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MONCRIEF ARMY

OUTPATIENT FORMULARY

Alphabetical Listing by Name

This document is current as of . The availability of formulary items is subject to change.

February 13, 2018

HEALTH CLINIC

AcebutololOutpatient Dosage FormsCapsule, Oral, as hydrochloride:Generic: 200 mg, 400 mg

AcetaminophenOutpatient Dosage FormsSolution, Oral:Generic: 160 mg/5 mL (10 mL, 473 mL, 5 mL)

Solution, Oral [drops]:Generic: 80 mg/0.8 mL (15 mL)

Suppository, Rectal:Generic: 120 mg (12s); 325 mg (12s); 650 mg (12s)

Suspension, Oral:Mapap Children's: 160 mg/5 mL (118 mL) [ethanol free; contains benzoic acid,propylene glycol, sodium benzoate; cherry flavor]

Tylenol Children's: 160 mg/5 mL (120 mL) [ethanol free; contains propyleneglycol, sodium 2 mg/5 mL, sodium benzoate; cherry flavor]

Tablet, Oral:Generic: 325 mg

Acetaminophen and CodeineOutpatient Dosage FormsSolution, Oral [C-V]:Generic: Acetaminophen 120 mg and codeine phosphate 12 mg per 5 mL(120 mL, 480 mL) [contains alcohol 7%] [BCF]

Suspension, Oral [C-V]:Tylenol with Codeine: Acetaminophen 120 mg and codeine phosphate 12 mgper 5 mL (480 mL) [contains ethanol 7%, sodium benzoate; cherry flavor]

Tablet, Oral [C-III]:Generic: Acetaminophen 300 mg and codeine phosphate 30 mg [BCF]

AcetaZOLAMIDEOutpatient Dosage FormsTablet, Oral:Generic: 250 mg

Acetic Acid, Propylene Glycol Diacetate, and HydrocortisoneOutpatient Dosage FormsSolution, Otic [drops]:Acetasol HC: Acetic acid 2%, propylene glycol diacetate 3%, and hydro-cortisone 1% (10 mL) [contains benzethonium chloride]

VoSol HC: Acetic acid 2%, propylene glycol diacetate 3%, and hydrocortisone1% (10 mL) [contains benzethonium chloride]

Acyclovir (Systemic)Outpatient Dosage FormsCapsule, Oral:Generic: 200 mg [BCF]

Suspension, Oral:Generic: 200 mg/5 mL (473 mL) [BCF]

Tablet, Oral:Generic: 400 mg [BCF], 800 mg [BCF]

AdalimumabOutpatient Dosage FormsKit, Subcutaneous [preservative free]:Humira: 40 mg/0.8 mL [contains polysorbate 80] [BCF]

AdapaleneOutpatient Dosage FormsGel, External:Generic: 0.3% (45 g)

AlbendazoleOutpatient Dosage FormsTablet, Oral:Albenza: 200 mg [contains saccharin sodium]

AlbuterolOutpatient Dosage FormsAerosol solution, inhalation:ProAir HFA: 108 (90 Base) mcg/actuation (8.5 g) [BCF]

Nebulization solution, inhalation: 0.083% [2.5 mg/3 mL] (25s, 30s, 60s) [BCF];0.5% [100 mg/20 mL] (1s)

Syrup, oral: 2 mg/5 mL (473 mL)

Alcohol (Isopropyl)Outpatient Dosage FormsPads: 70%Solution: 70% (480 mL); 99% (3840 mL)

AlendronateOutpatient Dosage FormsSolution, oral: 70 mg/75 mL [BCF]Tablet, oral: 5 mg [BCF], 10 mg [BCF], 35 mg [BCF], 70 mg [BCF]

AlfuzosinOutpatient Dosage FormsTablet extended release 24 hour, oral, as hydrochloride: 10 mg [BCF]

AllopurinolOutpatient Dosage FormsTablet, oral: 100 mg [BCF], 300 mg [BCF]

ALPRAZolamOutpatient Dosage FormsTablet, oral: 0.25 mg, 0.5 mg, 1 mg

Aluminum Acetate and Acetic AcidOutpatient Dosage FormsSolution, otic [drops]: Aluminum acetate 10% and acetic acid 2% (60 mL)Otic Domeboro: Aluminum acetate 0.79% and acetic acid 2% (60 mL)

Aluminum Chloride HexahydrateOutpatient Dosage FormsSolution, topical:Drysol: 20% (37.5 mL) [contains ethanol 93%]

Aluminum Hydroxide, Magnesium Hydroxide, and SimethiconeOutpatient Dosage FormsLiquid, oral: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, andsimethicone 20 mg per 5 mL (360 mL)Maalox® Advanced Maximum Strength: Aluminum hydroxide 400 mg, mag-nesium hydroxide 400 mg, and simethicone 40 mg per 5 mL (355 mL, 769mL) [contains magnesium 167 mg/5 mL; cherry flavor]

Maalox® Advanced Regular Strength: Aluminum hydroxide 200 mg, magne-sium hydroxide 200 mg, and simethicone 20 mg per 5 mL (360 mL, 780 mL)[contains magnesium 75 mg/5 mL, potassium 5 mg/5 mL, propylene glycol;mint flavor]

Suspension, oral:Mag-Al Plus XS: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg,and simethicone 40 mg per 5 mL (30 mL) [dye free, ethanol free, sugar free;cherry flavor]

Aluminum Sulfate and Calcium AcetateOutpatient Dosage FormsPowder for solution, topical:Domeboro: Aluminum sulfate 1191 mg and calcium acetate 839 mg perpacket (12s)

AmantadineOutpatient Dosage FormsCapsule, oral, as hydrochloride: 100 mg [BCF]Syrup, oral, as hydrochloride: 50 mg/5 mL (473 mL) [BCF]

AmcinonideOutpatient Dosage FormsCream, topical: 0.1% (30 g)

AmiodaroneOutpatient Dosage FormsTablet, oral, as hydrochloride: 200 mg [BCF]

AmitriptylineOutpatient Dosage FormsTablet, oral, as hydrochloride: 10 mg [BCF], 25 mg [BCF], 50 mg [BCF], 75 mg[BCF]

AmLODIPineOutpatient Dosage FormsTablet, oral: 2.5 mg [BCF], 5 mg [BCF], 10 mg [BCF]

Amlodipine and BenazeprilOutpatient Dosage FormsCapsule, oral:2.5/10: Amlodipine 2.5 mg and benazepril hydrochloride 10 mg [BCF]5/10: Amlodipine 5 mg and benazepril hydrochloride 10 mg [BCF]5/20: Amlodipine 5 mg and benazepril hydrochloride 20 mg [BCF]5/40: Amlodipine 5 mg and benazepril hydrochloride 40 mg [BCF]10/20: Amlodipine 10 mg and benazepril hydrochloride 20 mg [BCF]10/40: Amlodipine 10 mg and benazepril hydrochloride 40 mg [BCF]

AmoxicillinOutpatient Dosage FormsCapsule, oral: 250 mg [BCF], 500 mg [BCF]Powder for suspension, oral: 250 mg/5 mL (150 mL) [BCF]; 400 mg/5 mL (100mL) [BCF]

Tablet, oral: 875 mg

Amoxicillin and ClavulanateOutpatient Dosage FormsPowder for suspension, oral:Augmentin: 125: Amoxicillin 125 mg and clavulanate potassium 31.25 mg per5 mL (75 mL, 100 mL, 150 mL) [contains potassium 0.16 mEq/5 mL; bananaflavor] [BCF]

200: Amoxicillin 200 mg and clavulanate potassium 28.5 mg per 5 mL [BCF]250: Amoxicillin 250 mg and clavulanate potassium 62.5 mg per 5 mL [BCF]400: Amoxicillin 400 mg and clavulanate potassium 57 mg per 5 mL [BCF]600: Amoxicillin 600 mg and clavulanate potassium 42.9 mg per 5 mL [BCF]

ACEBUTOLOL

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Tablet, oral:Amoxicillin 250 mg and clavulanate potassium 125 mg [BCF]Amoxicillin 500 mg and clavulanate potassium 125 mg [BCF]Amoxicillin 875 mg and clavulanate potassium 125 mg [BCF]

Tablet, extended release, oral: Amoxicillin 1000 mg and clavulanate acid62.5 mg

AmpicillinOutpatient Dosage FormsCapsule: 250 mg, 500 mg

AnastrozoleOutpatient Dosage FormsTablet, oral: 1 mg

ApixabanOutpatient Dosage FormsTablet, Oral:Eliquis: 2.5 mg [BCF], 5 mg [BCF]Eliquis Starter Pack: 5 mg

Artificial TearsOutpatient Dosage FormsSolution, ophthalmic: 1% (15 mL)HypoTears PF: (15 mL)Refresh: (0.4 mL)

AspirinOutpatient Dosage FormsTablet: 325 mgTablet, enteric coated: 81 mg, 325 mg

Aspirin and DipyridamoleOutpatient Dosage FormsCapsule extended release 12 hour, oral: Aspirin 25 mg [immediate release] anddipyridamole 200 mg [extended release]

AtenololOutpatient Dosage FormsTablet, oral: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]

AtoMOXetineOutpatient Dosage FormsCapsule, oral:Strattera: 10 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80 mg, 100 mg

AtorvaSTATinOutpatient Dosage FormsTablet, oral: 10 mg [BCF], 20 mg [BCF], 40 mg [BCF], 80 mg [BCF]

Atropine (Ophthalmic)Outpatient Dosage FormsOintment, ophthalmic, as sulfate: 1% (3.5 g)Solution, ophthalmic, as sulfate: 1% (5 mL)

AzaTHIOprineOutpatient Dosage FormsTablet, oral: 50 mg

Azelastine (Nasal)Outpatient Dosage FormsSolution, intranasal, as hydrochloride [spray]: 0.1% [137 mcg/spray] (30 mL)

Azithromycin (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic:AzaSite: 1% (2.5 mL) [contains benzalkonium chloride, disodium edta]

Azithromycin (Systemic)Outpatient Dosage FormsPowder for suspension, oral, as dihydrate [strength expressed as base]:100 mg/5 mL (15 mL) [BCF]; 1 g/packet (3s) [BCF]Zithromax®: 100 mg/5 mL (15 mL) [contains sodium 3.7 mg/5 mL; cherry-crème de vanilla-banana flavor]

Zithromax®: 200 mg/5 mL (15 mL, 22.5 mL, 30 mL) [contains sodium 7.4 mg/5 mL; cherry-crème de vanilla-banana flavor]

Zithromax®: 1 g/packet (10s) [contains sodium 37 mg/packet; banana-cherryflavor]

Powder for suspension, oral, as monohydrate [strength expressed as base]:200 mg/5 mL (15 mL)

Tablet, oral, as monohydrate [strength expressed as base]: 250 mg, 500 mgTablet, oral, as dihydrate [strength expressed as base]: 250 mg [BCF],500 mg [BCF]Zithromax® TRI-PAK™ [unit-dose pack]: 500 mg (3s) [contains sodium1.8 mg per tablet]

Zithromax® Z-PAK® [unit-dose pack]: 250 mg (6s) [contains sodium 0.9 mgper tablet]

Bacitracin, Neomycin, and Polymyxin B (Ophthalmic)Outpatient Dosage FormsOintment, ophthalmic: Bacitracin 400 units, neomycin 3.5 mg, and polymyxin B10,000 units per g (3.5 g) [BCF]

Bacitracin (Ophthalmic)Outpatient Dosage FormsOintment, Ophthalmic:Generic: 500 units/g (3.5 g)

Bacitracin (Topical)Outpatient Dosage FormsOintment, External, as zinc [strength expressed as base]:Generic: 500 units/g (0.9 g, 15 g, 30 g)

BaclofenOutpatient Dosage FormsTablet, oral: 10 mg, 20 mg

Belladonna and OpiumOutpatient Dosage FormsSuppository, rectal: Belladonna extract 16.2 mg and opium 60 mg (12s)

BenazeprilOutpatient Dosage FormsTablet, oral, as hydrochloride: 5 mg, 10 mg, 20 mg, 40 mg

BenzocaineOutpatient Dosage FormsLozenge, Mouth/Throat:Cēpacol Sore Throat: 15 mg [contains menthol; cherry flavor]

BenzoinOutpatient Dosage FormsTincture, topical: Benzoin Compound USP: benzoin 10% (60 mL)

BenzonatateOutpatient Dosage FormsCapsule, softgel, oral: 100 mg, 200 mgTessalon®: 100 mg, 200 mg

Benzoyl PeroxideOutpatient Dosage FormsGel, topical: 5% (45 g); 10% (45 g)Wash, topical:BPO: 5%

BenztropineOutpatient Dosage FormsTablet, oral, as mesylate: 0.5 mg [BCF], 1 mg [BCF], 2 mg [BCF]

Betamethasone (Topical)Outpatient Dosage FormsCream, topical, as valerate [strength expressed as base]: 0.1% (15 g, 45 g)Beta-Val®: 0.1% (15 g)

Lotion, topical, as valerate [strength expressed as base]: 0.1% (60 mL)Ointment, topical, as dipropionate [strength expressed as base, augmented]:Diprolene®: 0.05% (15 g)

Ointment, topical, as valerate [strength expressed as base]: 0.1% (15 g)

BethanecholOutpatient Dosage FormsTablet, oral, as chloride:Urecholine®: 10 mg, 25 mg [scored]

BicalutamideOutpatient Dosage FormsTablet, oral: 50 mg [BCF]

BimatoprostOutpatient Dosage FormsSolution, ophthalmic [drops]:Lumigan®: 0.01% (2.5 mL) [contains benzalkonium chloride]

BisacodylOutpatient Dosage FormsSuppository, rectal: 10 mgTablet, enteric coated, oral: 5 mgDulcolax®: 5 mg

Bismuth SubsalicylateOutpatient Dosage FormsLiquid, as subsalicylate:Kaopectate®: 262 mg/15 mL (236 mL, 354 mL) [contains potassium 5 mg/15mL, sodium 5 mg/15 mL; regular flavor]

Tablet, chewable, oral, as subsalicylate: 262 mgPeptic Relief: 262 mgPepto-Bismol®: 262 mg [sugar free; contains sodium <1 mg; cherry andwintergreen flavors]

BISMUTH SUBSALICYLATE

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Brimonidine (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as tartrate [drops]: 0.15% (5 mL, 10 mL, 15 mL) [BCF]Alphagan® P: 0.15% (5 mL, 10 mL, 15 mL) [contains Purite®] [BCF]

BromocriptineOutpatient Dosage FormsTablet, oral:Parlodel® SnapTabs®: 2.5 mg [scored]

Budesonide (Oral Inhalation)Outpatient Dosage FormsSuspension, for nebulization:Pulmicort Respules®: 0.25 mg/2 mL (2 mL); 0.5 mg/2 mL (2 mL)

BuPROPionOutpatient Dosage FormsTablet, oral, as hydrochloride: 75 mg [BCF], 100 mg [BCF]Wellbutrin®: 75 mg [BCF], 100 mg [BCF]

Tablet, extended release, oral, as hydrochloride: 100 mg [BCF], 150 mg [BCF],300 mg [BCF]

Tablet, sustained release, oral, as hydrochloride:Wellbutrin SR®: 150 mg [BCF]

BusPIRoneOutpatient Dosage FormsTablet, oral, as hydrochloride: 5 mg [BCF], 10 mg [BCF], 15 mg [BCF]

Butalbital, Acetaminophen, and CaffeineOutpatient Dosage FormsTablet, oral: Butalbital 50 mg, acetaminophen 325 mg, and caffeine 40 mg[BCF]Fioricet®: Butalbital 50 mg, acetaminophen 325 mg, and caffeine 40 mg

CalamineOutpatient Dosage FormsLotion, topical: Calamine 8%, zinc oxide 8%, glycerin 2% and bentonite magmain calcium hydroxide solution (120 mL, 240 mL, 480 mL)

Calcitriol (Systemic)Outpatient Dosage FormsCapsule, softgel, oral: 0.25 mcgRocaltrol: 0.25 mcg [contains coconut oil]

Solution, oral: 1 mcg/mL (15 mL)Rocaltrol: 1 mcg/mL (15 mL) [contains palm oil]

Calcium and Vitamin DOutpatient Dosage FormsTablet, oral: Calcium 500 mg and vitamin D 200 int. units

Calcium CarbonateOutpatient Dosage FormsTablet, oral: 1250 mg [equivalent to elemental calcium 500 mg]

CapsaicinOutpatient Dosage FormsCream, External:Capzasin-HP: 0.1% (42.5 g) [contains benzyl alcohol]Generic: 0.025% (60 g)

CaptoprilOutpatient Dosage FormsTablet, oral: 12.5 mg [BCF], 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]

CarbacholOutpatient Dosage FormsSolution, intraocular:Miostat®: 0.01% (1.5 mL)

Solution, ophthalmic:Isopto® Carbachol: 3% (15 mL) [contains benzalkonium chloride]

CarBAMazepineOutpatient Dosage FormsSuspension, oral: 100 mg/5 mL (10 mL, 450 mL) [BCF]Tablet, oral: 200 mg [BCF]Tablet, chewable, oral: 100 mg [BCF]Tablet, extended release 12 hour, oral: 200 mg, 400 mg [BCF]

Carbamide PeroxideOutpatient Dosage FormsSolution, otic [drops]:Debrox®: 6.5% (15 mL, 30 mL)

CarbidopaOutpatient Dosage FormsTablet, oral: 25 mg

Carbidopa and LevodopaOutpatient Dosage FormsTablet, oral:10/100: Carbidopa 10 mg and levodopa 100 mg [BCF]25/100: Carbidopa 25 mg and levodopa 100 mg [BCF]25/250: Carbidopa 25 mg and levodopa 250 mg [BCF]Sinemet®:10/100: Carbidopa 10 mg and levodopa 100 mg25/250: Carbidopa 25 mg and levodopa 250 mg [scored]

Tablet, sustained release, oral:Sinemet® CR:25/100: Carbidopa 25 mg and levodopa 100 mg [scored]50/200: Carbidopa 50 mg and levodopa 200 mg

CarboxymethylcelluloseOutpatient Dosage FormsSolution, ophthalmic, as sodium:Refresh Tears®: 0.5% (15 mL)

Solution, ophthalmic, as sodium [drops; preservative free]:Refresh Plus®: 0.5% (0.4 mL) [available in packages of 30 or 50]

CarvedilolOutpatient Dosage FormsCapsule extended release 24 hour, oral, as phosphate:Coreg CR: 10 mg, 20 mg, 40 mg, 80 mg

Tablet, oral: 3.125 mg [BCF], 6.25 mg [BCF], 12.5 mg [BCF], 25 mg [BCF]

CefdinirOutpatient Dosage FormsCapsule, oral: 300 mgPowder for suspension, oral: 125 mg/5 mL (60 mL, 100 mL); 250 mg/5 mL (60mL, 100 mL)Omnicef®: 125 mg/5 mL (100 mL); 250 mg/5 mL (100 mL, 60 mL) [containssodium benzoate, sucrose 2.86 g/5 mL; strawberry flavor]

CefprozilOutpatient Dosage FormsPowder for suspension, oral, as anhydrous: 250 mg/5 mL (50 mL, 75 mL, 100mL)Cefzil®: 250 mg/5 mL (50 mL, 75 mL, 100 mL) [contains phenylalanine 28 mg/5 mL, sodium benzoate; bubblegum flavor]

Tablet, oral, as anhydrous: 250 mg, 500 mgCefzil®: 250 mg, 500 mg

CefuroximeOutpatient Dosage FormsTablet, oral, as axetil [strength expressed as base]: 250 mg, 500 mg

CelecoxibOutpatient Dosage FormsCapsule, oral:Celebrex®: 100 mg, 200 mg

CephalexinOutpatient Dosage FormsCapsule, oral: 250 mg [BCF], 500 mg [BCF]Keflex®: 250 mg, 500 mg

Powder for suspension, oral: 250 mg/5 mL (200 mL) [BCF]

Cetirizine (Systemic)Outpatient Dosage FormsSyrup, oral, as hydrochloride: 5 mg/5 mL (120s)Tablet, oral, as hydrochloride: 5 mg, 10 mg

Chlorhexidine Gluconate (Oral)Outpatient Dosage FormsSolution, Mouth/Throat:Peridex: 0.12% (118 mL, 1893 mL) [contains alcohol, usp, saccharin sodium;mint flavor] [BCF]

Periogard: 0.12% (473 mL) [mint flavor] [BCF]Generic: 0.12% (473 mL) [BCF]

ChlorpheniramineOutpatient Dosage FormsTablet, oral, as maleate: 4 mg

ChlorproPAMIDEOutpatient Dosage FormsTablet, oral: 250 mgDiabinese®: 250 mg [scored]

ChlorthalidoneOutpatient Dosage FormsTablet, oral: 25 mg [BCF], 50 mg [BCF]

CholecalciferolOutpatient Dosage FormsCapsule, oral: 1000 units, 5000 units

BRIMONIDINE (OPHTHALMIC)

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CilostazolOutpatient Dosage FormsTablet, oral: 50 mg, 100 mg

Ciprofloxacin and DexamethasoneOutpatient Dosage FormsSuspension, otic:Ciprodex®: Ciprofloxacin 0.3% and dexamethasone 0.1% (7.5 mL) [containsbenzalkonium chloride]

Ciprofloxacin (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as hydrochloride: 0.3% (5 mL)

