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NAVAL HOSPITAL BREMERTON

OUTPATIENT FORMULARY

Alphabetical Listing by

This document is current as of .

The availability of formulary items is subject to change.

Name

January 24, 2017

Absorption BaseOutpatient Dosage FormsOintment, topical:Absorbase®: 4 oz, 16 ozVelvachol®: 14 oz

AcetaminophenOutpatient Dosage FormsLiquid, oral: 160 mg/5 mL (120 mL, 473 mL)Suppository, rectal: 120 mg, 325 mg, 650 mgSuspension, oral: 160 mg/5 mL (5 mL, 10.15 mL, 20.3 mL)Tablet, oral: 325 mgTablet, chewable, oral: 80 mg

Acetaminophen and CodeineOutpatient Dosage FormsSolution, oral [C-V]: Acetaminophen 120 mg and codeine phosphate 12 mg per5 mL (118 mL) [BCF]

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

Acetaminophen, Isometheptene, and DichloralphenazoneOutpatient Dosage FormsCapsule, oral: Acetaminophen 325 mg, isometheptene mucate 65 mg, anddichloralphenazone 100 mg

AcetaZOLAMIDEOutpatient Dosage FormsCapsule, sustained release, oral:Diamox® Sequels®: 500 mg

Tablet, oral: 250 mg

Acetic Acid and OxyquinoloneOutpatient Dosage FormsJelly, vaginal:Aci-Jel: Acetic acid 0.92%, oxyquinoline sulfate 0.025%, ricinoleic acid 0.7%

Acetic Acid (Otic)Outpatient Dosage FormsSolution, otic [drops]: 2% (15 mL, 60 mL)

Acetic Acid, Propylene Glycol Diacetate, and HydrocortisoneOutpatient Dosage FormsSolution, otic [drops]: Acetic acid 2%, propylene glycol diacetate 3%, andhydrocortisone 1% (10 mL)

AcetylcholineOutpatient Dosage FormsPowder for solution, intraocular, as chloride:Miochol®-E: 20 mg (2 mL) [supplied with diluent; reconstitution results in 1:100solution]

AcetylcysteineOutpatient Dosage FormsSolution, for inhalation/oral: 20% [200 mg/mL] (30 mL)

Acyclovir (Systemic)Outpatient Dosage FormsCapsule, oral: 200 mg [BCF]Suspension, oral: 200 mg/5 mL (473 mL) [BCF]Tablet, oral: 400 mg [BCF], 800 mg [BCF]

Acyclovir (Topical)Outpatient Dosage FormsOintment, topical:Zovirax®: 5% (15 g, 30 g)

AdalimumabOutpatient Dosage FormsPen-injector Kit, Subcutaneous [preservative free]:Humira Pen: 40 mg/0.8 mL (1 ea) [contains polysorbate 80] [BCF]

AlbiglutideOutpatient Dosage FormsPen-injector, Subcutaneous [preservative free]:Tanzeum: 30 mg (1 ea); 50 mg (1 ea) [contains polysorbate 80]

AlbuterolOutpatient Dosage FormsAerosol, for oral inhalation:Ventolin® HFA: 90 mcg/inhalation (18 g) [chlorofluorocarbon free; 200 meteredactuations] [BCF]

Solution, for nebulization: 0.083% [2.5 mg/3 mL] (60s) [BCF]; 0.5% [2.5 mg/0.5mL] (20 mL)

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

Alcohol (Isopropyl)Outpatient Dosage FormsPads, topical: 200/box

AlendronateOutpatient Dosage FormsTablet, oral [daily]: 5 mg [BCF], 10 mg [BCF],Tablet, oral [weekly]: 35 mg [BCF], 70 mg [BCF]

Alendronate and CholecalciferolOutpatient Dosage FormsTablet, oral:Fosamax Plus D® 70/2800: Alendronate 70 mg and cholecalciferol 2800 unitsFosamax Plus D®: 70/5600: Alendronate 70 mg and cholecalciferol 5600 int.units

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

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

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

Aluminum Hydroxide and Magnesium CarbonateOutpatient Dosage FormsTablet, chewable:Gaviscon® Extra Strength: Aluminum hydroxide 160 mg and magnesiumcarbonate 105 mg [contains sodium 19 mg/tablet (1.3 mEq/tablet); cherryand original flavors]

Aluminum Hydroxide, Magnesium Hydroxide, and SimethiconeOutpatient Dosage FormsLiquid, oral: Aluminum hydroxide 400 mg, magnesium hydroxide 400 mg, andsimethicone 40 mg per 5 mL (360 mL)

Aluminum Sulfate and Calcium AcetateOutpatient Dosage FormsPowder, for topical solution: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 FormsOintment, topical: 0.1% (60 g)

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

AmitriptylineOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 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: 125 mg/5 mL (150 mL); 250 mg/5 mL (150 mL)[BCF]; 400 mg/5 mL (100 mL) [BCF]

Amoxicillin and ClavulanateOutpatient Dosage FormsPowder for suspension, oral:200: Amoxicillin 200 mg and clavulanate potassium 28.5 mg per 5 mL (100mL) [BCF]

400: Amoxicillin 400 mg and clavulanate potassium 57 mg per 5 mL (100mL) [BCF]

600: Amoxicillin 600 mg and clavulanate potassium 42.9 mg per 5 mL (75mL) [BCF]

ABSORPTION BASE

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

AmpicillinOutpatient Dosage FormsCapsule, oral: 250 mg

Amyl NitriteOutpatient Dosage FormsLiquid, for inhalation: USP: 85% to 103% (0.3 mL) [crushable covered glasscapsule]

AnastrozoleOutpatient Dosage FormsTablet, oral: 1 mg

Antipyrine and BenzocaineOutpatient Dosage FormsSolution, otic [drops]: Antipyrine 5.4% and benzocaine 1.4% (10 mL) [BCF]

ARIPiprazoleOutpatient Dosage FormsTablet, oral:Abilify®: 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, 30 mg

Artificial TearsOutpatient Dosage FormsSolution, ophthalmic: Polyvinyl alcohol 1.4% (30 mL) [contains benzalkoniumchloride]

Ascorbic AcidOutpatient Dosage FormsTablet, oral: 500 mg

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

Aspirin and DipyridamoleOutpatient Dosage FormsCapsule, variable release:Aggrenox®: Aspirin 25 mg [immediate release] and dipyridamole 200 mg[extended release] [contains lactose, sucrose]

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

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 [drops]: 1% (15 mL)

AzaTHIOprineOutpatient Dosage FormsInjection, powder for reconstitution: 100 mgTablet, oral: 50 mg

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

Azithromycin (Systemic)Outpatient Dosage FormsPowder for suspension, oral, as monohydrate [strength expressed as base]:100 mg/5 mL (15 mL) [BCF]; 200 mg/5 mL (15 mL, 22.5 mL, 30 mL); 1 g/packet (3s)

Tablet, oral, as dihydrate [strength expressed as base]:Zithromax® Z-PAK®: 250 mg [contains sodium 0.9 mg/tablet] [BCF]

Tablet, oral, as monohydrate [strength expressed as base]: 250 mg [BCF],500 mg [BCF]

Bacitracin and Polymyxin B (Ophthalmic)Outpatient Dosage FormsOintment, ophthalmic: Bacitracin 500 units and polymyxin B 10,000 units per g(3.5 g)

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, Neomycin, and Polymyxin B (Topical)Outpatient Dosage FormsOintment, topical: Bacitracin 400 units, neomycin 3.5 mg, and polymyxin B 5000units per g (15 g)

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, 30 g)

BaclofenOutpatient Dosage FormsTablet, oral: 10 mg

Balanced Salt SolutionOutpatient Dosage FormsSolution, ophthalmic [irrigation; preservative free]: Sodium chloride 0.64%,potassium chloride 0.075%, calcium chloride 0.048%, magnesium chloride0.03%, sodium acetate 0.39%, sodium citrate 0.17% (15 mL)

Belladonna and OpiumOutpatient Dosage FormsSuppository: Belladonna extract 16.2 mg and opium 30 mg; belladonna extract16.2 mg and opium 60 mg

BenzocaineOutpatient Dosage FormsLozenge, oral: 6 mg (18s)Cepacol® Sore Throat: 15 mg (16s) [contains cetylpyridinium, menthol; cherryflavor]

BenzonatateOutpatient Dosage FormsCapsule, softgel, oral: 100 mg

Benzoyl PeroxideOutpatient Dosage FormsGel, topical: 5% (45 g)Liquid, topical [wash/water based]:Desquam-X® 5: 5% (140 g)

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

Betamethasone (Topical)Outpatient Dosage FormsLotion, topical, as dipropionate [strength expressed as base]: 0.05% (60 mL)

Betaxolol (Ophthalmic)Outpatient Dosage FormsSuspension, ophthalmic [drops]:Betoptic S®: 0.25% (10 mL) [contains benzalkonium chloride]

BethanecholOutpatient Dosage FormsTablet, oral, as chloride: 25 mg

BicalutamideOutpatient Dosage FormsTablet, oral: 50 mg

BimatoprostOutpatient Dosage FormsSolution, Ophthalmic:Lumigan: 0.01% (5 mL) [contains benzalkonium chloride]

BisacodylOutpatient Dosage FormsSuppository, rectal: 10 mg (12s)Tablet, enteric coated, oral: 5 mg

Bismuth SubsalicylateOutpatient Dosage FormsTablet, chewable, oral, as subsalicylate: 262 mg

Brimonidine (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as tartrate [drops]: 0.15% (15 mL) [BCF]; 0.2% (15 mL)[BCF]

BRIMONIDINE (OPHTHALMIC)

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BromocriptineOutpatient Dosage FormsTablet, oral: 2.5 mg

Brompheniramine and PseudoephedrineOutpatient Dosage FormsLiquid, oral: Brompheniramine maleate 1 mg and pseudoephedrine hydrochlor-ide 15 mg per 5 mL

Budesonide (Oral Inhalation)Outpatient Dosage FormsSuspension, for nebulization: 0.25 mg/2 mL (30s)

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

Tablet, extended release, oral, as hydrochloride: 150 mg [generic for WellbutrinXL®] [BCF], 300 mg [generic for Wellbutrin XL®] [BCF]

Tablet, sustained release, oral, as hydrochloride:Wellbutrin SR®: 100 mg [BCF], 150 mg [BCF]

BusPIRoneOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 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]

Butalbital, Aspirin, and CaffeineOutpatient Dosage FormsCapsule: Butalbital 50 mg, aspirin 325 mg, and caffeine 40 mg

CalamineOutpatient Dosage FormsSuspension, topical: 8% (118 mL)

CalcitoninOutpatient Dosage FormsSolution, intranasal [calcitonin-salmon/rDNA origin/spray]:Fortical®: 200 units/actuation (3.7 mL) [contains benzyl alcohol; delivers 30doses]

Calcitriol (Systemic)Outpatient Dosage FormsCapsule, softgel, oral:Generic: 0.25 mcg, 0.5 mcg

Calcium and Vitamin DOutpatient Dosage FormsTablet, oral: Calcium 250 mg and vitamin D 125 units; calcium 600 mg andvitamin D 400 units

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

Calcium GlubionateOutpatient Dosage FormsSyrup, oral:Calcionate: 1.8 g/5 mL (473 mL) [contains benzoic acid; caramel-orange flavor;equivalent to elemental calcium 115 mg/5 mL]

Calcium LactateOutpatient Dosage FormsTablet, oral: 650 mg [equivalent to elemental calcium 84.5 mg]

CandesartanOutpatient Dosage FormsTablet, oral, as cilexetil:Atacand®: 4 mg, 8 mg, 16 mg, 32 mg [scored]

Candesartan and HydrochlorothiazideOutpatient Dosage FormsTablet:Atacand HCT®:16/12.5: Candesartan cilexetil 16 mg and hydrochlorothiazide 12.5 mg32/12.5: Candesartan cilexetil 32 mg and hydrochlorothiazide 12.5 mg

CapecitabineOutpatient Dosage FormsTablet, oral:Xeloda®: 150 mg, 500 mg

CaptoprilOutpatient Dosage FormsTablet, oral: 25 mg [BCF]

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

CarBAMazepineOutpatient Dosage FormsSuspension, oral: 100 mg/5 mL (450 mL) [BCF]Tablet, oral: 200 mg [BCF]Tablet, chewable, oral: 100 mg [BCF]Tablet, extended release, oral:TEGretol®-XR: 100 mg, 200 mg, 400 mg [BCF]

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

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]

Tablet, extended release:25/100: Carbidopa 25 mg and levodopa 100 mg50/200: Carbidopa 50 mg and levodopa 200 mg

CarboxymethylcelluloseOutpatient Dosage FormsSolution, ophthalmic, as sodium [drops, preservative free]:Refresh Plus®: 0.5% (0.3 mL)

Carteolol (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as hydrochloride [drops]: 1% (10 mL) [contains benzalko-nium chloride]

CarvedilolOutpatient Dosage FormsTablet, oral: 3.125 mg [BCF], 6.25 mg [BCF], 12.5 mg [BCF], 25 mg [BCF]

CefdinirOutpatient Dosage FormsPowder for suspension, oral: 125 mg/5 mL (6100 mL); 250 mg/5 mL (100 mL)

CefpodoximeOutpatient Dosage FormsTablet, oral: 200 mg

CelecoxibOutpatient Dosage FormsCapsule, Oral:Generic: 100 mg, 200 mg

CephalexinOutpatient Dosage FormsCapsule, oral: 250 mg [BCF], 500 mg [BCF]Powder for suspension, oral: 125 mg/5 mL (100 mL); 250 mg/5 mL (200mL) [BCF]

CetirizineOutpatient Dosage FormsSyrup, oral, as hydrochloride: 5 mg/5 mL (120 mL)Tablet, oral, as hydrochloride: 5 mg, 10 mg

ChlordiazePOXIDEOutpatient Dosage FormsCapsule, oral, as hydrochloride: 10 mg, 25 mg

Chlorhexidine GluconateOutpatient Dosage FormsLiquid, oral [rinse]: 0.12% (473 mL) [BCF]Liquid, topical [surgical scrub]:Betasept®: 4% (473 mL) [contains isopropyl alcohol 4%]

ChloroquineOutpatient Dosage FormsTablet, oral, as phosphate: 250 mg [equivalent to chloroquine base 150 mg],500 mg [equivalent to chloroquine base 300 mg]

ChlorpheniramineOutpatient Dosage FormsSyrup, oral, as maleate:Aller-chlor®: 2 mg/5 mL (118 mL) [contains ethanol 5%, menthol, propyleneglycol; cherry flavor]

Tablet, oral, as maleate: 4 mg

ChlorproMAZINEOutpatient Dosage FormsTablet, oral, as hydrochloride: 10 mg, 25 mg, 100 mg

BROMOCRIPTINE

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ChlorthalidoneOutpatient Dosage FormsTablet, Oral:Generic: 25 mg [BCF], 50 mg [BCF]

CholecalciferolOutpatient Dosage FormsLiquid, Oral:Generic: 400 units/mL (50 mL)

Tablet, Oral:Generic: 1000 units

CimetidineOutpatient Dosage FormsTablet, oral: 400 mg

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

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 [BCF],250 mg [BCF], 500 mg [BCF], 750 mg

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

ClarithromycinOutpatient Dosage FormsTablet, oral: 250 mg, 500 mgTablet, extended release, oral: 500 mg

Cleansing LotionOutpatient Dosage FormsCream:Lotion, Lipid free:Cētaphil®: 240 mL

Clidinium and ChlordiazepoxideOutpatient Dosage FormsCapsule: Clidinium bromide 2.5 mg and chlordiazepoxide hydrochloride 5 mg

Clindamycin and Benzoyl PeroxideOutpatient Dosage FormsGel, External:Generic: Clindamycin phosphate 1.2% and benzoyl peroxide 5% (45 g) [BCF]

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

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

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

ClobetasolOutpatient Dosage FormsCream, topical, emollient, as propionate: 0.05% (15 g, 60 g)Ointment, topical, as propionate: 0.05% (15 g, 60 g)

ClomiPHENEOutpatient Dosage FormsTablet, oral, as citrate: 50 mg

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

CloNIDineOutpatient Dosage FormsPatch, transdermal: 0.1 mg/24 hours (4s); 0.2 mg/24 hours (4s); 0.3 mg/24hours (4s)

