or intolerant to Augmentin (suspension only); GC (tablets) |
SUPRAX |
|
|
CEFDINIR, suspension only |
OMNICEF |
|
|
CEFTRIAXONE |
ROCEPHIN |
|
|
CEFUROXINE Code 1 restricted to 2nd line for sinusitis, otitis media and CAP up to a maximum of 250 mg per dose |
CEFTIN |
|
|
CEPHALEXIN |
KEFLEX |
|
|
CETIRIZINE |
ZYRTEC OTC |
|
|
CHLORAL HYDRATE syrup, for pediatric use only |
NOCTEC |
|
|
CHLORHEXIDINE GLUCONATE * |
HIBICLENS |
|
|
CHLOROQUINE HCL |
ARALEN |
|
|
CHLORPHENIRAMINE * |
CHLOR-TRIMETON |
|
|
CHLORPROPAMIDE |
DIABENESE |
|
|
CHOLESTYRAMINE/SUCROSE bulk powder only |
QUESTRAN |
|
|
CIMETIDINE |
TAGAMET |
|
|
CIPROFLOXACIN Code 1 restricted to use in the treatment of PID, GC, UTI, polymicrobial skin and compromised febrile GI or blood infections when other 1st line antibiotics cannot be used or P. aeruginosa is suspected |
CIPRO |
|
|
CIPROFLOXACIN ophthalmic AND otic |
CILOXAN, CIPRO-HC |
|
|
CIPROFLOXACIN/DEXAMETHASONE OTIC |
CIPRO-DEX |
|
|
CITALOPRAM |
CELEXA |
|
|
CLARITHROMYCIN Code 1 in individuals with HIV infection, for otitis media when other first line antibiotics cannot be used or treatment of H. pylori( maximum 2 weeks) |
BIAXIN |
|
|
CLEMASTINE FUMARATE * |
TAVIST-1 |
|
|
CLINDAMYCIN HYDROCHLORIDE Code 1 restricted to treatment of polymicrobial skin infections when other 1st line antibiotics cannot be used |
CLEOCIN |
|
|
CLINDAMYCIN PHOSPHATE |
CLEOCIN |
|
|
CLINDAMYCIN TOPICAL SOLUTION |
CLEOCIN |
|
|
CLOFAZIMINE |
LAMPRENE |
|
|
CLOMIPRAMINE |
ANAFRANIL |
|
|
CLONAZEPAM |
KLONOPIN |
|
|
CLONIDINE all forms |
CATAPRES |
|
|
CLOPIDOGREL Code 1 for stent replacement or intolerance or failure to aspirin |
PLAVIX |
|
|
CLOTRIMAZOLE * |
LOTRIMIN |
|
|
COAL TAR SOLUTION |
COAL TAR |
|
|
CODEINE all forms |
CODEINE |
|
|
CODEINE PHOSPHATE/ACETAMINOPHEN 15 mg & 30 mg only, QL maximum 120 tablets per 30 days |
TYLENOL W/CODEINE |
|
|
COLCHICINE |
COLCHICINE |
|
|
COLCHICINE/PROBENECID |
COLBENEMID |
|
|
COLESTIPOL bulk |
COLESTID |
|
|
COLLAGENASE |
SANTYL |
|
|
CONDOMS, MALE * |
TROJAN |
|
|
CORTISONE |
CORTONE |
|
|
CROMOLYN all forms |
INTAL,CROLOM |
|
|
CROTAMITON |
EURAX |
|
|
CYANCOCOBALAMIN * |
VITAMIN B-12 |
|
|
CYCLOBENZAPRINE QL maximum 50 tablets per month |