Ciprofloxacin (Otic)Outpatient Dosage FormsSolution, otic, as hydrochloride [preservative free]:Cetraxal®: 0.5 mg/0.25 mL (14s) [equivalent to ciprofloxacin base 0.2%]

Ciprofloxacin (Systemic)Outpatient Dosage FormsMicrocapsules for suspension, oral:Cipro®: 250 mg/5 mL (100 mL) [strawberry flavor] [BCF]

Tablet, oral, as hydrochloride [strength expressed as base]: 100 mg, 250 mg[BCF], 500 mg [BCF], 750 mgCipro®: 500 mg [BCF]

CitalopramOutpatient Dosage FormsSolution, oral: 10 mg/5 mL (240 mL) [BCF]Tablet, oral: 10 mg [BCF], 20 mg [BCF], 40 mg [BCF]Celexa®: 10 mg, 20 mg, 40 mg

ClarithromycinOutpatient Dosage FormsGranules for suspension, oral: 250 mg/5 mL (50 mL, 100 mL)Biaxin®: 250 mg/5 mL (50 mL, 100 mL) [fruit-punch flavor]

Tablet, oral: 250 mg, 500 mgBiaxin®: 250 mg, 500 mg

Tablet, extended release, oral: 500 mgBiaxin® XL: 500 mg

Clindamycin and Benzoyl PeroxideOutpatient Dosage FormsGel, topical:Clindamycin 1% and benzoyl peroxide 5%Clindamycin phosphate 1.2% and benzoyl peroxide 5%

Clindamycin (Systemic)Outpatient Dosage FormsCapsule, oral, as hydrochloride [strength expressed as base]: 150 mg [BCF],300 mgCleocin HCl®: 150 mg [contains tartrazine], 300 mg

Granules for solution, oral, as palmitate hydrochloride [strength expressed asbase]: 75 mg/5 mL (100 mL)Cleocin Pediatric®: 75 mg/5 mL (100 mL) [cherry flavor]

Clindamycin (Topical)Outpatient Dosage FormsCream, vaginal, as phosphate [strength expressed as base]: 2% (40 g) [BCF]Solution, topical, as phosphate [strength expressed as base]: 1% (30 mL, 60mL) [BCF]

ClobetasolOutpatient Dosage FormsAerosol, topical, as propionate [foam]:Olux-E™: 0.05% (100 g) [ethanol free]Olux®: 0.05% (50 g) [contains ethanol 60%; for scalp application]

Cream, topical, as propionate: 0.05% (60 g)Temovate®: 0.05% (30 g)

Cream, topical, as propionate [emollient-based]: 0.05% (30 g)Embeline™ E: 0.05% (30 g)

Gel, topical, as propionate: 0.05% (30 g)Temovate®: 0.05% (30 g)

Ointment, topical, as propionate: 0.05% (15 g, 60 g)Temovate®: 0.05% (30 g)

Shampoo, topical, as propionate:Clobex®: 0.05% (118 mL) [contains ethanol]

Solution, topical, as propionate [for scalp application]: 0.05% (50 mL)Cormax®: 0.05% (50 mL) [contains isopropyl alcohol 40%]

Solution, topical, as propionate [spray]:Clobex®: 0.05% (125 mL) [contains ethanol]

ClonazePAMOutpatient Dosage FormsTablet, oral: 0.5 mg [BCF], 1 mg, 2 mgKlonopin®: 0.5 mg, 1 mg, 2 mg

CloNIDineOutpatient Dosage FormsPatch, transdermal [once-weekly patch]:Catapres-TTS®-1: 0.1 mg/24 hours (4s)Catapres-TTS®-2: 0.2 mg/24 hours (4s)Catapres-TTS®-3: 0.3 mg/24 hours (4s)

Tablet, oral, as hydrochloride: 0.1 mg [BCF], 0.2 mg [BCF], 0.3 mg [BCF]Catapres®: 0.1 mg, 0.2 mg, 0.3 mg [BCF] [scored]

ClopidogrelOutpatient Dosage FormsTablet, oral: 75 mg [BCF]Plavix®: 75 mg [BCF]

Clotrimazole (Oral)Outpatient Dosage FormsTroche, oral:Mycelex®: 10 mg (70s)

Clotrimazole (Topical)Outpatient Dosage FormsCream, topical: 1% (15 g)Cream, vaginal: 1% (45 g)Gyne-Lotrimin® 7: 1% (45 g) [contains benzyl alcohol; packaged with refillableapplicator]

Solution, topical: 1% (10 mL) [BCF]

CodeineOutpatient Dosage FormsTablet, oral, as sulfate: 30 mg

ColchicineOutpatient Dosage FormsTablet, oral: 0.6 mg

ColestipolOutpatient Dosage FormsGranules for suspension, oral, as hydrochloride: 5 g/packet (30s)Colestid®: 5 g/teaspoon (300 g) [unflavored]

Tablet, oral, as hydrochloride [micronized]:Colestid®: 1 g

CortisoneOutpatient Dosage FormsTablet, oral, as acetate: 10 mg, 25 mg

Cromolyn (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as sodium:Crolom®: 4% (10 mL) [contains benzalkonium chloride]

Cromolyn (Systemic)Outpatient Dosage FormsAerosol, for oral inhalation, as sodium:Intal®: 800 mcg/inhalation (14.2 g) [contains chlorofluorocarbon; 200 meteredinhalations; 100 doses]

Solution, for nebulization, as sodium: 20 mg/2 mL (60s, 120s)Solution, oral, as sodium [concentrate]:Gastrocrom®: 100 mg/5 mL (5 mL)

CrotamitonOutpatient Dosage FormsCream, topical:Eurax®: 10% (60 g)

Lotion, topical:Eurax®: 10% (480 mL)

CyanocobalaminOutpatient Dosage FormsTablet, oral: 1000 mcg

CyclobenzaprineOutpatient Dosage FormsTablet, oral, as hydrochloride: 5 mg, 10 mg [BCF]

CyclopentolateOutpatient Dosage FormsSolution, ophthalmic, as hydrochloride [drops]:Cyclogyl®: 1% (15 mL) [contains benzalkonium chloride]

CycloSPORINE (Ophthalmic)Outpatient Dosage FormsEmulsion, ophthalmic [preservative free]:Restasis: 0.05% (1 ea) [contains polysorbate 80]

CyproheptadineOutpatient Dosage FormsSyrup, oral, as hydrochloride: 2 mg/5 mL (480 mL) [BCF]Tablet, oral, as hydrochloride: 4 mg [BCF]

CYPROHEPTADINE

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Dapsone (Systemic)Outpatient Dosage FormsTablet, oral: 25 mg

DesipramineOutpatient Dosage FormsTablet, oral, as hydrochloride: 25 mg

DesmopressinOutpatient Dosage FormsSolution, intranasal, as acetate:DDAVP®: 0.1 mg/mL (2.5 mL) [contains benzalkonium chloride; with rhi-nal tube]

Solution, intranasal, as acetate [spray]: 0.1 mg/mL (5 mL)

DesonideOutpatient Dosage FormsCream, topical: 0.05% (60 g)Ointment, topical: 0.05% (60 g)

Dexamethasone (Systemic)Outpatient Dosage FormsTablet, oral: 0.5 mg, 4 mg

DextroamphetamineOutpatient Dosage FormsCapsule, extended release, oral, as sulfate: 5 mgCapsule, sustained release, oral, as sulfate:Dexedrine® Spansule®: 10 mg, 15 mg

Tablet, oral, as sulfate: 5 mg, 10 mgDextroStat®: 10 mg [scored; contains tartrazine]

Dextroamphetamine and AmphetamineOutpatient Dosage FormsCapsule, extended release, oral:5 mg [dextroamphetamine sulfate 1.25 mg, dextroamphetamine saccharate1.25 mg, amphetamine aspartate monohydrate 1.25 mg, amphetamine sul-fate 1.25 mg (equivalent to amphetamine base 3.1 mg)] [BCF]

10 mg [dextroamphetamine sulfate 2.5 mg, dextroamphetamine saccharate2.5 mg, amphetamine aspartate monohydrate 2.5 mg, amphetamine sulfate2.5 mg (equivalent to amphetamine base 6.3 mg)] [BCF]

20 mg [dextroamphetamine sulfate 5 mg, dextroamphetamine saccharate5 mg, amphetamine aspartate monohydrate 5 mg, amphetamine sulfate5 mg (equivalent to amphetamine base 12.5 mg)] [BCF]

25 mg [dextroamphetamine sulfate 6.25 mg, dextroamphetamine saccharate6.25 mg, amphetamine aspartate monohydrate 6.25 mg, amphetamine sul-fate 6.25 mg (equivalent to amphetamine base 15.6 mg)] [BCF]

30 mg [dextroamphetamine sulfate 7.5 mg, dextroamphetamine saccharate7.5 mg, amphetamine aspartate monohydrate 7.5 mg, amphetamine sulfate7.5 mg (equivalent to amphetamine base 18.8 mg)] [BCF]

Adderall XR®: 5 mg [dextroamphetamine sulfate 1.25 mg, dextroamphet-amine saccharate 1.25 mg, amphetamine aspartate monohydrate 1.25 mg,amphetamine sulfate 1.25 mg (equivalent to amphetamine base3.1 mg)] [BCF]

Adderall XR®: 10 mg [dextroamphetamine sulfate 2.5 mg, dextroamphet-amine saccharate 2.5 mg, amphetamine aspartate monohydrate 2.5 mg,amphetamine sulfate 2.5 mg (equivalent to amphetamine base6.3 mg)] [BCF]

Adderall XR®: 20 mg [dextroamphetamine sulfate 5 mg, dextroamphetaminesaccharate 5 mg, amphetamine aspartate monohydrate 5 mg, amphetaminesulfate 5 mg (equivalent to amphetamine base 12.5 mg)] [BCF]

Adderall XR®: 25 mg [dextroamphetamine sulfate 6.25 mg, dextroamphet-amine saccharate 6.25 mg, amphetamine aspartate monohydrate 6.25 mg,amphetamine sulfate 6.25 mg (equivalent to amphetamine base15.6 mg)] [BCF]

Adderall XR®: 30 mg [dextroamphetamine sulfate 7.5 mg, dextroamphet-amine saccharate 7.5 mg, amphetamine aspartate monohydrate 7.5 mg,amphetamine sulfate 7.5 mg (equivalent to amphetamine base18.8 mg)] [BCF]

Tablet, oral:5 mg [dextroamphetamine sulfate 1.25 mg, dextroamphetamine saccharate1.25 mg, amphetamine aspartate monohydrate 1.25 mg, amphetamine sul-fate 1.25 mg (equivalent to amphetamine base 3.13 mg)]

10 mg [dextroamphetamine sulfate 2.5 mg, dextroamphetamine saccharate2.5 mg, amphetamine aspartate monohydrate 2.5 mg, amphetamine sulfate2.5 mg (equivalent to amphetamine base 6.3 mg)]

20 mg [dextroamphetamine sulfate 5 mg, dextroamphetamine saccharate5 mg, amphetamine aspartate monohydrate 5 mg, amphetamine sulfate5 mg (equivalent to amphetamine base 12.6 mg)]

30 mg [dextroamphetamine sulfate 7.5 mg, dextroamphetamine saccharate7.5 mg, amphetamine aspartate monohydrate 7.5 mg, amphetamine sulfate7.5 mg (equivalent to amphetamine base 18.8 mg)]

Adderall®: 5 mg [dextroamphetamine sulfate 1.25 mg, dextroamphetaminesaccharate 1.25 mg, amphetamine aspartate monohydrate 1.25 mg,amphetamine sulfate 1.25 mg (equivalent to amphetamine base 3.13 mg)]

Adderall®: 10 mg [dextroamphetamine sulfate 2.5 mg, dextroamphetaminesaccharate 2.5 mg, amphetamine aspartate monohydrate 2.5 mg, amphet-amine sulfate 2.5 mg (equivalent to amphetamine base 6.3 mg)]

Adderall®: 20 mg [dextroamphetamine sulfate 5 mg, dextroamphetaminesaccharate 5 mg, amphetamine aspartate monohydrate 5 mg, amphetaminesulfate 5 mg (equivalent to amphetamine base 12.6 mg)]

Adderall®: 30 mg [dextroamphetamine sulfate 7.5 mg, dextroamphetaminesaccharate 7.5 mg, amphetamine aspartate monohydrate 7.5 mg, amphet-amine sulfate 7.5 mg (equivalent to amphetamine base 18.8 mg)]

Diabetic SuppliesOutpatient Dosage FormsLancetMonitor:Precision Xtra Blood Glucose Monitoring System

Pen needle:BD Pen Ultra-Fine Pen Needle 31G 5/16 inch Universal Fit

Syringe and needle:BD Syringe 0.5 mL (Ultra-Fine II) 31 gauge x 5/16" [BCF]BD Syringe 1 mL (Ultra-Fine II) 31 gauge x 5/16" [BCF]

Test Strips:FreeStyle Lite Test Strips: 50/box, 100/box [BCF]Precision Xtra Blood Glucose Test Strips

DiazePAMOutpatient Dosage FormsTablet, oral: 5 mg [BCF]Valium®: 5 mg [scored] [BCF]

DibucaineOutpatient Dosage FormsOintment, topical: 1% [10 mg/g] (30 g)

Diclofenac (Systemic)Outpatient Dosage FormsTablet, delayed release, enteric coated, oral, as sodium: 50 mg, 75 mg

Diclofenac (Topical)Outpatient Dosage FormsGel, transdermal, as sodium:Voltaren: 1% [contains isopropyl alcohol, propylene glycol]

DicloxacillinOutpatient Dosage FormsCapsule, oral: 250 mg [BCF]

DicyclomineOutpatient Dosage FormsSyrup, oral, as hydrochloride: 10 mg/5 mL (473 mL) [BCF]Bentyl®: 10 mg/5 mL (480 mL) [contains propylene glycol] [BCF]

Tablet, oral, as hydrochloride: 20 mg [BCF]Bentyl®: 20 mg [BCF]

DigoxinOutpatient Dosage FormsElixir, oral [pediatric]:Lanoxin: 50 mcg/mL (60 mL) [contains ethanol 10%; lime flavor]

Tablet, oral: 125 mcg [BCF], 250 mcg [BCF]Lanoxin: 125 mcg, 250 mcg [scored]

DilTIAZemOutpatient Dosage FormsCapsule, extended release, oral, as hydrochloride [once-daily dosing]: 120 mg[BCF], 180 mg [BCF], 240 mg [BCF], 300 mg [BCF], 360 mg [BCF], 420 mg[BCF]Cardizem® CD: 120 mg, 240 mgTiazac®: 120 mg, 180 mg, 240 mg, 300 mg, 360 mg, 420 mg

Capsule, extended release, as hydrochloride [twice-daily dosing]: 90 mgTablet, oral, as hydrochloride:Cardizem®: 30 mg, 60 mg

DimenhyDRINATEOutpatient Dosage FormsTablet, oral:Dramamine®: 50 mg

Tablet, chewable:Dramamine®: 50 mg [contains phenylalanine 0.84 mg/tablet; orange flavor]

DiphenhydrAMINE (Systemic)Outpatient Dosage FormsCapsule, oral, as hydrochloride: 25 mg, 50 mgElixir, oral, as hydrochloride:Banophen™: 12.5 mg/5 mL (120 mL)

Liquid, oral, as hydrochloride:Benadryl® Children’s Allergy: 12.5 mg/5 mL (120 mL, 240 mL) [ethanol free;contains sodium 14 mg/5 mL, sodium benzoate; cherry flavor]

Solution, oral, as hydrochloride:Diphenhist®: 12.5 mg/5 mL (480 mL) [ethanol free; contains sodium ben-zoate]

DAPSONE (SYSTEMIC)

6

DipyridamoleOutpatient Dosage FormsTablet, oral: 25 mgPersantine®: 25 mg

DisopyramideOutpatient Dosage FormsCapsule, controlled release, oral:Norpace® CR: 100 mg, 150 mg

DisulfiramOutpatient Dosage FormsTablet, oral: 250 mg

DocusateOutpatient Dosage FormsCapsule, oral, as sodium: 100 mgColace®: 100 mg [contains sodium 5 mg/capsule]

Capsule, softgel, oral, as sodium:Dok™: 100 mg

Liquid, oral, as sodium:Diocto: 150 mg/15 mL (480 mL) [vanilla flavor]

DonepezilOutpatient Dosage FormsTablet, oral, as hydrochloride:Aricept®: 5 mg, 10 mg

DorzolamideOutpatient Dosage FormsSolution, ophthalmic: 2% (10 mL)Trusopt®: 2% (10 mL) [contains benzalkonium chloride]

Dorzolamide and TimololOutpatient Dosage FormsSolution, ophthalmic: Dorzolamide hydrochloride 2% (base) and timolol maleate0.5% (base) (10 mL)

DoxazosinOutpatient Dosage FormsTablet, oral: 1 mg, 2 mg, 4 mg, 8 mgCardura®: 1 mg [scored]

Doxepin (Systemic)Outpatient Dosage FormsCapsule, oral, as hydrochloride: 10 mg [BCF], 25 mg [BCF], 50 mg [BCF],100 mg

Solution, oral, as hydrochloride [concentrate]: 10 mg/mL (120 mL) [BCF]

DoxycyclineOutpatient Dosage FormsCapsule, 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]

DULoxetineOutpatient Dosage FormsCapsule delayed release particles, oral: 20 mg, 30 mg, 60 mg

EmollientsOutpatient Dosage FormsCream, topical:Vanicream™: 454 g

EnalaprilOutpatient Dosage FormsTablet, oral, as maleate: 2.5 mg, 5 mg, 10 mg, 20 mgVasotec®: 2.5 mg, 5 mg, 10 mg, 20 mg

EnoxaparinOutpatient Dosage FormsInjection, solution, as sodium [preservative free]:Lovenox®: 30 mg/0.3 mL (0.3 mL) [BCF]; 40 mg/0.4 mL (0.4 mL) [BCF];60 mg/0.6 mL (0.6 mL) [BCF]; 80 mg/0.8 mL (0.8 mL) [BCF]; 100 mg/mL (1mL) [BCF]; 120 mg/0.8 mL (0.8 mL) [BCF]; 150 mg/mL (1 mL) [BCF]

EPINEPHrine (Oral Inhalation)Outpatient Dosage FormsSolution, for oral inhalation [racepinephrine, preservative free]:S2: 2.25% (0.5 mL) [as d-epinephrine 1.125% and l-epinehrine 1.125%]

EPINEPHrine (Systemic)Outpatient Dosage FormsInjection, solution:0.1 mg/mL (10 mL)0.3 mg/0.3 mL (1.1 mL) [1:1000 solution; delivers 0.3 mg per injection]0.15 mg/0.15 mL [1:1000 solution; delivers 0.15 mg per injection]

EpiPen®: 0.3 mg/0.3 mL (2 mL) [contains sodium metabisulfite; 1:1000]EpiPen® Jr.: 0.15 mg/0.3 mL (2 mL) [contains sodium metabisulfite; 1:2000]

ErgocalciferolOutpatient Dosage FormsCapsule, oral:Drisdol: 50,000 int. units [contains soybean oil, tartrazine; 1.25 mg]

Tablet, oral: 400 units, 2000 units

Erythromycin (Ophthalmic)Outpatient Dosage FormsOintment, Ophthalmic:Generic: 5 mg/g (3.5 g) [BCF]

Erythromycin (Systemic)Outpatient Dosage FormsGranules for suspension, oral, as ethylsuccinate [strength expressed as base]:E.E.S.®: 200 mg/5 mL (200 mL) [contains sodium 25.9 mg (1.1 mEq)/5 mL;cherry flavor] [BCF]

Powder for suspension, oral, as ethylsuccinate [strength expressed as base]:200 mg/5 mL (480 mL); 400 mg/5 mL (480 mL)EryPed®: 200 mg/5 mL (200 mL) [contains sodium 117.5 mg (5.1 mEq)/5 mL;fruit flavor]

Tablet, oral, as base: 250 mgTablet, oral, as ethylsuccinate [strength expressed as base]: 400 mgE.E.S.®: 400 mg

Tablet, oral, as stearate [strength expressed as base]:Erythrocin®: 250 mg [contains potassium 5 mg (0.1 mEq)/tablet, sodium56.7 mg (2.5 mEq)/tablet] [BCF]

Tablet, delayed release, enteric coated, as base:Ery-Tab®: 250 mg [contains sodium 8.3 mg (0.4 mEq)/tablet] [BCF]

Erythromycin (Topical)Outpatient Dosage FormsGel, topical: 2% (30 g) [BCF]Solution, topical: 2% (60 mL) [BCF]Eryderm®: 2% (60 mL) [contains ethanol 77%]

EscitalopramOutpatient Dosage FormsTablet, oral: 10 mg, 20 mg

EsomeprazoleOutpatient Dosage FormsSuspension reconstituted, oral, as magnesium [strength expressed as base]:NexIUM: 2.5 mg; 5 mg; 10 mg; 20 mg; 40 mg

