goodfellow afb ross clinic formulary

24 Pages·2016·0.21 MB·English

GOODFELLOW AFB ROSS CLINIC FORMULARY
Alphabetical Listing by Therapeutic Category
This document is current as of October 8, 2020.
The availability of formulary items is subject to change.
ACARBOSE
Acarbose ALPRAZolam
OutpatientDosageForms OutpatientFormularyBrandsAvailableXanax
Tablet,Oral: OutpatientDosageForms
Generic:25mg,50mg,100mg Tablet,Oral:
Xanax:0.5mg,1mg[scored]
Acetaminophen
Generic:0.5mg,1mg
Outpatient Formulary Brands Available Mapap Children's [OTC];Mapap
[OTC] AluminumChlorideHexahydrate
OutpatientDosageForms OutpatientFormularyBrandsAvailableDrysol
Suspension,Oral: OutpatientDosageForms
MapapChildren's:160mg/5mL(118mL)[ethanolfree;containspropylene Solution,External:
glycol,sodiumbenzoate;cherryflavor] Drysol:20%(60mL)
Tablet,Oral:
AluminumHydroxide,MagnesiumHydroxide,andSimethicone
Mapap:325mg
Generic:325mg OutpatientDosageForms
Liquid,Oral:
AcetaminophenandCodeine Generic: Aluminum hydroxide 200mg, magnesium hydroxide 200mg, and
OutpatientDosageForms simethicone20mgper5mL(360mL)
Solution,Oral[C-V]:
Amantadine
Generic: Acetaminophen 120mg and codeine phosphate 12mg per 5 mL
(118mL)[BCF] OutpatientDosageForms
Tablet,Oral[C-III]: Capsule,Oral,ashydrochloride:
Generic:Acetaminophen300mgandcodeinephosphate30mg[BCF] Generic:100mg[BCF]
AcetaZOLAMIDE Amiodarone
OutpatientDosageForms OutpatientDosageForms
Tablet,Oral: Tablet,Oral,ashydrochloride:
Generic:200mg[BCF]
Generic:250mg
Amitriptyline
AceticAcid,PropyleneGlycolDiacetate,andHydrocortisone
OutpatientDosageForms
OutpatientDosageForms
Tablet,Oral,ashydrochloride:
Solution,Otic:
Generic:10mg[BCF],25mg[BCF],75mg[BCF]
Generic:Aceticacid2%,propyleneglycoldiacetate3%,andhydrocortisone
1%(10mL) AmLODIPine
Acyclovir(Systemic) OutpatientDosageForms
Tablet,Oral:
OutpatientDosageForms
Generic:2.5mg[BCF],5mg[BCF],10mg[BCF]
Capsule,Oral:
Generic:200mg[BCF] AmlodipineandBenazepril
Tablet,Oral: OutpatientFormularyBrandsAvailableLotrel
Generic:800mg[BCF] OutpatientDosageForms
Acyclovir(Topical) Capsule,Oral:
Lotrel:
OutpatientFormularyBrandsAvailableZovirax
2.5/10:Amlodipine2.5mgandbenazeprilhydrochloride10mg[BCF]
OutpatientDosageForms
5/10:Amlodipine5mgandbenazeprilhydrochloride10mg[BCF]
Cream,External:
5/20:Amlodipine5mgandbenazeprilhydrochloride20mg[BCF]
Zovirax:5%(5g)
5/40:Amlodipine5mgandbenazeprilhydrochloride40mg[BCF]
Generic:5%(5g)
10/20:Amlodipine10mgandbenazeprilhydrochloride20mg[BCF]
Ointment,External:
10/40:Amlodipine10mgandbenazeprilhydrochloride40mg[BCF]
Zovirax:5%(30g)
Generic:
Generic:5%(30g)
2.5/10:Amlodipine2.5mgandbenazeprilhydrochloride10mg[BCF]
Albendazole 5/10:Amlodipine5mgandbenazeprilhydrochloride10mg[BCF]
5/20:Amlodipine5mgandbenazeprilhydrochloride20mg[BCF]
OutpatientFormularyBrandsAvailableAlbenza
5/40:Amlodipine5mgandbenazeprilhydrochloride40mg[BCF]
OutpatientDosageForms
10/20:Amlodipine10mgandbenazeprilhydrochloride20mg[BCF]
Tablet,Oral:
10/40:Amlodipine10mgandbenazeprilhydrochloride40mg[BCF
Albenza:200mg[containssaccharinsodium]
Generic:200mg Amoxicillin
OutpatientDosageForms
Albuterol
Capsule,Oral:
OutpatientFormularyBrandsAvailableProventil®HFA
Generic:250mg[BCF],500mg[BCF]
OutpatientDosageForms SuspensionReconstituted,Oral:
AerosolSolution,Inhalation: Generic:125mg/5mL(100mL);250mg/5mL(150mL)[BCF];400mg/5mL
ProAirHFA:90mcg/actuation(8.5g) (100mL)[BCF]
Generic:90mcg/actuation(8.5g) Tablet,Oral:
NebulizationSolution,Inhalation: Generic:875mg
Generic:0.083%[2.5mg/3mL](60s)[BCF]
NebulizationSolution,Inhalation[preservativefree]: AmoxicillinandClavulanate
Generic:0.083%[2.5mg/3mL](60s)[BCF] OutpatientDosageForms
SuspensionReconstituted,Oral:
Alendronate
Generic:
OutpatientFormularyBrandsAvailableFosamax 200:Amoxicillin200mgandclavulanatepotassium28.5mgper5mL(100
OutpatientDosageForms mL)[BCF]
Tablet,Oral: 400:Amoxicillin400mgandclavulanatepotassium57mgper5mL(100
Fosamax:35mg[BCF],70mg[BCF] mL)[BCF]
Generic:35mg[BCF],70mg[BCF] 600:Amoxicillin600mgandclavulanatepotassium42.9mgper5mL(125
mL)[BCF]
Alfuzosin
Tablet,Oral:
OutpatientFormularyBrandsAvailableUroxatral Generic:
OutpatientDosageForms 500:Amoxicillin500mgandclavulanatepotassium125mg[BCF]
TabletExtendedRelease24Hour,Oral,ashydrochloride: 875:Amoxicillin875mgandclavulanatepotassium125mg[BCF]
Uroxatral:10mg[BCF] TabletExtendedRelease12Hour,Oral:
Generic:10mg[BCF] Generic:Amoxicillin1000mgandclavulanateacid62.5mg
Allopurinol Anastrozole
OutpatientDosageForms OutpatientDosageForms
Tablet,Oral: Tablet,Oral:
Generic:100mg[BCF],300mg[BCF] Generic:1mg
2
CALCITRIOL(SYSTEMIC)
Apixaban OutpatientDosageForms
OutpatientFormularyBrandsAvailableEliquis Lozenge,Mouth/Throat:
OutpatientDosageForms CepacolSoreThroat:15mg(16ea)[containscetylpyridinium,menthol;cherry
Tablet,Oral: flavor]
Eliquis:5mg
Benzonatate
ARIPiprazole OutpatientFormularyBrandsAvailableTessalonPerles
OutpatientFormularyBrandsAvailableAbilify OutpatientDosageForms
OutpatientDosageForms Capsule,Oral:
Tablet,Oral: TessalonPerles:100mg
Abilify:2mg,5mg,10mg Generic:100mg
Generic:2mg,5mg,10mg
BenzoylPeroxide
ArtificialTears
OutpatientDosageForms
OutpatientDosageForms
Gel,External:
Ointment,Ophthalmic:
Generic:2.5%(60g),10%(45g)
RefreshP.M.:3.5g
Liquid,External[wash]:
Solution,Ophthalmic:
Generic:Polyvinylalcohol1.4%(15mL,30mL) Generic:5%(148g);10%(148g)
Aspirin Benztropine
OutpatientDosageForms OutpatientDosageForms
Tablet,Chewable,Oral: Tablet,Oral,asmesylate:
Generic:81mg Generic:1mg[BCF]
Tablet,EntericCoated,Oral:
BetamethasoneandClotrimazole
Generic:81mg,325mg
OutpatientDosageForms
Atenolol Cream,External:
OutpatientDosageForms Generic: Betamethasone dipropionate 0.05% (base) and clotrimazole
Tablet,Oral: 1%(15g)
Generic:25mg[BCF],50mg[BCF],100mg[BCF]
Bisacodyl
AtoMOXetine
OutpatientFormularyBrandsAvailableDucodyl[OTC]
OutpatientFormularyBrandsAvailableStrattera
OutpatientDosageForms
OutpatientDosageForms
Suppository,Rectal:
Capsule,Oral:
Generic:10mg(12ea,50ea,100ea)
Strattera:10mg,18mg,25mg,40mg,60mg,80mg
TabletDelayedRelease,Oral:
Generic:10mg,18mg,25mg,40mg,60mg,80mg
Ducodyl:5mg
AtorvaSTATin
BismuthSubsalicylate
OutpatientFormularyBrandsAvailableLipitor
OutpatientDosageForms OutpatientFormularyBrandsAvailablePepticRelief[OTC]
Tablet,Oral: OutpatientDosageForms
Lipitor:10mg[BCF],20mg[BCF],40mg[BCF],80mg[BCF] TabletChewable,Oral,assubsalicylate:
Generic:10mg[BCF],20mg[BCF],40mg[BCF],80mg[BCF] PepticRelief:262mg
Generic:262mg
AtovaquoneandProguanil
OutpatientFormularyBrandsAvailableMalarone Brimonidine(Ophthalmic)
OutpatientDosageForms OutpatientFormularyBrandsAvailableAlphaganP
Tablet,Oral: OutpatientDosageForms
Malarone:Atovaquone250mgandproguanilhydrochloride100mg Solution,Ophthalmic,astartrate:
Generic:Atovaquone250mgandproguanilhydrochloride100mg AlphaganP:0.1%(10mL);0.15%(5mL)[containsPurite]
Atropine(Ophthalmic) Generic:0.15%(5mL)[BCF];0.2%(5mL)[BCF]
OutpatientDosageForms Budesonide(OralInhalation)
Solution,Ophthalmic,assulfate[drops]:
OutpatientDosageForms
Generic:1%(15mL)
Suspension,Inhalation:
Azelastine(Nasal) Generic:0.25mg/2mL(2mL);0.5mg/2mL(2mL)
OutpatientDosageForms
BuPROPion
Solution,Nasal,ashydrochloride:
Generic:0.1%[137mcg/spray](30mL) OutpatientDosageForms
Tablet,Oral,ashydrochloride:
Azithromycin(Systemic) Generic:75mg[BCF]
OutpatientFormularyBrandsAvailableZithromax TabletExtendedRelease12Hour,Oral,ashydrochloride:
OutpatientDosageForms Generic:100mg[BCF]
Packet,Oral: TabletExtendedRelease24Hour,Oral,ashydrochloride:
Zithromax:1g(3ea)[cherry-bananaflavor][BCF] Generic:300mg[BCF]
Generic:1g(3ea)[BCF]
SuspensionReconstituted,Oral: BusPIRone
Zithromax:100mg/5mL(15mL)[cherry-vanilla-bananaflavor][BCF] OutpatientDosageForms
Zithromax:200mg/5mL(15mL)[cherryflavor] Tablet,Oral,ashydrochloride:
Generic:100mg/5mL(15mL)[BCF];200mg/5mL(15mL) Generic:5mg[BCF],15mg[BCF]
Tablet,Oral:
Generic:500mg[BCF] Butalbital,Acetaminophen,andCaffeine
OutpatientDosageForms
BacitracinandPolymyxinB(Ophthalmic)
Tablet,Oral:
OutpatientDosageForms
Generic:Butalbital50mg,acetaminophen325mg,andcaffeine40mg[BCF]
Ointment,Ophthalmic:
Generic:Bacitracin500unitsandpolymyxinB10,000unitsperg(3.5g) Calcipotriene
Bacitracin,Neomycin,andPolymyxinB(Ophthalmic) OutpatientDosageForms
OutpatientDosageForms Ointment,External:
Ointment,Ophthalmic: Generic:0.005%(60g)
Generic:Bacitracin400units,neomycin3.5mg,andpolymyxinB10,000units Calcitriol(Systemic)
perg(3.5g)[BCF]
OutpatientDosageForms
Benzocaine Capsule,Oral:
OutpatientFormularyBrandsAvailableCepacolSoreThroat[OTC] Generic:0.25mcg
3
CALCIUMANDVITAMIND
CalciumandVitaminD Ciclopirox
OutpatientDosageForms OutpatientDosageForms
Tablet,Oral: Solution,External:
Generic: Calcium 500mg and vitamin D 200 units; Calcium 600mg and Generic:8%(6.6mL)
vitaminD200int.units
CiprofloxacinandDexamethasone
Tablet,Chewable,Oral:
Generic:Calcium500mgandvitaminD400int.units;calcium600mgand OutpatientFormularyBrandsAvailableCiprodex
vitaminD400int.units OutpatientDosageForms
Suspension,Otic:
Capsaicin Ciprodex: Ciprofloxacin 0.3% and dexamethasone 0.1% (7.5 mL) [contains
OutpatientDosageForms benzalkoniumchloride]
Cream,External:
Ciprofloxacin(Systemic)
Generic:0.025%(60g)
OutpatientDosageForms
Captopril Tablet,Oral,ashydrochloride[strengthexpressedasbase]:
OutpatientDosageForms Generic:500mg[BCF]
Tablet,Oral:
Citalopram
Generic:50mg[BCF]
OutpatientDosageForms
CarbidopaandLevodopa Tablet,Oral:
OutpatientDosageForms Generic:10mg[BCF],20mg[BCF],40mg[BCF]
Tablet,Oral:
Clarithromycin
Generic:
OutpatientDosageForms
25/100:Carbidopa25mgandlevodopa100mg[BCF]
Tablet,Oral:
25/250:Carbidopa25mgandlevodopa250mg[BCF]
Generic:500mg
TabletExtendedRelease,Oral:
Generic:25/100:Carbidopa25mgandlevodopa100mg ClindamycinandBenzoylPeroxide
Carboxymethylcellulose OutpatientDosageForms
OutpatientFormularyBrandsAvailableRefreshCelluvisc[OTC];Refresh Gel,External:
Generic:Clindamycinphosphate1.2%andbenzoylperoxide5%(50g)
Plus[OTC]
OutpatientDosageForms Clindamycin(Systemic)
Solution,Ophthalmic,assodium[preservativefree]: OutpatientDosageForms
RefreshCelluvisc:1%(0.4mL)[30/box] Capsule,Oral,ashydrochloride[strengthexpressedasbase]:
RefreshPlus:0.5%(0.4mL)[30/box] Generic:150mg[BCF],300mg
Carvedilol Clindamycin(Topical)
OutpatientDosageForms OutpatientDosageForms
Tablet,Oral: Solution,External,asphosphate[strengthexpressedasbase]:
Generic:3.125mg[BCF],6.25mg[BCF],12.5mg[BCF],25mg[BCF] Generic:1%(60mL)[BCF]
Cefdinir Clobetasol
OutpatientDosageForms OutpatientDosageForms
Capsule,Oral: Cream,External,aspropionate:
Generic:300mg Generic:0.05%(15g,30g)
SuspensionReconstituted,Oral: Foam,External:
Generic:125mg/5mL(100mL);250mg/5mL(100mL) Generic:0.05%(100g)
Ointment,External,aspropionate:
Cefprozil
Generic:0.05%(15g,30g)
OutpatientDosageForms
Shampoo,External,aspropionate:
SuspensionReconstituted,Oral: Generic:0.05%(118mL)
Generic:125mg/5mL(100mL)
ClomiPHENE
Cefuroxime
OutpatientDosageForms
OutpatientDosageForms Tablet,Oral,ascitrate:
Tablet,Oral,asaxetil[strengthexpressedasbase]: Generic:50mg
Generic:250mg,500mg
ClonazePAM
Celecoxib
OutpatientDosageForms
OutpatientFormularyBrandsAvailableCeleBREX Tablet,Oral:
OutpatientDosageForms Generic:0.5mg[BCF],1mg
Capsule,Oral:
CeleBREX:100mg,200mg CloNIDine
Generic:100mg,200mg OutpatientFormularyBrandsAvailableCatapres-TTS-1
OutpatientDosageForms
Cephalexin
Tablet,Oral,ashydrochloride:
OutpatientDosageForms Generic:0.1mg[BCF],0.2mg[BCF]
Capsule,Oral:
Generic:250mg[BCF],500mg[BCF] Clopidogrel
SuspensionReconstituted,Oral: OutpatientFormularyBrandsAvailablePlavix
Generic:250mg/5mL(200mL)[BCF] OutpatientDosageForms
Tablet,Oral:
Cetirizine(Systemic)
Plavix:75mg[BCF]
OutpatientDosageForms Generic:75mg[BCF]
Syrup,Oral,ashydrochloride:
Generic:5mg/5mL(120mL) Clotrimazole(Oral)
Tablet,Oral,ashydrochloride: OutpatientDosageForms
Generic:10mg Troche,Mouth/Throat:
Generic:10mg
ChlorhexidineGluconate(Oral)
OutpatientDosageForms Clotrimazole(Topical)
Solution,Mouth/Throat: OutpatientDosageForms
Generic:0.12%(473mL)[BCF] Cream,External:
Generic:1%(15g,30g,45g)
Chlorthalidone Cream,Vaginal:
OutpatientDosageForms Generic:1%(45g)
Tablet,Oral: Solution,External:
Generic:25mg[BCF],50mg[BCF] Generic:1%(10mL,30mL)
4
DOCUSATE
Colchicine Tablet,Oral:
OutpatientDosageForms Generic:
Tablet,Oral: 5mg[dextroamphetaminesulfate1.25mg,dextroamphetaminesaccharate
1.25mg, amphetamine aspartate monohydrate 1.25mg, amphetamine
Colcrys:0.6mg
sulfate1.25mg(equivalenttoamphetaminebase3.13mg)]
Generic:0.6mg
10mg[dextroamphetaminesulfate2.5mg,dextroamphetaminesaccharate
Colestipol 2.5mg, amphetamine aspartate monohydrate 2.5mg, amphetamine sul-
OutpatientFormularyBrandsAvailableColestid fate2.5mg(equivalenttoamphetaminebase6.3mg)]
OutpatientDosageForms DiabeticSupplies
Packet,Oral,ashydrochloride: OutpatientFormularyBrandsAvailableBDSyringe;FreeStyleLite
Colestid:5g(30ea)[unflavoredflavor] OutpatientDosageForms
Generic:5g(30ea) Lancet:100/box
Tablet,Oral,ashydrochloride: Syringeandneedle:
Colestid:1g BDInsulinSyringe(Ultra-Fine)30gaugex1/2"(0.3mL)
Generic:1g BDSyringe0.5mL(Ultra-FineII)31gaugex5/16"[BCF]
Cyanocobalamin BDSyringe1mL(Ultra-FineII)31gaugex5/16"[BCF]
BDSyringe0.5mL(Ultra-Fine)30gauge[100/box]
OutpatientDosageForms
BDUltra-FineShortPenNeedle31gaugeX5mm[100/box]
Solution,Injection: BDUltra-FineShortPenNeedle31gaugeX8mm[100/box]
Generic:1000mcg/mL(1mL) TestStrips:
Tablet,Oral: FreeStyleLite[50/box]
Generic:1000mcg
DiazePAM
Cyclobenzaprine
OutpatientDosageForms
OutpatientDosageForms Tablet,Oral:
Tablet,Oral,ashydrochloride: Generic:5mg[BCF]
Generic:5mg,10mg[BCF]
Diclofenac(Ophthalmic)
CycloSPORINE(Ophthalmic) OutpatientDosageForms
OutpatientFormularyBrandsAvailableRestasis Solution,Ophthalmic,assodium:
OutpatientDosageForms Generic:0.1%(2.5mL)
Emulsion,Ophthalmic[preservativefree]:
Diclofenac(Systemic)
Restasis:0.05%(0.4mL)[containscastoroil]
OutpatientDosageForms
Cyproheptadine TabletDelayedRelease,Oral,assodium:
OutpatientDosageForms Generic:50mg,75mg
Tablet,Oral,ashydrochloride:
Diclofenac(Topical)
Generic:4mg[BCF]
OutpatientFormularyBrandsAvailableVoltaren
Desipramine OutpatientDosageForms
OutpatientDosageForms Gel,Transdermal,assodium:
Tablet,Oral,ashydrochloride: Voltaren:1%(100g)[containsisopropylalcohol,propyleneglycol]
Generic:25mg,50mg Dicloxacillin
Desmopressin OutpatientDosageForms
OutpatientFormularyBrandsAvailableDDAVP Capsule,Oral:
Generic:250mg[BCF]
OutpatientDosageForms
Tablet,Oral,asacetate: Dicyclomine
DDAVP:0.1mg,0.2mg[scored] OutpatientDosageForms
Generic:0.1mg,0.2mg Capsule,Oral,ashydrochloride:
Desonide Generic:10mg[BCF]
Tablet,Oral,ashydrochloride:
OutpatientDosageForms
Generic:20mg[BCF]
Cream,External:
Generic:0.05%(60g) Difluprednate
OutpatientFormularyBrandsAvailableDurezol
DexAMETHasone(Systemic)
OutpatientDosageForms
OutpatientDosageForms
Emulsion,Ophthalmic:
Tablet,Oral: Durezol:0.05%(5mL)[containssorbicacid]
Generic:4mg
Digoxin
Dexmethylphenidate
OutpatientFormularyBrandsAvailableLanoxin
OutpatientDosageForms OutpatientDosageForms
Tablet,Oral,ashydrochloride: Tablet,Oral:
Generic:5mg Lanoxin:125mcg[BCF],250mcg[BCF][scored]
DextroamphetamineandAmphetamine DilTIAZem
OutpatientFormularyBrandsAvailableAdderallXR OutpatientFormularyBrandsAvailableTiazac
OutpatientDosageForms OutpatientDosageForms
Capsule,ExtendedRelease,Oral: CapsuleExtendedRelease24Hour,Oral,ashydrochloride:
AdderallXR Tiazac: 120mg [BCF], 180mg [BCF], 240mg [BCF], 300mg [BCF],
5mg[dextroamphetaminesulfate1.25mg,dextroamphetaminesaccharate 360mg[BCF]