FLEXERIL |
|
|
CYCLOPENTOLATE |
CYCLOGYL |
|
|
D (top) |
|
|
|
DAPSONE |
DAPSONE |
|
|
DESIPRAMINE |
NORPRAMIN |
|
|
DESMOPRESSIN ACETATE |
DDAVP |
|
|
DESONIDE |
DESOWEN |
|
|
DEXAMETHASONE |
DECADRON |
|
|
DEXAMETHASONE SODIUM PHOSPHATE |
DECADRON PHOSPHATE |
|
|
DEXTROAMPHETAMINE SULFATE |
DEXEDRINE |
|
|
DEXTROSE SOLUTION |
DEXTROSE |
|
|
DIABETIC SUPPLIES |
ONE TOUCH, B-D |
|
|
DIAPHRAGM |
ORTHO-DIAPHRAGM |
|
|
DIAZEPAM |
VALIUM |
|
|
DICLOFENAC/MISOPROSTOL |
ARTHROTEC |
|
|
DICLOFENAC SODIUM |
VOLTAREN |
|
|
DICLOXACILLIN |
DYNAPEN |
|
|
DICYCLOMINE |
BENTYL |
|
|
DIETHYLSTILBESTROL |
STILPHOSTROL |
|
|
DIGOXIN |
LANOXIN |
|
|
DIHYDROTACHYSTEROL |
DHT |
|
|
DILTIAZEM all forms |
CARDIZEM |
|
|
DIMENHYDRINATE * |
DRAMAMINE |
|
|
DIPHENHYDRAMINE |
BENADRYL |
|
|
DIPHENOXYLATE/ATROPINE SULFATE |
LOMOTIL |
|
|
DIPYRIDAMOLE |
PERSANTINE |
|
|
DISOPYRAMIDE |
NORPACE |
|
|
DISULFIRAM |
ANTABUSE |
|
|
DIVALPROEX SODIUM |
DEPAKOTE |
|
|
DIVALPROEX SODIUM psych exempt |
DEPAKOTE ER |
|
|
DOCUSATE CALCIUM * |
SURFAK |
|
|
DOCUSATE SODIUM * |
COLACE |
|
|
DOLASETRON MESYLATE |
ANZEMET |
|
|
DORZOLAMIDE |
TRUSOPT |
|
|
DORZOLAMIDE/TIMOLOL |
COSOPT |
|
|
DOXEPIN |
SINEQUAN |
|
|
DOXYCYCLINE HYCLATE |
VIBRAMYCIN |
|
|
E (top) |
||
|
ECHOTHIOPHATE IODIDE |
PHOSPHOLINE |
|
|
ECONAZOLE NITRATE 1% CREAM |
SPECTAZOLE 1% CREAM |
|
|
ENALAPRIL |
VASOTEC |
|
|
ENALAPRIL/HYDROCHLOROTHIAZIDE |
VASERETIC |
|
|
ENOXAPARIN QL maximum 14 days |
LOVENOX |
|
|
ENTACAPONE |
COMTAN |
|
|
EPINASTINE opthalmic |
ELESTAT |
|
|
ERGOCALCIFEROL * |
VITAMIN D |
|
|
ERGOLOID MESYLATES |
HYDERGINE |
|
|
ERGONOVINE |
ERGOTRATE |
|
|
ERGOTAMINE |
ERGOSTAT |
|
|
ERGOTAMINE TARTRATE/CAFFEINE |
CAFERGOT |
|
|
ERGOTAMINE/CAFFEINE/BELLADONNA/PHENOBARBITAL |
CAFERGOT PB |
|
|
ERYTHROMYCIN BASE |
ERY-TAB |
|
|
ERYTHROMYCIN ETHYLSUCCINATE |
E.E.S |
|
|
ERYTHROMYCIN OPHTHALMIC |
ILOTYCIN |
|
|
ERYTHROMYCIN STEARATE |
ERYTHROCIN STEARATE |
|
|
ERYTHROMYCIN/SULFISOXAZOLE |
PEDIAZOLE |
|
|
ESTRADIOL CYPIONATE |
DEPO-ESTRADIOL |
|
|
ESTRADIOL |
ESTRACE |
|
|
ETHACRYNIC ACID |
EDECRIN |
|
|
ETHAMBUTOL |
MYAMBUTOL |
|
|
ETHIONANIDE |
TRECATOR-SC |
|
|
ETHOSUXIMIDE |
ZARONTIN |
|
|
