Alphabetical Listing by Name OUTPATIENT FORMULARY AFB SCOTT

32 Pages·2017·0.2 MB·English

by  Lacure, Mary

SCOTT AFB
OUTPATIENT FORMULARY
Alphabetical Listing by Name
This document is current as of May 5, 2022.
The availability of formulary items is subject to change.
Scott AFB Outpatient Formulary
Alphabetical Drug Listing Available Dosage Forms
Acetaminophen Suppository, Rectal:
Generic: 120 mg (12s); 650 mg (12s)
Liquid, Oral:
Generic: 160 mg/5 mL (120 mL)
Tablet, Oral:
Generic: 325 mg
Acetaminophen and Codeine Solution, Oral [C-V]:
Generic: Acetaminophen 120 mg and codeine phosphate 12 mg per 5 mL (120 mL)
Tablet, Oral [C-III]:
Generic: Acetaminophen 300 mg and codeine phosphate 30 mg [BCF]
AcetaZOLAMIDE Capsule Extended Release 12 Hour, Oral:
Generic: 500 mg
Tablet, Oral:
Generic: 250 mg
Acetic Acid and Hydrocortisone Solution, Otic [drops]:
Generic: Acetic acid 2%, propylene glycol diacetate 3%, and hydrocortisone 1% (10 mL)
Acetic Acid (Otic) Solution, Otic:
Generic: 2% (15 mL)
Acyclovir (Systemic) Capsule, Oral:
Generic: 200 mg [BCF]
Tablet, Oral:
Generic: 400 mg [BCF], 800 mg [BCF]
Acyclovir (Topical) Cream, External:
Generic: 5% (5 g)
Ointment, External:
Generic: 5% (5 g, 15 g, 30 g)
Adalimumab Pen-injector Kit, Subcutaneous [preservative free]:
Humira Pen: 40 mg/0.4 mL (1 ea) [BCF], 40 mg/0.8 mL (1 ea) [contains polysorbate 80] [BCF]
Prefilled Syringe Kit, Subcutaneous [preservative free]:
Humira: 40 mg/0.8 mL (1 ea) [BCF] [contains polysorbate 80]
Adapalene Gel, External:
Generic: 0.3% (45 g)
Albendazole Tablet, Oral:
Albenza: 200 mg [contains saccharin sodium]
Albuterol Aerosol Solution, Inhalation:
ProAir HFA: 108 (90 Base) mcg/actuation (8.5 g) [BCF]
Nebulization Solution, Inhalation [preservative free]:
Generic: Generic: 0.63 mg/3 mL (3 mL); 1.25 mg/3 mL (3 mL); 0.083% [2.5 mg/3 mL] (25s,
30s, 60s) [BCF]
Syrup, Oral:
Generic: 2 mg/5 mL (473 mL)
Tablet, Oral:
Generic: 2 mg
Alcohol (Isopropyl) Pad, External:
Generic: 70% (100 ea)
Alendronate Tablet, Oral:
Generic: 5 mg [BCF], 10 mg [BCF], 35 mg [BCF] , 70 mg [BCF]
Alfuzosin Tablet Extended Release 24 Hour, Oral, as hydrochloride:
Generic: 10 mg [BCF]
Aliskiren This medication is nonformulary. For formulary alternatives, refer to Therapeutic Category.
Aliskiren and This medication is nonformulary. For formulary alternatives, refer to Therapeutic Category.