1.25mg,amphetamineaspartatemonohydrate1.25mg,amphetaminesul- Generic: 120mg [BCF], 180mg [BCF], 240mg [BCF], 300mg [BCF],
fate1.25mg(equivalenttoamphetaminebase3.1mg)][BCF] 360mg[BCF]
10mg[dextroamphetaminesulfate2.5mg,dextroamphetaminesaccharate
DiphenhydrAMINE(Systemic)
2.5mg, amphetamine aspartate monohydrate 2.5mg, amphetamine sul-
OutpatientDosageForms
fate2.5mg(equivalenttoamphetaminebase6.3mg)][BCF]
15mg [dextroamphetamine sulfate 3.75mg, dextroamphetamine saccha- Capsule,Oral,ashydrochloride:
Generic:25mg
rate 3.75mg, amphetamine aspartate monohydrate 3.75mg, amphet-
aminesulfate3.75mg(equivalenttoamphetaminebase9.4mg)][BCF] Dipyridamole
20mg [dextroamphetamine sulfate 5mg, dextroamphetamine saccharate OutpatientDosageForms
5mg, amphetamine aspartate monohydrate 5mg, amphetamine sulfate Tablet,Oral:
5mg(equivalenttoamphetaminebase12.5mg)][BCF] Generic:25mg
30mg[dextroamphetaminesulfate7.5mg,dextroamphetaminesaccharate
7.5mg, amphetamine aspartate monohydrate 7.5mg, amphetamine sul- Docusate
fate7.5mg(equivalenttoamphetaminebase18.8mg)][BCF] OutpatientFormularyBrandsAvailableColace[OTC]
5
DOCUSATE
OutpatientDosageForms Esomeprazole
Capsule,Oral,assodium: OutpatientDosageForms
Colace:100mg[containsfd&cred#40,fd&cyellow#6(sunsetyellow)] CapsuleDelayedRelease,Oral,asmagnesium[strengthexpressedasbase]:
Generic:20mg,40mg
Donepezil
OutpatientFormularyBrandsAvailableAricept Estradiol(Systemic)
OutpatientDosageForms OutpatientDosageForms
Tablet,Oral,ashydrochloride: PatchWeekly,Transdermal:
Aricept:5mg,10mg Generic:0.025mg/24hours(4ea)[BCF];0.0375mg/24hours(4ea)[BCF];
Generic:5mg,10mg 0.05mg/24hours(4ea)[BCF];0.1mg/24hours(4ea)[BCF]
Tablet,Oral:
DorzolamideandTimolol
Generic:1mg,2mg
OutpatientDosageForms
Solution,Ophthalmic: Estradiol(Topical)
Generic: Dorzolamide hydrochloride 2% [strength expressed as base] and OutpatientFormularyBrandsAvailableEstrace
timololmaleate0.5%[strengthexpressedasbase](10mL) OutpatientDosageForms
Doxazosin Cream,Vaginal:
Estrace:0.1mg/g(42.5g)
OutpatientDosageForms
Generic:0.1mg/g(42.5g)
Tablet,Oral:
Generic:1mg,2mg,4mg,8mg Estrogens(Conjugated/Equine)andMedroxyprogesterone
Doxepin(Systemic) OutpatientFormularyBrandsAvailablePrempro
OutpatientDosageForms
OutpatientDosageForms
Tablet,Oral:
Capsule,Oral:
Prempro: 0.3/1.5: Conjugated estrogens 0.3mg and medroxyprogesterone
Generic:10mg[BCF],25mg[BCF]
acetate1.5mg[BCF]
Doxycycline Prempro:0.45/1.5:Conjugatedestrogens0.45mgandmedroxyprogesterone
OutpatientDosageForms acetate1.5mg[BCF]
Tablet,Oral,ashyclate[strengthexpressedasbase]: Prempro:0.625/2.5:Conjugatedestrogens0.625mgandmedroxyprogester-
Generic:100mg[BCF] oneacetate2.5mg[BCF]
Prempro:0.625/5:Conjugatedestrogens0.625mgandmedroxyprogesterone
Eletriptan acetate5mg[BCF]
OutpatientFormularyBrandsAvailableRelpax
Estrogens(Conjugated/Equine,Systemic)
OutpatientDosageForms
OutpatientFormularyBrandsAvailablePremarin
Tablet,Oral:
OutpatientDosageForms
Relpax:20mg,40mg
Generic:20mg,40mg Tablet,Oral:
Premarin: 0.3mg [BCF], 0.45mg [BCF], 0.625mg [BCF], 0.9mg,
Emollients 1.25mg[BCF]
Outpatient Formulary Brands Available Dermabase [OTC]; Hydrocerin
Estrogens(Conjugated/Equine,Topical)
[OTC]
OutpatientDosageForms OutpatientFormularyBrandsAvailablePremarin
Cream,External: OutpatientDosageForms
Dermabase:454g Cream,Vaginal:
Hydrocerin:454g Premarin:0.625mg/g(30g)[BCF]
Enoxaparin Eszopiclone
OutpatientFormularyBrandsAvailableLovenox OutpatientDosageForms
OutpatientDosageForms Tablet,Oral:
Solution,Subcutaneous,assodium[preservativefree]: Generic:2mg,3mg
Lovenox: 30mg/0.3 mL (0.3 mL) [BCF]; 40mg/0.4 mL (0.4 mL) [BCF]; EthinylEstradiolandDesogestrel
60mg/0.6mL(0.6mL)[BCF];80mg/0.8mL(0.8mL)[BCF];100mg/mL
OutpatientFormularyBrandsAvailableOrtho-Cept
(1mL)[BCF][prefilledsyringe]
OutpatientDosageForms
Generic:30mg/0.3mL(0.3mL)[BCF];40mg/0.4mL(0.4mL)[BCF];60mg/
Tablet,Oral:
0.6mL(0.6mL)[BCF];80mg/0.8mL(0.8mL)[BCF];100mg/mL(1mL)
Ortho-Cept28:Ethinylestradiol0.03mganddesogestrel0.15mg(28s)[21
[BCF];150mg/mL(1mL)[BCF]
lightorangetabletsand7greeninactivetablets]
EPINEPHrine(Systemic)
EthinylEstradiolandDrospirenone
OutpatientFormularyBrandsAvailableEpiPen2-Pak;EpiPenJr2-Pak
OutpatientFormularyBrandsAvailableYasmin;Yaz
OutpatientDosageForms
OutpatientDosageForms
SolutionAuto-injector,Injection:
EpiPen2-Pak:0.3mg/0.3mL(2mL)[containssodiummetabisulfite;1:1000 Tablet,Oral:
solution;delivers0.3mgperinjection] Yasmin:Ethinylestradiol0.03mganddrospirenone3mg[21yellowactive
EpiPen Jr 2-Pak: 0.15mg/0.3 mL (2 mL) [contains sodium metabisulfite; tabletsand7whiteinactivetablets](28s)[BCF]
1:2000solution;delivers0.15mgperinjection] Yaz:Ethinylestradiol0.02mganddrospirenone3mg[24lightpinktablets
Generic:0.15mg/0.3mL(1ea);0.15mg/0.15mL(1ea[DSC],2ea);0.3mg/ and4whiteinactivetablets](28s)[BCF]
0.3mL(1ea) EthinylEstradiolandEthynodiolDiacetate
Erythromycin(Ophthalmic) OutpatientFormularyBrandsAvailableZovia1/35
OutpatientDosageForms OutpatientDosageForms
Ointment,Ophthalmic: Tablet,Oral:
Generic:5mg/g(3.5g)[BCF] Zovia1/35:Ethinylestradiol0.035mgandethynodioldiacetate1mg[21light
pinktabletsand7whiteinactivetablets]
Erythromycin(Systemic)
EthinylEstradiolandEtonogestrel
OutpatientFormularyBrandsAvailableE.E.S.