ETIDRONATE |
DIDRONEL |
|
|
ETODOLAC |
LODINE |
|
|
ETONOGESTREL/ETHINYL ESTRADIOL |
NUVARING |
|
|
|
|
|
|
FAMOTIDINE |
PEPCID |
|
FERROUS GLUCONATE * |
FERGON |
|
FERROUS SULFATE * |
FER-IN-SOL |
|
FINASTERIDE 5 mg only |
PROSCAR |
|
FLECAINIDE ACETATE |
TAMBOCOR |
|
FLUCONAZOLE |
DIFLUCAN |
|
FLUCYTOSINE |
ANCOBON |
|
FLUDROCORTISONE |
FLORINEF |
|
FLUNISOLIDE |
AEROBID |
|
FLUNISOLIDE |
NASAREL |
|
FLUOCINONIDE |
LIDEX |
|
FLUOCINOLONE ACETONIDE |
SYNALAR |
|
FLUOROMETHOLONE |
FML |
|
FLUOROURACIL |
EFUDEX |
|
FLUOXETINE 10mg & 20mg capsules only |
PROZAC |
|
FLUOXYMESTERONE |
HALOTESTIN |
|
FLURAZEPAM |
DALMANE |
|
FLUTICASONE 110 mcg strength should be reserved for doses that can not be delivered by 220 mcg strength |
FLOVENT |
|
FLUTICASONE PROPIONATE |
FLONASE |
|
FLUTICASONE/SALMETEROL |
ADVAIR |
|
FOLIC ACID * |
FOLIC ACID |
|
FOSAMAX, all |
FOSCAVIR |
|
FOSINOPRIL |
MONOPRIL |
|
FURAZOLIDONE |
FUROXONE |
|
FUROSEMIDE |
LASIX |
|
G (top) |
|
|
GABAPENTIN |
NEURONTIN |
|
GEMFIBROZIL |
LOPID |
|
GENTAMICIN all forms |
GARAMYCIN |
|
GLIMEPIRIDE |
AMARYL |
|
GLIPIZIDE |
GLUCOTROL |
|
GLUCAGON 1 mg emergency kit |
GLUCAGON |
|
GLUCOSE MONITORS $100.00 maximum |
TRUETRACK |
|
GLUCOSE TESTING STRIPS (BLOOD) |
TRUETRACK |
|
GLUCOSE TESTING STRIPS (URINE) |
CLINISTIX |
|
GLUCOSE/KETONE TEST COMBO (URINE) |
KETO-DIASTIX |
|
GLYBURIDE |
MICRONASE |
|
GLYCERIN/HYDROXYETHYLCELLULOSE * |
K-Y JELLY |
|
GLYCERIN SUPPOSITORIES * |
GLYCERIN |
|
GLYCOPYRROLATE |
ROBINUL |
|
GOLD SODIUM THIOMALATE |
MYOCHRYSINE |
|
GRANISETRON QL 6 per Rx |
KYTRIL |
|
GRISEOFULVIN |
FULVICIN |
|
GUAIFENESIN * |
ROBITUSSIN |
|
GUAIFENESIN/CODEINE * |
ROBITUSSIN A-C |
|
GUAIFENESIN/DEXTROMETHORPHAN * |
ROBITUSSIN DM |
|
GUANFACINE |
TENEX |
|
H (top) |
|
|
HYDROCHLOROTHIAZIDE/MOEXIPRIL |
UNIRETIC |
|
HYDROCHLOROTHIAZIDE/TRIAMTERENE all forms |
DYAZIDE |
|
HEPARIN SODIUM |
HEPARIN |
|
HOMATROPINE HBR |
ISOPTO HOMATROPINE |
|
HYALURONIDASE |
WYDASE |
|
HYDRALAZINE |
APRESOLINE |
|
HYDROCHLOROTHIAZIDE |
HYDRODIURIL |
|
HYDROCODONE BITARTRATE/ACETAMINOPHEN 5/500 & 7.5 750, QL maximum 120 tablets per 30 days |
VICODIN & VICODIN ES |
|
HYDROCODONE BITARTRATE/ACETAMINOPHEN 10/325, QL maximum 120 tablets per 30 days |