Hydrochlorothiazide
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Scott AFB Outpatient Formulary
Allopurinol Tablet, Oral, as sodium:
Generic: 100 mg [BCF], 300 mg [BCF]
ALPRAZolam Tablet, Oral:
Generic: 0.25 mg, 0.5 mg, 1 mg, 2 mg
Alprostadil Kit, Intracavernosal:
Edex: 20 mcg, 40 mcg
Aluminum Chloride Hexahydrate Solution, External:
Drysol: 20% (35 mL) [contains ethanol 93%]
Amantadine Capsule, Oral, as hydrochloride:
Generic: 100 mg [BCF]
Syrup, Oral, as hydrochloride:
Generic: 50 mg/5 mL (10 mL, 473 mL) [BCF]
Amiodarone Tablet, Oral, as hydrochloride:
Generic: 200 mg [BCF]
Amitriptyline Tablet, Oral, as hydrochloride:
Generic: 10 mg [BCF], 25 mg [BCF], 50 mg [BCF], 75 mg [BCF] , 100 mg, 150 mg
AmLODIPine Tablet, Oral:
Generic: 2.5 mg [BCF], 5 mg [BCF], 10 mg [BCF]
Amlodipine and Benazepril Capsule, Oral:
Generic: 2.5/10: Amlodipine 2.5 mg and benazepril hydrochloride 10 mg [BCF]
Generic: 5/10: Amlodipine 5 mg and benazepril hydrochloride 10 mg [BCF]
Generic: 5/20: Amlodipine 5 mg and benazepril hydrochloride 20 mg [BCF]
Generic: 5/40: Amlodipine 5 mg and benazepril hydrochloride 40 mg [BCF]
Generic: 10/20: Amlodipine 10 mg and benazepril hydrochloride 20 mg [BCF]
Generic: 10/40: Amlodipine 10 mg and benazepril hydrochloride 40 mg [BCF]
Amoxicillin Capsule, Oral:
Generic: 250 mg [BCF], 500 mg [BCF]
Suspension Reconstituted, Oral:
Generic: 125 mg/5 mL (80 mL, 100 mL, 150 mL); 250 mg/5 mL (80 mL, 100 mL, 150 mL)
[BCF]; 400 mg/5 mL (50 mL, 75 mL, 100 mL) [BCF]
Tablet Chewable, Oral:
Generic: 125 mg, 250 mg
Amoxicillin and Clavulanate Powder for Suspension, Oral:
Potassium Generic: 200: Amoxicillin 200 mg and clavulanate potassium 28.5 mg per 5 mL (50 mL, 75 mL,
100 mL) [BCF]
Generic: 250: Amoxicillin 250 mg and clavulanate potassium 62.5 mg per 5 mL (75 mL, 100
mL, 150 mL) [BCF]
Generic: 400: Amoxicillin 400 mg and clavulanate potassium 57 mg per 5 mL (50 mL, 75 mL,
100 mL) [BCF]
Generic: 600: Amoxicillin 600 mg and clavulanate potassium 42.9 mg per 5 mL (75 mL, 125
mL, 200 mL) [BCF]
Tablet, Oral:
Generic: 250: Amoxicillin 250 mg and clavulanate potassium 125 mg [BCF]
Generic: 500: Amoxicillin 500 mg and clavulanate potassium 125 mg [BCF]
Generic: 875: Amoxicillin 875 mg and clavulanate potassium 125 mg [BCF]
Anastrozole Tablet, Oral:
Generic: 1 mg
Apixaban Tablet, Oral:
Eliquis: 2.5 mg [BCF], 5 mg [BCF]
ARIPiprazole Tablet, Oral:
Generic: 2 mg [BCF], 5 mg [BCF], 10 mg [BCF], 15 mg [BCF], 20 mg [BCF], 30 mg [BCF]
Aspirin Tablet, Oral:
Generic: 325 mg
Tablet, Enteric Coated, Oral:
Generic: 81 mg, 325 mg
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Scott AFB Outpatient Formulary
Aspirin and Dipyridamole Capsule Extended Release 12 Hour, Oral:
Generic: Aspirin 25 mg [immediate release] and dipyridamole 200 mg [extended release]
Atenolol Tablet, Oral:
Generic: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]
Atenolol and Chlorthalidone Tablet, Oral:
50: Atenolol 50 mg and chlorthalidone 25 mg
100: Atenolol 100 mg and chlorthalidone 25 mg
Atomoxetine Capsule, Oral:
Generic: 10 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80 mg, 100 mg
Atorvastatin Tablet, Oral:
Generic: 10 mg [BCF], 20 mg [BCF], 40 mg [BCF], 80 mg [BCF]
Atropine (Ophthalmic) Solution, Ophthalmic, as sulfate:
Generic: 1% (15 mL)
AzaTHIOprine Tablet, Oral:
Generic: 50 mg
Azelaic Acid Cream, External:
Azelex: 20% (30 g, 50 g)
Gel, External:
Finacea: 15% (50 g) [contains benzoic acid, disodium edta, polysorbate 80, propylene glycol]
Azelastine (Nasal) Solution, Nasal, as hydrochloride:
Generic: 137 mcg/spray (30 mL); 0.1% (30 mL)
Azithromycin (Systemic) Suspension Reconstituted, Oral:
Generic: 100 mg/5 mL (15 mL) [BCF] ; 200 mg/5 mL (15 mL, 22.5 mL, 30 mL)
Tablet, Oral:
Zithromax TRI-PAK: 500 mg [BCF]
Zithromax Z-PAK: 250 mg [BCF]
Generic: 250 mg [BCF], 500 mg [BCF]
Bacitracin and Polymyxin B Ointment, Ophthalmic:
(Ophthalmic) Generic: Bacitracin 500 units and polymyxin B 10,000 units per g (3.5 g)
Bacitracin, Neomycin, and Ointment, ophthalmic: Bacitracin 400 units, neomycin 3.5 mg, and polymyxin B 10,000 units
Polymyxin B (Ophthalmic) per g (3.5 g) [BCF]
Bacitracin (Ophthalmic) Ointment, Ophthalmic:
Generic: 500 units/g (3.5 g)
Bacitracin (Topical) Ointment, External, as zinc [strength expressed as base]:
Generic: 500 units/g (28 g)
Baclofen Tablet, Oral:
Generic: 10 mg, 20 mg
Benzocaine Lozenge, Mouth/Throat:
Cepacol Sore Throat: 15 mg (18 ea) [contains menthol 3.6 mg]
Generic: 15 mg (18 ea) [contains menthol 3.6 mg]
Benzonatate Capsule, Oral:
Generic: 100 mg, 200 mg
Benzoyl Peroxide Gel, External:
Generic: 10% (56 g, 60 g, 90 g)
Liquid, External:
Benzoyl Peroxide Wash: 5% (148 g, 237 g)
Benztropine Tablet, Oral, as mesylate:
Generic: 0.5 mg [BCF], 1 mg [BCF], 2 mg [BCF]
Betamethasone
Betamethasone and Cream, External:
Clotrimazole Generic: Betamethasone dipropionate 0.05% (base) and clotrimazole 1% (15 g, 45 g)
Lotion, External:
Generic: Betamethasone dipropionate 0.05% (base) and clotrimazole 1% (30 mL)
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Scott AFB Outpatient Formulary
Bethanechol Tablet, Oral, as chloride:
Generic: 10 mg, 25 mg
Bicalutamide Tablet, Oral:
Generic: 50 mg [BCF]
Bimatoprost Solution, Ophthalmic:
Lumigan: 0.01% (5 mL) [contains benzalkonium chloride]
Bisacodyl Suppository, Rectal:
Generic: 10 mg (12 ea, 50 ea)
Tablet Delayed Release, Oral:
Generic: 5 mg
Bismuth Subsalicylate Tablet Chewable, Oral, as subsalicylate:
Generic: 262 mg
Brimonidine and Timolol Solution, Ophthalmic [drops]:
Combigan: Brimonidine tartrate 0.2% and timolol maleate 0.5% (10 mL) [contains
benzalkonium chloride]
Brimonidine (Ophthalmic) Solution, Ophthalmic, as tartrate:
Alphagan P: 0.1% (5 mL, 10 mL, 15 mL); 0.15% (5 mL, 10 mL, 15 mL) [contains
carboxymethylcellulose sodium] [BCF]
Generic: 0.15% (5 mL, 10 mL, 15 mL) [BCF]; 0.2% (5 mL, 10 mL, 15 mL) [BCF]
Bromocriptine Tablet, Oral:
Parlodel: 2.5 mg [scored]
Generic: 2.5 mg
Budesonide (Oral Inhalation) Suspension, Inhalation:
Generic: 0.25 mg/2 mL (2 mL); 0.5 mg/2 mL (2 mL); 1 mg/2 mL (2 mL)
Budesonide (Systemic) Capsule Delayed Release Particles, Oral:
Generic: 3 mg
Bumetanide Tablet, Oral:
Generic: 0.5 mg, 1 mg, 2 mg
BuPROPion Tablet Extended Release 12 Hour, Oral, as hydrochloride:
Generic: 100 mg [BCF], 150 mg [BCF] , 200 mg
Tablet Extended Release 24 Hour, Oral, as hydrochloride:
Generic: 150 mg [BCF], 300 mg [BCF]
BusPIRone Tablet, oral, as hydrochloride: 5 mg [BCF], 10 mg [BCF], 15 mg [BCF]
Butalbital, Acetaminophen, and Tablet, Oral:
Caffeine Generic: Butalbital 50 mg, acetaminophen 325 mg, and caffeine 40 mg [BCF]
Cabergoline Tablet, Oral:
Generic: 0.5 mg
Calcipotriene Cream, External:
Generic: 0.005% (60 g)
Solution, External:
Generic: 0.005% (60 mL)
Calcitonin Solution, Nasal:
Generic: 200 units/actuation (3.7 mL)
Calcitriol (Systemic) Capsule, Oral:
Generic: 0.25 mcg, 0.5 mcg
Calcium Acetate Capsule, Oral:
Generic: 667 mg
Calcium Carbonate Tablet, Oral:
Generic: 1500 mg [equivalent to elemental calcium 600 mg]
Captopril Tablet, Oral:
Generic: 12.5 mg [BCF], 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]
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Scott AFB Outpatient Formulary
CarBAMazepine Capsule Extended Release 12 Hour, Oral:
Generic: 100 mg, 200 mg, 300 mg
Suspension, Oral:
Generic: 100 mg/5 mL (10 mL, 450 mL) [BCF]
Tablet, Oral:
Generic: 200 mg [BCF]
Tablet, Chewable, Oral:
Generic: 100 mg [BCF]
Tablet Extended Release 12 Hour, Oral:
Generic: 200 mg, 400 mg [BCF]
Carbidopa and Levodopa Tablet, Oral:
Generic: 10/100: Carbidopa 10 mg and levodopa 100 mg [scored] [BCF]
Generic: 25/100: Carbidopa 25 mg and levodopa 100 mg [scored] [BCF]
Generic: 25/250: Carbidopa 25 mg and levodopa 250 mg [scored] [BCF]
Tablet Extended Release, Oral:
25/100: Carbidopa 25 mg and levodopa 100 mg
50/200: Carbidopa 50 mg and levodopa 200 mg
Carboxymethylcellulose Solution, Ophthalmic, as sodium [drops]:
Refresh Plus: 0.5% (30 ea, 50 ea, 70 ea)
Refresh Tears: 0.5% (15 mL, 30 mL)
Solution, Ophthalmic, as sodium [preservative free]:
Refresh Celluvisc: 1% (30 ea)
Carvedilol Tablet, Oral:
Generic: 3.125 mg [BCF], 6.25 mg [BCF], 12.5 mg [BCF], 25 mg [BCF]
Cefadroxil Capsule, Oral:
Generic: 500 mg
Suspension Reconstituted, Oral:
Generic: 250 mg/5 mL (50 mL, 100 mL); 500 mg/5 mL (75 mL, 100 mL)
Cefdinir Capsule, Oral:
Generic: 300 mg
Cefpodoxime Tablet, Oral:
Generic: 100 mg, 200 mg
Cefprozil Suspension Reconstituted, Oral:
Generic: 250 mg/5 mL (50 mL, 75 mL, 100 mL)
Tablet, Oral:
Generic: 250 mg, 500 mg
Cefuroxime Axetil Tablet, Oral, as axetil [strength expressed as base]:
Generic: 250 mg, 500 mg
Celecoxib Capsule, Oral:
Generic: 100 mg, 200 mg, 400 mg
Cephalexin Capsule, Oral:
Generic: 250 mg [BCF], 500 mg [BCF]
Suspension Reconstituted, Oral:
Generic: 250 mg/5 mL (100 mL, 200 mL) [BCF]
Cetirizine and Pseudoephedrine Tablet, Extended Release, Oral:
Generic: Cetirizine hydrochloride 5 mg and pseudoephedrine hydrochloride 120 mg
Cetirizine (Systemic) Syrup, Oral, as hydrochloride:
Generic: 5 mg/5 mL (120 mL, 480 mL)
Tablet, Oral, as hydrochloride:
Generic: 10 mg
Chlorhexidine Gluconate (Oral) Solution, Mouth/Throat:
Peridex: 0.12% (473 mL) [contains ethanol 11.6%; mint flavor] [BCF]
Generic: 0.12% (15 mL, 473 mL, 480 mL) [BCF]
Chloroquine Tablet, Oral, as phosphate:
Generic: 500 mg [equivalent to chloroquine base 300 mg]
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Scott AFB Outpatient Formulary
Chlorpheniramine Tablet, Oral, as maleate:
Generic: 4 mg
ChlorproMAZINE Tablet, Oral, as hydrochloride:
Generic: 25 mg, 50 mg, 100 mg
Chlorthalidone Tablet, Oral:
Generic: 25 mg [BCF], 50 mg [BCF]
Cholecalciferol Capsule, Oral:
Generic: 5000 units, 50,000 units
Liquid, Oral:
Generic: 400 units/mL (50 mL)
Tablet, Oral:
Generic: 1000 units, 2000 units
Cholestyramine Resin Powder, Oral:
Questran: 4 g/dose (378 g) [orange flavor]
Questran Light: 4 g/dose (210 g) [sugar free; contains aspartame; orange flavor]
Ciclopirox Solution, External:
Generic: 8% (6.6 mL)
Cimetidine Tablet, Oral:
Generic: 300 mg, 400 mg
Ciprofloxacin and Suspension, Otic:
Dexamethasone Ciprodex: Ciprofloxacin 0.3% and dexamethasone 0.1% (7.5 mL) [contains benzalkonium
chloride]
Ciprofloxacin (Ophthalmic) Solution, Ophthalmic, as hydrochloride:
Generic: 0.3% (2.5 mL, 5 mL, 10 mL)
Ciprofloxacin (Systemic) Tablet, Oral, as hydrochloride [strength expressed as base]:
Generic: 250 mg [BCF], 500 mg [BCF], 750 mg [BCF]
Citalopram Tablet, Oral:
Generic: 10 mg [BCF], 20 mg [BCF], 40 mg [BCF]
Clarithromycin Suspension Reconstituted, Oral:
Generic: 250 mg/5 mL (50 mL, 100 mL)
Tablet, Oral:
Generic: 250 mg, 500 mg
Clindamycin and Benzoyl Gel, External:
Peroxide Generic: Clindamycin 1% and benzoyl peroxide 5% (25 g, 35 g, 50 g)
Generic: Clindamycin phosphate 1.2% and benzoyl peroxide 5% (45 g)