OutpatientDosageForms OutpatientFormularyBrandsAvailableNuvaRing
Tablet,Oral,asethylsuccinate: OutpatientDosageForms
E.E.S.400:400mg[containsfd&cred#40,fd&cyellow#10(quinolineyellow)] Ring,Vaginal:
Generic:400mg NuvaRing:Ethinylestradiol0.015mgandetonogestrel0.12mgper24hours
(1ea)[latexfree]
Erythromycin(Topical)
EthinylEstradiolandLevonorgestrel
OutpatientDosageForms
Solution,External: OutpatientFormularyBrandsAvailableLessina;Levora;Trivora
Generic:2%(60mL)[BCF] OutpatientDosageForms
Tablet,Oral:
Escitalopram Lessina:Ethinylestradiol0.02mgandlevonorgestrel0.1mg[21pinktablets
OutpatientDosageForms and7whiteinactivetablets](28s)[BCF]
Tablet,Oral: Levora:Ethinylestradiol0.03mgandlevonorgestrel0.15mg[21whitetablets
Generic:5mg,10mg,20mg and7peachinactivetablets](28s)[BCF]
6
FLUTICASONEANDSALMETEROL
Trivora: FenofibrateandDerivatives
Day 1-6: Ethinyl estradiol 0.03mg and levonorgestrel 0.05mg [6 blue OutpatientFormularyBrandsAvailableTriCor
tablets] OutpatientDosageForms
Day 7-11: Ethinyl estradiol 0.04mg and levonorgestrel 0.075mg [5 white Tablet,Oral,asfenofibrate:
tablets] TriCor:48mg[BCF],145mg[BCF][containssoybeanlecithin]
Day12-21:Ethinylestradiol0.03mgandlevonorgestrel0.125mg[10pink Generic:54mg,160mg
tablets]
Day22-28:7peachinactivetablets(28s) FerrousSulfate
Generic:Ethinylestradiol0.03mgandlevonorgestrel0.15mg[84tablets]and OutpatientDosageForms
ethinylestradiol0.01mg[7tablets](91s) Liquid,Oral:
Generic:75mg/mL(50mL)[elementaliron15mg/mL]
EthinylEstradiolandNorelgestromin Tablet,Oral:
OutpatientFormularyBrandsAvailableOrthoEvra Generic:325mg[elementaliron65mg]
OutpatientDosageForms
Fexofenadine
PatchWeekly,Transdermal:
OrthoEvra:Ethinylestradiol0.75mgandnorelgestromin6mg(3s)[releases OutpatientDosageForms
ethinylestradiol20mcgandnorelgestromin150mcgperday] Tablet,Oral,ashydrochloride:
Generic:30mg,60mg,180mg
EthinylEstradiolandNorethindrone
FexofenadineandPseudoephedrine
OutpatientFormularyBrandsAvailableLoLoestrinFe;LoestrinFe1.5/30;
OutpatientFormularyBrandsAvailableAllegra-D12Hour[OTC]
LoestrinFe1/20;Norinyl1+35
OutpatientDosageForms
OutpatientDosageForms
Tablet,ExtendedRelease,Oral:
Tablet,Oral:
Allegra-D 12 Hour: Fexofenadine hydrochloride 60mg [immediate release]
LoestrinFe1/20:Ethinylestradiol0.02mgandnorethindroneacetate1mg
andpseudoephedrinehydrochloride120mg[extendedrelease]
[21tablets]andferrousfumarate75mg[7tablets][DSC]
Generic: Fexofenadine hydrochloride 60mg [immediate release] and pseu-
Loestrin Fe 1.5/30: Ethinyl estradiol 0.03mg and norethindrone acetate
doephedrinehydrochloride120mg[extendedrelease]
1.5mg [21 tablets] and ferrous fumarate 75mg [7 tablets] [contains fd&c
red#40aluminumlake] Finasteride
Norinyl 1+35:Ethinyl estradiol 0.035mg andnorethindrone 1mg (28s)[21 OutpatientDosageForms
yellow-greentabletsand7orangeinactivetablets][BCF] Tablet,Oral:
Generic:Ethinylestradiol0.02mgandnorethindroneacetate1mg[21tablets] Generic:5mg[BCF]
andferrousfumarate75mg[7tablets]
Flecainide
EthinylEstradiolandNorgestimate OutpatientDosageForms
OutpatientFormularyBrandsAvailableMonoNessa;OrthoTri-CyclenLo; Tablet,Oral,asacetate:
Ortho-Cyclen;Sprintec;TriNessa Generic:50mg,100mg,150mg
OutpatientDosageForms
Fluconazole
Tablet,Oral:
MonoNessa:Ethinylestradiol0.035mgandnorgestimate0.25mg[21blue OutpatientDosageForms
tabletsand7greeninactivetablets][BCF] Tablet,Oral:
Ortho-Cyclen:Ethinylestradiol0.035mgandnorgestimate0.25mg(28s)[21 Generic:150mg[BCF]
bluetabletsand7greeninactivetablets] Fluocinolone(Topical)
OrthoTri-CyclenLo[BCF]:
OutpatientDosageForms
Day 1-7: Ethinyl estradiol 0.025mg and norgestimate 0.18mg [7 white
Solution,External,asacetonide:
tablets]
Generic:0.01%(60mL)
Day8-14:Ethinylestradiol0.025mgandnorgestimate0.215mg[7lightblue
tablets] Fluocinonide
Day 15-21: Ethinyl estradiol 0.025mg and norgestimate 0.25mg [7 dark OutpatientDosageForms
bluetablets] Cream,External:
Day22-28:7darkgreeninactivetablets Generic:0.05%(15g,30g,60g)[BCF]
Sprintec: Ethinyl estradiol 0.035mg and norgestimate 0.25mg [21 blue Gel,External:
tabletsand7whiteinactivetablets][BCF] Generic:0.05%(15g)
TriNessa[BCF]: Ointment,External:
Day 1-7: Ethinyl estradiol 0.035mg and norgestimate 0.18mg [7 white Generic:0.05%(15g,60g)
tablets]
Fluoride
Day8-14:Ethinylestradiol0.035mgandnorgestimate0.215mg[7lightblue
tablets] Outpatient Formulary Brands Available Gel-Kam[OTC];PreviDent 5000
Day 15-21: Ethinyl estradiol 0.035mg and norgestimate 0.25mg [7 blue Plus
tablets] OutpatientDosageForms
Day22-28:7greeninactivetablets Cream,Oral,assodium[toothpaste]:
PreviDent 5000 Plus: 1.1% (51g) [contains sodium benzoate; spearmint
EthinylEstradiolandNorgestrel flavor;equivalenttofluoride2.5mg/dose]
OutpatientFormularyBrandsAvailableLo/Ovral-28;Low-Ogestrel Gel,Topical,asstannousflouride:
OutpatientDosageForms Gel-Kam:0.4%(129g)[mintflavor]
Tablet,Oral: Solution,Oral,assodium[drops]:
Generic:1.1mg/mL(50mL)[equivalenttofluoride0.5mg/mL]