|
|
HYDROCODONE BITARTRATE/ACETAMINOPHEN 10/650 & 10/500, QL maximum 120 tablets per 30 days |
LORCET & LORTAB |
|
HYDROCORTISONE all forms |
HYDROCORTISONE |
|
HYDROMORPHONE all forms |
DILAUDID |
|
HYDROXYCHLOROQUINE |
PLAQUENIL |
|
HYDROXYPROPYLMETHYLCELLULOSE |
ISOPTO ALKALINE |
|
HYDROXYZINE all forms |
ATARAX, VISTARIL |
|
I (top) |
|
|
IBUPROFEN all forms |
MOTRIN |
|
IMIPRAMINE HCL |
TOFRANIL |
|
IMIQUIMOD |
ALDARA |
|
IMMUNE GLOBULIN - IM Code 1 restricted to patients with AIDS or AIDS related conditions under 13 years old |
IMMUNE GLOBULIN |
|
INDOMETHACIN Code 1 intractable spondylitis; severe acute inflammatory process |
INDOCIN |
|
INHALER DEVICE * |
AEROCHAMBER |
|
INSULIN all forms, vials only |
|
|
INSULIN SYRINGES/NEEDLES |
B-D SYRINGES, NEEDLES |
|
IPRATROPIUM |
ATROVENT |
|
IPRATROPIUM/ALBUTEROL |
COMBIVENT |
|
IPRATROPIUM NASAL SPRAY |
ATROVENT NASAL SPRAY |
|
IRON DEXTRAN COMPLEX |
INFED |
|
ISONIAZID |
INH |
|
ISOMETHEPTENE/DICHL0RALPHENAZONE/ACETAMINOPHEN |
MIDRIN |
|
ISOSORBIDE DINITRATE |
ISORDIL |
|
IVERMECTIN Code 1 restricted to treatment of resistant lice / scabies |
STROMECTOL |
|
K (top) |
|
|
KETOCONAZOLE all forms except 2% shampoo |
NIZORAL |
|
KETONE TESTING PRODUCTS |
ACETEST |
|
KETOPROFEN |
ORUDIS |
|
KETOROLAC TROMETHAMINE, ophthalmic solution only |
ACULAR |
|
KETOTIFEN, OTC |
ZADITOR, OTC |
|
L (top) |
|
|
LABETOLOL Code 1 restricted to use during pregnancy |
TRANDATE & NORMODYNE |
|
LACTULOSE |
CEPHULAC |
|
LAMOTRIGINE (QL of ˝ tablet dose when appropriate) |
LAMICTAL |
|
LATANOPROST |
XALATAN |
|
LEUCOVORIN |
LEUCOVORIN |
|
LEVAMISOLE |
ERGAMISOL |
|
LEVETIRACETAM |
KEPPRA |
|
LEVOBUNOLOL |
BETAGAN |
|
LEVOCARNITINE |
CARNITOR |
|
LEVODOPA |
LARODOPA |
|
LEVOFLOXACIN Code 1 age > 50 years. and lower respiratory infection |
LEVAQUIN |
|
LEVONORGESTREL |
PLAN B |
|
LEVONORGESTREL long acting |
NORPLANT |
|
LEVONORGESTREL/ETHINYL ESTRADIOL |
PREVEN |
|
LEVOTHYROXINE SODIUM |
SYNTHROID |
|
LIDOCAINE all forms except transdermal patch |
XYLOCAINE |
|
LIOTHYRONINE |
CYTOMEL |
|
LISINOPRIL |
PRINIVIL, ZESTRIL |
|
LISINOPRIL/HYDROCHLOROTHIAZIDE |
PRINIZIDE, ZESTORETIC |
|
LOPERAMIDE * |
IMODIUM |
|