Clindamycin (Systemic) Capsule, Oral, as hydrochloride [strength expressed as base]:
Generic: 150 mg [BCF], 300 mg
Solution Reconstituted, Oral, as palmitate hydrochloride [strength expressed as base]:
Generic: 75 mg/5 mL (100 mL)
Clindamycin (Topical) Cream, Vaginal, as phosphate [strength expressed as base]:
Generic: 2% (40 g) [BCF]
Lotion, External, as phosphate [strength expressed as base]:
Generic: 1% (60 mL)
Solution, External, as phosphate [strength expressed as base]:
Generic: 1% (30 mL, 60 mL) [BCF]
Clobetasol Cream, External, as propionate:
Generic: 0.05% (15 g, 30 g, 45 g, 60 g)
Foam, External, as propionate:
Generic: 0.05% (100 g)
Gel, External, as propionate:
Generic: 0.05% (15 g, 30 g, 60 g)
Ointment, External, as propionate:
Generic: 0.05% (15 g, 30 g, 45 g, 60 g)
Solution, External, as propionate:
Generic: 0.05% (25 mL, 50 mL)
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Scott AFB Outpatient Formulary
ClomiPHENE Tablet, Oral, as citrate:
Generic: 50 mg
ClonazePAM Tablet, Oral:
Generic: 0.5 mg [BCF] , 1 mg, 2 mg
CloNIDine Patch Weekly, Transdermal:
Generic: 0.1 mg/24 hr (1 ea, 4 ea); 0.2 mg/24 hr (1 ea, 4 ea); 0.3 mg/24 hr (1 ea, 4 ea)
Tablet, Oral, as hydrochloride:
Generic: 0.1 mg [BCF], 0.2 mg [BCF], 0.3 mg [BCF]
Clopidogrel Tablet, Oral:
Generic: 75 mg [BCF]
Clotrimazole (Oral) Troche, Mouth/Throat:
Generic: 10 mg
Clotrimazole (Topical) Cream, External:
Generic: 1% (15 g, 30 g, 45 g)
Cream, Vaginal:
Generic: 1% (45 g)
Codeine Tablet, Oral, as sulfate:
Generic: 30 mg
Colchicine Tablet, Oral:
Generic: 0.6 mg
Colestipol Tablet, Oral, as hydrochloride:
Generic: 1 g
Cromolyn (Oral Inhalation) Nebulization Solution, Inhalation, as sodium:
Generic: 20 mg/2 mL (2 mL)
Cyanocobalamin Solution, Injection:
Generic: 1000 mcg/mL (1 mL, 10 mL, 30 mL)
Cyclobenzaprine Tablet, Oral, as hydrochloride:
Generic: 5 mg, 10 mg [BCF]
Cyclopentolate Solution, Ophthalmic, as hydrochloride:
Generic: 0.5% (15 mL); 1% (2 mL, 15 mL)
CycloSPORINE (Ophthalmic) Emulsion, Ophthalmic [preservative free]:
Restasis: 0.05% (1 ea) [contains polysorbate 80]
CycloSPORINE (Systemic) Capsule, Oral:
Generic: 25 mg, 100 mg
Cyproheptadine Tablet, Oral, as hydrochloride:
Generic: 4 mg [BCF]
Dabigatran Etexilate Capsule, Oral:
Pradaxa: 75 mg, 150 mg
Dapsone (Systemic) Tablet, Oral:
Generic: 25 mg
Desipramine Tablet, Oral, as hydrochloride:
Generic: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, 150 mg
Desmopressin Solution, Nasal, as acetate:
Generic: 0.01% (2.5 mL, 5 mL)
Desonide Cream, External:
Generic: 0.05% (15 g, 60 g)
Ointment, External:
Generic: 0.05% (15 g, 60 g)
DexAMETHasone (Systemic) Elixir, Oral:
Generic: 0.5 mg/5 mL (237 mL)
Tablet, Oral:
Generic: 0.5 mg, 0.75 mg, 4 mg