Lo/Ovral-28:Ethinylestradiol0.03mgandnorgestrel0.3mg[21whitetablets
and7pinkinactivetablets](28s) Fluorometholone
Low-Ogestrel: Ethinyl estradiol 0.03mg and norgestrel 0.3mg [21 white OutpatientDosageForms
tabletsand7peachinactivetablets]
Suspension,Ophthalmic,asbase:
Exenatide Generic:0.1%(5mL)
OutpatientFormularyBrandsAvailableBydureonBCise FLUoxetine
OutpatientDosageForms OutpatientDosageForms
Auto-injector,Subcutaneous: Capsule,Oral:
BydureonBCise:2mg/0.85mL(0.85mL) Generic:10mg[BCF],20mg[BCF],40mg[BCF]
Solution,Oral:
Ezetimibe
Generic:20mg/5mL(5mL,120mL)[BCF]
OutpatientFormularyBrandsAvailableZetia
OutpatientDosageForms FluticasoneandSalmeterol
Tablet,Oral: OutpatientFormularyBrandsAvailableAdvairDiskus;AdvairHFA
Zetia:10mg OutpatientDosageForms
Generic:10mg Aerosol,forOralInhalation:
AdvairHFA:
Felodipine 45/21:Fluticasonepropionate45mcgandsalmeterol21mcgperinhalation
OutpatientDosageForms (12g)[chlorofluorocarbonfree;120meteredactuations][BCF]
TabletExtendedRelease24Hour,Oral: 115/21:Fluticasonepropionate115mcgandsalmeterol21mcgperinhala-
Generic:2.5mg,5mg,10mg tion(12g)[chlorofluorocarbonfree;120meteredactuations][BCF]
7
FLUTICASONEANDSALMETEROL
230/21:Fluticasonepropionate230mcgandsalmeterol21mcgperinhala- Glycerin
tion(12g)[chlorofluorocarbonfree;120meteredactuations][BCF] OutpatientDosageForms
Powder,forOralInhalation: Suppository,Rectal[pediatric]:
AdvairDiskus: Generic:82.5%(12s)
100/50:Fluticasonepropionate100mcgandsalmeterol50mcg(14s,60s)
[containslactose][BCF] Griseofulvin
250/50:Fluticasonepropionate250mcgandsalmeterol50mcg(14s,60s) OutpatientFormularyBrandsAvailableGris-PEG
[containslactose][BCF] OutpatientDosageForms
500/50:Fluticasonepropionate500mcgandsalmeterol50mcg(14s,60s) Suspension,Oral:
[containslactose][BCF] Generic:125mg/5mL(120mL)[BCF]
Tablet,Oral:
Fluticasone(Nasal)
Gris-PEG:125mg[BCF],250mg[BCF][scored]
OutpatientDosageForms
Generic:250mg[BCF]
Suspension,Nasal,aspropionate:
Flonase: 50 mcg/inhalation (16g) [contains benzalkonium chloride; 120 GuaiFENesin
meteredactuations][BCF] OutpatientFormularyBrandsAvailableMucinex[OTC]
Generic:50mcg/inhalation(16g)[BCF] OutpatientDosageForms
Syrup,Oral:
Fluticasone(OralInhalation)
Generic:100mg/5mL(118mL)
OutpatientFormularyBrandsAvailableFloventDiskus;FloventHFA
TabletExtendedRelease12Hour,Oral:
OutpatientDosageForms Mucinex:600mg
Aerosol,Inhalation,aspropionate:
FloventHFA:44mcg/actuation(10.6g)[BCF] GuaifenesinandCodeine
FloventHFA:110mcg/actuation(12g)[BCF] OutpatientDosageForms
FloventHFA:220mcg/actuation(12g)[BCF] Solution,Oral:
AerosolPowderBreathActivated,Inhalation,aspropionate: Generic: Guaifenesin 100mg and codeine phosphate 10mg per 5 mL
FloventDiskus:50mcg/blister(60s)[containslactose][BCF] (118mL)
FloventDiskus:100mcg/blister(60s)[containslactose][BCF]
FloventDiskus:250mcg/blister(60s)[containslactose][BCF] GuaifenesinandDextromethorphan
OutpatientFormularyBrandsAvailableMucinexDM[OTC]
FolicAcid
OutpatientDosageForms
OutpatientDosageForms Syrup,Oral:
Tablet,Oral: Generic:Guaifenesin100mganddextromethorphanhydrobromide10mgper
Generic:1mg[BCF] 5mL(118mL)
Tablet,ExtendedRelease,Oral:
Furosemide
Mucinex DM: Guaifenesin 600mg and dextromethorphan hydrobro-
OutpatientDosageForms
mide30mg
Solution,Oral:
Generic:10mg/mL(60mL,120mL)[BCF] GuaifenesinandPseudoephedrine
Tablet,Oral: OutpatientFormularyBrandsAvailableMucinexD[OTC]
Generic:20mg[BCF],40mg[BCF],80mg OutpatientDosageForms
TabletExtendedRelease12Hour,Oral:
Gabapentin
MucinexD:Guaifenesin600mgandpseudoephedrinehydrochloride60mg
OutpatientDosageForms
Generic:Guaifenesin600mgandpseudoephedrinehydrochloride60mg
Capsule,Oral:
Generic:100mg[BCF],300mg[BCF],400mg[BCF] GuanFACINE
Tablet,Oral: OutpatientDosageForms
Generic:600mg[BCF],800mg[BCF] TabletExtendedRelease24Hour,Oral:
Generic:1mg,2mg,3mg
Gemfibrozil
OutpatientDosageForms HydrALAZINE
Tablet,Oral: OutpatientDosageForms
Generic:600mg[BCF] Tablet,Oral,ashydrochloride:
Generic:10mg[BCF],25mg[BCF],50mg[BCF]
Gentamicin(Ophthalmic)
OutpatientFormularyBrandsAvailableGaramycin;Gentak HydroCHLOROthiazide
OutpatientDosageForms OutpatientDosageForms
Ointment,Ophthalmic: Capsule,Oral:
Gentak:0.3%(3.5g)[BCF] Generic:12.5mg[BCF]
Ointment,Ophthalmic[preservativefree]: Tablet,Oral:
Garamycin:0.3%(3.5g)[BCF] Generic:25mg[BCF],50mg[BCF]
Solution,Ophthalmic[drops]:
Generic:0.3%(5mL)[BCF] HydrochlorothiazideandTriamterene
OutpatientDosageForms
Glimepiride
Tablet,Oral:
OutpatientDosageForms Generic:
Tablet,Oral: Hydrochlorothiazide25mgandtriamterene37.5mg[BCF]
Generic:2mg Hydrochlorothiazide50mgandtriamterene75mg[BCF]
GlipiZIDE HydrocodoneandAcetaminophen
OutpatientFormularyBrandsAvailableGlucotrolXL OutpatientDosageForms
OutpatientDosageForms Tablet,Oral:
Tablet,Oral: Generic:
Generic:5mg[BCF],10mg[BCF] Hydrocodonebitartrate5mgandacetaminophen325mg
TabletExtendedRelease24Hour,Oral: Hydrocodonebitartrate7.5mgandacetaminophen325mg
GlucotrolXL:2.5mg,5mg,10mg Hydrocodonebitartrate10mgandacetaminophen325mg