LORATIDINE * |
CLARITIN |
|
LORAZEPAM QL maximum 90 days per 365 days * |
ATIVAN |
|
LOVASTATIN |
MEVACOR |
|
M (top) |
|
|
MAGALDRATE/SIMETHICONE * |
RIOPAN |
|
MAGNESIUM HYDROXIDE * |
MILK OF MAGNESIA |
|
MAGNESIUM HYDROXIDE/ALUMINUM HYDROXIDE * |
MAALOX |
|
MAGNESIUM OXIDE Code 1 restricted to renal failure * |
MAG-OXIDE |
|
MALATHION |
OVIDE |
|
MAPROTILINE psych exempt |
LUDIOMIL |
|
MEBENDAZOLE |
VERMOX |
|
MECLIZINE * |
ANTIVERT |
|
MEDROXYPROGESTERONE |
DEPO-PROVERA, PROVERA |
|
MEDROXYPROGESTERONE/ESTRADIOL CYPIONATE |
LUNELLE |
|
|
MEGACE |
|
MELOXICAM |
MOBIC |
|
MEPERIDINE |
DEMEROL |
|
MEPHENYTOIN |
MESANTOIN |
|
MESALAMINE Code 1 restricted to intolerance or unresponsive to sulfasalzine |
ASACOL |
|
METAPROTERENOL |
ALUPENT |
|
METFORMIN |
GLUCOPHAGE |
|
METHADONE QL maximum 90 day supply per fill |
DOLOPHINE |
|
METHENAMINE HIPPURATE |
HIPREX |
|
METHENAMINE MANDELATE |
MANDELAMINE |
|
METHIMAZOLE |
TAPAZOLE |
|
METHOCARBAMOL QL maximum 50 tablets per 30 days |
ROBAXIN |
|
METHOTREXATE |
METHOTREXATE |
|
METHSUXIMIDE |
CELONTIN |
|
METHYLDOPA |
ALDOMET |
|
METHYLERGONOVINE |
METHERGINE |
|
METHYLPHENIDATE all forms |
RITALIN |
|
METHYLPHENIDATE all sustained release forms, limited to 1 daily |
CONCERTA, METADATE |
|
METHYLPREDNISOLONE all forms |
MEDROL |
|
METHYLPREDNISOLONE SODIUM SUCCINATE |
SOLU-MEDROL |
|
METHYLTESTOSTERONE |
ANDROID |
|
METIPRANOLOL |
OPTIPRANOLOL |
|
METOCLOPRAMIDE |
REGLAN |
|
METOLAZONE QL maximum 1 tablet per day for 2.5mg & 5mg strengths |
ZAROXOLYN |
|
METOPROLOL TARTRATE |
LOPRESSOR |
|
METRONIDAZOLE |
FLAGYL |
|
METRONIDAZOLE |
METROGEL |
|
MEXILETINE |
MEXITIL |
|
MICONAZOLE NITRATE * |
MONISTAT |
|
MINOCYCLINE |
MINOCIN |
|
MINOXIDIL |
LONITEN |
|
MIRTAZAPINE |
REMERON |
|
MISOPROSTOL |
CYTOTEC |
|
MOEXIPRIL |
UNIVASC |
|
MOEXIPRIL/HYDROCHLOROTHIAZIDE |
UNIRETIC |
|
MOMETASONE FUROATE, for children under 4 YO only |
ASMANEX, NASONEX |
|
MORPHINE SULFATE all forms of generic |
ROXANOL, MS CONTIN |
|
MOXIFLOXACIN, ophthalmic only |
VIGAMOX |
|
MULTIVITAMINS W/FLUORIDE |
POLY-VI-FLOR |
|
MUPIROCIN OINTMENT ONLY |
BACTROBAN |
|
N (top) |
|
|
NIFEDIPINE XL |
PROCARDIA XL |
|
NAFCILLIN |
UNIPEN |
|
NAPHAZOLINE HYDROCHLORIDE/ANTAZOLINE * |