Dexmethylphenidate Capsule Extended Release 24 Hour, Oral, as hydrochloride:
Generic: 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg, 35 mg, 40 mg
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Scott AFB Outpatient Formulary
Dextroamphetamine Tablet, Oral, as sulfate:
Generic: 5 mg
Dextroamphetamine and Capsule, Extended Release, Oral:
Amphetamine 5 mg [dextroamphetamine sulfate 1.25 mg, dextroamphetamine saccharate 1.25 mg,
amphetamine aspartate monohydrate 1.25 mg, amphetamine sulfate 1.25 mg (equivalent to
amphetamine base 3.1 mg)] [BCF]
10 mg [dextroamphetamine sulfate 2.5 mg, dextroamphetamine saccharate 2.5 mg,
amphetamine aspartate monohydrate 2.5 mg, amphetamine sulfate 2.5 mg (equivalent to
amphetamine base 6.3 mg)] [BCF]
15 mg [dextroamphetamine sulfate 3.75 mg, dextroamphetamine saccharate 3.75 mg,
amphetamine aspartate monohydrate 3.75 mg, amphetamine sulfate 3.75 mg (equivalent to
amphetamine base 9.4 mg)] [BCF]
20 mg [dextroamphetamine sulfate 5 mg, dextroamphetamine saccharate 5 mg, amphetamine
aspartate monohydrate 5 mg, amphetamine sulfate 5 mg (equivalent to amphetamine base
12.5 mg)] [BCF]
25 mg [dextroamphetamine sulfate 6.25 mg, dextroamphetamine saccharate 6.25 mg,
amphetamine aspartate monohydrate 6.25 mg, amphetamine sulfate 6.25 mg (equivalent to
amphetamine base 15.6 mg)] [BCF]
30 mg [dextroamphetamine sulfate 7.5 mg, dextroamphetamine saccharate 7.5 mg,
amphetamine aspartate monohydrate 7.5 mg, amphetamine sulfate 7.5 mg (equivalent to
amphetamine base 18.8 mg)] [BCF]
Tablet, Oral:
5 mg [scored; dextroamphetamine sulfate 1.25 mg, dextroamphetamine saccharate 1.25 mg,
amphetamine aspartate monohydrate 1.25 mg, amphetamine sulfate 1.25 mg (equivalent to
amphetamine base 3.13 mg)]
10 mg [scored; dextroamphetamine sulfate 2.5 mg, dextroamphetamine saccharate 2.5 mg,
amphetamine aspartate monohydrate 2.5 mg, amphetamine sulfate 2.5 mg (equivalent to
amphetamine base 6.3 mg)]
15 mg [scored; dextroamphetamine sulfate 3.75 mg, dextroamphetamine saccharate 3.75 mg,
amphetamine aspartate monohydrate 3.75 mg, amphetamine sulfate 3.75 mg (equivalent to
amphetamine base 9.4 mg)]
20 mg [scored; dextroamphetamine sulfate 5 mg, dextroamphetamine saccharate 5 mg,
amphetamine aspartate monohydrate 5 mg, amphetamine sulfate 5 mg (equivalent to
Dextromethorphan a Smypruhpe,t aOmrainl,e a bs ahsyed r1o2b.6ro mmgid)e] :
Generic: Dextromethorphan polistirex [equivalent to dextromethorphan hydrobromide 30 mg/5
mL] (89 mL)
Diabetic Supplies Glucose, meter:
FreeStyle Lite Meter
Precision Xtra Glucose Monitor
Lancets
Syringe and needle: 31 gauge x 5/16" [BCF]
Pen Needles: 30 gauge x 8 mm, 31 gauge x 8 mm, & 32 gauge x 4 mm