Estradiol (Systemic)Outpatient Dosage FormsPatch, transdermal [once-weekly patch]: 0.025 mg/24 hours (4s) [BCF];0.0375 mg/24 hours (4s) [BCF]; 0.05 mg/24 hours (4s) [BCF]; 0.06 mg/24hours (4s) [BCF]; 0.075 mg/24 hours (4s) [BCF]; 0.1 mg/24 hours (4s) [BCF]Climara®:0.025 mg/24 hours (4s) [6.5 cm2, total estradiol 2.04 mg] [BCF]Climara®:0.0375 mg/24 hours (4s) [9.375 cm2, total estradiol 2.85 mg] [BCF]Climara®:0.05 mg/24 hours (4s) [12.5 cm2, total estradiol 3.8 mg] [BCF]Climara®:0.06 mg/24 hours (4s) [15 cm2, total estradiol 4.55 mg] [BCF]Climara®:0.075 mg/24 hours (4s) [18.75 cm2, total estradiol 5.7 mg] [BCF]Climara®:0.1 mg/24 hours (4s) [25 cm2, total estradiol 7.6 mg] [BCF]

Patch, transdermal [twice-weekly patch]:Estraderm®:0.05 mg/24 hours (8s) [10 cm2, total estradiol 4 mg]Estraderm®:0.1 mg/24 hours (8s) [20 cm2, total estradiol 8 mg]

Tablet, oral: 0.5 mg, 1 mg, 2 mg

Estradiol (Topical)Outpatient Dosage FormsCream, vaginal:Estrace: 0.1 mg/g (42.5 g)

Tablet, vaginal, as base:Vagifem: 10 mcg

Estrogens (Conjugated/Equine) and MedroxyprogesteroneOutpatient Dosage FormsTablet, oral:Prempro®: 0.3/1.5: Conjugated estrogens 0.3 mg and medroxyprogesteroneacetate 1.5 mg [BCF]

Prempro®: 0.625/2.5: Conjugated estrogens 0.625 mg and medroxyproges-terone acetate 2.5 mg [BCF]

Prempro®: 0.625/5: Conjugated estrogens 0.625 mg and medroxyprogester-one acetate 5 mg [BCF]

Estrogens (Conjugated/Equine, Systemic)Outpatient Dosage FormsTablet, oral:Premarin®: 0.3 mg [BCF], 0.45 mg [BCF], 0.625 mg [BCF], 1.25 mg [BCF]

Estrogens (Conjugated/Equine, Topical)Outpatient Dosage FormsCream, vaginal:Premarin®: 0.625 mg/g (42.5 g) [BCF]

ESTROGENS (CONJUGATED/EQUINE, TOPICAL)

7

Estrogens (Esterified) and MethyltestosteroneOutpatient Dosage FormsTablet, oral: Esterified estrogens 1.25 mg and methyltestosterone 2.5 mg[contains tartrazine]; esterified estrogen 0.625 mg and methyltestosterone1.25 mgCovaryx™ H.S.: Estrogens (Esterified) 0.625 mg and methyltestosterone1.25 mg [contains tartrazine]

Estratest®: Estrogens (Esterified) 1.25 mg and methyltestosterone 2.5 mg[contains sodium benzoate]

EszopicloneOutpatient Dosage FormsTablet, oral: 1 mg, 2 mg, 3 mg

EthambutolOutpatient Dosage FormsTablet, oral, as hydrochloride: 100 mg [BCF], 400 mg [BCF]

Ethinyl Estradiol and DesogestrelOutpatient Dosage FormsTablet, oral [monophasic formulation]:Ortho-Cept® 28: Ethinyl estradiol 0.03 mg and desogestrel 0.15 mg (28s) [21orange tablets and 7 green inactive tablets]

Ethinyl Estradiol and DrospirenoneOutpatient Dosage FormsTablet, oral:Yasmin®: Ethinyl estradiol 0.03 mg and drospirenone 3 mg [21 yellow activetablets and 7 white inactive tablets] [BCF]

Yaz®: Ethinyl estradiol 0.02 mg and drospirenone 3 mg [24 light pink tabletsand 4 white inactive tablets] [BCF]

Ethinyl Estradiol and Ethynodiol DiacetateOutpatient Dosage FormsTablet, oral:Zovia® 1/35: Ethinyl estradiol 0.035 mg and ethynodiol diacetate 1 mg [21light pink tablets and 7 white inactive tablets]

Ethinyl Estradiol and EtonogestrelOutpatient Dosage FormsRing, vaginal:NuvaRing®: Ethinyl estradiol 0.015 mg/day and etonogestrel 0.12 mg/day(1s) [3-week duration]

Ethinyl Estradiol and LevonorgestrelOutpatient Dosage FormsTablet, oral [low dose formulation]:Aviane™ 28: Ethinyl estradiol 0.02 mg and levonorgestrel 0.1 mg [21 orangetablets and 7 light green inactive tablets] [BCF]

Lessina® 28: Ethinyl estradiol 0.02 mg and levonorgestrel 0.1 mg [21 pinktablets and 7 white inactive tablets] [BCF]

Levlite™ 28: Ethinyl estradiol 0.02 mg and levonorgestrel 0.1 mg (28s) [21pink tablets and 7 white inactive tablets] [BCF]

Tablet, oral [monophasic formulation]:Levora®: Ethinyl estradiol 0.03 mg and levonorgestrel 0.15 mg [21 whitetablets and 7 peach inactive tablets] [BCF]

Nordette® 28: Ethinyl estradiol 0.03 mg and levonorgestrel 0.15 mg (28s) [21light orange tablets and 7 pink inactive tablets] [BCF]

Tablet, oral [triphasic formulation]:Triphasil® 28:Day 1-6: Ethinyl estradiol 0.03 mg and levonorgestrel 0.05 mg [6 browntablets]

Day 7-11: Ethinyl estradiol 0.04 mg and levonorgestrel 0.075 mg [5 whitetablets]

Day 12-21: Ethinyl estradiol 0.03 mg and levonorgestrel 0.125 mg [10 lightyellow tablets]

Day 22-28: 7 light green inactive tablets

Ethinyl Estradiol and NorelgestrominOutpatient Dosage FormsPatch, transdermal:Ortho Evra®: Ethinyl estradiol 0.75 mg and norelgestromin 6 mg (1s, 3s)[releases ethinyl estradiol 20 mcg and norelgestromin 150 mcg per day]

Ethinyl Estradiol and NorethindroneOutpatient Dosage FormsTablet, oral [monophasic formulation]:Loestrin® Fe 1/20: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg(28s) [21 white tablets] and ferrous fumarate 75 mg [7 brown tablets]

Microgestin™ Fe 1/20: Ethinyl estradiol 0.02 mg and norethindrone acetate1 mg (28s) [21 white tablets] and ferrous fumarate 75 mg [7 brown tablets]

Microgestin® Fe 1.5/30: Ethinyl estradiol 0.03 mg and norethindrone acetate1.5 mg [21 green tablets] and ferrous fumarate 75 mg [7 brown tablets]

Norinyl® 1+35: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [21 yellowgreen tablets and 7 orange inactive tablets] [BCF]

Tablet, oral [triphasic formulation]:Ortho-Novum® 7/7/7-28:Day 1-7: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [7 whitetablets]

Day 8-16: Ethinyl estradiol 0.035 mg and norethindrone 0.75 mg [7 lightpeach tablets]

Day 17-21: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [7 peachtablets]

Day 22-28: 7 green inactive tabletsTri-Norinyl®:Day 1-7: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [7 bluetablets]

Day 8-16: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [9 yellow-green tablets]

Day 17-21: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [5 bluetablets]

Day 22-28: 7 orange inactive tablets

Ethinyl Estradiol and NorgestimateOutpatient Dosage FormsTablet, monophasic formulations:Ortho-Cyclen®: Ethinyl estradiol 0.035 mg and norgestimate 0.25 mg (28s)[21 blue tablets and 7 green inactive tablets] [BCF]

Tablet, oral [triphasic formulation]:Ortho Tri-Cyclen® Lo:Day 1-7: Ethinyl estradiol 0.025 mg and norgestimate 0.18 mg [7 whitetablets]

Day 8-14: Ethinyl estradiol 0.025 mg and norgestimate 0.215 mg [7 light bluetablets]

Day 15-21: Ethinyl estradiol 0.025 mg and norgestimate 0.25 mg [7 darkblue tablets]

Day 22-28: 7 green inactive tabletsTriNessa®:Day 1-7: Ethinyl estradiol 0.035 mg and norgestimate 0.18 mg [7 whitetablets]

Day 8-14: Ethinyl estradiol 0.035 mg and norgestimate 0.215 mg [7 light bluetablets]

Day 15-21: Ethinyl estradiol 0.035 mg and norgestimate 0.25 mg [7 bluetablets]

Day 22-28: 7 green inactive tablets

Ethinyl Estradiol and NorgestrelOutpatient Dosage FormsTablet, oral:Ogestrel®: Ethinyl estradiol 0.05 mg and norgestrel 0.5 mg

Tablet, oral [monophasic formulation]:Low-Ogestrel®: Ethinyl estradiol 0.03 mg and norgestrel 0.3 mg [21 whitetablets and 7 peach inactive tablets]

Lo/Ovral®-28: Ethinyl estradiol 0.03 mg and norgestrel 0.3 mg [21 whitetablets and 7 pink inactive tablets] (28s)

ExemestaneOutpatient Dosage FormsTablet, oral: 25 mg

EzetimibeOutpatient Dosage FormsTablet, oral:Zetia®: 10 mg

FelodipineOutpatient Dosage FormsTablet, extended release, oral: 2.5 mg, 5 mg, 10 mg

Fenofibrate and DerivativesOutpatient Dosage FormsTablet, oral:TriCor®: 48 mg [BCF], 145 mg [BCF] [contains soybean lecithin]

FentaNYLOutpatient Dosage FormsPatch, transdermal, as base: 12 mcg/hour (5s); 25 mcg/hour (5s); 50 mcg/hour(5s); 75 mcg/hour (5s); 100 mcg/hour (5s)Duragesic®:25 (5s) [delivers 25 mcg/hour; 10 cm2; contains ethanol 0.1 mL/10 cm2]50 (5s) [delivers 50 mcg/hour; 20 cm2; contains ethanol 0.1 mL/10 cm2]75 (5s) [delivers 75 mcg/hour; 30 cm2; contains ethanol 0.1 mL/10 cm2]100 (5s) [delivers 100 mcg/hour; 40 cm2; contains ethanol 0.1 mL/10 cm2]

Ferrous SulfateOutpatient Dosage FormsElixir, oral: 220 mg/5 mL (473 mL) [elemental iron 44 mg/5 mL]Liquid, oral [drops]:Fer-Gen-Sol: 75 mg/0.6 mL (50 mL) [elemental iron 15 mg/0.6 mL]

Tablet, oral: 325 mg [elemental iron 65 mg]

FexofenadineOutpatient Dosage FormsTablet, oral, as hydrochloride: 180 mg

FinasterideOutpatient Dosage FormsTablet, oral: 5 mg [BCF]Proscar®: 5 mg

ESTROGENS (ESTERIFIED) AND METHYLTESTOSTERONE

8

FlecainideOutpatient Dosage FormsTablet, oral, as acetate: 50 mg, 100 mgTambocor™: 50 mg, 100 mg

FluconazoleOutpatient Dosage FormsTablet, oral: 100 mg, 150 mg [BCF], 200 mgDiflucan®: 100 mg, 150 mg [BCF], 200 mg

FludrocortisoneOutpatient Dosage FormsTablet, oral, as acetate: 0.1 mg

Fluocinolone (Topical)Outpatient Dosage FormsOil, topical, as acetonide [body oil]:Derma-Smoothe/FS®: 0.01% (120 mL) [contains peanut oil]

Oil, topical, as acetonide [scalp oil]:Derma-Smoothe/FS®: 0.01% (120 mL) [contains peanut oil]

Shampoo, topical, as acetonide:Capex®: 0.01% (120 mL)

Solution, topical, as acetonide: 0.01% (60 mL)

FluocinonideOutpatient Dosage FormsCream, anhydrous, emollient, topical: 0.05% (15 g, 30 g, 60 g) [BCF]Ointment, topical: 0.05% (15 g, 30 g, 60 g)

FluorometholoneOutpatient Dosage FormsOintment, ophthalmic, as base:FML®: 0.1% (3.5 g)

Suspension, ophthalmic, as acetate:Flarex®: 0.1% (5 mL) [contains benzalkonium chloride]

Suspension, ophthalmic, as base:FML®: 0.1% (5 mL) [contains benzalkonium chloride]

Fluorouracil (Topical)Outpatient Dosage FormsCream, topical:Fluoroplex®: 1% (30 g) [contains benzyl alcohol]

FLUoxetineOutpatient Dosage FormsCapsule, oral: 10 mg [BCF], 20 mg [BCF], 40 mg [BCF]Prozac®: 10 mg, 20 mg, 40 mg [BCF]

Solution, oral: 20 mg/5 mL (5 mL, 120 mL) [BCF]

FluoxymesteroneOutpatient Dosage FormsTablet, oral: 10 mg

FluPHENAZineOutpatient Dosage FormsElixir, oral, as hydrochloride: 2.5 mg/5 mL (60 mL)Tablet, oral, as hydrochloride: 5 mg

FlurandrenolideOutpatient Dosage FormsTape, topical [roll]:Cordran®: 4 mcg/cm2 (24 inch)

Flurbiprofen (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as sodium: 0.03% (2.5 mL)

FlutamideOutpatient Dosage FormsCapsule, oral: 125 mg

Fluticasone and SalmeterolOutpatient Dosage FormsAerosol, for oral inhalation:Advair® HFA:45/21: Fluticasone propionate 45 mcg and salmeterol 21 mcg per inhalation(12 g) [chlorofluorocarbon free; 120 metered actuations] [BCF]

115/21: Fluticasone propionate 115 mcg and salmeterol 21 mcg per inhala-tion (12 g) [chlorofluorocarbon free; 120 metered actuations] [BCF]

230/21: Fluticasone propionate 230 mcg and salmeterol 21 mcg per inhala-tion (12 g) [chlorofluorocarbon free; 120 metered actuations] [BCF]

Powder, for oral inhalation:Advair Diskus®:100/50: Fluticasone propionate 100 mcg and salmeterol 50 mcg (60s)[contains lactose] [BCF]

250/50: Fluticasone propionate 250 mcg and salmeterol 50 mcg (60s)[contains lactose] [BCF]

500/50: Fluticasone propionate 500 mcg and salmeterol 50 mcg (60s)[contains lactose] [BCF]

Fluticasone (Nasal)Outpatient Dosage FormsSuspension, intranasal, as propionate [spray]:Flonase®: 50 mcg/inhalation (16 g) [contains benzalkonium chloride; 120metered actuations] [BCF]

Fluticasone (Oral Inhalation)Outpatient Dosage FormsAerosol, Inhalation, as propionate:Flovent HFA: 44 mcg/inhalation (10.6 g) [chlorofluorocarbon free; 120 meteredactuations] [BCF]

Flovent HFA: 110 mcg/inhalation (12 g) [chlorofluorocarbon free; 120 meteredactuations] [BCF]

Flovent HFA: 220 mcg/inhalation (12 g) [chlorofluorocarbon free; 120 meteredactuations] [BCF]

Aerosol Powder Breath Activated, Inhalation, as propionate:Flovent Diskus: 50 mcg (60 ea) [contains lactose] [BCF]Flovent Diskus: 100 mcg (60 ea) [contains lactose] [BCF]Flovent Diskus: 250 mcg (60 ea) [contains lactose] [BCF]

Folic AcidOutpatient Dosage FormsTablet, oral: 1 mg [BCF]

FurosemideOutpatient Dosage FormsSolution, oral: 10 mg/mL (60 mL) [BCF]Tablet, oral: 20 mg [BCF], 40 mg [BCF]

GabapentinOutpatient Dosage FormsCapsule, oral: 100 mg [BCF], 300 mg [BCF], 400 mg [BCF]Neurontin®: 100 mg, 300 mg, 400 mg

Tablet, oral: 600 mg [BCF], 800 mg [BCF]Neurontin®: 600 mg, 800 mg [scored]

GatifloxacinOutpatient Dosage FormsSolution, ophthalmic: 0.5% (2.5 mL)

GemfibrozilOutpatient Dosage FormsTablet, oral: 600 mg [BCF]

Gentamicin (Ophthalmic)Outpatient Dosage FormsOintment, ophthalmic:Gentak®: 0.3% [3 mg/g] (3.5 g) [BCF]

Solution, ophthalmic [drops]: 0.3% (5 mL) [BCF]

Gentamicin (Topical)Outpatient Dosage FormsCream, topical: 0.1% (15 g, 30 g)

GlipiZIDEOutpatient Dosage FormsTablet, oral: 5 mg [BCF], 10 mg [BCF]Glucotrol®: 10 mg [scored; dye free]

GlyBURIDEOutpatient Dosage FormsTablet, oral: 1.25 mg [BCF], 2.5 mg [BCF], 5 mg [BCF]Tablet, oral [micronized]: 1.5 mg [BCF], 3 mg [BCF], 6 mg [BCF]

Glyburide and MetforminOutpatient Dosage FormsTablet, oral: 1.25/250: Glyburide 1.25 mg and metformin hydrochloride 250 mg,2.5/500: Glyburide 2.5 and metformin hydrochloride 500 mgGlucovance®: 5/500: Glyburide 5 mg and metformin hydrochloride 500 mg

GlycerinOutpatient Dosage FormsSolution, rectal:Fleet® Babylax®: 2.3 g/2.3 mL (4 mL)

Suppository, rectal [adult]: 82.5% (12s, 24s, 25s, 50s, 100s)Suppository, rectal [pediatric]: 82.5% (12s, 25s)Colace® Glycerin Suppositories: 1.2 g (24s)

Glycopyrrolate (Systemic)Outpatient Dosage FormsTablet, oral: 1 mg

GriseofulvinOutpatient Dosage FormsSuspension, oral [microsize]: 125 mg/5 mL (120 mL) [BCF]Grifulvin V®: 125 mg/5 mL (120 mL) [contains ethanol 0.2%, propylene glycol]

Tablet, oral [ultramicrosize]:Gris-PEG®: 125 mg [BCF], 250 mg [BCF] [scored]

GRISEOFULVIN

9

GuaiFENesinOutpatient Dosage FormsSyrup, oral: 100 mg/5 mL (5 mL, 15 mL, 118 mL)Tablet, extended release 12 hour, oral: 600 mg

Guaifenesin and CodeineOutpatient Dosage FormsSolution, oral: Guaifenesin 100 mg and codeine phosphate 10 mg per 5 mL (5mL)

Guaifenesin and DextromethorphanOutpatient Dosage FormsSyrup, oral: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mgper 5 mL (5 mL, 118 mL)

Tablet, extended release, oral:Mucinex DM: Guaifenesin 600 mg and dextromethorphan hydrobro-mide 30 mg

GuanFACINEOutpatient Dosage FormsTablet, Oral:Generic: 1 mg, 2 mg

Tablet Extended Release 24 Hour, Oral:Intuniv: 1 mg, 2 mgGeneric: 1 mg, 2 mg

HomatropineOutpatient Dosage FormsSolution, ophthalmic, as hydrobromide:Isopto® Homatropine: 5% (5 mL) [contains benzalkonium chloride]

Hyaluronate and DerivativesOutpatient Dosage FormsInjection, solution, intra-articular:Euflexxa™: 10 mg/mL (2 mL) [contains natural rubber/natural latex in pack-aging]

HydrALAZINEOutpatient Dosage FormsTablet, oral, as hydrochloride: 10 mg [BCF], 25 mg [BCF]

HydroCHLOROthiazideOutpatient Dosage FormsCapsule, oral: 12.5 mg [BCF]Tablet, oral: 12.5 mg, 25 mg [BCF], 50 mg [BCF]

Hydrochlorothiazide and TriamtereneOutpatient Dosage FormsTablet, oral: Hydrochlorothiazide 25 mg and triamterene 37.5 mg [BCF]; hydro-chlorothiazide 50 mg and triamterene 75 mg [BCF]Maxzide®: Hydrochlorothiazide 50 mg and triamterene 75 mg [scored]Maxzide®-25: Hydrochlorothiazide 25 mg and triamterene 37.5 mg [scored]

Hydrocodone and AcetaminophenOutpatient Dosage FormsSolution, oral:Generic: Hydrocodone bitartrate 7.5 mg and acetaminophen 325 mg per 15mL (473 mL)

Tablet, oral:Norco: Hydrocodone bitartrate 5 mg and acetaminophen 325 mgNorco: Hydrocodone bitartrate 7.5 mg and acetaminophen 325 mg

Hydrocodone and HomatropineOutpatient Dosage FormsSyrup, oral: Hydrocodone bitartrate 5 mg and homatropine methylbromide1.5 mg per 5 mL

Hydrocodone and IbuprofenOutpatient Dosage FormsTablet, oral: Hydrocodone bitartrate 7.5 mg and ibuprofen 200 mgVicoprofen®: 7.5/200: Hydrocodone bitartrate 7.5 mg and ibuprofen 200 mg

Hydrocortisone (Systemic)Outpatient Dosage FormsTablet, oral, as base:Cortef®: 5 mg, 20 mg [scored]

Hydrocortisone (Topical)Outpatient Dosage FormsCream, topical, as base: 0.5% (30 g); 1% (1.5 g, 30 g)Cortaid® Maximum Strength: 1% (30 g)

Cream, topical, as valerate: 0.2% (15 g)Westcort®: 0.2% (15 g)

Lotion, topical, as base: 1% (120 mL)Ointment, topical, as base: 1% (454 g)Ointment, topical, as valerate: 0.2% (15 g)Westcort®: 0.2% (15 g)

Suppository, rectal, as acetate: 25 mg (24s) [BCF]Anucort-HC™: 25 mg (12s)Anusol-HC®: 25 mg (12s, 24s)