VASOCON-A |
|
NAPHAZOLINE HYDROCHLORIDE/PHENIRAMINE * |
NAPHCON-A |
|
NAPROXEN |
NAPROSYN |
|
NAPROXEN SODIUM |
ANAPROX |
|
NATAMYCIN |
NATACYN |
|
NEFAZODONE maximum 2 tablets per day lower strengths |
SERZONE |
|
NEOMYCIN/POLYMYXIN/PREDNISOLONE |
POLY-PRED |
|
NEOSTIGMINE BROMIDE |
PROSTIGMIN |
|
NIACIN all forms |
NIACIN, NIASPAN |
|
NICLOSAMIDE |
NICLOCIDE |
|
NICOTINE PATCH QL 12 weeks per 365 days and smoking cessation class certificate * |
NICOTROL |
|
NICOTINE POLACRILEX QL 12 weeks per 365 days and smoking cessation class certificate*e |
NICORETTE |
|
NIFEDIPINE SR |
ADALAT CC |
|
NITROFURANTOIN all forms |
FURADANTIN |
|
NITROFURANTOIN/NITROFURAN MACROCRYSTALS |
MACROBID |
|
NITROGLYCERIN all tablets, capsules, and ointment |
NITROGLYCERIN |
|
NONOXYNOL 9 * |
CONCEPTROL |
|
NORELGESTROMIN/ETHINYL ESTRADIOL |
ORTHO EVRA |
|
NORTRIPTYLINE |
PAMELOR |
|
NYSTATIN |
MYCOSTATIN |
|
NYSTATIN/TRIAMCINOLONE |
MYCOLOG II |
|
O (top) |
|
|
OCTOXYNOL 9 * |
ORTHO-GYNOL |
|
OFLOXACIN OTIC & tablets Code 1 restricted to use in the treatment of PID, GC, UTI, polymicrobial skin and febrile GI or blood infections when other first line antibiotics cannot be used |
FLOXIN |
|
OLOPATADINE |
PATANOL |
|
OMERPRAZOLE OTC ONLY QL 2 TABLETS/DAY * |
PRILOSEC |
|
ONDANSETRON QL 12 / Rx |
ZOFRAN |
|
OXCARBAZEPINE |
TRILEPTAL |
|
OXYBUTYNIN |
DITROPAN |
|
OXYCODONE |
ROXICODONE |
|
OXYCODONE/ACETAMINOPHEN QL maximum 100 per 30 days |
PERCOCET |
|
OXYCODONE/ASPIRIN QL maximum 100 per 30 days |
PERCODAN |
|
P (top) |
|
|
PAROXETINE |
PAXIL |
|
PENICILLIN G PROCAINE & BENZATHINE |
WYCILLIN |
|
PENICILLIN V POTASSIUM |
PEN VK |
|
PENTAMIDINE Code1 HIV history of PCP or with CD4(T4) lymphocycte count < 200 cells/mm3 |
PENTAM 300 |
|
PENTOXIFYLLINE Code1 restricted to use over 65years of age diagnosed with intermittent claudication, or diabetics of any age diagnosed with intermittent claudication |
TRENTAL |
|
|
MIRALAX POWDER |
|
PEG 3350/ELECTROLYTES |
COLYTE/GOLYTELY |
|
PERGOLIDE MESYLATE |
PERMAX |
|
PERMETHRIN |
ELIMITE |
|
PHENAZOPYRIDINE |
PYRIDIUM |
|
PHENOBARBITAL all forms * |
PHENOBARBITAL |
|
PHENSUXIMIDE * |
MILONTIN |
|
PHENYTOIN SODIUM |
DILANTIN |