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

ClopidogrelOutpatient Dosage FormsTablet, oral: 75 mg [BCF]

Clotrimazole (Oral)Outpatient Dosage FormsTroche, oral: 10 mg

Clotrimazole (Topical)Outpatient Dosage FormsCream, topical: 1% (30 g)Cream, vaginal: 1% (45 g)Solution, topical: 1% (30 mL) [BCF]

Coal TarOutpatient Dosage FormsOintment, topical:MG217® Medicated Tar Intensive Strength: Coal tar solution 10% (107 g)[equivalent to coal tar 2%]

CodeineOutpatient Dosage FormsTablet, oral, as sulfate: 30 mg

ColchicineOutpatient Dosage FormsTablet, oral: 0.6 mg

ColestipolOutpatient Dosage FormsGranules for suspension, oral, as hydrochloride: 7.5 g/scoop (450 g); 5 g/packet(30s)

Tablet, oral, as hydrochloride: 1 g

CortisoneOutpatient Dosage FormsTablet, oral, as acetate: 25 mg

Cromolyn (Nasal)Outpatient Dosage FormsSolution, intranasal, as sodium [spray]: 5.2 mg/dose [200 sprays]

Cromolyn (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as sodium [drops]: 4% (10 mL)

Cromolyn (Oral Inhalation)Outpatient Dosage FormsNebulization Solution, Inhalation, as sodium:Generic: 20 mg/2 mL (2 mL)

Cromolyn (Systemic)Outpatient Dosage FormsConcentrate, Oral, as sodium:Generic: 100 mg/5 mL (5 mL)

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

CyanocobalaminOutpatient Dosage FormsInjection, solution: 1000 mcg/mL (1 mL)Tablet, oral: 1000 mcg

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

CyclopentolateOutpatient Dosage FormsSolution, ophthalmic, as hydrochloride [drops]: 1% (15 mL)

CyclophosphamideOutpatient Dosage FormsTablet, oral: 25 mg, 50 mg

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

CycloSPORINE (Systemic)Outpatient Dosage FormsCapsule, softgel, oral [modified]: 25 mg, 100 mgSolution, oral [modified]: 100 mg/mL (50 mL)

CyproheptadineOutpatient Dosage FormsSyrup, oral, as hydrochloride: 2 mg/5 mL (473 mL) [BCF]Tablet, oral, as hydrochloride: 4 mg [BCF]

CYPROHEPTADINE

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Dabigatran EtexilateOutpatient Dosage FormsCapsule, Oral:Pradaxa: 150 mg

DanazolOutpatient Dosage FormsCapsule, oral: 200 mg

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

DesipramineOutpatient Dosage FormsTablet, oral, as hydrochloride: 25 mg, 50 mg, 75 mg, 100 mg

DesmopressinOutpatient Dosage FormsSolution, intranasal, as acetate: 0.1 mg/mL (2.5 mL)

DesonideOutpatient Dosage FormsOintment, topical: 0.05% (15 g)

DesoximetasoneOutpatient Dosage FormsCream, topical: 0.25% (15 g, 60 g)

Dexamethasone (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as phosphate [drops]: 0.1% (5 mL)

Dexamethasone (Systemic)Outpatient Dosage FormsElixir, oral: 0.5 mg/5 mL (237 mL)Tablet, oral: 0.5 mg, 1 mg, 4 mg

DextroamphetamineOutpatient Dosage FormsCapsule, extended release, oral, as sulfate: 5 mg, 10 mg, 15 mgTablet, oral, as sulfate: 5 mg

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]

15 mg [dextroamphetamine sulfate 3.75 mg, dextroamphetamine saccharate3.75 mg, amphetamine aspartate monohydrate 3.75 mg, amphetamine sul-fate 3.75 mg (equivalent to amphetamine base 9.4 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]

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)]

Diabetic SuppliesOutpatient Dosage FormsGauze sponge, nonsterile: 2" x 2" (200/pkg)Lancet:BD™ Ultra-Fine™ II: 200/box

Syringe and needle:Sure Comfort Pen Needles 30 gauge X 8 MM (100/box)

Test Strips/Kit:FreeStyle® Test Strips: 50/boxFreeStyle Lite® Test Strips: 50/boxKeto-Diastix® Test Strips: 50/boxPrecision Xtra® Blood Glucose Test Strips: 100/box [BCF]

DiazePAMOutpatient Dosage FormsTablet, oral: 5 mg [BCF]

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

Diclofenac (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as sodium [drops]: 0.1% (5 mL)

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% (100 g) [contains isopropyl alcohol, propylene glycol]

DicloxacillinOutpatient Dosage FormsCapsule, oral: 250 mg [BCF], 500 mg [BCF]Suspension, oral: 62.5 mg/5 mL

DicyclomineOutpatient Dosage FormsCapsule, oral, as hydrochloride: 10 mg [BCF]Syrup, oral, as hydrochloride: 10 mg/5 mL (473 mL) [BCF]Tablet, oral, as hydrochloride: 20 mg [BCF]

DigoxinOutpatient Dosage FormsSolution, oral: 0.5 mg/mL (60 mL)Tablet, oral: 0.125 mg [BCF], 0.25 mg [BCF]

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]

Tablet, oral, as hydrochloride: 30 mg, 60 mg

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

Diphenoxylate and AtropineOutpatient Dosage FormsTablet, oral: Diphenoxylate hydrochloride 2.5 mg and atropine sulfate 0.025 mg

DipyridamoleOutpatient Dosage FormsTablet, oral: 25 mg, 75 mg

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

DisulfiramOutpatient Dosage FormsTablet, oral: 250 mg

DocusateOutpatient Dosage FormsCapsule, softgel, oral, as calcium: 240 mg

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

DorzolamideOutpatient Dosage FormsSolution, ophthalmic [drops]: 2% (10 mL)

DoxazosinOutpatient Dosage FormsTablet, oral: 1 mg, 2 mg, 4 mg, 8 mg

Doxepin (Systemic)Outpatient Dosage FormsCapsule, oral: 10 mg [BCF], 25 mg [BCF], 50 mg [BCF], 75 mg [BCF], 150 mgSolution, oral [concentrate]: 10 mg/mL (118 mL) [BCF]

DABIGATRAN ETEXILATE

6

DoxycyclineOutpatient Dosage FormsCapsule, oral, as hyclate [strength expressed as base]: 100 mg [BCF]Tablet, oral, as hyclate [strength expressed as base]: 100 mg [BCF]

DoxylamineOutpatient Dosage FormsTablet, Oral, as succinate:Unisom: 25 mg

DronedaroneOutpatient Dosage FormsTablet, oral:Multaq®: 400 mg

DULoxetineOutpatient Dosage FormsCapsule Delayed Release Particles, Oral:Generic: 20 mg, 30 mg, 40 mg, 60 mg

EmollientsOutpatient Dosage FormsCream, topical:Velvachol®: 420 g

Ointment, topical:Absorbase®: 4 oz, 16 oz

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

EnoxaparinOutpatient Dosage FormsInjection, solution, as sodium [preservative free]: 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 (1 mL) [BCF]; 120 mg/0.8 mL (0.8 mL) [BCF];150 mg/mL (1 mL) [BCF]

EPINEPHrine (Systemic)Outpatient Dosage FormsInjection, solution:Twinject®: 0.15 mg/0.15 mL (1.1 mL) [contains chlorobutanol, sodium bisulfite;1:1000 solution; delivers 0.15 mg per injection]

Twinject®: 0.3 mg/0.3 mL (1.1 mL) [contains chlorobutanol, sodium bisulfite;1:1000 solution; delivers 0.3 mg per injection]

Epoetin AlfaOutpatient Dosage FormsInjection, solution:Epogen®: 10,000 units/mL (2 mL); 20,000 units/mL (1 mL) [contains albumin(human), benzyl alcohol]

Procrit®: 10,000 units/mL (2 mL); 20,000 units/mL (1 mL) [contains albumin(human), benzyl alcohol]

Injection, solution [preservative free]:Epogen®: 2000 units/mL (1 mL); 3000 units/mL (1 mL); 4000 units/mL (1 mL);10,000 units/mL (1 mL) [contains albumin (human)]

Procrit®: 2000 units/mL (1 mL); 3000 units/mL (1 mL); 4000 units/mL (1 mL);10,000 units/mL (1 mL); 40,000 units/mL (1 mL) [contains albumin (human)]

ErgocalciferolOutpatient Dosage FormsCapsule, oral: 50,000 units [1.25 mg]

Ergotamine and CaffeineOutpatient Dosage FormsTablet, oral: Ergotamine tartrate 1 mg and caffeine 100 mg

Erythromycin and SulfisoxazoleOutpatient Dosage FormsPowder for oral suspension: Erythromycin ethylsuccinate 200 mg and sulfisox-azole acetyl 600 mg per 5 mL (200 mL)

Erythromycin (Ophthalmic)Outpatient Dosage FormsOintment, Ophthalmic:Generic: 5 mg/g (1 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 (100 mL) [contains sodium 25.9 mg (1.1 mEq)/5 mL;cherry flavor] [BCF]

Tablet, delayed release, enteric coated, oral, 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, 60 g) [BCF]Solution, topical: 2% (60 mL) [BCF]

EscitalopramOutpatient Dosage FormsTablet, Oral:Generic: 5 mg, 10 mg, 20 mg

EsomeprazoleOutpatient Dosage FormsCapsule, delayed release, oral, as magnesium [strength expressed as base]:NexIUM®: 20 mg [BCF], 40 mg [BCF]

Estradiol (Systemic)Outpatient Dosage FormsInjection, oil, as valerate: 20 mg/mL (5 mL)Patch, 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]

Tablet, oral [micronized]: 1 mg, 2 mg

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: 0.45/1.5: Conjugated estrogens 0.45 mg and medroxyprogesteroneacetate 1.5 mg [BCF]

Prempro: 0.625/2.5: Conjugated estrogens 0.625 mg and medroxyprogester-one acetate 2.5 mg [BCF]

Prempro: 0.625/5: Conjugated estrogens 0.625 mg and medroxyprogesteroneacetate 5 mg [BCF]

Estrogens (Conjugated/Equine, Systemic)Outpatient Dosage FormsInjection, powder for reconstitution:Premarin®: 25 mg [contains lactose 200 mg]

Tablet, oral:Premarin®: 0.3 mg [BCF], 0.45 mg [BCF], 0.625 mg [BCF], 0.9 mg,1.25 mg [BCF]

Estrogens (Conjugated/Equine, Topical)Outpatient Dosage FormsCream, vaginal:Premarin®: 0.625 mg/g (30 g) [BCF]

Estrogens (Esterified) and MethyltestosteroneOutpatient Dosage FormsTablet: Esterified estrogen 0.625 mg and methyltestosterone 1.25 mg; esterifiedestrogens 1.25 mg and methyltestosterone 2.5 mg

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

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

Ethinyl Estradiol and DesogestrelOutpatient Dosage FormsTablet, monophasic formulations:Desogen®: Ethinyl estradiol 0.03 mg and desogestrel 0.15 mg [21 whitetablets and 7 green inactive tablets] (28s)

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] (28s) [BCF]

Yaz®: Ethinyl estradiol 0.02 mg and drospirenone 3 mg [24 light pink activetablets and 4 white inactive tablets] (28s) [BCF]

Ethinyl Estradiol and Ethynodiol DiacetateOutpatient Dosage FormsTablet, monophasic formulations:Zovia® 1/35-28: Ethinyl estradiol 0.035 mg and ethynodiol diacetate 1 mg [21light pink tablets and 7 white inactive tablets] (28s)

Zovia® 1/50-28: Ethinyl estradiol 0.05 mg and ethynodiol diacetate 1 mg [21pink tablets and 7 white inactive tablets] (28s)

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

Ethinyl Estradiol and LevonorgestrelOutpatient Dosage FormsTablet, oral [extended cycle regimen]:Jolessa™: Ethinyl estradiol 0.03 mg and levonorgestrel 0.15 mg (91s) [84 pinktablets and 7 white inactive tablets] [BCF]

ETHINYL ESTRADIOL AND LEVONORGESTREL

7

Tablet, oral [low dose formulation]:Aviane™: Ethinyl estradiol 0.02 mg and levonorgestrel 0.1 mg [21 orangetablets and 7 light green inactive tablets] (28s) [BCF]

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

Lutera®: Ethinyl estradiol 0.02 mg and levonorgestrel 0.1 mg (28s) [21 whitetablets and 7 peach inactive tablets] [BCF]

Orsythia™: Ethinyl estradiol 0.02 mg and levonorgestrel 0.1 mg (28s) [21 pinktablets and 7 light green inactive tablets] [BCF]

Sronyx®: Ethinyl estradiol 0.02 mg and levonorgestrel 0.1 mg (28s) [21 whitetablets and 7 peach inactive tablets] [BCF]

Tablet, oral [monophasic formulation]:Altavera™: Ethinyl estradiol 0.03 mg and levonorgestrel 0.15 mg (28s) [21peach tablets and 7 white inactive tablets] [BCF]

Levora®: Ethinyl estradiol 0.03 mg and levonorgestrel 0.15 mg (28s) [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]

Portia® 28: Ethinyl estradiol 0.03 mg and levonorgestrel 0.15 mg (28s) [21 pinktablets and 7 white inactive tablets] [BCF]

Tablet, oral [triphasic formulation]:Enpresse®:Day 1-6: Ethinyl estradiol 0.03 mg and levonorgestrel 0.05 mg [6 pink tablets]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 orangetablets]

Day 22-28: 7 light green inactive tablets (28s)Myzilra™:Day 1-6: Ethinyl estradiol 0.03 mg and levonorgestrel 0.05 mg [6 beigetablets]

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 (28s)Trivora®:Day 1-6: Ethinyl estradiol 0.03 mg and levonorgestrel 0.05 mg [6 blue tablets]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 pinktablets]

Day 22-28: 7 peach inactive tablets (28s)

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

Ethinyl Estradiol and NorethindroneOutpatient Dosage FormsTablet, oral, monophasic formulations:Loestrin® 21 1/20: Ethinyl estradiol 0.02 mg and norethindrone acetate 1 mg[light yellow tablets] (21s)

Loestrin® 21 1.5/30: Ethinyl estradiol 0.03 mg and norethindrone acetate1.5 mg [pink tablets] (21s)

Loestrin® Fe 1.5/30: Ethinyl estradiol 0.03 mg and norethindrone acetate1.5 mg [21 pink tablets] and ferrous fumarate 75 mg [7 brown tablets] (28s)

Norinyl® 1+35: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [21 yellow-green tablets and 7 orange inactive tablets] (28s) [BCF]

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

Day 8-14: Ethinyl estradiol 0.035 mg and norethindrone 0.75 mg [7 lightpeach tablets]

Day 15-21: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [7 peachtablets]

Day 22-28: 7 green inactive tablets (28s)

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

Tablet, triphasic formulations:Ortho Tri-Cyclen® [BCF]: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 dark green inactive tablets (28s)Ortho Tri-Cyclen® Lo [BCF]: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 dark bluetablets]

Day 22-28: 7 dark green inactive tablets (28s)

Ethinyl Estradiol and NorgestrelOutpatient Dosage FormsTablet, monophasic formulations: Ethinyl estradiol 0.03 mg and norgestrel0.3 mg [21 tablets and 7 inactive tablets] (28s)Lo/Ovral®-28: Ethinyl estradiol 0.03 mg and norgestrel 0.3 mg [21 whitetablets and 7 pink inactive tablets] (28s)

EtodolacOutpatient Dosage FormsCapsule, oral: 200 mg, 300 mgTablet, oral: 400 mg, 500 mg

ExenatideOutpatient Dosage FormsPen-Injector, Subcutaneous:Bydureon: 2 mg (1 ea)

Suspension Reconstituted ER, Subcutaneous:Bydureon: 2 mg (1 ea)

EzetimibeOutpatient Dosage FormsTablet, oral:Zetia®: 10 mg

Ezetimibe and SimvastatinOutpatient Dosage FormsTablet:Vytorin® 10/10: Ezetimibe 10 mg and simvastatin 10 mgVytorin® 10/20: Ezetimibe 10 mg and simvastatin 20 mgVytorin® 10/40: Ezetimibe 10 mg and simvastatin 40 mgVytorin® 10/80: Ezetimibe 10 mg and simvastatin 80 mg