Syringes: 21 gauge 1.5" (3 mL); 25 gauge 1" (3 mL); 31 gauge 5/16" (0.3 mL, 0.5 mL, 1 mL);
30 gauge 1/2" (0.5 mL, 1 mL)
Test Strips/Kit:
FreeStyle Lite Test Strips: 50/box, 100/box [BCF]
Precision Xtra GlucoseTest Strips
Presicion Xtra Blood Ketone Strips
Urine Ketone Strips
DiazePAM Tablet, Oral:
Generic: 2 mg, 5 mg [BCF], 10 mg
Diclofenac (Ophthalmic) Solution, Ophthalmic, as sodium:
Generic: 0.1% (2.5 mL, 5 mL)
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Scott AFB Outpatient Formulary
Diclofenac (Systemic) Tablet Delayed Release, Oral, as sodium:
Generic: 25 mg, 50 mg, 75 mg
Tablet Extended Release 24 Hour, Oral, as sodium:
Generic: 100 mg
Diclofenac (Topical) Gel, Transdermal, as sodium:
Generic: 1% (100 g)
Dicloxacillin Capsule, Oral:
Generic: 250 mg [BCF], 500 mg [BCF]
Dicyclomine Capsule, Oral, as hydrochloride:
Generic: 10 mg [BCF]
Tablet, Oral, as hydrochloride:
Generic: 20 mg [BCF]
Difluprednate Emulsion, Ophthalmic:
Durezol: 0.05% (5 mL) [contains edetate sodium (tetrasodium), polysorbate 80]
Digoxin Tablet, Oral:
Generic: 125 mcg [BCF], 250 mcg [BCF]
DilTIAZem Capsule Extended Release 24 Hour, Oral, as hydrochloride:
Tiazac: 120 mg [BCF], 180 mg [BCF], 240 mg [BCF], 300 mg [BCF], 360 mg [BCF], 420 mg
[BCF]
Generic: 120 mg [BCF], 180 mg [BCF], 240 mg [BCF], 300 mg [BCF], 360 mg [BCF], 420 mg
[BCF]
Tablet, Oral, as hydrochloride:
Generic: 30 mg, 60 mg, 120 mg
DiphenhydrAMINE (Systemic) Capsule, Oral, as hydrochloride:
Generic: 25 mg, 50 mg
Solution, Oral, as hydrochloride:
Generic: 12.5 mg/5 mL (120 mL) [alcohol free; contains sodium benzoate]
Diphenoxylate and Atropine Tablet, Oral:
Generic: Diphenoxylate hydrochloride 2.5 mg and atropine sulfate 0.025 mg
Dipyridamole Tablet, Oral:
Generic: 25 mg, 50 mg, 75 mg
Docusate Capsule, Oral, as sodium:
Generic: 100 mg
Donepezil Tablet, Oral, as hydrochloride:
Generic: 5 mg, 10 mg
Dorzolamide Solution, Ophthalmic:
Generic: 2% (10 mL)
Dorzolamide and Timolol Solution, Ophthalmic:
Generic: Dorzolamide 2% [20 mg/mL] and timolol 0.5% [5 mg/mL] (10 mL)
Doxazosin Tablet, Oral:
Generic: 2 mg, 4 mg, 8 mg
Doxepin (Systemic) Capsule, Oral:
Generic: 10 mg [BCF], 25 mg [BCF], 50 mg [BCF], 75 mg [BCF] , 100 mg, 150 mg
Concentrate, Oral:
Generic: 10 mg/mL (118 mL, 120 mL) [BCF]
Doxycycline Capsule, Oral, as hyclate [strength expressed as base]:
Generic: 50 mg, 100 mg [BCF]
Tablet, Oral, as hyclate [strength expressed as base]:
Generic: 20 mg, 100 mg [BCF]
Dronedarone Tablet, Oral:
Multaq: 400 mg
Dulaglutide Solution Pen-injector, Subcutaneous [preservative free]:
Trulicity: 0.75 mg/0.5 mL (0.5 mL); 1.5 mg/0.5 mL (0.5 mL) [contains polysorbate 80]
DULoxetine Capsule Delayed Release Particles, Oral:
Generic: 20 mg, 30 mg, 60 mg
9