|
PHYTONADIONE * |
MEPHYTON |
|
PILOCARPINE HYDROCHLORIDE |
ISOPTO CARPINE |
|
PIOGLITAZONE |
ACTOS |
|
PIPERACILLIN |
PIPRACIL |
|
PIPERAZINE CITRATE |
PIPERAZINE |
|
PIPERONYL BUTOXIDE/PYRETHRINS * |
RID |
|
PIRBUTEROL |
MAXAIR |
|
PIROXICAM |
FELDENE |
|
PODOFILOX gel only |
CONDYLOX |
|
POLYMYXIN B SULFATE/BACITRACIN drops and ointment * |
POLYSPORIN |
|
POTASSIUM CHLORIDE all forms |
K-DUR |
|
POTASSIUM IODIDE |
SSKI |
|
POVIDONE-IODINE 10% solution only * |
BETADINE |
|
PSEDUOEPHEDRINE/BROMPHENIRAMINE * |
DIMETAPP |
|
PRAMIPEXOLE DIHYDROCHLORIDE |
MIRAPEX |
|
PRAZOSIN |
MINIPRESS |
|
PREDNICARBATE all forms |
DERMATOP |
|
PREDNISOLONE |
PRELONE |
|
PREDNISOLONE ACETATE |
PRED FORTE, PRED MILD |
|
PREDNISONE |
PREDNISONE |
|
PRENATAL VITAMINS |
PRENAVITE |
|
PRIMAQUINE |
PRIMAQUINE |
|
PRIMIDONE |
MYSOLINE |
|
PRIMIPEXOLE |
MIRAPEX |
|
PROBENECID |
BENEMID |
|
PROCAINAMIDE |
PRONESTYL |
|
PROCHLORPERAZINE MALEATE all forms |
COMPAZINE |
|
PROGESTERONE inj |
PROGESTERONE INJ |
|
PROMETHAZINE all forms except cough and cold combinations |
PHENERGAN |
|
PROPAFENONE |
RYTHMOL |
|
PROPOXYPHENE NAPSYLATE/ACETAMINOPHEN QL maximum 50 tablets per 30 days |
DARVOCET-N 100 |
|
PROPRANOLOL all forms |
INDERAL, INDERAL LA |
|
PROPYLTHIOURACIL, PTU |
PROPYLTHIOURACIL |
|
PROTAMINE SULFATE |
PROTAMINE |
|
PROTRIPTYLINE |
VIVACTIL |
|
PSEUDOEPHEDRINE HYDROCHLORIDE all forms * |
SUDAFED |
|
PSEUDOEPHEDRINE /TRIPROLIDINE * |
ACTIFED |
|
PYRANTEL |
ANTIMINTH |
|
PYRAZINAMIDE |
PYRAZINAMIDE |
|
PYRIDOSTIGMINE |
MESTINON |
|
PYRIDOXINE * |
VITAMIN B-6 |
|
PYRIMETHAMINE |
DARAPRIM |
|
Q (top) |
|
|
QUINAPRIL |
ACCUPRIL |
|
QUINIDINE GLUCONATE |
QUINAGLUTE |
|
QUINIDINE SULFATE |
QUINIDIN |
|
QUININE SULFATE |
QUINAMM |
|
R (top) |
|
|
RALOXIFENE |
EVISTA |
|
RANITIDINE |
ZANTAC |
|
REPAGLINIDE |
PRANDIN |
|
RIFABUTIN Code 1 for use in prevention of MAC disease in advanced HIV infection |
MYCOBUTIN |
|
RIFAMPIN |
RIFADIN |
|
RIFAMPIN/ISONIAZID |
RIFAMATE |
|
RIFAMPIN/ISONIAZID /PYRAZINAMIDE |
RIFATER |
|
RILUZOLE Code 1 treatment of ALS only |
RILUTEK |
|
RISEDRONATE SODIUM |
ACTONEL |
|
ROSIGLITAZONE |
AVANDIA |
|
S (top) |
|
|
SALMETEROL |
SEREVENT |
|
SALSALATE |
DISALCID |