HYDROmorphoneOutpatient Dosage FormsTablet, oral, as hydrochloride: 2 mg, 4 mg

HydroxychloroquineOutpatient Dosage FormsTablet, oral, as sulfate: 200 mg

HydroxyureaOutpatient Dosage FormsCapsule, oral: 500 mg

HydrOXYzineOutpatient Dosage FormsCapsule, oral, as pamoate: 25 mg, 50 mgSyrup, oral, as hydrochloride: 10 mg/5 mL (120 mL, 480 mL) [BCF]Tablet, oral, as hydrochloride: 10 mg [BCF], 25 mg [BCF], 50 mg [BCF]

HyoscyamineOutpatient Dosage FormsTablet, oral, as sulfate: 0.125 mgTablet, extended release, oral, as sulfate: 0.375 mg

Hyoscyamine, Atropine, Scopolamine, and PhenobarbitalOutpatient Dosage FormsElixir, oral:Donnatal®: Hyoscyamine sulfate 0.1037 mg, atropine sulfate 0.0194 mg,scopolamine hydrobromide 0.0065 mg, and phenobarbital 16.2 mg per 5mL (120 mL) [contains ethanol <23.8%; citrus flavor]

Tablet, oral: Hyoscyamine sulfate 0.1037 mg, atropine sulfate 0.0194 mg,scopolamine hydrobromide 0.0065 mg, and phenobarbital 16.2 mgDonnatal®: Hyoscyamine sulfate 0.1037 mg, atropine sulfate 0.0194 mg,scopolamine hydrobromide 0.0065 mg, and phenobarbital 16.2 mg

IbandronateOutpatient Dosage FormsTablet, oral:Generic: 150 mg

IbuprofenOutpatient Dosage FormsSuspension, oral: 100 mg/5 mL (480 mL)Motrin® Children's: 100 mg/5 mL (120 mL) [ethanol free; contains sodium2 mg/5 mL, sodium benzoate; berry flavor]

Tablet, oral: 200 mg, 400 mg [BCF], 600 mg [BCF], 800 mg [BCF]Motrin® IB: 200 mg

ImipramineOutpatient Dosage FormsTablet, oral, as hydrochloride: 10 mg [BCF], 25 mg [BCF]Tofranil®: 10 mg [BCF], 25 mg [BCF]

ImiquimodOutpatient Dosage FormsCream, topical: 5% (24s) [0.25 g/packet]

IndapamideOutpatient Dosage FormsTablet, oral: 1.25 mg, 2.5 mg

IndomethacinOutpatient Dosage FormsCapsule, oral: 25 mg [BCF], 50 mg [BCF]

Inhalation DevicesOutpatient Dosage FormsMask:EasiVent®: Small, medium, large

Spacer:EasiVent®

Insulin AspartOutpatient Dosage FormsInjection, solution:NovoLOG®: 100 units/mL (3 mL) [BCF] [FlexPen® prefilled syringe orPenFill® prefilled cartridge]; (10 mL) [vial] [BCF] (Diabetic Supplies on page6 available at MACH)

Insulin Aspart Protamine and Insulin AspartOutpatient Dosage FormsInjection, suspension:NovoLog® Mix 70/30: Insulin aspart protamine suspension 70% [intermediateacting] and insulin aspart solution 30% [rapid acting]: 100 units/mL (3 mL)[BCF] [FlexPen® prefilled syringe]; (10 mL) [vial] [BCF] (Diabetic Supplieson page 6 available at MACH)

GUAIFENESIN

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Insulin GlargineOutpatient Dosage FormsInjection, solution:Lantus®: 100 units/mL (3 mL, 10 mL) [BCF] (Diabetic Supplies on page 6available at MACH)

Insulin NPHOutpatient Dosage FormsInjection, suspension:NovoLIN® N: 100 units/mL (10 mL) [BCF] (Diabetic Supplies on page 6available at MACH)

Insulin NPH and Insulin RegularOutpatient Dosage FormsInjection, suspension:NovoLIN® 70/30: Insulin NPH suspension 70% [intermediate acting] andinsulin regular solution 30% [short acting]: 100 units/mL (10 mL) [vial][BCF] (Diabetic Supplies on page 6 available at MACH)

Insulin RegularOutpatient Dosage FormsInjection, solution:NovoLIN® R: 100 units/mL (10 mL) [BCF] (Diabetic Supplies on page 6available at MACH)

Interferon Beta-1bOutpatient Dosage FormsKit, subcutaneous:Betaseron: 0.3 mg [contains albumin human] [BCF]

Ipratropium and AlbuterolOutpatient Dosage FormsAerosol, for oral inhalation:Combivent®: Ipratropium bromide 18 mcg and albuterol (base) 90 mcg perinhalation (14.7 g) [contains chlorofluorocarbon, soya lecithin; 200 meteredactuations] [BCF]

Solution, for nebulization:DuoNeb®: Ipratropium bromide 0.5 mg and albuterol (base) 2.5 mg per 3 mL(3 mL)

Ipratropium (Nasal)Outpatient Dosage FormsSolution, nasal, as bromide: 0.03% (30 mL)

Ipratropium (Oral Inhalation)Outpatient Dosage FormsAerosol, for oral inhalation, as bromide:Atrovent® HFA: 17 mcg/actuation (12.9 g) [chlorofluorocarbon free] [BCF]

Solution, for nebulization, as bromide: 0.02% [500 mcg/2.5 mL] (60s)

IsoniazidOutpatient Dosage FormsTablet, oral: 100 mg [BCF], 300 mg [BCF]

Isosorbide DinitrateOutpatient Dosage FormsTablet, oral: 5 mg [BCF], 10 mg [BCF], 20 mg [BCF], 30 mg [BCF]Isordil®: 10 mg, 40 mg

Tablet, sublingual: 5 mg

Isosorbide MononitrateOutpatient Dosage FormsTablet, oral: 20 mgTablet, extended release, oral: 30 mg [BCF], 60 mg [BCF], 120 mg [BCF]Imdur®: 30 mg [scored], 60 mg [scored], 120 mg

ISOtretinoinOutpatient Dosage FormsCapsule, Oral:Generic: 10 mg, 20 mg, 30 mg, 40 mg

ItraconazoleOutpatient Dosage FormsCapsule, oral: 100 mg

Ketoconazole (Systemic)Outpatient Dosage FormsTablet, oral: 200 mgNizoral®: 200 mg

Ketoconazole (Topical)Outpatient Dosage FormsAerosol, topical [foam]:Extina®: 2% (100 g)

Cream, topical: 2% (15 g, 30 g)Shampoo, topical: 2% (120 mL)

Ketorolac (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as tromethamine:Acular®: 0.5% (5 mL) [contains benzalkonium chloride]Acular LS®: 0.4% (5 mL) [contains benzalkonium chloride]

Ketorolac (Systemic)Outpatient Dosage FormsTablet, oral, as tromethamine: 10 mg

Ketotifen (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic [drops]: 0.025%

LactuloseOutpatient Dosage FormsSolution, oral: 10 g/15 mL (473 mL) [BCF]

LatanoprostOutpatient Dosage FormsSolution, ophthalmic [drops]:Xalatan®: 0.005% (2.5 mL) [contains benzalkonium chloride] [BCF]

LetrozoleOutpatient Dosage FormsTablet, oral: 2.5 mg

LevalbuterolOutpatient Dosage FormsSolution, for nebulization, as hydrochloride [strength expressed as base,preservative free]:Xopenex®: 0.63 mg/3 mL (3 mL); 1.25 mg/3 mL (3 mL)

LevETIRAcetamOutpatient Dosage FormsSolution, Oral:Generic: 100 mg/5 mL

Tablet, Oral:Generic: 250 mg, 500 mg, 750 mg, 1000 mg

Tablet Extended Release 24 Hour, Oral:Generic: 500 mg, 750 mg

LevoFLOXacin (Systemic)Outpatient Dosage FormsSolution, oral: 25 mg/mL [BCF]Tablet, oral: 250 mg [BCF], 500 mg [BCF], 750 mg [BCF]

Levonorgestrel (Systemic)Outpatient Dosage FormsTablet, Oral:Plan B: 0.75 mg [BCF]

LevorphanolOutpatient Dosage FormsTablet, oral, as tartrate: 2 mg

LevothyroxineOutpatient Dosage FormsTablet, oral, as sodium: 25 mcg [BCF], 50 mcg [BCF], 75 mcg [BCF], 88 mcg[BCF], 100 mcg [BCF], 112 mcg [BCF], 125 mcg [BCF], 137 mcg [BCF], 150mcg [BCF], 175 mcg [BCF], 200 mcg [BCF], 300 mcg [BCF]Synthroid®: 25 mcg [BCF], 50 mcg [BCF], 75 mcg [BCF], 88 mcg [BCF], 100mcg [BCF], 112 mcg [BCF], 125 mcg [BCF], 137 mcg [BCF], 150 mcg[BCF], 175 mcg [BCF], 200 mcg [BCF]

Lidocaine (Topical)Outpatient Dosage FormsGel, topical: 2% (30 mL)Jelly, topical, as hydrochloride: 2% (30 mL)Ointment, topical: 5%Patch, topical: 5%Solution, mouth/throat, as hydrochloride: 2%Solution, topical, as hydrochloride: 4% (50 mL)

LiothyronineOutpatient Dosage FormsTablet, oral:Cytomel®: 5 mcg, 25 mcg

LisinoprilOutpatient Dosage FormsTablet, oral: 2.5 mg [BCF], 5 mg [BCF], 10 mg [BCF], 20 mg [BCF], 30 mg[BCF], 40 mg [BCF]Zestril®: 30 mg

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Lisinopril and HydrochlorothiazideOutpatient Dosage FormsTablet, oral:10/12.5: Lisinopril 10 mg and hydrochlorothiazide 12.5 mg [BCF]20/12.5: Lisinopril 20 mg and hydrochlorothiazide 12.5 mg [BCF]20/25: Lisinopril 20 mg and hydrochlorothiazide 25 mg [BCF]Zestoretic®:10/12.5: Lisinopril 10 mg and hydrochlorothiazide 12.5 mg20/12.5: Lisinopril 20 mg and hydrochlorothiazide 12.5 mg20/25: Lisinopril 20 mg and hydrochlorothiazide 25 mg

LithiumOutpatient Dosage FormsCapsule, Oral, as carbonate:Generic: 150 mg [BCF], 300 mg [BCF]

Solution, Oral, as citrate:Generic: 300 mg/5 mL (5 mL, 473 mL, 500 mL) [equivalent to amount oflithium in lithium carbonate] [BCF]

Syrup, Oral, as citrate:Generic: 300 mg/5 mL [BCF]

Tablet Extended Release, Oral, as carbonate:Generic: 300 mg, 450 mg

LoperamideOutpatient Dosage FormsCaplet, oral:Imodium® A-D: 2 mg

Capsule, oral, as hydrochloride: 2 mg [BCF]

LoratadineOutpatient Dosage FormsSolution, oral: 5 mg/5 mL (120 mL)Syrup, oral: 5 mg/5 mL (120 mL)Claritin® Children's Allergy: 5 mg/5 mL (120 mL) [dye free, ethanol free;contains propylene glycol, sodium benzoate; fruit flavor]

Tablet, oral:Claritin® 24 Hour Allergy: 10 mg

LORazepamOutpatient Dosage FormsTablet, oral: 0.5 mg, 1 mgAtivan®: 1 mg [scored]

LosartanOutpatient Dosage FormsTablet, oral, as potassium:Cozaar®:25 mg [contains potassium 2.12 mg (0.054 mEq)]50 mg [contains potassium 4.24 mg (0.108 mEq)]100 mg [contains potassium 8.48 mg (0.216 mEq)]

Losartan and HydrochlorothiazideOutpatient Dosage FormsTablet, oral:Hyzaar® 50/12.5: Losartan potassium 50 mg and hydrochlorothiazide12.5 mg [contains potassium 4.24 mg (0.108 mEq)]

Hyzaar® 100/12.5: Losartan potassium 100 mg and hydrochlorothiazide12.5 mg

Hyzaar® 100/25: Losartan potassium 100 mg and hydrochlorothiazide 25 mg[contains potassium 8.48 mg (0.216 mEq)]

LoteprednolOutpatient Dosage FormsGel, Ophthalmic, as etabonate:Lotemax: 0.5% (5 g) [contains benzalkonium chloride, edetate disodiumdihydrate, propylene glycol]

Ointment, Ophthalmic, as etabonate:Lotemax: 0.5% (3.5 g)

Suspension, Ophthalmic, as etabonate:Lotemax: 0.5% (5 mL)

LoxapineOutpatient Dosage FormsCapsule, oral:Loxitane®: 10 mg

LubiprostoneOutpatient Dosage FormsCapsule, oral:Amitiza: 8 mcg, 24 mcg

LurasidoneOutpatient Dosage FormsTablet, Oral, as hydrochloride:Latuda: 20 mg, 40 mg, 60 mg, 80 mg, 120 mg

Magnesium CitrateOutpatient Dosage FormsSolution, oral: 290 mg/5 mL (300 mL) [cherry and lemon flavors]Citroma®: 290 mg/5 mL (300 mL) [contains magnesium 48 mg and potassium13 mg per 5 mL; cherry and lemon flavors]; (300 mL) [contains magnesium48 mg and sodium 7.5 mg per 5 mL; grape and lemony flavors]

Magnesium HydroxideOutpatient Dosage FormsSuspension, oral: 400 mg/5 mL (30 mL, 473 mL)Milk of Magnesia: 400 mg/5 mL (360 mL, 473 mL, 480 mL, 960 mL, 3840 mL)

Magnesium OxideOutpatient Dosage FormsTablet, oral:Mag-Ox® 400: 400 mg [scored; equivalent to elemental magnesium 240 mg(20 mEq)]

MeclizineOutpatient Dosage FormsTablet, oral, as hydrochloride: 25 mgAntivert®: 25 mg

MedroxyPROGESTERoneOutpatient Dosage FormsTablet, oral, as acetate: 2.5 mg [BCF], 10 mg [BCF]Provera®: 2.5 mg, 10 mg [scored]

MegestrolOutpatient Dosage FormsSuspension, oral, as acetate: 400 mg/10 mL

MelatoninOutpatient Dosage FormsTablet, oral: 3 mg

MeloxicamOutpatient Dosage FormsTablet, oral: 7.5 mg [BCF], 15 mg [BCF]Mobic®: 7.5 mg [BCF], 15 mg [BCF]

MemantineOutpatient Dosage FormsTablet, oral, as hydrochloride: 5 mg, 10 mg

MentholOutpatient Dosage FormsCrystals: 120 g

MesalamineOutpatient Dosage FormsEnema, rectal: 4 g (60 mL)Tablet delayed release, oral:Lialda: 1.2 g [BCF]

MetFORMINOutpatient Dosage FormsTablet, oral, as hydrochloride: 500 mg [BCF], 850 mg [BCF], 1000 mg [BCF]Glucophage®: 500 mg, 850 mg, 1000 mg

Tablet, extended release, oral, as hydrochloride: 500 mg [BCF], 750 mg [BCF]Glucophage® XR: 750 mg

MethazolAMIDEOutpatient Dosage FormsTablet, oral: 50 mg

MethIMAzoleOutpatient Dosage FormsTablet, oral:Tapazole®: 5 mg, 10 mg [scored]

MethocarbamolOutpatient Dosage FormsTablet, oral: 500 mg [BCF]Robaxin®: 500 mg [scored]

MethotrexateOutpatient Dosage FormsTablet, oral: 2.5 mg [BCF]

MethylcelluloseOutpatient Dosage FormsPowder, oral:Citrucel®: 2 g/level scoop (448 g, 840 g, 1418 g, 1843 g) [gluten free; con-tains potassium 105 mg/level scoop, sodium 3 mg/level scoop; orangeflavor]

MethyldopaOutpatient Dosage FormsTablet, oral: 250 mg

LISINOPRIL

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MethylergonovineOutpatient Dosage FormsTablet, oral, as maleate:Methergine®: 0.2 mg

MethylphenidateOutpatient Dosage FormsTablet, oral, as hydrochloride:Methylin®: 5 mg [BCF], 10 mg [BCF]Ritalin®: 5 mg [BCF], 10 mg [BCF]

Tablet, extended release, oral, as hydrochloride [bi-modal release]:Concerta®: 18 mg [4 mg immediate release, 14 mg extended release] [BCF]Concerta®: 27 mg [6 mg immediate release, 21 mg extended release] [BCF]Concerta®: 36 mg [8 mg immediate release, 28 mg extended release] [BCF]Concerta®: 54 mg [12 mg immediate release, 42 mg extended release] [BCF]

Tablet, sustained release, oral, as hydrochloride:Ritalin-SR®: 20 mg [dye free]

MethylPREDNISoloneOutpatient Dosage FormsTablet, oral:Medrol: 4 mg

Tablet, oral [dose-pack]:Medrol Dosepak: 4 mg (21s) [scored]

Methyl Salicylate and MentholOutpatient Dosage FormsBalm, topical: 30 g

MethylTESTOSTERoneOutpatient Dosage FormsCapsule, oral:Android®: 10 mg

MetoclopramideOutpatient Dosage FormsSolution, oral: 5 mg/5 mL (10 mL, 480 mL) [BCF]Tablet, oral: 10 mg [BCF]Reglan®: 10 mg

MetOLazoneOutpatient Dosage FormsTablet, oral: 2.5 mgZaroxolyn®: 2.5 mg, 5 mg

MetoprololOutpatient Dosage FormsTablet, oral, as tartrate: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]Lopressor®: 50 mg [scored]

Tablet, extended release, oral, as succinate: 25 mg [BCF], 50 mg [BCF],100 mg [BCF], 200 mg [BCF] [expressed as mg equivalent to tartrate]Toprol-XL®: 25 mg, 50 mg, 100 mg, 200 mg [expressed as mg equivalent totartrate]

MetroNIDAZOLE (Systemic)Outpatient Dosage FormsTablet, oral: 250 mg [BCF], 500 mg [BCF]Flagyl®: 250 mg

MetroNIDAZOLE (Topical)Outpatient Dosage FormsCream, topical:MetroCream®: 0.75% (45 g) [contains benzyl alcohol]

Gel, topical: 0.75% (45 g)MetroGel®: 1% (60 g)

Gel, vaginal: 0.75% (70 g) [BCF]MetroGel-Vaginal®: 0.75% (70 g)

MexiletineOutpatient Dosage FormsCapsule, oral, as hydrochloride: 150 mg, 250 mg

Miconazole (Topical)Outpatient Dosage FormsCream, topical, as nitrate: 2% (28 g)Cream, vaginal, as nitrate [prefilled or refillable applicator]:Monistat® 7: 2% (45 g) [contains benzoic acid; 100 mg/applicator]

Mineral OilOutpatient Dosage FormsOil, oral: 100% (30 mL, 480 mL, 3840 mL)Oil, rectal [enema]:Fleet® Mineral Oil Enema: 100% per 118 mL delivered dose (133 mL)

Oil, topical: 100% (480 mL)

MinocyclineOutpatient Dosage FormsCapsule, oral: 50 mg, 100 mg

MirtazapineOutpatient Dosage FormsTablet, oral: 15 mg, 30 mg, 45 mgRemeron®: 15 mg, 30 mg, 45 mg

Mometasone (Nasal)Outpatient Dosage FormsSuspension, Nasal, as furoate:Generic: 50 mcg/actuation (17 g)

MontelukastOutpatient Dosage FormsPacket, oral: 4 mg/packet (30s) [BCF]Tablet, oral: 10 mg [BCF]Tablet chewable, oral: 4 mg [BCF], 5 mg [BCF]

Morphine (Systemic)Outpatient Dosage FormsSolution, oral, as sulfate [concentrate]: 100 mg/5 mL (30 mL)Tablet, oral, as sulfate: 15 mg, 30 mgTablet, controlled release, oral, as sulfate:MS Contin: 15 mg [BCF], 30 mg [BCF], 60 mg [BCF]

Mouthwash, MagicOutpatient Dosage FormsLiquid, oral: Extemporaneously prepared by pharmacy

Moxifloxacin (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic:Vigamox®: 0.5% (3 mL)

Moxifloxacin (Systemic)Outpatient Dosage FormsTablet, oral: 400 mg

MupirocinOutpatient Dosage FormsCream, topical, as calcium [strength expressed as base]:Bactroban Cream®: 2% (15 g) [contains benzyl alcohol]

Ointment, topical: 2% (22 g) [BCF]

Naphazoline and PheniramineOutpatient Dosage FormsSolution, ophthalmic:Opcon-A®: Naphazoline hydrochloride 0.027% and pheniramine maleate0.3% (15 mL) [contains benzalkonium chloride]

NaproxenOutpatient Dosage FormsSuspension, oral: 125 mg/5 mL (500 mL) [BCF]Tablet, oral: 250 mg [BCF], 500 mg [BCF]

NedocromilOutpatient Dosage FormsSolution, ophthalmic, as sodium:Alocril®: 2% (5 mL) [contains benzalkonium chloride]

NeomycinOutpatient Dosage FormsTablet, oral, as sulfate: 500 mg

Neomycin, Colistin, Hydrocortisone, and ThonzoniumOutpatient Dosage FormsSuspension, otic [drops]:Coly-Mycin® S: Neomycin 0.33%, colistin 0.3%, hydrocortisone acetate 1%,and thonzonium bromide 0.05% (5 mL) [contains thimerosal]