FamotidineOutpatient Dosage FormsTablet, oral: 20 mg

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

Fenofibrate and DerivativesOutpatient Dosage FormsTablet, oral: 54 mg, 160 mgTriCor®: 48 mg [BCF], 145 mg [BCF] [contains soybean lecithin]

FentaNYLOutpatient Dosage FormsPatch, transdermal, as base: 12 [delivers 12.5 mcg/hr] (5s); 25 [delivers 25 mcg/hr] (5s); 50 [delivers 50 mcg/hr] (5s); 75 [delivers 75 mcg/hr] (5s); 100 [delivers100 mcg/hr] (5s)

Ferrous SulfateOutpatient Dosage FormsLiquid, oral [drops]: 75 mg/mL (50 mL) [elemental iron 15 mg/mL]Tablet, oral: 324 mg [elemental iron 65 mg]

FexofenadineOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 60 mg, 180 mg

FinasterideOutpatient Dosage FormsTablet, oral: 5 mg [BCF]

FlavoxATEOutpatient Dosage FormsTablet, oral, as hydrochloride: 100 mg

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

Fluocinolone (Topical)Outpatient Dosage FormsSolution, topical, as acetonide: 0.01% (60 mL)

FluocinonideOutpatient Dosage FormsCream, topical: 0.05% (60 g) [BCF]

ETHINYL ESTRADIOL AND LEVONORGESTREL

8

FluorideOutpatient Dosage FormsCream, oral, as sodium [toothpaste]: 1.1% (51 g) [equivalent to fluoride 2.5 mg/dose]PreviDent® 5000 Plus®: 1.1% (51 g) [contains sodium benzoate; equivalent tofluoride 2.5 mg/dose]

Solution, oral, as sodium [drops]:Flura-Drops®: 0.55 mg/drop (24 mL) [dye free, sugar free; equivalent tofluoride 0.25 mg/drop]

Tablet, chewable, oral, as sodium: 1.1 mg [equivalent to fluoride 0.5 mg], 2.2 mg[equivalent to fluoride 1 mg]

FluorometholoneOutpatient Dosage FormsSuspension, ophthalmic, as base [drops]: 0.1% (5 mL)

Fluorouracil (Topical)Outpatient Dosage FormsCream, topical: 5% (40 g)

FLUoxetineOutpatient Dosage FormsCapsule, oral: 10 mg [BCF], 20 mg [BCF], 40 mg [BCF]Solution, oral: 20 mg/5 mL (120 mL) [BCF]

FluPHENAZineOutpatient Dosage FormsTablet, oral, as hydrochloride: 1 mg, 5 mg

FlurandrenolideOutpatient Dosage FormsTape, topical [roll]:Cordran®: 4 mcg/cm2 (80 inch)

Flurbiprofen (Systemic)Outpatient Dosage FormsTablet, oral: 100 mg

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

Advair® HFA: 115/21: Fluticasone propionate 115 mcg and salmeterol 21 mcgper inhalation (12 g) [chlorofluorocarbon free; 120 metered actuations] [BCF]

Advair® HFA: 230/21: Fluticasone propionate 230 mcg and salmeterol 21 mcgper inhalation (12 g) [chlorofluorocarbon free; 120 metered actuations] [BCF]

Powder, for oral inhalation:Advair Diskus®: 100/50: Fluticasone propionate 100 mcg and salmeterol 50mcg (14s, 60s) [contains lactose] [BCF]

Advair Diskus®: 250/50: Fluticasone propionate 250 mcg and salmeterol 50mcg (14s, 60s) [contains lactose] [BCF]

Advair Diskus®: 500/50: Fluticasone propionate 500 mcg and salmeterol 50mcg (14s, 60s) [contains lactose] [BCF]

Fluticasone (Nasal)Outpatient Dosage FormsSuspension, intranasal, as propionate [spray]: 50 mcg/inhalation (16 g) [BCF]

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

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

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

Powder, for oral inhalation, as propionate:Flovent® Diskus®: 50 mcg (60s) [contains lactose] [BCF]Flovent® Diskus®: 100 mcg (60s) [contains lactose] [BCF]Flovent® Diskus®: 250 mcg (60s) [contains lactose] [BCF]

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

FosinoprilOutpatient Dosage FormsTablet, oral, as sodium: 10 mg, 20 mg, 40 mg

FurosemideOutpatient Dosage FormsSolution, oral: 10 mg/mL (120 mL) [BCF]Tablet, oral: 20 mg [BCF], 40 mg [BCF]

GabapentinOutpatient Dosage FormsCapsule, oral: 100 mg [BCF], 300 mg [BCF], 400 mg [BCF]Tablet, oral: 600 mg [BCF], 800 mg [BCF]

Ganciclovir (Ophthalmic)Outpatient Dosage FormsGel, ophthalmic [drops]:Zirgan®: 0.15% (5 g) [contains benzalkonium chloride]

GemfibrozilOutpatient Dosage FormsTablet, oral: 600 mg [BCF]

Gentamicin (Ophthalmic)Outpatient Dosage FormsOintment, ophthalmic [preservative free]:Garamycin™: 0.3% (3.5 g) [BCF]

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

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

Gentian VioletOutpatient Dosage FormsSolution, topical: 2% (60 mL)

Glatiramer AcetateOutpatient Dosage FormsKit, Subcutaneous:Copaxone: 20 mg/mL [contains mannitol]

GlimepirideOutpatient Dosage FormsTablet, oral: 1 mg, 2 mg, 4 mg

GlipiZIDEOutpatient Dosage FormsTablet, oral: 5 mg [BCF], 10 mg [BCF]Tablet, extended release, oral: 2.5 mg, 5 mg, 10 mg

Glipizide and MetforminOutpatient Dosage FormsTablet, oral:2.5/250: Glipizide 2.5 mg and metformin hydrochloride 250 mg2.5/500: Glipizide 2.5 mg and metformin hydrochloride 500 mg5/500: Glipizide 5 mg and metformin hydrochloride 500 mg

GlucagonOutpatient Dosage FormsInjection, powder for reconstitution:Glucagon Emergency Kit: 1 mg [contains glycerin (in diluent), lactose 49 mg;equivalent to 1 unit]

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], 5 mg [BCF], 6 mg [BCF]

Glyburide and MetforminOutpatient Dosage FormsTablet, oral:1.25 mg/250 mg: Glyburide 1.25 mg and metformin hydrochloride 250 mg2.5 mg/500 mg: Glyburide 2.5 mg and metformin hydrochloride 500 mg5 mg/500 mg: Glyburide 5 mg and metformin hydrochloride 500 mg

GlycerinOutpatient Dosage FormsSuppository, rectal [pediatric]: 1.5 g (12s)

Glycopyrrolate (Systemic)Outpatient Dosage FormsSolution, Injection:Generic: 0.2 mg/mL (20 mL)

Tablet, Oral:Generic: 1 mg

GoserelinOutpatient Dosage FormsImplant, subcutaneous:Zoladex®: 3.6 mg (1s) [1 month implant] [BCF]Zoladex®: 10.8 mg (1s) [3 month implant] [BCF]

GriseofulvinOutpatient Dosage FormsSuspension, oral [microsize]: 125 mg/5 mL (120 mL) [BCF]Tablet, oral [ultramicrosize]:Gris-PEG®: 125 mg [BCF], 250 mg [BCF] [scored]

GRISEOFULVIN

9

GuaiFENesinOutpatient Dosage FormsSyrup, oral: 100 mg/5 mL (118 mL)Tablet, extended release, oral:Mucinex®: 600 mg

Guaifenesin and CodeineOutpatient Dosage FormsSyrup, oral: Guaifenesin 100 mg and codeine phosphate 10 mg per 5 mL (473mL)

Guaifenesin and DextromethorphanOutpatient Dosage FormsSyrup, oral: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mgper 5 mL (120 mL)

Guaifenesin and PseudoephedrineOutpatient Dosage FormsTablet, extended release, oral:Mucinex® D: Guaifenesin 600 mg and pseudoephedrine hydrochloride 60 mg

GuanFACINEOutpatient Dosage FormsTablet, extended release, oral:Intuniv®: 1 mg, 2 mg, 3 mg, 4 mg

HaloperidolOutpatient Dosage FormsTablet, oral: 0.5 mg, 1 mg, 2 mg, 5 mg

HeparinOutpatient Dosage FormsInjection, solution, as sodium [lock flush preparation; porcine intestinal mucosasource]: 10 units/mL (5 mL); 100 units/mL (5 mL)

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

Hydrocodone and AcetaminophenOutpatient Dosage FormsTablet, oral:Hydrocodone bitartrate 5 mg and acetaminophen 325 mgHydrocodone bitartrate 5 mg and acetaminophen 500 mgHydrocodone bitartrate 10 mg and acetaminophen 325 mg

Hydrocortisone (Systemic)Outpatient Dosage FormsTablet, oral, as base: 5 mg, 20 mg

Hydrocortisone (Topical)Outpatient Dosage FormsCream, topical, as acetate: 1% (28.4 g)Cream, topical, as base:Anusol-HC®: 2.5% (30 g) [contains benzyl alcohol] [BCF]ProctoCream®-HC: 2.5% (30 g) [contains benzyl alcohol] [BCF]

Cream, topical, as valerate: 0.2% (15 g, 60 g)Lotion, topical, as base: 1% (118 mL)Ointment, topical, as acetate [strength expressed as base]: 1% (30 g)Ointment, topical, as valerate: 0.2% (15 g, 60 g)Suppository, rectal, as acetate: 25 mg (12s) [BCF]Anusol-HC®: 25 mg (12s, 24s) [BCF]

Suspension, rectal, as base: 100 mg/60 mL (60 mL)

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

HydroxychloroquineOutpatient Dosage FormsTablet, oral, as sulfate: 200 mg [equivalent to 155 mg base]

Hydroxypropyl MethylcelluloseOutpatient Dosage FormsSolution, ophthalmic [drops]:Nature's Tears: 0.4% (15 mL) [contains benzalkonium chloride]

HydroxyureaOutpatient Dosage FormsCapsule, oral: 500 mg

HydrOXYzineOutpatient Dosage FormsCapsule, oral, as pamoate: 25 mg, 50 mgSyrup, oral, as hydrochloride: 10 mg/5 mL (118 mL) [BCF]Tablet, oral, as hydrochloride: 10 mg [BCF], 25 mg [BCF], 50 mg [BCF]

Hyoscyamine, Atropine, Scopolamine, and PhenobarbitalOutpatient Dosage FormsElixir: Hyoscyamine sulfate 0.1037 mg, atropine sulfate 0.0194 mg, scopol-amine hydrobromide 0.0065 mg, and phenobarbital 16.2 mg per 5 mL (473mL)

Tablet: Hyoscyamine sulfate 0.1037 mg, atropine sulfate 0.0194 mg, scopol-amine hydrobromide 0.0065 mg, and phenobarbital 16.2 mg

IbandronateOutpatient Dosage FormsTablet, oral: 150 mg

IbuprofenOutpatient Dosage FormsSuspension, oral: 100 mg/5 mL (120 mL)Tablet, oral: 400 mg [BCF], 600 mg [BCF], 800 mg [BCF]

ImatinibOutpatient Dosage FormsTablet, oral:Gleevec®: 100 mg [scored]

ImipramineOutpatient Dosage FormsCapsule, oral, as pamoate: 75 mg [BCF]Tablet, oral, as hydrochloride: 10 mg [BCF], 25 mg [BCF], 50 mg [BCF]

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

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

Inhalation DevicesOutpatient Dosage FormsHolding chamber:AeroChamber™ with mask (small, medium)

Insulin AspartOutpatient Dosage FormsInjection, solution:NovoLOG®: 100 units/mL (10 mL) [vial] [BCF]NovoLOG® FlexPen®: 100 units/mL (3 mL) [BCF]

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 (10mL) [BCF]

Insulin DetemirOutpatient Dosage FormsInjection, solution:Levemir®: 100 units/mL (10 mL)

Insulin GlargineOutpatient Dosage FormsInjection, solution:Lantus®: 100 units/mL (10 mL) [vial] [BCF]Lantus® Solostar®: 100 units/mL (3 mL) [prefilled pen] [BCF]

Insulin NPHOutpatient Dosage FormsInjection, suspension:NovoLIN® N: 100 units/mL (10 mL) [vial] [BCF]

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]

Insulin RegularOutpatient Dosage FormsInjection, solution:NovoLIN® R: 100 units/mL (10 mL) [BCF]

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

GUAIFENESIN

10

Ipratropium and AlbuterolOutpatient Dosage FormsSolution for nebulization: Ipratropium bromide 0.5 mg and albuterol (base)2.5 mg per 3 mL (60s)

Solution, for oral inhalation [spray]:Combivent® Respimat®: Ipratropium bromide 20 mcg and albuterol (base) 100mcg per inhalation (4 g) [contains benzalkonium chloride; 120 meteredactuations]

Ipratropium (Oral Inhalation)Outpatient Dosage FormsAerosol, for oral inhalation, as bromide:Atrovent® HFA: 17 mcg/actuation (12.9 g) [chlorofluorocarbon free; 200metered actuations] [BCF]

Solution, for nebulization, as bromide: 0.02% [500 mcg/2.5 mL] (30s)

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

Isosorbide DinitrateOutpatient Dosage FormsCapsule, sustained release, oral:Dilatrate®-SR: 40 mg

Tablet, oral: 5 mg [BCF], 10 mg [BCF], 20 mg [BCF], 30 mg [BCF]Tablet, sublingual: 5 mg

Isosorbide MononitrateOutpatient Dosage FormsTablet, extended release, oral: 30 mg [BCF], 60 mg [BCF], 120 mg [BCF]

ISOtretinoinOutpatient Dosage FormsCapsule, oral:Accutane® [CAN]: 10 mg, 20 mg, 40 mg [contains soybean oil]

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

Ketoconazole (Topical)Outpatient Dosage FormsCream, topical: 2% (15 g, 30 g, 60 g)Shampoo, topical: 2% (120 mL)

Ketotifen (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic [drops]: 0.025% (5 mL)

LabetalolOutpatient Dosage FormsTablet, oral, as hydrochloride: 100 mg, 200 mg

Lactic Acid and Ammonium HydroxideOutpatient Dosage FormsLotion, topical: Lactic acid 12% with ammonium hydroxide (225 g)

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

LamoTRIgineOutpatient Dosage FormsTablet, oral: 25 mg, 100 mg, 150 mg, 200 mgTablet, chewable/dispersible, oral: 5 mg, 25 mg

LanolinOutpatient Dosage FormsOintment, hydrous: 16 oz

LatanoprostOutpatient Dosage FormsSolution, ophthalmic [drops]: 0.005% (2.5 mL) [BCF]

LetrozoleOutpatient Dosage FormsTablet, oral: 2.5 mg

Leucovorin CalciumOutpatient Dosage FormsTablet, oral [strength expressed as base]: 5 mg

LeuprolideOutpatient Dosage FormsInjection, powder for reconstitution, as acetate [depot formulation, preservativefree]:Lupron Depot®: 3.75 mg (monthly), 11.25 mg (3 month)[contains polylactide-co-glycolide, polysorbate 80]

LevETIRAcetamOutpatient Dosage FormsTablet, oral: 250 mg, 500 mg, 750 mg

Levocabastine (Ophthalmic)Outpatient Dosage FormsSuspension, ophthalmic:Livostin®: 0.05% (5 mL) [contains benzalkonium chloride]

LevoFLOXacin (Systemic)Outpatient Dosage FormsSolution, oral: 25 mg/mL (480 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]

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]Levoxyl®: 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 (Systemic)Outpatient Dosage FormsInjection, solution, as hydrochloride: 2% [20 mg/mL] (2 mL, 5 mL, 20 mL, 50 mL)

Lidocaine (Topical)Outpatient Dosage FormsJelly, topical, as hydrochloride: 2% (30 mL)Ointment, topical: 5% (35.4 g)Patch, External:Generic: 5% (30 ea)

Solution, topical, as hydrochloride: 4% [40 mg/mL] (50 mL)

LindaneOutpatient Dosage FormsShampoo, topical: 1% (60 mL)

LiothyronineOutpatient Dosage FormsTablet, oral: 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]

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]

LithiumOutpatient Dosage FormsCapsule, oral, as carbonate: 150 mg [BCF], 300 mg [BCF]Solution, oral, as citrate: 300 mg/5 mL (500 mL) [equivalent to amount of lithiumin lithium carbonate] [BCF]