Generic:2.5mg,5mg,10mg
HydrocodoneandChlorpheniramine
Glucagon OutpatientDosageForms
OutpatientFormularyBrandsAvailableGlucagonEmergency Suspension,ExtendedRelease,Oral:
OutpatientDosageForms Generic:Hydrocodonepolistirex[equivalenttohydrocodonebitartrate10mg]
Kit,Injection: and chlorpheniramine polistirex [equivalent to chlorpheniramine maleate
GlucagonEmergency:1mg[containslactose] 8mg]per5mL(480mL)
GlyBURIDE Hydrocortisone(Topical)
OutpatientDosageForms OutpatientFormularyBrandsAvailableAnucort-HC;Proctozone-HC2.5%
Tablet,Oral: OutpatientDosageForms
Generic:2.5mg[BCF],5mg[BCF] Cream,External,asbase:
Tablet,Micronized,Oral: Proctozone-HC2.5%:2.5%(30g)[BCF]
Generic:3mg[BCF],5mg[BCF] Generic:1%(30g),2.5%(30g)
8
ISOSORBIDEDINITRATE
Cream,External,asvalerate: OutpatientDosageForms
Generic:0.2%(15g,45g) Suspension,Subcutaneous:
Ointment,External,asbase: NovoLOGMix70/30:Insulinaspartprotaminesuspension70%[intermediate
Generic:1%(30g) acting]andinsulinaspartsolution30%[rapid-acting]:100units/mL(10mL)
Ointment,External,asvalerate: NovoLOGMix70/30FlexPen:100units/mL:Insulinaspartprotaminesuspen-
Generic:0.2%(15g) sion70%[intermediateacting]andinsulinaspartsolution30%[rapid-acting]
Suppository,Rectal,asacetate: (3mL)[BCF]
Anucort-HC:25mg(12s)[BCF]
Generic:25mg(12s)[BCF] InsulinGlargine
OutpatientFormularyBrandsAvailableLantus;LantusSoloStar
Hydroxychloroquine
OutpatientDosageForms
OutpatientDosageForms
Solution,Subcutaneous:
Tablet,Oral,assulfate:
Lantus:100units/mL(10mL)[containsmetacresol][BCF]
Generic:200mg[equivalentto155mgbase]
SolutionPen-injector,Subcutaneous:
HydrOXYzine LantusSolostar:100units/mL(3mL)[BCF]
OutpatientDosageForms InsulinNPH
Capsule,Oral,aspamoate:
OutpatientFormularyBrandsAvailableNovoLINN
Generic:25mg,50mg
OutpatientDosageForms
Solution,Oral,ashydrochloride:
Generic:10mg/5mL(473mL)[BCF] Suspension,Subcutaneous:
Syrup,Oral,ashydrochloride: NovoLINN:100units/mL(10mL)[containsmetacresol,phenol][BCF]
Generic:10mg/5mL(118mL,473mL)[BCF] InsulinNPHandInsulinRegular
Tablet,Oral,ashydrochloride:
Generic:10mg[BCF],25mg[BCF],50mg[BCF] OutpatientFormularyBrandsAvailableHumuLIN70/30;NovoLIN70/30
OutpatientDosageForms
Hyoscyamine Suspension,Subcutaneous:
OutpatientDosageForms HumuLIN 70/30: 100 units/mL: Insulin NPH suspension 70% [intermediate
Tablet,Oral,assulfate: acting]andinsulinregularsolution30%[short-acting](3mL,10mL)
Generic:0.125mg NovoLIN70/30:InsulinNPHsuspension70%[intermediateacting]andinsulin
regularsolution 30%[short acting]:100units/mL(10 mL)[containsmeta-
Hyoscyamine,Atropine,Scopolamine,andPhenobarbital
cresol,phenol][BCF]
OutpatientFormularyBrandsAvailableDonnatal
OutpatientDosageForms InsulinRegular
Elixir,Oral: OutpatientFormularyBrandsAvailableNovoLINR
Donnatal:Hyoscyaminesulfate0.1037mg,atropinesulfate0.0194mg,sco- OutpatientDosageForms
polamine hydrobromide 0.0065mg, and phenobarbital 16.2mg per 5 mL Solution,Injection:
(118mL)[containsethanol<23.8%;grapeflavor] NovoLINR:100units/mL(10mL)[containsmetacresol][BCF]
Generic:Hyoscyaminesulfate0.1037mg,atropinesulfate0.0194mg,scopol-
amine hydrobromide 0.0065mg, and phenobarbital 16.2mg per 5 mL InterferonBeta-1b
(120mL) OutpatientFormularyBrandsAvailableBetaseron
OutpatientDosageForms
Ibandronate
Kit,Subcutaneous:
OutpatientDosageForms
Betaseron:0.3mg[containsalbuminhuman][BCF]
Tablet,Oral:
Generic:150mg IpratropiumandAlbuterol
Ibuprofen OutpatientFormularyBrandsAvailableCombivent
OutpatientDosageForms
OutpatientDosageForms
Solution,forNebulization:
Suspension,Oral:
DuoNeb:Ipratropiumbromide0.5mgandalbuterol(base)2.5mgper3mL
Generic:100mg/5mL(120mL)
Tablet,Oral: (30s,60s)[BCF]
Generic:400mg[BCF],600mg[BCF],800mg[BCF] Generic:Ipratropiumbromide0.5mgandalbuterol(base)2.5mgper3mL
(30s,60s)[BCF]
Imipramine Solution,forOralInhalation[spray]:
OutpatientDosageForms CombiventRespimat:Ipratropiumbromide20mcgandalbuterol(base)100
Capsule,Oral,aspamoate: mcgperinhalation(4g)[containsbenzalkoniumchloride][BCF]
Generic:75mg[BCF]
Ipratropium(Nasal)
Tablet,Oral,ashydrochloride:
Generic:10mg[BCF],50mg[BCF] OutpatientFormularyBrandsAvailableAtrovent
OutpatientDosageForms
Imiquimod Solution,Nasal,asbromide:
OutpatientDosageForms Atrovent:0.06%(15mL[DSC])
Cream,External: Generic:0.03%(30mL);0.06%(15mL)
Generic:5%(24ea)[0.25g/packet]
Ipratropium(OralInhalation)
Indomethacin
OutpatientFormularyBrandsAvailableAtroventHFA
OutpatientDosageForms OutpatientDosageForms
Capsule,Oral: AerosolSolution,Inhalation,asbromide:
Generic:25mg[BCF],50mg[BCF]
AtroventHFA:17mcg/actuation(12.9g)[containsalcohol,usp][BCF]
InhalationDevices Solution,Inhalation,asbromide:
Outpatient Formulary Brands Available AeroChamber; OptiChamber; Generic:0.02%(2.5mL)[BCF]
OptiHaler Isoniazid
OutpatientDosageForms
OutpatientDosageForms
Holdingchamberwithmask:
Solution,Oral:
Adult
Generic:50mg/5mL(473mL)
Pediatric:Small,medium,large
Tablet,Oral:
InsulinAspart Generic:100mg[BCF]