Neomycin, Polymyxin B, and DexamethasoneOutpatient Dosage FormsOintment, ophthalmic: Neomycin 3.5 mg, polymyxin B sulfate 10,000 units, anddexamethasone 0.1% per g (3.5 g)Maxitrol®: Neomycin 3.5 mg, polymyxin B sulfate 10,000 units, and dexame-thasone 0.1% per g (3.5 g)

Suspension, ophthalmic:Maxitrol®: Neomycin 3.5 mg, polymyxin B sulfate 10,000 units, and dexame-thasone 0.1% per 1 mL (5 mL) [contains benzalkonium chloride]

Neomycin, Polymyxin B, and GramicidinOutpatient Dosage FormsSolution, ophthalmic [drops]: Neomycin 1.75 mg, polymyxin B 10,000 units, andgramicidin 0.025 mg per 1 mL (10 mL) [BCF]Neosporin®: Neomycin 1.75 mg, polymyxin B 10,000 units, and gramicidin0.025 mg per 1 mL (10 mL)

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Neomycin, Polymyxin B, and Hydrocortisone (Otic)Outpatient Dosage FormsSolution, otic: Neomycin 3.5 mg, polymyxin B 10,000 units, and hydrocortisone10 mg per 1 mL (10 mL)Cortisporin®: Neomycin 3.5 mg, polymyxin B 10,000 units, and hydrocortisone10 mg per 1 mL (10 mL) [contains potassium metabisulfite]

Suspension, otic: Neomycin 3.5 mg, polymyxin B 10,000 units, and hydro-cortisone 10 mg per mL (10 mL) [BCF]Cortisporin®: Neomycin 3.5 mg, polymyxin B 10,000 units, and hydrocortisone10 mg per 1 mL (10 mL) [contains thimerosal]

NiacinOutpatient Dosage FormsCapsule, timed release, oral: 500 mgTablet, oral: 50 mg, 500 mgTablet, extended release, oral:Niaspan®: 500 mg [BCF], 750 mg [BCF], 1000 mg [BCF]

NicotineOutpatient Dosage FormsLozenge, mouth/throat, as polacrilex: 2 mg [BCF], 4 mg [BCF]Patch 24 hour, transdermal: 7 mg/24 hr [BCF]; 14 mg/24 hr [BCF]; 21 mg/24hr [BCF]

NIFEdipineOutpatient Dosage FormsCapsule, softgel, oral:Procardia®: 10 mg

Tablet, extended release, oral: 30 mg [BCF], 60 mg [BCF], 90 mg [BCF]Adalat® CC: 30 mg, 60 mg, 90 mg

NilutamideOutpatient Dosage FormsTablet, oral:Nilandron®: 150 mg

NitrofurantoinOutpatient Dosage FormsCapsule, oral [macrocrystal]: 50 mg [BCF]Macrodantin®: 50 mg

Capsule, oral [macrocrystal/monohydrate]: 100 mg [BCF]Macrobid®: 100 mg [nitrofurantoin macrocrystal 25% and nitrofurantoin mono-hydrate 75%]

Suspension, oral:Furadantin®: 25 mg/5 mL (230 mL)

NitroglycerinOutpatient Dosage FormsCapsule, extended release, oral: 2.5 mg, 6.5 mg, 9 mgOintment, topical:Nitro-Bid®: 2% [20 mg/g] (1 g, 30 g, 60 g)

Patch, transdermal [once-daily patch]: 0.2 mg/hour (30s) [BCF]; 0.4 mg/hour(30s) [BCF]; 0.6 mg/hour (30s) [BCF]Nitro-Dur®: 0.2 mg/hour (30s); 0.3 mg/hour (30s) [BCF]; 0.4 mg/hour (30s);0.6 mg/hour (30s); 0.8 mg/hour (30s) [BCF]

Solution, translingual [spray]:Nitrolingual®: 0.4 mg/spray (12 g) [contains ethanol 20%; 200 meteredsprays] [BCF]

Tablet, sublingual:Nitrostat®: 0.3 mg, 0.4 mg [BCF], 0.6 mg

NorethindroneOutpatient Dosage FormsTablet, oral:Nor-QD®: 0.35 mg [BCF]Ortho Micronor®: 0.35 mg

Tablet, oral, as acetate:Aygestin®: 5 mg [scored]

NortriptylineOutpatient Dosage FormsCapsule, oral: 10 mg [BCF], 25 mg [BCF]Pamelor®: 10 mg [BCF], 25 mg [may contain benzyl alcohol; 50 mg may alsocontain sodium bisulfite

Nystatin and TriamcinoloneOutpatient Dosage FormsCream, topical: Nystatin 100,000 units and triamcinolone acetonide 0.1%Ointment, topical: Nystatin 100,000 units and triamcinolone acetonide 0.1%

Nystatin (Oral)Outpatient Dosage FormsSuspension, oral: 100,000 units/mL (5 mL, 60 mL, 480 mL) [BCF]Tablet, oral: 500,000 units

Nystatin (Topical)Outpatient Dosage FormsCream, topical: 100,000 units/g (15 g) [BCF]

Ointment, topical: 100,000 units/g (30 g) [BCF]Powder, topical: 100,000 units/g (15 g)

Ofloxacin (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic [drops]: 0.3% (5 mL)Ocuflox®: 0.3% (5 mL) [contains benzalkonium chloride]

Olopatadine (Ophthalmic)Outpatient Dosage FormsSolution, Ophthalmic:Patanol: 0.1% (5 mL) [contains benzalkonium chloride] [BCF]Pazeo: 0.7% (2.5 mL) [contains benzalkonium chloride]

OlsalazineOutpatient Dosage FormsCapsule, oral, as sodium:Dipentum®: 250 mg

Omega-3 Fatty AcidsOutpatient Dosage FormsCapsule, oral: 1 g

OmeprazoleOutpatient Dosage FormsCapsule, delayed release, oral: , 20 mg [BCF], 40 mg

OndansetronOutpatient Dosage FormsSolution, Injection [INPT]:Zofran: 2 mg/mL (2 mL)

Solution, Oral, as hydrochloride [strength expressed as base]:Zofran: 4 mg/5 mL (50 mL) [strawberry flavor]

Tablet, Oral:Zofran: 4 mg, 8 mg

Tablet Disintegrating, Oral:Zofran ODT: 4 mg, 8 mg [contains aspartame, methylparaben sodium, pro-pylparaben sodium; strawberry flavor]

Generic: 4 mg, 8 mg

OseltamivirOutpatient Dosage FormsCapsule, oral, as phosphate:Tamiflu: 30 mg, 45 mg, 75 mg

Suspension reconstituted, oral, as base:Tamiflu: 6 mg/mL (60 mL) [contains saccharin sodium, sodium benzoate; tutti-frutti flavor]

OxybutyninOutpatient Dosage FormsSyrup, oral, as chloride: 5 mg/5 mL (473 mL)Tablet, oral, as chloride: 5 mgDitropan®: 5 mg

Tablet, extended release, oral, as chloride: 5 mg [BCF], 10 mg [BCF],15 mg [BCF]Ditropan XL®: 5 mg, 10 mg, 15 mg

OxyCODONEOutpatient Dosage FormsTablet, oral, as hydrochloride: 5 mg

Oxycodone and AcetaminophenOutpatient Dosage FormsCapsule, oral: 5/500: Oxycodone hydrochloride 5 mg and acetaminophen500 mg

Tablet, oral:5/325: Oxycodone hydrochloride 5 mg and acetaminophen 325 mg [BCF]10/325: Oxycodone hydrochloride 10 mg and acetaminophen 325 mg

Oxymetazoline (Nasal)Outpatient Dosage FormsSolution, intranasal, as hydrochloride [spray]:Afrin® Original: 0.05% (15 mL) [contains benzalkonium chloride]

PancrelipaseOutpatient Dosage FormsCapsule, delayed release, enteric coated microsphere, oral [porcine derived]:Creon: Lipase 3000 USP units, protease 9500 USP units, and amylase 15,000USP units [BCF]

Creon: Lipase 6000 USP units, protease 19,000 USP units, and amylase30,000 USP units [BCF]

Creon: Lipase 12,000 USP units, protease 38,000 USP units, and amylase60,000 USP units [BCF]

Creon: Lipase 24,000 USP units, protease 76,000 USP units, and amylase120,000 USP units [BCF]

Creon: Lipase 36,000 USP units, protease 114,000 USP units, and amylase180,000 USP units [BCF]

NEOMYCIN, POLYMYXIN B, AND GRAMICIDIN

14

PantoprazoleOutpatient Dosage FormsTablet, delayed release, oral: 20 mg, 40 mg

PARoxetineOutpatient Dosage FormsTablet, oral, as hydrochloride [strength expressed as base]: 10 mg, 20 mg,30 mg, 40 mgPaxil®: 10 mg, 20 mg, 30 mg, 40 mg

PenicillAMINEOutpatient Dosage FormsCapsule, oral:Cuprimine®: 250 mg

Penicillin V PotassiumOutpatient Dosage FormsPowder for solution, oral: 250 mg/5 mL (200 mL) [BCF]Tablet, oral: 250 mg [BCF], 500 mg [BCF]

Penicillin G BenzathineOutpatient Dosage FormsInjection, suspension:Bicillin® L-A: 600,000 units/mL (1 mL, 2 mL, 4 mL)

PentoxifyllineOutpatient Dosage FormsTablet, controlled release:Trental®: 400 mg

Tablet, extended release: 400 mg

PermethrinOutpatient Dosage FormsCream, topical: 5% (60 g) [BCF]Elimite®: 5% (60 g) [contains coconut oil] [BCF]

Liquid, topical [creme rinse formulation]:Nix®: 1% (60 mL) [contains isopropyl alcohol 20%]

PerphenazineOutpatient Dosage FormsTablet, oral: 4 mg

PhenazopyridineOutpatient Dosage FormsTablet, oral, as hydrochloride: 100 mg [BCF], 200 mg [BCF]Pyridium®: 100 mg, 200 mg [BCF]

PHENobarbitalOutpatient Dosage FormsElixir, oral: 20 mg/5 mL (5 mL) [BCF]Tablet, oral: 15 mg [BCF], 100 mg [BCF]

Phenylephrine (Nasal)Outpatient Dosage FormsSolution, nasal, as hydrochloride [drops]: 0.125%

Phenylephrine (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as hydrochloride: 2.5% (15 mL); 10% (5 mL)

Phenylephrine (Topical)Outpatient Dosage FormsOintment, rectal, as hydrochloride:Preparation H®: 0.25% (30 g, 60 g) [contains benzoic acid]

PhenytoinOutpatient Dosage FormsCapsule, extended release, oral, as sodium: 100 mg [BCF]Dilantin: 30 mg [contains sodium benzoate]

Suspension, oral: 125 mg/5 mL (240 mL) [BCF]

PhytonadioneOutpatient Dosage FormsTablet, oral:Mephyton®: 5 mg

Pilocarpine (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as hydrochloride: 1% (15 mL) [BCF]; 2% (15 mL) [BCF];4% (15 mL) [BCF]

PimecrolimusOutpatient Dosage FormsCream, topical:Elidel®: 1% (30 g) [BCF]

PioglitazoneOutpatient Dosage FormsTablet, oral:Actos®: 15 mg, 30 mg, 45 mg

Piroxicam (Systemic)Outpatient Dosage FormsCapsule, oral: 20 mgFeldene®: 20 mg

PodofiloxOutpatient Dosage FormsSolution, topical:Condylox®: 0.5% (3.5 mL) [contains ethanol 95%]

Polyethylene Glycol-Electrolyte SolutionOutpatient Dosage FormsPowder for solution, oral: PEG 3350 240 g, sodium sulfate 22.72 g, sodiumbicarbonate 6.72 g, sodium chloride 5.84 g, and potassium chloride 2.98 g(4000 mL)

Potassium ChlorideOutpatient Dosage FormsCapsule, extended release, microencapsulated, oral: 10 mEq [BCF]Powder for solution, oral: 20 mEq/packet [BCF]K-Lor™: 20 mEq/packet (30s) [fruit flavor]

Solution, oral: 20 mEq/15 mL (15 mL, 30 mL, 480 mL) [BCF]Tablet, extended release, microencapsulated, oral: 10 mEq [BCF], 20mEq [BCF]Klor-Con® M20: 20 mEq [scored; 1500 mg]

Tablet, extended release, wax matrix, oral:Klor-Con® 8: 8 mEq [600 mg]Klor-Con® 10: 10 mEq [750 mg]

Povidone-Iodine (Topical)Outpatient Dosage FormsSolution, topical:Betadine®: 10% (3840 mL)

PramipexoleOutpatient Dosage FormsTablet, oral, as dihydrochloride monohydrate: 0.125 mg, 0.25 mg, 0.5 mg,0.75 mg, 1 mg

Pramoxine and HydrocortisoneOutpatient Dosage FormsAerosol, rectal [foam]:Proctofoam®-HC: Pramoxine hydrochloride 1% and hydrocortisone acetate1% (10 g)

PravastatinOutpatient Dosage FormsTablet, oral, as sodium: 10 mg [BCF], 20 mg [BCF], 40 mg [BCF], 80 mg[BCF]Pravachol®: 10 mg, 20 mg, 40 mg, 80 mg

PrazosinOutpatient Dosage FormsCapsule, oral, as hydrochloride: 1 mg, 2 mg, 5 mgMinipress®: 1 mg, 2 mg, 5 mg

PrednisoLONE (Ophthalmic)Outpatient Dosage FormsSuspension, ophthalmic, as acetate [drops]: 1% (5 mL) [BCF]Pred Forte®: 1% (1 mL, 5 mL) [contains benzalkonium chloride, sodiumbisulfite]

Pred Mild®: 0.12% (5 mL) [contains benzalkonium chloride, sodium bisul-fite] [BCF]

PrednisoLONE (Systemic)Outpatient Dosage FormsSolution, oral, as sodium phosphate [strength expressed as base]: 15 mg/5 mL(237 mL, 473 mL) [BCF]Orapred®: Prednisolone base 15 mg/5 mL (20 mL, 240 mL) [dye free;contains ethanol 2%, sodium benzoate; grape flavor]

Pediapred®: 5 mg/5 mL (120 mL) [dye free; raspberry flavor]Syrup, oral, as base:Prelone®: 15 mg/5 mL (480 mL) [contains benzoic acid, ethanol 5%, propy-lene glycol; wild cherry flavor]

PredniSONEOutpatient Dosage FormsTablet, oral: 1 mg [BCF], 5 mg [BCF], 10 mg [BCF], 20 mg [BCF], 50 mgSterapred®: 5 mg [scored]

PregabalinOutpatient Dosage FormsCapsule, Oral:Lyrica: 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 225 mg, 300 mg[contains corn starch]

PrimaquineOutpatient Dosage FormsTablet, oral, as phosphate: 26.3 mg [15 mg base]

PRIMAQUINE

15

PrimidoneOutpatient Dosage FormsTablet, oral: 50 mg, 250 mg [generic tablet may contain sodium benzoate]Mysoline®: 50 mg, 250 mg

ProbenecidOutpatient Dosage FormsTablet, Oral:Generic: 500 mg [BCF]

ProcainamideOutpatient Dosage FormsCapsule, oral, as hydrochloride:Pronestyl®: 250 mg, 375 mg

ProchlorperazineOutpatient Dosage FormsSuppository, rectal: 25 mg (12s)Tablet, oral, as maleate [strength expressed as base]: 5 mg

ProgesteroneOutpatient Dosage FormsSuppository, vaginal [compounding kit]:First™-Progesterone VGS 25: 25 mg (30s)

PromethazineOutpatient Dosage FormsSuppository, rectal, as hydrochloride: 12.5 mg (12s) [BCF]; 25 mg (12s) [BCF]Phenergan®: 25 mg (12s)

Syrup, oral, as hydrochloride: 6.25 mg/5 mL (473 mL) [BCF]Tablet, oral, as hydrochloride: 25 mg [BCF], 50 mg

PropanthelineOutpatient Dosage FormsTablet, oral, as bromide: 15 mg

PropranololOutpatient Dosage FormsCapsule, extended release, oral, as hydrochloride: 60 mg, 80 mgCapsule, sustained release, oral, as hydrochloride:Inderal® LA: 80 mg, 120 mg

Tablet, oral, as hydrochloride: 10 mg, 40 mg, 80 mg

PropylthiouracilOutpatient Dosage FormsTablet, oral: 50 mg [BCF]

PseudoephedrineOutpatient Dosage FormsLiquid, Oral, as hydrochloride:Generic: 30 mg/5 mL (120 mL)

Syrup, Oral, as hydrochloride:Generic: 30 mg/5 mL (118 mL)

Tablet, Oral, as hydrochloride:Sudafed: 30 mgSudoGest: 30 mgGeneric: 30 mg

Tablet Extended Release 12 Hour, Oral, as hydrochloride:Generic: 120 mg

PsylliumOutpatient Dosage FormsPowder, oral:Metamucil®: 3.4 g/packe, 390 g, 570 g, 870 g

Pyrantel PamoateOutpatient Dosage FormsSuspension, oral, as pamoate:Pin-X®: 144 mg/mL (30 mL, 60 mL) [sugar free; contains sodium benzoate;caramel flavor; equivalent to pyrantel base 50 mg/mL]

Tablet, chewable, oral, as pamoate:Pin-X®: 720.5 mg [scored; contains aspartame; equivalent to pyrantel base250 mg]

PyrazinamideOutpatient Dosage FormsTablet, oral: 500 mg [BCF]

PyridoxineOutpatient Dosage FormsTablet, oral, as hydrochloride: 50 mg

QUEtiapineOutpatient Dosage FormsTablet, oral:Seroquel®: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF], 200 mg [BCF]

Tablet, extended release, oral:Seroquel XR®: 150 mg [BCF], 200 mg [BCF], 300 mg [BCF], 400 mg [BCF]

RABEprazoleOutpatient Dosage FormsTablet Delayed Release, Oral, as sodium:Generic: 20 mg

RaloxifeneOutpatient Dosage FormsTablet, oral, as hydrochloride:Evista®: 60 mg [BCF]

RamiprilOutpatient Dosage FormsCapsule, oral: 1.25 mg [BCF], 2.5 mg [BCF], 5 mg [BCF], 10 mg [BCF]

RaNITIdineOutpatient Dosage FormsSyrup, oral: 15 mg/mL (5 mL [BCF], 10 mL [BCF])Zantac®: 15 mg/mL (480 mL) [contains ethanol 7.5%; peppermint flavor]

Tablet, oral: 150 mg [BCF]Zantac®: 150 mg

RifAMPinOutpatient Dosage FormsCapsule, oral: 150 mg, 300 mg [BCF]Rifadin®: 150 mg, 300 mg

RisperiDONEOutpatient Dosage FormsSolution, oral: 1 mg/mL (30 mL) [BCF]Risperdal®: 1 mg/mL (30 mL) [contains benzoic acid]

Tablet, oral: 0.25 mg [BCF], 0.5 mg [BCF], 1 mg [BCF], 2 mg [BCF], 3 mg[BCF], 4 mg [BCF]Risperdal®: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg

RivaroxabanOutpatient Dosage FormsTablet, Oral:Xarelto: 10 mg, 15 mg, 20 mg

Tablet Therapy Pack, Oral:Xarelto Starter Pack: 15 mg (42s) and 20 mg (9s) (51 ea)

RizatriptanOutpatient Dosage FormsTablet, oral:Maxalt®: 5 mg [BCF], 10 mg [BCF]

Tablet, orally disintegrating:Maxalt-MLT®:5 mg [contains phenylalanine 1.05 mg/tablet; peppermint flavor] [BCF]10 mg [contains phenylalanine 2.1 mg/tablet; peppermint flavor] [BCF]

ROPINIRoleOutpatient Dosage FormsTablet, oral: 0.25 mg, 0.5 mg, 1 mg, 2 mg

RosuvastatinOutpatient Dosage FormsTablet, Oral:Crestor: 5 mg [BCF], 10 mg [BCF], 20 mg [BCF], 40 mg [BCF]

SalmeterolOutpatient Dosage FormsPowder, for oral inhalation:Serevent® Diskus®: 50 mcg (60s) [contains lactose] [BCF]

SalsalateOutpatient Dosage FormsTablet, oral: 750 mg [BCF]

Scopolamine (Systemic)Outpatient Dosage FormsPatch 72 hour, transdermal:Transderm-Scop: 1.5 mg

SelegilineOutpatient Dosage FormsCapsule, oral, as hydrochloride: 5 mgEldepryl®: 5 mg

Selenium SulfideOutpatient Dosage FormsLotion, topical: 2.5% (120 mL) [BCF]

SennaOutpatient Dosage FormsTablet, oral: Sennosides 8.6 mg

PRIMIDONE

16

SertralineOutpatient Dosage FormsSolution, oral [concentrate]: 20 mg/mL (60 mL) [BCF]Tablet, oral: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]Zoloft®: 25 mg, 50 mg, 100 mg

SildenafilOutpatient Dosage FormsTablet, Oral:Revatio: 20 mg [ECF]Viagra: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]Generic: 20 mg [ECF]

Silver SulfadiazineOutpatient Dosage FormsCream, topical: 1% (25 g, 50 g) [BCF]Silvadene®: 1% (400 g)SSD AF®: 1% (400 g)Thermazene®: 1% (400 g)

SimethiconeOutpatient Dosage FormsSuspension, oral [drops]:Mylicon® Infants': 40 mg/0.6 mL (30 mL) [ethanol free; contains sodiumbenzoate]