Tablet, extended release, oral, as carbonate: 450 mg

LoperamideOutpatient Dosage FormsCapsule, oral, as hydrochloride: 2 mg [BCF]

LoratadineOutpatient Dosage FormsSyrup, oral: 5 mg/5 mL (120 mL)Tablet, oral: 10 mg

Loratadine and PseudoephedrineOutpatient Dosage FormsTablet, extended release: Loratadine 10 mg and pseudoephedrine sulfate240 mg

LORazepamOutpatient Dosage FormsTablet, oral: 0.5 mg, 1 mg

LosartanOutpatient Dosage FormsTablet, oral, as potassium: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]

LOSARTAN

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Losartan and HydrochlorothiazideOutpatient Dosage FormsTablet, oral:50/12.5: Losartan potassium 50 mg and hydrochlorothiazide 12.5 mg [BCF]100/12.5: Losartan potassium 100 mg and hydrochlorothiazide 12.5 mg [BCF]100/25: Losartan potassium 100 mg and hydrochlorothiazide 25 mg [BCF]

Magnesium CitrateOutpatient Dosage FormsSolution, oral: 290 mg/5 mL (296 mL)

Magnesium HydroxideOutpatient Dosage FormsSuspension, oral: 400 mg/5 mL (473 mL)

Magnesium OxideOutpatient Dosage FormsTablet, oral: 400 mg [equivalent to elemental magnesium 240 mg]

MeclizineOutpatient Dosage FormsTablet, oral, as hydrochloride: 25 mg

MeclofenamateOutpatient Dosage FormsCapsule, oral, as sodium: 50 mg, 100 mg

MedroxyPROGESTERoneOutpatient Dosage FormsInjection, suspension, as acetate: 150 mg/mL (1 mL)Depo-Provera®: 400 mg/mL (2.5 mL)

Tablet, oral, as acetate: 2.5 mg [BCF], 5 mg [BCF], 10 mg [BCF]

Mefenamic AcidOutpatient Dosage FormsCapsule, oral: 250 mg

MegestrolOutpatient Dosage FormsTablet, oral, as acetate: 40 mg

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

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

MeperidineOutpatient Dosage FormsTablet, oral, as hydrochloride: 50 mg

MercaptopurineOutpatient Dosage FormsTablet, oral: 50 mg

MesalamineOutpatient Dosage FormsCapsule Extended Release 24 Hour, Oral:Apriso: 0.375 g [contains aspartame]

Suspension, rectal: 4 g/60 mL (7s, 28s)Suppository, rectal:Canasa®: 1000 mg (30s) [contains saturated vegetable fatty esters]

Tablet Delayed Release, Oral:Lialda: 1.2 g [BCF]

MetaproterenolOutpatient Dosage FormsSyrup, oral, as sulfate: 10 mg/5 mL (473 mL)Tablet, oral, as sulfate: 10 mg

MetFORMINOutpatient Dosage FormsTablet, oral, as hydrochloride: 500 mg [BCF], 850 mg [BCF], 1000 mg [BCF]Tablet, extended release, oral, as hydrochloride: 500 mg [BCF], 750 mg [BCF]

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

MethazolAMIDEOutpatient Dosage FormsTablet, oral: 50 mg

MethIMAzoleOutpatient Dosage FormsTablet, oral: 5 mg

MethocarbamolOutpatient Dosage FormsTablet, oral: 500 mg [BCF], 750 mg

MethotrexateOutpatient Dosage FormsTablet, oral: 2.5 mg [BCF]

MethyldopaOutpatient Dosage FormsTablet, oral: 250 mg, 500 mg

MethylergonovineOutpatient Dosage FormsTablet, oral, as maleate: 0.2 mg

MethylphenidateOutpatient Dosage FormsCapsule, extended release, oral, as hydrochloride [bi-modal release]: 20 mg[generic for Ritalin LA®]Metadate CD®: 10 mg [contains sucrose; 3 mg immediate release, 7 mgextended release]

Metadate CD®: 20 mg [contains sucrose; 6 mg immediate release, 14 mgextended release]

Metadate CD®: 30 mg [contains sucrose; 9 mg immediate release, 21 mgextended release]

Ritalin LA®: 10 mg [5 mg immediate release, 5 mg extended release] [BCF]Ritalin LA®: 20 mg [10 mg immediate release, 10 mg extended release] [BCF]Ritalin LA®: 30 mg [15 mg immediate release, 15 mg extended release] [BCF]Ritalin LA®: 40 mg [20 mg immediate release, 20 mg extended release] [BCF]

Tablet, oral, as hydrochloride: 5 mg [BCF], 10 mg [BCF]Tablet, extended release, oral, as hydrochloride [bi-modal release]: 18 mg[BCF], 27 mg [BCF], 36 mg [BCF], 54 mg [BCF]

Tablet, sustained release, oral, as hydrochloride: 20 mg

MethylPREDNISoloneOutpatient Dosage FormsTablet, oral [dose-pack]: 4 mg [21s]

MethysergideOutpatient Dosage FormsTablet, as maleate: 2 mg

MetoclopramideOutpatient Dosage FormsSolution, oral: 5 mg/5 mL (473 mL) [BCF]Tablet, oral: 10 mg [BCF]

MetOLazoneOutpatient Dosage FormsTablet, oral: 2.5 mg, 5 mg

MetoprololOutpatient Dosage FormsTablet, oral, as tartrate: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]Tablet, extended release, oral, as succinate [expressed as mg equivalent totartrate]: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF], 200 mg [BCF]

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

MetroNIDAZOLE (Topical)Outpatient Dosage FormsGel, topical:MetroGel®: 1% (55 g, 60 g)

Gel, vaginal: 0.75% (70 g) [BCF]

MexiletineOutpatient Dosage FormsCapsule, oral, as hydrochloride: 150 mg, 200 mg

Miconazole (Topical)Outpatient Dosage FormsCream, topical, as nitrate: 2% (30 g)Suppository, vaginal, as nitrate: 100 mg (7s)

Mineral OilOutpatient Dosage FormsOil, oral: 100% (480 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: 100 mg

LOSARTAN AND HYDROCHLOROTHIAZIDE

12

Minoxidil (Systemic)Outpatient Dosage FormsTablet, oral: 10 mg

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

ModafinilOutpatient Dosage FormsTablet, oral: 100 mg, 200 mg

MontelukastOutpatient Dosage FormsGranules, oral:Singulair®: 4 mg/packet (30s) [BCF]

Tablet, oral:Singulair®: 10 mg [contains lactose 89.3 mg/tablet] [BCF]

Tablet, chewable, oral:Singulair®: 4 mg [contains phenylalanine 0.67 mg/tablet; cherry flavor] [BCF]Singulair®: 5 mg [contains phenylalanine 0.84 mg/tablet; cherry flavor] [BCF]

Morphine (Systemic)Outpatient Dosage FormsSolution, oral, as sulfate: 10 mg/5 mL (5 mL, 100 mL, 500 mL)Tablet, oral, as sulfate: 15 mgTablet, controlled release, oral, as sulfate:MS Contin®: 15 mg [BCF], 30 mg [BCF], 60 mg [BCF]

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

MupirocinOutpatient Dosage FormsOintment, topical: 2% (22 g) [BCF]

NabumetoneOutpatient Dosage FormsTablet, oral: 500 mg, 750 mg

NadololOutpatient Dosage FormsTablet, oral: 40 mg, 80 mg

NaloxoneOutpatient Dosage FormsLiquid, Nasal:Narcan: 4 mg/0.1 mL (1 ea) [contains benzalkonium chloride, edetate diso-dium] [BCF]

Naphazoline and PheniramineOutpatient Dosage FormsSolution, ophthalmic:Visine-A®: Naphazoline hydrochloride 0.025% and pheniramine maleate 0.3%(15 mL) [contains benzalkonium chloride]

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

NeomycinOutpatient Dosage FormsTablet, oral, as sulfate: 500 mg

Neomycin, Polymyxin B, and DexamethasoneOutpatient Dosage FormsSuspension, ophthalmic [drops]: Neomycin 3.5 mg, polymyxin B sulfate 10,000units, and dexamethasone 0.1% per 1 mL (5 mL)

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]

Neomycin, Polymyxin B, and Hydrocortisone (Otic)Outpatient Dosage FormsSuspension, otic: Neomycin 3.5 mg, polymyxin B 10,000 units, and hydro-cortisone 10 mg per 1 mL (10 mL) [BCF]

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

Niacin and SimvastatinOutpatient Dosage FormsTablet, variable release, oral:Simcor®:500/20: Niacin 500 mg [extended release] and simvastatin 20 mg [immediaterelease]

750/20: Niacin 750 mg [extended release] and simvastatin 20 mg [immediaterelease]

1000/20: Niacin 1000 mg [extended release] and simvastatin 20 mg [imme-diate release]

NicotineOutpatient Dosage FormsGum, Mouth/Throat, as polacrilex:Generic: 2 mg (50 ea); 4 mg (50 ea) [BCF]

Patch 24 Hour, Transdermal:Generic: 7 mg/24 hr (7 ea) [BCF]; 14 mg/24 hr (7 ea) [BCF]; 21 mg/24 hr (7ea) [BCF]

NIFEdipineOutpatient Dosage FormsCapsule, softgel, oral: 10 mgTablet, extended release, oral: 30 mg [BCF], 60 mg [BCF], 90 mg [BCF]

Nipple Ointment

NitrofurantoinOutpatient Dosage FormsCapsule, oral [macrocrystal]: 50 mg [BCF]Capsule, oral [macrocrystal/monohydrate]: 100 mg [BCF]Suspension, oral: 25 mg/5 mL (230 mL)

NitroglycerinOutpatient Dosage FormsCapsule, extended release, oral: 2.5 mg, 6.5 mg, 9 mgOintment, topical:Nitro-Bid®: 2% (60 g) [~15 mg/inch]

Patch, transdermal: 0.1 mg/hour (30s) [BCF]; 0.2 mg/hour (30s) [BCF]; 0.3 mg/hour (30s) [BCF]; 0.4 mg/hour (30s) [BCF]; 0.6 mg/hour (30s) [BCF]; 0.8 mg/hour (30s) [BCF]

Solution, translingual [spray]: 0.4 mg/spray (4.9 g, 12 g) [BCF]Tablet, sublingual:Nitrostat®: 0.4 mg [BCF]

Nonoxynol 9Outpatient Dosage FormsGel, vaginal:Gynol II® Extra Strength: 3% (81 g)

NorethindroneOutpatient Dosage FormsTablet, oral: 0.35 mg [BCF]

NortriptylineOutpatient Dosage FormsCapsule, oral: 10 mg [BCF], 25 mg [BCF], 50 mg [BCF]Solution, oral: 10 mg/5 mL (473 mL) [BCF]

Nystatin and TriamcinoloneOutpatient Dosage FormsCream: Nystatin 100,000 units and triamcinolone acetonide 0.1% (15 g)

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

Nystatin (Topical)Outpatient Dosage FormsCream, topical: 100,000 units/g (15 g, 30 g) [BCF]Ointment, topical: 100,000 units/g (15 g, 30 g) [BCF]Powder, topical: 100,000 units/g (15 g, 30 g, 60 g)Tablet, vaginal: 100,000 units

Ocular LubricantOutpatient Dosage FormsOintment, ophthalmic [preservative free]:Tears Renewed®: 3.5 g (3.5 g)

Ofloxacin (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic [drops]: 0.3% (5 mL)

OLANZapineOutpatient Dosage FormsTablet, oral: 2.5 mg, 5 mg, 10 mg, 15 mg

OLANZAPINE

13

Olopatadine (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic [drops]:Patanol®: 0.1% (5 mL) [contains benzalkonium chloride] [BCF]

OmeprazoleOutpatient Dosage FormsCapsule, delayed release, oral: 10 mg [BCF], 20 mg [BCF]Powder for suspension, oral [compounding kit]:First®-Omeprazole: 2 mg/mL (150 mL) [contains benzyl alcohol]

OndansetronOutpatient Dosage FormsTablet, oral: 4 mg, 8 mg

Orphenadrine, Aspirin, and CaffeineOutpatient Dosage FormsTablet: Orphenadrine citrate 50 mg, aspirin 770 mg, and caffeine 60 mg

OxazepamOutpatient Dosage FormsCapsule, oral: 15 mg

OXcarbazepineOutpatient Dosage FormsTablet, oral: 150 mg, 300 mg, 600 mg

OxybutyninOutpatient Dosage FormsSyrup, oral, as chloride: 5 mg/5 mL (473 mL)Tablet, oral, as chloride: 5 mgTablet, extended release, oral, as chloride: 5 mg [BCF], 10 mg [BCF],15 mg [BCF]

OxyCODONEOutpatient Dosage FormsSolution, Oral, as hydrochloride:Generic: 5 mg/5 mL (5 mL)

Tablet, Oral, as hydrochloride:Generic: 5 mg, 10 mg

Tablet, Controlled Release, Oral, as hydrochloride:OxyCONTIN: 10 mg, 15 mg, 20 mg, 40 mg, 80 mg

Oxycodone and AcetaminophenOutpatient Dosage FormsTablet, oral: 5/325: Oxycodone hydrochloride 5 mg and acetaminophen 325 mg[BCF]

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

PancrelipaseOutpatient Dosage FormsCapsule, delayed release, enteric coated microspheres [new formulation; por-cine derived]:Creon®: Lipase 6000 units, protease 19,000 units, and amylase 30,000units [BCF]

Creon®: Lipase 12000 units, protease 38,000 units, and amylase 60,000units [BCF]

Creon®: Lipase 24,000 units, protease 76,000 units, and amylase 120,000units [BCF]

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

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

PentoxifyllineOutpatient Dosage FormsTablet, extended release, oral: 400 mg

PermethrinOutpatient Dosage FormsCream, topical: 5% (60 g) [BCF]

PerphenazineOutpatient Dosage FormsTablet, oral: 4 mg

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

PHENobarbitalOutpatient Dosage FormsElixir, oral: 20 mg/5 mL (473 mL) [BCF]Tablet, oral: 15 mg [BCF], 32.4 mg

PhenoxybenzamineOutpatient Dosage FormsCapsule, oral, as hydrochloride:Dibenzyline®: 10 mg

Phenylephrine (Nasal)Outpatient Dosage FormsSolution, intranasal, as hydrochloride [drops]:Little Noses® Decongestant: 0.125% (15 mL) [ethanol free; contains benzal-konium chloride]

Solution, intranasal, as hydrochloride [spray]:Neo-Synephrine® Regular Strength: 0.5% (15 mL) [contains benzalkoniumchloride]

Phenylephrine (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as hydrochloride [drops]: 2.5% (15 mL)AK-Dilate™: 10% (5 mL) [contains benzalkonium chloride]Neofrin: 10% (5 mL)

PhenytoinOutpatient Dosage FormsCapsule, extended release, oral, as sodium: 100 mg [BCF]Suspension, oral: 125 mg/5 mL (237 mL) [BCF]Tablet, chewable, oral:Dilantin®: 50 mg [scored] [BCF]

PhytonadioneOutpatient Dosage FormsTablet, oral:Mephyton®: 5 mg [scored]

Pilocarpine (Ophthalmic)Outpatient Dosage FormsGel, ophthalmic, as hydrochloride:Pilopine HS®: 4% (4 g) [contains benzalkonium chloride] [BCF]

Solution, ophthalmic, as hydrochloride [drops]: 1% (15 mL) [BCF]; 2% (15 mL)[BCF]; 4% (15 mL) [BCF]; 6% (15 mL)

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

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

Pioglitazone and MetforminOutpatient Dosage FormsTablet, oral:Actoplus Met®:15/500: Pioglitazone 15 mg and metformin hydrochloride 500 mg15/850: Pioglitazone 15 mg and metformin hydrochloride 850 mg

PiroxicamOutpatient Dosage FormsCapsule, oral: 20 mg

PodofiloxOutpatient Dosage FormsSolution, topical: 0.5% (3.5 mL)

Polyethylene Glycol 3350Outpatient Dosage FormsPowder for solution, oral: 17 g/dose (527 g)

Polyethylene Glycol-Electrolyte SolutionOutpatient Dosage FormsPowder, for solution, oral:GoLYTELY®: PEG 3350 236 g, sodium sulfate 22.74 g, sodium bicarbonate6.74 g, sodium chloride 5.86 g, and potassium chloride 2.97 g (4000 mL)[regular and pineapple flavor]