OutpatientFormularyBrandsAvailableNovoLOG;NovoLOGFlexPen IsosorbideDinitrate
OutpatientDosageForms
OutpatientFormularyBrandsAvailableDilatrate-SR
Solution,Subcutaneous:
OutpatientDosageForms
NovoLOG:100units/mL(10mL)[containsmetacresol,phenol][BCF]
SolutionPen-injector,Subcutaneous: CapsuleExtendedRelease,Oral:
NovoLOGFlexPen:100units/mL(3mL)[containsmetacresol,phenol][BCF] Dilatrate-SR:40mg
Tablet,Oral:
InsulinAspartProtamineandInsulinAspart Generic:5mg[BCF]
Outpatient Formulary Brands Available NovoLOG Mix 70/30; NovoLOG Tablet,ExtendedRelease,Oral:
Mix70/30FlexPen Generic:40mg[BCF]
9
ISOSORBIDEMONONITRATE
IsosorbideMononitrate OutpatientDosageForms
OutpatientDosageForms Jelly,External,ashydrochloride:
Tablet,Oral: Xylocaine:2%(30mL)
Generic:20mg Ointment,External:
Generic:5%(30g,50g)
Ketoconazole(Systemic) Patch,External:
OutpatientDosageForms Generic:5%(1ea,30ea)
Tablet,Oral: Solution,Mouth/Throat,ashydrochloride:
Generic:200mg Generic:2%(100mL)
Ketoconazole(Topical) LinaCLOtide
OutpatientDosageForms OutpatientFormularyBrandsAvailableLinzess
Cream,External: OutpatientDosageForms
Generic:2%(15g) Capsule,Oral:
Shampoo,External: Linzess:145mcg,290mcg
Generic:2%(120mL)
Liraglutide
LacticAcidandAmmoniumHydroxide OutpatientFormularyBrandsAvailableVictoza
OutpatientFormularyBrandsAvailableAmLactin[OTC] OutpatientDosageForms
OutpatientDosageForms SolutionPen-injector,Subcutaneous:
Lotion,External: Victoza:18mg/3mL(3mL)[containsphenol,propyleneglycol]
AmLactin:Lacticacid12%withammoniumhydroxide(225g)
Lisinopril
Generic:Lacticacid12%withammoniumhydroxide(225g)
OutpatientDosageForms
Lactobacillus Tablet,Oral:
OutpatientDosageForms Generic: 2.5mg [BCF], 5mg [BCF], 10mg [BCF], 20mg [BCF], 30mg
Capsule,Oral: [BCF],40mg[BCF]
Culturelle:L.rhamnosusGG10billioncolony-formingunits LisinoprilandHydrochlorothiazide
Packet,Oral:
OutpatientDosageForms
CulturelleKids
Tablet,Oral:
Lactulose Generic:
OutpatientDosageForms 10/12.5:Lisinopril10mgandhydrochlorothiazide12.5mg[BCF]
Solution,Oral: 20/12.5:Lisinopril20mgandhydrochlorothiazide12.5mg[BCF]
Generic:10g/15mL(15mL,30mL,237mL,473mL,500mL,946mL,1892 20/25:Lisinopril20mgandhydrochlorothiazide25mg[BCF]
mL)[BCF] Lithium
Solution,Oral/Rectal:
OutpatientDosageForms
Generic:10g/15mL(237mL,473mL,946mL)[BCF]
Capsule,Oral,ascarbonate:
LamoTRIgine Generic:150mg[BCF],300mg[BCF]
OutpatientDosageForms Solution,Oral,ascitrate:
Generic: 300mg/5 mL (500 mL) [equivalent to amount of lithium in lithium
Tablet,Oral:
carbonate][BCF]
Generic:25mg
Loperamide
Latanoprost
OutpatientDosageForms
OutpatientDosageForms
Capsule,Oral,ashydrochloride:
Solution,Ophthalmic:
Generic:2mg[BCF]
Generic:0.005%(2.5mL)[BCF]
Loratadine
LevETIRAcetam
OutpatientDosageForms
OutpatientDosageForms
Syrup,Oral:
Solution,Oral:
Generic:5mg/5mL(120mL)
Generic:100mg/mL(5mL,473mL,500mL)
Tablet,Oral:
Tablet,Oral:
Generic:10mg
Generic:250mg,500mg,750mg,1000mg
TabletExtendedRelease24Hour,Oral: LORazepam
Generic:500mg,750mg OutpatientDosageForms
LevoFLOXacin(Systemic) Tablet,Oral:
Generic:0.5mg,1mg
OutpatientFormularyBrandsAvailableLevaquin
OutpatientDosageForms Losartan
Solution,Oral: OutpatientFormularyBrandsAvailableCozaar
Levaquin: 25mg/mL (480 mL) [contains benzyl alcohol, propylene gly- OutpatientDosageForms
col][BCF] Tablet,Oral,aspotassium:
Generic:25mg/mL(480mL)[BCF] Cozaar:25mg[containspotassium2.12mg(0.054mEq)][BCF]
Tablet,Oral: Cozaar:50mg[containspotassium4.24mg(0.108mEq)][BCF]
Levaquin:250mg[BCF] Cozaar:100mg[containspotassium8.48mg(0.216mEq)][BCF]
Generic:250mg[BCF] Generic:25mg[BCF],50mg[BCF],100mg[BCF]
Levonorgestrel(Systemic) LosartanandHydrochlorothiazide
OutpatientFormularyBrandsAvailablePlanB OutpatientFormularyBrandsAvailableHyzaar
OutpatientDosageForms OutpatientDosageForms
Tablet,Oral: Tablet,Oral:
PlanB:0.75mg[BCF] Hyzaar:
50/12.5:Losartanpotassium50mgandhydrochlorothiazide12.5mg[con-
Levothyroxine
tainspotassium4.24mg(0.108mEq)][BCF]
OutpatientFormularyBrandsAvailableSynthroid 100/12.5: Losartan potassium 100mg and hydrochlorothiazide 12.5mg
OutpatientDosageForms [containspotassium8.48mg(0.216mEq)][BCF]
Tablet,Oral,assodium: 100/25: Losartan potassium 100mg and hydrochlorothiazide 25mg [con-
Synthroid:25mcg[BCF],50mcg[BCF],75mcg[BCF],88mcg[BCF],100 tainspotassium8.48mg(0.216mEq)][BCF]
mcg [BCF], 112 mcg [BCF], 125 mcg [BCF], 137 mcg [BCF], 150 mcg Generic:
[BCF],175mcg[BCF],200mcg[BCF],300mcg[BCF] 50/12.5:Losartanpotassium50mgandhydrochlorothiazide12.5mg[BCF]
Generic:25mcg[BCF],50mcg[BCF],75mcg[BCF],88mcg[BCF],100 100/12.5: Losartan potassium 100mg and hydrochlorothiazide
mcg [BCF], 112 mcg [BCF], 125 mcg [BCF], 137 mcg [BCF], 150 mcg 12.5mg[BCF]
[BCF],175mcg[BCF],200mcg[BCF],300mcg[BCF] 100/25:Losartanpotassium100mgandhydrochlorothiazide25mg[BCF]
Lidocaine(Topical) Lubiprostone
OutpatientFormularyBrandsAvailableXylocaine OutpatientFormularyBrandsAvailableAmitiza
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