Tablet, chewable, oral: 80 mg

SimvastatinOutpatient Dosage FormsTablet, oral: 5 mg [BCF], 10 mg [BCF], 20 mg [BCF], 40 mg [BCF], 80 mg[BCF]Zocor®: 5 mg, 10 mg, 20 mg, 40 mg, 80 mg

SITagliptinOutpatient Dosage FormsTablet, oral:Januvia®: 50 mg [BCF], 100 mg [BCF]

Sitagliptin and MetforminOutpatient Dosage FormsTablet, oral:Janumet® 50/500: Sitagliptin 50 mg and metformin hydrochloride500 mg [BCF]

Janumet® 50/1000: Sitagliptin 50 mg and metformin hydrochloride1000 mg [BCF]

Tablet, extended release, oral:Janumet® XR: 50/1000: Sitagliptin 50 mg and metformin hydrochloride1000 mg [BCF]

Janumet® XR: 100/1000: Sitagliptin 100 mg and metformin hydrochloride1000 mg [BCF]

Sodium BicarbonateOutpatient Dosage FormsTablet, oral: 325 mg [3.8 mEq], 650 mg [7.6 mEq]

Sodium ChlorideOutpatient Dosage FormsGel, nasal:Ayr Saline Nasal No-Drip: (22 mL) [contains aloe barbadensis, benzalkoniumchloride, benzyl alcohol, soybean oil]

Ointment, ophthalmic: 5% (3.5 g)Solution, for inhalation [preservative free]: 0.9% (3 mL)Solution, intranasal [drops]:Ayr Saline: 0.65% (50 mL) [ethanol free; contains benzalkonium chloride]

Solution, intranasal [spray]:Deep Sea: 0.65% (45 mL) [contains benzalkonium chloride, benzyl alcohol]

Solution, ophthalmic: 5% (15 mL)Solution, ophthalmic [drops]:Muro 128: 5% (15 mL, 30 mL)

Tablet, oral: 1 g

Sodium PhosphatesOutpatient Dosage FormsSolution, oral: Monobasic sodium phosphate monohydrate 2.4 g and dibasicsodium phosphate heptahydrate 0.9 g per 5 mL (45 mL)

Solution, rectal [enema]: Monobasic sodium phosphate monohydrate 19 g anddibasic sodium phosphate heptahydrate 7 g per 118 mL delivered dose(133 mL)Fleet Enema: Monobasic sodium phosphate monohydrate 19 g and dibasicsodium phosphate heptahydrate 7 g per 118 mL delivered dose (133 mL)[contains sodium 4.4 g/118 mL]

Fleet Pedia-Lax Enema: Monobasic sodium phosphate monohydrate 9.5 gand dibasic sodium phosphate heptahydrate 3.5 g per 59 mL delivered dose(66 mL) [contains sodium 2.2 g/59 mL]

Sodium Polystyrene SulfonateOutpatient Dosage FormsSuspension, oral/rectal:SPS®: 15 g/60 mL (60 mL, 120 mL, 473 mL, 480 mL) [contains ethanol 0.3%,propylene glycol, sodium 1500 mg (65 mEq)/60 mL, sorbitol; cherry flavor]

SolifenacinOutpatient Dosage FormsTablet, oral, as succinate:VESIcare: 5 mg, 10 mg

SorbitolOutpatient Dosage FormsSolution, oral: 70% (480 mL)

SotalolOutpatient Dosage FormsTablet, oral, as hydrochloride:Betapace®: 80 mgSorine®: 80 mg

SpironolactoneOutpatient Dosage FormsTablet, oral: 25 mg [BCF]Aldactone®: 25 mg

SucralfateOutpatient Dosage FormsSuspension, oral:Carafate: 1 g/10 mL (420 mL) [contains fd&c red #40, methylparaben; cherryflavor]

Tablet, oral: 1 g

Sulfacetamide (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as sodium [drops]: 10% (15 mL) [BCF]

Sulfamethoxazole and TrimethoprimOutpatient Dosage FormsSuspension, oral: Sulfamethoxazole 200 mg and trimethoprim 40 mg per 5 mL(473 mL) [BCF]Sulfatrim: Sulfamethoxazole 200 mg and trimethoprim 40 mg per 5 mL (473mL) [contains ethanol ≤0.5%, propylene glycol; cherry flavor]

Tablet, oral: Sulfamethoxazole 400 mg and trimethoprim 80 mg [BCF]Bactrim™: Sulfamethoxazole 400 mg and trimethoprim 80 mg

Tablet, double strength, oral: Sulfamethoxazole 800 mg and trimethoprim160 mg [BCF]Bactrim™ DS: Sulfamethoxazole 800 mg and trimethoprim 160 mgSeptra® DS: Sulfamethoxazole 800 mg and trimethoprim 160 mg

SulfaSALAzineOutpatient Dosage FormsTablet, oral: 500 mgTablet delayed release, oral: 500 mg [BCF]

Sulfur and SulfacetamideOutpatient Dosage FormsLotion, topical: Sulfur 5% and sulfacetamide sodium 10% (25 g, 30 g, 45 g,60 g)

SulindacOutpatient Dosage FormsTablet, oral: 200 mgClinoril®: 200 mg

SUMAtriptanOutpatient Dosage FormsSolution, intranasal [spray]:Imitrex®: 20 mg/0.1 mL (6s)

Tablet, oral, as succinate [strength expressed as base]: 25 mg, 50 mg, 100 mgImitrex®: 25 mg, 50 mg, 100 mg

Surgical LubricantOutpatient Dosage FormsGel, topical:Surgilube®: 3 g (144s) [foil pack]; 60 g

TamoxifenOutpatient Dosage FormsTablet, oral: 10 mg [BCF], 20 mg [BCF]

TamsulosinOutpatient Dosage FormsCapsule, oral, as hydrochloride: 0.4 mg [BCF]Flomax®: 0.4 mg

TAMSULOSIN

17

TazaroteneOutpatient Dosage FormsCream, topical:Tazorac: 0.05% (30 g, 60 g); 0.1% (30 g, 60 g) [contains benzyl alcohol]

Gel, topical:Tazorac: 0.05% (30 g, 100 g); 0.1% (30 g, 100 g) [contains benzyl alcohol]

TelmisartanOutpatient Dosage FormsTablet, Oral:Generic: 20 mg, 40 mg, 80 mg

Telmisartan and HydrochlorothiazideOutpatient Dosage FormsTablet, Oral:Micardis HCT: 40/12.5: Telmisartan 40 mg and hydrochlorothiazide 12.5 mgMicardis HCT: 80/12.5: Telmisartan 80 mg and hydrochlorothiazide 12.5 mgMicardis HCT: 80/25: Telmisartan 80 mg and hydrochlorothiazide 25 mg

TemazepamOutpatient Dosage FormsCapsule, oral: 15 mg [BCF], 30 mg [BCF]Restoril™: 15 mg, 30 mg

TerazosinOutpatient Dosage FormsCapsule, oral: 1 mg [BCF], 2 mg [BCF], 5 mg [BCF], 10 mg [BCF]

Terbinafine (Topical)Outpatient Dosage FormsCream, topical, as hydrochloride:Lamisil AT®: 1% (12 g) [contains benzyl alcohol]

TerconazoleOutpatient Dosage FormsCream, vaginal:Terazol® 7: 0.4% (45 g)

TestosteroneOutpatient Dosage FormsGel, topical:Fortesta™: 10 mg/actuation (60 g) [contains ethanol; 0.5 g gel/actuation; 120metered actuations] [BCF]

TetracyclineOutpatient Dosage FormsCapsule, oral, as hydrochloride: 250 mg [BCF], 500 mg [BCF]

TheophyllineOutpatient Dosage FormsSolution, oral:Elixophyllin® Elixir: 80 mg/15 mL (473 mL) [contains ethanol 20%; mixed fruitflavor] [BCF]

ThiamineOutpatient Dosage FormsTablet, oral, as hydrochloride: 50 mg

Thyroid, DesiccatedOutpatient Dosage FormsTablet, oral:Armour Thyroid: 30 mg, 60 mg

Timolol (Ophthalmic)Outpatient Dosage FormsGel forming solution, ophthalmic, as maleate [strength expressed as base,drops]:Timolol GFS: 0.25% (5 mL) [BCF]; 0.5% (5 mL) [BCF]Timoptic-XE®: 0.25% (5 mL) [BCF]; 0.5% (5 mL) [BCF]

Solution, ophthalmic, as maleate [strength expressed as base, drops]: 0.25% (5mL) [BCF]; 0.5% (5 mL) [BCF]

TiotropiumOutpatient Dosage FormsAerosol Solution, Inhalation:Spiriva Respimat: 1.25 mcg/actuation (4 g) [BCF]; 2.5 mcg/actuation (4 g)[BCF] [contains benzalkonium chloride, disodium edta]

Capsule, Inhalation:Spiriva HandiHaler: 18 mcg [contains milk protein] [BCF]

TiZANidineOutpatient Dosage FormsTablet, oral: 2 mg, 4 mg

Tobramycin and DexamethasoneOutpatient Dosage FormsOintment, ophthalmic:TobraDex®: Tobramycin 0.3% and dexamethasone 0.1% (3.5 g)

Suspension, ophthalmic:TobraDex®: Tobramycin 0.3% and dexamethasone 0.1% (5 mL) [containsbenzalkonium chloride]

Tobramycin (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic: 0.3% (5 mL)

TolnaftateOutpatient Dosage FormsSolution, topical: 1% (10 mL)

TolterodineOutpatient Dosage FormsCapsule, extended release, oral, as tartrate:Detrol® LA: 2 mg [BCF], 4 mg [BCF]

TopiramateOutpatient Dosage FormsTablet, oral:Topamax®: 25 mg, 50 mg, 100 mg, 200 mg

TraMADolOutpatient Dosage FormsTablet, oral, as hydrochloride: 50 mg [BCF]Ultram®: 50 mg

TraZODoneOutpatient Dosage FormsTablet, oral, as hydrochloride: 50 mg [BCF], 100 mg [BCF]

Tretinoin (Topical)Outpatient Dosage FormsCream, topical: 0.025% (20 g) [BCF]; 0.05% (20 g) [BCF]; 0.1% (20 g)Retin-A®: 0.025% (20 g); 0.05% (20 g); 0.1% (20 g)

Gel, topical: 0.01% (15 g)Retin-A®: 0.01% (15 g) [contains ethanol 90% w/w]

Triamcinolone (Nasal)Outpatient Dosage FormsAerosol, Nasal, as acetonide:Generic: 55 mcg/actuation (16.5 g, 16.9 mL)

Triamcinolone (Topical)Outpatient Dosage FormsAerosol, topical, as acetonide:Kenalog®: 0.2 mg/2-second spray (63 g) [contains dehydrated ethanol 10.3%]

Cream, topical, as acetonide: 0.1% (15 g, 454 g, 80 g) [BCF]Ointment, topical, as acetonide: 0.1% (15 g, 454 g, 80 g)Paste, oral, topical, as acetonide: 0.1% (5 g)Kenalog® in Orabase®: 0.1% (5 g)

TrifluridineOutpatient Dosage FormsSolution, ophthalmic:Viroptic®: 1% (7.5 mL)

TrihexyphenidylOutpatient Dosage FormsElixir, oral, as hydrochloride: 2 mg/5 mL (473 mL) [BCF]Tablet, oral, as hydrochloride: 2 mg [BCF]

TrimethoprimOutpatient Dosage FormsTablet, oral: 100 mg

Trimethoprim and Polymyxin BOutpatient Dosage FormsSolution, ophthalmic: Trimethoprim 1 mg and polymyxin B sulfate 10,000 unitsper mL (10 mL) [contains benzalkonium chloride] [BCF]

ValACYclovirOutpatient Dosage FormsCaplet, oral:Valtrex®: 500 mg, 1 g

Valproic Acid and DerivativesOutpatient Dosage FormsCapsule, sprinkle, oral: 125 mg [strength expressed as valproic acid] [BCF]Depakote® Sprinkle: 125 mg [strength expressed as valproic acid]

Syrup, oral, as valproate sodium:Depakene®: 250 mg/5 mL (473 mL) [strength expressed as valproic acid]

Tablet, delayed release, oral: 125 mg [BCF], 250 mg [BCF], 500 mg [BCF][strength expressed as valproic acid]Depakote®: 125 mg, 250 mg, 500 mg [strength expressed as valproic acid]

Tablet, extended release, oral: 250 mg [BCF], 500 mg [BCF] [strengthexpressed as valproic acid]Depakote® ER: 250 mg, 500 mg [strength expressed as valproic acid]

TAMSULOSIN

18

ValsartanOutpatient Dosage FormsTablet, oral:Diovan®: 40 mg [BCF], 80 mg [BCF], 160 mg [BCF], 320 mg [BCF]

Valsartan and HydrochlorothiazideOutpatient Dosage FormsTablet, oral:Diovan HCT® 80 mg/12.5 mg: Valsartan 80 mg and hydrochlorothiazide12.5 mg [BCF]

Diovan HCT® 160 mg/12.5 mg: Valsartan 160 mg and hydrochlorothiazide12.5 mg [BCF]

Diovan HCT® 320 mg/12.5 mg: Valsartan 320 mg and hydrochlorothiazide12.5 mg [BCF]

Diovan HCT® 160 mg/25 mg: Valsartan 160 mg and hydrochlorothiazide25 mg [BCF]

Diovan HCT® 320 mg/25 mg: Valsartan 320 mg and hydrochlorothiazide25 mg [BCF]

VancomycinOutpatient Dosage FormsCapsule, oral: 125 mg, 250 mg

VareniclineOutpatient Dosage FormsTablet, oral:Chantix Continuing Month Pak: 1 mgChantix Starting Month Pak: 0.5 mg (11 ea) and 1 mg (42 ea)

VenlafaxineOutpatient Dosage FormsCapsule, extended release, oral:Effexor XR®: 37.5 mg [BCF], 75 mg [BCF], 150 mg [BCF]

Tablet, oral: 25 mg [BCF], 37.5 mg [BCF], 75 mg [BCF]Tablet, extended release, oral: 225 mg [BCF]

VerapamilOutpatient Dosage FormsTablet, oral, as hydrochloride:Calan®: 80 mg, 120 mg [scored]

Tablet, extended release, oral, as hydrochloride: 120 mg [BCF], 180 mg [BCF],240 mg [BCF]

Vitamin B Complex CombinationsOutpatient Dosage FormsTablet, oral:Foltanx: [contains l-methylfolate 3 mg, methylcobalamin 2 mg, pyri-doxal 35 mg]

Vitamins (Multiple/Oral)Outpatient Dosage FormsTablet, oral: [prescription must be written for "multivitamin" and not aspecific name brand]

Vitamins (Multiple/Prenatal)Outpatient Dosage FormsContent varies depending on product used.Tablet, oral: 100sPrenatal

WarfarinOutpatient Dosage FormsTablet, oral, as sodium: 1 mg [BCF], 2 mg [BCF], 2.5 mg [BCF], 5 mg [BCF],Coumadin®: 1 mg, 2 mg, 2.5 mg, 5 mg

Witch HazelOutpatient Dosage FormsPad, topical:Tucks®: 50% (40s) [dye free; contains ethanol]

ZaleplonOutpatient Dosage FormsCapsule, oral: 5 mg, 10 mg

Zinc OxideOutpatient Dosage FormsOintment, topical: 20% (30 g)

ZiprasidoneOutpatient Dosage FormsCapsule, Oral, as hydrochloride:Generic: 20 mg, 40 mg, 60 mg, 80 mg

ZOLMitriptanOutpatient Dosage FormsTablet, oral: 2.5 mg, 5 mgTablet dispersible, oral: 2.5 mg, 5 mg

ZolpidemOutpatient Dosage FormsTablet, oral, as tartrate: 5 mg [BCF], 10 mg [BCF]Tablet extended release, oral, as tartrate: 6.25 mg, 12.5 mg

ZOLPIDEM

19

Therapeutic Category Index

21

Acetylcholinesterase Inhibitor (Central)Donepezil ..................................................................................................7

Acne ProductsAdapalene ................................................................................................ 2Benzoyl Peroxide ..................................................................................... 3Clindamycin and Benzoyl Peroxide ......................................................... 5Erythromycin (Topical) ..............................................................................7ISOtretinoin .............................................................................................11Sulfur and Sulfacetamide .......................................................................17Tazarotene ..............................................................................................18Tretinoin (Topical) ...................................................................................18

Adrenergic Agonist AgentOxymetazoline (Nasal) ...........................................................................14

Aldehyde Dehydrogenase InhibitorDisulfiram ..................................................................................................7

Alkalinizing AgentSodium Bicarbonate ...............................................................................17

Alkylamine DerivativeChlorpheniramine ..................................................................................... 4Naphazoline and Pheniramine ...............................................................13

Alpha1 AgonistNaphazoline and Pheniramine ...............................................................13

Alpha1 BlockerAlfuzosin ...................................................................................................2Doxazosin .................................................................................................7Prazosin ..................................................................................................15Tamsulosin ............................................................................................. 17Terazosin ................................................................................................ 18

Alpha2-Adrenergic AgonistCloNIDine ................................................................................................. 5GuanFACINE ..........................................................................................10Methyldopa .............................................................................................12TiZANidine ..............................................................................................18

Alpha2 Agonist, OphthalmicBrimonidine (Ophthalmic) .........................................................................4

Alpha-Adrenergic AgonistPhenylephrine (Nasal) ............................................................................15Phenylephrine (Ophthalmic) ...................................................................15Phenylephrine (Topical) ..........................................................................15

Alpha/Beta AgonistEPINEPHrine (Oral Inhalation) .................................................................7EPINEPHrine (Systemic) ..........................................................................7Pseudoephedrine ................................................................................... 16

5 Alpha-Reductase InhibitorFinasteride ................................................................................................8

AmebicideMetroNIDAZOLE (Systemic) .................................................................. 13

Aminoquinoline (Antimalarial)Hydroxychloroquine ................................................................................10Primaquine ............................................................................................. 15

5-Aminosalicylic Acid DerivativeMesalamine ............................................................................................ 12Olsalazine ...............................................................................................14SulfaSALAzine ........................................................................................17

Ammonium DetoxicantLactulose ................................................................................................ 11Neomycin ................................................................................................13

Analgesic Combination (Opioid)Acetaminophen and Codeine ...................................................................2Belladonna and Opium ............................................................................ 3Hydrocodone and Acetaminophen .........................................................10Hydrocodone and Ibuprofen .................................................................. 10Oxycodone and Acetaminophen ............................................................14

Analgesic, NonopioidAcetaminophen .........................................................................................2Aspirin .......................................................................................................3Celecoxib ..................................................................................................4Diclofenac (Systemic) ...............................................................................6Ibuprofen ................................................................................................ 10Indomethacin ..........................................................................................10Ketorolac (Systemic) .............................................................................. 11Meloxicam .............................................................................................. 12Naproxen ................................................................................................13Piroxicam (Systemic) ..............................................................................15Sulindac ..................................................................................................17

Analgesic, OpioidAcetaminophen and Codeine ...................................................................2Belladonna and Opium ............................................................................ 3Codeine .................................................................................................... 5FentaNYL ................................................................................................. 8Hydrocodone and Acetaminophen .........................................................10HYDROmorphone .................................................................................. 10Levorphanol ............................................................................................11Morphine (Systemic) .............................................................................. 13OxyCODONE ......................................................................................... 14Oxycodone and Acetaminophen ............................................................14TraMADol ............................................................................................... 18

Analgesic, TopicalBenzocaine ...............................................................................................3Capsaicin ..................................................................................................4Lidocaine (Topical) ..................................................................................11Methyl Salicylate and Menthol ............................................................... 13

Analgesic, UrinaryPhenazopyridine .....................................................................................15

AndrogenFluoxymesterone ......................................................................................9MethylTESTOSTERone ......................................................................... 13Testosterone ...........................................................................................18

Anesthetic/CorticosteroidPramoxine and Hydrocortisone ..............................................................15

Angiotensin II Receptor BlockerLosartan ..................................................................................................12Losartan and Hydrochlorothiazide ......................................................... 12Telmisartan ............................................................................................. 18Telmisartan and Hydrochlorothiazide .....................................................18Valsartan .................................................................................................19Valsartan and Hydrochlorothiazide ........................................................ 19

Angiotensin-Converting Enzyme (ACE) InhibitorAmlodipine and Benazepril ...................................................................... 2Benazepril .................................................................................................3Captopril ................................................................................................... 4Enalapril ....................................................................................................7Lisinopril ..................................................................................................11Lisinopril and Hydrochlorothiazide ......................................................... 12Ramipril .................................................................................................. 16

Anilidopiperidine OpioidFentaNYL ................................................................................................. 8

AntacidAluminum Hydroxide, Magnesium Hydroxide, and Simethicone .............2Calcium Carbonate ...................................................................................4Magnesium Hydroxide ............................................................................12Sodium Bicarbonate ...............................................................................17

AnthelminticAlbendazole ..............................................................................................2Pyrantel Pamoate ...................................................................................16

Antianginal AgentAmLODIPine .............................................................................................2Amlodipine and Benazepril ...................................................................... 2Atenolol .....................................................................................................3DilTIAZem .................................................................................................6Isosorbide Dinitrate .................................................................................11Isosorbide Mononitrate ...........................................................................11Metoprolol ...............................................................................................13NIFEdipine ..............................................................................................14Nitroglycerin ............................................................................................14Propranolol ............................................................................................. 16Verapamil ............................................................................................... 19