Potassium ChlorideOutpatient Dosage FormsCapsule, extended release, microencapsulated, oral: 10 mEq [BCF]Powder for solution, oral:Klor-Con®: 20 mEq/packet (30s) [sugar free; fruit flavor] [BCF]

Solution, oral: 20 mEq/15 mL (473 mL) [BCF]Tablet, extended release, oral: 10 mEq [BCF]Tablet, extended release, microencapsulated, oral: 8 mEq, 10 mEq, 20mEq [BCF]

OLOPATADINE (OPHTHALMIC)

14

Potassium CitrateOutpatient Dosage FormsTablet, extended release, oral: 540 mg [5 mEq]; 1080 mg [10 mEq]

Potassium IodideOutpatient Dosage FormsSolution, oral:SSKI®: 1 g/mL (30 mL)

Potassium Phosphate and Sodium PhosphateOutpatient Dosage FormsPowder for solution, oral:Phos-NaK: Dibasic potassium phosphate, monobasic potassium phosphate,dibasic sodium phosphate, and monobasic sodium phosphate per packet(100s) [sugar free; equivalent to elemental phosphorus 250 mg (8 mmol),sodium 160 mg (6.9 mEq), and potassium 280 mg (7.1 mEq) per packet; fruitflavor]

Povidone-Iodine (Topical)Outpatient Dosage FormsOintment, topical: 10% (30 g)Solution, topical: 10% (237 mL)Solution, topical [surgical scrub]: 7.5% (120 mL)

PramipexoleOutpatient Dosage FormsTablet, oral, as dihydrochloride monohydrate: 0.125 mg, 0.25 mg, 0.5 mg,0.75 mg, 1 mg, 1.5 mg

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

Aerosol, foam, topical:Epifoam®: Pramoxine hydrochloride 1% and hydrocortisone acetate 1% (10 g)

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

PrazosinOutpatient Dosage FormsCapsule, oral: 1 mg, 2 mg, 5 mg

PrednisoLONE (Ophthalmic)Outpatient Dosage FormsSuspension, ophthalmic, as acetate [drops]: 1% (5 mL) [BCF]

PrednisoLONE (Systemic)Outpatient Dosage FormsSolution, oral, as sodium phosphate [strength expressed as base]: 15 mg/5 mL(237 mL, 473 mL) [BCF]

PredniSONEOutpatient Dosage FormsTablet, oral: 1 mg [BCF], 5 mg [BCF], 10 mg [BCF], 20 mg [BCF]

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

PrimidoneOutpatient Dosage FormsTablet, oral: 50 mg, 250 mg

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

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

PromethazineOutpatient Dosage FormsSuppository, rectal, as hydrochloride: 12.5 mg (12s) [BCF]; 25 mg (12s) [BCF]Syrup, oral, as hydrochloride: 6.25 mg/5 mL (473 mL) [BCF]Tablet, oral, as hydrochloride: 25 mg [BCF]

PropanthelineOutpatient Dosage FormsTablet, oral, as bromide: 15 mg

ProparacaineOutpatient Dosage FormsSolution, ophthalmic, as hydrochloride [drops]: 0.5% (15 mL)

PropranololOutpatient Dosage FormsCapsule, extended release, oral, as hydrochloride: 60 mg, 80 mg, 120 mg,160 mg

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

PropylthiouracilOutpatient Dosage FormsTablet, oral: 50 mg [BCF]

PseudoephedrineOutpatient Dosage FormsSyrup, oral, as hydrochloride: 30 mg/5 mL (118 mL)Tablet, oral, as hydrochloride: 30 mg

PsylliumOutpatient Dosage FormsPowder, oral: 3.5 mg/dose per tspKonsyl-D™: (397 g) [contains calcium, dextrose, potassium, sodium]

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

PyrazinamideOutpatient Dosage FormsTablet, oral: 500 mg [BCF]

Pyrethrins and Piperonyl ButoxideOutpatient Dosage FormsShampoo:RID® Maximum Strength: Pyrethrins 0.33% and piperonyl butoxide 4% (120mL) [packaged with nit removal comb; also available in a kit containingshampoo, gel, and furniture spray]

PyridoxineOutpatient Dosage FormsTablet, oral, as hydrochloride: 50 mg

QUEtiapineOutpatient Dosage FormsTablet, oral: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF], 200 mg [BCF], 300 mg[BCF], 400 mg [BCF]

Tablet, extended release, oral:SEROquel XR®: 50 mg [BCF], 150 mg [BCF], 200 mg [BCF], 300 mg [BCF],400 mg [BCF]

QuiNIDineOutpatient Dosage FormsTablet, oral, as sulfate: 200 mgTablet, extended release, oral, as gluconate: 324 mg [equivalent to quinidinebase 202 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 (473 mL) [BCF]Tablet, oral: 150 mg [BCF], 300 mg

RifAMPinOutpatient Dosage FormsCapsule, oral: 300 mg [BCF]

RisperiDONEOutpatient Dosage FormsSolution, oral: 1 mg/mL (30 mL) [BCF]Tablet, oral: 0.25 mg [BCF], 0.5 mg [BCF], 1 mg [BCF], 2 mg [BCF], 3 mg[BCF], 4 mg [BCF]

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 fla-vor] [BCF]

Maxalt-MLT®: 10 mg [contains phenylalanine 2.1 mg/tablet; peppermint fla-vor] [BCF]

RIZATRIPTAN

15

ROPINIRoleOutpatient Dosage FormsTablet, oral: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg, 5 mg

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

Salicylic AcidOutpatient Dosage FormsLiquid, topical: 17% (15 mL)Pad, topical:Curad® Mediplast®: 40% (25s)

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

SalsalateOutpatient Dosage FormsTablet, oral: 500 mg [BCF], 750 mg [BCF]

Scopolamine (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as hydrobromide [drops]:Isopto® Hyoscine: 0.25% (5 mL) [contains benzalkonium chloride]

SecobarbitalOutpatient Dosage FormsCapsule, oral, as sodium:Seconal®: 100 mg

SelegilineOutpatient Dosage FormsTablet, oral, as hydrochloride: 5 mg

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

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

SildenafilOutpatient Dosage FormsTablet, oral:Viagra®: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]

Silver SulfadiazineOutpatient Dosage FormsCream, topical: 1% (25 g) [BCF]

SimethiconeOutpatient Dosage FormsTablet, chewable, oral: 80 mg

SimvastatinOutpatient Dosage FormsTablet, oral: 5 mg [BCF], 10 mg [BCF], 20 mg [BCF], 40 mg [BCF], 80 mg[limited use]

SITagliptinOutpatient Dosage FormsTablet, oral:Januvia®: 25 mg [BCF], 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: 50/500: Sitagliptin 50 mg and metformin hydrochloride500 mg [BCF]

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: 650 mg [7.6 mEq]

Sodium ChlorideOutpatient Dosage FormsInjection, solution: 0.9% (25 mL, 50 mL, 100 mL, 150 mL, 250 mL, 500 mL, 1000mL)

Ointment, ophthalmic: 5% (3.5 g)Solution, ophthalmic [drops]: 5% (15 mL)Solution, intranasal [spray]: 0.65% (45 mL)Solution, for inhalation [preservative free]: 0.9% (3 mL)

Sodium Citrate and Citric AcidOutpatient Dosage FormsSolution, oral: Sodium citrate 500 mg and citric acid 334 mg per 5 mL (480 mL)

Sodium HypochloriteOutpatient Dosage FormsSolution, topical:Dakin's Solution: 0.25% (473 mL)

Sodium PhosphatesOutpatient Dosage FormsSolution, rectal [enema]: Monobasic sodium phosphate monohydrate 19 g anddibasic sodium phosphate heptahydrate 7 g per 118 mL delivered dose (133mL)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 FormsPowder for suspension, oral/rectal: (454 g)Suspension, oral/rectal:SPS®: 15 g/60 mL (473 mL) [contains ethanol 0.3%, propylene glycol, sodium1500 mg (65 mEq)/60 mL, sorbitol; cherry flavor]

SpironolactoneOutpatient Dosage FormsTablet, oral: 25 mg [BCF]

SucralfateOutpatient Dosage FormsSuspension, oral: 1 g/10 mL (420 mL)Tablet, oral: 1 g

Sulfacetamide and PrednisoloneOutpatient Dosage FormsOintment, ophthalmic:Blephamide®: Sulfacetamide sodium 10% and prednisolone acetate0.2% (3.5 g)

Suspension, ophthalmic [drops]:Blephamide®: Sulfacetamide sodium 10% and prednisolone acetate 0.2% (5mL) [contains benzalkonium chloride]

Sulfacetamide (Ophthalmic)Outpatient Dosage FormsOintment, ophthalmic, as sodium: 10%Solution, 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]

Tablet, double strength, oral: Sulamethoxazole 800 mg and trimethoprim160 mg [BCF]

SulfaSALAzineOutpatient Dosage FormsTablet, oral: 500 mg [BCF]

Sulfur and Salicylic AcidOutpatient Dosage FormsShampoo, topical:ala seb: Sulfur 2% and salicylic acid 2% (118 mL) [contains coal tar 1% andsoya lecithin]

SulindacOutpatient Dosage FormsTablet, oral: 150 mg

SUMAtriptanOutpatient Dosage FormsInjection, solution, as succinate [strength expressed as base]: 6 mg/0.5 mL (0.5mL) [BCF]

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

Surgical LubricantOutpatient Dosage FormsJelly:Packet: 144sTube: 30 g

ROPINIROLE

16

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

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

TelmisartanOutpatient Dosage FormsTablet, oral:Micardis®: 20 mg, 40 mg [scored], 80 mg [scored]

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: 7.5 mg, 15 mg [BCF], 30 mg [BCF]

TemozolomideOutpatient Dosage FormsCapsule, oral:Temodar®: 5 mg, 20 mg, 100 mg, 250 mg

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

Terbinafine (Systemic)Outpatient Dosage FormsTablet, oral: 250 mg

TerbutalineOutpatient Dosage FormsTablet, oral, as sulfate: 5 mg

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

Injection, oil, as cypionate: 200 mg/mL (10 mL)Injection, oil, as enanthate: 200 mg/mL (5 mL)Patch, transdermal:Androderm®: 2 mg/24 hours (60s); 4 mg/24 hours (30s) [contains ethanol,metal]

Tetracaine (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as hydrochloride [drops]: 0.5% [5 mg/mL] (15 mL)

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

TheophyllineOutpatient Dosage FormsCapsule, extended release, oral:Theo-24®: 300 mg [BCF], 400 mg [BCF] [24 hours]

Solution, oral: 80 mg/15 mLElixophyllin® Elixir: 80 mg/15 mL (473 mL) [contains ethanol 20%; mixed fruitflavor] [BCF]

Tablet, extended release, oral: 100 mg, 200 mg [BCF], 300 mg [BCF],400 mg [BCF]

ThiamineOutpatient Dosage FormsTablet, oral, as hydrochloride: 50 mg

ThioridazineOutpatient Dosage FormsTablet, oral, as hydrochloride: 25 mg, 50 mg, 100 mg

ThiothixeneOutpatient Dosage FormsCapsule, oral: 5 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]: 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: 2.5 mcg/actuation (4 g) [contains benzalkonium chloride,disodium edta]

Powder, for Oral Inhalation:Spiriva HandiHaler: 18 mcg/capsule (30s) [contains lactose] [BCF]

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

TOLAZamideOutpatient Dosage FormsTablet, oral: 250 mg

TOLBUTamideOutpatient Dosage FormsTablet, oral: 500 mg

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

TopiramateOutpatient Dosage FormsCapsule, sprinkle, oral: 15 mg, 25 mgTablet, oral: 25 mg, 100 mg, 200 mg

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

TraZODoneOutpatient Dosage FormsTablet, oral, as hydrochloride: 50 mg [BCF], 100 mg [BCF], 150 mg [BCF],300 mg [BCF]

Tretinoin (Topical)Outpatient Dosage FormsCream, topical: 0.025% (20 g) [BCF]; 0.05% (20 g) [BCF]; 0.1% (20 g)Gel, topical: 0.01% (15 g); 0.025% (15 g)

Triamcinolone (Topical)Outpatient Dosage FormsAerosol, spray, 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, 80 g) [BCF]; 0.5% (15 g, 80 g)Ointment, topical, as acetonide: 0.1% (15 g, 80 g)Paste, oral topical, as acetonide: 0.1% (5 g)

TriamtereneOutpatient Dosage FormsCapsule, oral:Dyrenium®: 50 mg, 100 mg

TriazolamOutpatient Dosage FormsTablet, oral: 0.25 mg

TrifluoperazineOutpatient Dosage FormsTablet, oral: 5 mg

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 [drops]: Trimethoprim 1 mg and polymyxin B sulfate 10,000units per 1 mL (10 mL) [BCF]

Triprolidine and PseudoephedrineOutpatient Dosage FormsTablet, oral: Triprolidine hydrochloride 2.5 mg and pseudoephedrine hydro-chloride 60 mg

TRIPROLIDINE AND PSEUDOEPHEDRINE

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TropicamideOutpatient Dosage FormsSolution, ophthalmic [drops]: 1% (15 mL)

Undecylenic Acid and DerivativesOutpatient Dosage FormsPowder: 2% (42 g)

Urea (Topical)Outpatient Dosage FormsCream, topical: 40% (28 g)Carmol 20: 20% (90 g)

Lotion, topical:Carmol 10: 10% (236 mL)

ValACYclovirOutpatient Dosage FormsTablet, oral: 500 mg, 1 g

Valproic Acid and DerivativesOutpatient Dosage FormsCapsule, softgel, oral: 250 mg [strength expressed as valproic acid]Capsule, sprinkle, oral [strength expressed as valproic acid]: 125 mg [BCF]Syrup, oral, as valproate sodium: 250 mg/5 mL (473 mL) [strength expressed asvalproic acid]

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

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

ValsartanOutpatient Dosage FormsTablet, oral:Diovan®: 40 mg [scored] [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®: 160 mg/25 mg: Valsartan 160 mg and hydrochlorothiazide25 mg [BCF]

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

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

VenlafaxineOutpatient Dosage FormsCapsule, extended release, oral: 37.5 mg [BCF], 75 mg [BCF], 150 mg [BCF]Tablet, oral: 25 mg [BCF], 37.5 mg [BCF], 50 mg [BCF], 75 mg [BCF],100 mg [BCF]

VerapamilOutpatient Dosage FormsTablet, oral, as hydrochloride: 80 mgTablet, extended release, oral, as hydrochloride: 120 mg [BCF], 180 mg [BCF],240 mg [BCF]

Vitamin E (Systemic)Outpatient Dosage FormsCapsule, softgel, oral: 400 units

Vitamins (Multiple/Oral)Outpatient Dosage FormsContent varies depending on product used.Tablet, oral

Vitamins (Multiple/Pediatric)Outpatient Dosage FormsContent varies depending on product used.Solution, oral [drops]:Poly-Vi-Sol With Iron: 50 mL

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

WarfarinOutpatient Dosage FormsTablet, oral, as sodium:Coumadin®: 1 mg [BCF], 2 mg [BCF], 2.5 mg [BCF], 3 mg [BCF], 4 mg[BCF], 5 mg [BCF], 6 mg [BCF], 7.5 mg [BCF], 10 mg [BCF]

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

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

ZOLMitriptanOutpatient Dosage FormsTablet, oral:Zomig®: 2.5 mg [scored]Zomig®: 5 mg

Tablet, orally disintegrating, oral:Zomig-ZMT®: 2.5 mg [contains phenylalanine 2.81 mg/tablet; orange flavor]Zomig-ZMT®: 5 mg [contains phenylalanine 5.62 mg/tablet; orange flavor]

ZolpidemOutpatient Dosage FormsTablet, oral, as tartrate: 5 mg [BCF], 10 mg [BCF]Tablet Extended Release, Oral, as tartrate: 6.25 mg, 12.5 mg

TROPICAMIDE

18

Therapeutic Category Index

19

Acetylcholinesterase Inhibitor (Central)Donepezil .................................................................................................... 6

Acne ProductsBenzoyl Peroxide ........................................................................................3Clindamycin and Benzoyl Peroxide ........................................................... 5Erythromycin (Topical) ................................................................................ 7ISOtretinoin ............................................................................................... 11Salicylic Acid .............................................................................................16Tretinoin (Topical) ..................................................................................... 17

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

Aldehyde Dehydrogenase InhibitorDisulfiram .................................................................................................... 6

Alkalinizing AgentSodium Bicarbonate ................................................................................. 16

Alkalinizing Agent, OralPotassium Citrate ..................................................................................... 15Sodium Citrate and Citric Acid .................................................................16

Alkylamine DerivativeBrompheniramine and Pseudoephedrine .................................................. 4Chlorpheniramine ........................................................................................4Naphazoline and Pheniramine .................................................................13Triprolidine and Pseudoephedrine ........................................................... 17

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

Alpha1 BlockerAlfuzosin ......................................................................................................2Doxazosin ................................................................................................... 6Phenoxybenzamine .................................................................................. 14Prazosin .................................................................................................... 15Tamsulosin ................................................................................................ 17Terazosin ...................................................................................................17

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

Alpha2 Agonist, OphthalmicBrimonidine (Ophthalmic) ........................................................................... 3

Alpha-Adrenergic AgonistPhenylephrine (Nasal) .............................................................................. 14Phenylephrine (Ophthalmic) .....................................................................14

Alpha/Beta AgonistBrompheniramine and Pseudoephedrine .................................................. 4EPINEPHrine (Systemic) ............................................................................7Guaifenesin and Pseudoephedrine ..........................................................10Loratadine and Pseudoephedrine ............................................................ 11Pseudoephedrine ......................................................................................15Triprolidine and Pseudoephedrine ........................................................... 17

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

AmebicideMetroNIDAZOLE (Systemic) .................................................................... 12

Aminoquinoline (Antimalarial)Chloroquine .................................................................................................4Hydroxychloroquine .................................................................................. 10Primaquine ................................................................................................15

5-Aminosalicylic Acid DerivativeMesalamine ...............................................................................................12SulfaSALAzine ..........................................................................................16

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

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

Analgesic, NonopioidAcetaminophen ........................................................................................... 2Acetaminophen, Isometheptene, and Dichloralphenazone .......................2Aspirin ......................................................................................................... 3Celecoxib .................................................................................................... 4Diclofenac (Systemic) .................................................................................6Etodolac ...................................................................................................... 8

Flurbiprofen (Systemic) ...............................................................................9Ibuprofen ................................................................................................... 10Indomethacin ............................................................................................ 10Meclofenamate ......................................................................................... 12Mefenamic Acid ........................................................................................ 12Meloxicam .................................................................................................12Nabumetone ............................................................................................. 13Naproxen ...................................................................................................13Piroxicam .................................................................................................. 14Sulindac .................................................................................................... 16

Analgesic, OpioidAcetaminophen and Codeine .....................................................................2Belladonna and Opium ...............................................................................3Codeine .......................................................................................................5FentaNYL .................................................................................................... 8Hydrocodone and Acetaminophen ...........................................................10HYDROmorphone .....................................................................................10Meperidine ................................................................................................ 12Methadone ................................................................................................ 12Morphine (Systemic) .................................................................................13OxyCODONE ............................................................................................14Oxycodone and Acetaminophen ..............................................................14TraMADol .................................................................................................. 17

Analgesic, TopicalBenzocaine ................................................................................................. 3Lidocaine (Topical) .................................................................................... 11

Analgesic, UrinaryPhenazopyridine ....................................................................................... 14

AndrogenDanazol ....................................................................................................... 6Testosterone ............................................................................................. 17

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

Angiotensin II Receptor BlockerCandesartan ................................................................................................4Candesartan and Hydrochlorothiazide .......................................................4Losartan .................................................................................................... 11Losartan and Hydrochlorothiazide ........................................................... 12Telmisartan ................................................................................................17Telmisartan and Hydrochlorothiazide .......................................................17Valsartan ................................................................................................... 18Valsartan and Hydrochlorothiazide .......................................................... 18

Angiotensin-Converting Enzyme (ACE) InhibitorAmlodipine and Benazepril ........................................................................ 2Captopril ......................................................................................................4Enalapril ...................................................................................................... 7Fosinopril .....................................................................................................9Lisinopril .................................................................................................... 11Lisinopril and Hydrochlorothiazide ........................................................... 11Ramipril ..................................................................................................... 15

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

AntacidAluminum Hydroxide and Magnesium Carbonate .....................................2Aluminum Hydroxide, Magnesium Hydroxide, and Simethicone ..............2Calcium Carbonate .....................................................................................4Magnesium Hydroxide ..............................................................................12Sodium Bicarbonate ................................................................................. 16

AnthelminticPyrantel Pamoate ..................................................................................... 15

Antianginal AgentAmLODIPine ............................................................................................... 2Amlodipine and Benazepril ........................................................................ 2Amyl Nitrite ..................................................................................................3Atenolol ....................................................................................................... 3DilTIAZem ................................................................................................... 6Isosorbide Dinitrate ................................................................................... 11Isosorbide Mononitrate ............................................................................. 11Metoprolol ................................................................................................. 12Nadolol ...................................................................................................... 13NIFEdipine ................................................................................................ 13Nitroglycerin .............................................................................................. 13Propranolol ................................................................................................15Verapamil .................................................................................................. 18

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

ACETYLCHOLINESTERASE INHIBITOR (CENTRAL)

20

Antiarrhythmic Agent, Class IaDisopyramide .............................................................................................. 6QuiNIDine ..................................................................................................15

Antiarrhythmic Agent, Class IbLidocaine (Systemic) .................................................................................11Mexiletine .................................................................................................. 12

Antiarrhythmic Agent, Class IIPropranolol ................................................................................................15

Antiarrhythmic Agent, Class IIIAmiodarone .................................................................................................2Dronedarone ............................................................................................... 7

Antiarrhythmic Agent, Class IVDilTIAZem ................................................................................................... 6Verapamil .................................................................................................. 18

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

Antibiotic, AminoglycosideGentamicin (Ophthalmic) ............................................................................9Gentamicin (Topical) ...................................................................................9Neomycin .................................................................................................. 13Tobramycin (Ophthalmic) ..........................................................................17

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

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

Antibiotic/Corticosteroid, OphthalmicNeomycin, Polymyxin B, and Dexamethasone ....................................... 13Sulfacetamide and Prednisolone ............................................................. 16

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

Antibiotic, FluoroquinoloneCiprofloxacin (Systemic) .............................................................................5LevoFLOXacin (Systemic) ........................................................................11Moxifloxacin (Systemic) ............................................................................13Ofloxacin (Ophthalmic) ............................................................................. 13

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

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

Antibiotic, Macrolide CombinationErythromycin and Sulfisoxazole .................................................................7

Antibiotic, MiscellaneousDapsone (Systemic) ................................................................................... 6MetroNIDAZOLE (Systemic) .................................................................... 12Nitrofurantoin .............................................................................................13RifAMPin ................................................................................................... 15Sulfamethoxazole and Trimethoprim ....................................................... 16Trimethoprim ............................................................................................. 17

Antibiotic, OphthalmicBacitracin and Polymyxin B (Ophthalmic) ................................................. 3Bacitracin, Neomycin, and Polymyxin B (Ophthalmic) ..............................3Bacitracin (Ophthalmic) .............................................................................. 3Erythromycin (Ophthalmic) ......................................................................... 7Gentamicin (Ophthalmic) ............................................................................9Neomycin, Polymyxin B, and Gramicidin ................................................ 13Ofloxacin (Ophthalmic) ............................................................................. 13Sulfacetamide (Ophthalmic) ..................................................................... 16Tobramycin (Ophthalmic) ..........................................................................17Trimethoprim and Polymyxin B ................................................................ 17

Antibiotic, Oral RinseChlorhexidine Gluconate ............................................................................ 4

Antibiotic, OticCiprofloxacin and Dexamethasone ............................................................ 5Neomycin, Polymyxin B, and Hydrocortisone (Otic) ............................... 13

Antibiotic, PenicillinAmoxicillin ................................................................................................... 2

Amoxicillin and Clavulanate ....................................................................... 2Ampicillin ..................................................................................................... 3Dicloxacillin ................................................................................................. 6Penicillin V Potassium ..............................................................................14

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

Antibiotic, Sulfonamide DerivativeErythromycin and Sulfisoxazole .................................................................7Sulfamethoxazole and Trimethoprim ....................................................... 16

Antibiotic, Tetracycline DerivativeDoxycycline .................................................................................................7Minocycline ............................................................................................... 12Tetracycline ............................................................................................... 17

Antibiotic, TopicalBacitracin, Neomycin, and Polymyxin B (Topical) .....................................3Bacitracin (Topical) ..................................................................................... 3Chlorhexidine Gluconate ............................................................................ 4Erythromycin (Topical) ................................................................................ 7Gentamicin (Topical) ...................................................................................9Gentian Violet ............................................................................................. 9MetroNIDAZOLE (Topical) ........................................................................12Mupirocin ...................................................................................................13Silver Sulfadiazine .................................................................................... 16

Anticholinergic AgentBenztropine .................................................................................................3Dicyclomine .................................................................................................6Glycopyrrolate (Systemic) .......................................................................... 9Hyoscyamine, Atropine, Scopolamine, and Phenobarbital ..................... 10Ipratropium and Albuterol ......................................................................... 11Ipratropium (Oral Inhalation) .....................................................................11Propantheline ............................................................................................15Scopolamine (Ophthalmic) ....................................................................... 16Tiotropium ................................................................................................. 17Tolterodine .................................................................................................17Trihexyphenidyl .........................................................................................17

Anticholinergic Agent, Long-ActingTiotropium ................................................................................................. 17

Anticholinergic Agent, OphthalmicAtropine (Ophthalmic) .................................................................................3Cyclopentolate ............................................................................................ 5Scopolamine (Ophthalmic) ....................................................................... 16

AnticoagulantDabigatran Etexilate ................................................................................... 6Enoxaparin ..................................................................................................7Heparin ......................................................................................................10Warfarin .....................................................................................................18

Anticoagulant, Direct Thrombin InhibitorDabigatran Etexilate ................................................................................... 6

Anticoagulant, HeparinHeparin ......................................................................................................10

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

Anticoagulant, Vitamin K AntagonistWarfarin .....................................................................................................18

Anticonvulsant, BarbituratePHENobarbital .......................................................................................... 14

Anticonvulsant, BenzodiazepineClonazePAM ............................................................................................... 5DiazePAM ................................................................................................... 6LORazepam .............................................................................................. 11

Anticonvulsant, HydantoinPhenytoin .................................................................................................. 14

Anticonvulsant, MiscellaneousAcetaZOLAMIDE ........................................................................................ 2CarBAMazepine ..........................................................................................4Gabapentin ..................................................................................................9LamoTRIgine .............................................................................................11LevETIRAcetam ........................................................................................ 11OXcarbazepine ......................................................................................... 14Primidone .................................................................................................. 15Topiramate ................................................................................................ 17Valproic Acid and Derivatives .................................................................. 18

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

ANTIDEPRESSANT, ALPHA-2 ANTAGONIST

21

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

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

Antidepressant, Selective Serotonin Reuptake InhibitorCitalopram ...................................................................................................5Escitalopram ............................................................................................... 7FLUoxetine ..................................................................................................9PARoxetine ............................................................................................... 14Sertraline ...................................................................................................16

Antidepressant, Serotonin/Norepinephrine Reuptake InhibitorDULoxetine ................................................................................................. 7Venlafaxine ............................................................................................... 18

Antidepressant, Serotonin Reuptake Inhibitor/AntagonistTraZODone ............................................................................................... 17

Antidepressant, Tricyclic (Secondary Amine)Desipramine ................................................................................................6Nortriptyline ............................................................................................... 13

Antidepressant, Tricyclic (Tertiary Amine)Amitriptyline .................................................................................................2Doxepin (Systemic) .....................................................................................6Imipramine ................................................................................................ 10

Antidiabetic Agent, BiguanideGlipizide and Metformin ..............................................................................9Glyburide and Metformin ............................................................................ 9MetFORMIN ..............................................................................................12Pioglitazone and Metformin ......................................................................14Sitagliptin and Metformin ..........................................................................16

Antidiabetic Agent, Dipeptidyl Peptidase 4 (DPP-4) InhibitorSITagliptin ..................................................................................................16Sitagliptin and Metformin ..........................................................................16

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

Antidiabetic Agent, Glucagon-Like Peptide-1 (GLP-1) ReceptorAgonist

Albiglutide ....................................................................................................2Exenatide .................................................................................................... 8

Antidiabetic Agent, SulfonylureaGlimepiride .................................................................................................. 9GlipiZIDE .....................................................................................................9Glipizide and Metformin ..............................................................................9GlyBURIDE ................................................................................................. 9Glyburide and Metformin ............................................................................ 9TOLAZamide .............................................................................................17TOLBUTamide .......................................................................................... 17

Antidiabetic Agent, ThiazolidinedionePioglitazone .............................................................................................. 14Pioglitazone and Metformin ......................................................................14

AntidiarrhealBismuth Subsalicylate ................................................................................ 3Diphenoxylate and Atropine ....................................................................... 6Loperamide ............................................................................................... 11Psyllium .....................................................................................................15

AntidoteAcetylcysteine ............................................................................................. 2Amyl Nitrite ..................................................................................................3Calcitonin .................................................................................................... 4Calcium Carbonate .....................................................................................4Glucagon .....................................................................................................9Leucovorin Calcium .................................................................................. 11Naloxone ...................................................................................................13Phenoxybenzamine .................................................................................. 14Potassium Iodide ...................................................................................... 15Sodium Polystyrene Sulfonate .................................................................16

Antidote, ExtravasationNitroglycerin .............................................................................................. 13Terbutaline .................................................................................................17

Antidote, HypoglycemiaGlucagon .....................................................................................................9

AntiemeticDexamethasone (Systemic) ....................................................................... 6HydrOXYzine ............................................................................................ 10Meclizine ................................................................................................... 12Metoclopramide ........................................................................................ 12Ondansetron ............................................................................................. 14Perphenazine ............................................................................................14

Prochlorperazine .......................................................................................15Promethazine ............................................................................................15

AntiflatulentAluminum Hydroxide, Magnesium Hydroxide, and Simethicone ..............2Simethicone .............................................................................................. 16

Antifungal Agent, Imidazole DerivativeClotrimazole (Oral) ......................................................................................5Clotrimazole (Topical) ................................................................................. 5Ketoconazole (Systemic) .......................................................................... 11Ketoconazole (Topical) ............................................................................. 11Miconazole (Topical) .................................................................................12

Antifungal Agent, OralFluconazole .................................................................................................8Griseofulvin ................................................................................................. 9Ketoconazole (Systemic) .......................................................................... 11Terbinafine (Systemic) .............................................................................. 17

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

Antifungal Agent, Oral Nonabsorbed/Partially AbsorbedClotrimazole (Topical) ................................................................................. 5Miconazole (Topical) .................................................................................12Nystatin (Oral) ...........................................................................................13

Antifungal Agent, ParenteralFluconazole .................................................................................................8

Antifungal Agent, TopicalClotrimazole (Topical) ................................................................................. 5Gentian Violet ............................................................................................. 9Ketoconazole (Topical) ............................................................................. 11Miconazole (Topical) .................................................................................12Nystatin and Triamcinolone ......................................................................13Nystatin (Topical) ...................................................................................... 13Undecylenic Acid and Derivatives ........................................................... 18

Antifungal Agent, VaginalClotrimazole (Topical) ................................................................................. 5Miconazole (Topical) .................................................................................12

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

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

Antihemorrhoidal AgentDibucaine .................................................................................................... 6Hydrocortisone (Topical) ...........................................................................10

AntihypertensiveAmLODIPine ............................................................................................... 2Amlodipine and Benazepril ........................................................................ 2Atenolol ....................................................................................................... 3Candesartan ................................................................................................4Candesartan and Hydrochlorothiazide .......................................................4Captopril ......................................................................................................4Carvedilol .................................................................................................... 4Chlorthalidone .............................................................................................5CloNIDine ....................................................................................................5DilTIAZem ................................................................................................... 6Doxazosin ................................................................................................... 6Enalapril ...................................................................................................... 7Felodipine ....................................................................................................8Fosinopril .....................................................................................................9Furosemide ................................................................................................. 9GuanFACINE ............................................................................................ 10HydrALAZINE ........................................................................................... 10HydroCHLOROthiazide ............................................................................ 10Hydrochlorothiazide and Triamterene ...................................................... 10Labetalol ....................................................................................................11Lisinopril .................................................................................................... 11Lisinopril and Hydrochlorothiazide ........................................................... 11Losartan .................................................................................................... 11Losartan and Hydrochlorothiazide ........................................................... 12Methyldopa ................................................................................................12Metoprolol ................................................................................................. 12Minoxidil (Systemic) ..................................................................................13Nadolol ...................................................................................................... 13NIFEdipine ................................................................................................ 13Prazosin .................................................................................................... 15Propranolol ................................................................................................15Ramipril ..................................................................................................... 15Spironolactone .......................................................................................... 16Telmisartan ................................................................................................17Telmisartan and Hydrochlorothiazide .......................................................17