Antianxiety Agent, MiscellaneousBusPIRone ............................................................................................... 4

Antiarrhythmic Agent, Class IaDisopyramide ............................................................................................7Procainamide ..........................................................................................16

Antiarrhythmic Agent, Class IbMexiletine ............................................................................................... 13

Antiarrhythmic Agent, Class IcFlecainide ................................................................................................. 9

Antiarrhythmic Agent, Class IIAcebutolol .................................................................................................2Propranolol ............................................................................................. 16Sotalol .....................................................................................................17

ACETYLCHOLINESTERASE INHIBITOR (CENTRAL)

22

Antiarrhythmic Agent, Class IIIAmiodarone .............................................................................................. 2Sotalol .....................................................................................................17

Antiarrhythmic Agent, Class IVDilTIAZem .................................................................................................6Verapamil ............................................................................................... 19

Antiarrhythmic Agent, MiscellaneousDigoxin ......................................................................................................6

Antibiotic, AminoglycosideGentamicin (Ophthalmic) ..........................................................................9Gentamicin (Topical) ................................................................................ 9Neomycin ................................................................................................13Tobramycin (Ophthalmic) ....................................................................... 18

Antibiotic, Cephalosporin (First Generation)Cephalexin ................................................................................................4

Antibiotic, Cephalosporin (Second Generation)Cefprozil ................................................................................................... 4Cefuroxime ............................................................................................... 4

Antibiotic, Cephalosporin (Third Generation)Cefdinir ..................................................................................................... 4

Antibiotic/Corticosteroid, OphthalmicNeomycin, Polymyxin B, and Dexamethasone ......................................13Tobramycin and Dexamethasone .......................................................... 18

Antibiotic/Corticosteroid, OticCiprofloxacin and Dexamethasone .......................................................... 5Neomycin, Colistin, Hydrocortisone, and Thonzonium ..........................13Neomycin, Polymyxin B, and Hydrocortisone (Otic) ..............................14

Antibiotic, FluoroquinoloneCiprofloxacin (Ophthalmic) .......................................................................5Ciprofloxacin (Otic) ...................................................................................5Ciprofloxacin (Systemic) ...........................................................................5Gatifloxacin ...............................................................................................9LevoFLOXacin (Systemic) ......................................................................11Moxifloxacin (Ophthalmic) ......................................................................13Moxifloxacin (Systemic) ..........................................................................13Ofloxacin (Ophthalmic) ...........................................................................14

Antibiotic, LincosamideClindamycin (Systemic) ............................................................................5Clindamycin (Topical) ............................................................................... 5

Antibiotic, MacrolideAzithromycin (Ophthalmic) ....................................................................... 3Azithromycin (Systemic) ...........................................................................3Clarithromycin ...........................................................................................5Erythromycin (Ophthalmic) .......................................................................7Erythromycin (Systemic) .......................................................................... 7Erythromycin (Topical) ..............................................................................7

Antibiotic, MiscellaneousDapsone (Systemic) .................................................................................6MetroNIDAZOLE (Systemic) .................................................................. 13Nitrofurantoin ..........................................................................................14Sulfamethoxazole and Trimethoprim ..................................................... 17Trimethoprim .......................................................................................... 18

Antibiotic, OphthalmicAzithromycin (Ophthalmic) ....................................................................... 3Bacitracin, Neomycin, and Polymyxin B (Ophthalmic) ............................ 3Bacitracin (Ophthalmic) ............................................................................3Ciprofloxacin (Ophthalmic) .......................................................................5Erythromycin (Ophthalmic) .......................................................................7Gatifloxacin ...............................................................................................9Gentamicin (Ophthalmic) ..........................................................................9Moxifloxacin (Ophthalmic) ......................................................................13Neomycin, Polymyxin B, and Gramicidin ...............................................13Ofloxacin (Ophthalmic) ...........................................................................14Sulfacetamide (Ophthalmic) ...................................................................17Tobramycin (Ophthalmic) ....................................................................... 18Trimethoprim and Polymyxin B .............................................................. 18

Antibiotic, Oral RinseChlorhexidine Gluconate (Oral) ............................................................... 4

Antibiotic, OticCiprofloxacin and Dexamethasone .......................................................... 5Ciprofloxacin (Otic) ...................................................................................5Neomycin, Colistin, Hydrocortisone, and Thonzonium ..........................13Neomycin, Polymyxin B, and Hydrocortisone (Otic) ..............................14

Antibiotic, PenicillinAmoxicillin .................................................................................................2Amoxicillin and Clavulanate ..................................................................... 2

Ampicillin .................................................................................................. 3Dicloxacillin ...............................................................................................6Penicillin V Potassium ............................................................................15Penicillin G Benzathine .......................................................................... 15

Antibiotic, Respiratory FluoroquinoloneLevoFLOXacin (Systemic) ......................................................................11Moxifloxacin (Systemic) ..........................................................................13

Antibiotic, Sulfonamide DerivativeSulfamethoxazole and Trimethoprim ..................................................... 17Sulfur and Sulfacetamide .......................................................................17

Antibiotic, Tetracycline DerivativeDoxycycline .............................................................................................. 7Minocycline .............................................................................................13Tetracycline ............................................................................................ 18

Antibiotic, TopicalBacitracin (Topical) ...................................................................................3Erythromycin (Topical) ..............................................................................7Gentamicin (Topical) ................................................................................ 9MetroNIDAZOLE (Topical) ..................................................................... 13Mupirocin ................................................................................................13Silver Sulfadiazine ..................................................................................17

Anticholinergic AgentBenztropine .............................................................................................. 3Dicyclomine .............................................................................................. 6Glycopyrrolate (Systemic) ........................................................................ 9Hyoscyamine ..........................................................................................10Hyoscyamine, Atropine, Scopolamine, and Phenobarbital ....................10Ipratropium and Albuterol .......................................................................11Ipratropium (Nasal) .................................................................................11Ipratropium (Oral Inhalation) .................................................................. 11Propantheline ......................................................................................... 16Scopolamine (Systemic) .........................................................................16Solifenacin ..............................................................................................17Tiotropium ...............................................................................................18Tolterodine ..............................................................................................18Trihexyphenidyl ...................................................................................... 18

Anticholinergic Agent, Long-ActingTiotropium ...............................................................................................18

Anticholinergic Agent, OphthalmicAtropine (Ophthalmic) .............................................................................. 3Cyclopentolate ..........................................................................................5Homatropine ...........................................................................................10

AnticoagulantApixaban ...................................................................................................3Enoxaparin ............................................................................................... 7Rivaroxaban ........................................................................................... 16Warfarin .................................................................................................. 19

Anticoagulant, Factor Xa InhibitorApixaban ...................................................................................................3Rivaroxaban ........................................................................................... 16

Anticoagulant, Low Molecular Weight HeparinEnoxaparin ............................................................................................... 7

Anticoagulant, Vitamin K AntagonistWarfarin .................................................................................................. 19

Anticonvulsant, BarbituratePHENobarbital ........................................................................................15

Anticonvulsant, BenzodiazepineClonazePAM .............................................................................................5DiazePAM .................................................................................................6LORazepam ........................................................................................... 12

Anticonvulsant, HydantoinPhenytoin ................................................................................................15

Anticonvulsant, MiscellaneousAcetaZOLAMIDE ......................................................................................2CarBAMazepine ....................................................................................... 4Gabapentin ...............................................................................................9LevETIRAcetam ......................................................................................11Pregabalin .............................................................................................. 15Primidone ............................................................................................... 16Topiramate ..............................................................................................18Valproic Acid and Derivatives ................................................................ 18

Antidepressant, Alpha-2 AntagonistMirtazapine .............................................................................................13

Antidepressant, Dopamine/Norepinephrine-Reuptake InhibitorBuPROPion .............................................................................................. 4

ANTIDEPRESSANT, DOPAMINE/NOREPINEPHRINE-REUPTAKE INHIBITOR

23

Antidepressant, Monoamine Oxidase InhibitorSelegiline ................................................................................................16

Antidepressant, Selective Serotonin Reuptake InhibitorCitalopram ................................................................................................ 5Escitalopram .............................................................................................7FLUoxetine ............................................................................................... 9PARoxetine .............................................................................................15Sertraline ................................................................................................ 17

Antidepressant, Serotonin/Norepinephrine Reuptake InhibitorDULoxetine ...............................................................................................7Venlafaxine .............................................................................................19

Antidepressant, Serotonin Reuptake Inhibitor/AntagonistTraZODone .............................................................................................18

Antidepressant, Tricyclic (Secondary Amine)Desipramine ............................................................................................. 6Nortriptyline ............................................................................................ 14

Antidepressant, Tricyclic (Tertiary Amine)Amitriptyline ..............................................................................................2Doxepin (Systemic) .................................................................................. 7Imipramine ..............................................................................................10

Antidiabetic Agent, BiguanideGlyburide and Metformin ..........................................................................9MetFORMIN ........................................................................................... 12Sitagliptin and Metformin ....................................................................... 17

Antidiabetic Agent, Dipeptidyl Peptidase 4 (DPP-4) InhibitorSITagliptin ...............................................................................................17Sitagliptin and Metformin ....................................................................... 17

Antidiabetic Agent, Dopamine AgonistBromocriptine ........................................................................................... 4

Antidiabetic Agent, SulfonylureaChlorproPAMIDE ...................................................................................... 4GlipiZIDE .................................................................................................. 9GlyBURIDE ...............................................................................................9Glyburide and Metformin ..........................................................................9

Antidiabetic Agent, ThiazolidinedionePioglitazone ............................................................................................15

AntidiarrhealBismuth Subsalicylate .............................................................................. 3Loperamide .............................................................................................12Psyllium .................................................................................................. 16

AntidoteCalcium Carbonate ...................................................................................4Sodium Polystyrene Sulfonate ...............................................................17

Antidote, ExtravasationNitroglycerin ............................................................................................14

AntiemeticDexamethasone (Systemic) ..................................................................... 6HydrOXYzine ..........................................................................................10Meclizine .................................................................................................12Metoclopramide ......................................................................................13Ondansetron ...........................................................................................14Perphenazine ......................................................................................... 15Prochlorperazine .................................................................................... 16Promethazine ......................................................................................... 16

AntiflatulentAluminum Hydroxide, Magnesium Hydroxide, and Simethicone .............2Simethicone ............................................................................................17

Antifungal Agent, Azole DerivativeTerconazole ............................................................................................ 18

Antifungal Agent, Imidazole DerivativeClotrimazole (Oral) ................................................................................... 5Clotrimazole (Topical) ...............................................................................5Ketoconazole (Systemic) ........................................................................11Ketoconazole (Topical) ........................................................................... 11Miconazole (Topical) .............................................................................. 13

Antifungal Agent, OralFluconazole .............................................................................................. 9Griseofulvin ...............................................................................................9Itraconazole ............................................................................................ 11Ketoconazole (Systemic) ........................................................................11

Antifungal Agent, Oral NonabsorbedClotrimazole (Oral) ................................................................................... 5

Antifungal Agent, Oral Nonabsorbed/Partially AbsorbedClotrimazole (Topical) ...............................................................................5

Miconazole (Topical) .............................................................................. 13Nystatin (Oral) ........................................................................................ 14

Antifungal Agent, ParenteralFluconazole .............................................................................................. 9

Antifungal Agent, TopicalClotrimazole (Topical) ...............................................................................5Ketoconazole (Topical) ........................................................................... 11Miconazole (Topical) .............................................................................. 13Nystatin and Triamcinolone ....................................................................14Nystatin (Topical) ....................................................................................14Terbinafine (Topical) ............................................................................... 18Tolnaftate ................................................................................................18

Antifungal Agent, VaginalClotrimazole (Topical) ...............................................................................5Miconazole (Topical) .............................................................................. 13Terconazole ............................................................................................ 18

Antigout AgentAllopurinol .................................................................................................2Colchicine .................................................................................................5

Antihemophilic AgentDesmopressin ...........................................................................................6

Antihemorrhoidal AgentDibucaine ..................................................................................................6Hydrocortisone (Topical) ........................................................................ 10Phenylephrine (Topical) ..........................................................................15Witch Hazel ............................................................................................ 19

AntihypertensiveAcebutolol .................................................................................................2AmLODIPine .............................................................................................2Amlodipine and Benazepril ...................................................................... 2Atenolol .....................................................................................................3Benazepril .................................................................................................3Captopril ................................................................................................... 4Carvedilol ..................................................................................................4Chlorthalidone .......................................................................................... 4CloNIDine ................................................................................................. 5DilTIAZem .................................................................................................6Doxazosin .................................................................................................7Enalapril ....................................................................................................7Felodipine .................................................................................................8Furosemide ...............................................................................................9GuanFACINE ..........................................................................................10HydrALAZINE .........................................................................................10HydroCHLOROthiazide .......................................................................... 10Hydrochlorothiazide and Triamterene .................................................... 10Indapamide .............................................................................................10Lisinopril ..................................................................................................11Lisinopril and Hydrochlorothiazide ......................................................... 12Losartan ..................................................................................................12Losartan and Hydrochlorothiazide ......................................................... 12Methyldopa .............................................................................................12Metoprolol ...............................................................................................13NIFEdipine ..............................................................................................14Prazosin ..................................................................................................15Propranolol ............................................................................................. 16Ramipril .................................................................................................. 16Spironolactone ....................................................................................... 17Telmisartan ............................................................................................. 18Telmisartan and Hydrochlorothiazide .....................................................18Terazosin ................................................................................................ 18Valsartan .................................................................................................19Valsartan and Hydrochlorothiazide ........................................................ 19Verapamil ............................................................................................... 19

Anti-inflammatory AgentDexamethasone (Systemic) ..................................................................... 6

Anti-inflammatory, Locally AppliedCarbamide Peroxide .................................................................................4

Antilipemic Agent, 2-AzetidinoneEzetimibe ..................................................................................................8

Antilipemic Agent, Bile Acid SequestrantColestipol ..................................................................................................5

Antilipemic Agent, Fibric AcidFenofibrate and Derivatives ..................................................................... 8Gemfibrozil ............................................................................................... 9

Antilipemic Agent, HMG-CoA Reductase InhibitorAtorvaSTATin ............................................................................................3Pravastatin ..............................................................................................15

ANTIDEPRESSANT, MONOAMINE OXIDASE INHIBITOR

24

Rosuvastatin ...........................................................................................16Simvastatin .............................................................................................17

Antilipemic Agent, MiscellaneousNiacin ......................................................................................................14

Antilipemic Agent, Omega-3 Fatty AcidsOmega-3 Fatty Acids ............................................................................. 14

Antimalarial AgentHydroxychloroquine ................................................................................10Primaquine ............................................................................................. 15

Antimanic AgentLithium ....................................................................................................12RisperiDONE ..........................................................................................16Valproic Acid and Derivatives ................................................................ 18

Antimigraine AgentRizatriptan .............................................................................................. 16SUMAtriptan ........................................................................................... 17ZOLMitriptan ...........................................................................................19

Antineoplastic Agent, AntiandrogenBicalutamide .............................................................................................3Flutamide ..................................................................................................9Nilutamide ...............................................................................................14

Antineoplastic Agent, AntimetaboliteFluorouracil (Topical) ................................................................................9

Antineoplastic Agent, Antimetabolite (Antifolate)Methotrexate ...........................................................................................12

Antineoplastic Agent, Antimetabolite (Pyrimidine Analog)Fluorouracil (Topical) ................................................................................9

Antineoplastic Agent, Aromatase InhibitorAnastrozole ...............................................................................................3Exemestane ..............................................................................................8Letrozole .................................................................................................11

Antineoplastic Agent, Estrogen Receptor AntagonistTamoxifen ............................................................................................... 17

Antineoplastic Agent, HormoneMegestrol ................................................................................................12

Antineoplastic Agent, MiscellaneousHydroxyurea ........................................................................................... 10

Antineoplastic Agent, Retinoic Acid DerivativeISOtretinoin .............................................................................................11

Antiparasitic Agent, TopicalPermethrin ..............................................................................................15

Anti-Parkinson Agent, AnticholinergicBenztropine .............................................................................................. 3Trihexyphenidyl ...................................................................................... 18

Anti-Parkinson Agent, Decarboxylase InhibitorCarbidopa .................................................................................................4Carbidopa and Levodopa .........................................................................4

Anti-Parkinson Agent, Dopamine AgonistAmantadine .............................................................................................. 2Bromocriptine ........................................................................................... 4Pramipexole ............................................................................................15ROPINIRole ............................................................................................16

Anti-Parkinson Agent, Dopamine PrecursorCarbidopa and Levodopa .........................................................................4

Anti-Parkinson Agent, MAO Type B InhibitorSelegiline ................................................................................................16

Antiplatelet AgentAspirin .......................................................................................................3Aspirin and Dipyridamole ......................................................................... 3Cilostazol ..................................................................................................5Clopidogrel ............................................................................................... 5Dipyridamole .............................................................................................7

Antiplatelet Agent, ThienopyridineClopidogrel ............................................................................................... 5

Antiprotozoal, NitroimidazoleMetroNIDAZOLE (Systemic) .................................................................. 13

Antirheumatic, Disease ModifyingAdalimumab ..............................................................................................2Methotrexate ...........................................................................................12

Antirheumatic MiscellaneousHyaluronate and Derivatives ..................................................................10

Antiseborrheic Agent, TopicalSelenium Sulfide .................................................................................... 16Sulfur and Sulfacetamide .......................................................................17

Antiseptic, TopicalAlcohol (Isopropyl) ....................................................................................2Benzoin .....................................................................................................3Povidone-Iodine (Topical) .......................................................................15

Antiseptic, VaginalPovidone-Iodine (Topical) .......................................................................15

Antispasmodic Agent, GastrointestinalHyoscyamine, Atropine, Scopolamine, and Phenobarbital ....................10

Antispasmodic Agent, UrinaryBelladonna and Opium ............................................................................ 3Oxybutynin ..............................................................................................14

Antithyroid AgentMethIMAzole ...........................................................................................12Propylthiouracil .......................................................................................16

Antitubercular AgentEthambutol ............................................................................................... 8Isoniazid ..................................................................................................11Pyrazinamide ..........................................................................................16RifAMPin .................................................................................................16

AntitussiveBenzonatate ............................................................................................. 3Codeine .................................................................................................... 5Guaifenesin and Codeine ...................................................................... 10Guaifenesin and Dextromethorphan ...................................................... 10Hydrocodone and Homatropine ............................................................. 10

Antiviral AgentAcyclovir (Systemic) .................................................................................2Amantadine .............................................................................................. 2Oseltamivir ..............................................................................................14ValACYclovir ...........................................................................................18

Antiviral Agent, AdamantaneAmantadine .............................................................................................. 2

Antiviral Agent, OphthalmicTrifluridine ...............................................................................................18

Antiviral Agent, OralValACYclovir ...........................................................................................18

Appetite StimulantMegestrol ................................................................................................12

AstringentWitch Hazel ............................................................................................ 19

BarbiturateButalbital, Acetaminophen, and Caffeine .................................................4PHENobarbital ........................................................................................15Primidone ............................................................................................... 16

BenzodiazepineALPRAZolam ............................................................................................2ClonazePAM .............................................................................................5DiazePAM .................................................................................................6LORazepam ........................................................................................... 12Temazepam ............................................................................................18

Beta2-Adrenergic AgonistIpratropium and Albuterol .......................................................................11

Beta2-Adrenergic Agonist, Long-ActingFluticasone and Salmeterol ..................................................................... 9Salmeterol .............................................................................................. 16

Beta2 AgonistAlbuterol ................................................................................................... 2Fluticasone and Salmeterol ..................................................................... 9Levalbuterol ............................................................................................ 11Salmeterol .............................................................................................. 16

Beta-Adrenergic Blocker, NonselectiveDorzolamide and Timolol ......................................................................... 7Propranolol ............................................................................................. 16Sotalol .....................................................................................................17

Beta-Blocker, Beta-1 SelectiveAtenolol .....................................................................................................3Metoprolol ...............................................................................................13

Beta-Blocker, NonselectiveTimolol (Ophthalmic) .............................................................................. 18

BETA-BLOCKER, NONSELECTIVE

25

Beta-Blocker With Alpha-Blocking ActivityCarvedilol ..................................................................................................4

Beta-Blocker With Intrinsic Sympathomimetic ActivityAcebutolol .................................................................................................2

Bisphosphonate DerivativeAlendronate .............................................................................................. 2Ibandronate ............................................................................................ 10

Blood Viscosity Reducer AgentPentoxifylline .......................................................................................... 15

Calcineurin InhibitorCycloSPORINE (Ophthalmic) ...................................................................5Pimecrolimus ..........................................................................................15

Calcium Channel BlockerAmLODIPine .............................................................................................2Amlodipine and Benazepril ...................................................................... 2DilTIAZem .................................................................................................6Felodipine .................................................................................................8NIFEdipine ..............................................................................................14Verapamil ............................................................................................... 19

Calcium Channel Blocker, DihydropyridineAmLODIPine .............................................................................................2Amlodipine and Benazepril ...................................................................... 2Felodipine .................................................................................................8NIFEdipine ..............................................................................................14

Calcium Channel Blocker, NondihydropyridineDilTIAZem .................................................................................................6Verapamil ............................................................................................... 19

Calcium SaltCalcium and Vitamin D ............................................................................ 4Calcium Carbonate ...................................................................................4

Carbonic Anhydrase InhibitorAcetaZOLAMIDE ......................................................................................2MethazolAMIDE ......................................................................................12