ANTIDEPRESSANT, DOPAMINE/NOREPINEPHRINE-REUPTAKE INHIBITOR

22

Terazosin ...................................................................................................17Triamterene ...............................................................................................17Valsartan ................................................................................................... 18Valsartan and Hydrochlorothiazide .......................................................... 18Verapamil .................................................................................................. 18

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

Anti-inflammatory Agent, OphthalmicDexamethasone (Ophthalmic) ....................................................................6

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

Antilipemic Agent, 2-AzetidinoneEzetimibe .................................................................................................... 8Ezetimibe and Simvastatin .........................................................................8

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

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

Antilipemic Agent, HMG-CoA Reductase InhibitorAtorvaSTATin .............................................................................................. 3Ezetimibe and Simvastatin .........................................................................8Niacin and Simvastatin .............................................................................13Pravastatin ................................................................................................ 15Rosuvastatin ............................................................................................. 16Simvastatin ................................................................................................16

Antilipemic Agent, MiscellaneousNiacin ........................................................................................................ 13Niacin and Simvastatin .............................................................................13

Antimalarial AgentChloroquine .................................................................................................4Hydroxychloroquine .................................................................................. 10Primaquine ................................................................................................15QuiNIDine ..................................................................................................15

Antimanic AgentChlorproMAZINE .........................................................................................4Lithium .......................................................................................................11OLANZapine ............................................................................................. 13RisperiDONE ............................................................................................ 15Valproic Acid and Derivatives .................................................................. 18

Antimigraine AgentErgotamine and Caffeine ............................................................................7Rizatriptan ................................................................................................. 15SUMAtriptan ..............................................................................................16ZOLMitriptan ............................................................................................. 18

Antineoplastic Agent, Alkylating AgentCyclophosphamide ..................................................................................... 5

Antineoplastic Agent, Alkylating Agent (Nitrogen Mustard)Cyclophosphamide ..................................................................................... 5

Antineoplastic Agent, Alkylating Agent (Triazene)Temozolomide ...........................................................................................17

Antineoplastic Agent, AntiandrogenBicalutamide ................................................................................................3

Antineoplastic Agent, AntimetaboliteCapecitabine ............................................................................................... 4Fluorouracil (Topical) .................................................................................. 9Mercaptopurine ......................................................................................... 12

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

Antineoplastic Agent, Antimetabolite (Purine Analog)Mercaptopurine ......................................................................................... 12

Antineoplastic Agent, Antimetabolite (Pyrimidine Analog)Capecitabine ............................................................................................... 4Fluorouracil (Topical) .................................................................................. 9

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

Antineoplastic Agent, BCR-ABL Tyrosine Kinase InhibitorImatinib ......................................................................................................10

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

Antineoplastic Agent, Gonadotropin-Releasing Hormone AgonistGoserelin .....................................................................................................9Leuprolide ..................................................................................................11

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

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

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

Antineoplastic Agent, Tyrosine Kinase InhibitorImatinib ......................................................................................................10

Antiparasitic Agent, TopicalLindane ......................................................................................................11Permethrin .................................................................................................14Pyrethrins and Piperonyl Butoxide ...........................................................15

Anti-Parkinson Agent, AnticholinergicBenztropine .................................................................................................3Trihexyphenidyl .........................................................................................17

Anti-Parkinson Agent, Decarboxylase InhibitorCarbidopa 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 ........................................................................... 3Clopidogrel .................................................................................................. 5Dipyridamole ............................................................................................... 6

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

Antiprotozoal, NitroimidazoleMetroNIDAZOLE (Systemic) .................................................................... 12

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

Antirheumatic MiscellaneousCyclophosphamide ..................................................................................... 5

Antiseborrheic Agent, TopicalSulfur and Salicylic Acid ...........................................................................16

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

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

Antispasmodic Agent, GastrointestinalClidinium and Chlordiazepoxide .................................................................5Hyoscyamine, Atropine, Scopolamine, and Phenobarbital ..................... 10

Antispasmodic Agent, UrinaryBelladonna and Opium ...............................................................................3FlavoxATE ...................................................................................................8Oxybutynin ................................................................................................ 14

Antithyroid AgentMethIMAzole ............................................................................................. 12Potassium Iodide ...................................................................................... 15Propylthiouracil ......................................................................................... 15

Antitubercular AgentEthambutol .................................................................................................. 7Isoniazid .................................................................................................... 11Pyrazinamide ............................................................................................ 15RifAMPin ................................................................................................... 15

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

ANTITUSSIVE

23

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

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

Antiviral Agent, OphthalmicGanciclovir (Ophthalmic) ............................................................................ 9

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

Antiviral Agent, TopicalAcyclovir (Topical) .......................................................................................2

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

BarbiturateButalbital, Acetaminophen, and Caffeine ...................................................4Butalbital, Aspirin, and Caffeine .................................................................4PHENobarbital .......................................................................................... 14Primidone .................................................................................................. 15Secobarbital .............................................................................................. 16

BenzodiazepineChlordiazePOXIDE ..................................................................................... 4Clidinium and Chlordiazepoxide .................................................................5ClonazePAM ............................................................................................... 5DiazePAM ................................................................................................... 6LORazepam .............................................................................................. 11Oxazepam .................................................................................................14Temazepam .............................................................................................. 17Triazolam ...................................................................................................17

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

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

Beta2 AgonistAlbuterol ...................................................................................................... 2Fluticasone and Salmeterol ........................................................................9Metaproterenol ..........................................................................................12Salmeterol ................................................................................................. 16Terbutaline .................................................................................................17

Beta-Adrenergic Blocker, NonselectivePropranolol ................................................................................................15

Beta-Blocker, Beta-1 SelectiveAtenolol ....................................................................................................... 3Metoprolol ................................................................................................. 12

Beta-Blocker, NonselectiveNadolol ...................................................................................................... 13Timolol (Ophthalmic) .................................................................................17

Beta-Blocker With Alpha-Blocking ActivityCarvedilol .................................................................................................... 4Labetalol ....................................................................................................11

Biological, MiscellaneousGlatiramer Acetate ......................................................................................9

Bisphosphonate DerivativeAlendronate .................................................................................................2Alendronate and Cholecalciferol ................................................................ 2Ibandronate ...............................................................................................10

Blood Viscosity Reducer AgentPentoxifylline .............................................................................................14

Calcineurin InhibitorCycloSPORINE (Ophthalmic) .....................................................................5CycloSPORINE (Systemic) ........................................................................ 5Pimecrolimus ............................................................................................ 14

Calcium Channel BlockerAmLODIPine ............................................................................................... 2Amlodipine and Benazepril ........................................................................ 2DilTIAZem ................................................................................................... 6Felodipine ....................................................................................................8NIFEdipine ................................................................................................ 13Verapamil .................................................................................................. 18

Calcium Channel Blocker, DihydropyridineAmLODIPine ............................................................................................... 2Amlodipine and Benazepril ........................................................................ 2

Felodipine ....................................................................................................8NIFEdipine ................................................................................................ 13

Calcium Channel Blocker, NondihydropyridineDilTIAZem ................................................................................................... 6Verapamil .................................................................................................. 18

Calcium SaltCalcium and Vitamin D ...............................................................................4Calcium Carbonate .....................................................................................4Calcium Glubionate .................................................................................... 4Calcium Lactate .......................................................................................... 4

Carbonic Anhydrase InhibitorAcetaZOLAMIDE ........................................................................................ 2MethazolAMIDE ........................................................................................ 12

Carbonic Anhydrase Inhibitor (Ophthalmic)Dorzolamide ................................................................................................6

Cardiac GlycosideDigoxin ........................................................................................................ 6

CatharticSodium Phosphates ................................................................................. 16

Central Nervous System StimulantDextroamphetamine ....................................................................................6Dextroamphetamine and Amphetamine .................................................... 6Ergotamine and Caffeine ............................................................................7Methylphenidate ........................................................................................12Modafinil ....................................................................................................13

Chemotherapy Modulating AgentLeucovorin Calcium .................................................................................. 11

Cholinergic AgonistAcetylcholine ...............................................................................................2Bethanechol ................................................................................................ 3Carbachol ....................................................................................................4

Colony Stimulating FactorEpoetin Alfa .................................................................................................7

ContraceptiveEthinyl Estradiol and Desogestrel ..............................................................7Ethinyl Estradiol and Drospirenone ........................................................... 7Ethinyl Estradiol and Ethynodiol Diacetate ................................................7Ethinyl Estradiol and Etonogestrel .............................................................7Ethinyl Estradiol and Levonorgestrel ......................................................... 7Ethinyl Estradiol and Norelgestromin .........................................................8Ethinyl Estradiol and Norethindrone .......................................................... 8Ethinyl Estradiol and Norgestimate ............................................................8Ethinyl Estradiol and Norgestrel .................................................................8Levonorgestrel (Systemic) ........................................................................ 11MedroxyPROGESTERone ....................................................................... 12Nonoxynol 9 ..............................................................................................13Norethindrone ........................................................................................... 13

Corticosteroid, Inhalant (Oral)Budesonide (Oral Inhalation) ......................................................................4Fluticasone and Salmeterol ........................................................................9Fluticasone (Oral Inhalation) ...................................................................... 9

Corticosteroid, NasalFluticasone (Nasal) .....................................................................................9

Corticosteroid, OphthalmicDexamethasone (Ophthalmic) ....................................................................6Fluorometholone ......................................................................................... 9PrednisoLONE (Ophthalmic) ....................................................................15

Corticosteroid, OticCiprofloxacin and Dexamethasone ............................................................ 5Dexamethasone (Ophthalmic) ....................................................................6Neomycin, Polymyxin B, and Hydrocortisone (Otic) ............................... 13

Corticosteroid, RectalHydrocortisone (Topical) ...........................................................................10

Corticosteroid, SystemicCortisone .....................................................................................................5Dexamethasone (Systemic) ....................................................................... 6Hydrocortisone (Systemic) ....................................................................... 10MethylPREDNISolone .............................................................................. 12PrednisoLONE (Systemic) ....................................................................... 15PredniSONE ............................................................................................. 15

Corticosteroid, TopicalAmcinonide ................................................................................................. 2Betamethasone (Topical) ............................................................................3Clobetasol ................................................................................................... 5Desonide ..................................................................................................... 6

ANTIVIRAL AGENT

24

Desoximetasone ......................................................................................... 6Fluocinolone (Topical) .................................................................................8Fluocinonide ................................................................................................8Flurandrenolide ........................................................................................... 9Hydrocortisone (Topical) ...........................................................................10Nystatin and Triamcinolone ......................................................................13Triamcinolone (Topical) .............................................................................17

DecongestantBrompheniramine and Pseudoephedrine .................................................. 4Loratadine and Pseudoephedrine ............................................................ 11Oxymetazoline (Nasal) ............................................................................. 14Phenylephrine (Nasal) .............................................................................. 14Pseudoephedrine ......................................................................................15Triprolidine and Pseudoephedrine ........................................................... 17

Diagnostic AgentGlucagon .....................................................................................................9

Diagnostic Agent, OphthalmicHydroxypropyl Methylcellulose .................................................................10

Direct Oral Anticoagulant (DOAC)Dabigatran Etexilate ................................................................................... 6

Disinfectant, Antibacterial (Topical)Sodium Hypochlorite ................................................................................ 16

Diuretic, Carbonic Anhydrase InhibitorAcetaZOLAMIDE ........................................................................................ 2MethazolAMIDE ........................................................................................ 12

Diuretic, LoopFurosemide ................................................................................................. 9

Diuretic, Potassium-SparingHydrochlorothiazide and Triamterene ...................................................... 10Spironolactone .......................................................................................... 16Triamterene ...............................................................................................17

Diuretic, ThiazideCandesartan and Hydrochlorothiazide .......................................................4HydroCHLOROthiazide ............................................................................ 10Hydrochlorothiazide and Triamterene ...................................................... 10Lisinopril and Hydrochlorothiazide ........................................................... 11Losartan and Hydrochlorothiazide ........................................................... 12Telmisartan and Hydrochlorothiazide .......................................................17Valsartan and Hydrochlorothiazide .......................................................... 18

Diuretic, Thiazide-RelatedChlorthalidone .............................................................................................5MetOLazone ............................................................................................. 12

Electrolyte Supplement, OralCalcium and Vitamin D ...............................................................................4Calcium Carbonate .....................................................................................4Magnesium Oxide .....................................................................................12Potassium Chloride .................................................................................. 14Potassium Phosphate and Sodium Phosphate .......................................15Sodium Bicarbonate ................................................................................. 16

Electrolyte Supplement, ParenteralPotassium Chloride .................................................................................. 14Sodium Bicarbonate ................................................................................. 16Sodium Chloride ....................................................................................... 16Sodium Phosphates ................................................................................. 16

EnzymePancrelipase ............................................................................................. 14

Ergot AlkaloidMethysergide ............................................................................................ 12

Ergot DerivativeBromocriptine ..............................................................................................4Ergotamine and Caffeine ............................................................................7Methylergonovine ......................................................................................12

Erythropoiesis-Stimulating Agent (ESA)Epoetin Alfa .................................................................................................7

Estrogen and Androgen CombinationEstrogens (Esterified) and Methyltestosterone ..........................................7

Estrogen and Progestin CombinationEstrogens (Conjugated/Equine) and Medroxyprogesterone ..................... 7Ethinyl Estradiol and Desogestrel ..............................................................7Ethinyl Estradiol and Drospirenone ........................................................... 7Ethinyl Estradiol and Ethynodiol Diacetate ................................................7Ethinyl Estradiol and Etonogestrel .............................................................7Ethinyl Estradiol and Levonorgestrel ......................................................... 7Ethinyl Estradiol and Norelgestromin .........................................................8Ethinyl Estradiol and Norethindrone .......................................................... 8

Ethinyl Estradiol and Norgestimate ............................................................8Ethinyl Estradiol and Norgestrel .................................................................8

Estrogen DerivativeEstradiol (Systemic) ....................................................................................7Estrogens (Conjugated/Equine, Systemic) ................................................ 7Estrogens (Conjugated/Equine, Topical) ....................................................7

Ethanolamine DerivativeDiphenhydrAMINE (Systemic) ....................................................................6Doxylamine ................................................................................................. 7

ExpectorantGuaiFENesin .............................................................................................10Guaifenesin and Codeine .........................................................................10Guaifenesin and Dextromethorphan ........................................................ 10Guaifenesin and Pseudoephedrine ..........................................................10Potassium Iodide ...................................................................................... 15

Fiber SupplementPsyllium .....................................................................................................15

First Generation (Typical) AntipsychoticChlorproMAZINE .........................................................................................4FluPHENAZine ............................................................................................9Haloperidol ................................................................................................10Perphenazine ............................................................................................14Prochlorperazine .......................................................................................15Thioridazine ...............................................................................................17Thiothixene ................................................................................................17Trifluoperazine .......................................................................................... 17

GABA AnalogGabapentin ..................................................................................................9

Gastrointestinal Agent, MiscellaneousAdalimumab ................................................................................................ 2Sucralfate .................................................................................................. 16

Gastrointestinal Agent, ProkineticMetoclopramide ........................................................................................ 12

General AnestheticFentaNYL .................................................................................................... 8

Genitourinary IrrigantSodium Chloride ....................................................................................... 16

Gonadotropin Releasing Hormone AgonistGoserelin .....................................................................................................9Leuprolide ..................................................................................................11

Hematopoietic AgentEpoetin Alfa .................................................................................................7

Hemostatic AgentAluminum Chloride Hexahydrate ............................................................... 2Desmopressin ............................................................................................. 6