Carbonic Anhydrase Inhibitor (Ophthalmic)Dorzolamide ............................................................................................. 7Dorzolamide and Timolol ......................................................................... 7

Cardiac GlycosideDigoxin ......................................................................................................6

CatharticSodium Phosphates ............................................................................... 17

Central Nervous System StimulantDextroamphetamine ................................................................................. 6Dextroamphetamine and Amphetamine .................................................. 6Methylphenidate ..................................................................................... 13

Chelating AgentPenicillAMINE .........................................................................................15

Chloride Channel ActivatorLubiprostone ...........................................................................................12

Cholinergic AgonistBethanechol ..............................................................................................3Carbachol ................................................................................................. 4

ContraceptiveEthinyl Estradiol and Desogestrel ............................................................8Ethinyl Estradiol and Drospirenone ......................................................... 8Ethinyl Estradiol and Ethynodiol Diacetate ..............................................8Ethinyl Estradiol and Etonogestrel ...........................................................8Ethinyl Estradiol and Levonorgestrel ....................................................... 8Ethinyl Estradiol and Norelgestromin .......................................................8Ethinyl Estradiol and Norethindrone ........................................................ 8Ethinyl Estradiol and Norgestimate ..........................................................8Ethinyl Estradiol and Norgestrel .............................................................. 8Levonorgestrel (Systemic) ......................................................................11MedroxyPROGESTERone ..................................................................... 12Norethindrone .........................................................................................14

Corticosteroid, Inhalant (Oral)Budesonide (Oral Inhalation) ................................................................... 4Fluticasone and Salmeterol ..................................................................... 9Fluticasone (Oral Inhalation) ....................................................................9

Corticosteroid, NasalFluticasone (Nasal) .................................................................................. 9Mometasone (Nasal) ..............................................................................13Triamcinolone (Nasal) ............................................................................ 18

Corticosteroid, OphthalmicFluorometholone .......................................................................................9

Loteprednol ............................................................................................ 12PrednisoLONE (Ophthalmic) ..................................................................15

Corticosteroid, OticCiprofloxacin and Dexamethasone .......................................................... 5Neomycin, Colistin, Hydrocortisone, and Thonzonium ..........................13Neomycin, Polymyxin B, and Hydrocortisone (Otic) ..............................14

Corticosteroid, RectalHydrocortisone (Topical) ........................................................................ 10

Corticosteroid, SystemicCortisone .................................................................................................. 5Dexamethasone (Systemic) ..................................................................... 6Fludrocortisone .........................................................................................9Hydrocortisone (Systemic) ..................................................................... 10MethylPREDNISolone ............................................................................ 13PrednisoLONE (Systemic) ..................................................................... 15PredniSONE ...........................................................................................15

Corticosteroid, TopicalAmcinonide ...............................................................................................2Betamethasone (Topical) ......................................................................... 3Clobetasol .................................................................................................5Desonide .................................................................................................. 6Fluocinolone (Topical) .............................................................................. 9Fluocinonide ............................................................................................. 9Flurandrenolide .........................................................................................9Hydrocortisone (Topical) ........................................................................ 10Nystatin and Triamcinolone ....................................................................14Triamcinolone (Topical) .......................................................................... 18

Cosmetic Agent, ImplantHyaluronate and Derivatives ..................................................................10

DecongestantOxymetazoline (Nasal) ...........................................................................14Phenylephrine (Nasal) ............................................................................15Pseudoephedrine ................................................................................... 16

Direct Oral Anticoagulant (DOAC)Apixaban ...................................................................................................3Rivaroxaban ........................................................................................... 16

Diuretic, Carbonic Anhydrase InhibitorAcetaZOLAMIDE ......................................................................................2MethazolAMIDE ......................................................................................12

Diuretic, LoopFurosemide ...............................................................................................9

Diuretic, Potassium-SparingHydrochlorothiazide and Triamterene .................................................... 10Spironolactone ....................................................................................... 17

Diuretic, ThiazideHydroCHLOROthiazide .......................................................................... 10Hydrochlorothiazide and Triamterene .................................................... 10Lisinopril and Hydrochlorothiazide ......................................................... 12Losartan and Hydrochlorothiazide ......................................................... 12Telmisartan and Hydrochlorothiazide .....................................................18Valsartan and Hydrochlorothiazide ........................................................ 19

Diuretic, Thiazide-RelatedChlorthalidone .......................................................................................... 4Indapamide .............................................................................................10MetOLazone ...........................................................................................13

Electrolyte Supplement, OralCalcium and Vitamin D ............................................................................ 4Calcium Carbonate ...................................................................................4Magnesium Oxide .................................................................................. 12Potassium Chloride ................................................................................ 15Sodium Bicarbonate ...............................................................................17

Electrolyte Supplement, ParenteralPotassium Chloride ................................................................................ 15Sodium Bicarbonate ...............................................................................17Sodium Chloride .....................................................................................17Sodium Phosphates ............................................................................... 17

EnzymePancrelipase ...........................................................................................14

Ergot DerivativeBromocriptine ........................................................................................... 4Methylergonovine ................................................................................... 13

Estrogen and Androgen CombinationEstrogens (Esterified) and Methyltestosterone ........................................8

Estrogen and Progestin CombinationEstrogens (Conjugated/Equine) and Medroxyprogesterone ....................7

BETA-BLOCKER WITH ALPHA-BLOCKING ACTIVITY

26

Ethinyl Estradiol and Desogestrel ............................................................8Ethinyl Estradiol and Drospirenone ......................................................... 8Ethinyl Estradiol and Ethynodiol Diacetate ..............................................8Ethinyl Estradiol and Etonogestrel ...........................................................8Ethinyl Estradiol and Levonorgestrel ....................................................... 8Ethinyl Estradiol and Norelgestromin .......................................................8Ethinyl Estradiol and Norethindrone ........................................................ 8Ethinyl Estradiol and Norgestimate ..........................................................8Ethinyl Estradiol and Norgestrel .............................................................. 8

Estrogen DerivativeEstradiol (Systemic) ................................................................................. 7Estradiol (Topical) .....................................................................................7Estrogens (Conjugated/Equine, Systemic) .............................................. 7Estrogens (Conjugated/Equine, Topical) ..................................................7

Ethanolamine DerivativeDimenhyDRINATE ....................................................................................6DiphenhydrAMINE (Systemic) ..................................................................6

ExpectorantGuaiFENesin .......................................................................................... 10Guaifenesin and Codeine ...................................................................... 10Guaifenesin and Dextromethorphan ...................................................... 10

Fiber SupplementMethylcellulose .......................................................................................12Psyllium .................................................................................................. 16

First Generation (Typical) AntipsychoticFluPHENAZine ......................................................................................... 9Loxapine .................................................................................................12Perphenazine ......................................................................................... 15Prochlorperazine .................................................................................... 16

GABA AnalogGabapentin ...............................................................................................9Pregabalin .............................................................................................. 15

Gastrointestinal Agent, MiscellaneousAdalimumab ..............................................................................................2Lubiprostone ...........................................................................................12Sucralfate ............................................................................................... 17

Gastrointestinal Agent, ProkineticMetoclopramide ......................................................................................13

General AnestheticFentaNYL ................................................................................................. 8

Genitourinary IrrigantSodium Chloride .....................................................................................17Sorbitol ................................................................................................... 17

GlycopeptideVancomycin ............................................................................................ 19

Hemostatic AgentAluminum Chloride Hexahydrate ............................................................. 2Desmopressin ...........................................................................................6

Histamine H1 AntagonistAzelastine (Nasal) .................................................................................... 3Cetirizine (Systemic) ................................................................................ 4Chlorpheniramine ..................................................................................... 4Cyproheptadine ........................................................................................ 5DimenhyDRINATE ....................................................................................6DiphenhydrAMINE (Systemic) ..................................................................6Fexofenadine ............................................................................................8HydrOXYzine ..........................................................................................10Ketotifen (Ophthalmic) ............................................................................11Loratadine ...............................................................................................12Meclizine .................................................................................................12Naphazoline and Pheniramine ...............................................................13Olopatadine (Ophthalmic) ...................................................................... 14Promethazine ......................................................................................... 16

Histamine H1 Antagonist, First GenerationChlorpheniramine ..................................................................................... 4Cyproheptadine ........................................................................................ 5DimenhyDRINATE ....................................................................................6DiphenhydrAMINE (Systemic) ..................................................................6HydrOXYzine ..........................................................................................10Meclizine .................................................................................................12Naphazoline and Pheniramine ...............................................................13Promethazine ......................................................................................... 16

Histamine H1 Antagonist, Second GenerationAzelastine (Nasal) .................................................................................... 3Cetirizine (Systemic) ................................................................................ 4Fexofenadine ............................................................................................8Ketotifen (Ophthalmic) ............................................................................11

Loratadine ...............................................................................................12Olopatadine (Ophthalmic) ...................................................................... 14

Histamine H2 AntagonistRaNITIdine ............................................................................................. 16

Histone Deacetylase InhibitorValproic Acid and Derivatives ................................................................ 18

HormoneMelatonin ................................................................................................12

Hormone, Posterior PituitaryDesmopressin ...........................................................................................6

Hypnotic, MiscellaneousEszopiclone .............................................................................................. 8Melatonin ................................................................................................12Zaleplon ..................................................................................................19Zolpidem .................................................................................................19

Imidazoline DerivativeNaphazoline and Pheniramine ...............................................................13Oxymetazoline (Nasal) ...........................................................................14

Immunosuppressant AgentAzaTHIOprine ...........................................................................................3CycloSPORINE (Ophthalmic) ...................................................................5Methotrexate ...........................................................................................12Pimecrolimus ..........................................................................................15

Inhalation, MiscellaneousInhalation Devices ..................................................................................10

Insulin, CombinationInsulin Aspart Protamine and Insulin Aspart ......................................... 10Insulin NPH and Insulin Regular ............................................................ 11

Insulin, Intermediate-ActingInsulin NPH .............................................................................................11

Insulin, Long-ActingInsulin Glargine .......................................................................................11

Insulin, Rapid-ActingInsulin Aspart ..........................................................................................10

Insulin, Short-ActingInsulin Regular ........................................................................................11

InterferonInterferon Beta-1b ...................................................................................11

Iron SaltFerrous Sulfate .........................................................................................8

IrrigantSodium Chloride .....................................................................................17

Keratolytic AgentPodofilox .................................................................................................15Tazarotene ..............................................................................................18

LaxativeMagnesium Hydroxide ............................................................................12Methylcellulose .......................................................................................12

Laxative, Bowel EvacuantSodium Phosphates ............................................................................... 17

Laxative, Bulk-ProducingMethylcellulose .......................................................................................12Psyllium .................................................................................................. 16

Laxative, LubricantMineral Oil .............................................................................................. 13

Laxative, OsmoticGlycerin .................................................................................................... 9Lactulose ................................................................................................ 11Polyethylene Glycol-Electrolyte Solution ............................................... 15Sorbitol ................................................................................................... 17

Laxative, SalineMagnesium Citrate ................................................................................. 12

Laxative, StimulantBisacodyl .................................................................................................. 3Senna ..................................................................................................... 16

Leukotriene-Receptor AntagonistMontelukast ............................................................................................ 13

Local AnestheticBenzocaine ...............................................................................................3

LOCAL ANESTHETIC

27

Dibucaine ..................................................................................................6Lidocaine (Topical) ..................................................................................11

Lubricant, OcularSodium Chloride .....................................................................................17

Magnesium SaltMagnesium Citrate ................................................................................. 12Magnesium Hydroxide ............................................................................12Magnesium Oxide .................................................................................. 12

Mast Cell StabilizerCromolyn (Ophthalmic) ............................................................................ 5Ketotifen (Ophthalmic) ............................................................................11Nedocromil ............................................................................................. 13

Melatonin Receptor AgonistMelatonin ................................................................................................12

Mineralocorticoid (Aldosterone) Receptor AntagonistsSpironolactone ....................................................................................... 17

Miscellaneous ProductDiabetic Supplies ......................................................................................6

Monoclonal AntibodyAdalimumab ..............................................................................................2

MouthwashMouthwash, Magic ................................................................................. 13

Neuraminidase InhibitorOseltamivir ..............................................................................................14

N-Methyl-D-Aspartate Receptor AntagonistMemantine ..............................................................................................12

Nonsteroidal Anti-inflammatory Drug (NSAID)Diclofenac (Systemic) ...............................................................................6Diclofenac (Topical) ..................................................................................6

Nonsteroidal Anti-inflammatory Drug (NSAID), COX-2 SelectiveCelecoxib ..................................................................................................4

Nonsteroidal Anti-inflammatory Drug (NSAID), OphthalmicFlurbiprofen (Ophthalmic) .........................................................................9Ketorolac (Ophthalmic) ...........................................................................11

Nonsteroidal Anti-inflammatory Drug (NSAID), OralAspirin .......................................................................................................3Diclofenac (Systemic) ...............................................................................6Hydrocodone and Ibuprofen .................................................................. 10Ibuprofen ................................................................................................ 10Indomethacin ..........................................................................................10Ketorolac (Systemic) .............................................................................. 11Meloxicam .............................................................................................. 12Naproxen ................................................................................................13Piroxicam (Systemic) ..............................................................................15Sulindac ..................................................................................................17

Nonsteroidal Anti-inflammatory Drug (NSAID), ParenteralIbuprofen ................................................................................................ 10Indomethacin ..........................................................................................10Ketorolac (Systemic) .............................................................................. 11

Nonsteroidal Anti-inflammatory Drug (NSAID), TopicalDiclofenac (Topical) ..................................................................................6

Norepinephrine Reuptake Inhibitor, SelectiveAtoMOXetine ............................................................................................ 3

Ophthalmic Agent, AntiglaucomaAcetaZOLAMIDE ......................................................................................2Bimatoprost .............................................................................................. 3Brimonidine (Ophthalmic) .........................................................................4Carbachol ................................................................................................. 4Dorzolamide ............................................................................................. 7Dorzolamide and Timolol ......................................................................... 7Latanoprost .............................................................................................11MethazolAMIDE ......................................................................................12Phenylephrine (Ophthalmic) ...................................................................15Pilocarpine (Ophthalmic) ........................................................................15Timolol (Ophthalmic) .............................................................................. 18

Ophthalmic Agent, MioticCarbachol ................................................................................................. 4Pilocarpine (Ophthalmic) ........................................................................15

Ophthalmic Agent, MiscellaneousArtificial Tears ...........................................................................................3Carboxymethylcellulose ............................................................................4

Ophthalmic Agent, MydriaticAtropine (Ophthalmic) .............................................................................. 3

Homatropine ...........................................................................................10Phenylephrine (Ophthalmic) ...................................................................15

Ophthalmic Agent, VasoconstrictorNaphazoline and Pheniramine ...............................................................13

Ophthalmic Agent, ViscoelasticHyaluronate and Derivatives ..................................................................10

Otic Agent, Anti-infectiveAcetic Acid, Propylene Glycol Diacetate, and Hydrocortisone ................2Aluminum Acetate and Acetic Acid ..........................................................2

Otic Agent, CerumenolyticCarbamide Peroxide .................................................................................4

Partial Nicotine AgonistVarenicline ..............................................................................................19

PediculocidePermethrin ..............................................................................................15

Pharmaceutical AidMenthol ...................................................................................................12

Phenothiazine DerivativeFluPHENAZine ......................................................................................... 9Perphenazine ......................................................................................... 15Prochlorperazine .................................................................................... 16Promethazine ......................................................................................... 16

Phosphate BinderCalcium Carbonate ...................................................................................4

Phosphodiesterase-3 Enzyme InhibitorCilostazol ..................................................................................................5

Phosphodiesterase-5 Enzyme InhibitorSildenafil .................................................................................................17

Phosphodiesterase Enzyme Inhibitor, NonselectiveTheophylline ........................................................................................... 18

Piperazine DerivativeCetirizine (Systemic) ................................................................................ 4HydrOXYzine ..........................................................................................10Meclizine .................................................................................................12

Piperidine DerivativeCyproheptadine ........................................................................................ 5Fexofenadine ............................................................................................8Ketotifen (Ophthalmic) ............................................................................11Loratadine ...............................................................................................12Olopatadine (Ophthalmic) ...................................................................... 14

Potassium BinderSodium Polystyrene Sulfonate ...............................................................17

ProgestinLevonorgestrel (Systemic) ......................................................................11MedroxyPROGESTERone ..................................................................... 12Megestrol ................................................................................................12Norethindrone .........................................................................................14Progesterone ..........................................................................................16

Prostaglandin, OphthalmicBimatoprost .............................................................................................. 3Latanoprost .............................................................................................11

Proton Pump InhibitorEsomeprazole ...........................................................................................7Omeprazole ............................................................................................14Pantoprazole .......................................................................................... 15RABEprazole ..........................................................................................16

Retinoic Acid DerivativeISOtretinoin .............................................................................................11Tretinoin (Topical) ...................................................................................18

RifamycinRifAMPin .................................................................................................16

SalicylateAspirin .......................................................................................................3Methyl Salicylate and Menthol ............................................................... 13Salsalate .................................................................................................16

Scabicidal AgentCrotamiton ................................................................................................5Permethrin ..............................................................................................15

Second Generation (Atypical) AntipsychoticLurasidone ..............................................................................................12QUEtiapine ............................................................................................. 16

LOCAL ANESTHETIC

28

RisperiDONE ..........................................................................................16Ziprasidone .............................................................................................19

Selective 5-HT3 Receptor AntagonistOndansetron ...........................................................................................14

Selective Estrogen Receptor Modulator (SERM)Raloxifene ...............................................................................................16Tamoxifen ............................................................................................... 17

Serotonin 5-HT1B, 1D Receptor AgonistRizatriptan .............................................................................................. 16SUMAtriptan ........................................................................................... 17ZOLMitriptan ...........................................................................................19

Skeletal Muscle RelaxantBaclofen ....................................................................................................3Cyclobenzaprine .......................................................................................5Methocarbamol .......................................................................................12

Skin and Mucous Membrane AgentImiquimod ...............................................................................................10

Skin and Mucous Membrane Agent, MiscellaneousEmollients .................................................................................................7Hyaluronate and Derivatives ..................................................................10

Smoking Cessation AidBuPROPion .............................................................................................. 4Nicotine ...................................................................................................14Varenicline ..............................................................................................19

Sodium SaltSodium Chloride .....................................................................................17

Stool SoftenerDocusate .................................................................................................. 7

Substituted BenzimidazoleEsomeprazole ...........................................................................................7Omeprazole ............................................................................................14Pantoprazole .......................................................................................... 15RABEprazole ..........................................................................................16

ThioamideMethIMAzole ...........................................................................................12Propylthiouracil .......................................................................................16

Thyroid ProductLevothyroxine ......................................................................................... 11Liothyronine ............................................................................................ 11Thyroid, Desiccated ................................................................................18

Topical Skin ProductAluminum Chloride Hexahydrate ............................................................. 2Aluminum Sulfate and Calcium Acetate .................................................. 2Benzoin .....................................................................................................3Benzoyl Peroxide ..................................................................................... 3Calamine .................................................................................................. 4Capsaicin ..................................................................................................4Clindamycin and Benzoyl Peroxide ......................................................... 5Emollients .................................................................................................7Erythromycin (Topical) ..............................................................................7Fluorouracil (Topical) ................................................................................9Imiquimod ...............................................................................................10Methyl Salicylate and Menthol ............................................................... 13Pimecrolimus ..........................................................................................15Podofilox .................................................................................................15Povidone-Iodine (Topical) .......................................................................15Selenium Sulfide .................................................................................... 16Surgical Lubricant ...................................................................................17Zinc Oxide .............................................................................................. 19

Topical Skin Product, AcneAdapalene ................................................................................................ 2Benzoyl Peroxide ..................................................................................... 3Clindamycin and Benzoyl Peroxide ......................................................... 5Clindamycin (Topical) ............................................................................... 5Erythromycin (Topical) ..............................................................................7Sulfur and Sulfacetamide .......................................................................17Tazarotene ..............................................................................................18Tretinoin (Topical) ...................................................................................18

Transient Receptor Potential Vanilloid 1 (TRPV1) AgonistCapsaicin ..................................................................................................4

Tumor Necrosis Factor (TNF) Blocking AgentAdalimumab ..............................................................................................2

Uricosuric AgentProbenecid ............................................................................................. 16

Vasodilator

Cilostazol ..................................................................................................5

Dipyridamole .............................................................................................7

HydrALAZINE .........................................................................................10

Isosorbide Dinitrate .................................................................................11

Isosorbide Mononitrate ...........................................................................11

Nitroglycerin ............................................................................................14

Vasopressin Analog, Synthetic

Desmopressin ...........................................................................................6

Vitamin

Vitamin B Complex Combinations ......................................................... 19

Vitamins (Multiple/Oral) ..........................................................................19

Vitamins (Multiple/Prenatal) ................................................................... 19

Vitamin D Analog

Calcitriol (Systemic) ..................................................................................4

Cholecalciferol ..........................................................................................4

Ergocalciferol ............................................................................................7

Vitamin, Fat Soluble

Calcium and Vitamin D ............................................................................ 4

Phytonadione ......................................................................................... 15

Vitamin, Water Soluble

Cyanocobalamin .......................................................................................5

Folic Acid ..................................................................................................9

Niacin ......................................................................................................14

Pyridoxine ...............................................................................................16

Thiamine .................................................................................................18

Xanthine Oxidase Inhibitor

Allopurinol .................................................................................................2

XANTHINE OXIDASE INHIBITOR

29