Histamine H1 AntagonistAzelastine (Nasal) .......................................................................................3Brompheniramine and Pseudoephedrine .................................................. 4Cetirizine ..................................................................................................... 4Chlorpheniramine ........................................................................................4Cyproheptadine ...........................................................................................5DiphenhydrAMINE (Systemic) ....................................................................6Doxylamine ................................................................................................. 7Fexofenadine .............................................................................................. 8HydrOXYzine ............................................................................................ 10Ketotifen (Ophthalmic) .............................................................................. 11Levocabastine (Ophthalmic) .....................................................................11Loratadine ................................................................................................. 11Loratadine and Pseudoephedrine ............................................................ 11Meclizine ................................................................................................... 12Naphazoline and Pheniramine .................................................................13Olopatadine (Ophthalmic) .........................................................................14Promethazine ............................................................................................15Triprolidine and Pseudoephedrine ........................................................... 17

Histamine H1 Antagonist, First GenerationBrompheniramine and Pseudoephedrine .................................................. 4Chlorpheniramine ........................................................................................4Cyproheptadine ...........................................................................................5DiphenhydrAMINE (Systemic) ....................................................................6Doxylamine ................................................................................................. 7HydrOXYzine ............................................................................................ 10Meclizine ................................................................................................... 12Naphazoline and Pheniramine .................................................................13Promethazine ............................................................................................15Triprolidine and Pseudoephedrine ........................................................... 17

HISTAMINE H1ANTAGONIST, FIRST GENERATION

25

Histamine H1 Antagonist, Second GenerationAzelastine (Nasal) .......................................................................................3Cetirizine ..................................................................................................... 4Fexofenadine .............................................................................................. 8Ketotifen (Ophthalmic) .............................................................................. 11Levocabastine (Ophthalmic) .....................................................................11Loratadine ................................................................................................. 11Loratadine and Pseudoephedrine ............................................................ 11Olopatadine (Ophthalmic) .........................................................................14

Histamine H2 AntagonistCimetidine ................................................................................................... 5Famotidine .................................................................................................. 8RaNITIdine ................................................................................................15

Histone Deacetylase InhibitorValproic Acid and Derivatives .................................................................. 18

HormoneCalcitonin .................................................................................................... 4

Hormone, Posterior PituitaryDesmopressin ............................................................................................. 6

Hypnotic, MiscellaneousEszopiclone .................................................................................................7Zolpidem ................................................................................................... 18

Imidazoline DerivativeNaphazoline and Pheniramine .................................................................13Oxymetazoline (Nasal) ............................................................................. 14

Immunosuppressant AgentAzaTHIOprine ............................................................................................. 3Cyclophosphamide ..................................................................................... 5CycloSPORINE (Ophthalmic) .....................................................................5CycloSPORINE (Systemic) ........................................................................ 5Mercaptopurine ......................................................................................... 12Methotrexate ............................................................................................. 12Pimecrolimus ............................................................................................ 14

Inhalation, MiscellaneousInhalation Devices .................................................................................... 10

Insulin, CombinationInsulin Aspart Protamine and Insulin Aspart ........................................... 10Insulin NPH and Insulin Regular ..............................................................10

Insulin, Intermediate-ActingInsulin NPH ...............................................................................................10

Insulin, Long-ActingInsulin Detemir .......................................................................................... 10Insulin Glargine .........................................................................................10

Insulin, Rapid-ActingInsulin Aspart ............................................................................................ 10

Insulin, Short-ActingInsulin Regular .......................................................................................... 10

InterferonInterferon Beta-1b .....................................................................................10

Iron SaltFerrous Sulfate ........................................................................................... 8

IrrigantSodium Chloride ....................................................................................... 16

Irrigating SolutionBalanced Salt Solution ............................................................................... 3

Keratolytic AgentPodofilox ................................................................................................... 14Salicylic Acid .............................................................................................16Urea (Topical) ........................................................................................... 18

LaxativeMagnesium Hydroxide ..............................................................................12

Laxative, Bowel EvacuantSodium Phosphates ................................................................................. 16

Laxative, Bulk-ProducingPsyllium .....................................................................................................15

Laxative, LubricantMineral Oil .................................................................................................12

Laxative, OsmoticGlycerin ....................................................................................................... 9Lactulose ................................................................................................... 11Polyethylene Glycol 3350 .........................................................................14Polyethylene Glycol-Electrolyte Solution ................................................. 14

Laxative, SalineMagnesium Citrate ....................................................................................12

Laxative, StimulantBisacodyl .....................................................................................................3

Leukotriene-Receptor AntagonistMontelukast ...............................................................................................13

Local AnestheticBenzocaine ................................................................................................. 3Dibucaine .................................................................................................... 6Lidocaine (Systemic) .................................................................................11Lidocaine (Topical) .................................................................................... 11Tetracaine (Ophthalmic) ........................................................................... 17

Local Anesthetic, OphthalmicProparacaine .............................................................................................15

Lubricant, OcularHydroxypropyl Methylcellulose .................................................................10Ocular Lubricant ....................................................................................... 13Sodium Chloride ....................................................................................... 16

Magnesium SaltMagnesium Citrate ....................................................................................12Magnesium Hydroxide ..............................................................................12Magnesium Oxide .....................................................................................12

Mast Cell StabilizerCromolyn (Nasal) ........................................................................................5Cromolyn (Ophthalmic) ...............................................................................5Cromolyn (Oral Inhalation) ......................................................................... 5Cromolyn (Systemic) .................................................................................. 5Ketotifen (Ophthalmic) .............................................................................. 11

Mineralocorticoid (Aldosterone) Receptor AntagonistsSpironolactone .......................................................................................... 16

Miscellaneous ProductDiabetic Supplies ........................................................................................6

Monoclonal AntibodyAdalimumab ................................................................................................ 2

Mucolytic AgentAcetylcysteine ............................................................................................. 2

N-Methyl-D-Aspartate Receptor AntagonistMemantine ................................................................................................ 12

Nonsteroidal Anti-inflammatory Drug (NSAID)Diclofenac (Ophthalmic) ............................................................................. 6Diclofenac (Systemic) .................................................................................6Diclofenac (Topical) .................................................................................... 6

Nonsteroidal Anti-inflammatory Drug (NSAID), COX-2 SelectiveCelecoxib .................................................................................................... 4

Nonsteroidal Anti-inflammatory Drug (NSAID), OphthalmicDiclofenac (Ophthalmic) ............................................................................. 6

Nonsteroidal Anti-inflammatory Drug (NSAID), OralAspirin ......................................................................................................... 3Diclofenac (Systemic) .................................................................................6Etodolac ...................................................................................................... 8Flurbiprofen (Systemic) ...............................................................................9Ibuprofen ................................................................................................... 10Indomethacin ............................................................................................ 10Meclofenamate ......................................................................................... 12Mefenamic Acid ........................................................................................ 12Meloxicam .................................................................................................12Nabumetone ............................................................................................. 13Naproxen ...................................................................................................13Piroxicam .................................................................................................. 14Sulindac .................................................................................................... 16

Nonsteroidal Anti-inflammatory Drug (NSAID), ParenteralIbuprofen ................................................................................................... 10Indomethacin ............................................................................................ 10

Nonsteroidal Anti-inflammatory Drug (NSAID), TopicalDiclofenac (Topical) .................................................................................... 6

Norepinephrine Reuptake Inhibitor, SelectiveAtoMOXetine ...............................................................................................3

Nutritional SupplementFluoride ....................................................................................................... 9

Ophthalmic Agent, AntiglaucomaAcetaZOLAMIDE ........................................................................................ 2Betaxolol (Ophthalmic) ............................................................................... 3Bimatoprost ................................................................................................. 3

HISTAMINE H1ANTAGONIST, SECOND GENERATION

26

Brimonidine (Ophthalmic) ........................................................................... 3Carbachol ....................................................................................................4Carteolol (Ophthalmic) ................................................................................4Dorzolamide ................................................................................................6Latanoprost ............................................................................................... 11MethazolAMIDE ........................................................................................ 12Phenylephrine (Ophthalmic) .....................................................................14Pilocarpine (Ophthalmic) .......................................................................... 14Timolol (Ophthalmic) .................................................................................17

Ophthalmic Agent, MioticAcetylcholine ...............................................................................................2Carbachol ....................................................................................................4Pilocarpine (Ophthalmic) .......................................................................... 14

Ophthalmic Agent, MiscellaneousArtificial Tears ..............................................................................................3Balanced Salt Solution ............................................................................... 3Carboxymethylcellulose ..............................................................................4Ocular Lubricant ....................................................................................... 13

Ophthalmic Agent, MydriaticAtropine (Ophthalmic) .................................................................................3Phenylephrine (Ophthalmic) .....................................................................14Scopolamine (Ophthalmic) ....................................................................... 16Tropicamide .............................................................................................. 18

Ophthalmic Agent, VasoconstrictorNaphazoline and Pheniramine .................................................................13

Opioid AntagonistNaloxone ...................................................................................................13

Otic Agent, AnalgesicAntipyrine and Benzocaine ........................................................................ 3

Otic Agent, Anti-infectiveAcetic Acid (Otic) ........................................................................................ 2Acetic Acid, Propylene Glycol Diacetate, and Hydrocortisone ................. 2

Otic Agent, CerumenolyticAntipyrine and Benzocaine ........................................................................ 3Carbamide Peroxide ...................................................................................4

Ovulation StimulatorClomiPHENE .............................................................................................. 5

PediculocideLindane ......................................................................................................11Permethrin .................................................................................................14Pyrethrins and Piperonyl Butoxide ...........................................................15

Phenothiazine DerivativeChlorproMAZINE .........................................................................................4FluPHENAZine ............................................................................................9Perphenazine ............................................................................................14Prochlorperazine .......................................................................................15Promethazine ............................................................................................15Thioridazine ...............................................................................................17Trifluoperazine .......................................................................................... 17

Phosphate BinderCalcium Carbonate .....................................................................................4

Phosphodiesterase-5 Enzyme InhibitorSildenafil ....................................................................................................16

Phosphodiesterase Enzyme Inhibitor, NonselectiveTheophylline ..............................................................................................17

Piperazine DerivativeCetirizine ..................................................................................................... 4HydrOXYzine ............................................................................................ 10Meclizine ................................................................................................... 12

Piperidine DerivativeCyproheptadine ...........................................................................................5Fexofenadine .............................................................................................. 8Ketotifen (Ophthalmic) .............................................................................. 11Levocabastine (Ophthalmic) .....................................................................11Loratadine ................................................................................................. 11Loratadine and Pseudoephedrine ............................................................ 11Olopatadine (Ophthalmic) .........................................................................14

ProgestinLevonorgestrel (Systemic) ........................................................................ 11MedroxyPROGESTERone ....................................................................... 12Megestrol .................................................................................................. 12Norethindrone ........................................................................................... 13

Prostaglandin, OphthalmicBimatoprost ................................................................................................. 3Latanoprost ............................................................................................... 11

Proton Pump InhibitorEsomeprazole ............................................................................................. 7Omeprazole ...............................................................................................14

Rescue Agent (Chemotherapy)Leucovorin Calcium .................................................................................. 11

Retinoic Acid DerivativeISOtretinoin ............................................................................................... 11Tretinoin (Topical) ..................................................................................... 17

SalicylateAspirin ......................................................................................................... 3Salsalate ................................................................................................... 16

Scabicidal AgentCrotamiton ...................................................................................................5Lindane ......................................................................................................11Permethrin .................................................................................................14

Second Generation (Atypical) AntipsychoticARIPiprazole ............................................................................................... 3OLANZapine ............................................................................................. 13QUEtiapine ................................................................................................15RisperiDONE ............................................................................................ 15Ziprasidone ............................................................................................... 18

SedativeAcetaminophen, Isometheptene, and Dichloralphenazone .......................2

Selective 5-HT3 Receptor AntagonistOndansetron ............................................................................................. 14

Selective Estrogen Receptor Modulator (SERM)ClomiPHENE .............................................................................................. 5Raloxifene ................................................................................................. 15Tamoxifen ..................................................................................................17

Serotonin 5-HT1B, 1D Receptor AgonistRizatriptan ................................................................................................. 15SUMAtriptan ..............................................................................................16ZOLMitriptan ............................................................................................. 18

Shampoo, PediculocidePyrethrins and Piperonyl Butoxide ...........................................................15

Skeletal Muscle RelaxantBaclofen ...................................................................................................... 3Cyclobenzaprine ......................................................................................... 5Methocarbamol ......................................................................................... 12Orphenadrine, Aspirin, and Caffeine ........................................................14

Skin and Mucous Membrane AgentImiquimod ..................................................................................................10

Skin and Mucous Membrane Agent, MiscellaneousEmollients ....................................................................................................7

Smoking Cessation AidBuPROPion .................................................................................................4Nicotine ..................................................................................................... 13

Sodium SaltSodium Chloride ....................................................................................... 16

SpermicideNonoxynol 9 ..............................................................................................13

Stool SoftenerDocusate ..................................................................................................... 6

Substituted BenzimidazoleEsomeprazole ............................................................................................. 7Omeprazole ...............................................................................................14

SympathomimeticAcetaminophen, Isometheptene, and Dichloralphenazone .......................2

ThioamideMethIMAzole ............................................................................................. 12Propylthiouracil ......................................................................................... 15

Thyroid ProductLevothyroxine ............................................................................................11Liothyronine ...............................................................................................11Thyroid, Desiccated ..................................................................................17

Topical Skin ProductAbsorption Base ......................................................................................... 2Aluminum Chloride Hexahydrate ............................................................... 2Aluminum Sulfate and Calcium Acetate .................................................... 2Benzoyl Peroxide ........................................................................................3Calamine ..................................................................................................... 4Cleansing Lotion ......................................................................................... 5

TOPICAL SKIN PRODUCT

27

Clindamycin and Benzoyl Peroxide ........................................................... 5

Coal Tar .......................................................................................................5

Emollients ....................................................................................................7

Erythromycin (Topical) ................................................................................ 7

Fluorouracil (Topical) .................................................................................. 9

Imiquimod ..................................................................................................10

Lactic Acid and Ammonium Hydroxide ....................................................11

Lanolin .......................................................................................................11

Pimecrolimus ............................................................................................ 14

Podofilox ................................................................................................... 14

Povidone-Iodine (Topical) .........................................................................15

Selenium Sulfide .......................................................................................16

Surgical Lubricant .....................................................................................16

Urea (Topical) ........................................................................................... 18

Zinc Oxide .................................................................................................18

Topical Skin Product, Acne

Benzoyl Peroxide ........................................................................................3

Clindamycin and Benzoyl Peroxide ........................................................... 5

Clindamycin (Topical) ................................................................................. 5

Erythromycin (Topical) ................................................................................ 7

Salicylic Acid .............................................................................................16

Tretinoin (Topical) ..................................................................................... 17

Tumor Necrosis Factor (TNF) Blocking Agent

Adalimumab ................................................................................................ 2

Uricosuric Agent

Probenecid ................................................................................................15

Vasodilator

Amyl Nitrite ..................................................................................................3

Dipyridamole ............................................................................................... 6

HydrALAZINE ........................................................................................... 10

Isosorbide Dinitrate ................................................................................... 11

Isosorbide Mononitrate ............................................................................. 11

Nitroglycerin .............................................................................................. 13

Vasodilator, Direct-Acting

Minoxidil (Systemic) ..................................................................................13

Vasopressin Analog, Synthetic

Desmopressin ............................................................................................. 6

Vitamin

Vitamins (Multiple/Oral) ............................................................................ 18

Vitamins (Multiple/Pediatric) ..................................................................... 18

Vitamins (Multiple/Prenatal) ......................................................................18

Vitamin D Analog

Alendronate and Cholecalciferol ................................................................ 2

Calcitriol (Systemic) .................................................................................... 4

Cholecalciferol ............................................................................................ 5

Ergocalciferol .............................................................................................. 7

Vitamin, Fat Soluble

Calcium and Vitamin D ...............................................................................4

Phytonadione ............................................................................................ 14

Vitamin E (Systemic) ................................................................................ 18

Vitamin, Water Soluble

Ascorbic Acid .............................................................................................. 3

Cyanocobalamin ......................................................................................... 5

Folic Acid .................................................................................................... 9

Leucovorin Calcium .................................................................................. 11

Niacin ........................................................................................................ 13

Pyridoxine ................................................................................................. 15

Thiamine ................................................................................................... 17

Xanthine Oxidase Inhibitor

Allopurinol ................................................................................................... 2

TOPICAL SKIN PRODUCT

28